Airway and Swallowing Outcomes Following Laryngotracheoplasty With Posterior Grafting in Children

xlomafota13 shared this article with you from Inoreader Airway and Swallowing Outcomes Following Laryngotracheoplasty With Posterior Grafting in Children Via The Laryngoscope Objectives/Hypothesis Evaluate swallowing and airway outcomes following laryngotracheoplasty with posterior grafting (LTP PCCG). Methods Retrospective review of pediatric patients undergoing LTP PCCG from 2016 to 2019 at a tertiary care pediatric hospital. We included demographics, indications, approach, and revision status. We evaluated preoperative and postoperative instrumental and functional swallow evaluations, and we also gathered information on airway outcomes. Results Thirty-one patients were included in the study. Median (interquartile range [IQR]) age was 4.0 (2.0, 7.0) years old. Primary indication for surgery was bilateral vocal cord immobility (BVCI) in 11 (35.5%) and posterior glottic stenosis (PGS) in 20 (64.5%). Mean (standard deviation) length of follow-up was 11.0 (8.3) months. Twelve patients had gastrostomy tubes (GT) before surgery, and no patients required placement of GT after surgery. Of the remaining 19 patients, 6 required nasogastric feeding for >4 weeks (average length 1.8 months, longest 3.5 months). At last follow-up, 25 (80.6%) patients were primarily orally fed. Eighteen patients had tracheotomies prior to surgery. No patients without a tracheostomy required placement of tracheostomy before or after surgery and only 1 patient had a tracheostomy at last follow-up. Average time to decannulation was 3.7 months, with surgery-specific success of 87.1% and overall success of 96.8%. Four (12.9%) patients required a m ajor intervention to achieve decannulation. Conclusion LTP PCCG is an effective surgical technique to address PGS and BVCI with high decannulation rates. It may cause temporary swallowing dysfunction, but in this series a majority of children were orally fed at last follow-up. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Framed and non‐framed robotics in neurosurgery:a ten‐years single‐center experience

xlomafota13 shared this article with you from Inoreader Framed and non‐framed robotics in neurosurgery:a ten‐years single‐center experience Via The International Journal of Medical Robotics and Computer Assisted Surgery ABSTRACT Background Safety, efficacy and efficiency of neurosurgical robots are defined by their design (i.e., framed and non-framed) and procedural workflow (from image to surgery). The present study describes the quality indicators of three different robots in brain and spine surgery. Methods This single-center study enrolled 252 patients over a ten-years period. Safety (complication rate) and efficacy (diagnostic yield, pedicle screw placement) were determined. Predictors of workflow efficiency (e.g., skin-to-skin) were evaluated and compared to conventional techniques (neuronavigation, stereotaxy). Results All robots showed excellent reliability (97.5-100%) with low complication rates (4.5-5.3%) and high efficacy (94.7-97.7%). Robotics demonstrated a better time-efficiency than neuronavigation. However, there was no shortening of surgery time compared to conventional stereotaxy. Time-efficiency differed significantly between framed and non-framed workflows. Conclusion While all neurosurgical robots were reliable, safe and efficacious, there were significant differences in time-efficiency. Procedural workflows should be improved to increase the acceptance of robotics in neurosurgery. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An improved method for assessing the technical accuracy of optical tracking systems for orthopaedic surgical navigation

xlomafota13 shared this article with you from Inoreader An improved method for assessing the technical accuracy of optical tracking systems for orthopaedic surgical navigation Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract: Background Optical tracking systems (OTS) are essential components of many modern computer assisted orthopaedic surgery (CAOS) systems but patient movement is often neglected in the evaluation of the accuracy. The aim of this study was to develop a representative test to assess the accuracy of OTSs including patient movement and demonstrate the effect of pointer design and OTS choice. Method A mobile phantom with dynamic reference base (DRB) attached was designed and constructed. The point registration trueness and precision were evaluated for measurements with both a static and moving phantom. Results The trueness of the total target registration error (TTRE) was 1.4 to 2.7 times worse with a moving phantom compared to a static phantom. Conclusion The accuracy of OTSs for CAOS applications should be evaluated by measurements with a moving phantom as the evaluation of the TTRE with a static frame significantly underestimates the measurement error. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mitochondrial support and local translation of mitochondrial proteins in synaptic plasticity and function

