MRI as a road‐map for surgical intervention of acute invasive fungal sinusitis

xlomafota13 shared this article with you from Inoreader MRI as a road‐map for surgical intervention of acute invasive fungal sinusitis in Covid‐19 era Via Clinical Otolaryngology Abstract Objectives Acute invasive fungal sinusitis AIFS has high mortality rate, and its incidence has increased without explanation in Covid-19 era. Proper diagnosis and effective surgical debridement have a crucial role in decreasing this high mortality rate. MRI could detect early ischemic changes with localization of extrasinus devitalized fungal inflamed tissue to guide surgical intervention. Study design Prospective study Setting ORL-HNS department -Zagazig University. Methods T1 with gadolinium and T2 fat suppression sequences were investigated and correlated with surgical findings in cases recently recovered from Covid-19 "seroconversion". Loss of contrast enhancement LOCE/black sign in T1+G was hypothesized to reflect necrotic areas while hyperintense signal/white sign in T2 fat suppression was hypothesized to correlate with severely inflamed devitalized tissue in periantral region These radiological findings were correlated with intraoperative findings to identify positive predictive finding. Results 40 patients were included in this study, of which 38 had LOCE/ black sign in T1+G 95%. True ischemic turbinate was detected only in 35 cases (positive predictable value PPV= 92.1%). Hyperintense signal/ white sign in T2 fat suppression was detected in orbit, pterygopalatine-infratemporal fossa, sphenoid process, zygoma, external skin, and these findings were correlated with intraoperative findings (PPV ranging from 72.7% to 100%). Conclusion MRI has a crucial role in localization of devitalized tissue, and subsequently guides surgical intervention. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Enhanced removal of radioactive iodine anions from wastewater using modified bentonite: Experimental and theoretical study

xlomafota13 shared this article with you from Inoreader Enhanced removal of radioactive iodine anions from wastewater using modified bentonite: Experimental and theoretical study Via radioactive iodine Chemosphere. 2021 Dec 22:133401. doi: 10.1016/j.chemosphere.2021.133401. Online ahead of print. ABSTRACT Efficient and cost-effective removal of radioactive iodine anions from contaminated water has become a crucial task and a great challenge for waste treatment and environmental remediation. Herein, we present hexadecylpyridinium chloride monohydrate modified bentonite (HDPy-bent) for the efficient and selective removal of iodine anions (I- and IO3-) from contaminated water. Batch experiments showed that HDPy-bent could remove more than 95% of I- and IO3- within 10 min, and had maximum I- and IO3- adsorption capacities of 80.0 and 50.2 mg/g, respectively. Competitive experiments indicated that HDPy-bent exhibited excellent I- and IO3- selectivity in the excessive presence of common concomitant anions including PO43-, SO42-, HCO3-, NO3-, Cl- (maximum mole ratio of anions vs iodine anions was ∼50,000). An anion exchange mechanism was proposed for the selective adsorption of iodine anions. Optimal adsorption structure of HDPy+/I- (IO3-) at atomic level and driving forces of the I- (IO3-) adsorption were calculated by density functional theory (DFT) simulati ons. Moreover, the good durability and reusability of the HDPy-bent has been demonstrated with 5 adsorption-desorption cycles. Dynamic column experiment also demonstrated that HDPy-bent exhibited excellent removal and fractional recovery capabilities towards I- and IO3- from simulated groundwater and environmental water samples. In conclusion, this work presents a promising adsorbent material for the decontamination of radioactive iodine anions from wastewater on a large scale. PMID:34953880 | DOI:10.1016/j.chemosphere.2021.133401 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical responses following inspiratory muscle training in exercise-induced laryngeal obstruction

