Ετικέτες

Τρίτη 28 Δεκεμβρίου 2021

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

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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.

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Management of the middle turbinate during and after sinus surgery

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

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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

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Reversible Iodine Capture by Nonporous Adaptive Crystals of a Bipyridine Cage

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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

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Δευτέρα 27 Δεκεμβρίου 2021

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

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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

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

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Thyroid, Ahead of Print.
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Κυριακή 26 Δεκεμβρίου 2021

Gustatory Function and Salivary Flow Rate in Healthy Adults

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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

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Anterior Palatoplasty With Expansion Sphincter Pharyngoplasty for All Type of Pharyngeal Collapse

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Objectives/Hypothesis

This study was aimed to compare the efficiency of the anterior palatoplasty and expansion sphincter pharyngoplasty (APwESP) technique for all patterns of velopharyngeal obstruction (anterior–posterior [APPC], lateral [LPC], or combined circular pharyngeal collapse [CPC]).

Study Design

The study was designed as a randomized prospective trial at Kâtip Çelebi University, Atatürk Training, and Research Hospital.

Methods

Patients only with velopharyngeal obstruction were included. Three groups were created according to the obstruction pattern (APPC, LPC, and CPC) for the study. Outcome parameters included patient's demographics, apnea-hypopnea index (AHI), lowest oxygen saturation (LOS), Stanford subjective scale of snoring (SSSS), and Epworth sleepiness scale (ESS).

Results

Thirty-one (34.1%) patients were in APPC group, while 30 (33.0%) patients were in LPC, and 30 (33.0%) were in CPC group. Preoperatively for all patients, on average, AHI was 33.4 ± 13.6, SSSS was 8.3 ± 1.0, ESS was 16.5 ± 2.6, and LOS was determined as 85.5 ± 3.6. There was a significant postoperative improvement in all parameters for all patients. There was no significant difference in outcome parameters between the groups according to obstruction pattern postoperatively. After APwESP surgery, obstruction pattern was not a significant factor for AHI (P = .234), SSSS (P = .180), and LOS (P = .280) (repeated measure analysis of variance test). The rate of surgical success was detected similarly for both of the study groups (P = .435). The rate of successful surgery for severe obstructive sleep apnea in the APPC group was 72.2%, 88.2% in the LPC group, and 75.0% in the CPC group (P =& nbsp;.472).

Conclusion

A combination of APwESP surgery can manage all types of pharyngeal obstruction confidently.

Level of Evidence

3 Laryngoscope, 2021

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Role and mechanism of the Dectin-1-mediated Syk/NF-κB signaling pathway in Talaromyces marneffei infection

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Exp Ther Med. 2022 Jan;23(1):84. doi: 10.3892/etm.2021.11007. Epub 2021 Nov 25.

ABSTRACT

Dendritic cell-associated C-type lectin-1 (Dectin-1), a C-type lectin receptor, serves a critical role in host antifungal immunity. However, the molecular mechanism and function of Dectin-1-mediated signaling in response to infection by the pathogenic fungus Talaromyces marneffei remains unclear. To understand the role of Dectin-1 signaling against T. marneffei infection, the phosphorylation of spleen tyrosine kinase (Syk), nuclear factor of κ light polypeptide gene enhancer in B-cells inhibitor, α (IκBα) and NF-κB were analyzed using western blotting, and the secretion of cytokines was detected using ELISA. Upon sporular or hyphal heat-killed T. marneffei stimulation, Dectin-1 in THP-1 macrophages recognized and induced the activation of Syk, and in turn triggered phosphorylation of downstream molecules IκBα and NF-κB, thus increasing the secretion of TNF-α and IL-8. Conversely, knockdown of Dectin-1 in THP-1 macrophages downregulated the phosphorylation of Syk, IκBα and NF-κB molecules, and significantly decreased the production of TNF-α and IL-8. These results indicated that Dectin-1 may have a crucial role in inducing the inflammatory response via increasing levels of TNF-α and IL-8 induced by T. marneffei, whereas NF-κB may be the key downstream molecule involved in the response to T. marneffei infection. Subsequently, THP-1 macrophages could orchestrate the innate immune system by releasing the cytokines TNF-α and IL-8. Therefore, it was hypothesized that regulation of the Dectin-1 signaling pathway may effectively interfere with the defense ability of the host against T. marneffei infection.

PMID:34938366 | PMC:PMC8688926 | DOI:10.3892/etm.2021.11007

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Association of Maternal Thyroid Function with Gestational Hypercholanemia

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Thyroid, Ahead of Print.
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Intracorporeal Cortical Telemetry as a Step to Automatic Closed-Loop EEG-Based CI Fitting: A Proof of Concept

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Audiol Res. 2021 Dec 13;11(4):691-705. doi: 10.3390/audiolres11040062.

ABSTRACT

Electrically evoked auditory potentials have been used to predict auditory thresholds in patients with a cochlear implant (CI). However, with exception of electrically evoked compound action potentials (eCAP), conventional extracorporeal EEG recording devices are still needed. Until now, built-in (intracorporeal) back-telemetry options are limited to eCAPs. Intracorporeal recording of auditory responses beyond the cochlea is still lacking. This study describes the feasibility of obtaining longer latency cortical responses by concatenating interleaved short recording time windows used for eCAP recordings. Extracochlear reference electrodes were dedicated to record cortical responses, while intracochlear electrodes were used for stimulation, enabling intracorporeal telemetry (i.e., without an EEG device) to assess higher cortical processing in CI recipients. Simulta neous extra- and intra-corporeal recordings showed that it is feasible to obtain intracorporeal slow vertex potentials with a CI similar to those obtained by conventional extracorporeal EEG recordings. Our data demonstrate a proof of concept of closed-loop intracorporeal auditory cortical response telemetry (ICT) with a cochlear implant device. This research breaks new ground for next generation CI devices to assess higher cortical neural processing based on acute or continuous EEG telemetry to enable individualized automatic and/or adaptive CI fitting with only a CI.

PMID:34940020 | DOI:10.3390/audiolres11040062< /p>

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