Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Τρίτη 12 Οκτωβρίου 2021

Radioiodine

Comparison of Pericranial Autograft and AlloDerm for Duraplasty in Patients With Type I Chiari Malformation: Retrospective Cohort Analysis

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Oper Neurosurg (Hagerstown). 2021 Oct 11:opab343. doi: 10.1093/ons/opab343. Online ahead of print.

ABSTRACT

BACKGROUND: Pericranial autograft is a popular option for duraplasty during Chiari decompression with several theoretical advantages, but comparisons to other materials have yielded mixed results.

OBJECTIVE: To compare outcomes between pericranial autograft and AlloDerm (BioHorizons).

METHODS: Consecutive suboccipital craniectomies for patients with type I Chiari malformation (CM-I) over an 8-yr period at a single institution were identified. Exclusion criteria included revision surgeries and suboccipital decompressions without duraplasty. Outcomes included incisional cerebrospinal fluid (CSF) leakage, length of stay (LOS), wound complication, aseptic meningitis, syrinx improvement, and symptomatic improvement.

RESULTS: A total of 101 patients (70 females and 31 males) with a median (interquartile range) age of 17 yr ( 11-32) met the inclusion criteria. There were 51 (50%) patients who underwent duraplasty with pericranial autograft, and the remainder underwent duraplasty with AlloDerm. There were 9 (9%) patients who experienced a postoperative CSF leak. After adjusting for confounding factors, obesity (odds ratio [OR]: 4.69, 95% CI: 1.03-25.6) and use of AlloDerm (OR: 10.54, 95% CI: 1.7-206.12) were associated with CSF leak. Wound complication occurred in 8 (8%) patients but was not associated with graft type (P = .8). Graft type was not associated with LOS, syrinx improvement, or symptom improvement. Reoperations occurred in 10 patients with 4 in the autograft group and 6 in the AlloDerm group (P = .71).

CONCLUSION: In patients with CM-I, expansile duraplasty with AlloDerm was associated with greater odds of CSF leakage than pericranial autograft. Obesity was also associated with increased odds of CSF leakage.

PMID:34634804 | DOI:10.1093/ons/opab343

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Resveratrol protects against inorganic arsenic-induced oxidative damage and cytoarchitectural alterations in female mouse hippocampus

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Via histochem

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Acta Histochem. 2021 Oct 8;123(7):151792. doi: 10.1016/j.acthis.2021.151792. Online ahead of print.

ABSTRACT

Prolonged inorganic arsenic (iAs) exposure is widely associated with brain damage particularly in the hippocampus via oxidative and apoptotic pathways. Resveratrol (RES) has gained considerable attention because of its benefits to human health. However, its neuroprotective potential against iAs-induced toxicity in CA1 region of hippocampus remains unexplored. Therefor e, we investigated the neuroprotective efficacy of RES against arsenic trioxide (As2O3)-induced adverse effects on neuronal morphology, apoptotic markers and oxidative stress parameters in mouse CA1 region (hippocampus). Adult female Swiss albino mice of reproductive maturity were orally exposed to either As2O3 (2 and 4 mg/kg bw) alone or in combination with RES (40 mg/kg bw) for a period of 45 days. After animal sacrifice on day 46, the perfusion fixed brain samples were used for the observation of neuronal morphology and studying the morphometric features. While the freshly dissected hippocampi were processed for biochemical estimation of oxidative stress markers and western blotting of apoptosis-associated proteins. Chronic iAs exposure led to significant decrease in Stratum Pyramidale layer thickness along with reduction in cell density and area of Pyramidal neurons in contrast to the controls. Biochemical analysis showed reduced hippo campal GSH content but no change in total nitrite (NO) levels following iAs exposure. Western blotting showed apparent changes in the expression levels of Bax and Bcl-2 proteins following iAs exposure, however the change was statistically insignificant. Contrastingly, iAs +RES co-treatment exhibited substantial reversal in morphological and biochemical observations. Together, these findings provide preliminary evidence of neuroprotective role of RES on structural and biochemical alterations pertaining to mouse hippocampus following chronic iAs exposure.

PMID:34634674 | DOI:10.1016/j.acthis.2021.151792

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Mechanisms and thermodynamic modelling of iodide sorption on AFm phases

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J Colloid Interface Sci. 2021 Sep 22;608(Pt 1):683-691. doi: 10.1016/j.jcis.2021.09.104. Online ahead of print.

ABSTRACT

Both, experimental and modelling evidence is presented in this study showing that interlayer anion exchange is the dominant sorption mechanism for iodide (I-) on AFm phases. AFm phases are Ca-Al(Fe) based layered double hydroxides (LDH) known for their large potential for the immobilization of anionic radionuclides, such as dose-relevant iodine-129, em anating from low- and intermediate-level radioactive waste (L/ILW) repositories. Monosulfate, sulfide-AFm, hemicarbonate and monocarbonate are safety-relevant AFm phases, expected to be present in the cementitious near-field of such repositories. Their ability to bind I- was investigated in a series of sorption and co-precipitation experiments. The sorption of I- on different AFm phases was found to depend on the type of the interlayer anion. Sorption Rd values are very similar for monosulfate, sulfide-AFm and hemicarbonate. A slightly higher uptake occurs by AFm phases with a singly charged anion in the interlayer (HS-AFm) as compared to AFm with divalent ions (monosulfate), whereas uptake by hemicarbonate is intermediate. No significant sorption occurs onto monocarbonate. Our derived thermodynamic solid solution models reproduce the experimentally obtained sorption isotherms on HS-AFm, hemicarbonate and monosulfate, indicating that anion exchange i n the interlayer is the dominant mechanism and that the contribution of I- electrostatic surface sorption to the overall uptake is negligible.

