Hearing Aid Use in Children With Unilateral Hearing Loss: A Randomized Crossover Clinical Trial

xlomafota13 shared this article with you from Inoreader Hearing Aid Use in Children With Unilateral Hearing Loss: A Randomized Crossover Clinical Trial Via The Laryngoscope Objectives/Hypothesis In children with mild to moderately severe unilateral hearing loss (UHL), assess whether subject-reported quality of life (QOL) and teacher- and parent-reported perception of listening difficulty are affected by use of a hearing aid (HA) with baseline accommodations, compared to children receiving only baseline accommodations. Study Design Randomized crossover clinical trial. Methods Thirty-seven children 6–12 years of age with mild to moderately severe UHL and ≥80% word recognition scores in the poorer hearing ear were randomized into arm 1, using baseline accommodations (frequency-modulated system and strategic seating) for 12 weeks, followed by addition of a HA for 12 weeks. The other participants were randomized into the reverse methodology: arm 2, using a HA in addition to baseline accommodations for 12 weeks, followed by baseline accommodations alone. Surveys of QOL (Hearing Environments and Reflection on Quality of Life) and listening difficulties or challenges with hearing amplification (CHILD and LIFE-R questionnaires) were administered at 6-week intervals. Differences in mean survey scores, percent change, and improvement over time were computed between the two arms and inter-arm intervals. Per-protocol analysis was used. Results Of the 37 children enrolled, 34 children underwent the study interventions and were included in the analysis, (arm 1 = 20, arm 2 = 14) (mean [standard deviation] age = 8 [1.5] years; 21 boys [61.8%]). Survey scores averaged across both arms during the HA interval (77.79 [15.13]) were significantly higher than during the baseline-only interval (69.67 [14.69], P = .036). There was no significant difference between trial arms in mean scores between the two HA intervals (P = .450) and two baseline-only intervals (P = .539). Conclusions Hearing-related QOL and listening ability improved in children who met eligibility criteria with mild to moderately severe UHL with HA use compared with baseline accommodations alone. Trial Registration: ClinicalTrials.gov identifier: NCT02269124. Level of Evidence 1 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of the Signal Intensity of Vestibular Schwannoma Between Growing and Nongrowing Tumors

xlomafota13 shared this article with you from Inoreader Comparison of the Signal Intensity of Vestibular Schwannoma Between Growing and Nongrowing Tumors Via The Laryngoscope Objectives/Hypothesis To determine the relationship between signal intensity on gadolinium (Gd)-enhanced magnetic resonance images and growth of vestibular schwannomas (VSs). Study Design Cross-sectional study. Methods In this cross-sectional study, we retrospectively reviewed the data of 31 patients with VSs who underwent magnetic resonance imaging (MRI). The mean signal intensities within the regions of interest in the tumor, pons, and temporal muscles were measured on Gd-enhanced T1-weighted MRI. Relative intensity ratios were calculated as follows: T/N pons ratio (T/Np) is the tumor signal intensity/pons signal intensity and T/N muscle ratio (T/Nm) is the tumor signal intensity/temporal muscle signal intensity. Volume measurements were used to assess the tumor size. Growth rate was determined by assessing previous imaging studies. Growing VS was defined as a tumor with a growth rate >100 mm3/year. Results The mean (standard deviation) T/Np and T/Nm were 1.47 (0.27) and 1.50 (0.24), respectively, in nongrowing tumors and 1.78 (0.17) and 1.90 (0.12), respectively, in growing tumors. The T/Np and T/Nm differed significantly between the two groups (T/Np, P < .001; T/Nm, P < .001). Receiver operating characteristic curve analysis showed that cutoffs of 1.56 and 1.76 for T/Np (93.33% sensitivity, 75.00% specificity) and T/Nm (100.00% sensitivity, 93.75% specificity), respectively, could be used to diagnose a growth rate of >100 mm3/year. The area under the curve was 0.85 (95% confidence interval, 0.70–1.00) for T/Np and 0.94 (0.82–1.00) for T/Nm. Conclusion Growing VSs show higher signal intensities on Gd-enhanced MRI. Thus, measuring the signal intensity of VS on Gd-enhanced MRI may aid in predicting VS growth. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cricothyroid Muscle Dysfunction Affects Aerodynamic Performance in Patients with Unilateral Vocal Fold Paralysis

