Benign paroxysmal positional vertigo: is hypothyroidism a risk factor for recurrence?

xlomafota13 shared this article with you from Inoreader Benign paroxysmal positional vertigo: is hypothyroidism a risk factor for recurrence? Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2022 Feb 7. doi: 10.14639/0392-100X-N1775. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the relationship between risk of Benign Paroxysmal Positional Vertigo (BPPV) recurrence and hypothyroidism treated with hormone replacement therapy (HRT). METHODS: 797 patients with idiopathic BPPV were divided into two groups: 250 patients with recurrence of BPPV (R-BPPV) and 547 patients without recurrence (NR-BPPV). Regarding patients with thyroid disease on HRT, we collected serum test results of thyroidstimulating hormone (TSH), free triiodothyronine f-T3, free thyroxine f-T4, thyroglobulin antibodies (TG-Ab) and thyroid peroxidase antibodies (TPO-Ab). RESULTS: Hypothyroidism in long-term HRT was found in 61/250 (24.4%) patients of the RBPPV group vs 79/547 (14.4%) of the NR-BPPV-group (p = 0.0006). Hashimoto thyroiditis (HT) was associated with recurrence (p < 0.0001). A significant correlation was found between recurrence and level of serum TPO-Ab (p = 0.0117) and TG-Ab (p = 0.0025), but not with mean serum TSH, f-T3 and f-T4. CONCLUSIONS: We assume that patients with hypothyroidism in HRT have an increased risk of BPPV recurrence, which is particularly strong for patients with HT and positive thyroid antibodies, suggesting an association between autoimmunity and recurrent vertigo. PMID:35129542 | DOI:10.14639/0392-100X-N1775 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quantification of near-infrared fluorescence imaging with indocyanine green in free flap breast reconstruction

xlomafota13 shared this article with you from Inoreader Quantification of near-infrared fluorescence imaging with indocyanine green in free flap breast reconstruction Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 14:S1748-6815(22)00003-1. doi: 10.1016/j.bjps.2021.12.004. Online ahead of print. ABSTRACT BACKGROUND: One of the complications of free flap breast reconstruction is the occurrence of skin and fat necrosis. Intra-operative use of near-infrared (NIR) fluorescence imaging with Indocyanine Green (ICG) has the potential to predict these complications. In this study, the quantification of the fluorescence intensity measured in free flap breast reconstruction was performed to gain insight into the perfusion patterns observed with ICG NIR fluorescence imaging. METHODS: ICG NIR fluorescence imaging was performed in patients undergoing free flap breast reconstruction following mastectomy. After completion of the arterial and venous anastomosis, 7.5 mg ICG was administered intravenously. The fluorescence intensity over time was recorded using the Quest Spectrum Platform®. Four regions of interest (R OI) were selected based on location and interpretation of the NIR fluorescence signal: (1) The perforator, (2) normal perfusion, (3) questionable perfusion, and (4) low perfusion. Time-intensity curves were analyzed, and two parameters were extracted: Tmax and Tmax slopes. RESULTS: Successful ICG NIR fluorescence imaging was performed in 13 patients undergoing 17 free flap procedures. Region selection included 16 perforators, 17 normal perfusions, 8 questionable perfusions, and 5 low perfusion ROIs. Time-intensity curves of the perforator ROIs were comparable to the ROIs of normal perfusion and demonstrated a fast inflow. No outflow was observed for the ROIs with questionable and low perfusion. CONCLUSION: This study provides insight into the perfusion patterns observed with ICG NIR fluorescence imaging in free flap breast reconstruction. Future studies should correlate quantitative parameters with clinical perfusion assessment and outcome. PMID:35131194 | DOI:10.1016/j.bjps.2021.12.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predicting outcomes from sentinel node biopsy for melanoma in the UK: Is the MIA nomogram the answer?

