Seborrheic keratosis-like melanoma: a diagnostic challenge

xlomafota13 shared this article with you from Inoreader Seborrheic keratosis-like melanoma: a diagnostic challenge Via Melanoma Research - Published Ahead-of-Print This article summarizes the main epidemiologic and diagnostic features of seborrheic keratosis-like (SK-like) melanoma. We performed a review of the current literature. The real and current incidence and prevalence of SK-like melanoma are unknown. Many lesions are misdiagnosed and not excised with histo pathologic confirmation, or excised without an appropriate surgical approach due to a benign clinical and dermoscopic appearance. SK-like melanoma presents both melanoma and SK features. SK-like melanoma and SK are often clinically indistinguishable even for experienced dermatologists. Clinically, it develops as a black-dark brown or light slightly elevated, papule, nodule or plaque with rapid growth and a regular or irregular shape. SK-like melanoma presents melanocytic and nonmelanocytic dermoscopic features. Irregular dark-brown dots/globules, a blue-grayish veil, streaks, irregular pigmentation or network and brown lines point to a melanoma diagnosis. Among the nonmelanocytic features, milia-like cysts and comedo-like openings have been highlighted. The association of polarized and nonpolarized dermoscopic techniques is more accurate for studying the dermoscopic features of SK-like melanoma. If the dermoscopic features are unclear, further investigations with reflectance confoca l microscopy (RCM) or biopsy with histologic examination are essential. SK-like melanoma is a dermatologic challenge. Careful clinical and dermoscopic evaluation favor a correct diagnosis. In unclear cases, it is important to perform a biopsy with histologic examination to confirm the correct diagnosis. Received 29 March 2021 Accepted 18 May 2021 Correspondence to Agata Janowska, MD, Department of Dermatology, University of Pisa, Via Roma 67, 56127, Pisa, Italia, Tel: +39 050 992436; fax: +39 050 992556; e-mail: dottoressajanowska@gmail.com Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Successful encorafenib desensitization in a patient with recurrent metastatic melanoma

xlomafota13 shared this article with you from Inoreader Successful encorafenib desensitization in a patient with recurrent metastatic melanoma Via Melanoma Research - Published Ahead-of-Print Type I hypersensitivity reactions (HSR) to dabrafenib are rare but have been previously described. We present a case where a 72-year-old woman with recurrent, metastatic BRAF-mutated melanoma developed a type I HSR to dabrafenib. We, therefore, developed a desensitization protocol with encorafenib, a similar class agent, to allow the patient to continue with treatment. Patients with a history of HSR to dabrafenib may be considered for encorafenib desensitization when other therapeutic options are limited. Received 21 February 2021 Accepted 18 May 2021 Correspondence to Gerald W. Volcheck, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA, Tel: +1 507 284 3165; fax: +1 507 284 0902; e-mail: volcheck.gerald@mayo.edu Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A New Risk of Using Alkaline Drops in Patients With Laryngopharyngeal Reflux

xlomafota13 shared this article with you from Inoreader A New Risk of Using Alkaline Drops in Patients With Laryngopharyngeal Reflux Via Journal of Voice Laryngopharyngeal reflux (LPR) is common in the otolaryngologist's office, and a multimodal treatment regimen is employed often. Counseling patients on lifestyle modifications is important. Alkaline water consumption has been recommended as a nonmedical "antacid" for its value in deactivating pepsin, a proteolytic enzyme responsible for laryngeal tissue inflammatory changes in LPR. Alkaline water can be found as premade bottled water, or it can be made at home by titrating regular-pH water with concentrated alkaline drops. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inflammatory Myofibroblastic Tumor of the Larynx: Report of a Case

