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.

Expression and clinical significance of lncRNA TCL6 in serum of patients with preeclampsia

xlomafota13 shared this article with you from Inoreader Expression and clinical significance of lncRNA TCL6 in serum of patients with preeclampsia Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):41. doi: 10.3892/etm.2021.10963. Epub 2021 Nov 12. ABSTRACT Preeclampsia is a common syndrome in pregnancy and a leading cause of mortality of pregnant females and their infants. To investigate the diagnostic and prognostic utility of lncRNA T-cell leukemia/lymphoma 6 (TCL6) in patients with preeclampsia, 120 singleton pregnant females with preeclampsia and another 100 healthy pregnant control subjects were analyzed in the present study. The expression of lncRNA TCL6 in the serum of the included patients was detected. Receiver operating characteristic curve analysis was applied to evaluate the efficiency of lncRNA TCL6 in terms of preeclampsia diagnosis and grading. Kaplan-Meier analysis was adopted to assess the effect of lncRNA TCL6 expression on the rate of adverse pregnancy. Multivariate logistic regression was used to determine high-risk factors of adverse pregnancy. The results indicated that lncRNA T CL6 was significantly increased in the serum of patients with preeclampsia. Furthermore, TCL6 was elevated in subgroups of patients with early-onset or severe preeclampsia and with Haemolysis, Elevated Liver enzymes and Low Platelet count syndrome in comparison with other patients with preeclampsia. High expression of TCL6 in pregnant females corresponded to a higher rate of adverse pregnancy outcomes. Severe preeclampsia, early-onset preeclampsia and high TCL6 expression were identified as independent risk factors for adverse pregnancy outcomes. For each unit increase in TCL6 expression, a 9.5-fold increase of the risk of adverse maternal and fetal outcomes was determined. Collectively, high expression of lncRNA TCL6 may assist the diagnosis and grading of preeclampsia and may be adopted as an independent risk factor for adverse pregnancy outcomes. PMID:34849156 | PMC:PMC8613530 | DOI:10.3892/etm.2021.10963 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute kidney injury in moderate and severe COVID-19 patients: Report of two university hospitals

xlomafota13 shared this article with you from Inoreader Acute kidney injury in moderate and severe COVID-19 patients: Report of two university hospitals Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):37. doi: 10.3892/etm.2021.10959. Epub 2021 Nov 10. ABSTRACT Acute kidney injury (AKI) is one of the most severe complications of SARS-CoV-2 infection. In a retrospective study, we aimed to describe the influence of COVID-19-related factors on the severity, outcome and timing of AKI in 268 patients admitted in two large COVID-19-designated university hospitals over a period of 6 months. In the univariate analysis, there was a significant relationship between KDIGO stage and the extension of COVID-19 pneumonia on computed tomography (CT), need for oxygen supplementation, serum levels of ferritin, interleukin-6, and procalcitonin, but none of these variables had a value for predicting KDIGO stage in multinomial regression. The odds of recovery of renal function were significantly diminished by d-dimer values. Lack of immunomodulatory treatment was found to be correlated with increased need for renal replacemen t therapy (RRT). Compared with AKI at admission, hospital-acquired AKI was predicted by the severity of lung damage on CT, evolved more frequently with incomplete recovery of renal function, and was significantly associated with antiviral therapy. PMID:34849152 | PMC:PMC8613528 | DOI:10.3892/etm.2021.10959 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Graves' Autoantibodies Exhibit Different Stimulating Activities in Cultures of Thyrocytes and Orbital Fibroblasts Not Reflected by Clinical Assays

xlomafota13 shared this article with you from Inoreader Graves' Autoantibodies Exhibit Different Stimulating Activities in Cultures of Thyrocytes and Orbital Fibroblasts Not Reflected by Clinical Assays Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Migration of Ventriculoperitoneal Shunt to Uterus In A Child: A Case Report

