To Study the Role of FNAC in Pre-operative Diagnostic Work Up and Management in Parotid Tumours

Abstract

Parotid gland is an important major salivary gland connected to the oral cavity. Salivary gland tumours are infrequent around less than 3% of head and neck tumours. Parotid gland is the most common site for the occurrence of salivary tumors. They are heterogeneous group of neoplasm characterized by the varying histological features and clinical behaviour. In our study we have examined the role of FNAC for preoperative diagnostic and management. We have concluded that Fine needle aspiration cytology is advocated routinely to know the type and nature of the tumour as an important pre-operatively diagnostic work up. It helps in preoperative identification of type of tumour neoplastic or benign, preoperative counselling of patient, planning of management of tumour, and preparing the patient and the surgical team for the more extensive procedure generally required for a high grade malignancy.



https://ift.tt/2qDPL82

Newborn Hearing Screening: Time to Act!

Abstract

The present study was carried out with the aim of assessing the outcomes of otoacoustic hearing screening in newborns coupled with the three stage protocol. It was a hospital based observational study which was conducted over a time period of twelve months at a tertiary care institute to screen 2000 live neonates for congenital hearing impairment using OAE, followed up by tympanometry and BERA, if required. 2000 neonates were screened for hearing impairment. 406 were in high risk group and the rest in non-high risk group. Seven neonates had absent V wave on BERA. Five of them were high risk babies and the rest two were non-high risk ones. In order to ensure that early detection and effective intervention are possible for all neonates with hearing impairment, UNHS should be performed. Three stage UNHS protocol using OAE and BERA showed that the implementation of UNHS for congenital childhood hearing loss for all neonates would be beneficial.



https://ift.tt/2H4bErX

Invasive Listeriosis of Intracardiac Device

Introduction. Listeria monocytogenes is a food-borne pathogen which can cause invasive infection in immunocompromised adults. Listeria has been known to cause infections during pregnancy and in older adults. Listeria endocarditis is a rare condition. A case of listeria-related intracardiac device infection is reported below. Case Report. A 74-year-old male with a past medical history of coronary artery disease, congestive cardiac failure, permanent atrial fibrillation status after nodal ablation, and placement of a biventricular pacemaker presented to the hospital with complaints of generalized fatigue. He was found to have listeria bacteremia, and transthoracic echocardiogram (TTE) showed pacemaker lead vegetation. The patient was treated with 6 weeks of vancomycin followed by oral suppression with amoxicillin. Discussion. Listeria can affect native valves, prosthetic valves, or nonvalvular intracardiac devices. The mean age of prosthetic valve endocarditis has been reported to be 67 years with male-to-female ratio 1.7 : 1 and mitral-to-aortic valve ratio 1.3 : 1. There have been case reports of listeria prosthetic valve endocarditis; however, there is paucity of literature on listeria-related pacemaker lead infection. Treatment is mostly a combination of penicillin and aminoglycosides for 4–6 weeks. Surgical removal of the infected device is preferred. Invasive listeriosis is a rare but fatal entity which should be identified and treated promptly to ensure a good outcome.

https://ift.tt/2ETj5fM

40 Millionen Euro für die medizinische Forschung

Die Hochschulmedizin in Deutschland soll für junge Wissenschaftler attraktiver werden. Den Startschuss dazu gibt jetzt nicht etwa die öffentliche Hand, sondern eine private Stiftung.



https://ift.tt/2JRRO18

Rezepte gestohlen? Schadensersatz droht!

Werden Rezepte und Stempel aus der Praxis gestohlen, sind Schadensersatzansprüche gegen Ärzte durchaus möglich — vorausgesetzt, sie haben ihre Sorgfaltspflicht verletzt.



https://ift.tt/2ES5ENc

Bei Krampfadern ist das Thromboserisiko erhöht

Varizen sollten, auch wenn sie keine Beschwerden verursachen, nicht nur als kosmetisches Problem angesehen werden: Sie sind mit einer erhöhten Rate von tiefen Venenthrombosen verknüpft.



https://ift.tt/2JRRK1o

Tagung Dermatologische Praxis 2018

Der Einsatz von Lasern in der ästhetischen Medizin ist vielfältig, wie jüngst auch wieder bei der Tagung Dermatologische Praxis 2018 gezeigt wurde. Die Weiterentwicklung der Methoden und die Kombination mit anderen Behandlungsformen verbessern die Ergebnisse zunehmend.



https://ift.tt/2JRRn70

Vitamin D schützt die Haut vor dem Altern, oder?

