Unsuccessful palliative treatment of extraocular sebaceous carcinoma with shave removal and electrocoagulation

pay.thelady61 shared this article with you from Inoreader Unsuccessful palliative treatment of extraocular sebaceous carcinoma with shave removal and electrocoagulation Via Dermatologic Therapy View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ectropion surgery might not be a long‐term solution for harlequin ichthyosis

pay.thelady61 shared this article with you from Inoreader Ectropion surgery might not be a long‐term solution for harlequin ichthyosis Via Dermatologic Therapy View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Can Rituximab Be Used In The Treatment Of Pemphigus Vulgaris During The COVID‐19 Pandemic?

pay.thelady61 shared this article with you from Inoreader Can Rituximab Be Used In The Treatment Of Pemphigus Vulgaris During The COVID‐19 Pandemic? Via Dermatologic Therapy Abstract Rituximab is a monoclonal antibody that targets CD20, a B‐lymphocyte antigen; that leads to a decline in the B‐cell counts for at least a year. The patients who have received rituximab treatment in the previous 5 years with the diagnosis of pemphigus group of diseases at CerrahpaŞa Medical Faculty were questioned for COVID‐19 infection. A total of 48 patients were included in this study; only one male patient had COVID‐19 infection which had a mild course. There is no significant difference in the total number of lymphocytes between patients who have received rituximab within the previous 5 years or last year. The number of lymphocytes is independent of the number of courses of rituximab treatment received. Therefore, we suggest that all pemphigus patients who have received rituximab treatment within the previous 5 years should be careful of the preventive measures against the COVID‐19 infection irrespective of the number of treatment courses or the number of year s which has passed since the treatment. The disease course was mild in the only infected patient. Thus, rituximab may be used in the treatment of pemphigus vulgaris during the COVID‐19 pandemic if its use is necessary. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The additive efficacy of therapeutic low‐intensity pulsed ultrasound in the treatment of vitiligo: a randomized, left‐right comparison clinical trial

pay.thelady61 shared this article with you from Inoreader The additive efficacy of therapeutic low‐intensity pulsed ultrasound in the treatment of vitiligo: a randomized, left‐right comparison clinical trial Via Dermatologic Therapy Abstract Repigmentation of vitiligo relies on the proliferation and migration of melanoblasts from hair follicles to the epidermis to replenish epidermal melanin. Our previous work has demonstrated low‐intensity pulsed ultrasound (LIPUS) can stimulate melanoblast migration in vitro. We sought to evaluate the potential additive efficacy and safety of LIPUS for repigmentation of vitiligo. Twenty‐seven adult patients with stable generalized vitiligo on the face or trunk were recruited in this randomized, open, left‐right comparison study. In each patient, two symmetric lesional sites were randomly selected; one was assigned as the target lesion, which was treated with add‐on LIPUS twice weekly for 24 weeks, and the other as the control lesion, which was administrated with sham sonification. The primary outcome was the difference of repigmentation degree between the target and control lesions at week 24, based on the 7‐point physician global assessment score. At the end of s tudy, 23 patients with vitiligo on the face (n = 10) or trunk (n = 13) completed the 24‐week treatment course. Enhanced repigmentation for vitiligo receiving LIPUS as compared to sham sonification was observed in 38.5% (5/13) of the patients with truncal vitiligo, but none of those with facial vitiligo. Truncal vitiligo (p = .046) and higher intensity of LIPUS administered (p = .01) were statistically significantly associated with the effectiveness of additive LIPUS treatment. The LIPUS treatment was well‐tolerated without remarkable adverse effects. This pilot study showed that LIPUS could provide therapeutic benefits and could be considered as a treatment adjunct for truncal vitiligo. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safety and efficacy profile of oral cyclosporine versus oral methotrexate versus oral acitretin in palmoplantar psoriasis ‐ A hospital based prospective investigator blind randomized controlled comparative study