xlomafota13 shared this article with you from Inoreader Inflammatory Myofibroblastic Tumor of the Larynx: Report of a Case Via Journal of Voice Inflammatory myofibroblastic tumor (IMT) is a rare tumor composed of mesenchymal myofibroblastic spindle cells enveloped by an inflammatory infiltrate. Historically, this tumor sparked debate regarding whether it was a true malignancy with metastatic potential or merely a locally destructive physiologic inflammatory response. Few reports of IMT exist in the recent literature, with the majority of cases occurring in the pediatric population and favoring the lungs. Here we present an exceedingly rare case of IMT involving the larynx of a 22-year-old female. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Automated quantification of inflection events in the electroglottographic signal

xlomafota13 shared this article with you from Inoreader Automated quantification of inflection events in the electroglottographic signal Via Journal of Voice Certain aspects of the contacting and decontacting phases of the vocal folds can be analyzed indirectly through the electroglottographic (EGG1) signal. Since 19571 EGG has been widely used in the clinic and in voice research given that it provides information regarding the contact area of the vocal folds during phonation2. Its main quantitative parameters: contact quotient [3–9], open quotient [3,4,10–12] and fundamental frequency estimation [13–17] have been widely used in research studies and in the voice clinic. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcome of Immunoglobulin Replacement Therapy in Adults With Rhinosinusitis

xlomafota13 shared this article with you from Inoreader Outcome of Immunoglobulin Replacement Therapy in Adults With Rhinosinusitis Via The Laryngoscope Objective To evaluate the outcome of immunoglobulin (IG) replacement therapy in adults with rhinosinusitis and primary humoral immunodeficiency disorders (PID). Study Design Retrospective cohort study. Methods Retrospective chart review of adult (18 years and older) patients who were diagnosed with PID and had the diagnosis of recurrent acute rhinosinusitis (RARS) and chronic rhinosinusitis (CRS) and who are on IG replacement therapy. Demographic data, associated conditions, and duration of treatment were reviewed. Number of yearly sinus infections, sinus CT Lund-Mackay (LM) score, and need for functional endoscopic sinus surgery (FESS) were reviewed before and after starting IG therapy. Results Fifty-eight patients were included. Average age was 52 years (18–79 years). About 74% were female. Thirty patients (51.7%) had common variable immunodeficiency (CVID), 18 (31.1%) had hypogammaglobulinemia, and 10 (17.2%) had specific antibody deficiency (SAD). About 79% of patients had allergic rhinitis and 74% had asthma. Pretreatment LM score was 7.6 (±2.2, range of 0–24) compared to posttreatment score of 3.5 (±1.3, range of 0–16) (P = .01). Eleven patients (19%) had FESS pretreatment compared to only two patients (3.4%) requiring ESS after starting treatment on IG therapy (P = .004). Prior to starting IG therapy, five patients (8.6%) had more than 10 sinus infections per year, 33 patients (56.9%) had 5 to 10 infections, and 20 patients (34.5%) had 1 to 5 infections per year. After starting on IG, 34 patients (58.6%) had no infections reported anymore (P < .001), and 24 patients (41.4%) had only 1 to 5 infections repor ted per year Conclusion IG therapy is a promising treatment option for recurrent rhinosinusitis in patients with PID. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comprehensive histochemical and stereological study of the parotid and sublingual salivary glands in Caucasian squirrel (Sciurus anomalus)