xlomafota13 shared this article with you from Inoreader Clinical responses following inspiratory muscle training in exercise-induced laryngeal obstruction 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 Dec 26. doi: 10.1007/s00405-021-07214-5. Online ahead of print. ABSTRACT PURPOSE: Exercise-induced laryngeal obstruction (EILO) is relatively common in young people. Treatment rests on poor evidence; however, inspiratory muscle training (IMT) has been proposed a promising strategy. We aimed to assess laryngeal outcomes shortly after IMT, and to compare self-reported symptoms with a control group 4-6 years later. METHODS: Two groups were retrospectively identified from the EILO-register at Haukeland University Hospital, Norway; one group had received only information and breathing advice (IBA), and another additionally IMT (IBA + IMT). At diagnosis, all participants performed continuous laryngoscopy during exercise (CLE), with findings split by glottic and supraglottic scores, and completed a questionnaire mapping exercise-related symptoms. After 2-4 weeks, the IBA + IMT-group was re-evaluated with CLE-test. After 4-6 years, both groups were re-assessed with a questionnaire. RESULTS: We identified 116 eligible patients from the EILO-register. Response rates after 4-6 years were 23/58 (40%) and 32/58 (55%) in the IBA and IBA + IMT-group, respectively. At diagnosis, both groups rated symptoms similarly, but laryngeal scores were higher in the IBA + IMT-group (P = 0.003). After 2-4 weeks, 23/32 in the IBA + IMT-group reported symptom improvements, associated with a decrease of mainly glottic scores (1.7-0.3; P < 0.001), contrasting unchanged scores in the 9/32 without symptom improvements. After 4-6 years, exercise-related symptoms and activity levels had decreased to similar levels in both groups, with no added benefit from IMT; however, full symptom resolution was reported by only 8/55 participants. CONCLUSION: Self-reported EILO symptoms had improved after 4-6 years, irrespective of initial treatment. Full symptom resolution was rare, suggesting individual follo w-up should be offered. PMID:34954812 | DOI:10.1007/s00405-021-07214-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incidence of Head and Neck Cancers before and after 9/11 in New York City and New York State

xlomafota13 shared this article with you from Inoreader Incidence of Head and Neck Cancers before and after 9/11 in New York City and New York State Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: The incidence of cancers in New York State (NYS) before and after 9/11 including lung, colorectal, and renal cancers has been previously described. To date, the incidence of head and neck cancers (HNCs) before and after 9/11 has not been described. Methods: Cancers involving the oral cavity and oropharynx; the nose, nasal cavity, nasopharynx, and middle ear; larynx; and thyroid were identified using the New York State Cancer Registry (NYSCR). Age-adjusted incidence and rates per 100,000 residents from 1987 to 2015 were analyzed using joinpoint regression. Trends in incidence using annual percent changes are presented. Results: The overall rate of HNC increased slightly by 0.7% (p #x3c; 0.001) from 1987 to 2003 in NYS. From 2003 to 2008, the rate increased by 5.73% (p #x3c; 0.001), and from 2008 to 2015, the rate increased by 1.68% (p #x3c; 0.001). The rate of thyroid cancer increased by 6.79% (p #x3c; 0.001) from 1987 to 2003, by 9.99% (p #x3c; 0.001) from 2003 to 2009, and by 2.41% (p = 0.001) from 2009 to 2015. The rate of thyroid cancer was higher in women at all time points. In a subset analysis of HNCs excluding thyroid cancer, the rate decreased by 2.02% (p #x3c; 0.001) from 1991 to 2001, followed by a nonsignificant increase of 0.1% (p = 0.515) from 2001 to 2015. The rate of oropharyngeal (OP) cancer significantly increased from 1999 to 2015 (2.65%; p #x3c; 0.001). The rate of oral cavity cancer significantly decreased from 1987 to 2003 (1.97%; p #x3c; 0.001), with no significant change after 2003. The rate of laryngeal cancer decreased significantly by 2.43% (p #x3c; 0.001) from 1987 to 2015, as did the rate of nasal cavity/nasopharyngeal cancer (0.33%; p = 0.03). Conclusions: In NYS, OP cancer and thyroid cancer rates increased significantly during the study period. The rate of thyroid cancer wa s higher in women. The rate of combined HNC increased significantly after 9/11 compared to before 9/11; however, in a subset analysis of all HNC patients excluding thyroid cancer, the rate decreased significantly prior to 9/11 and then nonsignificantly increased afterward. This suggests that the increase in thyroid cancer accounts for the increase in combined HNC in NYS. The impact of 9/11 on rates of HNC requires further research. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Priority setting in breast reconstructive surgery: A DELPHI consensus