pay.thelady61 shared this article with you from Inoreader Safety and efficacy profile of oral cyclosporine versus oral methotrexate versus oral acitretin in palmoplantar psoriasis ‐ A hospital based prospective investigator blind randomized controlled comparative study Via Dermatologic Therapy ABSTRACT Background Palmoplantar psoriasis (PPP) is a variant of psoriasis which affects only 5% body surface area, but has a devastating impact on affected individual's quality of life. There are few studies assessing efficacy of individual drugs, and few comparative studies of efficacy of two drugs in the literature, however randomized control trial comparing all three drugs against each other has not been done. Methods 75 patients of PPP were enrolled for study and randomly divided into three groups A, B, C of 25 each and assigned for treatment with Cyclosporine (CSA)(2.5‐5mg/kg/day), Methotrexate (MTX)(7.5‐15mg/week) and Acitretin (ACT)(25‐50mg/day) respectively. Modified PASI, PSS, VAS, PGA & PPQOL were used for monitoring response to therapy and improvement in quality of life up to end of study, and thereafter monthly follow‐up was done to find duration of remission for next 90 days. Side effects if any were recorded. Results There was a statistically significant difference in modified PASI for CSA, MTX and ACT. The mean Modified PASI at baseline was 12.8±4.8 for CSA, 12.57±3.8 for MTX and 11.92±3.28 for ACT(P=0.75). Mean Modified PASI reduced to 2.91±1.8 for CSA, 6.57±2.2 for MTX and 4.7±2.2 for ACT at week 5(P=<0.01). Mean Modified PASI further reduced to 0.095±0.35 for CSA, 2.12±1.4 for MTX and 0.78±0.97 for ACT at end of study(P=<0.01). However, Average duration of remission was 9 weeks for ACT group, followed by 6.47 and 3 weeks for CSA and MTX group respectively. Adverse events were comparatively more in ACT group as compared to MTX and CSA groups. Conclusion PPP affects quality of life tremendously and warrants systemic treatment for the same. CSA provides fastest resolution of lesions and have highest efficacy. MTX and ACT have similar efficacy, but ACT provides longer duration of remission. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parent-Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation.

payth.elady61 shared this article with you from Inoreader Parent-Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation. Via pubmed: dysphagia Parent-Reported Outcome Questionnaire for Swallowing Dysfunction in Healthy Infants and Toddlers: Construction and Content Validation. Otolaryngol Head Neck Surg. 2020 Dec 08;:194599820970950 Authors: Baqays A, Johannsen W, Rashid M, Jaffal H, Hicks A, Jeffery C, Seikaly H, El-Hakim H Abstract OBJECTIVES: There is limited epidemiological information on swallowing dysfunction (SwD) in otherwise healthy infants and toddlers (OHITs). Cost, invasiveness, expertise, and resources constrain the repeatability and utility of instrumental diagnostic tests. A parent-reported outcomes (PRO) tool has the potential to mitigate these disadvantages. Hence, we set out to develop and validate a novel PRO tool to assess SwD in OHITs. STUDY DESIGN: A mixed-method study. SETTING: Tertiary pediatric center. METHODS: We recruited parents of OHITs with SwD and excluded those with a confounding diagnosis (syndromes or neurological impairment). Interviews were conducted and thematically analyzed to extract the relevant domains and items. A similar analytical method was performed on the reports from a systematic review and literature search. Four verification sessions of parents and experts were conducted to maintain rigor. A panel of experts assessed and established the content validity of the items using a modified Delphi technique. RESULTS: We achieved information saturation after interviewing 10 parents and generated 7 domains with 72 items. Over the course of 3 rounds of modified Delphi content validation, the domains were reduced to 3 (swallowing, breathing, and illness) containing 21 items; a content validity index of 82.1% was achieved. CONCLUSION: We validated the content of a new PRO instrument to assess SwD in OHITs. The instrument is composed of 3 primary domains representing 21 items. This tool has the potential to screen for swallowing dysfunction and can assess management outcomes specifically for this population at a community level. PMID: 33287657 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Single-session endoscopic fundoplication after peroral endoscopic myotomy (POEM+F) for prevention of post gastroesophageal reflux - 1-year follow-up study.