xlomafota13 shared this article with you from Inoreader Predicting outcomes from sentinel node biopsy for melanoma in the UK: Is the MIA nomogram the answer? Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 21:S1748-6815(22)00031-6. doi: 10.1016/j.bjps.2022.01.017. Online ahead of print. NO ABSTRACT PMID:35131192 | DOI:10.1016/j.bjps.2022.01.017 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Depleting hsa_circ_0000567 suppresses acquired gefitinib resistance and proliferation of lung adenocarcinoma cells through regulating the miR-377-3p / ZFX axis: an in vitro and in vivo study

xlomafota13 shared this article with you from Inoreader Depleting hsa_circ_0000567 suppresses acquired gefitinib resistance and proliferation of lung adenocarcinoma cells through regulating the miR-377-3p / ZFX axis: an in vitro and in vivo study Via Cellular and Molecular Biology Histol Histopathol. 2022 Feb 8:18431. doi: 10.14670/HH-18-431. Online ahead of print. ABSTRACT BACKGROUND: Circular RNAs (circRNAs) expression profile has been reported in lung adenocarcinoma (LUAD) cells resistant to gefitinib, and hsa_circ_0000567 was abnormally upregulated. However, its precise role in gefitinib resistance remains unclarified. METHODS: Levels of hsa_circ_0000567, microRNA (miR)-377-3p and zinc finger protein X-linked (ZFX) were detected by real-time quantitative PCR. Direct attachment was confirmed by dual-luciferase reporter assay and RNA immunoprecipitation assay. Gefitinib resistance was measured by MTT assay, colony formation assay, flow cytometry, western blotting, and xenograft in mice. RESULTS: Expression of hsa_circ_0000567 was upreguated in human gefitinib-resistant human LUAD tissues and cells (HCC827/GR and PC9/GR). Clinically, higher hsa_circ_0000567 correlated with advanced tumor burden. Blo ckage of hsa_circ_0000567 suppressed cell viability, half maximal inhibitory concentration (IC₅₀) value, colony formation ability, and expression of Bcl-2 and proliferating cell nuclear antigen (PCNA) in HCC827/GR and PC9/GR cells under gefitinib treatment or not, accompanied with enhanced apoptosis rate and Bax expression. In vivo, tumor growth of PC9/GR cells untreated and treated with gefitinib was restrained by silencing hsa_circ_0000567. miR-377-3p was directly regulated by hsa_circ_0000567, and then targeted ZFX. Similar to hsa_circ_0000567 knockdown, overexpressing miR-377-3p inhibited chemoresistance in genitinib-resistant LUAD cells in vitro, whereas, depleting miR-377-3p was able to promote gefitinib resistance in spite of hsa_circ_0000567 knockdown. Moreover, restoring ZFX abrogated miR-377-3p-mediated chemosensitivity in genitinib-resistant LUAD cells in vitro. CONCLUSION: The hsa_circ_0000567/miR-377-3p/ZFX axis might contribute to acquired gefitinib resistanc e in LUAD cells both in vitro and in vivo, suggesting hsa_circ_0000567 as a novel therapeutic target in treatment of gefitinib-resistant LUAD. PMID:35133000 | DOI:10.14670/HH-18-431 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Benefits and adverse events of melatonin use in the elderly (Review)

xlomafota13 shared this article with you from Inoreader Benefits and adverse events of melatonin use in the elderly (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2022 Mar;23(3):219. doi: 10.3892/etm.2022.11142. Epub 2022 Jan 14. ABSTRACT Melatonin is a hormone secreted by the pineal gland in accordance with the circadian rhythm when the light level decreases. Reduction of melatonin secretion with age may be associated with physiological aging in neurodegenerative diseases by affecting the suprachiasmatic nucleus or of the neuronal pathways of transmission to the pineal gland. A significant decrease in melatonin synthesis has been reported in various disorders and diseases, including cardiovascular diseases, metabolic disorders (particularly diabetes type 2), cancer and endocrine diseases. In addition to the fact, that melatonin is a sleep inducer, it also exerts cytoprotective properties as an antioxidant and free radical scavenger. The therapeutic role of melatonin has been demonstrated in sleep disorders, eye damage and cardiovascular disease. The association between melatonin a nd β-blockers has had a positive impact on sleep disorders in clinical trials. Previous studies have reported the anti-inflammatory effect of melatonin by adjusting levels of pro-inflammatory cytokines, including interleukin (IL)-6, IL-1β and tumor necrosis factor-α. Melatonin treatment has been demonstrated to decrease IL-6 and IL-10 expression levels and efficiently attenuate T-cell proliferation. Currently, there is an inconsistency of scientific data regarding the lowest optimal dose and safety of melatonin for long-term use. The aim of the present review was to summarize the evidence on the role of melatonin in various clinical conditions and highlight the future research in this area. PMID:35126722 | PMC:PMC8796282 | DOI:10.3892/etm.2022.11142 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of antioxidants and oxidative stress in the evolution of acute pancreatitis (Review)

