Features of the clinic, diagnosis and treatment of parapharyngeal abscesses in children: analysis of 121 observations

xlomafota13 shared this article with you from Inoreader Features of the clinic, diagnosis and treatment of parapharyngeal abscesses in children: analysis of 121 observations Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):62-68. doi: 10.17116/otorino20218606162. ABSTRACT Parapharyngeal and retropharyngeal abscesses (PPA) in children are a rare pathology, for the diagnosis of which it is necessary to use additional instrumental examination methods. The tactics of treating patients remains a subject of discussion. OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of PPA in children. MATERIAL AND METHODS: According to the hospital database, a retrospective analysis of the medical histories of children discharged from the clinic with a diagnosis of "J39.0 Retropharyngeal and parapharyngeal abscess" was carried out in the period from 01.01.14 to 31.12.19. In all cases, the diagnosis was confirmed by computed tomography (CT) data with contrast enhancement. Complaints at the time of treatment, anamnesis and instrumental diagnosis data, clinical features of the course of the disease and the e ffectiveness of treatment were analyzed. RESULTS: 121 children were treated for PPA (average age 73±41 months; Me=52.5 months), which is 0.4% of all hospitalized in the otorhinolaryngological department, 0.7% of the number of emergency hospitalizations, 0.8% of the number of hospitalized children with pharyngeal diseases, and 8.3% of the number of patients with pharyngeal abscess. Abscesses were more often localized in the upper pharynx, at the level of the I-II cervical vertebrae (49.6% of all observations); abscesses were found least often in the pharyngeal space (5.8%), there was no statistically significant difference between the right-sided and left-sided location: 47.9% and 46.2%, respectively. Surgical treatment was performed in 98 (81%) patients in the presence of an abscess capsule or an abscess diameter of more than 2 cm according to CT; the remaining 23 (19%) children were treated conservatively. The opening of the abscess was performed endopharyngeal, in the case of a pronounced deep lateral location of the abscess and its proximity to large blood vessels - with access through the tonsillar niche after preliminary tonsillectomy (19.4% of those operated). CONCLUSION: The final diagnosis of parapharyngeal and retropharyngeal abscess can be established by contrast-enhanced computed tomography. Conservative treatment is indicated for a limited group of patients at the initial stages of the disease, most patients need surgical treatment. PMID:34964332 | DOI:10.17116/otorino20218606162 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis

xlomafota13 shared this article with you from Inoreader Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):105-112. doi: 10.17116/otorino202186061105. ABSTRACT The review presents the current understanding of the pathogenesis of chronic rhinosinusitis. The causes of damage to the mucous membrane of the paranasal sinuses are most often the result of a combination of immunological, infectious and anatomical factors. This indicates the need for a multidisciplinary approach to the study of the pathogenesis of this pathology. There is no single universally recognized classification of chronic rhinosinusitis, which takes into account histological and immunological changes in the mucous membrane of the paranasal sinuses. The discovery of the mechanism of completion of the life cycle of neutrophils - the formation of a neutrophil extracellular trap or NETosis, different from necrosis and apoptosis, opened up new prospects in the study of the pathogenesis of inflammatory processes, including rhinosinusitis. Neutroph il extracellular traps reduce the permeability of the epithelial barrier in the mucous membrane of the paranasal sinuses. This determines their possible role in the etiopathogenesis of rhinosinusitis. In recent years, more and more attention has been paid to the feasibility, effectiveness and safety of therapy that affects the immune component of the inflammatory process, including NETosis. The data obtained in the study of extracellular traps can be used in clinical practice. It is neutrophil extracellular traps that can become a potential target in the treatment of patients with chronic rhinosinusitis. PMID:34964339 | DOI:10.17116/otorino202186061105 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case of ear miasis in a 2-month-old child

xlomafota13 shared this article with you from Inoreader A case of ear miasis in a 2-month-old child Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):113-116. doi: 10.17116/otorino202186061113. ABSTRACT A clinical case is presented - a rare observation of ear myasis in a 2-month-old child. PMID:34964340 | DOI:10.17116/otorino202186061113 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal cysts in children