payth.elady61 shared this article with you from Inoreader Single-session endoscopic fundoplication after peroral endoscopic myotomy (POEM+F) for prevention of post gastroesophageal reflux - 1-year follow-up study. Via pubmed: dysphagia Single-session endoscopic fundoplication after peroral endoscopic myotomy (POEM+F) for prevention of post gastroesophageal reflux - 1-year follow-up study. Endoscopy. 2020 Dec 08;: Authors: Bapaye A, Dashatwar P, Dharamsi S, Pujari R, Gadhikar HP Abstract Background and Aim Peroral endoscopic myotomy (POEM) is an established treatment for achalasia cardia (AC), however post-POEM gastroesophageal reflux (GER) remains a significant problem. Concomitant endoscopic fundoplication following POEM (POEM+F) was recently described to reduce post-POEM GER. This single-center study reports medium-term outcomes of POEM+F. Patients and Methods Retrospective analysis of prospectively maintained database of patients undergoing POEM+F. Abstracted data - demographics, achalasia type, pre-POEM Eckardt score (ES), prior therapy, follow-up. Follow-up was 3-monthly for one-year. Follow-up assessments included post-POEM ES, GerdQ score, EGD - wrap integrity and esophagitis, and pH studies. GER was defined according to Lyon consensus. Data was recorded as mean (SD) or median (IQR), P-value < 0.05 was considered statistically significant. Results 25 patients underwent POEM+F, mean age (SD) - 40.13 (13.66) years, 12 females. POEM+F was technically successful in 23/25 (92%). Significant dysphagia improvement was seen in all 25 (mean [SD] pre- and post-POEM ES 8.21 [1.08] and 0.1 [0.3] respectively, p < 0.05). Mean total procedure and fundoplication time (SD) - 115.6 (27.2) and 46.7 (12.4) minutes respectively. Time reduced significantly after initial 5 cases. Median follow-up was 12-months (IQR 9 - 13). Intact wrap was seen in 19/23 (82.6%). GER (abnormal EAET) was seen in 2/18 (11.1%); one reported GerdQ > 8. Borderline GER (asymptomatic grade A esophagitis, normal EAET) was identified in 4/22 (18.1%). Two (8%) minor delayed adverse events required no intervention. Conclusions POEM+F is safe and reproducible. At 12-months follow-up, incidence of post-POEM+F GER was low and acceptable. PMID: 33291157 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristics and Burden of Diagnostic Error-Related Malpractice Claims in Neurosurgery.

payth.elady61 shared this article with you from Inoreader Characteristics and Burden of Diagnostic Error-Related Malpractice Claims in Neurosurgery. Via pubmed: "world neurosurg"[jo... Characteristics and Burden of Diagnostic Error-Related Malpractice Claims in Neurosurgery. World Neurosurg. 2020 Dec 05;: Authors: Otsuki K, Watari T Abstract BACKGROUND: Neurosurgery is a specialty at high risk for malpractice claims, which can be influenced by the quality and safety of care. Diagnostic errors have gained increasing attention as a potentially preventable problem. Despite the burden of diagnostic errors, few studies have analyzed diagnostic errors in the field of neurosurgery. Here we delineate the effect of diagnostic errors on malpractice claims involving a neurosurgeon. METHODS: This is a retrospective study, using the national Japanese malpractice claims database, and includes cases closed between 1961 and 2017. To examine the effect of diagnostic errors in neurosurgery, we compared diagnostic error-related claims (DERCs) with non-DERCs in indemnity, clinical outcomes, and factors relating to neurosurgeons. RESULTS: There were 95 closed malpractice claims involving neurosurgeons during the study period. Of these claims, 36 (37.9%, 95% confidence interval [CI]: 28.7%-47.9%) were DERCs. Death was the most common outcome in patients associated with DERCs. Wrong, delayed, and missed diagnosis occurred in 25 (69.4%; 95% CI: 53.1%-82.0%), 4 (11.1%; 95% CI: 4.4%-25.3%), and 7 (19.4%; 95% CI: 9.8%-35.0%) cases, respectively. The most common presenting medical condition in DERCs was stroke. Subarachnoid hemorrhage, accounting for 85.7% of stroke cases, led to 27.8% of the total indemnity paid in DERCs. CONCLUSION: DERCs are associated with higher numbers of accepted claims and worse outcomes. Identifying diagnostic errors is important in neurosurgery, and countermeasures are required to reduce the burden on neurosurgeons and improve quality. This is the first study to focus on diagnostic errors in malpractice claims arising from neurosurgery. PMID: 33290895 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes of dura splitting decompression versus posterior fossa decompression with duraplasty in the treatment of Chiari I malformation: a systematic review and meta-analysis.

