Κυριακή 23 Ιανουαρίου 2022

MAKO Robotic Assisted Total Hip Replacement (THR) for Patients with Fused Hips

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Abstract

Background

: Previous articles about MAKO robotic-assisted total hip replacement (THR) were mainly in patients with comparatively normal anatomy.

Methods

: From July 2020 to June 2021, we performed MAKO robotic-assisted THR in three hip-fused patients. We assessed the accuracy of prostheses implantation, collected clinical data, and discussed the value of this technique in this kind of patients.

Result

: All three patients achieved good leg length and prostheses position. A patient got femoral artery injury during the surgery. Moreover, she developed a thrombus. All three patients got acceptable Visual Analogue Scale (VAS) scores and function recovery six months later.

Conclusion

: MAKO robotic-assisted THR achieved excellent prosthesis position in hip fused patients. More cases are needed to confirm this advantage. The function recovery was acceptable. Caution should be paid to protect the surrounding abnormal arteries, especially in a limited surgical field.

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Real life safety of systemic steroids for sudden sensorineural hearing loss: a chart review

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Eur Arch Otorhinolaryngol. 2022 Jan 20. doi: 10.1007/s00405-022-07264-3. Online ahead of print.

ABSTRACT

OBJECTIVES: To report adverse events (AEs) associated with systemic steroid treatment in idiopathic sudden sensorineural hearing loss (ISSNHL).

MATERIAL AND METHODS: A retrospective chart review of consecutive patients newly diagnosed with ISSNHL necessitating systemic steroidal treatment was conducted from 1/2017 to 2/2021. Blood pressure (BP) was monitored three times daily and morning fasting glucose was monitored once daily during treatment. An AE was defined as a fasting blood glucose level > 160 mg/dl, systolic BP > 80 mmHg, and diastolic BP > 100 mmHg.

RESULTS: In total, 143 patients were enrolled [69 (48%) males and 74 (52%) females] of whom 29 (20%) had diabetes mellitus (DM) and 46 (32%) had hypertension (HTN). The cohort's median age (interquartile range) was 58 (37-69) years. Fifty-three patients (37 %) did not complete the oral steroidal treatment due to any AE (glycemic or hypertensive). Background DM highly correlated with increased risk of a glycemic event (0.59 vs. 0.13 for diabetic and non-diabetic patients, respectively, P < 0.001). HTN correlated significantly with increased risk of an overall AE (0.54 vs. 0.29 for hypertensive and non-hypertensive patients, respectively, P = 0.001). Neither pre-treatment BP nor glucose level predicted the risk of an AE (P = 0.310 and 0.521, respectively).

CONCLUSIONS: AEs due to systemic steroidal treatment are common among ISSNHL patients. Demographic and baseline values cannot predict the risk of AEs which can occur throughout the entire duration of treatment. Patients with DM and HTN are at the greatest risk of AEs. Tight blood glucose and BP monitoring are recommended during treatment.

LEVEL OF EVIDENCE: 4.

PMID:35059792 | DOI:10.1007/s00405-022-07264-3

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Frontal Sino-Cutaneous Fistula Masquerading as a Basal Cell Carcinoma

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Ear Nose Throat J. 2022 Jan 20:1455613221075235. doi: 10.1177/01455613221075235. Online ahead of print.

NO ABSTRACT

PMID:35057655 | DOI:10.1177/01455613221075235

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Predictive Factors for Skip Lymph Node Metastasis and Their Implication on Recurrence in Papillary Thyroid Carcinoma

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Biomedicines. 2022 Jan 16;10(1):179. doi: 10.3390/biomedicines10010179.

ABSTRACT

Skip lymph node (LN) metastases in papillary thyroid carcinoma (PTC) belong to N1b classification in the absence of central neck LN involvement. This study aimed to evaluate the predictive factors of skip metastases and their impact on recurrence in PTC patients with pN1b. A total of 334 PTC patients who underwent total thyroidectomy with LN dissection (central and lateral neck compartment) followed by radioactive iodine ablation were included. Patients with skip metastases tended to have a small primary tumor (≤1 cm) and single lateral neck level involvement. Tumor size ≤ 1 cm was an important predictive factor for skip metastases. Univariate analysis for recurrence showed that patients with a central LN ratio > 0.68, lateral LN ratio > 0.21, and stimulated thyroglobulin (Tg) levels > 7.3 ng/mL had shorter RFS (recurrence-free survival). The stimulated Tg level was associated with shorter RFS on multivariate analysis (>7.3 vs. ≤7.3 ng/mL; hazard ratio, 4.226; 95% confidence interval, 2.226-8.022; p < 0.001). Although patients with skip metastases tended to have a small primary tumor and lower burden of lateral neck LN involvement, there was no association between skip metastases and RFS in PTC with pN1b. Stimulated Tg level was a strong predictor of recurrence.