xlomafota13 shared this article with you from Inoreader Mitochondrial support and local translation of mitochondrial proteins in synaptic plasticity and function Via Cellular and Molecular Biology Histol Histopathol. 2021 May 25:18345. doi: 10.14670/HH-18-345. Online ahead of print. ABSTRACT Complex neural and brain functions are executed through structural and functional alterations of synapses and neurons. Neuronal compartmentalization requires neurons to allocate mitochondria and proteins in a spatiotemporal manner to allow their plasticity, function and homeostasis. Importantly, mitochondria are known to interact with and modulate synaptic activities through their ATP supply, calcium buffering and signaling abilities. Over the years, mitochondrial support and local translation (including mitochondrial proteins) at neuronal sub-compartments and their synaptic specializations have been considered critical for maintaining synaptic plasticity and function. Recently, evidence has shown that late endosomes can serve as sites for local translation of mRNAs crucial for mitochondrial integrity and mitochondrial compartments can fuel plasticity-induced local translation. Indeed, failed mitochondrial homeostasis and subsequent synaptic dysfunction are often intricately linked in the malfunction of the central nervous system in synaptic aging and diseases. In this review, I will discuss the critical role of local translation (including mitochondrial proteins) in dendrites, axons and synapses on neuronal/synaptic plasticity and function. PMID:34032272 | DOI:10.14670/HH-18-345 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Letter to the Editor: Thyroiditis and Thyrotoxicosis After the SARS-CoV-2 mRNA Vaccine

xlomafota13 shared this article with you from Inoreader Letter to the Editor: Thyroiditis and Thyrotoxicosis After the SARS-CoV-2 mRNA Vaccine Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Training, supervision, and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda

xlomafota13 shared this article with you from Inoreader Training, supervision, and performance of Community Health Workers in the delivery of ear and hearing care to 321 community members in rural Uganda Via Clinical Otolaryngology Abstract Objectives Community Health Workers are one way to address the shortage of ear and hearing care specialists in low resource settings. However, there are few reports evaluating training and service delivery by Community Health Workers. Design, Setting and Participants We trained 13 Community Health Workers in primary ear and hearing care in Mukono District, Uganda. Community Health Workers attended a two-day training workshop and received remote supervision thereafter during service delivery in the community. An ear camp was held at the local health centre every two months, where a local ENT specialist could assess referred cases. Main outcome measures Clinical and diagnostic skills and decision making were assessed using an Objective Structured Clinical Examination, with scores recorded at baseline and six months. Service delivery was evaluated by analysing: (i) number of individuals evaluated; (ii) treatments delivered; (iii) cases referred for specialist opinion; (iv) proportion of appropriately referred cases; (v) agreement between Community Health Worker and specialist diagnosis. Results Observed Structured Clinical Examination scores were high and stable for six months. 312 individuals were screened in the community by the Community Health Workers, with 298 classified as having an abnormality. Care was delivered in the community to 167 of these, and the remaining 131 referred to the ear camp. Diagnostic agreement was 39%, but 98% of referrals were deemed "appropriate" by the ENT specialist. 27 individuals self-presented to the ear camp without prior assessment by a Community Health Worker, and 97% of these were deemed appropriate. Conclusion Trained Community Health Workers can play an important role in delivering ear and hearing services. Future work should look to explore this model in other contexts and/or compare to other models of service delivery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Image‐guided surgery in otolaryngology: A review of current applications and future directions in head and neck surgery

xlomafota13 shared this article with you from Inoreader Image‐guided surgery in otolaryngology: A review of current applications and future directions in head and neck surgery Via Head & Neck Abstract Image-guided surgery (IGS) has become a widely adopted technology in otolaryngology. Since its introduction nearly three decades ago, IGS technology has developed rapidly and improved real-time intraoperative visualization for a diverse array of clinical indications. As usability, accessibility, and clinical experiences with IGS increase, its potential applications as an adjunct in many surgical procedures continue to expand. Here, we describe the basic components of IGS and review both the current state and future directions of IGS in otolaryngology, with attention to current challenges to its application in surgery of the nonrigid upper aerodigestive tract. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

lncRNA PVT1 promotes cetuximab resistance of head and neck squamous cell carcinoma cells by inhibiting miR‐124‐3p

xlomafota13 shared this article with you from Inoreader lncRNA PVT1 promotes cetuximab resistance of head and neck squamous cell carcinoma cells by inhibiting miR‐124‐3p Via Head & Neck Abstract Background Cetuximab has been widely used in the clinical treatment of head and neck squamous cell carcinoma (HNSCC). However, whether long non-coding RNA plasmacytoma variant translocation 1 (lncRNA PVT1) is correlated with cetuximab resistance remains unclear. Methods Western blot and qRT-PCR were performed to quantify the levels of genes and proteins, respectively. Cell functions were measured using Cell Counting Kit-8 (CCK-8), Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), and flow cytometry assays. The methylation level was tested using methylation-specific PCR (MSP). Results PVT1 was upregulated and positively correlated with the poor prognosis of HNSCC. PVT1 overexpression markedly promoted the survival and weakened the cetuximab sensitivity of HNSCC cells, while miR-124-3p overexpression showed opposite effects. Mechanistically, the silence of PVT1 indirectly promoted miR-124-3p expression by reducing its promoter methylation. Importantly, miR-124-3p overexpression impeded the regulatory roles of PVT1 overexpression. Conclusion PVT1 decreased the sensitivity of HNSCC cells to cetuximab by enhancing methylation-mediated inhibition of miR-124-3p, which might provide a new insight for the cetuximab chemoresistance of HNSCC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Yin and Yang: a disrupted skin microbiome and an aberrant host immune response in Hidradenitis Suppurativa