Die Literatur liefert widersprüchliche Ergebnisse zum Thema Vitamin D und Hautalterung. In-vitro-Experimente zeigen, dass Vitamin D die Haut vor dem Alter schützt, Populationsstudien demonstrieren das Gegenteil. Was stimmt?



https://ift.tt/2JQRwqZ

Gynäkomastie — Ursachen und mögliche Behandlungen

Die Gynäkomastie ist eine relativ verbreitete Veränderung der männlichen Brustdrüse. Vor einer Therapie sollten mögliche ursächliche Erkrankungen überprüft werden. Bei einer mäßiggradigen Ausprägung ist eine Volumenreduktion ohne Straffung der Umgebungshaut ausreichend, während bei ausgeprägteren Formen eine zusätzliche Straffung des überschüssigen Hautmantels erforderlich ist.



https://ift.tt/2vntFMF

To Study the Role of FNAC in Pre-operative Diagnostic Work Up and Management in Parotid Tumours

Abstract

Parotid gland is an important major salivary gland connected to the oral cavity. Salivary gland tumours are infrequent around less than 3% of head and neck tumours. Parotid gland is the most common site for the occurrence of salivary tumors. They are heterogeneous group of neoplasm characterized by the varying histological features and clinical behaviour. In our study we have examined the role of FNAC for preoperative diagnostic and management. We have concluded that Fine needle aspiration cytology is advocated routinely to know the type and nature of the tumour as an important pre-operatively diagnostic work up. It helps in preoperative identification of type of tumour neoplastic or benign, preoperative counselling of patient, planning of management of tumour, and preparing the patient and the surgical team for the more extensive procedure generally required for a high grade malignancy.



https://ift.tt/2qDPL82

Newborn Hearing Screening: Time to Act!

Abstract

The present study was carried out with the aim of assessing the outcomes of otoacoustic hearing screening in newborns coupled with the three stage protocol. It was a hospital based observational study which was conducted over a time period of twelve months at a tertiary care institute to screen 2000 live neonates for congenital hearing impairment using OAE, followed up by tympanometry and BERA, if required. 2000 neonates were screened for hearing impairment. 406 were in high risk group and the rest in non-high risk group. Seven neonates had absent V wave on BERA. Five of them were high risk babies and the rest two were non-high risk ones. In order to ensure that early detection and effective intervention are possible for all neonates with hearing impairment, UNHS should be performed. Three stage UNHS protocol using OAE and BERA showed that the implementation of UNHS for congenital childhood hearing loss for all neonates would be beneficial.



https://ift.tt/2H4bErX

Epidemiological features of cancers of the oral cavity, oropharynx, hypopharynx and larynx cancer in Réunion Island

Publication date: Available online 16 April 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): A. Delagranda, G. Leterme, E. Chirpaz, C. Ferdynus, C. Fernandez, F. Rubin
IntroductionThis study had two objectives: firstly, to identify and compare characteristics of cancer of the oral cavity, oropharynx, hypopharynx and larynx in Réunion Island, a tropical French overseas territory in the southern hemisphere; and secondly, to discuss how incidence of these cancers is presented in the international literature.Material and methodA retrospective study included 599 patients diagnosed with cancer of the oral cavity, oropharynx, hypopharynx or larynx between 2009 and 2013 in Réunion Island. Demographic characteristics and data on alcohol consumption, smoking habits and HPV infection were analyzed. Standardized incidences were calculated for the worldwide population for both genders.ResultsSex ratio was 7.7 and mean age was 60 years. Cancer consisted of squamous cell carcinoma in 99.1% of patients. Three hundred and forty over 375 patients (81.25%) showed alcohol abuse; 309/359 (86.1%) were smokers; 31/184 (16%) had HPV infection. On the International Agency for Research on Cancer (IARC) anatomic classification, the incidence of "other pharynx" locations was 9.3/100,000 for men and 0.7/100,000 for women, and incidence of "larynx" locations was 6.4/100,000 for men and 0.4/100,000 for women.ConclusionRéunion Island features some particularities in terms of incidence: women are less than half as likely as in Metropolitan France to develop any type of cancer, whereas incidence in males is among highest in France. The presentation of results in cancer registries could be improved in line with everyday practice in head and neck surgery.