xlomafota13 shared this article with you from Inoreader Comprehensive histochemical and stereological study of the parotid and sublingual salivary glands in Caucasian squirrel (Sciurus anomalus) Via histochem Acta Histochem. 2021 Jun 17;123(5):151742. doi: 10.1016/j.acthis.2021.151742. Online ahead of print. ABSTRACT The present investigation tries to reflect histochemical and stereological properties of the parotid gland (PG) and sublingual gland (SLG) in the Caucasian squirrel. Totally, five male Caucasian squirrels were used. The glands were examind histochemical using PAS, Alcian blue (AB, pH = 2.5) and Aldehyde fucshin (AF) stainings. Total volume of the glands, acini, ducts as well as total length of ducts were estimated using streological procedures. The PG had a unique morphology and were connected to each other with an intermediated isthmus. The SLG was oval-shaped. Serous acini of PG exhibited strong, negative and weak reaction with AF, AB and PAS, respectively. While, mucous acini of SLG showed positive staining for AB and PAS, and negative staining for AF. The ductal system was consisted of intercalated (Id), striated (SD) and excretory ducts (Ed). The Sd in PG was lined with simple cuboidal to the columnar epithelium, while it was lined with simple cuboidal epithelium in SLG. The Ed was lined with stratified cuboidal epithelium in both glands. The striated duct was longest duct in both glands, the excretory and intercalated ducts were the shortest ones in PG and SLG, respectively. The maximum total volume in both gland were blonged to the acini and straited ducts. It concluded that PG and SLG in the Caucasian squirrel have some distinct structu ral properties in comparison to other rodents and mammalis species. PMID:34147989 | DOI:10.1016/j.acthis.2021.151742 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tracheal glomus tumor misdiagnosed as pulmonary disease: a case report and literature review

xlomafota13 shared this article with you from Inoreader Tracheal glomus tumor misdiagnosed as pulmonary disease: a case report and literature review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Jun 8:S1808-8694(21)00107-5. doi: 10.1016/j.bjorl.2021.05.011. Online ahead of print. NO ABSTRACT PMID:34147403 | DOI:10.1016/j.bjorl.2021.05.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A third hand to the surgeon: the use of an endoscope holding arm in endonasal sinus surgery and well beyond

xlomafota13 shared this article with you from Inoreader A third hand to the surgeon: the use of an endoscope holding arm in endonasal sinus surgery and well beyond 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 Jun 20. doi: 10.1007/s00405-021-06935-x. Online ahead of print. ABSTRACT BACKGROUND: Extended endoscopic endonasal operations of the sinuses and the frontal skull base require a bimanual action of the surgeon in many cases. Thus, typically an assistant guides the endoscope and centers the field of view. In this study, we investigate in which cases an endoscope holding arm can be used alternatively. MATERIALS AND METHODS: The electromagnetic system ENDOFIXexo was used in different surgical interventions of the paranasal sinuses and beyond questioning ergonomics and geometrical limitations. The realized degrees of freedom were documented, and a topography of possible applications compiled. RESULTS: The presented system is limited by the anatomy of the anterior ethmoid and dynamic working conditions in the sagittal direction. Especially in extended interventions in the posterior ethmoid, in whic h parts of the nasal septum have been resected and a static position of the endoscope is desired the surgeon can greatly benefit from the robotic arm. Moreover, through the high flexibility of the endoscopic arm surgeries of the pharynx and larynx were performed, questioning the current gold standard of microscope-assisted surgical procedures. CONCLUSION: Under the impression of an urging staff shortage and due to its unlimited patience, the ENDOFIXexo arm seems promising. Taking into account the complex anatomy and the limited access, we especially see a favorable field of application in the surgery of the pituitary gland and skull base tumors. PMID:34148145 | DOI:10.1007/s00405-021-06935-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case report of cerebrospinal fluid leak secondary to inner ear malformation

xlomafota13 shared this article with you from Inoreader A case report of cerebrospinal fluid leak secondary to inner ear malformation Via leak of cerebrospinal fluid Radiol Case Rep. 2021 Jun 7;16(8):1931-1933. doi: 10.1016/j.radcr.2021.04.072. eCollection 2021 Aug. ABSTRACT Spontaneous cerebrospinal fluid (CSF) rhinorrhea is rare and may develop secondary to inner ear malformation. A possible diagnosis of CSF leak should be considered in any pediatric patient who presents with hearing impairment, rhinorrhea, or otorrhea. Temporal bone computed tomography should be performed in children with hearing impairments. We describe a case of congenital inner ear anomaly in a 12-month-old girl who presented with intermittent rhinorrhea after birth and detected hearing problems when she was 6 months. After diagnosis, the CSF leak was surgically repaired without complications. PMID:34149977 | PMC:PMC8193066 | DOI:10.1016/j.radcr.2021.04.072 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adductor magnus muscle transfer to restore knee extension: Anatomical studies and clinical applications

