Evaluation of human acellular amniotic membrane for promoting anterior auricle reconstruction

xlomafota13 shared this article with you from Inoreader Evaluation of human acellular amniotic membrane for promoting anterior auricle reconstruction Via Experimental Dermatology View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long‐term hearing performance and soft tissue outcomes of the Baha® Attract system in patients with bilateral congenital microtia in a single centre

xlomafota13 shared this article with you from Inoreader Long‐term hearing performance and soft tissue outcomes of the Baha® Attract system in patients with bilateral congenital microtia in a single centre Via Clinical Otolaryngology Abstract The Baha® Attract system can provide effective and stable hearing amplification for patients with microtia. Concurrent surgeries of auricle reconstruction and Baha® Attract implantation do not result in more soft tissue complications. The number of adverse events increased with the duration of implantation, even one year postoperatively. Benign skin evolutions, including skin thinning and erythema at the implant side, are commonly seen in Baha® Attract users. Implants are not necessarily removed when skin necrosis occurs in Baha® Attract users. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The management of multimorphic cancer pain, from diagnosis to treatment

xlomafota13 shared this article with you from Inoreader The management of multimorphic cancer pain, from diagnosis to treatment Via Association française pour l'étude du cancer Bull Cancer. 2021 Nov 27:S0007-4551(21)00395-7. doi: 10.1016/j.bulcan.2021.08.013. Online ahead of print. ABSTRACT Cancer pain remains a major public health issue. Despite progress in pain medicine thanks to the interest shown in early and timely supportive care, more than half the patients managed for cancer are in pain. One of the key factors in high quality multidisciplinary management throughout the care pathway is to assess more than just pain: it is necessary to assess the patient as a whole. Understanding the complexity of cancer pain - or the various types of pain - through the innovative multimorphic cancer pain model, effectively opens up new perspectives for a targeted, personalised, and multimodal approach. The subsequent treatment strategies, whether drug-based with opioids, or interventional, are codified by guidelines based on scientific evidence for the healthcare professionals and, ultimately, patients. PMID:34848047 | DOI:10.1016/j.bulcan.2021.08.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New MAA: First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma

xlomafota13 shared this article with you from Inoreader New MAA: First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma Via Association française pour l'étude du cancer Bull Cancer. 2021 Nov 27:S0007-4551(21)00437-9. doi: 10.1016/j.bulcan.2021.09.013. Online ahead of print. NO ABSTRACT PMID:34848048 | DOI:10.1016/j.bulcan.2021.09.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of burned hand function after enzymatic debridement

xlomafota13 shared this article with you from Inoreader Evaluation of burned hand function after enzymatic debridement Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 22:S1748-6815(21)00517-9. doi: 10.1016/j.bjps.2021.09.074. Online ahead of print. ABSTRACT Hand burns are common injuries that can result in long-term impairment of hand function. Enzymatic debridement (ED) prevents damage to the viable dermis due to the procedure's selectivity and has become an option for obtaining an accurate depth assessment and enabling wound re-epithelialization with less skin graft use. We conducted a prospective study from July 2015 to July 2018, which enrolled patients with deep partial-thickness hand burns and treated them with ED using bromelain. After a specified period, we assessed the patients' hand function, using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Michigan Hand Outcomes Questionnaire (MHOQ) to assess their disabilities and activities of daily life, respectively. We assessed the hand joint range of motion using a goniometer a nd assessed scar quality with the Vancouver Scar Scale (VSS). We analyzed 72 patients with 90 burned hands at 3 months and, at the final assessment, 69 patients with 86 burned hands. Fire was the most common cause of the burns. Bromelain allowed for early debridement (73.6% during the first 24 h). At the 3-month evaluation, the mean DASH and MHOQ scores were 2.35 and 97.9%, respectively, with a high inverse correlation between the 2 types of scores (Spearman's rho, -0.78; p < .001). The mean wrist flexion and extension were 85.7 and 80°, respectively, the mean metacarpophalangeal flexion was 88.3°, the proximal interphalangeal (PIP) flexion was 112.9°, and the thumb opposition was 77°. The mean VSS score was 2.87. At the final evaluation, with a minimum follow-up of 391 days, the mean DASH and MHOQ scores were 0.18 and 99.71%, respectively. ED with bromelain in deep partial-thickness hand burns resulted in normal values at 3 months and at over 1 year of follow-up, with comple te restoration of function and quality of life and good scar results. PMID:34848129 | DOI:10.1016/j.bjps.2021.09.074 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic transcanal attico-antrostomy versus endoscopic-assisted canal wall up mastoidectomy in management of localized cholesteatoma: a randomized clinical trial

