Pediatric Intracranial Hypotension and Post-Dural Puncture Headache

xlomafota13 shared this article with you from Inoreader Pediatric Intracranial Hypotension and Post-Dural Puncture Headache Via leak of cerebrospinal fluid Semin Pediatr Neurol. 2021 Dec;40:100927. doi: 10.1016/j.spen.2021.100927. Epub 2021 Sep 3. ABSTRACT Pediatric intracranial hypotension can occur acutely following iatrogenic dural puncture for diagnostic or therapeutic purposes, or chronically from cerebrospinal fluid leak. The incidence of intracranial hypotension in children is not fully known. However, many steps can be taken to reduce the risk of a child developing a post-dural puncture headache. Other causes of intracranial hypotension, such as spontaneous intracranial hypotension or CSF fistulas, are rare and with little pediatric data to guide evaluation and management. This manuscript reviews the risk factors, diagnostic evaluations, and treatments for post-dural puncture headache, as well as a limited discussion of spontaneous intracranial hypotension as it may pertain to children and adolescents. PMID:34749914 | DOI:10.1016/j.spen.2021.100927 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Drainage of intraorbital abscess in infant via endoscopic nasalsinus approach: a case report

xlomafota13 shared this article with you from Inoreader Drainage of intraorbital abscess in infant via endoscopic nasalsinus approach: a case report Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1204-1206. doi: 10.3760/cma.j.cn115330-20201223-00946. NO ABSTRACT PMID:34749461 | DOI:10.3760/cma.j.cn115330-20201223-00946 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rhinocerebral mucormycosis secondary to acute leukemia: a case report

xlomafota13 shared this article with you from Inoreader Rhinocerebral mucormycosis secondary to acute leukemia: a case report Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1207-1209. doi: 10.3760/cma.j.cn115330-20210122-00030. NO ABSTRACT PMID:34749462 | DOI:10.3760/cma.j.cn115330-20210122-00030 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical comparative study of free posterior tibial artery perforator flap and radial forearm free flap for head and neck reconstruction

xlomafota13 shared this article with you from Inoreader Clinical comparative study of free posterior tibial artery perforator flap and radial forearm free flap for head and neck reconstruction Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1158-1163. doi: 10.3760/cma.j.cn115330-20210518-00280. ABSTRACT Objective: To compare the clinical application results of the FPTF (free posterior tibial artery perforator flap) and RFFF (radial forearm free flap) for reconstruction of head and neck defects. Methods: A retrospective analysis of 27 cases treated with FPTF (19 males and 8 females, aged 14-69 years) and 24 cases with RFFF (11 males and 13 females, aged 22-69 years) for head and neck defect reconstruction at Beijing Tongren Hospital of Capital Medical University from January 2015 to December 2020 was conducted. Flap size, vascular pedicle length, matching degree of recipient area blood vessels, preparation time, total operation time, hospital stay, recipient area complications, donor area complications and scale-based patient satisfaction were compared between two groups of patients with FTPF an d RFFF. SPSS 26.0 statistical software was used for statistical analysis. Results: There was no statistically significant difference between the two groups of patients in tumor T staging (P=0.38), primary sites (P=0.05) and mean flap areas ((53.67±29.84) cm2 vs. (41.13±11.08) cm2, t=-1.472, P=0.14). However the mean vascular pedicle length of FPTF was more than that of RFFF ((11.15±2.48)cm vs. (8.50±1.69)cm, t=-4.071, P<0.01). The donor sites of 4 patients in FPTF group could be sutured directly, while all the 24 patients in RFFF group received skin grafts from the donor sites. There was no statistically significant difference in the recipient area arteries between two groups of flaps (P=0.10), with more commonly using of the facial artery (RFFF: FPTF=21∶27), but there was significant difference in the recipient area veins (P<0.01), with more commonly using of the external jugular vein in RFFF (14/24) than FPTF (4/32) and the posterior facial vein in FPTF (27/32) than RFFF (9/24). There were 10 recipient complications and 3 donor complications in RFFF group; no recipient complication and 3 donor complications occurred in FPTF group. With patient's subjective evaluation of the donor site at 12 months after surgery, FPTF was better than RFFF (χ²=22.241, P<0.01). Conclusions: FPTF is an alternative to RFFF in head and neck reconstruction and has unique advantages in aesthetics and clinical application. PMID:34749454 | DOI:10.3760/cma.j.cn115330-20210518-00280 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Classification and reconstruction of complex defects after lateral facial tumor surgery

xlomafota13 shared this article with you from Inoreader Classification and reconstruction of complex defects after lateral facial tumor surgery Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1144-1149. doi: 10.3760/cma.j.cn115330-20210623-00370. ABSTRACT Objective: To explore the classification and reconstruction strategy of defects in lateral face region after operation of malignant tumors. Methods: Eighteen cases with the reconstruction of complicated defects after resection of tumors in the region of lateral face from January 2015 to January 2018 in Hunan Cancer Hospital were retrospectively reviewed. There were 14 males and 4 females, aged from 32 to 68 years. According to the presence or absence of bony scaffold, complicated defects were divided into two main categories: soft tissue perforating defects and soft tissue defects combined with bony scaffold defects. All soft tissue perforating defects in 5 cases were repaired with free anterolateral femoral flaps. Among 13 cases with soft tissue plus bony scaffold defects, 3 were repaired with free fibular flaps, 6 with free fibular flaps combined with free anterolateral femoral flaps, and 4 with chimeric deep circumflex iliac artery perforator flaps combined with anterolateral femoral flaps. Results: All flaps survived well. Two patients complicated with fistula in floor of mouth, but the wound healed after dressing change. Transoral feeding was resumed within 2 weeks after surgery in all patients. One year follow-up evaluation showed that 14 cases had symmetrical face and 10 cases had mouth opening more than 3 transverse fingers. After 36-50 months of follow-up, 6 patients died, with an overall 3-year survival rate of 66.7%. Conclusion: The classification of defects with or without bony stent loss is conducive to the overall repair design, the recovery of facial contour stent, the effective fill of dead space and the maintain of residual occlusal relationship. Good reconstruction results require a multi flap combination of osteocutaneous and soft tissue fl aps. PMID:34749452 | DOI:10.3760/cma.j.cn115330-20210623-00370 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Capsaicin restores sodium iodine symporter-mediated radioiodine uptake through bypassing canonical TSH-TSHR pathway in anaplastic thyroid carcinoma cells