xlomafota13 shared this article with you from Inoreader Laryngeal cysts in children Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):57-61. doi: 10.17116/otorino20218606157. ABSTRACT Laryngeal cysts in children are relatively rare, occupying the 4-5th place in the structure of congenital malformations. The paper presents the combined experience of two Russian pediatric otorhinolaryngological clinics traditionally involved in the rehabilitation of patients with congenital and acquired pathology of the larynx. OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of laryngeal cysts in children. MATERIAL AND METHODS: The study included 68 children with laryngeal cysts aged from 3 days to 16 years (on average 39.5±37.0 months, Me=15.5 months). The cyst was localized in the vestibular region of the larynx in 15 (22.1%) patients, in the vocal region - in 15 (22.1%) patients, and in the sub-vocal region - in 38 (55.9%) patients. Data on the presence of a history of tracheal intubation were available in 35 ( 89.7%) children, including 35 (92.1%) of 38 children with a subfold cyst. 11 patients were admitted with a previously applied tracheostomy. RESULTS: The main reasons for going to the clinic were signs of laryngeal stenosis (stridor, signs of obstruction of the upper airways) in 60.3% of patients, dysphonia - in 33.8%, and in 5.9%, the detection of a cyst became an accidental finding. To eliminate the cyst, the method of laser marsupialization was used in 10 patients, coagulatory ablation - in 2 patients, in the remaining 56 patients, decortication was performed with microinstruments, followed by laser treatment of the cyst bed. In the follow-up, children were traced from 6 months to 7 years. We did not observe a recurrence of a cyst in any case. CONCLUSION: Currently, the lining department is the "favorite" localization of the cyst in childhood. Subclavian cysts are more common in preterm infants who need tracheal intubation. A necessary condition for radical elimination is the resection of the cyst walls. PMID:34964331 | DOI:10.17116/otorino20218606157 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Hypothalamic Paraventricular Nucleus Is the Center of the Hypothalamic–Pituitary–Thyroid Axis for Regulating Thyroid Hormone Levels

xlomafota13 shared this article with you from Inoreader The Hypothalamic Paraventricular Nucleus Is the Center of the Hypothalamic–Pituitary–Thyroid Axis for Regulating Thyroid Hormone Levels Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Local radiotherapy versus nonradiotherapy to distant lesions for metastatic nasopharyngeal carcinoma: A retrospective cohort study

xlomafota13 shared this article with you from Inoreader Local radiotherapy versus nonradiotherapy to distant lesions for metastatic nasopharyngeal carcinoma: A retrospective cohort study Via Head & Neck Abstract Background To evaluate the efficiency of local radiotherapy to metastatic lesions in patients with metastatic nasopharyngeal carcinoma (mNPC). Methods The overall survival was observed and compared for mNPC patients who received local radiotherapy versus nonradiotherapy to metastatic lesions by using the Kaplan–Meier method and Cox analysis. Results One hundred and nine patients with NPC were involved in this study, with 61 (56.0%) received radiotherapy to metastatic sites and 48 (44.0%) did not receive radiotherapy to metastatic sites. The 2- and 5-year OS for patients who received local radiotherapy to metastatic lesions were 65.8% and 35.7%, and for patients who did not receive radiotherapy to metastatic lesions were 45.3% and 26.2%. The multivariable adjusted hazard radios for local radiotherapy versus nonradiotherapy to metastatic lesions were 0.482 (95% confidence interval is 0.278–0.834, p = 0.009). Conclusions Local radiotherapy to metastatic lesions might be a protective factor for patients with mNPC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of the middle turbinate during and after sinus surgery

