Current Status of Handheld Otoscopy Training: A Systematic Review

xlomafota13 shared this article with you from Inoreader Current Status of Handheld Otoscopy Training: A Systematic Review Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Feb 25:3489421997289. doi: 10.1177/0003489421997289. Online ahead of print. ABSTRACT OBJECTIVE: Otoscopy is a frequently performed procedure and competency in this skill is important across many specialties. We aim to systematically review current medical educational evidence for training of handheld otoscopy skills. METHODS: Following the PRISMA guideline, studies reporting on training and/or assessment of handheld otoscopy were identifi ed searching the following databases: PubMed, Embase, OVID, the Cochrane Library, PloS Medicine, Directory of Open Access Journal (DOAJ), and Web of Science. Two reviewers extracted data on study design, training intervention, educational outcomes, and results. Quality of educational evidence was assessed along with classification according to Kirkpatrick's model of educational outcomes. RESULTS: The searches yielded a total of 6064 studies with a final inclusion of 33 studies for the qualitative synthesis. Handheld otoscopy training could be divided into workshops, physical simulators, web-based training/e-learning, and smartphone-enabled otoscopy. Workshops were the most commonly described educational intervention and typically consisted of lectures, hands-on demonstrations, and training on peers. Almost all studies reported a favorable effect on either learner attitude, knowledge, or skills. The educational quality of the studies was reasonable but the educational outcomes were mostly evaluated on the lower Kirkpatrick levels with only a single study determining the effects of training on actual change in the learner behavior. CONCLUSION: Overall, it seems that any systematic approach to training of handheld otoscopy is beneficial in training regardless of learner level, but the heterogeneity of the studies makes comparisons between studies difficult and the relative effect sizes of the interventions could not be determined. PMID:33629599 | DOI:10.1177/0003489421997289 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Induction of IL‐1β and antimicrobial peptides as a potential mechanism for topical dithranol

xlomafota13 shared this article with you from Inoreader Induction of IL‐1β and antimicrobial peptides as a potential mechanism for topical dithranol Via Experimental Dermatology Abstract Topical dithranol is effective in autoimmune conditions like alopecia areata, inducing hair regrowth in a high percentage of cases. Exact mechanisms of dithranol in alopecia areata, with seemingly healthy epidermis besides altered hair follicles, are not well understood. To better understand dithranol's mechanisms on healthy skin, we analysed its effect on normal murine as well as xenografted human skin. We found a strong increase in mRNA expression of anti‐microbial peptides (AMPs) (eg Lcn2, Defb1, Defb3, S100a8, S100a9), keratinocyte differentiation markers (eg Serpinb3a, Flg, Krt16, Lce3e) and inflammatory cytokines (eg Il1b and Il17) in healthy murine skin. This effect was paralleled by inflammation and disturbed skin barrier, as well as an injury response resulting in epidermal hyperproliferation, as observed in murine and xenografted adult human skin. This contact response and disturbed barrier in duced by dithranol might lead via a vicious loop between AMPs such as S100a8/a9 (that led to skin swelling itself after topical application) and cytokines such as IL‐1β to an immune suppressive environment in the skin. A better understanding of the skin's physiologic response to dithranol may open up new avenues for the establishment of novel therapeutics (including AMP‐related/interfering molecules) for certain skin conditions, such as alopecia areata. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of constant light exposure on allergic and irritant contact dermatitis in mice reared under constant light conditions

xlomafota13 shared this article with you from Inoreader Effects of constant light exposure on allergic and irritant contact dermatitis in mice reared under constant light conditions Via Experimental Dermatology Abstract Environmental light levels can affect physiological functions, such as general activity, body temperature and metabolism. Irregular lifestyles, such as those involving exposure to light during the night, can exacerbate the clinical symptoms of several inflammatory skin diseases. However, the effects of constant light exposure on immune responses are not fully understood. This study aimed to elucidate the effects of constant light exposure on two major types of skin reactions, allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). BALB/c mice were kept under constant light conditions or a normal light and dark cycle, and their ACD and ICD responses were assessed after the topical application of 2,4,6‐trinitro‐1‐chlorobenzene and croton oil, respectively, to the ear skin. Interestingly, in both ACD and ICD, the ear‐swelling response and local leukocyte infiltration were aggravated by constant exposure to light, which has previously been shown to severely di sturb the behavioural rhythms of mice. In ACD, these findings were accompanied by increases in the numbers of degranulated mast cells and eosinophils. These results suggest that constant light exposure intensifies allergic and non‐allergic skin inflammation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical variations of the mandibular canal and their clinical implications in dental practice: a literature review

