Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report

paythelady.61 shared this article with you from Inoreader Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report Via SAGE Publications Inc: Annals of Otology, Rhinology & Laryngology: Table of Contents Annals of Otology, Rhinology &Laryngology, Ahead of Print. Objectives:To report a case of a morbidly obese 17-year-old boy who presented 4 days post-tonsillectomy with acute deep venous thromboses and a massive pulmonary embolism. To describe a protocol and decision-making tree for providing anticoagulation in the immediate post-tonsillectomy period.Methods:A chart review and review of the literature.Results:The patient ultimately did well and had no bleeding from the tonsil beds or further thromboembolic complications. A review of the literature revealed no available data regarding the safety of anticoagulation in the immediate post-tonsillectomy period.Conclusions:We propose that if anticoagulation is needed within 14 days of tonsillectomy, submaximal anticoagulation with a reversible and titratable anticoagulant may be optimal. A multidisciplinary team approach is needed for these complex cases. Future reporting and investigation of anticoagulation post-tonsillec tomy is needed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quantitative proteomics in medication‐related osteonecrosis of the jaw: a proof‐of‐concept study

paythelady.61 shared this article with you from Inoreader Quantitative proteomics in medication‐related osteonecrosis of the jaw: a proof‐of‐concept study Via Oral Diseases ABSTRACT Objective Medication-related osteonecrosis of the jaw (MRONJ) is a paradoxical effect associated with bone modifying agents (BMAs) and other drugs. Currently no valuable diagnostic or prognosis biomarkers exist. This goal of this research was to study MRONJ related salivary proteome. Materials and Methods This case-control aimed to study salivary proteome in MRONJ versus control groups i) formed from BMAs consumers and ii) healthy individuals to unravel biomarkers. 38 samples of unstimulated whole saliva (18 MRONJ patients, 10 BMA consumers, and 10 healthy controls) were collected. Proteomic analysis by SWATH-MS coupled to bioinformatics analysis was executed. Results 586 proteins were identified, 175 proteins showed significant differences among MRONJ versus controls. SWATH-MS revealed differentially expressed proteins among three groups, which have never isolated. These proteins had distinct roles including cell envelope organization, positive regulation of vesicle fusion, positive regulation of receptor binding, or regulation of low-density lipoprotein particle clearance. Integrative analysis prioritised 3 proteins (MMP9, AACT and HBD). Under receiver operating characteristic analysis, this panel discriminated MRONJ with a sensitivity of 90% and a specificity of 78.9%. Conclusion These findings may inform of a novel biomarker panel for MRONJ prediction or diagnosis. Nonetheless, further research is needed to validate this panel. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of Responses to DCN vs. VCN Stimulation in a Mouse Model of the Auditory Brainstem Implant (ABI)

paythelady.61 shared this article with you from Inoreader Comparison of Responses to DCN vs. VCN Stimulation in a Mouse Model of the Auditory Brainstem Implant (ABI) Via Latest Results for Journal of the Association for Research in Otolaryngology Abstract The auditory brainstem implant (ABI) is an auditory neuroprosthesis that provides hearing to deaf patients by electrically stimulating the cochlear nucleus (CN) of the brainstem. Whether such stimulation activates one or the other of the CN's two major subdivisions is not known. Here, we demonstrate clear response differences from the stimulation of the dorsal (D) vs. ventral (V) subdivisions of the CN in a mouse model of the ABI with a surface-stimulating electrode array. For the DCN, low levels of stimulation evoked multiunit responses in the inferior colliculus (IC) that were unimodally distributed with early latencies (avg. peak latency of 3.3 ms). However, high levels of stimulation evoked a bimodal distribution with the addition of a late latency response peak (avg. peak latency of 7.1 ms). For the VCN, in contrast, electrical stimulation elicited multiunit responses that were usually unimodal and had a latency similar to the DCN's late respon se. Local field potentials (LFP) from the IC showed components that correlated with early and late multiunit responses. Surgical cuts to sever the output of the DCN, the dorsal acoustic stria (DAS), gave insight into the origin of these early and late responses. Cuts eliminated early responses but had little-to-no effect on late responses. The early responses thus originate from cells that project through the DAS, such as DCN's pyramidal and giant cells. Late responses likely arise from the spread of stimulation from a DCN-placed electrode array to the VCN and could originate in bushy and/or stellate cells. In human ABI users, the spread of stimulation in the CN may result in abnormal response patterns that could hinder performance. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.