xlomafota13 shared this article with you from Inoreader Yin and Yang: a disrupted skin microbiome and an aberrant host immune response in Hidradenitis Suppurativa Via Experimental Dermatology Abstract The skin microbiome plays an important role in maintaining skin homeostasis by controlling inflammation, providing immune education, and maintaining host defense. However, in many inflammatory skin disorders the skin microbiome is disrupted. This dysbiotic community may contribute to disease initiation or exacerbation through the induction of aberrant immune responses in the absence of infection. Hidradenitis Suppurativa (HS) is a complex, multifaceted disease involving the skin, innate and adaptive immunity, microbiota, and environmental stimuli. Herein, we discuss the current state of HS skin microbiome research and how microbiome components may activate pattern recognition receptor (PRR) pathways, metabolite sensing pathways, and antigenic receptors to drive anti-microbial peptide, cytokine, miRNA, and adaptive immune cell responses in HS. We highlight the major open questions that remain to be addressed and how antibiotic therapies for HS likely influence both microbial burden and inflammation. Ultimately, we hypothesize that the two-way communication between the skin microbiome and host immune response in HS skin generates a chronic positive feed-forward loop that perpetuates chronic inflammation, tissue destruction, and disease exacerbation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Defining dipeptidyl peptidase‐4 inhibitors‐related bullous pemphigoid: A single‐centre retrospective study

xlomafota13 shared this article with you from Inoreader Defining dipeptidyl peptidase‐4 inhibitors‐related bullous pemphigoid: A single‐centre retrospective study Via Experimental Dermatology Abstract Background Many studies have corroborated the association of dipeptidyl peptidase-4 inhibitors (DPP4i) use with bullous pemphigoid (BP). It has been speculated that this drug-induced variant presents with a different clinical spectrum than conventional BP. Objective To determine the prevalence of DPP4i-induced cases of BP and to evaluate whether gliptin-related BP has specific clinicopathological and immunological features. Methods We conducted a retrospective, observational study of BP cases attended at our centre between January 2000 and June 2020. Epidemiological, clinical, histopathological and laboratory data were collected. Results A total of 257 cases of BP were collected; 51 (24.3%) were on treatment with DPP4i. When analysing DPP4i-induced BP cases, generalized BP was the predominant pattern and scalp/mucosal involvement was found in 13 patients. Gliptin-related BP cases were associated to a decrease in the eosinophilic infiltrate (p = 0.000) and both the detection rate and concentration of anti-BP180 IgG were lower (p = 0.004, p = 0.001, respectively) than non-DPP4i cases. Limitations Retrospective, single-centre study. Conclusion Our large DPP4i-induced BP case series has highlighted that DPP4i-induced BP is characterized by generalized lesions and scalp involvement. Lower titres of anti-BP180 antibodies and a decrease in eosinophils infiltrating into the skin may be distinct features of DPP4i-related BP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

“The Pruritogenic Role of the Type 2 Immune Response in Diseases Associated with Chronic Itch”

xlomafota13 shared this article with you from Inoreader "The Pruritogenic Role of the Type 2 Immune Response in Diseases Associated with Chronic Itch" Via Experimental Dermatology Abstract While there is a vast array of etiologies that may lead to chronic pruritus, recent data suggests that many of these conditions share similar interactions between keratinocytes, nerves, and the immune system. Specifically, the type 2 immune response, including Th2 T-Cells and their related cytokines, has been noted to play a major role in the development of pruritus in a variety of itchy conditions. To date, atopic dermatitis is the most striking example of this pathogenesis. However, the body of literature supporting its role in many other itchy conditions, including other inflammatory, bullous, as well as systemic diseases, continues to grow. In addition, new treatments targeting this type 2 immune system continue to be developed and investigated. In the current review, we present the current body of literature supporting the role of the type 2 immune response in itchy conditions beyond atopic dermatitis as well as potential therapeutic options that target this pathway for chron ic itch. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.