xlomafota13 shared this article with you from Inoreader Management of the middle turbinate during and after sinus surgery Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review Treatment of the middle turbinate (MT) during and after endoscopic sinus surgery (ESS) has been controversial. Historically, there has been concern that resection of the MT may result in smell loss and frontal sinus stenosis. However, these concerns must be balanced by knowledge that a residual diseased MT may result in surgical failure. This review discusses the current evidence on treatment of the MT during and after ESS. Recent findings Several review articles have shown the safety of performing MT resection. Studies have not shown increase rates of frontal sinus stenosis, olfactory loss, or empty nose syndrome. However, the benefit of MT resection is highly debated. There have also been many recent advances and technological developments to assist in management of the postoperative MT. Summary The literature supports the safety of performing MT resection, however, the benefit of resection over preservation is controversial. New technologies and techniques exist that may aid in preventing postoperative MT lateralization. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Flap survival and functional outcomes in elbow soft tissue reconstruction: A 25-year systematic review

xlomafota13 shared this article with you from Inoreader Flap survival and functional outcomes in elbow soft tissue reconstruction: A 25-year systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 2:S1748-6815(21)00637-9. doi: 10.1016/j.bjps.2021.11.091. Online ahead of print. ABSTRACT INTRODUCTION: Different elbow flap reconstructions have been described in the literature. We aim to define the optimal flap technique based on defect size and etiology. METHODS: A systematic review was undertaken using the terms "(Elbow reconstruction) AND ((Soft tissue) OR (flap))". Flaps were grouped under fasciocutaneous (FCF), muscular (MF), distant pedicled (DPF), and free flaps (FF). The primary outcome was flap survival. The secondary outcomes were postoperative complications and range of motion (pROM). RESULTS: Twenty articles with 224 patients were included. Defect sizes were small (<10 cm2) (18%), medium (10-30 cm2) (23%), large (30-100 cm2) (43%), and massive (>100 cm2) (16%). Etiologies included trauma (26%), burn contractures (26%), i nfection (26%), hardware coverage (16%), and others (6%). FCF (54%) was the preferred flap followed by MF (28%), DPF (13%), and FF (5%). The rate of flap necrosis was 4% and that of other complications was 10%. The postoperative range of motion (pROM) (reported in 154 patients) was >100°, 50-100°, and <50° in 82%, 17%, and 1% of the cases, respectively. Small defects were most commonly reconstructed with MFs (83%), medium defects were reconstructed with MFs (52%) or FCFs (46%), and large defects were reconstructed with FCFs (91%). Massive defects predominantly required DPFs (60%) and FFs (26%). FCFs were the most common reconstruction method for burn contractures (84%), infections (55%), and traumatic defects (51%). Hardware coverage was predominantly performed using MFs (86%). No difference in complications and pROM was found between flap techniques. CONCLUSION: Elbow flap reconstruction can be performed using different techniques. FCFs are the most commonly used rec onstruction method. MFs are useful for smaller defects and hardware coverage. DPFs and FFs are needed for massive injuries. PMID:34961697 | DOI:10.1016/j.bjps.2021.11.091 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reversible Iodine Capture by Nonporous Adaptive Crystals of a Bipyridine Cage

xlomafota13 shared this article with you from Inoreader Reversible Iodine Capture by Nonporous Adaptive Crystals of a Bipyridine Cage Via radioactive iodine J Am Chem Soc. 2021 Dec 28. doi: 10.1021/jacs.1c11731. Online ahead of print. ABSTRACT The ability to capture radioactive iodine species is crucial for nuclear accident preparedness and nuclear waste treatment; however, it remains a challenge. Here we report a new readily obtainable nitrogen-rich nonporous cage (BPy-Cage) based on bipyridine building blocks that supports iodine capture. This cage is able to capture not only volatile iodine in vapor form but also iodine disso lved in various organic solvents or aqueous media with an iodine uptake capacity of up to 3.23 g g-1. The iodine within the cage (I2@BPy-Cage) can be released quickly upon immersing the bound solid form in DMF, allowing for control over acylation reactions. The cage solids reported here could be reused several times without substantial loss in their iodine capture performance. The effectiveness of the present system is ascribed to its ability to support strong iodine-bipyridine nitrogen lone pair interactions. PMID:34962800 | DOI:10.1021/jacs.1c11731 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation - A systematic review

