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.

Posterior fossa decompression for children with Chiari I malformation and hydrocephalus

xlomafota13 shared this article with you from Inoreader Posterior fossa decompression for children with Chiari I malformation and hydrocephalus Via leak of cerebrospinal fluid Childs Nerv Syst. 2021 Oct 20. doi: 10.1007/s00381-021-05377-4. Online ahead of print. ABSTRACT INTRODUCTION: Chiari I malformation (CMI) and hydrocephalus often coexist, with no clear understanding of the cause-and-effect relationship. In the absence of other associated etiologies, the traditional teaching has been to treat the hydrocephalus first, partly to minimize the risk of cerebrospinal fluid (CSF) leak from CMI decompression in the setting of elevated ICP. We describe a series of consecutive pediatric patients with CMI and hydrocephalus, the majority of whom were managed with posterior fossa decompression. METHODS: A retrospective review was conducted on consecutive children who presented to the senior author with both hydrocephalus and CMI, with emphasis on rationale for and outcomes of surgical intervention, including the need for additional surgery. RESULTS: There were 14 patients aged 2 weeks to 16 years (median 2 year s) who presented with Chiari I and hydrocephalus. Four of these underwent posterior fossa decompression without duraplasty (PFD) as first-line therapy (one of whom eventually required duraplasty), 7 had PFD with duraplasty (PFDD), 1 received a ventriculoperitoneal shunt (VPS), and two had endoscopic third ventriculostomy (ETV). Of the 11 who had PFD/D, 9 (90%) had significant symptom improvement/resolution, 7 (55%) showed decrease in ventricle size, and 1 (10%) required VPS placement for persistent hydrocephalus. Both ETV patients improved clinically, and 1 showed decrease in ventricle size. There were no pseudomeningoceles, infections, or neurological deficits. One CSF leak occurred after an ETV and was successfully treated with wound revision. CONCLUSION: In patients with both CMI and hydrocephalus, treating the CMI first in an effort to avoid a shunt can be safe and effective. In this series, PFDD in the setting of hydrocephalus did not result in CSF leak or pseudomeningoce le. While limited by a small sample size, these data support a causative relationship between CMI and hydrocephalus. PMID:34671850 | DOI:10.1007/s00381-021-05377-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Iatrogenic Cervical Epidermoid Cyst Following Tracheostomy

xlomafota13 shared this article with you from Inoreader Iatrogenic Cervical Epidermoid Cyst Following Tracheostomy Via ear nose throat Ear Nose Throat J. 2021 Oct 20:1455613211053423. doi: 10.1177/01455613211053423. Online ahead of print. ABSTRACT Epidermoid cysts are generally benign lesions surrounded by squamous epithelium with cystic contents. The lining of the cysts produce keratin, which resemble a cheese-like material. They typically occur in the skin and mucous membranes and are congenital in origin; iatrogenic epidermoid cysts are rare. Epidermoid cysts are usually painless and asymptomatic, and the ir diagnosis is based on histological examination. This paper aims to present the case report of a 23-year-old patient with an iatrogenic epidermoid cyst that occurred following tracheostomy. The importance of preoperative radiological imaging in the diagnosis of epidermoid cysts is also highlighted. PMID:34670428 | DOI:10.1177/01455613211053423 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Jaw-retraction exercise increases anterior hyoid excursion during swallowing in older adults with mild dysphagia

xlomafota13 shared this article with you from Inoreader Jaw-retraction exercise increases anterior hyoid excursion during swallowing in older adults with mild dysphagia Via swallowing exercises Gerodontology. 2021 Oct 20. doi: 10.1111/ger.12595. Online ahead of print. ABSTRACT OBJECTIVES: The present study aimed to evaluate the effectiveness of a newly designed jaw-retraction exercise for strengthening the geniohyoid muscle and thus improving the anterior movement of the hyoid bone during swallowing. BACKGROUND: Although previous studies suggest a relationship between anterior hyoid excursion and upper esophageal sphincter (UES) opening, there are currently no repor ts of physical exercises without the use of special equipment that can effectively improve this movement of the hyoid bone during swallowing. MATERIALS AND METHODS: This before-after study included patients presenting to the authors' hospital with mild dysphagia (Level 5 on the Dysphagia Outcome and Severity Scale). The participants were instructed to perform a jaw-retraction exercise designed to strengthen the geniohyoid muscle. Each participant was instructed to perform two sets of the exercise daily for four weeks, with each set consisting of five repetitions. Before and after the four-week training period, videofluoroscopic swallowing studies were performed and later analysed. RESULTS: Twenty-five patients with a median age of 77 were included. The median peak anterior hyoid position before and after exercise were 129.82 and 132.74 (%C2-C4 length), respectively, and this increase was found to be significant (P = .007). The median extent of UES opening before and afte r exercise were 8.6 and 9.3 (mm), respectively, and this increase was also found to be significant (P = .040). CONCLUSION: Our findings demonstrate that the jaw-retraction exercise can effectively improve the anterior movement of the hyoid bone. This exercise may be effective in individuals with oral frailty when signs of swallowing disorders are observed. PMID:34672024 | DOI:10.1111/ger.12595 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High FITM2 expression promotes cell migration ability of hepatocellular carcinoma by regulating the formation of caveolae and indicates poor patient survival

