UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG).

xlomafota13 shared this article with you from Inoreader UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG). Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG). J Plast Reconstr Aesthet Surg. 2021 Jan;74(1):13-29 Authors: Turton P, El-Sharkawi D, Lyburn I, Sharma B, Mahalingam P, Turner SD, MacNeill F, Johnson L, Hamilton S, Burton C, Mercer N Abstract Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK) negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies a nd although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimize the need for systemic treatments, reduce morbidity and the risk of poor outcomes. These guidelines provide an evidence-based and systematic framework for the assessment and treatment of patients with suspected or proven BIA-ALCL and are aimed at all clinicians involved in the care of people with breast implants. PMID: 33483089 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review.

xlomafota13 shared this article with you from Inoreader The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review. J Plast Reconstr Aesthet Surg. 2021 Jan 08;: Authors: Hage JJ, van Akkooi ACJ Abstract Split-thickness skin grafts are often applied in the management of primary cutaneous melanoma. It is routine surgical practice to use the contralateral limb because of the alleged risk of donor site metastases that may occur when the ipsilateral limb is used. The rationale and clinical evidence for this routine were assessed in light of current understanding of pathways of metastasis of melanoma. We found the preference for the contralateral limb to go back to Paget's ideas on melanoma spread from 1889, and the clinical observation of five cases of split-thickness skin graft donor site metastases in a series of 226 tumours, published in 1962. We traced ten additional reported cases of melanoma metastases occurring in the skin graft donor site. Contralateral donor sites were involved in seven of these cases. In light of current knowledge, the occurrence and the location of any split skin donor site metastasis are to be considered as mere indicators of an aggressive course of s ystemic disease. Any location of a split skin donor site, whether ipsilateral or contralateral in relation to the primary tumour, may become the location of metastases but chances that such metastases occur are extremely rare. Because of the lack of evidence in favour of the use of the contralateral limb and because of sound considerations in favour of using the ipsilateral limb, we conclude that there is no objective argument to sustain the dogmatic ban of the ipsilateral limb as a donor site for a split-thickness skin graft in melanoma surgery. PMID: 33483262 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy.

xlomafota13 shared this article with you from Inoreader Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy. Via radioactive iodine Related Articles Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy. BMC Surg. 2021 Jan 22;21(1):53 Authors: Xing Z, Qiu Y, Li Z, Zhang L, Fei Y, Zhu J, Su A Abstract BACKGROUND: To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC). METHODS: This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines. RESULTS: Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392-55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649-267.384; P = 0.019). CONCLUSION: Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively. PMID: 33482804 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study.

xlomafota13 shared this article with you from Inoreader Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study. Via radioactive iodine Related Articles Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study. Ann Surg Oncol. 2021 Jan 22;: Authors: Ho J, Kim E, Han M, Jung I, Lee J, Jo YS Abstract BACKGROUND: Studies have shown that radioactive iodine therapy (RAIT) affects the development of second cancer in thyroid cancer patients. The impact of other factors, such as dyslipidemia are not clear. METHODS: A retrospective analysis of thyroid cancer patients with a 1,251,913 person-year follow-up was conducted using data from the Health Insurance Review and Assessment database in South Korea from January 2008 to December 2018. We investigated factors related to second cancer development using a nested case-control analysis to avoid length bias. RESULTS: The overall risk of developing second cancer was higher in thyroid cancer patients than in the general population [standardized incidence ratio, 3.34; 95% confidence interval (CI) 3.30-3.39]. Second cancer incidence was higher in patients who received RAIT than in those who did not [odds ratio (OR) 1.130; 95% CI 1.094-1.169]. Moreover, the risk of second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.265; 95% CI 1.223-1.309). After adjustment for RAIT, the incidence of a second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.262; 95% CI 1.221-1.306). CONCLUSIONS: The risk of second cancer development in patients with thyroid cancer appears to be high. Dyslipidemia may be associated with an increased risk of several types of second cancers. PMID: 33483844 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging.