xlomafota13 shared this article with you from Inoreader Migration of Ventriculoperitoneal Shunt to Uterus In A Child: A Case Report Via leak of cerebrospinal fluid J Pediatr Adolesc Gynecol. 2021 Nov 26:S1083-3188(21)00343-0. doi: 10.1016/j.jpag.2021.11.004. Online ahead of print. ABSTRACT BACKGROUND: Ventriculo-peritoneal shunt (VPS) is usually placed inside the peritoneal cavity for cerebrospinal fluid drainage. Rarely, it can migrate to various pelvic visceral organs. Inside the pelvis, the distal end of the shunt can perforate anywhere from the uterus or adnexa to the vulva and migration through the uterus is extremely rare. CASE: A three-and-a-half-year-old girl presented with CSF leak through the vagina following uterine perforation by VPS. The diagnosis was made with an ultrasound. Her symptoms resolved following revision surgery. CONCLUSION: In a patient with a VPS in situ, presenting with a watery fluid leak through vagina, perforation of fornix or uterus must always be kept in mind. Timely diagnosis and intervention can result in the prevention of complications. PMID:34843976 | DOI:10.1016/j.jpag.2021.11.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Geographic disparities in head and neck cancer survival

xlomafota13 shared this article with you from Inoreader Geographic disparities in head and neck cancer survival in Upstate New York 2011–2019 Via Head & Neck Abstract Purpose To examine the association between distance to care-center and urban–rural residence on 5-year overall survival (OS) from head and neck cancer (HNC). Materials and methods Five-year OS was retrospectively measured from date of initial diagnosis for patients with HNC treated at a single tertiary care center. Distances were calculated based on ZIP code of patient's residence and care center. Multilevel Weibull regression was used to adjust for confounders and identify disparities in 5-year all-cause mortality. Results A total of 670 patients included in study. Multivariable analysis revealed older age or late-stage cancer at diagnosis, and HPV negative status were associated with poorer OS. Patients residing in isolated small rural town (HR = 2.20, p = 0.015) or small rural town (HR = 2.07, p = 0.015) had lower OS. Distance to care center was not associated with OS (HR = 0.996, p = 0.11). Conclusions Greater rurality was associated with poorer OS among HNC patients in Upstate New York. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Heads up reconstructive microsurgery: Utilisation of the three-dimensional microscope in microvascular procedures

xlomafota13 shared this article with you from Inoreader Heads up reconstructive microsurgery: Utilisation of the three-dimensional microscope in microvascular procedures Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 15:S1748-6815(21)00575-1. doi: 10.1016/j.bjps.2021.11.036. Online ahead of print. ABSTRACT BACKGROUND: Since the earliest use of microscopes in surgery, several modifications have been made to improve the ergonomics of movement and posture, increase the resolution, and expand the visual field. The three-dimensional microscopes are latest innovation in this field. Despite the wider use of 3D microscopes in other specialities, their use in the reconstructive microsurgery in the United Kingdom is still limited. Reconstructive microsurgeons are highly skilled surgeons that are trained to operate utilising the microscope for long hours. This poses an occupational risk with a specific pattern of work-related conditions. AIMS AND METHODS: We aim in this report to demonstrate our experience utilising 3D microscopes in small cohort of patients matched to a control of patients operated utilising the traditional microscopes. Patients were matched by age, comorbidities, oncologic procedures. This was complemented by a survey completed by the operating surgeons. RESULTS: Nine patients were included in each group. There was no significant difference in operative or ischemia time and no significant post-operative complications in both groups. The surgeons reported better ergonomics, improved staff engagement, and a better teaching experience when utilising the 3D microscopes compared to traditional microscopes. CONCLUSION: The utilisation of the 3D microscopes in reconstructive microsurgery has shown to provide comfort, improve ergonomics of movement and posture without significant clinical implications in this series. PMID:34844881 | DOI:10.1016/j.bjps.2021.11.036 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.