Τρίτη 8 Φεβρουαρίου 2022

Vitamin D status in Dupuytren's disease: Association with clinical status and vitamin D receptor expression

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J Plast Reconstr Aesthet Surg. 2022 Jan 20:S1748-6815(22)00024-9. doi: 10.1016/j.bjps.2022.01.012. Online ahead of print.

ABSTRACT

BACKGROUND: Dupuytren's disease (DD) is a progressive fibroproliferative condition involving contractures of the fascia of the palm. Up to now, there are no relevant investigations on patients with DD in case of serum vitamin D deficiency. We hypothesized that transforming growth factor-β1 (TGF-β1) is increased in patients with DD in consequence of vitamin D deficiency, thereby leading to myofibroblast differentiation and subsequent progression of contractures.

METHODS: The aim of this study was to analyze serum vitamin D levels and explore possible clinical and immunohistochemical correlates with vitamin D concentrations in a group of patients with DD. Vitamin D levels were measured in all patients with DD and healthy controls. In the patient group, clinical characteristics were compared between vi tamin D deficient and nondeficient subgroups. Diseased palmar fascia samples were obtained from 14 patients undergoing fasciectomy for DD. Correlations between vitamin D levels and vitamin D receptor(VDR), TGF-β1 expression levels in collected fascia samples were evaluated.

RESULTS: Vitamin D concentrations were significantly lower in patients than in healthy controls. In addition, total extension deficit of involved fingers was higher in vitamin D deficient patients. Moreover, a positive correlation was found between vitamin D levels and expression of VDR in pathologic fascia in patients undergoing fasciectomy for contracture. Serum vitamin D levels were found to be low in patients with DD. Expression of VDR was lower in the vitamin D deficient group.

CONCLUSIONS: The results suggest a potential link between vitamin D status and DD but causation is not yet established. The potential role of vitamin D and its interaction with VDR and the TGF-β1 signaling pathway in the pathogenesis of DD needs to be explored further.

PMID:35131190 | DOI:10.1016/j.bjps.2022.01.012

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Quantification of near-infrared fluorescence imaging with indocyanine green in free flap breast reconstruction

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J Plast Reconstr Aesthet Surg. 2022 Jan 14:S1748-6815(22)00003-1. doi: 10.1016/j.bjps.2021.12.004. Online ahead of print.

ABSTRACT

BACKGROUND: One of the complications of free flap breast reconstruction is the occurrence of skin and fat necrosis. Intra-operative use of near-infrared (NIR) fluorescence imaging with Indocyanine Green (ICG) has the potential to predict these complications. In this study, the quantification of the fluorescence intensity measured in free flap breast reconstruction was performed to gain insight into the perfusion patterns observed with ICG NIR fluorescence imaging.

METHODS: ICG NIR fluorescence imaging was performed in patients undergoing free flap breast reconstruction following mastectomy. After completion of the arterial and venous anastomosis, 7.5 mg ICG was administered intravenously. The fluorescence intensity over time was recorded using the Quest Spectrum Platform®. Four regions of interest (R OI) were selected based on location and interpretation of the NIR fluorescence signal: (1) The perforator, (2) normal perfusion, (3) questionable perfusion, and (4) low perfusion. Time-intensity curves were analyzed, and two parameters were extracted: Tmax and Tmax slopes.

RESULTS: Successful ICG NIR fluorescence imaging was performed in 13 patients undergoing 17 free flap procedures. Region selection included 16 perforators, 17 normal perfusions, 8 questionable perfusions, and 5 low perfusion ROIs. Time-intensity curves of the perforator ROIs were comparable to the ROIs of normal perfusion and demonstrated a fast inflow. No outflow was observed for the ROIs with questionable and low perfusion.

CONCLUSION: This study provides insight into the perfusion patterns observed with ICG NIR fluorescence imaging in free flap breast reconstruction. Future studies should correlate quantitative parameters with clinical perfusion assessment and outcome.

PMID:35131194 | DOI:10.1016/j.bjps.2021.12.004

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Predicting outcomes from sentinel node biopsy for melanoma in the UK: Is the MIA nomogram the answer?

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J Plast Reconstr Aesthet Surg. 2022 Jan 21:S1748-6815(22)00031-6. doi: 10.1016/j.bjps.2022.01.017. Online ahead of print.

NO ABSTRACT

PMID:35131192 | DOI:10.1016/j.bjps.2022.01.017

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Δευτέρα 7 Φεβρουαρίου 2022

Identification of key pathways and genes in vestibular schwannoma using bioinformatics analysis

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Exp Ther Med. 2022 Mar;23(3):217. doi: 10.3892/etm.2022.11141. Epub 2022 Jan 13.