xlomafota13 shared this article with you from Inoreader Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging. Via leak of cerebrospinal fluid Related Articles Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging. Headache. 2021 Jan 23;: Authors: Schievink WI, Maya M, Prasad RS, Wadhwa VS, Cruz RB, Moser FG, Nuno M Abstract OBJECTIVE: To determine the occurrence of cerebrospinal fluid (CSF)-venous fistulas, a type of spinal CSF leak that cannot be detected with routine computerized tomography myelography, among patients with orthostatic headaches but normal brain and spine magnetic resonance imaging. BACKGROUND: Spontaneous spinal CSF leaks cause orthostatic headaches but their detection may require sophisticated spinal imaging techniques. METHODS: A prospective cohort study of patients with orthostatic headaches and normal brain and conventional spine imaging who underwent digital subtraction myelography (DSM) to look for CSF-venous fistulas, between May 2018 and May 2020, at a quaternary referral center for spontaneous intracranial hypotension. RESULTS: The mean age of the 60 consecutive patients (46 women and 14 men) was 46 years (range, 13-83 years), who had been suffering from orthostatic headaches between 1 and 180 months (mean, 43 months). DSM demonstrated a spinal CSF-venous fistula in 6 (10.0%; 95% confidence interval [CI]: 3.8-20.5%) of the 60 patients. The mean age of these five women and one man was 50 years (range, 41-59 years). Spinal CSF-venous fistulas were identified in 6 (19.4%; 95% CI: 7.5-37.5%) of 31 patients with spinal meningeal diverticula but in none (0%; 95% CI: 0-11.9%) of the 29 patients without spinal meningeal diverticula (p = 0.024). All CSF-venous fistulas were located in the thoracic spine. All patients underwent uneventful surgical ligation of the fistula. Complete and sustained resolution of symptoms was obtained in five patients, while in one patient, partial recurrence of symptoms was noted 3 months postoperatively. CONCLUSION: Concerns about a spinal CSF leak should not be dismissed in patients suffering from orthostatic headaches when conventional imaging turns out to be normal, even though the yield of identifying a CSF-venous fistula is low. PMID: 33484155 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lateral semicircular canal-BPPV: Prospective randomized study on the efficacy of four repositioning maneuvers