xlomafota13 shared this article with you from Inoreader Endoscopic transcanal attico-antrostomy versus endoscopic-assisted canal wall up mastoidectomy in management of localized cholesteatoma: a randomized clinical trial Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Dec 1. doi: 10.1007/s00405-021-07200-x. Online ahead of print. ABSTRACT OBJECTIVES: This study aims to compare results of endoscopic transcanal tympanoplasty with attico-antrostomy with endoscopic-assisted canal wall up mastoidectomy in treatment of cases of limited attic cholesteatoma. MATERIALS AND METHODS: A prospective randomized single-blinded study involving 40 patients with limited attic cholesteatoma was conducted. Randomization of the patients into two groups was done; 20 patients are managed by endoscopic transcanal tympanoplasty with attico-antrostomy, while the other 20 patients are managed by endoscopic-assisted canal wall up mastoidectomy. Primary outcome is recidivism, while secondary outcomes include hearing results, operative time, pain score and associated complications. RESULTS: Comparable recidivism rate was found in the two groups. The endoscopic-assisted canal wall up ma stoidectomy group was associated with significantly longer duration of surgery and higher postoperative pain score. There was no significant difference between both the groups regarding hearing results and associated complications. CONCLUSION: In localized attic cholesteatoma cases, endoscopic transcanal tympanoplasty with attico-antrostomy is a time-saving less-invasive reliable technique with good eradication results. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov (NCT04959539) "retrospectively registered" at 12/7/2021. PMID:34851451 | DOI:10.1007/s00405-021-07200-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow-band imaging technique: A systematic review

xlomafota13 shared this article with you from Inoreader Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow-band imaging technique: A systematic review Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):36. doi: 10.3892/etm.2021.10958. Epub 2021 Nov 10. ABSTRACT Narrow-band imaging (NBI), an on-demand, real-time endoscopic imaging technique, was developed to enhance visualization of the mucosal vascular network and surface texture. The present article provides a systematic review of studies that assessed the use of NBI in gynecological endoscopy. The following electronic databases were searched: PubMed (1950-2020), Google Scholar (2004-2020) and Cochrane Library (2010-2020). In the initial search, 3,836 entries were identified, of which 31 were finally included in the systematic review. Of the selected studies, 10 (32%) were case reports, 19 (61.2%) were prospective studies and 2 (6.4%) were randomized controlled trials with control groups. The selected studies reported on the use of NBI in hysteroscopy, laparoscopy and colposcopy. It was revealed that NBI utilization in hysteroscopy increased the accuracy , sensitivity and specificity in detecting malignant and premalignant lesions. NBI improved the specificity and sensitivity in the detection of endometriotic lesions and cervical lesions. Conventional white light endoscopy in gynecology may be significantly improved by the use of NBI. Further studies with larger cohorts and improved design are required to achieve more reliable results. It is of special interest that utilization of this method requires apparatus which is expensive; concerns are the long training and experience of staff required and the long learning curve. PMID:34849151 | PMC:PMC8613536 | DOI:10.3892/etm.2021.10958 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clarifying optimal outcome measures in intermittent and continuous laryngeal neuromonitoring

