Understanding Extremely Elevated Dizziness Handicap Inventory Scores: An Analysis of Predictive Factors

xlomafota13 shared this article with you from Inoreader Understanding Extremely Elevated Dizziness Handicap Inventory Scores: An Analysis of Predictive Factors Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Oct 25:34894211053788. doi: 10.1177/00034894211053788. Online ahead of print. ABSTRACT BACKGROUND: The Dizziness Handicap Inventory (DHI) measures impairment in quality of life due to dizziness, with higher scores indicating greater impairment. Little is known about the clinical features that predict extremely elevated DHI scores (eeDHI). OBJECTIVE: To identify clinical features associated with eeDHI. METHODS: A retrospective analysi s was conducted of 217 patients with dizziness between October 2016 and April 2019. Patients with eeDHI had DHI scores 1 standard deviation higher than the mean. Analyses were performed to generate odds ratios (OR) for having eeDHI based on clinical features and exam findings. RESULTS: The cut-off for eeDHI scores was 71. In total, 20.7% had eeDHI. Logistic regression identified 6 independent predictors for eeDHI scores: numbness in the face or body during dizziness (OR = 5.99, 95% CI 1.77-20.30), history of falls (OR = 4.37, 95% CI 1.74-10.97), female sex (OR = 2.81, 95% CI 1.18-6.66), caloric weakness (OR = 2.61, 95% CI 1.36-5.01), total number of diagnoses associated with dizziness (OR = 2.17, 95% CI 1.11-4.28), and total number of symptoms during dizziness (OR = 1.25, 95% CI 1.07-1.45). CONCLUSIONS: These findings suggest that patients with eeDHI have severe disease and should be screened for falls. By understanding the drivers of high DHI scores, we can alleviate di sease related suffering for vestibular disorders. PMID:34694153 | DOI:10.1177/00034894211053788 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical significance of the cognition-related pathogenic proteins in plasma neuronal-derived exosomes among normal cognitive adults over 45 years old with olfactory dysfunction

xlomafota13 shared this article with you from Inoreader Clinical significance of the cognition-related pathogenic proteins in plasma neuronal-derived exosomes among normal cognitive adults over 45 years old with olfactory dysfunction 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 Oct 24. doi: 10.1007/s00405-021-07143-3. Online ahead of print. ABSTRACT OBJECTIVES: Exosomal Phospho-Tau-181(P-T181-tau), Total tau (T-tau), and amyloid-β peptide 42 (Aβ42) have been proved the capacity for the amnestic mild cognitive impairment (MCI) and the diagnosis of Alzheimer's disease (AD). This study aimed to explore the cognitive function and the levels of P-T181-tau, T-tau, and Aβ42 in neuronal-derived exosomes (NDEs) extracted from plasma in normal cognitive adults over 45 years old with olfactory dysfunction. METHODS: A cross-sectional survey of 29 participants aged over 45 was conducted. Plasma exosomes were isolated, precipitated, and enriched by immuno-absorption with anti- L1 cell adhesion molecule (L1CAM) antibody. NDEs were characterized by CD81, and extracted NDE protein (P-T181-tau, T-tau, and Aβ42) biomarkers were quantified by enzyme-linked immunosorbent assay (ELISAs). O lfactory performance was assessed by Sniffin' Sticks and cognitive performance was assessed by Montreal Cognitive Assessment (MoCA). RESULTS: There was no significant difference between adults with olfactory dysfunction and without olfactory dysfunction regarding the cognitive function as measured by MoCA and all the participants showed normal cognition. Adults with olfactory dysfunction showed a higher concentration of P-T181-tau in plasma NDEs than did adults without olfactory dysfunction (P = 0.034). Both the levels of P-T181-tau (r = - 0.553, P = 0.003) and T-tau (r = - 0.417, P = 0.034) negatively correlated with the odor identification scores. In addition, the level of T-tau negatively correlated with MoCA scores (r = - 0.597, P = 0.002). The levels of P-T181-tau (r = - 0.464, P = 0.022) and T-tau (r = - 0.438, P = 0.032) negatively correlated with the delayed recall scores. CONCLUSIONS: This study demonstrated that cognition-related pathogenic proteins including P -T181-tau in plasma NDEs were significantly increased in adults over 45 years old with olfactory dysfunction before the occurrence of cognitive impairment. The impaired odor identification and the delayed recall function were highly associated with the increased levels of P-T181-tau and T-tau in plasma NDEs. PMID:34693486 | DOI:10.1007/s00405-021-07143-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Biomarkers in Otolaryngology-Head and Neck Surgery

