Definitive treatment of Graves' disease in children and adolescents

xlomafota13 shared this article with you from Inoreader Definitive treatment of Graves' disease in children and adolescents Via radioactive iodine Endokrynol Pol. 2021 Dec 2. doi: 10.5603/EP.a2021.0092. Online ahead of print. ABSTRACT Graves' disease (GD) is the most common cause of pediatric hyperthyroidism. In children and adolescents the clinical GD course is different from this seen in adults, due to low remission rate and high prevalence of adverse events related to treatment with antithyroid drugs (ATDs). The majority of patients in this group require definitive therapy. As in adults, there are two treatment options - t hyroid ablation with radioactive iodine (RAI) or surgery with preferred procedure of total thyroidectomy (TT). The choice of definitive therapy depends on many important factors such as children's age, effectiveness of the first- line ATD treatment, presence of ATDs side effects, presence of large goiter or thyroid nodules and concomitant diseases. The following paper provides the current guidelines on GD management in children and compares the efficacy of both definitive treatment methods as well as the acute and long-term complication rates, which must be taken into account to choose the optimal therapeutic option. PMID:34855196 | DOI:10.5603/EP.a2021.0092 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What are the retromolar and bifid/trifid mandibular canals as seen on cone-beam computed tomography? Revisiting classic gross anatomy of the inferior alveolar nerve and correcting terminology

xlomafota13 shared this article with you from Inoreader What are the retromolar and bifid/trifid mandibular canals as seen on cone-beam computed tomography? Revisiting classic gross anatomy of the inferior alveolar nerve and correcting terminology Via radiol anat Surg Radiol Anat. 2021 Dec 2. doi: 10.1007/s00276-021-02862-y. Online ahead of print. ABSTRACT PURPOSE: Since cone-beam computed tomography was developed, a number of radiological studies on the bifid mandibular canals (BMCs) and trifid mandibular canals (TMCs) have been reported. However, many of the suggested subtypes of the BMC described in the literature seem to be normal branches of the inferior alveolar nerve. This might be due to a lack of revisiting classic anatomica l studies in the field of radiology. Therefore, such studies are revisited here. METHODS: A database search using PubMed and Google Scholar was conducted on BMC and TMC. Eighty-nine articles underwent full-text assessment. The reported three classifications of BMC and the six modified classifications were reviewed and compared to the intramandibular inferior alveolar nerve branches. RESULTS: Some subtypes of BMC and TMC simply represent normal inferior alveolar nerve branches, i.e., retromolar branch, molar branch (alveolar branch/dental branch), large mental branch, or communicating branch. Others such as Naitoh's type III BMC and forward canal might be a true BMC. CONCLUSION: We found that the bifid mandibular canal is an additional intramandibular canal running parallel to the mandibular canal with/without confluence with the main canal through comparison of classifications of BMC/TMC between the radiology and anatomy fields. PMID:34854962 | DOI:10.1007/s00276-021-02862-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy

xlomafota13 shared this article with you from Inoreader Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Dec 2. doi: 10.1007/s00405-021-07199-1. Online ahead of print. ABSTRACT PURPOSE: Endoscopic arytenoid abduction lateropexy (EAAL) is a reliable surgical solution for the minimally invasive treatment of bilateral vocal fold palsy (BVFP), providing a stable airway by the lateralization of the arytenoid cartilages with a simple suture. The nondestructive manner of the intervention theoretically leads to higher regeneration potential, thus better voice quality. The study aimed to investigate the respiratory and phonatory outcomes of this treatment concept. METHODS: 61 BVFP patients with significant dyspnea associated with thyroid/parathyroid surgery were treated by unilateral EAAL. Jitter, Shimmer, Harmonics to Noise Ratio, Maximum Phonation Time, Fundamental frequency, Voice Handicap Index, Dysphonia Severity Index, Friedrich's Dysphonia Index, Global-Roughness-Breathiness scale, Quality of Life, and Peak Inspiratory Flow were evaluated 18 months after EAAL. RESULTS: All patients had a stable and adequate airway during the follow-up. Ten patients (16.4%) experienced complete bilateral motion recovery with objective acoustic parameters in the physiological ranges. Most functional results of the 13 patients (21.3%) with unilateral recovery also reached the normal values. Fifteen patients (24.6%) had unilateral adduction recovery only, with slightly impaired voice quality. Eleven patients (18.0%) had false vocal fold phonation with socially acceptable voice. In 12 patients (19.7%) no significant motion recovery was detected on the glottic level. CONCLUSION: EAAL does not interfere with the potential regeneration process and meets the most important phoniatric requirements while guaranteeing the reversibility of the procedure-therefore serving patients with transient palsy. Further, a socially acceptable voice quality and an adequate airway are ensured even in cases of p ermanent bilateral vocal fold paralysis. PMID:34854971 | DOI:10.1007/s00405-021-07199-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of rapid maxillary expansion on hearing loss and otitis media in cleft palate children