xlomafota13 shared this article with you from Inoreader Anatomical variations of the mandibular canal and their clinical implications in dental practice: a literature review Via radiol anat Surg Radiol Anat. 2021 Feb 25. doi: 10.1007/s00276-021-02708-7. Online ahead of print. ABSTRACT INTRODUCTION: The anatomical variations of the mandibular canal have been described according to the number of additional branches it presents, bifid and trifid. Within the bifids we can also find subtypes of variations such as the retromolar mandibular canal. These anatomical variations can have important clinical implications for the work of dental professionals. METHODS: A systematic search of the literature was carried out in different databases that met the following criteria: articles published between 2000 and 2020, and articles that established a clinical correlation with variations in the mandibular canal. RESULTS: After applying inclusion and exclusion criteria, 32 articles were obtained, in which the variations of the mandibular canal were identified, their prevalence and incidence, which was very varied between the different articles, it was also found that the CBCT was the main technique to identify the anatomical variations of the mandibular canal. Lastly, the anatomical variations of the mandibular canal have a direct clinical correlation with pre-surgical, intra-surgical and postsurgical complications in pathologies that require surgical intervention. CONCLUSIONS: The anatomical variations of the mandibular canal have a high incidence, so knowing them is of vital importance both for clinicians and anatomy professors who prov ide morphological training. We believe that research should focus on describing and diagnosing the causes of these anatomical variations. That said, there is also a continuous challenge for all health professionals to learn about the different anatomical variations that the human body presents and how these can affect clinical practice. PMID:33630105 | DOI:10.1007/s00276-021-02708-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Virtual thanks giving to a cadaver by medical students exposed to learning anatomy before and amidst COVID-19 pandemic

xlomafota13 shared this article with you from Inoreader Virtual thanks giving to a cadaver by medical students exposed to learning anatomy before and amidst COVID-19 pandemic Via radiol anat Surg Radiol Anat. 2021 Feb 25. doi: 10.1007/s00276-021-02715-8. Online ahead of print. ABSTRACT PURPOSE: Due to COVID-19 pandemic, Thanks giving ceremony to cadaver was different this year in two ways: the students were partially exposed to cadaveric dissections (for 7 months) and later learned Anatomy via online classes due to lockdown (for 5 months) and secondly it was not feasible to gather for the ceremony so virtual platform was preferred. The purpose of this study was to discern the gratitude for cadaver and to recognize the importance of cadaveric dissection from the reflection of students who experienced hybrid anatomy learning amidst COVID-19. METHODS: The study was conducted on 48 first year medical students who were admitted to the college in August 2019 and were willing to participate. An online invitation was sent to students to participate in virtual thanks giving to cadaver ceremony on the last day of their anatomy class (August 2020). RESULTS: Though the students partially studied gross anatomy with the aid of dissections on the cadaver; however, they expressed respect and gratitude to the silent mentor in the form of a card, poem, drawing or paragraph and shared it via google classroom platform. The students wished if they could continue their anatomy course in dissection hall as paused due to COVID-19 pandemic. CONCLUSIONS: Reflection of these students may mark impact on future anatomy students who may or may not get the chance for dissections. The thanks-giving gesture will also help to bind medical science and humanity especially during the crisis of pandemic. PMID:33630106 | DOI:10.1007/s00276-021-02715-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical variations of the sacro-iliac joint: a computed tomography study

xlomafota13 shared this article with you from Inoreader Anatomical variations of the sacro-iliac joint: a computed tomography study Via radiol anat Surg Radiol Anat. 2021 Feb 25. doi: 10.1007/s00276-021-02714-9. Online ahead of print. ABSTRACT PURPOSE: To identify, describe, and compare the prevalence of sacroiliac joint anatomical variants. METHODS: A retrospective study was performed on computed tomography scans. Joint space was measured, and variants were classified as accessory joint, ileosacral complex, bipartite bony plate, semicircular defect, iliac bony plate, and ossification centers. RESULTS: 400 s cans were analyzed. Mean age was 49 years, 180 men (45%), and 220 women (55%). 209 (52.2%) patients presented an anatomical variant with higher prevalence in women (65.4% vs 36.2%), and those older than 40 years of age (60% vs 40%). Mean joint space was similar bilaterally (right 2.41 ± 0.65 mm vs. left 2.37 ± 0.65 mm). Prevalence was: 19.8% accessory joint, 6.5% ileosacral complex, 12.3% bipartite bony plate, 8% semicircular defect, 5% iliac bony plate, and 0.8% for ossification centers. CONCLUSION: Prevalence of anatomical variants of the SIJ is higher in the Hispanic population, women, and those older than 40 years. PMID:33630107 | DOI:10.1007/s00276-021-02714-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Atypical presentation of shoulder brucellosis misdiagnosed as subacromial bursitis: A case report