xlomafota13 shared this article with you from Inoreader Clarifying optimal outcome measures in intermittent and continuous laryngeal neuromonitoring Via Head & Neck Abstract Background Intraoperative neuromonitoring (IONM) techniques have evolved over the past decade into intermittent IONM (I-IONM) and continuous IONM (C-IONM) modes of application. Despite many prior publications on both types of IONM, there remains uncertainty about what outcomes should be measured for each form of IONM. The primary objective of this paper is to define categories of benefit for I-IONM/C-IONM and to clarify and standardize their reporting outcomes. Methods Expert review consensus statement utilizing modified Delphi methodology. Results I-IONM provides diagnosis, classification, and prevention of nerve injury through accurate and early nerve identification. C-IONM provides real-time information on nerve functional integrity and thus may prevent some types of nerve injury but cannot assist in nerve localization. Sudden mechanisms of nerve injury cannot be predicted or prevented by either technique. Conclusions I-IONM and C-IONM are complementary techniques. Future studies evaluating the utility of IONM should focus on outcomes that are appropriate to the type of IONM being utilized. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emergence of Invasive Fungal Rhinosinusitis in Recently Recovered COVID-19 Patients

xlomafota13 shared this article with you from Inoreader Emergence of Invasive Fungal Rhinosinusitis in Recently Recovered COVID-19 Patients Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Dec 1:34894211060923. doi: 10.1177/00034894211060923. Online ahead of print. ABSTRACT OBJECTIVE: The risk of invasive fungal rhinosinusitis is increased in Coronavirus disease 2019 (COVID-19) because of its direct impact in altering innate immunity and is further exacerbated by widespread use of steroids/antibiotics/monoclonal antibodies. The study aims to describe this recently increased clinical entity in association with COVID-19. METHO D: A prospective, longitudinal study including patients diagnosed with acute invasive fungal rhinosinusitis (AIFRS) who recently recovered from COVID-19 infection or after an asymptomatic carrier state. A single-center, descriptive study investigating demographic details, clinical presentation, radio-pathological aspects, and advocated management. RESULT: A total of 21 patients were included with a mean age of 49.62 years (SD: 14.24). Diabetes mellitus (DM) was the most common underlying disorder (90.48%), and 63.16% of all patients with DM had a recent onset DM, either diagnosed during or after COVID-19 infection. Nineteen patients (90.48%) had recently recovered from active COVID-19 infection, and all had a history of prior steroid treatment (oral/parenteral). Remaining 2 patients were asymptomatic COVID-19 carriers. Surprisingly, 2 patients had no underlying disorder, and 5 (23.81%) recently received the Covishield vaccine. Fungal analysis exhibited Mucor (95.24%) and Asper gillus species (14.29%). Most common sign/symptom was headache and facial/periorbital pain (85.71%), followed by facial/periorbital swelling (61.90%). Disease involvement: sinonasal (100%), orbital (47.62%), pterygopalatine fossa (28.58%), infratemporal fossa (14.29%), intracranial (23.81%), and skin (9.52%). Exclusive endoscopic debridement and combined approach were utilized in 61.90% and 38.10%, respectively. Both liposomal amphotericin B and posaconazole were given in all patients except one. CONCLUSION: A high suspicion of AIFRS should be kept in patients with recent COVID-19 infection who received steroids and presenting with headache, facial pain, and/or facial swelling. Asymptomatic COVID-19 carriers and COVID-19 vaccinated candidates are also observed to develop AIFRS, although the exact immuno-pathogenesis is still unknown. Prompt diagnosis and early management are vital for a favorable outcome. PMID:34852669 | DOI:10.1177/00034894211060923 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Estimating Clinically Meaningful Change of Efficacy Outcomes in Inadequately Controlled Chronic Rhinosinusitis with Nasal Polyposis