xlomafota13 shared this article with you from Inoreader Role of antioxidants and oxidative stress in the evolution of acute pancreatitis (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2022 Mar;23(3):197. doi: 10.3892/etm.2022.11120. Epub 2022 Jan 5. ABSTRACT Acute pancreatitis (AP) is a severe disease with a high prevalence and 3 to 15% mortality worldwide, which can represent an important challenge for the physician. Oxidative stress and antioxidants are involved in AP progression. The mechanisms responsible for the onset and progression of AP are still poorly understood. Previous studies have highlighted the important contribution of antioxidants and oxidative stress in AP. The existence of a relationship between oxidative stress and antioxidants in AP is unquestionable, although a more accurate understanding of the mechanistic pathways involved is required to create a solid basis for potential prevention or treatment strategies. Further investigation is needed to clarify the role of antioxidant status and the severity of AP and to determine the association between oxidative stress and pancreatic enz yme activities. Antioxidant therapy may represent an interesting option for the management of patients with AP, although additional information about the effectiveness of this potential treatment is required. PMID:35126700 | PMC:PMC8794551 | DOI:10.3892/etm.2022.11120 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Breast and abdominal scarring after DIEP flap breast reconstruction: An exploration of patient-reported scar quality

xlomafota13 shared this article with you from Inoreader Breast and abdominal scarring after DIEP flap breast reconstruction: An exploration of patient-reported scar quality Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 14:S1748-6815(22)00002-X. doi: 10.1016/j.bjps.2021.12.003. Online ahead of print. ABSTRACT PURPOSE: This research aimed to explore factors associated with patient-reported breast and abdominal scar quality after deep inferior epigastric perforator (DIEP) flap breast reconstruction (BR). MATERIAL AND METHODS: This study was designed as a descriptive cross-sectional survey in which women after DIEP flap BR were invited to complete an online survey on breast and abdominal scarring. The online survey was distributed in the Netherlands in several ways in order to reach a diverse population of women. Outcomes were assessed with the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS). Additional items were assessed with a numeric rating scale (NRS). RESULTS: A total of 248 women completed the survey. There was a statistically significant worse POSAS scar appraisal for the abdominal scar compared with the breast scar. The vast majority of women reported high scores on at least one scar characteristic of their breast scar or abdominal scar. Overall, color, stiffness, thickness, and irregularity scored higher than pain and itching. Women were only moderately positive about the size, noticeability, location, and the information provided regarding scarring. CONCLUSION: It is crucial to address the inevitability of scars in patient education before a DIEP flap BR, with a particular focus on the abdominal scar, as women experience abdominal scars significantly worse than their breast scars. Providing more information on the experience of other women and the expected appearance will contribute to having realistic expectations while allowing them to make well-informed decisions. PMID:35125306 | DOI:10.1016/j.bjps.2021.12.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multiple spontaneous cerebrospinal fluid leaks: a rare case report and review of literature

xlomafota13 shared this article with you from Inoreader Multiple spontaneous cerebrospinal fluid leaks: a rare case report and review of literature Via leak of cerebrospinal fluid AME Case Rep. 2022 Jan 25;6:5. doi: 10.21037/acr-21-36. eCollection 2022. ABSTRACT While a spontaneous cerebrospinal fluid leak (sCSFL) is a rare phenomenon, patients who present with multiple cerebrospinal fluid leaks (mCSFLs) are an even rarer entity. There have been documented cases reported over the last decades, but many with only limited descriptions of each patient. We present a mCSFL patient as a case report and demonstrate the need for future prospective studies to improve further understanding and management of the condition. This is explored through summarizing the literature on mCSFLs to the present time. A 45-year-old obese female presented with a 5-week history of bilateral clear nasal discharge with no previous surgery or trauma. Initially misdiagnosed as allergic rhinitis, nasal discharge was later confirmed positive for beta-2-transferrin and a CT scan revealed multiple bony areas of skull base erosion. The patient underwent image guided endoscopic sinus surgery with multilayer skull base defect repair of three active CSFLs. Three months post-operatively the patient had no evidence of a recurrence. As mCSFL tend to be sporadic and asymptomatic in nature, it is likely they are underreported. Future prospective studies in the area of mCSFLs that take into consideration demographic and geographical information are needed for more accurate interpretation and better recruitment. Additionally, studies need to ensure longer follow-up time due to the underlying chronicity of increased intracranial pressure (ICP) and investigate whether or not a non-active leak site should be repaired or left alone. PMID:35128313 | PMC:PMC8762381 | DOI:10.21037/acr-21-36 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hipoacusia sensorioneural unilateral: Revisión de los manejos posibles en nuestra realidad nacional

