Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation

xlomafota13 shared this article with you from Inoreader Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Dec 30:34894211065805. doi: 10.1177/00034894211065805. Online ahead of print. ABSTRACT OBJECTIVES: Transoral laser surgery for glottic stenosis (transverse cordotomy and anteromedial arytenoidectomy (TCAMA)) is often complicated by granulation tissue (GT) formation. GT can cause dyspnea and may require surgical removal to alleviate airway obstruction. Inhaled corticosteroids (ICS) have been shown to reduce benign vocal fold granulomas, however its use to prevent GT formation has not been described. We aimed to analyze the effect of immediate postoperative ICS on GT formation in patients undergoing transoral laser surgery for glottic stenosis. METHODS: A retrospective analysis of patients that had transoral laser surgery for glottic stenosis from 2000 to 2019 was conducted. Surgical instances were grouped into those that received postoperative ICS and those that did not. Demographics, diagnosis, comorbidities, intraoperative adjuvant therapy, and perioperative medications were collected. Differences in GT formation and need for surgical removal were compared between groups. A multivariate exact logistic regression model was performed. RESULTS: Forty-four patients were included; 16 required 2 glottic airway surgeries (60 surgical instances). Of the 23 instances where patients received immediate postoperative ICS, 0 patients developed GT; and of the 37 instances that did not receive postoperative ICS, 15 (40.5%) developed GT (P < .0001). Eight (53.3%) of these cases returned to the OR for GT removal. ICS use was solely associated with the absence of GT formation (P = .042) in the multivariate analysis. CONCLUSIONS: Immediate postoperative use of ICS seems to be a safe and effective method to prevent granulation tissue formation and subsequent surgery in patients following transoral laser airway surgery for glottic stenosis. PMID:34965742 | DOI:10.1177/00034894211065805 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Successful Oral Levothyroxine Desensitization in a Patient with Severe Hypothyroidism Post Radioactive Iodine Therapy: A Case Report

xlomafota13 shared this article with you from Inoreader Successful Oral Levothyroxine Desensitization in a Patient with Severe Hypothyroidism Post Radioactive Iodine Therapy: A Case Report Via radioactive iodine J ASEAN Fed Endocr Soc. 2021;36(2):213-215. doi: 10.15605/jafes.036.02.10. Epub 2021 Aug 19. ABSTRACT Levothyroxine remains the standard therapy for patients with hypothyroidism worldwide. Levothyroxine allergy is rarely seen and alternative therapies are less efficacious and scarcely available. The use of liothyronine (LT3) monotherapy is less favoured due to its short half-life and unpredictable pharmacological profile. We report a 59-year-old male with a hypersensitivity reactio n to levothyroxine who was successfully desensitized with oral levothyroxine within a day using a 14-step protocol. PMID:34966208 | PMC:PMC8666481 | DOI:10.15605/jafes.036.02.10 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Obstructive sleep apnea and metabolic syndrome: an association study based on a large sample clinical database

xlomafota13 shared this article with you from Inoreader Obstructive sleep apnea and metabolic syndrome: an association study based on a large sample clinical database Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1263-1269. doi: 10.3760/cma.j.cn115330-20210531-00314. ABSTRACT Objective: To investigate the prevalence and associated risk factors of metabolic syndrome (MS) in patients with obstructive sleep apnea (OSA). Methods: From July 2007 to June 2017, a total of 8 155 adult subjects, including 6 484 males and 1 671 females, aged 18-90 (43.13±12.28), body mass index 14.61~59.56 (25.59±3.98) kg/m2,who were admitted to the Department of Otorhinolaryngology head and Neck surgery of The Sixth People's Hospital affiliated to Shanghai Jiao Tong University, were retrospectively analyzed. All patients underwent polysomnography and biochemical tests. Subjects were divided into four groups (non-OSA, mild OSA, moderate OSA, and severe OSA) according to OSA severity. The prevalence of MS was expressed as percentage, and the correlation between OSA and MS and its c haracteristic pathophysiological indicators was evaluated by logistic regression model after adjusting for factors such as gender, age, BMI, neck circumference, hip circumference, smoking and alcohol consumption, and was expressed by odds ratio (OR). SPSS 25.0 software was used for statistical analysis. Results: The overall prevalence of MS was 43.6%, and that of non-/mild/moderate/severe OSA group was 18.6%, 30.4%, 43.8%, 57.1%.Logistic regression showed that patients with mild/moderate/severe OSA had an increased risk of MS compared with non-OSA patients, with adjusted OR values and confidence intervals of 1.27 (1.05-1.54), 1.84 (1.53-2.22), and 2.08 (1.76-2.46), respectively (P<0.01).In addition, indicators of OSA anoxic burden [oxygen drop index(Toxygen=7.1), minimum blood oxygen(Tminimum=56.3), blood oxygen saturation below 90% cumulative time ratio (TCT90=10.6) ]were closely associated with MS disease(P<0.01), but sle ep fragmentation index (arousals index) was not significantly associated with MS disease. Conclusion: The risk of MS gradually increases with the severity of OSA, and the indicators reflecting OSA hypoxia burden are closely related to MS disease. PMID:34963213 | DOI:10.3760/cma.j.cn115330-20210531-00314 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of the cochlear implantation users rehabilitation results using psychoacoustic methods