xlomafota13 shared this article with you from Inoreader Effects of rapid maxillary expansion on hearing loss and otitis media in cleft palate children Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Dec 2. doi: 10.1007/s00405-021-07187-5. Online ahead of print. ABSTRACT PURPOSE: Otitis media with effusion (OME), recurrent acute otitis media and conductive hearing loss (CHL) are significantly prevalent in children with cleft palate (CP) and cleft lip and palate (CLP). Rapid Maxillary Expansion (RME) appears to have a positive effect also on middle ear disorders in these patients. The study aims to offer a prospective evaluation of RME effects in a group of patients with CP/CLP in terms of OME, CHL. METHODS: A prospective observational study was conducted. Thirty-four CP, CLP and submucosa cleft patients who received orthodontic indication to RME treatment for OME or conductive hearing loss in a tertiary institutional Care Unit of San Paolo Hospital, Milan (IT), were included. Twenty-two patients matched for age and with analogous inclusion criteria except for indication to RME treatment were en rolled in the control group. Clinical otolaryngological evaluation, pure tone audiometry and tympanogram were performed at the beginning of treatment (T0), at the end of the expansion (T1) and at 6-month follow-up (T2). MAIN OUTCOME MEASURES: Air-bone gaps and tympanogram results at each time interval. RESULTS: In the main group, RME allowed a statistically significant improvement of air-bone gaps (according to frequency, p < 0.001-0.089 T0 vs. T1 and < 0.001-0.044 T0 vs. T2, Friedman's test) and tympanometry results (p = 0.002 T0 vs. T1 and p < 0.001 T0 vs. T2, Friedman's test). Improvements were stable during follow-up and were significantly better in the main group than in the control group. CONCLUSION: CHL and middle ear effusion improved significantly overtime during RME and after 6 months of follow-up. PMID:34854972 | DOI:10.1007/s00405-021-07187-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficiency of resveratrol in the prevention and treatment of age-related hearing loss

xlomafota13 shared this article with you from Inoreader Efficiency of resveratrol in the prevention and treatment of age-related hearing loss Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):40. doi: 10.3892/etm.2021.10962. Epub 2021 Nov 12. ABSTRACT Age-related hearing loss (ARHL) is a major public health concern, which is characterized by gradual, progressive sensorineural hearing loss and deterioration of sound localization, with no effective treatment available to date. The aim of the present study was to evaluate the efficacy of resveratrol to prevent and treat ARHL. For this purpose, 32 male C57BL/6 mice were assigned to four groups: Early treatment, late treatment, control and sham control. The experiment lasted for 15 months. Treatment was started at three months of age in the early treatment group and at sixth months in the late treatment group. The auditory brainstem response test was performed once every three months. At the end of the study period, inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-2, NF-κB, Bcl-2, Bcl-xL, Bax, Bcl-2 homologous antagonist/killer (Bak), caspase-3 and caspase-9 levels in the cochlear tissues of the animals were analyzed by reverse transcription-quantitative PCR. Hearing thresholds of the mice in the early treatment group were better than those in the other groups (P<0.001) at the end of the study. However, hearing levels in the late treatment group were not significantly different from those in the control groups (P>0.05), although mean thresholds were lower. The threshold shift in the early treatment group was significantly lower at all frequencies when compared with those in the control groups (P<0.001). The mRNA expression levels of pro-apoptotic genes Bax and Bak were lower (P<0.05), anti-apoptotic genes Bcl-2 and Bcl-xL were higher (P<0.05), NF-κB, COX-2 and iNOS as genes that have a role in inflammation and caspase-3 and caspase-9 as genes with a vital role in apoptosis were lower (P<0.05) in the early treatment group when c ompared with the late treatment and control groups. These results suggested that resveratrol is effective in the prevention of ARHL, particularly when started prior to the beginning of hearing loss. PMID:34849155 | PMC:PMC8613532 | DOI:10.3892/etm.2021.10962 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second-line treatment: A clinical study