https://ift.tt/2HFJmRA

Marginal adaptation of lithium disilicate ceramic crowns cemented with three different resin cements

Abstract

Objectives

The cementation process and cementation materials have an influence on the marginal adaptation of restorations. The gap could be affected by thermal and mechanical loading (TCML). The computerized x-ray microtomography (μCT) method offers the possibility of measuring the marginal gap without destruction of the restoration. The aim of this study was to evaluate the marginal gap (MG) and the absolute marginal discrepancy (AMD) before and after TCML.

Materials and methods

Thirty-nine human premolars were prepared for full ceramic crowns made of lithium disilicate. The crowns were cemented by three different resins—Panavia F 2.0, Variolink II, and Relyx Unicem. The MG and AMD were evaluated by μCT before and after TCML.

Results

Panavia F 2.0 had the lowest MG (before 118 μm–after TMCL 124 μm) and AMD (before 145 μm–after TMCL 154 μm), followed by Relyx Unicem (MG: before 164 μm–after TCML 155 μm; AMD: before 213 μm–after TMCL 209 μm) and Variolink II (MG: before 317 μm–after TMCL 320 μm; AMD: before 412 μm–after TMCL 406 μm). The differences were statistically significant before and after TCML. Rather than TCML, it appeared the resin cement was responsible for differences between the MG and AMD before and after TCML.

Conclusions

μCT is an accurate technique for assessing cemented restorations. Panavia F 2.0 has the lowest MG and AMD before and after TCML.

Clinical relevance

The resin material that features a three-step protocol (Variolink II) produced higher MG and AMG values than the Panavia or Relyx Unicem varieties with less or no intermediate steps at all.



https://ift.tt/2vmdfE4

Analgetikabedarf bei Kindern im Alter zwischen 2 und 12 Jahren nach Tonsillenoperationen

10-1055-a-0596-7675-1.jpg

Laryngo-Rhino-Otol
DOI: 10.1055/a-0596-7675

Hintergrund Mandeloperationen bei Kindern zählen zu den schmerzhaftesten Eingriffen. Altersgerechte Schmerzskalen sind die Kindliche Unbehagens- und Schmerzskala (KUSS), die Faces Pain Scale–Revised (FPS-R) und der kaum bekannte PPPM-D-Fragebogen. Ziel war Evaluation der Analgesie bei durch Eltern angeforderter Nichtopioid-Medikation (NOM) mit Ibuprofen (IBU) und Paracetamol (PCM) nach intrakapsulärer Tonsillektomie (TO) oder extrakapsulärer Tonsillektomie (TE). Als Rescue-Medikation (RM) wurde nach Prüfung der Schmerzskalen Piritramid appliziert. Endpunkte waren Anteil der Patienten (PAT), der die RM benötigte, Menge applizierter NOM, Übereinstimmung der Indikation in verschiedenen Schmerzskalen, Korrelation von Schmerzen mit Prämedikation und Eingriffsdauer. Material/Methoden Postoperativ erfolgten 3 Messungen täglich mit KUSS bei PAT ≤ 4 Jahre bzw. FPS-R ≥ 5 Jahre. Eltern füllten den PPPM-D aus. Bei einem Wert ≥ 4 bei KUSS bzw. FPS-R oder ≥ 6 im PPPM-D wurde die RM indiziert. Ergebnisse 68 PAT wurden in eine Zwischenauswertung eingeschlossen. Durchschnittliche tägliche NOM in den ersten 3 Tagen: nach TE 14,1–16,3 mg/Kg IBU und 4,2–12,4 mg/Kg PCM bzw. nach TO 10,8–14,7 mg/Kg IBU und 5,2–8,8 mg/Kg PCM. Bei 212 Visiten wurde die RM indiziert, davon 121 Mal nur durch den PPPM-D. Nach Ausschluss eventuell falsch-positiver Indikationen benötigten 67 % der PAT nach TE und 48 % der PAT nach TO mindestens einmal die RM. Die Studie wurde wegen des hohen RM-Bedarfs abgebrochen. Schlussfolgerungen Der Bedarf an NOM wurde unterschätzt. Der PPPM-D kombiniert mit etablierten Skalen kann die postoperative Schmerztherapie verbessern.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text



https://ift.tt/2vq5e16

Does Encountering the Facial Nerve During Surgical Management of Mandibular Condylar Process Fractures Increase the Risk of Facial Nerve Weakness? A systematic review and meta-regression analysis