payth.elady61 shared this article with you from Inoreader Outcomes of dura splitting decompression versus posterior fossa decompression with duraplasty in the treatment of Chiari I malformation: a systematic review and meta-analysis. Via pubmed: "world neurosurg"[jo... Outcomes of dura splitting decompression versus posterior fossa decompression with duraplasty in the treatment of Chiari I malformation: a systematic review and meta-analysis. World Neurosurg. 2020 Dec 05;: Authors: Chang TW, Zhang X, Maoliti W, Yuan Q, Yang XP, Wang JC Abstract OBJECTIVE: Surgery is the definitive treatment option for symptomatic Chiari malformation I (CMI), but there is no clear consensus as to the preferred surgical method. This study aimed to quantitatively assess and compare the effect and safety of dura splitting decompression (DSD) and posterior fossa decompression with duraplasty (PFDD) in treating patients with CMI. METHODS: A literature search of EMBASE, MEDLINE, PubMed, Cochrane Library, and Web of Science databases was conducted. References from January 1990 to September 2020 were retrieved. We only included papers containing original data, comparing the use of DSD and PFDD in CMI patients. RESULTS: Overall, 11 relevant studies were identified, wherein, 443 patients treated for CMI by DSD were compared with 261 patients treated by PFDD. No difference was observed between PFDD and PFD in terms of clinical improvement (p=0.69), syringomyelia improvement(p=0.90), reoperation (p=0.22).DSD was associated with shorter operation durations (p=0.0007), shorter length of stay(p=0.0007), shorter overall postoperative complications (p＜0.0001) (especially CSF leak (p=0.005), meningitis (p=0.002), pseudomeningocele (p=0.002)), as compared with PFDD. CONCLUSIONS: This study confirmed that the dura splitting decompression has clinical and syringomyelia improvement outcomes comparable to posterior fossa decompression with duraplasty. Compared with PFDD, DSD not only significantly shortened the operation time and length of stay, but also significantly reduced the overall complication rate, especially those related to incidence of CSF-related complications. More evidence from advanced multi-center studies are needed to require to validate the findings. PMID: 33290896 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Woven EndoBridge (WEB) versus Conventional Coiling for Treatment of Patients with Aneurysmal Subarachnoid Haemorrhage: Propensity Score-Matched Analysis of Clinical and Angiographic Outcome Data.

payth.elady61 shared this article with you from Inoreader The Woven EndoBridge (WEB) versus Conventional Coiling for Treatment of Patients with Aneurysmal Subarachnoid Haemorrhage: Propensity Score-Matched Analysis of Clinical and Angiographic Outcome Data. Via pubmed: "world neurosurg"[jo... The Woven EndoBridge (WEB) versus Conventional Coiling for Treatment of Patients with Aneurysmal Subarachnoid Haemorrhage: Propensity Score-Matched Analysis of Clinical and Angiographic Outcome Data. World Neurosurg. 2020 Dec 05;: Authors: Pennig L, Goertz L, Cornelia Isabel Hoyer U, Dorn F, Siebert E, Herzberg M, Borggrefe J, Schlamann M, Liebig T, Kabbasch C Abstract OBJECTIVE: Conventional coiling is standard for treatment of ruptured intracranial aneurysms. We compared clinical and angiographic outcomes between intrasaccular flow-disruption with the Woven EndoBridge (WEB) and conventional coiling in patients with aneurysmal subarachnoid haemorrhage (aSAH) using a propensity score-matched analysis. METHODS: This is a retrospective study of consecutive patients with aSAH treated with the WEB or conventional coiling between 2010 and 2019. Baseline characteristics, procedural complications, angiographic results, and functional outcome were compared between both groups. RESULTS: Fifty-two patients treated with the WEB and 236 patients treated by coiling were included. The WEB group was characterized by a higher patient age (P=.024), a wider aneurysm neck (P<.001), and more frequent location at the posterior circulation (P=.004). Procedural complications were comparable between WEB (19.2%) and coiling (22.7%, P=.447). In-hospital mortality rates were higher in the coiling group (WEB: 5.8%, coiling: 17.8%; P=.0034). Favourable outcome (modified Rankin Scale ≤2) was obtained in 51.3% after WEB embolization and in 55.0% after coiling (P=.653). Retreatment was performed in 26.4% of patients after WEB and in 25.8% after coiling (P=.935). Propensity score analysis confirmed these results and revealed higher adequate occlusion rates at mid-term follow-up for WEB-treated aneurysms (WEB: 93.9%, coiling: 76.2%, P=.058). CONCLUSIONS: Compared to conventional coiling, aSAH patients treated with the WEB have a similar clinical and potentially improved angiographic outcome at mid-term follow-up. The WEB might be considered as an alternative to conventional coiling for the treatment of RIAs, in particular for those with wide-necked and thus challenging anatomy. PMID: 33290897 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Complex Structure of the Anterior White Commissure of the Human Brain: Fiber Dissection and Tractography Study.