xlomafota13 shared this article with you from Inoreader Priority setting in breast reconstructive surgery: A DELPHI consensus Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00613-6. doi: 10.1016/j.bjps.2021.11.068. Online ahead of print. ABSTRACT OBJECTIVES: Breast reconstructive surgery is often performed following breast cancer treatment to restore the natural appearance of the breast. Despite various research performed in this field, there is a discrepancy between the research question that is considered crucial jointly by patients, carers and healthcare professionals and the research performed. The Breast Reconstruction Priority Setting Partnership was formed to determine the top research priorities in all aspects of breast reconstructive surgery. METHODS: The Priority Setting Partnership (PSP) was conducted in line with James Lind Alliance (JLA) principles involving patients and clinicians. An online survey was conducted to gather uncertainties related to breast reconstruction by involving patients, carers and clinicians. Following this, a modified Delphi consensus process was performed to identify the top 10 research priorities. RESULT: A total of 239 unique research uncertainties were identified via the online survey, which involved 100 participants. A review of literature established that 58 of these uncertainties did not have a high-quality systematic review, prompting the need for more in-depth research. A further 28 research uncertainties were obtained by performing a literature search. Of the final 86 unique questions, the Delphi panel achieved consensus on the top ten research priorities. Recommendations to address these research priorities have been put forward based on current evidence. CONCLUSION: This study involved patients, carers and healthcare professionals to establish the top 10 priority areas for research in breast reconstructive surgery. Recommendations have been put forward on the necessary future research that is required to address these uncertainties. PMID:34955391 | DOI:10.1016/j.bjps.2021.11.068 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Optimising UK training in aesthetic surgery: A prospective national study using operative logbooks and questionnaires to determine factors associated with trainee participation

xlomafota13 shared this article with you from Inoreader Optimising UK training in aesthetic surgery: A prospective national study using operative logbooks and questionnaires to determine factors associated with trainee participation Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 29:S1748-6815(21)00634-3. doi: 10.1016/j.bjps.2021.11.082. Online ahead of print. ABSTRACT INTRODUCTION: We aimed to determine the proportion of UK aesthetic surgery training taking place in the independent sector, how this experience is gained, and factors associated with trainee participation. We also aimed to draw comparisons between training in the National Health Services (NHS) and independent sectors. METHODS: Plastic Surgery Trainees were asked to complete a 10-item questionnaire, in addition to their usual operative entry on eLogbook, when logging a procedure with an aesthetic operative code, prospectively over a 6-month period. Anonymised data was exported and analysed using SPSS. RESULTS: A total of 285 questionnaires were completed; all UK training regions were represented. The majority were for NHS procedures (88%), of which 56% were for breast surgery, 23% facial surgery, 19% body contouring, and 2% non-surgical. Trainees were significantly more likely to participate in procedures when they were performed in the NHS (odds ratio, OR, 9.7, p < 0.01) or when they were body contouring surgery (OR 1.5, p < 0.01). Trainees were more likely to participate in perioperative care in an NHS setting (p < 0.01). When trainees attend the independent sector, it was usually within contracted training hours (57%) with their consultant trainer with whom they are working in the NHS (63%). CONCLUSIONS: The majority of aesthetic surgery training occurs in the NHS but this is not representative of UK aesthetic practice. There is a need to engage the independent sector to provide formal aesthetic surgery training as part of the plastic surgery training programme, including procedural participation and perioperative care. Additional aesthetic fellowships and mechanisms for mentorship by established consultants should be developed. PMID:34955399 | DOI:10.1016/j.bjps.2021.11.082 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The baseline neutrophil lymphocyte ratio predicts survival in soft-tissue sarcoma: A 17-year cohort study