xlomafota13 shared this article with you from Inoreader Capsaicin restores sodium iodine symporter-mediated radioiodine uptake through bypassing canonical TSH-TSHR pathway in anaplastic thyroid carcinoma cells Via radioactive iodine J Mol Cell Biol. 2021 Nov 9:mjab072. doi: 10.1093/jmcb/mjab072. Online ahead of print. ABSTRACT Anaplastic thyroid cancer (ATC) is a rare but highly lethal disease. ATCs are resistant to standard therapies and are extremely difficult to manage. The stepwise cell dedifferentiation results in the impairment of the iodine-metabolizing machinery and the infeasibility of radioiodine treatment in ATC. Hence, re-inducing iodine-metabolizing gene expression to restore radioiodine avidity i s considered as a promising strategy to fight against ATC. In the present study, capsaicin (CAP), a natural potent transient receptor potential vanilloid type 1 (TRPV1) agonist, was discovered to re-induce ATC cell differentiation and to increase the expression of thyroid transcription factors (TTFs including TTF-1, TTF-2, and PAX8) and iodine-metabolizing proteins, including thyroid stimulating hormone receptor (TSHR), thyroid peroxidase, and sodium iodine symporter (NIS), in two ATC cell lines, 8505C and FRO. Strikingly, CAP treatment promoted NIS glycosylation and its membrane trafficking, resulting in a significant enhancement of radioiodine uptake of ATC cells in vitro. Mechanistically, CAP activated TRPV1 channel and subsequently triggered Ca2+ influx, cyclic adenosine monophosphate (cAMP) generation, and cAMP responsive element binding protein (CREB) signal activation. Next, CREB recognized and bound to the promoter of SLC5A5 to facilitate its transcription. Moreover, the TRP V1 antagonist CPZ, the calcium chelator BAPTA, and the PKA inhibitor H-89 effectively alleviated the re-differentiation exerted by CAP, demonstrating that CAP might improve radioiodine avidity through the activation of the TRPV1‒Ca2+/cAMP/PKA/CREB signaling pathway. In addition, our study indicated that CAP might trigger a novel cascade to re-differentiate ATC cells and provide unprecedented opportunities for radioiodine therapy in ATC, bypassing canonical TSH‒TSHR pathway. PMID:34751390 | DOI:10.1093/jmcb/mjab072 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparative Efficacy of the KTP Laser and Cold Steel in Office-Based Surgery for Oropharyngeal Papilloma

xlomafota13 shared this article with you from Inoreader Comparative Efficacy of the KTP Laser and Cold Steel in Office-Based Surgery for Oropharyngeal Papilloma Via ear nose throat Ear Nose Throat J. 2021 Nov 9:1455613211053413. doi: 10.1177/01455613211053413. Online ahead of print. ABSTRACT Objective: This study aims to compare the efficacy of the potassium-titanyl-phosphate (KTP) laser and cold steel surgery in treating oropharyngeal papilloma. Methods: Between 2017 and 2020, we enrolled 242 patients with oropharyngeal papilloma who were treated with either the KTP laser (n = 160) or cold steel surgery (n = 82). Patient charts were revi ewed for demographic data (age and gender), pathology, anatomical location of lesions, operative duration, pain rating, residual disease, and recurrence. Results: The oropharyngeal papillomas were successfully removed in all patients, except one with a significant pharyngeal reflex. There was no significant difference in the average time for lesion resection between KTP laser and cold steel group (18.11 ± 13.96 s vs 19.43 ± 16.91 s, P > .05). However, all patients who underwent cold steel surgery experienced bleeding during the operation and required postoperative observation (about 20 min), making the total procedure time longer than that of the KTP laser procedure, which did not cause any intraoperative bleeding or require postoperative observation. After KTP laser treatment, the pain rating was .49 ± .98, whereas after cold steel surgery, it was .74 ± 1.12 (P = .058). Twenty-five samples were sent for human papillomavirus (HPV) testing, and one tested positive for both HPV 6 and 11 strains, while another tested positive for HPV 16. No residual disease or recurrence was observed at the treatment sites after a long period of follow-up (M = 15.35 ± 10.79 mo; range = 6-39 mo). Conclusion: The KTP laser provided a better hemostasis effect and a good surgical field of vision during the operation, allowing the surgeon to complete the procedure in less time. No significant difference in terms of pain rating, incision recovery, and postoperative recurrence between the KTP laser treatment and cold steel surgery. PMID:34752174 | DOI:10.1177/01455613211053413 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.