Predisposing conditions for bacterial meningitis in children: what radiologists need to know

xlomafota13 shared this article with you from Inoreader Predisposing conditions for bacterial meningitis in children: what radiologists need to know Via leak of cerebrospinal fluid Jpn J Radiol. 2021 Aug 25. doi: 10.1007/s11604-021-01191-9. Online ahead of print. ABSTRACT A variety of underlying diseases can predispose infants and children to bacterial meningitis (BM). For the diagnosis, treatment, and prevention of its recurrence, radiologists should be familiar with its predisposing conditions so that they can suggest the appropriate imaging approach. Predisposing conditions of BM can be broadly classified into two categories: infection spread from the adjacent tissue to the cerebrospinal fluid (CSF) space and immunodeficiency. Diseases in the former category are further divided according to regardless of whether there is a structural defect between the CSF space and the adjacent tissue. When a structural defect is suspected in a patient with BM, computed tomography (CT) of the head and magnetic resonance (MR) imaging are first-line imaging examinations. Radionuclide cisternography should be implemented as a second-li ne step to identify the CSF leak site. In patients with suspected parameningeal infection without any structural defect, such as sinusitis or otitis media/mastoiditis, CT or MR images can identify not only the disease itself but also the associated intracranial complications. The purpose of this article is to discuss the diagnostic approach and imaging findings associated with the variety of conditions predisposing patients to recurrent BM, focusing on the role of radiology in their management. PMID:34432172 | DOI:10.1007/s11604-021-01191-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Persistent otorrhoea caused by cerebrospinal fluid leakage

xlomafota13 shared this article with you from Inoreader Persistent otorrhoea caused by cerebrospinal fluid leakage Via leak of cerebrospinal fluid Ned Tijdschr Geneeskd. 2021 Jun 10;165:D5456. ABSTRACT Persistent otorrhoea is a common issue for both children and adults, which can be caused by leakage of cerebrospinal fluid from the lateral skull base. Bacterial superinfection of the chronically humid middle ear, arising from continuous cerebrospinal fluid leakage, may contribute to an atypical clinical presentation. That is, otogenous cerebrospinal fluid leakage may mimic serious otitis media with concomitant conductive hearing loss, leading to a serious diagnostic delay in some patients. On the basis of three cases with cerebrospinal fluid leakage, resulting in persistent otorrhoea, we underline the importance of its timely diagnosis and treatment. PMID:34346583 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of primary tumor resection in patients with metastatic medullary thyroid cancer who have unresectable distant metastases

xlomafota13 shared this article with you from Inoreader Role of primary tumor resection in patients with metastatic medullary thyroid cancer who have unresectable distant metastases Via Head & Neck Abstract Background Whether patients with medullary thyroid carcinoma (MTC) who have unresectable synchronous distant metastases should undergo primary surgical resection (PTR) remains controversial. This study aimed to identify predictive factors associated with the survival of such patients. Methods We conducted a retrospective study of patients with MTC who were registered in the Surveillance, Epidemiology, and End Results registry. The overall and cancer-specific mortality rates were assessed using risk-adjusted Cox proportional hazards regression modeling and stratified propensity score matching. Results One hundred and eight matched patients were assessed. Patients in the PTR group had lower overall mortality than did those in the non-PTR group. The 1-, 3-, and 5-year overall and cancer-specific survival rates in the PTR group were significantly higher. Conclusions PTR appears to be the most appropriate intervention for patients with good performance status. Such patients are likely to benefit from surgery and to experience long-term stable disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The United Kingdom Thyroid Multi‐Disciplinary Team; a National Survey of Services and Comparison to Guidelines