paythelady.612 shared this article with you from Inoreader Atypical presentation of shoulder brucellosis misdiagnosed as subacromial bursitis: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):927-934. doi: 10.12998/wjcc.v9.i4.927. ABSTRACT BACKGROUND: Brucella infections in the shoulder joint are uncommon, and few have been reported in the literature. CASE SUMMARY: A 26-year-old male was admitted to our hospital with complaint of recurrent pain and limited movement of the right shoulder. The patient reported the pain to have first occurred as an isolated event 6 mo previously and to have reoccurred 5 mo later, when it was accompanied by limited movement of the shoulder. Findings from physical examination and magnetic resonance imaging (referred to as MRI) suggested the diagnosis of subacromial bursitis, and diagnostic paracentesis and arthroscopic debridement were performed. Surprisingly, synovial fluid culture detected brucella, and the finding was confirmed by mass spectrometry of a colony sample. The diagnosis was corrected to brucellosis of the shoulder joint, and antibiotic dru g treatment (oral rifampicin and doxycycline) was administrated for 6 wk. The 4-mo postoperative follow-up examination (MRI) yielded normal findings. The 2-year follow-up showed no signs of recurrence. CONCLUSION: This rare case of brucellosis infection in shoulder highlights the importance of increasing awareness to help avoid misdiagnosis. PMID:33585641 | PMC:PMC7852647 | DOI:10.12998/wjcc.v9.i4.927 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical characteristics and ABCC2 genotype in Dubin-Johnson syndrome: A case report and review of the literature

paythelady.612 shared this article with you from Inoreader Clinical characteristics and <em>ABCC2</em> genotype in Dubin-Johnson syndrome: A case report and review of the literature Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):878-885. doi: 10.12998/wjcc.v9.i4.878. ABSTRACT BACKGROUND: Dubin-Johnson syndrome (DJS) is a benign autosomal recessive liver disease involving mutations of the ABCC2 gene. It is characterized by chronic or intermittent conjugated hyperbilirubinemia, with chronic idiopathic jaundice as the main clinical manifestation. Genetic alterations of the ABCC2 gene are commonly used for diagnosing DJS; however, the causative ABCC2 point mutation in Chinese patients remains unknown. Research on ABCC2 mutations in Chinese DJS patients is extremely rare, and the diagnosis of DJS remains limited. The routine analysis of ABCC2 mutations is helpful for the diagnosis of DJS. Here, we report the clinical characteristics and ABCC2 genotype of an adult female DJS patient. This article is to expound the discovery of more potentially pathogenic ABCC2 variants will that con tribute to DJS identification. CASE SUMMARY: This study investigated a woman referred for DJS and involved clinical and genetic analyses. ABCC2 mutations were identified by next-generation sequencing (NGS). The patient showed intermittent jaundice and conjugated hyper-bilirubinemia. Histopathological examinations were consistent with the typical phenotype of DJS. Genetic diagnostic analysis revealed an ABCC2 genotype exhibiting a pathogenic variant, namely c.2443C>T (p.Arg815*), which has not been reported previously in the domestic or foreign literature. CONCLUSION: Pathogenic ABCC2 mutations play an important role in the diagnosis of DJS, especially in patients with atypical presentations. Currently, NGS is used in the routine analysis of DJS cases and such tests of further cases will better illuminate the relationship between various genotypes and phenotypes of DJS. PMID:33585635 | PMC:PMC7852649 | DOI:10.12998/wjcc.v9.i4.878 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Retroperitoneal teratoma resection assisted by 3-dimensional visualization and virtual reality: A case report

paythelady.612 shared this article with you from Inoreader Retroperitoneal teratoma resection assisted by 3-dimensional visualization and virtual reality: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):935-942. doi: 10.12998/wjcc.v9.i4.935. ABSTRACT BACKGROUND: Primary retroperitoneal tumor is a rare type of tumor with insidious onset, large tumor size at the time of diagnosis, and often extensive involvement of surrounding tissues and blood vessels in the retroperitoneum. Surgery for primary retroperitoneal tumors is technically challenging. Preoperative imaging evaluation is critical for the selection of the optimal surgical approach and can influence complete resection and recurrence rates. Three-dimensional model reconstruction combined with virtual reality is useful for preoperative assessment. CASE SUMMARY: A 17-year-old female patient was admitted for abdominal pain lasting for half a year that had been worsening for half a month. Abdominopelvic enhanced helical computed tomography revealed a retroperitoneal space-occupying lesion about 11.3 cm × 9.1 cm in size, with well-defined bord ers in the upper left quadrant of the abdomen. The lesion compressed the left renal artery and vein resulting in vascular displacement and deformation. A multidisciplinary team decided on the optimal treatment approach. Preoperative three-dimensional visualization and virtual reality technology were used to assess and simulate the surgical procedure. Then, retroperitoneal tumor resection along with renal artery reconstruction was decided as the treatment. Complete resection of the retroperitoneal tumor was performed. Stable blood flow was established after renal artery reconstruction. The tumor was diagnosed as mature cystic teratoma (retroperitoneal tumor) by postoperative pathologic analysis. The patient, who recovered well, was discharged after 2 wk and maintains regular follow-ups. CONCLUSION: A combination of three-dimensional reconstruction and virtual reality technology before surgery improves the rate of complete resection of retroperitoneal teratoma. PMID:33585642 | PMC:PMC7852646 | DOI:10.12998/wjcc.v9.i4.935 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of biofeedback combined with high-quality nursing in treatment of functional constipation

