Improved body quantitative susceptibility mapping by using a variable‐layer single‐min‐cut graph‐cut for field‐mapping

alexandrossfakianakis shared this article with you from Inoreader Improved body quantitative susceptibility mapping by using a variable‐layer single‐min‐cut graph‐cut for field‐mapping Via Magnetic Resonance in Medicine Purpose To develop a robust algorithm for field‐mapping in the presence of water–fat components, large field inhomogeneities and MR signal voids and to apply the developed method in body applications of quantitative susceptibility mapping (QSM). Methods A framework solving the cost‐function of the water–fat separation problem in a single‐min‐cut graph‐cut based on the variable‐layer graph construction concept was developed. The developed framework was applied to a numerical phantom enclosing an MR signal void, an air bubble experimental phantom, 14 large field of view (FOV) head/neck region in vivo scans and to 6 lumbar spine in vivo scans. Field‐mapping and subsequent QSM results using the proposed algorithm were compared to results using an iterative graph‐cut algorithm and a formerly proposed single‐min‐cut graph‐cut. Results The proposed method was shown to yield accurate field‐map and susceptibility values in all simulation and in vivo datasets when compared to reference values (simulation) or literature values (in vivo). The proposed method showed improved field‐map and susceptibility results compared to iterative graph‐cut field‐map especially in regions with low SNR, strong field‐map variations and high values. Conclusions A single‐min‐cut graph‐cut field‐mapping method with a variable‐layer construction was developed for field‐mapping in body water–fat regions, improving quantitative susceptibility mapping particularly in areas close to MR signal voids. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Balloon Eustachian Tuboplasty in Pediatric Patients: Is it Safe?

alexandrossfakianakis shared this article with you from Inoreader Balloon Eustachian Tuboplasty in Pediatric Patients: Is it Safe? Via The Laryngoscope Objectives/Hypothesis The objective of this study is to demonstrate that balloon eustachian tuboplasty (BET) is safe and had limited complications in the pediatric patient population. Study Design Retrospective chart review. Methods This study analyzed the medical records of 43 consecutive encounters of patients under the age of 18 years old who underwent attempted BET. Charts of patients' postoperative appointments and appointments 30 days following the procedure were reviewed. Any complications that were reported by the surgeons' operative report or documented postoperatively were stratified by the Classification of Surgical Complications as outlined by the American College of Surgeons. Additional data points that were analyzed included concomitant surgical procedures, estimated blood loss, and demographic information. Results A cohort of 43 pediatric patient encounters were investigated. There was a total of two complications from BET (4.7%) and one aborted case. The complications included epistaxis controlled with oxymetazoline and pressure, and vertigo that was later attributed to vestibular migraines. One case was aborted due to inadequate exposure. The average age of patients evaluated was 12.4 ± 3.2 years old with a range of 6.6 to 17.7 years old. Conclusions In this retrospective cohort, BET was demonstrated to be a relatively safe intervention with an overall complication rate of 4.7% in patients as young as 6.6 years old with recurrent or chronic eustachian tube dysfunction and/or related issues. Level of Evidence 4 Laryngoscope, 2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of Respiratory Pathogens Does Not Predict Risks After Outpatient Adenotonsillectomy

alexandrossfakianakis shared this article with you from Inoreader Detection of Respiratory Pathogens Does Not Predict Risks After Outpatient Adenotonsillectomy Via The Laryngoscope Objectives/Hypothesis To determine whether the presence of detectable upper respiratory infections (URIs) at the time of adenoidectomy/adenotonsillectomy is associated with increased morbidity, complications, and unexpected admissions. Study Design Prospective double‐blinded cohort. Methods In this prospective cohort study, nasopharyngeal swabs were obtained intraoperatively from 164 pediatric patients undergoing outpatient adenoidectomy/tonsillectomy with or without pressure equalization tubes (PETs) and were analyzed with PCR for the presence of 22 known URIs, including SARS‐CoV‐2. Surgeons and families were blinded to the results. At the conclusion of the study, rates of detectable infection were determined and intraoperative and postoperative events (unexpected admissions, length of PACU stay, rates of laryngospasm/bronchospasm, oxygen desaturation, bradycardia, and postoperative presentation to an emergency department) were compared between infected and uninfected patients. Results Of the 164 patients (50% male, 50% female, ages 8 mo‐18 y), 136 patients (82.9%) tested positive for one or more URI at the time of surgery. Forty one patients (25.0%) tested positive for three or more URIs concurrently, and 11 (6.7%) tested positive for five or more URIs concurrently. There were no significant differences in admission rates, length of PACU stay, rates of laryngospasm/bronchospasm, oxygen desaturation, bradycardia, or postoperative presentation to an emergency department between positive and negative patients. No patients tested positive for SARS‐CoV‐2. Conclusions A recent positive URI test does not confer any additional intraoperative or postoperative risk in the setting of outpatient adenoidectomy/tonsillectomy in healthy patients. There is no utility in preoperative URI testing, and delaying surgery due to a recent positive URI test is not warranted in this population. Level of evidence 3 Laryngoscope, 2020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tip60 protects against amyloid-β-induced transcriptomic alterations via different modes of action in early versus late stages of neurodegeneration