xlomafota13 shared this article with you from Inoreader Evaluation of the cochlear implantation users rehabilitation results using psychoacoustic methods Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):10-16. doi: 10.17116/otorino20218606110. ABSTRACT Currently, the number of patients with bilateral sensorineural deafness treated with cochlear implantation (CI) is increasing in the Russian Federation. In this regard, methods of assessing the auditory rehabilitation of this category of patients become more relevant. OBJECTIVE: To investigate the correlation of the speech intelligibility in quiet with frequency resolving power (FRP) of hearing using a ripple-spectrum phase reversion test (RSPRT) in CI users. MATERIAL AND METHODS: The study includes 30 CI users, three of them after bilateral CI, aged from 13 to 63 years with CI usage experience from 1 year to 16 years. 19 patients used CI systems manufactured by Cochlear Ltd. (Australia), 11 patients used CI systems manufactured by Advanced Bionics (Switzerland). All subjects underwent a number of studies including pure tone audiometry (TPA) , speech audiometry in quiet using a multi-syllable speech material on a two-channel clinical audiometer AC-40 (Interacoustics A/S, Denmark); PC with recorded phonetic material from which the signal was reproduced, acoustic speaker SP90 (Interacoustics A/S, Denmark), for FRP estimation - RSPRT test in a free sound field, which was installed on the PC and also reproduced through SP 90 speakers (Interacoustics A/S, Denmark) were used. RESULTS: According to TPA results in a free sound field, the sound perception thresholds in all subjects corresponded to the mild degree sensorineural hearing loss. The sound perception threshold in the free sound field in the range from 500 Hz to 4 kHz was within the range of 25-30 dB nHL. The percentage of speech intelligibility in quiet in the free sound field ranged from 5 to 100%. During the FRP study of patients using RSPRT test, the following results were obtained: the average value of RSPRT test results at the frequency of 1 kHz was 1.94 RP O; for 2 kHz - 2.3 RPO; for 4 kHz - 2.2. The significant correlation between the speech intelligibility in quiet and frequency resolution of hearing was obtained at 1 and 4 kHz. The highest correlation coefficient was detected at 1 kHz - r=0.57 (p=0.0005), while at 4 kHz it was lower - r=0.46 (p=0.009), and at 2 kHz - at the boundary of the significance: r=0.34 (p=0.051). CONCLUSIONS: As a result of the study, it was found that there is a correlation between speech intelligibility in quiet and FRP of hearing, which makes it possible to recommend the use of RSPRT in assessing the auditory rehabilitation of patients after CI. PMID:34964322 | DOI:10.17116/otorino20218606110 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.

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.

Macrophage inhibitory cytokine-1 produced by melanoma cells contributes to melanoma tumor growth and metastasis in vivo by enhancing tumor vascularization