xlomafota13 shared this article with you from Inoreader Message: The number of biomarkers in use in otolaryngology is rapidly expanding representing a new diagnostic modality for our field. This review defines the key biomarkers that are currently or likely to be soon translated into clinical use within the field of otolaryngology. The majority of these biomarkers are in the form of proteins such as beta-2 transferrin, thyroglobulin, and P16. Given their growing impact on diagnosis, management and surveillance of otolaryngologic disorders periodic surveys are needed for education and to guide further advances and applications of otolaryngologic biomarkers. What is a beta 2 transferrin test? Beta-2-transferrin is a form of the protein transferrin that is present in cerebrolspinal fluid (CSF), but not usually found in blood, nasal secretions or other body fluids. It is used to distinguish CSF from other watery discharge from the nose or ear after a traumatic injury to the brain and or spine. What does a high thyroglobulin mean? Your thyroglobulin levels are high and/or have increased over time. This may mean thyroid cancer cells are growing, and/or cancer is starting to spread. Little or no thyroglobulin was found. This may mean that your cancer treatment has worked to remove all thyroid cells from your body. What is p16 positive mean? Abstract. Expression of p16INK4A (p16 positive) is highly correlated with human papilloma virus (HPV) infection in head and neck squamous cell carcinoma (HNSCC), however, p16-positivity is not limited to HPV positive tumors and therefore, not a perfect surrogate for HPV. Clinical Biomarkers in Otolaryngology-Head and Neck Surgery Via ear nose throat Ear Nose Throat J. 2021 Oct 25:1455613211050698. doi: 10.1177/01455613211050698. Online ahead of print. ABSTRACT OBJECTIVE: The purpose of this paper is to review the literature and compile promising and clinically relevant biomarkers in otolaryngology-head & neck surgery not related to autoimmune disorders. STUDY DESIGN: Narrative review. METHODS: PubMed and Google Scholar were queried using combined key words such as "biomarkers" and "otolaryngology." Addit ional queries were made with combined key words such as "biomarkers" and a particular subspecialty such as "rhinology" or "otology" to maximize yield of relevant titles. Subsequently, specific biomarkers identified, such as "beta-2 transferrin," were used as key words. Relevant titles were reviewed and selected for abstract review. Applicable abstracts were then selected for review of the full text. RESULTS: Biomarkers currently in clinical use within the field of otolaryngology were included in this review. The compiled biomarkers were then detailed individually regarding their molecular characteristics, function, and clinical significance. CONCLUSIONS: The number of biomarkers in use in otolaryngology is rapidly expanding representing a new diagnostic modality for our field. This review defines the key biomarkers that are currently or likely to be soon translated into clinical use within the field of otolaryngology. The majority of these biomarkers are in the form of p roteins such as beta-2 transferrin, thyroglobulin, and P16. Given their growing impact on diagnosis, management and surveillance of otolaryngologic disorders periodic surveys are needed for education and to guide further advances and applications of otolaryngologic biomarkers. PMID:34694171 | DOI:10.1177/01455613211050698 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Real-World Efficacy and Safety of Multi-Tyrosine Kinase Inhibitors in Radioiodine Refractory Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Real-World Efficacy and Safety of Multi-Tyrosine Kinase Inhibitors in Radioiodine Refractory Thyroid Cancer Via liebertpub1 Thyroid, Volume 31, Issue 10, Page 1531-1541, October 2021. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Human papilloma virus in the etiopathogenesis of allergic nasal polyposis: A prospective study

xlomafota13 shared this article with you from Inoreader Human papilloma virus in the etiopathogenesis of allergic nasal polyposis: A prospective study Via American Journal of Otolaryngology Publication date: January–February 2022 Source: American Journal of Otolaryngology, Volume 43, Issue 1 Author(s): Avinash Shekhar Jaiswal, Pranay Tanwar, David Victor Kumar Irugu, Kapil Sikka, Rabia Monga, Alok Thakar, Hitesh Verma View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association Between Asthma and Meniere's Disease: A Nested Case–Control Study