xlomafota13 shared this article with you from Inoreader Message: https://link.springer.com/article/10.1007/s12070-019-01737-4#:~:text=BPPV%20originating%20from%20stimulation%20of,lateral%20canal%20instead%20of%20the Lateral Semicircular Canal BPPV…Are We Still Ignorant? Jaskaran Singh & Bhanu Bhardwaj Indian Journal of Otolaryngology and Head & Neck Surgery volume 72, pages175–183(2020)Cite this article 137 Accesses Metricsdetails Abstract Benign Paroxysmal Vertigo is one of the most common causes of vertigo. The most common semicircular canal involved in pathogenesis of BPPV is Posterior semicircular canal. However anterior and lateral semicircular canals can also sometimes be responsible for BPPV but their involvement in pathogenesis is still underrated. The incidence of lateral semicircular canal BPPV is in literature is around 10–12% while anterior canal is about 3%. The main objective of this study was to provide the database for incidence of lateral canal BPPV from a tertiary care hospital with the aim that more clinicians incorporate this entity into their differential diagnosis when their cases of posterior canal BPPV are refractory. This was an observational cross-sectional study of 300 patients of BPPV who were coming in ENT OPD as primum or as referral. All the patients underwent both the Dix–Hallpike maneuver as well as the supine roll test. The patients who were having upbeating torsional vertical nyst agmus on Dix–Hallpike were treated on lines of posterior canal BPPV whereas those with horizontal nystagmus on supine roll test were treated on lines of lateral canal BPPV. The data was tabulated and analysed for the incidence of lateral canal BPPV. Out of 300 patients; 188 were males and 122 were females. Most commonly affected age group by BPPV was 40–50 years. Out of 300 cases 260 cases (86.6%) had posterior BPPV and 37 cases (12.3%) had lateral canal BPPV. 3 cases (1%) also had anterior canal BPPV. 30/37 cases of lateral BPPV had geotropic nystagmus while 7 cases had apo-geotropic nystagmus. Posterior canal BPPv was treated by Epleys maneuver. Superior canal BPPV was treated by Yacovino maneuver. The cases of lateral canal BPPV were treated by either Vannucchi-asprella; Gufoni; Lempert maneuver or by the combination of two maneuvers. Lateral canal BPPV is an important diagnosis to consider in all cases of BPPV. Its true incidence is still under blanket as many clinicians are not using supine roll test routinely in their practice while diagnosing BPPV. Many refractory cases of BPPV can be cured if the involvement of other canals in its pathogenesis is kept in the mind so that correct diagnostic and repositioning maneuvers can be applied. 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Vannucchi P, Pecci R (2011) About nystagmus transformation in a case of apogeotropic lateral semicircular canal benign paroxysmal positional vertigo. Int J Otolaryngol 2011:4. https://doi.org/10.1155/2011/687921 Article Google Scholar 37. Kurtzer DA, Gans RE, McLeod H (2017) New horizontal canal benign paroxysmal positional vertigo treatment: kurtzer hybrid maneuver. Glob J Otol 6(3):555686. https://doi.org/10.19080/GJO.2017.06.555686 Article Google Scholar 38. Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Corrigan MD (2017) Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 156(3):S1–S47 Article Google Scholar 39. Fife TD, Iverson DJ, Lempert T, Furman JM, Baloh RW, Tusa RJ et al (2008) Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 70:2067–2074 CAS Article Google Scholar 40. Nuti D, Mandalà M, Salerni L (2009) Lateral canal paroxysmal positional vertigo revisited. Ann NY Acad Sci 1164:316–323 Article Google Scholar 41. Tirelli G, Russolo M (2004) 360-Degree canalith repositioning procedure for the horizontal canal. Otolaryngol Head Neck Surg 131:740–746 Article Google Scholar 42. Chiou WY, Lee HL, Tsai SC, Yu TH, Lee XX (2005) A single therapy for all subtypes of horizontal canal positional vertigo. Laryngoscope 115:1432–1435 Article Google Scholar Download references Author information Affiliations Sri Guru Ram Das Institute of Health Sciences and Research, Amritsar, India Jaskaran Singh & Bhanu Bhardwaj Mohali, India Jaskaran Singh Amritsar, India Bhanu Bhardwaj Corresponding author Correspondence to Bhanu Bhardwaj. Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Ethical Approval Before starting the study Ethical Clearance was taken from the institutional ETHICAL Committee as per DECLARATION OF HELSINKI. Informed consent Informed consent was duly taken from all the patients. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Reprints and Permissions About this article Verify currency and authenticity via CrossMark Cite this article Singh, J., Bhardwaj, B. Lateral Semicircular Canal BPPV…Are We Still Ignorant?. Indian J Otolaryngol Head Neck Surg 72, 175–183 (2020). https://doi.org/10.1007/s12070-019-01737-4 Download citation Received 06 September 2019 Accepted 09 September 2019 Published 26 September 2019 Issue Date June 2020 DOI https://doi.org/10.1007/s12070-019-01737-4 Keywords Horizontal canal BPPV Lateral canal BPPV Geotropic nystagmus Apo-geotropic nystagmus Supine roll test Bow and bean test Vannucchi asprella maneuver Gufoni maneuver Lempert maneuver Lateral semicircular canal-BPPV: Prospective randomized study on the efficacy of four repositioning maneuvers Via Acta Otorrinolaringológica Española Publication date: Available online 23 January 2021 Source: Acta Otorrinolaringológica Española Author(s): Filipe Correia, Luís Castelhano, Pedro Cavilhas, Pedro Escada View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Therapeutic options in Meniere's disease: Our experience