xlomafota13 shared this article with you from Inoreader The baseline neutrophil lymphocyte ratio predicts survival in soft-tissue sarcoma: A 17-year cohort study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 27:S1748-6815(21)00606-9. doi: 10.1016/j.bjps.2021.11.063. Online ahead of print. ABSTRACT BACKGROUND: Abnormal ratios of peripheral blood cells, e.g. neutrophil-lymphocyte ratio (NLR), are strongly associated with poor outcomes in numerous cancers. In soft-tissue sarcoma (STS), the NLR has been studied in populations outside the UK although many have major methodological flaws, which represents the rationale for this study. METHODS: Over 17 years old (2002-2019) adults with extremity STS were included. The baseline NLR (at the time of diagnosis) was calculated. The association between NLR, disease recurrence and survival was explored using cubic splines and a threshold of 3 selected, which is in keeping with the literature. Multivariable Cox regression was used to estimate overall survival, disease-free survival and recurrence with Hazard Ratios (HR) and 95% confidence intervals (CI). < p>RESULTS: Overall, 401 patients were included. The median follow-up was 3 years 8 months (interquartile range 1 years 7 months to 5 years 2 months). During surveillance 148 died (37%), of which 123 (76%) were attributable to sarcoma. At the time of diagnosis, an NLR≥3 was independently associated with worse overall survival (adjusted HR 1.44 [95% 1.01, 2.03]). However, the baseline NLR was not associated with the risk of recurrence (adjusted HR 0.98 [95% CI 0.62, 1.57]) or disease-free survival (adjusted HR 1.11 [95% CI 0.79, 1.56]). CONCLUSIONS: At the time of diagnosis of STS, the NLR is strongly associated with survival and may serve as a cheap and readily available biomarker to personalise treatment plans for patients. PMID:34955395 | DOI:10.1016/j.bjps.2021.11.063 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Construct validity of the anglicised FACE-Q skin cancer module

xlomafota13 shared this article with you from Inoreader Construct validity of the anglicised FACE-Q skin cancer module Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00636-7. doi: 10.1016/j.bjps.2021.11.093. Online ahead of print. ABSTRACT OBJECTIVES: The FACE-Q Skin Cancer module is a patient-reported outcome measure (PROM) for facial skin cancer. It has been anglicised for the UK population and undergone psychometric testing using classical test theory. In this study, further evaluation of construct validity using Rasch measurement theory and hypothesis testing was performed. METHODS: Patients were prospectively recruited to the Patient-Reported Outcome Measures In Skin Cancer Reconstruction (PROMISCR) study and asked to complete the anglicised FACE-Q Skin Cancer module. The scalability and unidimensionality of the data were assessed with a Mokken analysis prior to Rasch analysis. Response thresholds, targeting, fit statistics, local dependency, and internal consistency were examined for all items and subscales. Four a priori hypothese s were tested to evaluate the convergent and divergent validity. We additionally hypothesised that the median 'cancer worry' score would be lower in post-operative than pre-operative patients. RESULTS: 239 patients self-completed the questionnaire between August 2017 and May 2019. Of the ten subscales assessed, five showed relative fit to the Rasch model. Unidimensionality was present for all five subscales, with most demonstrating ordered item thresholds and appropriate fit statistics. Two items in the 'cancer worry' subscale had either disordered or very close response thresholds. Subscales of the FACE-Q Skin Cancer module demonstrated convergent and divergent validity with relevant Skin Cancer Index comparators (p < 0.001). Median 'cancer worry' was lower in post-operative patients (44 vs 39, p < 0.001). CONCLUSION: The anglicised FACE-Q Skin Cancer module shows psychometric validity through hypothesis testing, and both classical and modern test theory. PM ID:34955401 | DOI:10.1016/j.bjps.2021.11.093 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immediate Lymphatic Reconstruction for Prevention of Secondary Lymphedema: A Meta-Analysis