xlomafota13 shared this article with you from Inoreader Association Between Asthma and Meniere's Disease: A Nested Case–Control Study Via The Laryngoscope Objectives/Hypothesis This study aimed to investigate the association between Meniere's disease and prior history of asthma. Study Design A nested case-control study. Methods Among the patients aged ≥40 years from the Korean National Health Insurance Service-Health Screening Cohort 2002–2015, 7,734 diagnosed with Meniere's disease between 2004 and 2015 were enrolled in this study. From the 505,834 participants without a prior history of Meniere's disease, 30,936 control participants were selected based on age, sex, income, and region of residence. The presence of a prior history of asthma before the diagnosis of Meniere's disease was compared between the Meniere's disease group and control group using conditional logistic regression with odds ratios (ORs) and 95% confidence intervals (95% CIs). Results Prior history of asthma was associated with 1.30 (1.21–1.39) times higher odds of Meniere's disease (E-value = 1.92 [1.71]). Both allergic asthma and nonallergic asthma patients demonstrated higher odds of Meniere's disease than the control group (adjusted OR = 1.21 [1.08–1.36] and E-value = 1.72 [1.37] for allergic asthma; adjusted OR = 1.26 [1.17–1.36] and E-value = 1.83 [1.60] for nonallergic asthma). Conclusions This study is the first to demonstrate a positive relationship between Meniere's disease and prior asthma history in adults. The association between prior asthma history and Meniere's disease was noted in both allergic and nonallergic asthma cases. The potential development of Meniere's disease should be considered when managing the asthma patients with dizziness or vertigo. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cutibacterium acnes and Staphylococcus epidermidis: the unmissable modulators of skin inflammatory response

xlomafota13 shared this article with you from Inoreader Cutibacterium acnes and Staphylococcus epidermidis: the unmissable modulators of skin inflammatory response Via Experimental Dermatology Abstract Acne is a multifactorial inflammatory dermatose that affects all age categories from teenagers to adults, resulting in important psychological impacts. Multiple hypotheses currently attempt to decrypt the physiopathology of this disease, and four main actors were identified as highly implicated in it: hyperkeratinization of the pilosebaceous follicle, hyperseborrheae, host factors (innate immunity) and skin microbiota. In this letter, we present results illustrating the impact of skin microbiota on inflammatory skin response, and how far the proper balance between each bacterial community, especially C. acnes and S. epidermidis, is crucial to maintain an appropriate inflammatory response on the skin. The data presented in this study demonstrate that within the skin microbiota, an imbalance between Cutibacterium acnes and Staphylococcus epidermidis, is able to induce the activation of inflammation-related markers such as IL-1ra, IL-6, IL-8, G-CSF, and th e molecules C5 / C5a, soluble CD14 MIP-3beta, Serpin E1, VCAM-1 and beta-defensin-2. Moreover, S. epidermidis appears to have a more important role than C. acnes on the induction of inflammation-related markers, particularly on IL-6. This work is the basis of future in vitro studies to further understand acne physiopathology, inspiring the development of future innovative therapies based on skin microbiota modulation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Access and Polarization Electrode Impedance Changes in Electric-Acoustic Stimulation Cochlear Implant Users with Delayed Loss of Acoustic Hearing

xlomafota13 shared this article with you from Inoreader Access and Polarization Electrode Impedance Changes in Electric-Acoustic Stimulation Cochlear Implant Users with Delayed Loss of Acoustic Hearing Via Journal of the Association for Research in Otolaryngology Abstract Acoustic hearing can be preserved after cochlear implant (CI) surgery, allowing for combined electric-acoustic stimulation (EAS) and superior speech understanding compared to electric-only hearing. Among patients who initially retain useful acoustic hearing, 30–40 % experience a delayed hearing loss that occurs 3 or more months after CI activation. Increases in electrode impedances have been associated with delayed loss of residual acoustic hearing, suggesting a possible role of intracochlear inflammation/fibrosis as reported by Scheperle et al. (Hear Res 350:45–57, 2017) and Shaul et al. (Otol Neurotol 40(5):e518–e526, 2019). These studies measured only total impedance. Total impedance consists of a composite of access resistance, which reflects resistance of the intracochlear environment, and polarization impedance, which reflects resistive and capacitive properties of the electrode–electrolyte interface as described by Dymond (IEEE Trans Biomed Eng 23(4):274–280, 1976) and Tykocinski et al. (Otol Neurotol 26(5):948–956, 2005). To explore the role of access and polarization impedance components in loss of residual acoustic hearing, these measures were collected from Nucleus EAS CI users with stable acoustic hearing and subsequent precipitous loss of hearing. For the hearing loss group, total impedance and access resistance increased over time while polarization impedance remained stable. For the stable hearing group, total impedance and access resistance were stable while polarization impedance declined. Increased access resistance rather than polarization impedance appears to drive the increase in total impedances seen with loss of hearing. Moreover, access resistance has been correlated with intracochlear fibrosis/inflammation in animal studies as observed by Xu et al. (Hear Res 105(1–2):1–29, 1997) and Tykocinski et al. (Hear Res&n bsp;159(1–2):53–68, 2001). These findings thus support intracochlear inflammation as one contributor to loss of acoustic hearing in our EAS CI population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of an Autoinflation Device Does Not Lead to a Clinically Meaningful Change in Hearing Thresholds in Children With Otitis Media With Effusion