xlomafota13 shared this article with you from Inoreader Hipoacusia sensorioneural unilateral: Revisión de los manejos posibles en nuestra realidad nacional Via Otorrinolaringología y cirugía de cabeza y cuello Resumen La hipoacusia unilateral (HUL) definida como la pérdida auditiva de cualquier grado en un solo oído tiene prevalencias en edad escolar de 3% a 6%. La etiología es desconocida en la mayoría de los casos, pero destacan las anormalidades anatómicas severas a diferencia de las hipoacusias bilaterales, lo que le otorga importancia al estudio de imágenes. También se recomienda realizar evaluación oftalmológica. El impacto de la HUL se observa en la localización sonora, reconocimiento del habla, desarrollo del lenguaje, desempeño social y conducta, pero por sobre todo en el rendimiento académico. En este sentido es relevante mencionar que además de existir mayor probabilidad de repitencia de curso, es necesario mayor apoyo educacional individualizado para evitar dicha repitencia o lograr mismo éxito académico que un normoyente. En relación al diagnóstico aún faltan normas o protocolos, siendo éste un desafío en las zonas donde no hay screening universal. Se discute la importancia de las encuestas para realizar evaluaciones y seguimiento en estos casos. Finalmente se abordan las estrategias de intervención disponibles, además de un plan individualizado considerando al niño, su familia y sus expectativas, particularmente se discuten las características o factores a tomar en cuenta en el momento de la adaptación, para así lograr un tratamiento tendiente al éxito. Abstract Unilateral hearing loss (UHL) defined as hearing loss of any degree in only one ear has a school-age prevalence of 3% to 6%. The etiology is unknown in most cases, but severe anatomical abnormalities stand out as opposed to bilateral hearing loss, which gives importance to the study of images. Ophthalmological evaluation is also recommended. The impact of UHL is observed in sound localization, speech recognition, language development, social performance and behavior, but above all in academic performance. In this sense, it is relevant to mention that in additi on to having a higher probability of repeating the course, it is necessary to have more individualized educational support to avoid this repetition or achieve the same academic success as a normal listener. Regarding the diagnosis, there are still missing norms or protocols, this being a challenge in areas where there is no universal screening. The importance of surveys to carry out evaluations and follow-up in these cases is discussed. Finally, the available intervention strategies are discussed, in addition to an individualized plan considering the child, his family and his expectations, particularly, the factors to be taken into account at the time of adaptation, in order to achieve a success treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adenitis cervical con anaerobios sin causa aparente en lactante