xlomafota13 shared this article with you from Inoreader Message: Arch Otolaryngol 1977 Oct;103(10):589-93. doi: 10.1001/archotol.1977.00780270057007. Therapeutic options in Meniere's disease I K Arenberg, R F Bayer PMID: 303093 DOI: 10.1001/archotol.1977.00780270057007 Emphasis on treatment in Meniere's disease has recently shifted from a concentration on the vertiginous component alone to include conservation or improvement of hearing as well. This presentation tabulates the current otological literature's reports of both the medical and surgical options available in the treatment of Meniere's disease. The authors conclude that these more recent reports deemphasize the importance of the vertiginous component, while emphasizing the importance of the hearing component in evaluation of the efficacy of any therapeutic modality. Furthermore, these reports indicate that endolymphatic sac decompression and drainage surgery alone offers a considerable chance for conservation or improvement in hearing, as well as relief of vertigo in early cases of reversible, fluctuating hearing deficits. In nonreversible or nonfluctuating hearing deficits with hearing worth conserving, vestibular neurectomy with excision of Scarpa's ganglion yields the best results. Therapeutic options in Meniere's disease: Our experience Via American Journal of Otolaryngology Publication date: Available online 23 January 2021 Source: American Journal of Otolaryngology Author(s): Pietro De Luca, Claudia Cassandro, Massimo Ralli, Arianna Di Stadio, Pasquale Viola, Ettore Cassandro, Alfonso Scarpa View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Do collagen‐related diseases represent a risk factor for hidradenitis suppurativa?

xlomafota13 shared this article with you from Inoreader Do collagen‐related diseases represent a risk factor for hidradenitis suppurativa? Via Experimental Dermatology Abstract We read with great interest the work of Boer et al [1] that explores the role of mechanical stress as a potential triggering factor for hidradenitis suppurativa (HS). The authors reported two cases of patients who developed HS along the striae distensae (SD). The hypothesis proposed by the authors to explain this ectopic lesions is the fact that SD are characterized by a decrease of dermal thickness due to destruction of collagen fibres which may reduce the mechanical support to the pilosebaceous structures and if combined to frictional forces, may trigger the onset of HS by promoting skin inflammation. Matrix metalloproteinases (MMPs) are proteases able to degrade the major components of the extracellular matrix (ECM). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A narrative review of pharmacologic treatments for COVID‐19: safety considerations and ototoxicity

xlomafota13 shared this article with you from Inoreader A narrative review of pharmacologic treatments for COVID‐19: safety considerations and ototoxicity Via The Laryngoscope Abstract Objectives The purpose of this review is to summarize evidence‐based data regarding the ototoxic effects of potential COVID‐19 therapeutics to treat patients suffering from SARS‐CoV‐2. Methods Medications under investigation as novel therapeutics to treat COVID‐19 were identified using the search term coronavirus therapeutics, COVID therapeutics and SARS‐CoV‐2 therapeutics on ClinicalTrials.gov and the PubMed Database. A literature review was performed using the PubMed Database for each proposed COVID‐19 therapeutic to identify relevant articles. Search criteria included Medical Subject Headings (MeSH) and key word search terms for ototoxicity, vestibulotoxicity, hearing disorders and vertigo. Results Six proposed COVID‐19 therapeutics were identified as possessing ototoxic side effects including chloroquine and hydroxychloroquine, azithromycin, lopinavir‐ritonavir, interferon, ribavirin and ivermectin. Conclusions Available evidence suggests that ototoxic effects may be improved or mitigated by stopping the offending agent. Recognition of hearing loss, tinnitus or imbalance/vertigo is therefore crucial to facilitate early intervention and prevent long‐term damage. Hospitals should consider the inclusion of audiologic monitoring protocols for patients receiving COVID‐19 therapeutics with known ototoxicity, especially in high risk patient groups such as the elderly and hearing impaired. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.