Long‐term hearing performance and soft tissue outcomes of the Baha® Attract system in patients with bilateral congenital microtia in a single centre

xlomafota13 shared this article with you from Inoreader Long‐term hearing performance and soft tissue outcomes of the Baha® Attract system in patients with bilateral congenital microtia in a single centre Via Clinical Otolaryngology Abstract The Baha® Attract system can provide effective and stable hearing amplification for patients with microtia. Concurrent surgeries of auricle reconstruction and Baha® Attract implantation do not result in more soft tissue complications. The number of adverse events increased with the duration of implantation, even one year postoperatively. Benign skin evolutions, including skin thinning and erythema at the implant side, are commonly seen in Baha® Attract users. Implants are not necessarily removed when skin necrosis occurs in Baha® Attract users. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The management of multimorphic cancer pain, from diagnosis to treatment

xlomafota13 shared this article with you from Inoreader The management of multimorphic cancer pain, from diagnosis to treatment Via Association française pour l'étude du cancer Bull Cancer. 2021 Nov 27:S0007-4551(21)00395-7. doi: 10.1016/j.bulcan.2021.08.013. Online ahead of print. ABSTRACT Cancer pain remains a major public health issue. Despite progress in pain medicine thanks to the interest shown in early and timely supportive care, more than half the patients managed for cancer are in pain. One of the key factors in high quality multidisciplinary management throughout the care pathway is to assess more than just pain: it is necessary to assess the patient as a whole. Understanding the complexity of cancer pain - or the various types of pain - through the innovative multimorphic cancer pain model, effectively opens up new perspectives for a targeted, personalised, and multimodal approach. The subsequent treatment strategies, whether drug-based with opioids, or interventional, are codified by guidelines based on scientific evidence for the healthcare professionals and, ultimately, patients. PMID:34848047 | DOI:10.1016/j.bulcan.2021.08.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of burned hand function after enzymatic debridement

xlomafota13 shared this article with you from Inoreader Evaluation of burned hand function after enzymatic debridement Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 22:S1748-6815(21)00517-9. doi: 10.1016/j.bjps.2021.09.074. Online ahead of print. ABSTRACT Hand burns are common injuries that can result in long-term impairment of hand function. Enzymatic debridement (ED) prevents damage to the viable dermis due to the procedure's selectivity and has become an option for obtaining an accurate depth assessment and enabling wound re-epithelialization with less skin graft use. We conducted a prospective study from July 2015 to July 2018, which enrolled patients with deep partial-thickness hand burns and treated them with ED using bromelain. After a specified period, we assessed the patients' hand function, using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Michigan Hand Outcomes Questionnaire (MHOQ) to assess their disabilities and activities of daily life, respectively. We assessed the hand joint range of motion using a goniometer a nd assessed scar quality with the Vancouver Scar Scale (VSS). We analyzed 72 patients with 90 burned hands at 3 months and, at the final assessment, 69 patients with 86 burned hands. Fire was the most common cause of the burns. Bromelain allowed for early debridement (73.6% during the first 24 h). At the 3-month evaluation, the mean DASH and MHOQ scores were 2.35 and 97.9%, respectively, with a high inverse correlation between the 2 types of scores (Spearman's rho, -0.78; p < .001). The mean wrist flexion and extension were 85.7 and 80°, respectively, the mean metacarpophalangeal flexion was 88.3°, the proximal interphalangeal (PIP) flexion was 112.9°, and the thumb opposition was 77°. The mean VSS score was 2.87. At the final evaluation, with a minimum follow-up of 391 days, the mean DASH and MHOQ scores were 0.18 and 99.71%, respectively. ED with bromelain in deep partial-thickness hand burns resulted in normal values at 3 months and at over 1 year of follow-up, with comple te restoration of function and quality of life and good scar results. PMID:34848129 | DOI:10.1016/j.bjps.2021.09.074 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow-band imaging technique: A systematic review