paythelady.612 shared this article with you from Inoreader Effect of biofeedback combined with high-quality nursing in treatment of functional constipation Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):784-791. doi: 10.12998/wjcc.v9.i4.784. ABSTRACT BACKGROUND: Functional constipation (FC) is a common functional gastrointestinal disease with various clinical manifestations. It is a physical and mental disease, which seriously affects patient physical and mental health and quality of life. Biofeedback therapy is the treatment of choice for FC, especially outlet obstructive constipation caused by pelvic floor dysfunction. High-quality nursing is a new nursing model in modern clinical work and a new concept of modern nursing service. AIM: To explore the effect of biofeedback combined with high-quality nursing in the treatment of FC. METHODS: A total of 100 patients with FC admitted to our hospital from March 2015 to July 2019 were selected for clinical observation. These patients were randomly divided into two groups of 50: Experimental group (biofeedback combined with high-quality nursing treatment group) and control group (biofeedback group). RESULTS: The constipation symptom score of the experimental group was significantly lower than that of the control group, and the difference was statistically significant (P < 0.05). The anal canal resting pressure and initial defecation threshold of the experimental group were significantly lower than those of the control group, and the maximum squeeze systolic pressure of the anal canal of the experimental group was significantly higher than that of the control group (P < 0.05). The Self-Rating Anxiety Scale and Zung's Self-Rating Depression Scale scores of the two groups were significantly lower than before treatment. The Self-Rating Anxiety Scale and Self-Rating Depression Scale scores of the experimental group were significantly lower than those of the control group (P < 0.05). The patient satisfaction score of the experimental group was significantly higher than that of the control gro up (P < 0.05). CONCLUSION: The application of biofeedback combined with high-quality nursing in the treatment of FC has significant advantages over pure biofeedback treatment, and it is worthy of promotion in clinical work. PMID:33585624 | PMC:PMC7852631 | DOI:10.12998/wjcc.v9.i4.784 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Renal failure and hepatitis following ingestion of raw grass carp gallbladder: A case report

paythelady.612 shared this article with you from Inoreader Renal failure and hepatitis following ingestion of raw grass carp gallbladder: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Feb 6;9(4):943-950. doi: 10.12998/wjcc.v9.i4.943. ABSTRACT BACKGROUND: Fish gallbladder has long been used as a folk remedy in Asian countries. Multiple organ damage after ingestion of fish gallbladder resulting in near mortality has been known to us. Here, we describe a case of acute renal failure (ARF) and hepatitis due to grass carp gallbladder poisoning and review the literature. CASE SUMMARY: A previously healthy, 50-year-old woman was admitted to our hospital with a 2-d history of generalized abdominal pain and repeated vomiting following ingestion of two raw grass carp gallbladders in an attempt to alleviate her cough. She developed anuria on day 4 with markedly elevated serum creatinine, urea, bilirubin, alanine aminotransferase, and aspartate aminotransferase. Based on thorough evaluation of her history and prompt biochemical investigations, we diagnosed her with ARF and hepatitis secondary to fi sh gallbladder poisoning. Her renal biopsy revealed acute tubular necrosis, following which she underwent six sessions of conventional hemodialysis due to renal failure. Supportive treatment with gastric mucosal protectant and liver protectant was administered for targeted organ protection. The patient's liver function gradually recovered, and serum creatinine was 164 mmol/L at discharge on day 24. Over a follow-up period of 2 wk, her renal function completely recovered. CONCLUSION: Physicians should be mindful of toxic complications of raw grass carp gallbladder ingestion and we should promote awareness to reduce incidences of food poisoning. PMID:33585643 | PMC:PMC7852650 | DOI:10.12998/wjcc.v9.i4.943 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.