Nasal autoinflation devices for middle ear disease in cleft palate children: are they effective?

xlomafota13 shared this article with you from Inoreader Nasal autoinflation devices for middle ear disease in cleft palate children: are they effective? Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Aug;41(4):364-370. doi: 10.14639/0392-100X-N1277. ABSTRACT OBJECTIVE: Cleft lip palate (CLP) and cleft palate (CP) patients have a higher incidence of otitis media with effusion (OME) and conductive hearing problems. This article aims to evaluate the effectiveness of a 6-month course of self-administered autoinflation therapy in paediatric CP/CLP patients in terms of conductive hearing loss (CHL) and OME prevalence. METHODS: Fifty-one p atients with surgically corrected CP/CLP and diagnosis of OME received indication to 6-months autoinflation therapy with an Otovent® device. Clinical evaluation, tympanogram and pure tone audiometry were carried out at the time of prescription (T0), at the end of treatment (T1) and at 6-month follow-up (T2). Patients were divided in 2 groups based on therapeutic compliance (29 compliant children, group A, vs 22 non-compliant children, group B). RESULTS: Case series showed better audiological results and tympanometries at both time points (p < 0.001). Group A showed better outcomes at tympanograms and at each frequency, but were statistically significant only in terms of CHL at 250 and 1000 Hz frequencies at T1 (respectively 0.024 and 0.012). CONCLUSIONS: Nasal autoinflation therapy accelerates improvement of OME and hearing thresholds at short-/mid-term, leading to an earlier improved hearing performance. PMID:34533540 | DOI:10.14639/0392-100X-N1277 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A safety and clinical efficacy analysis of PCSK9 monoclonal antibodies in patients with markedly elevated creatine phosphokinase levels

xlomafota13 shared this article with you from Inoreader A safety and clinical efficacy analysis of PCSK9 monoclonal antibodies in patients with markedly elevated creatine phosphokinase levels Via American Journal of Blood Research Am J Blood Res. 2021 Aug 15;11(4):399-404. eCollection 2021. ABSTRACT INTRODUCTION: PCSK9 inhibitors (PCSK9i) are often used in statin-intolerant patients, aiming to reduce low-density lipoprotein cholesterol (LDL-C). Along with the growing experience with their use, there is a lack of evidence regarding the safety, tolerability, and clinical utility of PCSK9i in patients with markedly elevated creatine phosphokinase (CPK) levels. METHODS: We screened a comprehensive HMO database for patients treated with PCSK9i (Jan 2016-Dec 2019), in whom elevated CPK levels (>1,000 U/L) were documented prior to the initiation of therapy. Treatment plans, adherence, and the levels of CPK and LDL-C were analyzed. RESULTS: Of the 1,600 patients initiating treatment with PCSK9i, 26 had prior CPK values >1,000 U/L [median (IQR): 3,687 (1,876-8,344) U/L]. All 26 patients were previously treated with statins, which presumably resulted in adverse effects (myalgia in 24, and rhabdomyolysis in 5 patients) therefore mandating their discontinuation. Concomitant secondary factors for CPK elevation were present in 11 patients, and included renal failure, rheumatoid disorders, hypothyroidism, intensive exercise, proteinuria and genetic muscular disease. Of the 26 patients treated with PCSK9i, alirocumab was administered to 12 patients, and evolocumab to 14. Following the initiation of treatment with either drug, 24 patients (92%) demonstrated a reduction in CPK of >50%, and in 12 (46%) CPK levels have returned to normal values. With regard to treatment goals, 17 patients (65%) have achieved an LDL-C level of <70 mg/dL, and 12 (46%) have reached a level of <55 mg/dL. No serious adverse reactions were documented, and only 2 patients discontinued the treatment (not due to muscle symptoms or CPK elevation). CONCLUSIONS: PCSK9i constitute a safe, tolerable, and effective treatment for hyperlipidemia in patients wi th markedly elevated CPK. While statin intolerance is a major cause for CPK elevation, concomitant etiologies for increased CPK values were rather common. PMID:34540348 | PMC:PMC8446829 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysing 'tear-drop' prints of acute promyelocytic leukemia (APML): immunophenotypic prognostication of APML by FCM