xlomafota13 shared this article with you from Inoreader The United Kingdom Thyroid Multi‐Disciplinary Team; a National Survey of Services and Comparison to Guidelines Via Clinical Otolaryngology Abstract We have identified ambiguity in the current guidance on thyroid MDT's, and have also found nationwide variation in compliance with this. We recommend: All thyroid surgeons should complete a minimum of 20 thyroid procedures per year, and this should also form part of surgeons' annual appraisal. All surgeons should contribute data to UKRETS (unless prevented by local legal frameworks) and this should form part of surgeons' annual appraisal and be audited by individual MDT's and regional cancer networks. Thyroid MDT's should be held weekly where possible, with a minimum frequency of fortnightly. The core membership of thyroid MDT's (stand alone and joint) should include thyroid surgeons, specialist radiology, endocrinology, nuclear medicine, nurse specialists, histopathology +/- cytology and clinical oncology. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reliability of Early Ambulation after Intradural Spine Surgery : Risk Factors and a Preventive Method for Cerebrospinal Fluid Leak Related Complications

xlomafota13 shared this article with you from Inoreader Reliability of Early Ambulation after Intradural Spine Surgery : Risk Factors and a Preventive Method for Cerebrospinal Fluid Leak Related Complications Via leak of cerebrospinal fluid J Korean Neurosurg Soc. 2021 Aug 24. doi: 10.3340/jkns.2020.0350. Online ahead of print. ABSTRACT OBJECTIVE: Cerebrospinal fluid leakage related complications (CLC) occasionally occur after intradural spinal surgery. We sought to investigate the effectiveness of early ambulation after intradural spinal surgery and analyze the risk factors for CLC. METHODS: For this retrospective cohort study, we enrolled 314 patients who underwent intradural spinal surgery at a single institution. The early group contained 79 patients who started ambulation after 1 day of bedrest without position restrictions, while the late group consisted of 235 patients who started ambulation after at least 3 days of bed rest and were limited to the prone position after surgery. In the early group, Prolene 6-0 was used as the dura suture material, while black silk 5-0 was used as the dura suture material in the late group. RESULTS: The overall incidence rate of CLC was 10.8%. Significant differences between the early and late groups were identified in the rate of CLC (2.5% vs. 13.6%), surgical repair required (1.3% vs. 7.7%), and length of hospital stay (2.99 vs. 9.29 days) (p<0.05). Logistic regression analysis revealed that CLC was associated with practices specific to the late group (p=0.011) and the revision surgery (p=0.022). CONCLUSION: Using Prolene 6-0 as a dura suture material for intradural spinal surgery resulted in lower CLC rates compared to black silk 5-0 sutures despite a shorter bed rest period. Our findings revealed that suture - needle ratio related to dura defect was the most critical factor for CLC. One-day ambulation after primary dura closure using Prolene 6-0 sutures appears to be a cost-effective and safe strategy for intradural spinal surgery. PMID:34425635 | DOI:10.3340/jkns.2020.0350 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation

xlomafota13 shared this article with you from Inoreader Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation Via radiol anat Surg Radiol Anat. 2021 Aug 23. doi: 10.1007/s00276-021-02820-8. Online ahead of print. ABSTRACT PURPOSE: There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum's fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. METHODS: The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. RESULTS: For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. CONCLUSION: The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position. PMID:34426859 | DOI:10.1007/s00276-021-02820-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Voice Outcomes Following Colon Interposition

xlomafota13 shared this article with you from Inoreader Voice Outcomes Following Colon Interposition Via ear nose throat Ear Nose Throat J. 2021 Aug 24:1455613211041786. doi: 10.1177/01455613211041786. Online ahead of print. ABSTRACT SIGNIFICANCE STATEMENT: This case highlights the consequences of colon interposition on phonation and swallowing. Findings in this patient included laryngopharyngeal reflux, vocal fold paralysis, poor esophageal peristalsis, failed bolus transfers, and others. The mechanical and functional differences between the colon and the esophagus can impact bolus transfer, reflux, and phonation. Further research is required to identify the mechanisms by which colon interposition can impact voice and swallowing. PMID:34427138 | DOI:10.1177/01455613211041786 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.