xlomafota13 shared this article with you from Inoreader High FITM2 expression promotes cell migration ability of hepatocellular carcinoma by regulating the formation of caveolae and indicates poor patient survival Via Cellular and Molecular Biology Histol Histopathol. 2021 Oct 21:18382. doi: 10.14670/HH-18-382. Online ahead of print. ABSTRACT BACKGROUND: Hepatocellular carcinoma (HCC) is among the most malignant tumors with high recurrence and low 5-year survival rate. Lipid metabolism is essential in tumor metastasis, although how altered lipid metabolism promotes HCC progression has not been well elucidated. Fat Storage Inducing Transmembrane Protein 2 (FITM2) is a gene involved in lipid homeostasis and cytoskeletal organization; however, its role in regulating tumor biological behavior has not been evaluated. METHODS: In this study, immunohistochemistry was performed to evaluate the expression of FITM2 in HCC. Univariate and multivariate analysis was performed to identify the prognostic factors. RNA interference wound healing and transwell experiments were performed to analyze the biological role of FITM2. Western blot analysis was performed to investigate the potential downstream signaling. RESULTS: The results revealed that FITM2 was highly expressed in the intratumoral tissues of HCC. Expression of intratumoral FITM2 was associated with microvascular invasion. FITM2 is an independent risk factor of HCC disease-free survival and overall survival. In vitro studies revealed that knockdown of FITM2 significantly inhibited the migration ability of HCC cells. FITM2 promotes HCC cell migration by regulating the expression of caveolin-1 and promoting the formation of caveolae. These results indicate that high intratumoral expression of FITM2 is associated with poor HCC prognosis, which may be applied to develop a new adjuvant therapy. PMID:34672358 | DOI:10.14670/HH-18-382 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Case 32-2021: A 14-Year-Old Girl with Swelling of the Jaw and Hypercalcemia

xlomafota13 shared this article with you from Inoreader Message: A 14-year-old girl presented with progressive swelling of the jaw. Six weeks before this admission, a nonpainful lump in the left lower jaw developed. The mass increased in size, and swelling of the left side of the face and neck developed. A biopsy specimen from the mass showed abundant giant cells. The calcium level was 11.8 mg per deciliter. Giant cell, also called Langhans giant cell, large cell characterized by an arc of nuclei toward the outer membrane. The cell is formed by the fusion of epithelioid cells, which are derived from immune cells called macrophages. Once fused, these cells share the same cytoplasm, and their nuclei become arranged in an arc near the outer edge of the cell. Langhans giant cells typically form at the centre of granulomas (aggregates of macrophages) and are found in the tubercle, or primary focus of infection, in tuberculosis, in lesions of syphilis, leprosy, and sarcoidosis, and in fungal infections. Large cells that form by fusion in reaction to the presence in the body of foreign substances differ from Langhans giant cells in that their many nuclei are scattered throughout the cell. In giant-cell tumours of bone and tendon the cells have many nuclei crowded together. The megakaryocytes, the normal bone-marrow cells thought to be the source of the blood platelets, are also called giant cells. Case 32-2021: A 14-Year-Old Girl with Swelling of the Jaw and Hypercalcemia Via The New England Journal of Medicine: Otolaryngology Presentation of Case. Dr. Austin Be (Surgery): A 14-year-old girl was admitted to this hospital because of swelling of the left jaw. The patient had been well until 6 weeks before this admission, when she noticed a lump in the left lower jaw; there was no pain, tenderness, or discomfort in the jaw.… View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.