xlomafota13 shared this article with you from Inoreader Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow-band imaging technique: A systematic review Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):36. doi: 10.3892/etm.2021.10958. Epub 2021 Nov 10. ABSTRACT Narrow-band imaging (NBI), an on-demand, real-time endoscopic imaging technique, was developed to enhance visualization of the mucosal vascular network and surface texture. The present article provides a systematic review of studies that assessed the use of NBI in gynecological endoscopy. The following electronic databases were searched: PubMed (1950-2020), Google Scholar (2004-2020) and Cochrane Library (2010-2020). In the initial search, 3,836 entries were identified, of which 31 were finally included in the systematic review. Of the selected studies, 10 (32%) were case reports, 19 (61.2%) were prospective studies and 2 (6.4%) were randomized controlled trials with control groups. The selected studies reported on the use of NBI in hysteroscopy, laparoscopy and colposcopy. It was revealed that NBI utilization in hysteroscopy increased the accuracy , sensitivity and specificity in detecting malignant and premalignant lesions. NBI improved the specificity and sensitivity in the detection of endometriotic lesions and cervical lesions. Conventional white light endoscopy in gynecology may be significantly improved by the use of NBI. Further studies with larger cohorts and improved design are required to achieve more reliable results. It is of special interest that utilization of this method requires apparatus which is expensive; concerns are the long training and experience of staff required and the long learning curve. PMID:34849151 | PMC:PMC8613536 | DOI:10.3892/etm.2021.10958 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emergence of Invasive Fungal Rhinosinusitis in Recently Recovered COVID-19 Patients

xlomafota13 shared this article with you from Inoreader Emergence of Invasive Fungal Rhinosinusitis in Recently Recovered COVID-19 Patients Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Dec 1:34894211060923. doi: 10.1177/00034894211060923. Online ahead of print. ABSTRACT OBJECTIVE: The risk of invasive fungal rhinosinusitis is increased in Coronavirus disease 2019 (COVID-19) because of its direct impact in altering innate immunity and is further exacerbated by widespread use of steroids/antibiotics/monoclonal antibodies. The study aims to describe this recently increased clinical entity in association with COVID-19. METHO D: A prospective, longitudinal study including patients diagnosed with acute invasive fungal rhinosinusitis (AIFRS) who recently recovered from COVID-19 infection or after an asymptomatic carrier state. A single-center, descriptive study investigating demographic details, clinical presentation, radio-pathological aspects, and advocated management. RESULT: A total of 21 patients were included with a mean age of 49.62 years (SD: 14.24). Diabetes mellitus (DM) was the most common underlying disorder (90.48%), and 63.16% of all patients with DM had a recent onset DM, either diagnosed during or after COVID-19 infection. Nineteen patients (90.48%) had recently recovered from active COVID-19 infection, and all had a history of prior steroid treatment (oral/parenteral). Remaining 2 patients were asymptomatic COVID-19 carriers. Surprisingly, 2 patients had no underlying disorder, and 5 (23.81%) recently received the Covishield vaccine. Fungal analysis exhibited Mucor (95.24%) and Asper gillus species (14.29%). Most common sign/symptom was headache and facial/periorbital pain (85.71%), followed by facial/periorbital swelling (61.90%). Disease involvement: sinonasal (100%), orbital (47.62%), pterygopalatine fossa (28.58%), infratemporal fossa (14.29%), intracranial (23.81%), and skin (9.52%). Exclusive endoscopic debridement and combined approach were utilized in 61.90% and 38.10%, respectively. Both liposomal amphotericin B and posaconazole were given in all patients except one. CONCLUSION: A high suspicion of AIFRS should be kept in patients with recent COVID-19 infection who received steroids and presenting with headache, facial pain, and/or facial swelling. Asymptomatic COVID-19 carriers and COVID-19 vaccinated candidates are also observed to develop AIFRS, although the exact immuno-pathogenesis is still unknown. Prompt diagnosis and early management are vital for a favorable outcome. PMID:34852669 | DOI:10.1177/00034894211060923 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hearing Preservation Microsurgery in Vestibular Schwannomas: Worth Attempting in “Larger” Tumors?