xlomafota13 shared this article with you from Inoreader Adductor magnus muscle transfer to restore knee extension: Anatomical studies and clinical applications Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 8:S1748-6815(21)00152-2. doi: 10.1016/j.bjps.2021.03.063. Online ahead of print. ABSTRACT BACKGROUND: Loss of knee extension causes significant impairment. Though nerve-based reconstruction is preferable in cases of femoral nerve palsy or injury, these surgeries are not always appropriate if the pathology involves the quadriceps muscles or presentation too late for muscle reinnervation. Muscle transfers are another option that has been underutilized in the lower extremity. We describe the successful restoration of knee extension by adductor magnus muscle transfer without functional donor morbidity, along with anatomical considerations. METHODS: Ten fresh frozen cadaveric lower limbs were dissected at the groin and thigh. In addition, three patients presented with femoral nerve palsy for which nerve-based reconstruction was not appropriate because of late presentation. In these patients, add uctor magnus muscle transfers were performed, along with sartorius, gracilis, and tensor fasciae latae transfers if available and healthy. RESULTS: In cadavers, the pedicle for the adductor magnus is at the level of the gracilis and adequate for muscle transfer, with sufficient weavable tendon length. The only major structure at risk is the femoral neurovascular bundle, which is in a reliable anatomic position. Two patients recovered 4/5 active knee extension and ambulation without assistive devices. A third required reoperation for a loosened tendon weave, after which the noted improved stability and strength with ambulation but did not regain strong active knee extension and continued to require a cane. CONCLUSIONS: We present a novel reconstructive approach for loss of quadriceps function in patients, which yields good clinical outcomes, with anatomic and technical details to demonstrate the utility of this technique. Ongoing evaluation of optimal technique and rehabi litation to maximize functional outcomes is still needed. PMID:34148834 | DOI:10.1016/j.bjps.2021.03.063 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resident experiences with virtual education during the COVID-19 crisis

xlomafota13 shared this article with you from Inoreader Resident experiences with virtual education during the COVID-19 crisis Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 8:S1748-6815(21)00286-2. doi: 10.1016/j.bjps.2021.05.037. Online ahead of print. ABSTRACT BACKGROUND: Residency education has adapted to current social distancing recommendations by relying heavily on videoconferences. There is concern however, that this new paradigm may lead to over-saturation or burnout. METHODS: A 12-question survey investigating resident experiences with educational videoconferences was distributed to University of Washington plastic surgery residents. A modified Maslach Burnout Inventory was used to assess resident burnout from virtual conferences. Conference attendance and reasons for missing conferences were compared using paired two-tailed t-tests. RESULTS: A total of 24 residents were given the survey with 100% response rate. There was a significant decrease in the total number of weekly attended videoconferences (p<0.01) and in the number of attended educ ational videoconferences (p<0.01) over time. Reasons for absences included clinical duties (92% of respondents) followed by symptoms of burnout, including forgetfulness (67%) and feeling fatigued by videoconferencing lectures (54%), and to a lesser extent the belief that the lecture was not educational (25%). 79% of residents reported at least occasionally feeling emotionally drained from videoconferencing and 88% reported at least occasionally feeling burned out due to the number of videoconferencing activities. Despite declining attendance and burnout, 96% believe that videoconferences should continue after the end of quarantine but in a limited quantity. CONCLUSION: Videoconferences have become a valued means of resident education. The data suggests however that attendance has waned, largely due to what can be perceived as burnout. Residents remain interested in continuing educational videoconferences, although prioritizing quality over quantity will remain essential to prevent emotional fatigue and burnout. PMID:34148839 | DOI:10.1016/j.bjps.2021.05.037 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.