Τρίτη 12 Ιανουαρίου 2021

Middle turbinate mucosal flap: A low‐morbidity option in the management of skull base defects

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Abstract

Background

To describe the low morbidity of middle turbinate mucosal flap (MTMF) to repair anterior skull base defects.

Methods

Skull base endonasal endoscopic surgeries performed at a tertiary hospital between 2015 and 2018 were analyzed. Patients were divided into two groups according the existence or not of a significant intraoperative cerebrospinal fluid (CSF) leak. In Group 1 (n = 28), gasket seal and a pedicled endonasal flap were used to repair the defect: 13 nasoseptal flaps (NSF), 8 inferolateral wall flaps (ILF), and 7 MTMF. In Group 2 only an endonasal flap was used: 9 NSF, 4 ILF, and 18 MTMF. Surgical and recovery time were analyzed (Student's t test). Our favorite surgical technique is described.

Results

Fifty‐nine patients were included. Average surgical time was 27.7, 41.6, and 11.3 min for NSF, ILF, and MTMF, respectively. MTMF showed a faster recovery.

Conclusion

MTMF is a safe reconstructive option for anterior skull base defects.

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VHI-10 Scores in a Treatment-Seeking Population With Dysphonia

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The VHI-10 is a patient-reported outcome measure used to record the patient's perception of impairment or handicap due to a voice problem. Scores above 11 are abnormal and indicate voice handicap. Amongst a treatment-seeking population in a large tertiary voice center, scores below the VHI-10 cutoff score of 11 were frequently noted. The aim of this study was to examine the number of people seeking voice therapy for dysphonia who scored below the established VHI-10 cutoff score.
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Expression and Role of Thyrotropin Receptors in Proopiomelanocortin-Producing Pituitary Cells

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Thyroid, Ahead of Print.
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Use of a modular ontology and a semantic annotation tool to describe the care pathway of patients with amyotrophic lateral sclerosis in a coordination network

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journal.pone.0244604.g004&size=inline

by Sonia Cardoso, Pierre Meneton, Xavier Aimé, Vincent Meininger, David Grabli, Gilles Guezennec, Jean Charlet

The objective of this study was to describe the care pathway of patients with amyotrophic lateral sclerosis (ALS) based on real-life textual data from a regional coordination network, the Ile-de-France ALS network. This coordination network provides care for 92% of patients diagnosed with ALS living in Ile-de-France. We developed a modular ontology (OntoPaRON) for the automatic processing of these unstructured textual data. OntoPaRON has different modules: the core, medical, socio-environmental, coordination, and consolidation modules. Our approach was unique in its creation of fully defined concepts at different levels of the modular ontology to address specific topics relating to healthcare trajectories. We also created a semantic annotation tool specific to the French language and the specificities of our corpus, the Ontology-Based Semantic Annotation Module (OnBaSAM), using the OntoPaRON ontology as a reference. We used these tools to annotate the records of 928 patients automati cally. The semantic (qualitative) annotations of the concepts were transformed into quantitative data. By using these pipelines we were able to transform unstructured textual data into structured quantitative data. Based on data processing, semantic annotations, sociodemographic data for the patient and clinical variables, we found that the need and demand for human and technical assistance depend on the initial form of the disease, the motor state, and the patient age. The presence of exhaustion in care management, is related to the patient's motor and cognitive state.
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Associated factors, health-related quality of life, and reported costs of chronic otitis media in adults at two otologic referral centers in a middle-income country

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journal.pone.0244797.g002&size=inline

by Lucia C. Pérez-Herrera, Daniel Peñaranda, Sergio Moreno-López, Ana M. Otoya-Tono, Lorena Gutiérrez- Velasco, Juan Manuel García, Augusto Peñaranda

Background

Despite the high prevalence of chronic otitis media (COM) in low to middle-income countries, there are few studies regarding its associated factors, health-related quality of life, and treatment costs. This study aimed to identify associated factors of COM, assess its impact on the quality of life as well as estimate the patients' reported costs of COM treatment in Colombia.

Methods

Cross-sectional study. Two otology-referral centers in Bogotá (Colombia) were included. Questionnaires focusing on sociodemographic and clinical associated factors, quality of life, and patients' reported costs were administered to 200 adults with COM diagnosis and 144 control adults. Otoscopic evaluation and audiometric data were collected.