xlomafota13 shared this article with you from Inoreader Estimating Clinically Meaningful Change of Efficacy Outcomes in Inadequately Controlled Chronic Rhinosinusitis with Nasal Polyposis Via The Laryngoscope Objectives/Hypothesis Clinical trials of biologics to treat chronic rhinosinusitis with nasal polyposis (CRSwNP) have evaluated objective outcomes (e.g., University of Pennsylvania Smell Identification Test [UPSIT], nasal polyps score [NPS], and computed tomography Lund-Mackay score [CT-LMK]) and patient-reported symptoms (e.g., nasal congestion/obstruction [NC], loss of smell [LoS], and total symptom score [TSS]). We estimated anchor-based thresholds for clinically meaningful change in objective and patient-reported outcomes in patients with CRSwNP using data from LIBERTY NP SINUS-24 and SINUS-52 trials (NCT02912468; NCT02898454). Methods Target patient-reported outcomes were NC, LoS, and TSS; target objective outcomes were UPSIT, NPS, and CT-LMK. Anchor measures were the 22-item sinonasal outcome test (SNOT-22) rhinologic symptoms domain and total score and rhinosinusitis visual analog scale (VAS). The appropriateness of each anchor measure was evaluated by reviewing correlations between change in anchor measures and target outcomes and descriptive scores on target outcomes by levels of change in the anchor measure. Established thresholds for anchor measures (3.8 points for SNOT-22 rhinologic symptoms, 8.9 points for SNOT-22 total, 1-category improvement for rhinosinusitis VAS) were used to estimate clinically meaningful score changes for each target outcome. Results Based on correlations between change in anchor measures and target outcomes, SNOT-22 rhinologic symptoms domain was deemed the most appropriate anchor measure. Using this anchor measure, thresholds for clinically meaningful within-patient change were NC: 1 point; LoS: 1 point; TSS: 3 points; UPSIT: 8 points; NPS: 1 point; and CT-LMK: 5 points. Conclusion These thresholds support interpretation of efficacy results for target outcomes in CRSwNP trials. Level of Evidence 2 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hearing Preservation Microsurgery in Vestibular Schwannomas: Worth Attempting in “Larger” Tumors?

xlomafota13 shared this article with you from Inoreader Hearing Preservation Microsurgery in Vestibular Schwannomas: Worth Attempting in "Larger" Tumors? Via The Laryngoscope Objectives/Hypothesis To review hearing preservation after microsurgical resection of sporadic vestibular schwannomas according to tumor size. Study Design Retrospective cohort. Methods Baseline, intraoperative, and postoperative patient and tumor characteristics were retrospectively collected for a cohort who underwent hearing preservation microsurgery. Serviceable hearing was defined by a pure tone average ≤50 dB and word recognition score ≥50%. Results A total of 243 patients had serviceable hearing preoperatively. Fifty (21%) tumors were confined to the internal auditory canal, and the median tumor size was 16.2 mm (interquartile range [IQR] 11.3–23.2) for tumors with cerebellopontine angle extension. Serviceable hearing was maintained in 64% of patients with tumors confined to the internal auditory canal, 28% with cerebellopontine angle extension <15 mm, and 9% with cerebellopontine angle extension ≥15 mm. On multivariable analysis, the odds ratios of acquiring nonserviceable hearing postoperatively for tumors extending <15 mm and ≥15 mm into the cerebellopontine angle were 5.75 (95% confidence interval [CI] 2.13–15.53; P < .001) and 22.11 (95% CI 7.04–69.42; P < .001), respectively, compared with intracanalicular tumors. Conclusions The strongest predictor of hearing preservation with microsurgery after multivariable adjustment is tumor size. Approximately 10% of patients with tumors ≥15 mm of cerebellopontine angle extension will retain serviceable hearing after microsurgery. Furthermore, hearing preservation techniques offer cochlear nerve preservation and cochlear patency allowing for possible future cochlear implantation. An attempt at hearing preservation, including avoiding surgical approaches that necessarily sacrifice hearing, is worthwhile even in larger tumors if serviceable hearing is present preoperatively. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.