xlomafota13 shared this article with you from Inoreader Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second-line treatment: A clinical study Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):38. doi: 10.3892/etm.2021.10960. Epub 2021 Nov 11. ABSTRACT The purpose of the study was to establish whether shock wave lithotripsy (SWL) is a potential harmful first-line treatment for ureteric stones where ureteroscopy (URS) is necessary as a second-line treatment. Medical records of patients with ureteric stones who underwent either URS as the only therapy applied or SWL followed by URS over two years were retrospectively evaluated. In total, 158 patients were included: 79 patients in Group A (no SWL) and 79 in Group B (prior SWL before URS). There was no difference in major complications, Group A had higher stone-free rates, Group B had higher rates of ureteral edema and similar intraoperative ureteral lesions. In conclusion, the failure of SWL for lumbar or pelvic ureteral lithiasis does not appear to have a negative effect on the rate of intraoperative complications or the success rate of semi-rigid retrograde URS for this category of calculi, with the same safety profile as first-line endourological intervention. PMID:34849153 | PMC:PMC8613534 | DOI:10.3892/etm.2021.10960 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Expression and clinical significance of lncRNA TCL6 in serum of patients with preeclampsia

xlomafota13 shared this article with you from Inoreader Expression and clinical significance of lncRNA TCL6 in serum of patients with preeclampsia Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):41. doi: 10.3892/etm.2021.10963. Epub 2021 Nov 12. ABSTRACT Preeclampsia is a common syndrome in pregnancy and a leading cause of mortality of pregnant females and their infants. To investigate the diagnostic and prognostic utility of lncRNA T-cell leukemia/lymphoma 6 (TCL6) in patients with preeclampsia, 120 singleton pregnant females with preeclampsia and another 100 healthy pregnant control subjects were analyzed in the present study. The expression of lncRNA TCL6 in the serum of the included patients was detected. Receiver operating characteristic curve analysis was applied to evaluate the efficiency of lncRNA TCL6 in terms of preeclampsia diagnosis and grading. Kaplan-Meier analysis was adopted to assess the effect of lncRNA TCL6 expression on the rate of adverse pregnancy. Multivariate logistic regression was used to determine high-risk factors of adverse pregnancy. The results indicated that lncRNA T CL6 was significantly increased in the serum of patients with preeclampsia. Furthermore, TCL6 was elevated in subgroups of patients with early-onset or severe preeclampsia and with Haemolysis, Elevated Liver enzymes and Low Platelet count syndrome in comparison with other patients with preeclampsia. High expression of TCL6 in pregnant females corresponded to a higher rate of adverse pregnancy outcomes. Severe preeclampsia, early-onset preeclampsia and high TCL6 expression were identified as independent risk factors for adverse pregnancy outcomes. For each unit increase in TCL6 expression, a 9.5-fold increase of the risk of adverse maternal and fetal outcomes was determined. Collectively, high expression of lncRNA TCL6 may assist the diagnosis and grading of preeclampsia and may be adopted as an independent risk factor for adverse pregnancy outcomes. PMID:34849156 | PMC:PMC8613530 | DOI:10.3892/etm.2021.10963 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.