Πέμπτη 14 Οκτωβρίου 2021

Evaluation of Nocturnal Enuresis After Adenotonsillectomy in Children With Obstructive Sleep Apnea

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This secondary analysis of a randomized clinical trial of children who underwent adenotonsillectomy for nonsevere obstructive sleep apnea evaluates the prevalence of nocturnal enuresis after the operation.
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Olfactory Bulb Volume—A Novel Preclinical Biomarker for Smell Loss and Neurodegenerative Disease

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Neurodegenerative disorders, such as Alzheimer dementia and Parkinson disease, are disabling diseases that present a burden on society that rivals the costs of cancer and heart disease. Although current therapies are often unsuccessful at reversing the progression of these diseases, early detection in patients who are at risk of neurodegenerative disease could allow for timely interventions to delay and minimize the loss of brain function over time.
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Placement of a Double-Lumen Endotracheal Tube

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Management of Pediatric Graves Disease: A Review

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JAMA Otolaryngol Head Neck Surg. 2021 Oct 14. doi: 10.1001/jamaoto.2021.2715. Online ahead of print.

ABSTRACT

IMPORTANCE: The incidence of Graves disease (GD) is rising in children, and adequate care of these patients requires a multidisciplinary approach. Whether patients are seen in the context of endocrinology, nuclear medicine, or surgery, it is important to know the nuances of the therapeutic options in children.

OBSERVATIONS: Given the rarity of GD in children, it is important to rec ognize its various clinical presenting signs and symptoms, as well as the tests that may be important for diagnosis. The diagnosis is typically suspected clinically and then confirmed biochemically. Imaging tests, including thyroid ultrasonography and/or nuclear scintigraphy, may also be used as indicated during care. It is important to understand the indications for and interpretation of laboratory and imaging tools so that a diagnosis is made efficiently and unnecessary tests are not ordered. Clinicians should be well-versed in treatment options to appropriately counsel families. There are specific scenarios in which medical therapy, radioactive iodine therapy, or surgery should be offered.

CONCLUSIONS AND RELEVANCE: The diagnosis and treatment of pediatric patients with GD requires a multidisciplinary approach, involving pediatric specialists in the fields of endocrinology, ophthalmology, radiology, nuclear medicine, and surgery/otolaryngology. Antithyroid drugs are typical ly the first-line treatment, but sustained remission rates with medical management are low in the pediatric population. Consequently, definitive treatment is often necessary, either with radioactive iodine or with surgery, ideally performed by experienced, high-volume pediatric experts. Specific clinical characteristics, such as patients younger than 5 years or the presence of a thyroid nodule, may make surgery the optimal treatment for certain patients.

PMID:34647991 | DOI:10.1001/jamaoto.2021.2715

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Expression and clinical significance of TIMELESS in glioma

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Int J Clin Exp Pathol. 2021 Sep 15;14(9):938-955. eCollection 2021.

ABSTRACT

In recent years, studies have shown that TIMELESS, as an oncogene, is involved in progression of cancers. However, its relationship with prognosis in glioma patients is rarely reported. Our purpose was to explore the role of TIMELESS in glioma. Based on 1814 glioma samples from multiple databases such as The Cancer Genome Atlas (TCGA), The Chinese Glioma Genome Atlas (CGGA), and The Gene Expression Omnibus (GEO), we use a variety of bioinformatics methods to verify the mechanism of action of TIMELESS in glioma from mRNA to protein, from appearance to mechanism analysis, from clinical features to prognosis. Then, the connectivity map (CMap) tool was used to predict drugs that inhibit the expression of TIMELESS. First, we found TIMELESS is highly expressed in glioma at mRNA and protein levels. Second, TIMELESS is an inde pendent risk factor in prognosis and has suitable clinical diagnostic value in glioma. It was also positively correlated with World Health Organization (WHO) grade, age, and histology, and negatively correlated with isocitrate dehydrogenase (IDH) 1 mutation and 1p19q codeletion. Third, base excision, cell cycle, and mismatch repair pathway were activated by TIMELESS in glioma. We predict small molecules to inhibit TIMELESS such as 8-azaguanine, gw8510, 6-thioguanosine, and ursodeoxycholic acid. This study is the first comprehensive analysis of TIMELESS, revealing a relationship between this novel oncogene, clinical characteristics of patients with glioma, and a mechanism leading to poor prognosis. It also provides a biomarker for diagnosis and treatment of glioma and reveal the pathologic progress of glioma at the genetic level.

PMID:34646412 | PMC:PMC8493260

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The application of orthodontic bone stretching for correcting malpositioned dental implants

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Dental implants are sometimes initially placed in a wrong position leading to esthetic damage, which is difficult to solve with prosthetics. Moreover, implants placed in the anterior sector, like ankylosed tee...
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Disease-free time stratification in locally recurrent head and neck carcinoma after definitive radiotherapy or chemoradiotherapy

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Eur Arch Otorhinolaryngol. 2021 Oct 14. doi: 10.1007/s00405-021-07116-6. Online ahead of print.

ABSTRACT

PURPOSE: There is no standard definition of disease-free interval before local recurrence after treatment in head and neck carcinoma (HNSCC). We evaluated an easy-to-use stratification and its association with survival in a large cohort of patients.

METHODS: We performed a retrospective cohort analysis of prognostic variables in 325 HNSCC patients with a local recurrence after definitive radiotherapy or concurrent chemoradiotherapy. Endpoints were overall survival (OS) and post-recurrence survival (PRS).

RESULTS: Variables associated with the survival were the patient age (OS p < 0.0001, PRS p < 0.0001), the initial disease stage (OS p = 0.24, PRS p = 0.0358), localization (OS p = 0.012, PRS p = 0.0002), a complete initial response to treatment (OS p < 0.0001, PRS p = 0.019), synchronous regional or distant meta static disease (OS p = 0.0094, PRS p < 0.0001), a salvage surgery (OS p < 0.0001, PRS p < 0.0001) and time to recurrence (OS p = 0.0002, PRS p = 0.0029). Time to recurrence could be stratified between specific prognostic time categories that comprised disease persistence, early recurrence (< 12 months), standard recurrence (12 months-5 years) and late recurrence (> 5 years).

CONCLUSION: In HNSCC patients, time to local recurrence is a prognostic variable that can be defined using an easy-to-use stratification.

PMID:34648050 | DOI:10.1007/s00405-021-07116-6

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