Analysis of risk factors for delayed iatrogenic cerebrospinal fluid otorrhinorrhea

xlomafota13 shared this article with you from Inoreader Analysis of risk factors for delayed iatrogenic cerebrospinal fluid otorrhinorrhea Via leak of cerebrospinal fluid Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec;35(12):1111-1114. doi: 10.13201/j.issn.2096-7993.2021.12.011. ABSTRACT Objective:To explore the common causes of iatrogenic cerebrospinal fluid（CSF） otorrhinorrhea, and further analyze the risk factors for delayed iatrogenic CSF otorrhinorrhea. Methods:The clinical data of 35 iatrogenic CSF otorrhinorrhea patients in department of Otorhinolaryngology Head and Neck Surgery from January 2010 to January 2020 were retrospectively analyzed. Patients were divided into delayed and non-delayed iatrogenic CSF leak groups, according to the time intervals from medical intervention to CSF leak occurrence. The differences of baseline data, complications and success rate between the two groups were analyzed, and the risk factors of delayed iatrogenic cerebrospinal fluid otorrhinorrhea were further analyzed. Results:Endoscopic sinus surgery （n=11）, transsphenoidal p ituitary surgery（n=8）, craniotomy（n=12）, and radiotherapy（n=4） all contribute to iatrogenic CSF otorrhinorrhea. Compared with the non-delayed group, the incidence of meningitis in the delayed group was significantly higher（20% vs 60%, P=0.041）. There were no significant differences in gender, radiation, hypertension, diabetes, and success rate between the two groups. Additionally, binary logistic regression analysis showed that sex, age, history of radiation, hypertension and diabetes, as well as causes of CSF otorrhinorrhea had no association with delayed iatrogenic CSF leakage. Conclusion:Patients with delayed iatrogenic CSF otorrhinorrhea have an increased risk of meningitis. Timely diagnose and intervention with appropriate surgical approach and reconstruction method ensures good clinical outcomes. PMID:34886626 | DOI:10.13201/j.issn.2096-7993.2021.12.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Upregulation of TLR9 may contribute to activation of microglia and painful diabetic neuropathy via the p38 MAPK pathway in rats

xlomafota13 shared this article with you from Inoreader Upregulation of TLR9 may contribute to activation of microglia and painful diabetic neuropathy via the p38 MAPK pathway in rats Via Cellular and Molecular Biology Histol Histopathol. 2021 Dec 10:18405. doi: 10.14670/HH-18-405. Online ahead of print. ABSTRACT Painful diabetic neuropathy is a common chronic complication of diabetes, and the underlying mechanism remains largely elusive. A rat model of painful diabetic neuropathy was established via streptozotocin (STZ) injection and assessed as increased heat and mechanical hypersensitivity. An upregulation of TLR9 was observed in the spinal cords of rats injected with STZ and rat microglia (primary microglia and immortalized microglia HAPI) treated with high glucose. To investigate the role of TLR9 in high glucose-induced microglia activation, short hairpin RNAs targeting TLR9 were used in vitro to knock down TLR9 in HAPI cells. TLR9 interference suppressed the high glucose-induced expression and secretion of inflammatory cytokines (TNF-α, IL-1β, and IL-6), IBA-1 expression and the chemotaxis of HAPI microglia. Similar results were obtained when HAPI microglia were incubated with a p38 inhibitor (SB203580). P38 and ERK were downstream of TLR9 because TLR9 ablation markedly inhibited the phosphorylation of p38 and ERK. TLR9 was also knocked down in vivo via the injection of shTLR9 lentiviral vector into the rat spinal cord. Relief of STZ-induced heat and mechanical hypersensitivity was observed in rats with TLR9 interference, and TLR9 knockdown prevented STZ-induced inflammatory cytokine secretion and microglial and MAPK signaling activation. Our study revealed the participation of TLR9 in microglial activation and diabetes-induced hyperalgesia likely via the MAPK pathway. The targeting of TLR9 may be an effective strategy for the treatment of painful diabetic neuropathy. PMID:34889455 | DOI:10.14670/HH-18-405 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Voice Performance Chart: A Pedagogical Tool to Enhance Vocal Expressive Ability in Acting Students

xlomafota13 shared this article with you from Inoreader Voice Performance Chart: A Pedagogical Tool to Enhance Vocal Expressive Ability in Acting Students Via Journal of Voice The purpose of the present study was to explore the effectiveness of the Voice Performance Chart (VPCH) as a pedagogical training tool to enhance vocal expressive ability of 1st year acting students. Forty recorded audio samples were perceptually assessed by six blinded raters, using a five-points Likert scale for each of the dependent variables observed. Results showed that loudness, pitch, and speech rate variations significantly differ when comparing the vocal condition before and after a 11 weeks training period. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of Interventions for Dysphagia in Parkinson Disease: A Systematic Review

