Τετάρτη 13 Οκτωβρίου 2021

Voice Quality and Vocal Tract Discomfort Symptoms in Patients with COVID-19

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Dysphonia and laryngeal problems are some of the manifestations of the COVID-19 pandemic due to respiratory disease as a primary effect of COVID-19. The aim of the present study was to investigate voice quality and vocal tract discomfort symptoms in patients with COVID-19.
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Cerebrospinal Fluid Leaks Following Anterior Skull Base Trauma: A Systematic Review of the Literature

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World Neurosurg. 2021 Oct 9:S1878-8750(21)01562-X. doi: 10.1016/j.wneu.2021.10.065. Online ahead of print.

ABSTRACT

BACKGROUND: Anterior skull base (ASB) fractures are reported in 4% of head injuries and represent 21% of all skull fractures. Cerebrospinal fluid (CSF) leaks may follow, severely exacerbating outcomes. We systematically reviewed the literature to analyze and compare the roles of endoscopic surgery, open surgery, and combined approaches in the management of CSF leak repair following post-traumatic ASB fractures.

METHODS: PubMed, Web of Science, and Scopus databases were searched in accordance with the PRISMA guidelines. Studies reporting clinical data of patients with CSF leaks following ASB fracture were reviewed, focusing on management strategies and post-treatment outcomes.

RESULTS: We included 29 articles comprising 888 patients. The average age at diagnosis was 34 years (range 18-91), with a male predominance (54 %) and a male/female ratio of 2.9:1 (647/241). Clinical data was available for 888 patients with CSF leaks post-ASB fracture, reporting a median follow-up time of 33.5 months (SD: ±29; range 0.5-330.0 months). Open surgical repair was the most common approach (67.9%), followed by endoscopic surgical repair (32.1%). The endoscopy cohort showed lower rates of complications (0.7% vs. 11.1%) and fistula recurrence (2.8% vs. 5.3%) compared to open surgery.

CONCLUSION: ASB fractures are frequently treated as late surgery, 24 hours from injury or later, especially for endoscopic surgery. The endoscopic approach is overall preferred, mostly because of its safety and effectiveness, offering lower failure rates than open surgery.

PMID:34637942 | DOI:10.1016/j.wneu.2021.10.065

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Trends in contrast media research the last 100 years

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Acta Radiol. 2021 Oct 12:2841851211051014. doi: 10.1177/02841851211051014. Online ahead of print.

ABSTRACT

This review focuses on the trends in contrast media (CM) research published in Acta Radiologica during the last 100 years, since the first edition in 1921. The main topics covered are the developments of iodine- and gadolinium-based CM. Other topics include manganese-based CM for magnetic resonance imaging (MRI) and barium for the investigation of the alimentary tract. From a histori c point of view, special CM for use in cholegraphy and myelography are addressed in the review. Today, these imaging procedures are obsolete due to the development of computed tomography, MRI, and ultrasound. The historical use of radioactive thorium-based CM for angiography is also addressed. Furthermore, publications on adverse reactions to CM are reviewed.

PMID:34636678 | DOI:10.1177/02841851211051014

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Expanding indication of free hypothenar flap transfer: Sequential pedicled ulnar palm flap transfer to a relatively large hypothenar flap donor site

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J Plast Reconstr Aesthet Surg. 2021 Sep 20:S1748-6815(21)00408-3. doi: 10.1016/j.bjps.2021.08.021. Online ahead of print.

ABSTRACT

BACKGROUND: Free hypothenar flap (HTF) transfer allows sensible soft tissue reconstruction of the fingertip. However, HTF is basically indicated for a relatively small soft tissue defect, as width of an HTF is limited up to approximately 20 mm to allow primary donor site closure. Combined with sequential local flap to an HTF donor site, a larger HTF can be used without the contracture risk. The aim of this study was to evaluate feasibility of free HTF transfer and sequential ulnar palm flap (UPF) transfer (HTF-UPF) for relatively large fingertip reconstructions.

METHODS: Medical charts of patients who underwent HTF-UPF for fingertip reconstruction were reviewed. An HTF was designed transversely proximal to the proximal palmar crease, and a slightly smaller hemi-spindle-shaped UPF was designed longitud inally on the mid-lateral aspect of the ulnar palm; the UPF was used to close the HTF donor site. Patient and flap characteristics, intra-operative findings, and postoperative results were evaluated.

RESULTS: Twelve patients with average age of 42.7 years were included. HTF-UPF procedure was performed on 12 fingers. HTF's length/width ranged from 45/20 to 70/40 mm (average, 52.5/32.1 mm). UPF's length/width ranged from 40/20 to 55/30 mm (average, 46.7/24.2 mm). Time for sequential UPF transfer ranged from 3 to 9 min (average, 5.1 min). All HTFs and UPFs survived without flap necrosis or scar contracture. Postoperative sensation was comparable with the contralateral fingertip.

CONCLUSIONS: HTF-UPF procedure allows relatively large fingertip reconstruction with a minimum risk of HTF donor site contracture.