xlomafota13 shared this article with you from Inoreader Hearing Preservation Microsurgery in Vestibular Schwannomas: Worth Attempting in "Larger" Tumors? Via The Laryngoscope Objectives/Hypothesis To review hearing preservation after microsurgical resection of sporadic vestibular schwannomas according to tumor size. Study Design Retrospective cohort. Methods Baseline, intraoperative, and postoperative patient and tumor characteristics were retrospectively collected for a cohort who underwent hearing preservation microsurgery. Serviceable hearing was defined by a pure tone average ≤50 dB and word recognition score ≥50%. Results A total of 243 patients had serviceable hearing preoperatively. Fifty (21%) tumors were confined to the internal auditory canal, and the median tumor size was 16.2 mm (interquartile range [IQR] 11.3–23.2) for tumors with cerebellopontine angle extension. Serviceable hearing was maintained in 64% of patients with tumors confined to the internal auditory canal, 28% with cerebellopontine angle extension <15 mm, and 9% with cerebellopontine angle extension ≥15 mm. On multivariable analysis, the odds ratios of acquiring nonserviceable hearing postoperatively for tumors extending <15 mm and ≥15 mm into the cerebellopontine angle were 5.75 (95% confidence interval [CI] 2.13–15.53; P < .001) and 22.11 (95% CI 7.04–69.42; P < .001), respectively, compared with intracanalicular tumors. Conclusions The strongest predictor of hearing preservation with microsurgery after multivariable adjustment is tumor size. Approximately 10% of patients with tumors ≥15 mm of cerebellopontine angle extension will retain serviceable hearing after microsurgery. Furthermore, hearing preservation techniques offer cochlear nerve preservation and cochlear patency allowing for possible future cochlear implantation. An attempt at hearing preservation, including avoiding surgical approaches that necessarily sacrifice hearing, is worthwhile even in larger tumors if serviceable hearing is present preoperatively. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The potential adverse effect of 2.45 GHz microwave radiation on the testes of prenatally exposed peripubertal male rats

xlomafota13 shared this article with you from Inoreader The potential adverse effect of 2.45 GHz microwave radiation on the testes of prenatally exposed peripubertal male rats Via Cellular and Molecular Biology Histol Histopathol. 2021 Dec 2:18402. doi: 10.14670/HH-18-402. Online ahead of print. ABSTRACT In utero development of organs is easily influenced by many environmental factors. The aim of this study was to elucidate the effect of microwave radiation (MR) at a frequency of 2.45 GHz and a specific absorption rate of 1.73 W/kg on intrauterine development of testis. Pregnant albino rats were exposed to whole-body MR for 2 hours per day throughout the pregnancy. Male offspring (n=12, age 35 days) were not exposed to MR after birth. The study revealed that MR applied in utero induced apparent structural changes in the testes, such as irregular shape of seminiferous tubules, significant decrease in the diameter of seminiferous tubules (p<0.05) and in the height of the germinal epithelium (p<0.01), disorganisation of germ cells, desquamations of immature germ cells, formation of giant multinucleated cells, and significant (p<0.01) ex pansion of the interstitium. At the level of transmission electron microscopy, there were observed basement membrane irregularities in seminiferous tubules, vacuolation of the cytoplasm and adversely affected organelles in Sertoli cells, germ cells, Leydig cells, peritubular and endothelial cells. The tight junctions between adjacent Sertoli cells were often incomplete, and necrotizing germ cells were more numerous in experimental animals compared to controls. Enhanced necrotizations of germ cells proved by a Fluoro Jade C method, and declined germ cells proliferation confirmed by proliferating cell nuclear antigen analysis, were detected in MR exposed animals. Our results revealed that the prenatal exposure to MR had an adverse effect on the postnatal testicular development in rats. PMID:34854072 | DOI:10.14670/HH-18-402 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.