xlomafota13 shared this article with you from Inoreader Analysing "tear-drop" prints of acute promyelocytic leukemia (APML): immunophenotypic prognostication of APML by FCM Via American Journal of Blood Research Am J Blood Res. 2021 Aug 15;11(4):446-457. eCollection 2021. ABSTRACT INTRODUCTION: Acute promyelocytic leukemia (APML), although genetically and morphologically distinct from other AML (acute myeloid leukemia) subtypes, is one of the most best responsive acute myeloid leukemia. -Conventional diagnostic methods and morphological hints often fail in the majority of the cases in the peripheral laboratories owing to resource constraints, unavailability of cytogenetic work-up, hypogranular variants, morphological mimicry by AML-monocytic and myelo-monocytic, etc. Flowcytometry (FCM), however, can be utilized as a feasible and reliable immunophenotypic diagnostic and prognostic tool for prompt identification of APML. In order to rapidly and sensitively diagnose APML we intended to suggest a cost effective, sensitive FCM panel and also to prognositicate patients. MATERIAL AND METHODS: In this retrospective study, flowcytometry characte ristics of 123 cases of acute promyelocytic leukemia were studied including 40 hypogranular variants. The expression of markers was compared with the Mean flurescent Intensity (MFI) and percent expression of markers. A non-statistical comparison was made with cases of acute monocytic leukemia. The cases were grouped according to their immunophenotype characteristics and expression with comparison of MFI by multivariate logistic regression. The aberrant markers positive at diagnostic and remission flow test were compared with the survival outcomes, and their positive predictive values were calculated. RESULTS: The most common feature of side scatter property was the absence of blasts in the window and high side scatter, except hypogranular variants which had low side scatter. Immunophenotypically characterised by positivity for CD117, cMPO, and bright CD33 and CD13 positivity and lack of CD34 and HLA-DR was seen in the majority of APML including hypo-granular variant. We sugges t a rapid diagnostic four-tube panel for fast and rapid diagnosis of APML, including hypogranular variants with 100% sensitivity. The study also identified six groups of immunophenotypes with significant prediction values of APML, including hypogranular variants. The study also highlights CD2, CD56, and CD9 as prognostic markers for acute promyelocytic leukemia. PMID:34540354 | PMC:PMC8446832 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic factors for descending necrotizing mediastinitis development in deep space neck infections-a retrospective study

xlomafota13 shared this article with you from Inoreader Prognostic factors for descending necrotizing mediastinitis development in deep space neck infections-a retrospective study 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 Sep 20. doi: 10.1007/s00405-021-07081-0. Online ahead of print. ABSTRACT OBJECTIVES: Descending necrotizing mediastinitis (DNM) is the most serious complication of deep neck infections (DNI). The objective of this retrospective study was to evaluate prognostic factors for DNM development in deep space neck infections. METHODS: The study enrolled patients admitted to the Emergency Center of Vojvodina with the diagnosis of multispace DNI with or without DNM either as the primary diagnosis or with discharged diagnosis after surgical treatment during 7-year period. The data were obtained from patient medical records. RESULTS: After final analysis total of 141 charts were randomized for statystical analysis, 124 charts in DNI and 17 in DNI + DNM groups. The most common cause of infection in both groups was odontogenic. On multivariate regression analysis of collected data infection of retropharyng eal, pretracheal and carotid space, C-reactive protein and procalcitonine values were statistically significant predictors for DNM development. CONCLUSIONS: Treatment and diagnosis of DNM requires multidisciplinary approach, with prompt clinical and radiological examinations, empirical broad spectrum antibiotic therapy and radical surgical debridement. Multispace neck infection and especially infection of retropharyngeal, carotid and pretracheal spaces are the most sensitive predictors for DNM development in deep space neck infections. CLINICAL RELEVANCE: If the infection from deep neck spaces reach retropharyngeal, carotid or pretracheal space, the DNM is probable to occur. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT04865003. Date of registration 27.4.2021. PMID:34542654 | DOI:10.1007/s00405-021-07081-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mental health indicators in the later phase of lockdown due to COVID-19 pandemic in healthy youth combined elderly people: a web-based cross-sectional survey

xlomafota13 shared this article with you from Inoreader Mental health indicators in the later phase of lockdown due to COVID-19 pandemic in healthy youth combined elderly people: a web-based cross-sectional survey Via International Journal of Physiology, Pathophysiology and Pharmacology Int J Physiol Pathophysiol Pharmacol. 2021 Aug 15;13(4):117-125. eCollection 2021. ABSTRACT Lockdown was implemented throughout the world in March 2020 to control the spread of covid-19 infection. It affected the mental health of people in various ways. This web-based cross-sectional survey was conducted in the general population of India with an aim to evaluate the mental health of the healthy individuals in the later stage of the lockdown period. Data on socio-demographic factors, anxiety, depression (HADS scale), perceived stress (PSS scale), insomnia (insomnia severity index), subjective psychological feeling of well-being (WHO-5 well-being Index), and attitude towards covid-19 (7-point Likert scale) was collected. Univariate regression analysis and Karl Pearson's correlation were used to analyze the correlation of mental health abnormalities with socio-demographic factors. 119 subjects of mean age of 36.03 ± 18.04 years took part in the study. Their average number of days of stay at home during the lockdown and the average number of days of the lifestyle changes was 49.07 ± 31.92 and 61.39 ± 20.03 days, respectively. Depression, anxiety, stress, and clinical insomnia due to covid-19 were reported in 13.45%, 10.92%, 14.29%, and 11.76% subjects, respectively. There was a significant correlation of depression, anxiety, stress, and WHO-5 well-being score with age, socio-economic status, and the average number of days of the change in lifestyle due to the COVID-19 pandemic (P < 0.05). Therefore, the study concluded that the abnormalities of mental health were less prevalent in the older age group and lower socioeconomic status in the later phase of lockdown. PMID:34540132 | PMC:PMC8446773 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.