ABSTRACT

The aim of the present study is to identify novel promising marks and targets of diagnosis, therapy and prognosis for patients with vestibular schwannoma at the molecular level. The gene expression profiles of GSE54934, GSE39645 and GSE56597 datasets were obtained respectively from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) were identified by comparing between gene expression profiles of the vestibular schwannoma tissues and normal tissues. Subsequently, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and protein-protein interaction (PPI) network analysis were performed. The function and pathway enrichment analysis were performed for DEGs with DAVID. Reverse transcription-quantitative PCR were conducted to confirm the expression of BCL2, AGT, IL6 and ITGA2 in human Schwann cells and vestibular schwannoma cells. A total of 4,025, 1,1291 and 1,513 DEGs were identified from GSE54934, GSE56597 and GSE39645 datasets, respectively. GO and KEGG analysis showed that the mutual upregulated genes were mainly enriched in cell division, mitotic nuclear division, and transition of mitotic cell cycle, whilst mutual downregulated genes were enriched in chemical synaptic transmission, neurotransmitter transport, and synaptic vesicle membrane. Subsequently, 20 genes, including BCL2, AGT, IL6 and ITGA2 were selected as hub genes with high degrees after PPI network analysis. The significant differential expression of those genes were detected among vestibular schwannoma tissues compared with normal nerve tissues. In conclusion, BCL2, AGT, IL6 and ITGA2 are significantly higher expressed in vestibular schwannoma tissues compared with human Schwann tissues. The DEGs identified in the present study provide novel targets for the diagnosis and treatment of vestibular schwannoma.

PMID:35126720 | PMC:PMC8796280 | DOI:10.3892/etm.2022.11141

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Cytokines and Inflammation in Meniere Disease

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Clin Exp Otorhinolaryngol. 2022 Feb 8. doi: 10.21053/ceo.2021.00920. Online ahead of print.

ABSTRACT

Meniere disease (MD) is a rare set of conditions associated with the accumulation of endolymph in the cochlear duct and the vestibular labyrinth with a decrease of endocochlear potential. It is considered a chronic inflammatory disorder of the inner ear with a multifactorial origin. The clinical syndrome includes several groups of patients with a core phenotype: sensorineural hearing loss, episodes of vertigo, and tinnitus with a non-predictable course. Genetic factors and the innate immune response seem to play a central role in the pathophysiology of the condition. Autoimmune MD should be diagnosed if a patient fulfills the diagnostic criteria for MD and one of the following autoimmune disorders: autoimmune thyroid disease, psoriasis, autoimmune arthritis, ankylosing spondylitis, or systemic lupus erythematosus. We summarize the evide nce to support autoimmune MD as an endophenotype in bilateral MD associated with the allelic variant rs4947296 and nuclear factor-kappa B (NF-κB)-mediated inflammation, the role of cytokines (particularly interleukin-1β and tumor necrosis factor-α) in defining a subset of patients with autoinflammation, and the potential role of cytokines as biomarkers to distinguish between patients with MD and vestibular migraine. Finally, we also introduce a list of potential drugs that could regulate the immune response in MD with potential for repurposing in clinical trials.

PMID:35124944 | DOI:10.21053/ceo.2021.00920

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Adenitis cervical con anaerobios sin causa aparente en lactante