xlomafota13 shared this article with you from Inoreader Cricothyroid Muscle Dysfunction Affects Aerodynamic Performance in Patients with Unilateral Vocal Fold Paralysis Via Journal of Voice Emerging evidence has revealed that cricothyroid (CT) muscle dysfunction in unilateral vocal fold paralysis (UVFP) further impairs patients' voices. Given that CT muscle dysfunction does not influence vocal fold position, the mechanism of voice dysfunction induced by dysfunction of CT muscle in UVFP patients remains controversial. This study compares aerodynamics between UVFP patients with and without CT muscle involvement. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skin Microbiome Alterations in Seborrheic Dermatitis and Dandruff: A Systematic Review

xlomafota13 shared this article with you from Inoreader Skin Microbiome Alterations in Seborrheic Dermatitis and Dandruff: A Systematic Review Via Experimental Dermatology Abstract Seborrheic dermatitis (SD) and dandruff (DF) are common chronic inflammatory skin diseases characterized by recurrent greasy scales, sometimes with erythema and itchiness. Although the exact pathophysiology of the disease is still unclear, current theories highlight the role of microbes on the skin surface in the pathogenesis of SD. Here, we conducted a systematic review to investigate the skin microbiome alterations in patients with SD/DF. We searched Medline/PubMed, Embase and Web of Science for research studies published in English between January 1st, 2000 and December 31st, 2020. A total of 12 studies with 706 SD/DF samples and 379 healthy samples were included in this study. The scalp and face were predominated by the fungi of Ascomycota and Basidiomycota and the bacteria of Actinobacteria and Firmicutes. In general, the included studies demonstrated an increased M. restricta/M. globosa ratio and a reduction in the Cutibaterium/S taphylococcus ratio in the setting of SD/DF. Staphylococcus was associated with epidermal barrier damage, including elevated levels of trans-epidermal water loss and pH, while Cutibacterium had a positive correlation with water content. Malassezia was also found to be related to an increased itching score and disease severity. Further studies focusing on the interactions between various microbes and the host and microbes can help us to better understand the pathogenesis of SD/DF. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Expression of clec9a in the oral cancer microenvironment. A preliminary immunohistochemical pilot study

xlomafota13 shared this article with you from Inoreader Expression of clec9a in the oral cancer microenvironment. A preliminary immunohistochemical pilot study Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2021 Aug 20:24659. doi: 10.4317/medoral.24659. Online ahead of print. ABSTRACT BACKGROUND: The search for treatments to improve cancer survival has led to the emergence of immunotherapy and the study of the tumour microenvironment existing in neoplasms. This preliminary study aims to understand the clinical and pathological relationship of clec9a expression in oral cancer and to explore survival models for future studies. MATERIAL AND METHODS: Immunohistochemical study that included 26 patients with a diagnosis of oral squamous cell carcinoma (OSCC) in mobile tongue and floor of the mouth. Clinical and histopathological variables were recorded, and the biomarkers clec9a for dendritic cells and CD8 and CD4 for lymphocytes were used. RESULTS: Clec9a was expressed in 58% of the sample. It was more common in cases with low lymphoplasmacytic infiltration and in type 2 invasion patterns. It was sign ificantly related to CD8 expression (p=0.055 and p=0.007). No prognostic risks were evident in the survival models studied (overall survival, disease-specific survival, disease-free survival). CONCLUSIONS: CLEC9A expression is present in the OSCC microenvironment and is mainly related to the presence of CD8 lymphocytes. The relationship of its expression with survival prognosis in OSCC could not be confirmed; however, this needs to be confirmed through future studies with larger sample size. PMID:34415004 | DOI:10.4317/medoral.24659 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis

xlomafota13 shared this article with you from Inoreader Frailty and risk of complications in head and neck oncologic surgery. Systematic review and dose-response meta-analysis Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2021 Aug 20:24588. doi: 10.4317/medoral.24588. Online ahead of print. ABSTRACT BACKGROUND: There is emerging evidence that frail individuals present a decreased physiological reserve, decreased ability to maintain homeostasis, and increased vulnerability to stressors. The concept of frailty has become increasingly recognized as a valuable measure in oncological surgical patients, including those with head and neck cancer. Preoperative screening for frailty may provide an individualized risk assessment that can be used by an interdisciplinary team for preoperative counseling and to improve outcomes. The aim of this meta-analysis was to evaluate the relationship between frailty and the risk of major postoperative complications in frail individuals submitted to head and neck oncologic surgery. MATERIAL AND METHODS: PubMed, SCOPUS, Web of Science, Google Scholar and OpenThesis were systematically search ed to identify studies that evaluated the risk of major postoperative complications in frail individuals undergoing head and neck oncologic surgery. The search was performed on August 31, 2020, without language or date restrictions. Two independent investigators screened the searched studies based on each paper's title and abstract. Relevant studies were read in full and selected according to the eligibility criteria. Frailty was assessed by modified Frailty Index (mFI-11) and major postoperative complications were measured by the Clavien-Dindo classification. We performed a categorical and dose-response meta-analysis using a random-effects model to evaluate the association between frailty and the risk of major postoperative complications in patients submitted to head and neck oncologic surgery. The results of the meta-analysis were expressed as relative risk (RR) and 95% confidence interval (95% CI). The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). RESULT S: Four studies (9,947 patients) were included in this systematic review and meta-analysis. Frail patients presented an increased risk of life-threatening complications requiring intensive care unit (ICU) admission (RR = 4.67; 95% CI 1.54-14.10) and 30-day mortality (RR = 8.10; 95% CI 2.30-28.57) compared to non-frail patients. We found evidence of dose-response trend between mFI-11 and major postoperative complications. CONCLUSIONS: Higher frailty scores are associated with a significant increase in ICU-level complications and 30-day mortality after head and neck oncologic surgery. PMID:34414998 | DOI:10.4317/medor al.24588 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Percutaneous tracheostomy in COVID patients. Experience in our hospital center after one year of pandemic and review of the literature

xlomafota13 shared this article with you from Inoreader Percutaneous tracheostomy in COVID patients. Experience in our hospital center after one year of pandemic and review of the literature Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2021 Aug 20:24826. doi: 10.4317/medoral.24826. Online ahead of print. ABSTRACT BACKGROUND: The pandemic caused by SARS-COV-2 has caused an increase in the need of tracheostomies in patients affected with respiratory distress syndrome. In this article we report our experience during a year of pandemic, we develop our surgical technique to perform percutaneous tracheostomy with the patient in apnea and we compare our results with those of other centers through a bibliographic review. MATERIAL AND METHODS: A one-year retrospective clinical study was carried out on tracheotomies performed on patients admitted to the intensive care unit with severe SARS-CoV-2, with difficulty for ventilation or weaning. The technique performed was percutaneous, with fibroscopic control through the endotracheal tube, keeping the patient under apnea during the opening of the airway, reducing by this method the risk of expo sure to the virus. RESULTS: From 35 percutaneous tracheotomies performed, 31% of the patients died from respiratory complications due to SARS-COV-2, but none due to the surgical procedure. The most frequent complication (8.5% of patients) was bleeding around the tracheostoma, resolved with local measures. No healthcare provider involved in the performance of the technique had symptoms or was diagnosed with COVID-19. CONCLUSIONS: Our technique of performing percutaneous tracheostomy maintaining apnea during the procedure, under fibroscopic control, has proven to be safe for all those involved in the procedure, and for the patient. PMID:34415000 | DOI:10.4317/medoral.24826 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.