xlomafota13 shared this article with you from Inoreader Effectiveness of Interventions for Dysphagia in Parkinson Disease: A Systematic Review Via swallowing exercises Am J Speech Lang Pathol. 2021 Dec 10:1-23. doi: 10.1044/2021_AJSLP-21-00145. Online ahead of print. ABSTRACT PURPOSE: Dysphagia is a common sequela of Parkinson disease (PD) and is associated with malnutrition, aspiration pneumonia, and mortality. This review article synthesized evidence regarding the effectiveness of interventions for dysphagia in PD. METHOD: Electronic searches were conducted in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, an d speechBITE. Of the 2,015 articles identified, 26 met eligibility criteria: interventional or observational studies with at least five or more participants evaluating dysphagia interventions in adults with PD-related dysphagia, with outcomes measured using videofluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), or electromyography (EMG). Risk of bias (RoB) was evaluated using the Evidence Project tool and predetermined criteria regarding the rigor of swallowing outcome measures. RESULTS: Interventions were classified as follows: pharmacological (n = 11), neurostimulation (n = 8), and behavioral (n = 7). Primary outcome measures varied across studies, including swallowing timing, safety, and efficiency, and were measured using VFSS (n = 17), FEES (n = 6), and EMG (n = 4). Critical appraisal of study findings for RoB, methodological rigor, and transparency showed the majority of studies failed t o adequately describe contrast media used, signal acquisition settings, and rater blinding to time point. Low certainty evidence generally suggested improved swallow timing with exercises with biofeedback and deep brain stimulation (DBS), improved safety with DBS and expiratory muscle strength training, and improved efficiency with the Lee Silverman Voice Treatment and levodopa. CONCLUSIONS: Studies with lower RoB and greater experimental rigor showed potential benefit in improving swallowing efficiency but not safety. Further research investigating discrete changes in swallowing pathophysiology post-intervention is warranted to guide dysphagia management in PD. Supplemental Material https://doi.org/10.23641/asha.17132162. PMID:34890260 | DOI:10.1044/2021_AJSLP-21-00145 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delayed vocal fold palsy caused by an undetected fish bone impacted in the tracheoesophageal groove

xlomafota13 shared this article with you from Inoreader Delayed vocal fold palsy caused by an undetected fish bone impacted in the tracheoesophageal groove Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Nov 15:S1808-8694(21)00189-0. doi: 10.1016/j.bjorl.2021.04.013. Online ahead of print. NO ABSTRACT PMID:34893460 | DOI:10.1016/j.bjorl.2021.04.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sinonasal blue nevus: a case report and review

xlomafota13 shared this article with you from Inoreader Sinonasal blue nevus: a case report and review Via ear nose throat Ear Nose Throat J. 2021 Dec 10:1455613211064014. doi: 10.1177/01455613211064014. Online ahead of print. ABSTRACT Blue nevus is a type of uncommon benign pigmented lesion in the skin or the mucosa of human body which is featured by pigmented dendritic melanocytes and spindled melanocytic cells. Sinonasal blue nevus is extremely rare. We reported a sinonasal blue nevus case with the background of pituitary adenoma, type 2 diabetes mellitus, and hypertension (including endoscop ic and histological pictures). Further, the existing literature about blue nevus is reviewed. This paper puts a spotlight on the potential correlation between blue nevus with the endocrine system disorder and provides support for further experimental research. PMID:34892997 | DOI:10.1177/01455613211064014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

EFFECT OF BRAFV600E AND TERT PROMOTER MUTATIONS ON THYROGLOBULIN RESPONSE IN DISTANT-METASTATIC DIFFERENTIATED THYROID CANCER

xlomafota13 shared this article with you from Inoreader EFFECT OF BRAF<sup>V600E</sup> AND TERT PROMOTER MUTATIONS ON THYROGLOBULIN RESPONSE IN DISTANT-METASTATIC DIFFERENTIATED THYROID CANCER Via radioactive iodine Endocr Pract. 2021 Dec 7:S1530-891X(21)01410-5. doi: 10.1016/j.eprac.2021.12.005. Online ahead of print. ABSTRACT OBJECTIVE: To assess the impact of BRAFV600E and telomerase reverse transcriptase (TERT) promoter mutations in distant-metastatic differentiated thyroid cancer (DM-DTC) patients based on thyroglobulin (Tg) response to radioactive iodine (RAI) therapy. METHODS: BRAFV600E and TERT mutations in primary tumors or metastatic lymph nodes of 114 DM-D TC patients were retrospectively examined. RAI avidity was evaluated based on posttreatment 131I-WBS. Tg response was dynamically assessed with a median follow-up of 56.50 months (interquartile range, 28.43-97.98 months). RESULTS: BRAFV600E was detected in 38.6% of cases and TERT mutation in 21.1% of cases, and both BRAFV600E and TERT mutations were observed in 14.9% of cases. Patients with both mutations tended to be older at diagnosis (P<0.001), less multifocal (P=0.011) and have more aggressive histologic subtypes (P=0.011) and a higher Ki-67 index (P=0.003). Patients with neither mutation tended to be more RAI-avid than those with the BRAFV600E mutant alone or both mutations (P=0.001, <0.001, respectively). Patients with both mutations presented more unfavorable Tg response than those without both mutations and with the BRAFV600E mutant alone (P=0.001, 0.013, respectively). Tg progression-free survival (Tg-PFS) w as shorter in patients with TERT mutation alone than in those with neither mutation (P=0.021), and it tended to be shorter when BRAFV600E coexisted (P<0.001); however, no significant difference was observed between BRAFV600E alone and neither mutation (P=0.890). CONCLUSIONS: Coexistence of BRAFV600E and TERT promoter mutations synergistically induce loss of RAI avidity and an undesirable Tg response in DM-DTC. TERT promoter mutation appears to affect Tg response more than the BRAFV600E mutation. PMID:34890787 | DOI:10.1016/j.eprac.2021.12.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.