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Resumen Las adenopatías cervicales benignas en lactantes son relativamente frecuentes, se definen como el aumento de volumen ganglionar de más de 1 cm, sin síntomas sistémicos y cuando están presentes, el término correcto es adenitis. Para su estudio, las adenitis se dividen en: locales, sistémicas, unilaterales, bilaterales, agudas, crónicas, y por edad, con diferentes etiologías. Se presenta el caso clínico de un lactante de 11 meses de edad con diagnóstico de adenitis cervical abscedada unilateral aguda, con cuadro de 72 h de evolución, con crecimiento constante a nivel cervical derecho, compromiso del estado general, fiebre y anorexia, por lo que se inician antibióticos de primera línea para los agentes bacterianos más frecuentes (Staphylococcus aureus y Streptococcus pyogenes), con evolución tórpida a las 48 h, por lo que se solicita ultrasonido cervical, ya que la familia no contaba con recursos para solicitar cultivo o tomografía, reportando el ultrason ido ganglio cervical de 3,5 cm de diámetro abscedado, por lo que se agrega cobertura para anaerobios, con respuesta muy favorable a las 24 h. Queda la duda del origen de los anaerobios en la paciente, sin antecedentes de importancia y en grupo etario diferente al afectado por esos gérmenes. Consideramos este caso interesante por su comportamiento atípico, para el enriquecimiento del ejercicio de la otorrinolaringología, recalcando el invaluable apoyo de la clínica y solo con un ultrasonido, ya que no siempre se tendrán todos los recursos disponibles, pero siguiendo las pautas de lo reportado en la literatura, se tuvo una resolución exitosa.
Abstract Benign cervical lymphadenopathies in infants are relatively frequent, they are defined as an increase in lymph node volume of more than 1 cm, without systemic symptoms, and when they are present, the correct term is adenitis. For its study, adenitis is divided into: local, systemic, unilateral, bilateral, acute, chronic, and by age, with different etiologies. An 11-month-old infant with a diagnosis of acute unilateral abscessed cervical adenitis, with a 72 h evolution, with constant growth at the right cervical level, fever and anorexia, for which first-line antibiotics were started to the most frequent bacterial agents (Staphylococcus aureus and Streptococcus pyogenes), with torpid evolution at 48 h, for which only cervical ultrasound is requested, since the family did not have the resources to request culture or tomography, reporting the cervical ganglion ultrasound of 3.5 cm of abscessed diameter, so coverage for anaerobes is added, with a very favorable response at 24 hrs. There remains the doubt of the origin of the anaerobes in the patient, without important antecedents and in an age group different from that affected by these germs. We consider this case interesting due to its atypical behavior, for the enrichment of the otolaryngology exercise, emphasizing the invaluable support of the clinic, and only with an ultrasound, since other clinical tools were not available, but following the guidelines of what is reported in literature, there was a successful resolution.
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Complicaciones intraoperatorias en cirugía endoscópica nasosinusal en Servicio de Otorrinolaringología del Hospital del Salvador, revisión en los últimos 10 años

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Resumen Introducción: La cirugía endoscópica nasal (CEN) corresponde a una técnica quirúrgica mínimamente invasiva. Ha disminuido la morbimortalidad secundaria al acto quirúrgico. Pese a esto, no está exenta de riesgos y sus complicaciones pueden variar en severidad desde leves hasta catastróficas, siendo la hemorragia nasal la más frecuente. Objetivo: Analizar las complicaciones intraoperatorias, factores asociados a complicaciones y manejo en nuestra realidad local. Material y Método: Estudio retrospectivo, revisión de protocolos operatorios de pacientes atendidos en el Hospital del Salvador entre los años 2009 y 2019. Resultados: Se revisaron 602 cirugías de las cuales se excluyeron 18. De un total de 584 CEN realizadas durante los últimos diez años, la incidencia de complicaciones intraoperatorias fue de 3,3%. Sólo se observaron complicaciones hemorrágicas (2%) y orbitarias (1,2%). La incidencia de complicaciones mayores fue 0,51%. La única variable a sociada de forma significativa con la presencia de complicación intraoperatoria fue el tiempo quirúrgico. Conclusión: Como centro presentamos una tasa de complicaciones intraoperatorias de CEN baja en los últimos diez años, dentro de las cuales las más frecuentes son las hemorrágicas y las orbitarias; comparables con la literatura internacional. Se establece el primer reporte a nivel nacional sobre las complicaciones intraoperatorias de CEN.
Abstract Introduction: Endoscopic sinus surgery (ESS) is a minimally invasive surgical technique. It has decreased morbidity and mortality secondary to the surgical act. Despite this, endoscopic sinus surgery is not a risk-free procedure and its complications can range from mild to severe, with nosebleed being the most frequent. Aim: To analyze the surgical results of nasal endoscopic surgery, with its intraoperative complications and management in our local reality. Material and Method: Retrospective study, review of operative pro tocols of patients attended at the Salvador Hospital between 2009 and 2019. Results: 602 surgeries were reviewed, of which 18 were excluded. Of a total of 584 ESS performed during the last ten years, the incidence of intraoperative complications was 3,3%. Only hemorrhagic (2%) and orbital complications (1,2%) were observed. The incidence of major complications was 0,51%. The only variable significantly associated with the presence of intraoperative complications was surgical time. Conclusion: As a center, we present a low rate of intraoperative complications of ESS in the last ten years, among which the most frequent are hemorrhagic and orbital; comparable to international literature. The first national report on intraoperative complications of ESS is established.
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