xlomafota13 shared this article with you from Inoreader Macrophage inhibitory cytokine-1 produced by melanoma cells contributes to melanoma tumor growth and metastasis in vivo by enhancing tumor vascularization Via Melanoma Research - Current Issue Macrophage inhibitory cytokine-1 (MIC-1) has been reported to be elevated in various human cancers including melanoma; however, the function of MIC-1 in cancer remains unclear. In this study, we attempt to clarify the role of MIC-1 in tumor pathogenesis by employing the orthotopic B16F1 melanoma mouse model in which serum MIC-1 levels are positively correlated with tumor size. By stably transfecting a MIC-1 expression construct into B16F1 melanoma cells, we increased the expression and secretion levels of MIC-1. This increase in MIC-1 expression significantly enhanced the growth of tumors derived from B16F1 cells in vivo, despite not affecting in vitro cell growth. The elevated MIC-1 expression in B16F1 cells also resulted in lymph node metastasis in B16F1 tumor-bearing mice, significantly increasing mortality. Interestingly, among small melanoma tumors of similar size, tumors derived from the MIC-1-transfected B16F1 cells exhibited enhanced blood vessel formation compared with those of mock transfectant cells. Also, more MIC-1 was found in well-vascularized tumor regions than in poorly vascularized tumor regions. Moreover, conditioned medium (CM) of the MIC-1-transfected melanoma cells enhanced the angiogenic properties of endothelial cells more than CM of mock transfectant cells. Notably, hypoxic culture conditions forced parental B16F1 cells to secrete more endothelial cell-stimulating factors, among which the function of MIC-1 was confirmed by blocking the effects with an anti-MIC-1 antibody. Taken together, these results suggest that the MIC-1 produced by melanoma cells in response to oxygen de privation promotes tumor vascularization during melanoma development in vivo, leading to enhanced tumor growth and metastasis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Breathy Dysphonia, Not Just a Pain in the Neck

xlomafota13 shared this article with you from Inoreader Breathy Dysphonia, Not Just a Pain in the Neck Via ear nose throat Ear Nose Throat J. 2021 Dec 27:1455613211069919. doi: 10.1177/01455613211069919. Online ahead of print. ABSTRACT We describe a rare occurrence of unilateral vocal fold paralysis associated with a cervical osteophyte abutting the course of the recurrent laryngeal nerve. Trans-nasal laryngoscopy is vital in diagnosing vocal fold paralysis, but often does not provide insight into etiology. This case highlights the importance of radiographic imaging in newly diagnosed vocal fold paralysis, and underscores the principle that a diagnosis is not idiopathic until all sources have been ruled out. PMID:34958270 | DOI:10.1177/01455613211069919 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence and Treatment Outcomes of Marine-Lenhart Syndrome in Japan

xlomafota13 shared this article with you from Inoreader Prevalence and Treatment Outcomes of Marine-Lenhart Syndrome in Japan Via radioactive iodine Eur Thyroid J. 2021 Nov;10(6):461-467. doi: 10.1159/000510312. Epub 2020 Sep 30. ABSTRACT INTRODUCTION: Marine-Lenhart syndrome (MLS) is now understood to be a combination of Graves' disease and autonomously functioning thyroid nodule(s) (AFTNs). The prevalence of the syndrome and suitable treatments for those living in iodine-sufficient areas are uncertain. OBJECTIVES: We aimed to investigate the prevalence, treatment, and prognosis of MLS in Japan, an iodine-sufficient area. METHODS: This study involved patients who visited our hospital between February 2005 and August 2019. Among patients with both thyrotoxicosis and thyroid nodule(s) larger than 10 mm, MLS and isolated AFTNs were diagnosed based on serum thyroid-stimulating hormone receptor antibody levels and scintigraphy using radioiodine or technetium-99m and thyroid uptake. RESULTS: Twenty-two patients were found to have MLS, compared to 372 with isolated AFTNs and 8,343 with Graves' disease, during the period. Therefore, the rate of MLS cases was 0.26% among all patients with Graves' disease (22/8,343). Treatments and outcomes were assessed for cases of MLS (n = 18) and isolated AFTNs (n = 269). Antithyroid drugs (ATDs) were withdrawn in 27.8% of cases in the MLS group and 10.3% in the isolated AFTN group. There was no significant difference in the clinical outcome after ATD withdrawal between the 2 groups. However, the rate of hypothyroidism after radioactive iodine (R AI) administration was significantly higher in the MLS group than in the isolated AFTN group (42.9 vs. 9.0%, p = 0.005) despite similar doses of RAI. CONCLUSIONS: The prevalence of MLS among patients with Graves' disease was 0.26% in Japan. RAI therapy induces hypothyroidism more frequently than in those with AFTNs probably because RAI is taken up in the surrounding Graves' tissues. PMID:34950599 | PMC:PMC8647058 | DOI:10.1159/000510312 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.