payth.elady61 shared this article with you from Inoreader The Complex Structure of the Anterior White Commissure of the Human Brain: Fiber Dissection and Tractography Study. Via pubmed: "world neurosurg"[jo... The Complex Structure of the Anterior White Commissure of the Human Brain: Fiber Dissection and Tractography Study. World Neurosurg. 2020 Dec 05;: Authors: Çavdar S, Aydın AE, Algin O, Aydın S Abstract OBJECTIVES: Commissural fibers are necessary for bilateral integration, body coordination, and complex cognitive information flow between the hemispheres. The anterior commissure (AC) has a complex architecture interconnecting areas of the frontal, temporal and occipital lobes. The present study aims to demonstrate the connections and the course of the anterior (ACa) and posterior (ACp) limb of the AC using fiber dissection and DTI technique in the human brain. METHODS: Fiber dissection was performed in a stepwise manner from lateral to medial on 6 left hemispheres. The gray matter was decorticated and the ACa-ACp was exposed. The ACa and ACp tracts were demonstrated using a high-spatial-resolution DTI with a 3-tesla MR unit in 13 cases. RESULTS: Using both techniques showed that, the AC has complex interconnections with large areas of the frontal (olfactory tubercles, anterior olfactory nucleus, olfactory bulb, and the orbital gyri), temporal (amygdaloidal nuclei, temporal and perirhinal cortex), and occipital (visual cortex) lobes. The ACp make up the major component of the AC and is composed of temporal and occipital fibers. We observed that these fibers do not make a distinct bundle; the temporal fibers joined the uncinate fasciculus and the occipital fibers joined the sagittal striatum to reach their targets. CONCLUSION: Being aware of the course of the AC is important during transcallosal and interforniceal approaches to the 3rd ventricle tumors and temporal lobe epilepsy surgery. The intermingling fibers of the AC can provide a better understanding of the unexplained deficit that may occur during regional surgery. PMID: 33290898 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Novel surgical treatment of recurrent CSF leak by Temporoparietal Temporalis myofascial flap: a series of 6 cases.

payth.elady61 shared this article with you from Inoreader Novel surgical treatment of recurrent CSF leak by Temporoparietal Temporalis myofascial flap: a series of 6 cases. Via pubmed: "world neurosurg"[jo... Novel surgical treatment of recurrent CSF leak by Temporoparietal Temporalis myofascial flap: a series of 6 cases. World Neurosurg. 2020 Dec 05;: Authors: Kawsar KA, Land T, Tsermoulas G, Paluzzi A, Ahmed S Abstract BACKGROUND: With the advent of modern endoscopes and better anatomic understanding of the skull base, the indications of endonasal approaches are increasing. These procedures may be complicated by high rates of postoperative cerebrospinal fluid (CSF) leak and reconstruction of the defect remains challenging. In the anterior skull base, vascularised grafts have been reported as superior in preventing CSF leakage and infection. The Hadad-Bassagasteguy flap (HBF),being a pedicled flap is our first line flap to reconstruct the skull base. When we were not successful with this flap, we resorted to different flaps. OBJECTIVE: We modified the originally described temporoparietal fascial flap (TPFF) by Fortes et al. and applied clinically. The objective of this paper is to briefly describe the modification of the flap and to review the clinical outcome. METHODS: From 2014 to 2018, in 6 cases of CSF leak with the appropriate indication we used the temporoparietal myofascial flap (TPTMFF) repair which is a modification of the temporoparietal fascial flap (TPFF) by Fortes et al. We took all the 6 patients in our study and followed them up. RESULTS: All of the 6 repairs were successful and no CSF leak was found just after the operation in 6 to 48 months followup. CONCLUSION: We recommend our modified novel TPTMF flap as a very good option in case of failed cases of postoperative CSF leak. PMID: 33290899 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.