xlomafota13 shared this article with you from Inoreader Immediate Lymphatic Reconstruction for Prevention of Secondary Lymphedema: A Meta-Analysis Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00627-6. doi: 10.1016/j.bjps.2021.11.094. Online ahead of print. ABSTRACT BACKGROUND: Secondary lymphedema remains one of the most notorious complications of axillary and pelvic lymph node surgery following mastectomy. There is a lack of high-level evidence found on the effectiveness of immediate lymphatic reconstruction (ILR) in preventing secondary lymphedema. This meta-analysis evaluates the outcomes of ILR for prevention of secondary lymphedema in patients undergoing different surgeries, and provides suggestions for lymphatic microsurgical preventive healing approach (LYMPHA). METHODS: A review of PubMed, Embase, and Web of Science was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. All English-language studies published from January 1, 2009 to June 1, 2020 were included. We excluded non-ILR interventions, literature r eviews/letters/commentaries, and nonhuman or cadaver studies. A total of 789 patients that were enrolled in 13 studies were included in our one-arm meta-analysis. RESULTS: A total of 13 studies (n=789) met inclusion criteria: upper extremity ILR (n=665) and lower extremity ILR (n=124). The overall incidence of lymphedema for upper extremity ILR was 2.7% (95%CI: 1.1%-4.4%) and lower extremity ILR was 3.6% (95%CI: 0.3%-10.1%). For upper extremity ILR, the average follow-up time was 11.6 ± 7.8 months and the LE incidence appeared to be the highest approximately 1 to 2 years postoperation. CONCLUSIONS: Lymphedema is a common complication in cancer treatment. ILR, especially LYMPHA, may be an effective technique to facilitate lymphatic drainage at the time of the index procedure but future studies will be required to show its short-term efficacy and long-term outcomes. PMID:34955392 | DOI:10.1016/j.bjps.2021.11.094 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An anthropometric study of the external ear

xlomafota13 shared this article with you from Inoreader An anthropometric study of the external ear in the Thai population Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 27:S1748-6815(21)00608-2. doi: 10.1016/j.bjps.2021.11.065. Online ahead of print. ABSTRACT Auricular dimensions are important data for the treatment of auricular deformities, either congenital or acquired. Many previous studies have shown that the auricular dimension varies among ethnic groups; however, there are currently no available data for the Thai population. The objective of this investigation was to provide normative values regarding the adult ear dimensions in Thailand. A total of 200 Thai volunteers between the ages of 18 and 70 years (80 men, 120 women) were enrolled in this study. We measured six dimensions, including the auricular, lobular, and conchal length and width and the auricular projection at the superaurale and tragal levels. Moreover, we calculated the auricular, lobular, and conchal indices. The selected dimensions of the external ears were shown as means ± standard devia tions. These parameters were then compared between the right and left sides, men and women and participants aged ≥50 and <50 years. We found that men have a significantly larger and more projected ear than women do. The length of the entire auricles and the length of the earlobe were also significantly longer in the population ≥50 years than those <50 years. This study provides normative data of the external ear dimension and projection in the adult Thai population. These data can be used to reconstruct the ear and face more appropriately for Thai individuals. PMID:34955402 | DOI:10.1016/j.bjps.2021.11.065< /a> View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation - A systematic review

xlomafota13 shared this article with you from Inoreader Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation - A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 5:S1748-6815(21)00628-8. doi: 10.1016/j.bjps.2021.11.076. Online ahead of print. ABSTRACT BACKGROUND: Pain after amputation can be known as residual limb pain (RLP) or phantom limb pain (PLP); however, both can be disabling in daily life with reported incidences of 8% for finger amputations and up to 85% for major limb amputations. The current treatment is focused on reducing the pain after neuropathic pain occurs. However, surgical techniques to prevent neuropathic pain after amputation are available and effective, but they are underutilized. The purpose of the review is to investigate the effects of techniques during amputation to prevent neuropathic pain. METHODS: A systematic review was performed in multiple databases (Embase, Medline, Web of Science, Scopus, Cochrane, and Google Scholar) and following the PRISMA guidelines. Studies that reported surgical techniques to prevent neuropath ic pain during limb amputation were included. RESULTS: Of the 6188 selected studies, 13 eligible articles were selected. Five articles reported techniques for finger amputation: neurovascular island flap, centro-central union (CCU), and epineural ligatures, and flaps. For finger amputations, the use of prevention techniques resulted in a decrease of incidences from 8% to 0-3% with CCU being the most beneficial. For major limb amputations, the incidences for RLP were decreased to 0 to 55% with TMR and RPNI and compared to 64-91% for the control group. Eight articles reported techniques for amputations on major limbs: targeted muscle reinnervation (TMR), targeted nerve implantation, concomitant nerve coaptation, and regenerative peripheral nerve interface (RPNI). CONCLUSIONS: Based on the current literature, we state that during finger and major limb amputation, the techniques to prevent neuropathic pain and PLP should be performed. PMID:34955394 | DOI:10.1016/j.bjps.2021.11.076 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.