xlomafota13 shared this article with you from Inoreader Use of an Autoinflation Device Does Not Lead to a Clinically Meaningful Change in Hearing Thresholds in Children With Otitis Media With Effusion Via Clinical Otolaryngology Abstract Objectives The objective of this study was to establish whether autoinflation was an effective intervention in a paediatric audiology service. The aims were to evaluate whether there was improvement in hearing thresholds following introduction of an autoinflation device, and whether there was a reduction in further audiology follow-ups, and in referrals to an ear, nose and throat specialist for consideration of ventilation tube insertion. Design This was a pragmatic retrospective study with historical controls using a paired availability design at a single paediatric audiology service in England. Participants All children seen in the clinic over a two-year period who were aged between 3 and 11 years and who had a type B tympanogram in at least one ear were included. The Otovent autoinflation device was available as a treatment option over the second year (Cohort B) but not the first (Cohort A). There were 976 children included in the study: Cohort A comprised 513 children, Cohort B comprised 463 children. Results There was a statistically significant improvement in hearing thresholds in Cohort B compared to Cohort A, however the improvements were clinically minimal with small effect sizes. There was no significant difference in improvement of tympanometry results between the two cohorts. Significantly more children in Cohort B (autoinflation group) were referred to an ear, nose and throat specialist after their second appointment compared to Cohort A. Conclusions It was feasible to introduce autoinflation into the care pathway, however there was no evidence of clinically meaningful improved outcomes for patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Novel Adenoidectomy Training System

xlomafota13 shared this article with you from Inoreader A Novel Adenoidectomy Training System Via The Laryngoscope Objectives/Hypothesis Young residents find mirror-guided adenoidectomy difficult. Inexperienced trainees must learn to focus a headlight beam, work upside-down and backward in a small space and thoroughly ablate adenoid tissue—all new skills. We present an adenoidectomy training system that is low-cost, easy to construct, and is focused on these basic adenoidectomy skills. Study Design Prospective experimental study. Methods This training suite includes three stations each targeting a different skill. The first employs a mannequin head with exposed nasopharynx. It trains the student to coordinate a headlight and mirror while touching a series of targets with a curved probe. At the second station participants electrodessicate (or microdebride) an anchored piece of veal thymus. The third station combines both sets of skills as participants ablate thymus in a simulated nasopharynx (30 mm rectangular aluminum tube) constrained within a Crow-Davis retractor, using a headlight, mirror, and suction electrosurgical electrode (or microdebrider). To evaluate the training system's efficacy, we assessed the performance of 10 surgically naïve medical student volunteers before and after 15 minutes of practice using a validated rating scale used for adenoidectomy. Results There was significant improvement in adenoidectomy skill scores after practicing. Overall scores were higher, time taken to touch a series of targets with a headlight and mirror was less and amount of tissue ablated at the final station was greater (P < .05). Conclusion This novel adenoidectomy training system is inexpensive and easy to build. Practice with the model resulted in statistically significant improvement in adenoidectomy skill scores for inexperienced student surgeons. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lateral border and scapular tip free flaps: Old school versus new school

xlomafota13 shared this article with you from Inoreader Lateral border and scapular tip free flaps: Old school versus new school Via Head & Neck Abstract Free tissue transfer from the subscapular system provides a wide array of options for both soft tissue and bony reconstruction. When bone stock is required for head and neck reconstruction, both the lateral scapular border free flap (LSBFF), supplied by the circumflex scapular artery, and the scapular tip free flap (STFF), supplied by the angular artery, are excellent options. Issues with positioning had previously prevented the widespread use of these bony subscapular system flaps. However, through the use of a Spider Limb Positioner, current clinical practice patterns allow for two team approaches in both of these free flaps. The following pictorial essay compares and contrasts the specific positioning and harvesting technique used for both the LSBFF and STFF, while discussing the clinical advantages and drawbacks of each. Both the lateral border scapula and scapular tip free flaps provide excellent bone stock for head and neck reconstruction. By positioning with currently avail able technology, both of these free flaps can be harvested through a two team approach. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.