PMID:34642064 | DOI:10.1016/j.bjps.2021.08.021

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Preoperative SARS‐CoV‐2 Screening Fails to Detect Viral Particles Prior to Airway Surgery

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Abstract

Objectives

Children have higher rates of asymptomatic SARS-CoV-2 infections or milder courses of infection, and their carrier status may potentially impact viral transmission to those providing them care. The aim of this study is to compare the existing COVID-19 pre-operative screening protocols to the detection of SARS-CoV-2 viral particles in surgical samples.

Methods

We conducted a prospective study with consecutive convenience sampling of children undergoing adenoidectomy between January and April 2021. Total nucleic acid was extracted from adenoid tissue and real-time reverse transcription-polymerase chain reaction was conducted to test for presence of SARS-CoV-2 viral particles. Univariate logistic regression was used to summarize the effect size of variables of interest on the odds of having SARS-CoV-2 positive adenoid tissue.

Results

Forty adenoid samples were collected and 11 (27.5%) had a positive SARS-CoV-2 reverse transcriptase- polymerase chain reaction. Patients with positive adenoids were older (11.8 years vs 7.9 years, OR: 1.3, p=0.01) and more likely to have had a positive nasopharyngeal swab in the previous 90 days (4/11 or 36% vs 0).

Conclusion

This data is the first report on the presence of SARS-CoV-2 particles in pediatric adenoidectomy specimens, with a high percentage of patients showing evidence of viral particles within the adenoid. This finding calls in to question the utility of preoperative COVID screening protocols which have yet to be rigorously validated in asymptomatic patients and have the potential to delay patients' surgical care.

This article is protected by copyright. All rights reserved.

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Syndrome d’Eagle à l’origine d’une sténose grave de la carotide interne

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CMAJ. 2021 Oct 12;193(40):E1580-E1581. doi: 10.1503/cmaj.202803-f.

NO ABSTRACT

PMID:34642164 | DOI:10.1503/cmaj.202803-f

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A urine and serum metabolomics study of gastroesophageal reflux disease in TCM syndrome differentiation using UPLC-Q-TOF/MS

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J Pharm Biomed Anal. 2021 Nov 30;206:114369. doi: 10.1016/j.jpba.2021.114369. Epub 2021 Sep 15.

ABSTRACT

Gastroesophageal reflux disease (GERD) is a common, chronic and complex upper gastrointestinal disease. In Traditional Chinese medicine (TCM) theory, GERD is classified into two main types: stagnant heat of liver and stomach (SHLS) and deficient cold of spleen and stomach (DCSS). The discovery and evaluation of potential biomarkers for different syndrome types of GERD may contribute to comprehend specific molecular mechanism and identify new targets for diagnosis and appropriate management. In our study, 60 subjects including 40 GERD patients (20 SHLS and 20 DCSS) and 20 healthy controls were recruited, and the serum and urine metabolic profiles from untargeted liquid chromatography coupled to mass spectrometry (LC-MS) metabolomics approach were obtained. Finally 38 biomarkers associated with disease were identified and 9 metabolic pathway s were enriched. The most enriched pathways were amino acid metabolism, steroid hormone biosynthesis, glycerophospholipid metabolism, sphingolipid metabolism and TCA cycle. According to the area under curve (AUC) value, we propose a cohort of three metabolites from urine and serum samples as promising biomarkers for TCM syndrome differentiation of GERD, which are prolylhydroxyproline, glycitein-4'-O-glucuronide, capsianoside I in urine and neuAcalpha2-3Galbeta-Cer (d18:1/16:0), sphinganine, arachidonic acid in serum. The cumulative AUC value of merged biomarkers in urine and serum was 0.979 (95%CI 0.927-1) and 0.842 (95%CI 0.704-0.980), respectively. The results indicated that LC-MS based metabolomic profiling method might be an effective and promising tool on further pathogenesis discovering of GERD. The findings provided new strategy for the diagnosis of GERD TCM syndrome differentiation in clinic.

PMID:34551376 | DOI:10.1016/j.jpba.2021.114369

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Epistaxis-overview and current aspects

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Via hno

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HNO. 2021 Oct 13. doi: 10.1007/s00106-021-01110-4. Online ahead of print.

ABSTRACT

Nosebleeds (epistaxis) are usually minor. Medical intervention is only necessary in about 6% of cases. The source of bleeding is frequently located in the anterior region of the nose (Kiesselbach's plexus). The estimated lifetime prevalence of epistaxis is 60%. Diffuse epistaxis is often a manifestation of systemic disease. Epistaxis is the leading symptom of Rendu-Osler-Weber disease (hereditary hemorrhagi c telangiectasia, HHT). If intervention is required, the first-choice of treatment is bidigital compression for several minutes. Common therapeutic measures include local hemostasis using electrocoagulation or chemical agents, e.g., silver nitrate. Resorbable anterior nasal tampons or tampons with a smooth surface are also frequently employed. In case of failed surgical closure of the sphenopalatine artery, angiographic embolization is the method of choice.

PMID:34643746 | DOI:10.1007/s00106-021-01110-4

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