PMID:34634544 | DOI:10.1016/j.jcis.2021.09.104

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Necrotising Myositis - Learnings for a Plastic Surgeon

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J Plast Reconstr Aesthet Surg. 2021 Sep 20:S1748-6815(21)00434-4. doi: 10.1016/j.bjps.2021.08.046. Online ahead of print.

ABSTRACT

BACKGROUND: Necrotising myositis (NM) is a life-threatening emergency. Prompt treatment is associated with more favourable outcomes, but early diagnosis is challenging. The initial absence of cutaneous signs and symptoms coupled with delayed recognition commonly result in higher rates of morbidity and mortality.

OBJECTIVES: Analyse data regarding demographics, epidemiology, aetiology, clinical manifestations, diagnosis and treatment of previously reported cases. This publication is intended for plastic surgeons in training to help them look out for this disease.

SEARCH METHODS/CRITERIA: Publications reporting necrotising myositis between 1974 to January 2020 were identified from Embase, Medline All, Web of Science Core Collection, Google Scholar and Cochrane Central Register of Controlled Trial.

DATA COLLECTION AND ANALYSIS: Identified studies were exported to an end note library. In animal studies, studies relating to statin-induced myotoxicity and auto-immune myositis were excluded. The quality of included case reports was assessed using JBI Critical Appraisal Checklist for Case Reports.

MAIN RESULTS: The most common initial presentation was a few days of antecedent prodromal flu-like symptoms associated with muscle pain. The mean age was 43.3 years and 82% had no significant medical history. The most frequent misdiagnoses were muscle strain (11%), deep vein thrombosis (10%) and viral illness (9%). Seventy-four per cent of presentations were due to Group A Streptococcus infections and only 3.5% of cases were polymicrobial. The most common clinical course following the initial presentation was rapid deterioration into profound sepsis and progression into multi-organ failure. The overall mortality rate was 36.5%.

CONCLUSIONS: NM is a life-threatening musc le infection. It is a diagnostic conundrum as initial presentation is often only myalgia without features of preceding trauma. We propose that a high index of suspicion and increased awareness will reduce morbidity.

OTHER: PROSPERO (registration number CRD42018087060). Nil funding/conflict of interest.

PMID:34635455 | DOI:10.1016/j.bjps.2021.08.046

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Prepectoral implant-based breast reconstruction with TiLOOP® Bra Pocket - a single-centre retrospective study

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J Plast Reconstr Aesthet Surg. 2021 Sep 17:S1748-6815(21)00413-7. doi: 10.1016/j.bjps.2021.08.027. Online ahead of print.

ABSTRACT

BACKGROUND: Prepectoral implant-based reconstruction using synthetic meshes is feasible with good outcomes. We present our data using TiLOOP® Bra Pocket, a novel ready-to-use mesh pocket which acts as an internal bra and prevents the implant from dislocating or twisting.

MATERIALS AND METHODS: A single-centre retrospective cohort study was performed to assess short-term complication rates and cosmetic outcomes in patients with prepectoral implant-based reconstruction using the TiLOOP® Bra Pocket. The primary endpoint was complication rates during the first 6 months. The secondary endpoint was the cosmetic outcome after 6 to 12 months, which was judged by two breast surgeons using the Harvard score.

RESULTS: A total of 63 breasts (43 patients) were reconstructed using the TiLOOP® Bra Pocket be tween 2018 and 2020, 57 were immediate reconstructions. The overall complication rate was 30,2% (n = 19/63). Major complications occurred in seven breasts (n = 7/63; 11,1%) and minor complications occurred in 12 breasts (12/63; 19,0%). The unplanned revision rate was 12,7%. The cosmetic outcome was good (Harvard score: mean 3, range 1-4; SD 0,75). Seventeen cosmetic complications were observed (17/63; 27,0%) and six cosmetic revision surgeries were performed (6/63; 9,5%).

CONCLUSION: The use of the TiLOOP® Bra Pocket is convenient and standardized because the pocket is preformed and does not require to be sewn first. Cosmetic outcome is good; however, the surgical morbidity needs to be addressed in future reconstructions. Careful patient selection and preparation techniques are vital in order to achieve acceptable complication rates and satisfying cosmetic results.

PMID:34635454 | DOI:10.1016/j.bjps.2021.08.027

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A silent, trapped guest in the maxillary sinus: Oestrus ovis myiasis with unusual presentation (with CARE guideline)

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Publication date: Available online 11 October 2021

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): A. İşlek, S. Şimşek

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Extramedullary Solitary Plasmacytoma of Larynx: A Rare Entity and Therapeutic Challenge

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Abstract

Solitary extramedullary plasmacytoma is a rare entity. The diagnosis is established by clinical evaluation, detailed radiological workup and histopathology with immunohistochemistry markers. There is no clear standard of care for a solitary laryngeal plasmacytoma. A case of solitary laryngeal plasmacytoma is being reported here with the rationale for the chosen treatment modality.

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