The purpose of this study was to identify whether the incidence of systematically identified or incidentally encountered facial nerve branches during dissection to approach condylar fractures increases risk of transient and/or permanent facial nerve weakness.

https://ift.tt/2qE7xIU

Topical Janus Kinase Inhibitors: A Review of Applications in Dermatology

Janus kinase inhibitors (JAKi) have attracted attention for their role in treating inflammatory disorders. This new class of biologics has the potential to significantly impact the field of dermatology, especially with the development of topical formulations.

https://ift.tt/2qCVhHO

Clinical features and prognosis of Asian patients with acral lentiginous melanoma who have nodal nevi in their sentinel lymph node biopsy specimen.

Nodal melanocytic nevi (NN) encountered during sentinel lymph node biopsy (SLB) for malignant melanoma are usually difficult to distinguish from metastatic melanoma. However, NN have not been studied well in acral lentiginous melanoma (ALM) in Asian populations.

https://ift.tt/2H839fO

Functional and anatomical results of inside out approach for cholesteatoma surgery

To study the efficacy of inside-out approach in completely eradicating the cholesteatoma from middle ear and mastoid, preservation of hearing & and quality of life post mastoidectomy with regards to recurrent discharge, wax, granulations.

https://ift.tt/2IX3Gxy

Management of laryngeal cleft in mechanically ventilated children with severe comorbidities

Laryngeal clefts are rare congenital malformations of the posterior part of the larynx. The severities are correlated with the downward extension of the cleft and can involve numerous clinical symptoms including dysphagia and respiratory distress. As significant comorbidities may be present, individual treatments depend on the child's general condition and type of cleft involved. Herein, we describe two cases of children with laryngeal clefts and severe comorbidities requiring mechanical ventilation.

https://ift.tt/2qBgHFt

Incidence and treatment of complications in patients who had third molars or other teeth extracted

The aim of this study was to compare the incidence of complications after extraction of third molars (M3) or other teeth, and to describe their management. We made a retrospective cohort study of patients having M3 or other teeth extracted, and recorded complications up to two years' follow-up. A total of 142 complications developed after 2355 procedures (6%) – 7% after extraction of M3 compared with 5% after extractions of other teeth (p=0.024). The three most common complications were wound infection (2%), pain without apparent cause (<1%), and oroantral communication (<1%).

https://ift.tt/2vn031Q

Molecular interactions at the surface of extracellular vesicles

Abstract

Extracellular vesicles such as exosomes, microvesicles, apoptotic bodies, and large oncosomes have been shown to participate in a wide variety of biological processes and are currently under intense investigation in many different fields of biomedicine. One of the key features of extracellular vesicles is that they have relatively large surface compared to their volume. Some extracellular vesicle surface molecules are shared with those of the plasma membrane of the releasing cell, while other molecules are characteristic for extracellular vesicular surfaces. Besides proteins, lipids, glycans, and nucleic acids are also players of extracellular vesicle surface interactions. Being secreted and present in high number in biological samples, collectively extracellular vesicles represent a uniquely large interactive surface area which can establish contacts both with cells and with molecules in the extracellular microenvironment. Here, we provide a brief overview of known components of the extracellular vesicle surface interactome and highlight some already established roles of the extracellular vesicle surface interactions in different biological processes in health and disease.



https://ift.tt/2qABJob

Impact of age on postoperative complication rates among elderly patients with hip fracture: a retrospective matched study