Results

The mean age was 42.2 years (SD: 14.44). The median length of COM was 26.13 years (SD: 17.06), and 79.5% of the COM patients reported otorrhea during childhood (P-value: 0.01). The most frequently reported allergic disease amon g our study population was allergic rhinitis (26.5%). COM was less frequent in patients with a medium-high socioeconomic status (PR: 0.54; 95% CI: 0.39–0.72), and more frequent in patients who reported increased ear discharge due to upper respiratory tract infections (PR: 1.69; 95% CI: 1.68–1.70). The global score of the "Chronic Suppurative Otitis Media Questionnaire-12" showed a difference of 9 points between patients with active and inactive COM (P Conclusions

Associated factors found in this study are consistent with previous reports. COM has a significant financial impact and affects patients' quality of life. Worldwide research addressing these issues in poor-resource countries is scarce, further studies are needed.

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Κυριακή 10 Ιανουαρίου 2021

In vitro antileishmanial potentialities of essential oils from Citrus limon and Pistacia lentiscus harvested in Tunisia

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Abstract

Leishmaniasis is a tropical parasitic disease that affects up to 12 million people worldwide. Current chemotherapies have limitations such as toxicity, high cost, and parasite resistance. This work aims to select an essential oil (EssOil) isolated from the Tunisian flora as a new antileishmanial candidate. Two plants were chosen for their antileishmanial potential: Citrus limon (Citrus) and Pistacia lentiscus (Pistacia). Each of these plants was harvested from two different sites (area 1 and area 2). Extracted EssOils were characterized using GC-MS. Their antiparasitic activity against axenic and intracellular Leishmania major amastigotes and their cytotoxicity were assessed. Citrus EssOil from area 1 displayed an interesting activity against L. major intramacrophage amastigotes with IC50 value at 4.2 ± 1.3 μg/mL. Interestingly, this activity was close to that of miltefosine. Mod erate activities against intracellular amastigote were observed for Pistacia EssOil from area 1 and Citrus EssOil from area 2. However, low cytotoxicity with high selectivity index was proved only for Citrus EssOil from area 1, revealing its safety for macrophages. This study also demonstrated for the first time the antileishmanial activity of EssOil extracted from Citrus limon leaves. The EssOil interesting activity could be related to the lipophilic properties of terpenes that were shown in literature to contribute to the disruption of parasite intracellular metabolic pathways.

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Attenuation of the Induction of TLRs 2 and 4 Mitigates Inflammation and Promotes Neurological Recovery After Focal Cerebral Ischemia

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Abstract

The intense inflammatory response triggered in the brain after focal cerebral ischemia is detrimental. Recently, we showed that the suppression of toll-like receptors (TLRs) 2 and 4 attenuates infarct size and reduces the expression of pro-inflammatory cytokines in the ischemic brain. In this study, we further examined the effect of unsuppressed induction of TLRs 2 and 4 on the expression of its downstream signaling molecules and pro-inflammatory cytokines 1 week after reperfusion. The primary purpose of this study was to investigate the effect of simultaneous knockdown of TLRs 2 and 4 on M1/M2 microglial polarization dynamics and post-stroke neurological deficits and the recovery. Transient focal cerebral ischemia was induced in young adult male Sprague-Dawley rats by the middle cerebral artery occlusion (MCAO) procedure using a monofilament suture. Appropriate cohorts of rats were treated with a nanoparticle formulation of TLR2shRNA and TLR4shRNA (T2sh+T4s h) expressing plasmids (1 mg/kg each of T2sh and T4sh) or scrambled sequence inserted vector (vehicle control) expressing plasmids (2 mg/kg) intravenously via tail vein immediately after reperfusion. Animals from various cohorts were euthanized during reperfusion, and the ischemic brain tissue was isolated and utilized for PCR followed by agarose gel electrophoresis, real-time PCR, immunoblot, and immunofluorescence analysis. Appropriate groups were subjected to a battery of standard neurological tests at regular intervals until 14 days after reperfusion. The increased expression of both TLRs 2 and 4 and their downstream signaling molecules including the pro-inflammatory cytokines was observed even at 1-week after reperfusion. T2sh+T4sh treatment immediately after reperfusion attenuated the post-ischemic inflammation, preserved the motor function, and promoted recovery of the sensory and motor functions. We conclude that the post-ischemic induction of TLRs 2 and 4 per sists for at least 7 days after reperfusion, contributes to the severity of acute inflammation, and impedes neurological recovery. Unlike previous studies in TLRs 2 or 4 knockout models, results of this study in a pharmacologically relevant preclinical rodent stroke model have translational significance.

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