xlomafota13 shared this article with you from Inoreader Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation - A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 5:S1748-6815(21)00628-8. doi: 10.1016/j.bjps.2021.11.076. Online ahead of print. ABSTRACT BACKGROUND: Pain after amputation can be known as residual limb pain (RLP) or phantom limb pain (PLP); however, both can be disabling in daily life with reported incidences of 8% for finger amputations and up to 85% for major limb amputations. The current treatment is focused on reducing the pain after neuropathic pain occurs. However, surgical techniques to prevent neuropathic pain after amputation are available and effective, but they are underutilized. The purpose of the review is to investigate the effects of techniques during amputation to prevent neuropathic pain. METHODS: A systematic review was performed in multiple databases (Embase, Medline, Web of Science, Scopus, Cochrane, and Google Scholar) and following the PRISMA guidelines. Studies that reported surgical techniques to prevent neuropath ic pain during limb amputation were included. RESULTS: Of the 6188 selected studies, 13 eligible articles were selected. Five articles reported techniques for finger amputation: neurovascular island flap, centro-central union (CCU), and epineural ligatures, and flaps. For finger amputations, the use of prevention techniques resulted in a decrease of incidences from 8% to 0-3% with CCU being the most beneficial. For major limb amputations, the incidences for RLP were decreased to 0 to 55% with TMR and RPNI and compared to 64-91% for the control group. Eight articles reported techniques for amputations on major limbs: targeted muscle reinnervation (TMR), targeted nerve implantation, concomitant nerve coaptation, and regenerative peripheral nerve interface (RPNI). CONCLUSIONS: Based on the current literature, we state that during finger and major limb amputation, the techniques to prevent neuropathic pain and PLP should be performed. PMID:34955394 | DOI:10.1016/j.bjps.2021.11.076 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Intramolecular Ionic Interaction Linking Defective Sodium/Iodide Symporter Transport to the Plasma Membrane and Dyshormonogenic Congenital Hypothyroidism

xlomafota13 shared this article with you from Inoreader An Intramolecular Ionic Interaction Linking Defective Sodium/Iodide Symporter Transport to the Plasma Membrane and Dyshormonogenic Congenital Hypothyroidism Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gustatory Function and Salivary Flow Rate in Healthy Adults

xlomafota13 shared this article with you from Inoreader Gustatory Function and Salivary Flow Rate in Healthy Adults Via The Laryngoscope Objectives/Hypothesis In this study, we assessed gustatory function and whole-mouth saliva in healthy adults and investigated the association between gustatory function, salivary flow rate (SFR), and dry mouth. Study Design Descriptive clinical study. Methods We recruited 413 participants who reported a normal sense of smell–taste, comprising 206 females and 207 males with an age range of 19 to 80 years. Taste scores were obtained using whole-mouth tests to evaluate the gustatory function, SFR was assessed using the spitting method, and dry mouth was measured with the visual analog scale. Results The total taste score (TTS) and SFR were significantly negatively correlated with age (r taste = −0.522, P < .001; r SFR = −0.200, P < .001): TTS was significantly lower after the age of 50 and SFR decreased significantly after age 65. Women exhibited a significantly higher TTS than men (P < .001). However, there was no effect of sex on SFR. Dry mouth was negatively correlated with TTS (r = −0.223, P < .01) and SFR (r = −0.218, P < .01). Multiple regression analysis showed the independent variables of age, sex, and dry mouth predicted 34% of the variation in taste, while the independent variables of age and dry mouth predicted 6.1% of the variation in whole-mouth saliva. TTS was not significantly correlated with the SFR in healthy adults (r = 0.094, P = .056). Conclusions Age and dry mouth are important factors affecting gustatory function and whole-mouth saliva, with women exhibiting better taste sensitivity than men. Furthermore, there is no direct correlation between SFR and gustatory function in healthy adults. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.