Abstract

This study was performed to assess the impact of age of ≥ 90 years on predicting postoperative complications. We retrospectively identified all patients aged ≥ 65 years who underwent surgical repair of hip fractures over a 4.5-year period in our hospital. In total, 261 patients were identified (mean age, 86.2 ± 6.8 years). Ninety-one patients were aged ≥ 90 years (oldest-old group), and the remaining 170 were aged < 89 years (control old group). Postoperative complications developed in 54 of 261 patients (20.7%). The oldest-old group had a significantly higher proportion of patients with a Japanese long-term care insurance need level and trochanteric fracture than the control group. Spinal anesthesia was more frequently performed in the oldest-old group. After propensity adjustment for these characteristics, postoperative complication rates in the oldest-old group remained significantly higher than those in the matched control group (odds ratio (OR) 2.76, 95% confidence interval (95% CI) 1.24–6.49; P = 0.011). Major complications also developed more frequently in the oldest-old group than control group (OR 9.78, 95% CI 1.31–4.36; P = 0.018). Anesthesiologists and surgeons should pay attention to potential complications following hip fracture surgery for patients aged ≥ 90 years regardless of American Society of Anesthesiologists class or social dependency.



https://ift.tt/2HqHU7W

Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis

Miliary histoplasmosis is a rare presentation that may mimic miliary tuberculosis. We report a case of miliary histoplasmosis in a 52-year-old male who was being treated with hydroxychloroquine, methotrexate, and sulfasalazine for his rheumatoid arthritis and presented to the emergency department with shortness of breath and fevers. Computed tomography (CT) chest revealed miliary pulmonary nodules. Urine Histoplasma antigen and serum Histoplasma antigen were negative; however, Coccidioides immitis complement immunofixation assay and Coccidioides IgM were positive. The patient was initiated on treatment for pulmonary coccidioidomycosis and immunosuppression was held. However, a few days later, Histoplasma capsulatum was isolated from cultures from bronchoscopy. This case highlights the difficulty in diagnosing histoplasmosis in immunocompromised patients and the importance of having a broad differential diagnosis for miliary pulmonary nodules. Tissue culture and histopathology remain the gold standard for the diagnosis of histoplasmosis. Further research needs to be conducted to determine the optimal duration of histoplasmosis treatment in immunocompromised patients.

https://ift.tt/2HBtUWE

Atypical Presentation of Meckel’s Diverticulum in a Hispanic Man: A Case Report

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Abstract
The incidence of Meckel's diverticulum is 2% in the general population. Although most commonly found in children as painless rectal bleeding, in adults, obstruction, inflammation, and perforation are the usual manifestations. We present the case of a 32 year old man who arrived at our institution with hematochezia and symptomatic anemia. A large Meckel's diverticulum was encountered during work-up and treated by segmental small bowel resection. A literature review, including disease presentation, pathology findings, and treatment options is discussed.

https://ift.tt/2vqTn2X

Ambient Air Pollution and Asthma-Related Outcomes in Children of Color of the USA: a Scoping Review of Literature Published Between 2013 and 2017

Abstract

Purpose of Review

Given racial disparities in ambient air pollution (AAP) exposure and asthma risk, this review offers an overview of the literature investigating the ambient air pollution-asthma relationship in children of color between 2013 and 2017.

Recent Findings

AAP is likely a key contributor to the excess burden of asthma in children of color due to pervasive exposure before birth, at home, and in school. Recent findings suggest that psychosocial stressors may modify the relationship between AAP and asthma.

Summary

The effect of AAP on asthma in children of color is likely modulated by multiple unique psychosocial stressors and gene-environment interactions. Although children of color are being included in asthma studies, more research is still needed on impacts of specific criteria pollutants throughout the life course. Additionally, future studies should consider historical factors when analyzing current exposure profiles.



https://ift.tt/2HsCJ7A

Ambient Air Pollution and Asthma-Related Outcomes in Children of Color of the USA: a Scoping Review of Literature Published Between 2013 and 2017

Abstract

Purpose of Review

Given racial disparities in ambient air pollution (AAP) exposure and asthma risk, this review offers an overview of the literature investigating the ambient air pollution-asthma relationship in children of color between 2013 and 2017.

Recent Findings

AAP is likely a key contributor to the excess burden of asthma in children of color due to pervasive exposure before birth, at home, and in school. Recent findings suggest that psychosocial stressors may modify the relationship between AAP and asthma.

Summary

The effect of AAP on asthma in children of color is likely modulated by multiple unique psychosocial stressors and gene-environment interactions. Although children of color are being included in asthma studies, more research is still needed on impacts of specific criteria pollutants throughout the life course. Additionally, future studies should consider historical factors when analyzing current exposure profiles.



https://ift.tt/2HsCJ7A