alexandrossfakianakis shared this article with you from Inoreader Tip60 protects against amyloid-β-induced transcriptomic alterations via different modes of action in early versus late stages of neurodegeneration Via ScienceDirect Publication Molecular and Cellular Neuroscience Publication date: Available online 4 November 2020 Source: Molecular and Cellular Neuroscience Author(s): Haolin Zhang, Bhanu Chandra Karisetty, Akanksha Bhatnagar, Ellen M. Armour, Mariah Beaver, Tiffany V. Roach, Sina Mortazavi, Shreya Mandloi, Felice Elefant View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of ketamine on acute and chronic wound pain in patients undergoing breast surgery: a meta‐analysis and systematic review

alexandrossfakianakis shared this article with you from Inoreader The effect of ketamine on acute and chronic wound pain in patients undergoing breast surgery: a meta‐analysis and systematic review Via Pain Practice Abstract Introduction Perioperative use of ketamine has been discussed widely in many kinds of surgery. The aim of our study is to evaluate the short‐term and long‐term benefits and safety of ketamine after breast surgery. Method We performed a quantitative systematic review. Randomized controlled trials that compared intravenous administration of ketamine to a placebo control group or bupivacaine in combination with ketamine to bupivacaine alone in thoracic paravertebral block or pectoral block for patients undergoing breast surgery and took the pain or morphine consumption as a primary or secondary outcome were included. The primary outcome was postoperative pain intensity. Secondary outcomes included cumulative opioid consumption during 0‐24‐hour postoperative period, the effect in postmastectomy pain syndrome, the effect in postoperative depression, and the adverse events associated with the use of ketamine. Result 13 randomized controlled trials with 1182 patients were included for analysis. Compared with placebo, intravenous ketamine was effective to reduce the wound pain intensity during the first 6 hours after the surgery (WMD ‐0.83; 95%CI‐1.65, ‐0.01; p=0.048) and during the first 24 hours after the surgery(WMD ‐0.65; 95%CI, ‐0.95, ‐0.35; p<0.001), and decrease the opioid consumption(WMD ‐4.14; 95%CI ‐8.00, ‐0.29; p=0.035) for the first 24 hours after the surgery, without increasing the risks of gastrointestinal and CNS adverse events. Adding ketamine to bupivacaine in thoracic paravertebral block was also effective to reduce the postoperative wound pain during the 6 hours after the surgery (WMD ‐0.59; 95%CI, ‐1.06, ‐0.12; p=0.014) and during the first 24 hours after the surgery(WMD ‐0.90; 95%CI, ‐1.27, ‐0.53, p<0.001), and decrease the opioid consumption(WMD ‐4.59; 95%CI ‐5.76, ‐3.42; p<0.001) for the first 24 hours after the surgery. Periop erative use of ketamine was associated with improved postoperative depression symptoms (SMD ‐0.80; 95%CI ‐1.34, ‐0.27; p=0.003) and less incidence of postmastectomy pain syndrome (RR 0.79; 95%CI 0.63,0.99; p=0.043). Conclusion Ketamine is an effective and safe multimodal analgesic in patients undergoing breast surgery both intravenously and adding to bupivacaine in paravertebral block. Besides, ketamine showed long‐term benefit for preventing postoperative depression and postmastectomy pain syndrome. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inhaled Levodopa as a Potential Treatment for Diphasic Dyskinesia

alexandrossfakianakis shared this article with you from Inoreader Inhaled Levodopa as a Potential Treatment for Diphasic Dyskinesia Via Movement Disorders View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Striatal Dopamine Deficit and Motor Impairment in Idiopathic Normal Pressure Hydrocephalus

alexandrossfakianakis shared this article with you from Inoreader Striatal Dopamine Deficit and Motor Impairment in Idiopathic Normal Pressure Hydrocephalus Via Movement Disorders ABSTRACT Background Idiopathic normal pressure hydrocephalus can present with parkinsonism. However, abnormalities of the striatal dopamine reuptake transporter are unclear. Objectives To explore presence and features of striatal dopaminergic deficit in subjects with idiopathic normal pressure hydrocephalus as compared to Parkinson's disease (PD) patients and healthy controls. Methods We investigated 50 subjects with idiopathic normal pressure hydrocephalus, 25 with PD, and 40 healthy controls. All participants underwent [123I]‐N‐ω‐fluoropropyl‐2β‐carbomethoxy‐3β‐(4‐iodophenyl)nortropane and single‐photon emission computed tomography to quantify the striatal dopamine reuptake transporter binding. All subjects with idiopathic normal pressure hydrocephalus underwent a levodopa (l‐dopa) challenge test and magnetic resonance imaging to evaluate ventriculomegaly and white matter changes. Gait, cognition, balance, and continence were assessed with the Idiopathic Normal Pressure Hydrocephalus Rating Scale, and parkinsonism with the motor section of the Movement Disorder Society‐Unified Parkinson's Disease Rating Scale. All patients completed a 2‐year follow‐up. Results A total of 62% of patients with idiopathic normal pressure hydrocephalus featured a reduced striatal dopamine reuptake transporter binding, which correlated with the severity of parkinsonism but not with features of ventriculomegaly or white matter changes. Unlike PD, this dopaminergic deficit in idiopathic normal pressure hydrocephalus was more symmetric and prominent in the caudate nucleus. Conclusions Subjects with idiopathic normal pressure hydrocephalus can present a reduction of striatal dopamine reuptake transporter binding, which is consistent with the severity of parkinsonism and qualitatively differs from that found in PD patients. Longitudinal interventional studies are needed to prove a role for striatal dopamine reuptake transporter deficit in the pathophysiology of idiopathic normal pressure hydrocephalus. © 2020 International Parkinson and Movement Disorder Society View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.