xlomafota13 shared this article with you from Inoreader Adenitis cervical con anaerobios sin causa aparente en lactante Via Otorrinolaringología y cirugía de cabeza y cuello Resumen Las adenopatías cervicales benignas en lactantes son relativamente frecuentes, se definen como el aumento de volumen ganglionar de más de 1 cm, sin síntomas sistémicos y cuando están presentes, el término correcto es adenitis. Para su estudio, las adenitis se dividen en: locales, sistémicas, unilaterales, bilaterales, agudas, crónicas, y por edad, con diferentes etiologías. Se presenta el caso clínico de un lactante de 11 meses de edad con diagnóstico de adenitis cervical abscedada unilateral aguda, con cuadro de 72 h de evolución, con crecimiento constante a nivel cervical derecho, compromiso del estado general, fiebre y anorexia, por lo que se inician antibióticos de primera línea para los agentes bacterianos más frecuentes (Staphylococcus aureus y Streptococcus pyogenes), con evolución tórpida a las 48 h, por lo que se solicita ultrasonido cervical, ya que la familia no contaba con recursos para solicitar cultivo o tomografía, reportando el ultrason ido ganglio cervical de 3,5 cm de diámetro abscedado, por lo que se agrega cobertura para anaerobios, con respuesta muy favorable a las 24 h. Queda la duda del origen de los anaerobios en la paciente, sin antecedentes de importancia y en grupo etario diferente al afectado por esos gérmenes. Consideramos este caso interesante por su comportamiento atípico, para el enriquecimiento del ejercicio de la otorrinolaringología, recalcando el invaluable apoyo de la clínica y solo con un ultrasonido, ya que no siempre se tendrán todos los recursos disponibles, pero siguiendo las pautas de lo reportado en la literatura, se tuvo una resolución exitosa. Abstract Benign cervical lymphadenopathies in infants are relatively frequent, they are defined as an increase in lymph node volume of more than 1 cm, without systemic symptoms, and when they are present, the correct term is adenitis. For its study, adenitis is divided into: local, systemic, unilateral, bilateral, acute, chronic, and by age, with different etiologies. An 11-month-old infant with a diagnosis of acute unilateral abscessed cervical adenitis, with a 72 h evolution, with constant growth at the right cervical level, fever and anorexia, for which first-line antibiotics were started to the most frequent bacterial agents (Staphylococcus aureus and Streptococcus pyogenes), with torpid evolution at 48 h, for which only cervical ultrasound is requested, since the family did not have the resources to request culture or tomography, reporting the cervical ganglion ultrasound of 3.5 cm of abscessed diameter, so coverage for anaerobes is added, with a very favorable response at 24 hrs. There remains the doubt of the origin of the anaerobes in the patient, without important antecedents and in an age group different from that affected by these germs. We consider this case interesting due to its atypical behavior, for the enrichment of the otolaryngology exercise, emphasizing the invaluable support of the clinic, and only with an ultrasound, since other clinical tools were not available, but following the guidelines of what is reported in literature, there was a successful resolution. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complicaciones intraoperatorias en cirugía endoscópica nasosinusal en Servicio de Otorrinolaringología del Hospital del Salvador, revisión en los últimos 10 años

xlomafota13 shared this article with you from Inoreader Complicaciones intraoperatorias en cirugía endoscópica nasosinusal en Servicio de Otorrinolaringología del Hospital del Salvador, revisión en los últimos 10 años Via Otorrinolaringología y cirugía de cabeza y cuello Resumen Introducción: La cirugía endoscópica nasal (CEN) corresponde a una técnica quirúrgica mínimamente invasiva. Ha disminuido la morbimortalidad secundaria al acto quirúrgico. Pese a esto, no está exenta de riesgos y sus complicaciones pueden variar en severidad desde leves hasta catastróficas, siendo la hemorragia nasal la más frecuente. Objetivo: Analizar las complicaciones intraoperatorias, factores asociados a complicaciones y manejo en nuestra realidad local. Material y Método: Estudio retrospectivo, revisión de protocolos operatorios de pacientes atendidos en el Hospital del Salvador entre los años 2009 y 2019. Resultados: Se revisaron 602 cirugías de las cuales se excluyeron 18. De un total de 584 CEN realizadas durante los últimos diez años, la incidencia de complicaciones intraoperatorias fue de 3,3%. Sólo se observaron complicaciones hemorrágicas (2%) y orbitarias (1,2%). La incidencia de complicaciones mayores fue 0,51%. La única variable a sociada de forma significativa con la presencia de complicación intraoperatoria fue el tiempo quirúrgico. Conclusión: Como centro presentamos una tasa de complicaciones intraoperatorias de CEN baja en los últimos diez años, dentro de las cuales las más frecuentes son las hemorrágicas y las orbitarias; comparables con la literatura internacional. Se establece el primer reporte a nivel nacional sobre las complicaciones intraoperatorias de CEN. Abstract Introduction: Endoscopic sinus surgery (ESS) is a minimally invasive surgical technique. It has decreased morbidity and mortality secondary to the surgical act. Despite this, endoscopic sinus surgery is not a risk-free procedure and its complications can range from mild to severe, with nosebleed being the most frequent. Aim: To analyze the surgical results of nasal endoscopic surgery, with its intraoperative complications and management in our local reality. Material and Method: Retrospective study, review of operative pro tocols of patients attended at the Salvador Hospital between 2009 and 2019. Results: 602 surgeries were reviewed, of which 18 were excluded. Of a total of 584 ESS performed during the last ten years, the incidence of intraoperative complications was 3,3%. Only hemorrhagic (2%) and orbital complications (1,2%) were observed. The incidence of major complications was 0,51%. The only variable significantly associated with the presence of intraoperative complications was surgical time. Conclusion: As a center, we present a low rate of intraoperative complications of ESS in the last ten years, among which the most frequent are hemorrhagic and orbital; comparable to international literature. The first national report on intraoperative complications of ESS is established. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.