PMID:35052858 | DOI:10.3390/biomedicines10010179

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Radioiodination and Purification of [131I]β-CIT and [131I]FP-CIT with an Automated Radiosynthesizer

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Pharmaceuticals (Basel). 2022 Jan 14;15(1):96. doi: 10.3390/ph15010096.

ABSTRACT

Dopaminergic transporter (DAT) imaging with single photon emission computed tomography (SPECT) is used to diagnose Parkinson's disease and to differentiate it from other neurodegenerative disorders without presynaptic dopaminergic dysfunction. The radioiodinated tropane alkaloids [123I]FP-CIT and [123I]β-CIT enable the evaluation of the integrity of DATs. Commonly, the labeling o f these compounds is performed by electrophilic substitution of the alkylstannylated precursors with radioactive iodine and following purification by HPLC or solid phase extraction (SPE). This work presents the first radioiodination of β-CIT and FP-CIT with no carrier added [131I]NaI on a Scintomics GRP synthesis module. Free iodine-131 and impurities were removed by SPE over a C-18 Sep-Pak cartridge. We achieved a radiochemical yield of >75% and a radiochemical purity of >98% with both compounds. Our development of an automated synthesis on a commercially available synthesizer ensures robust and efficient labeling of [131I]FP-CIT and [131I]β-CIT starting with low concentrated radioiodine.

PMID:35056152 | DOI:10.3390/ph15010096

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Aberrant origin of bilateral vertebral arteries associated with bovine aortic arch

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Surg Radiol Anat. 2022 Jan 21. doi: 10.1007/s00276-021-02880-w. Online ahead of print.

ABSTRACT

PURPOSE: Variance of aortic arch branches are clinically significant as they are encountered in multiple endovascular treatments. The knowledge of different variants is crucial to perform successful vascular interventions.

METHODS: We report a novel anatomical variant of aortic arch found on contrast-enhanced computed tomography scan during a workup of cervical lymphadenopat hy.

RESULTS: The CT neck revealed a bovine aortic arch with an aberrant origin of bilateral vertebral arteries from the aortic arch. The right vertebral artery arose between the bovine trunk and the left subclavian artery, while the left vertebral artery was present distal to the left subclavian artery.

CONCLUSION: This article sheds light on the potential clinical significance of these various types of aortic arch branches. Knowing the exact type of variant is particularly important in patient undergoing management involving carotid and surrounding vessels.

PMID:35061096 | DOI:10.1007/s00276-021-02880-w< /a>

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The Clinical Characteristics in Children with Sinonasal Inverted Papilloma: A Case Report and Review of the Literature

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Ear Nose Throat J. 2022 Jan 21:1455613211068567. doi: 10.1177/01455613211068567. Online ahead of print.

ABSTRACT

Sinonasal inverted papilloma (SNIP) is one of the most common benign epithelial tumors but rarely occurs in children. The case of a 9-year-old Chinese boy, who presented with a left maxillofacial hump, nasal obstruction, and left nasal cavity and maxillary sinus masses under nasal endoscopy, is reported. The lesion was first diagnosed as a sinonasal tumor. However , to our surprise, the mass was determined to be an inverted papilloma after a detailed histological examination. We retrospectively reported the clinical data of this case and reviewed the relevant literatures on SNIP. This report aims to provide new insights into the clinical characteristics in children with SNIP and improve the understanding of this disease.

PMID:35060773 | DOI:10.1177/01455613211068567

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Imaging characteristics of hypertrophic pachymeningitis due to ANCA-associated vasculitis

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Publication date: Available online 21 January 2022

Source: Auris Nasus Larynx

Author(s): Taro Takagi, Masahiro Okada, Masashi Nakamura, Takahiro Hanari, Takahiro Nakata, Masato Teraoka, Naohito Hato

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New European approval: Idecabtagene vicleucel in relapsed and/or refractory myeloma after at least 3 lines of treatment

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Bull Cancer. 2022 Jan 18:S0007-4551(21)00686-X. doi: 10.1016/j.bulcan.2021.10.007. Online ahead of print.

NO ABSTRACT

PMID:35063182 | DOI:10.1016/j.bulcan.2021.10.007

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Exploration of chest wall perforator vascular anatomy on standard breast MRI: A potential aid to chest wall perforator flap planning

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J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00639-2. doi: 10.1016/j.bjps.2021.11.092. Online ahead of print.

ABSTRACT

Local chest wall perforator flaps (CWPFs) are a volume replacement technique permitting breast-conserving surgery in patients who otherwise may require a mastectomy. These flaps are based on one or more perforating arteries arising from the lateral chest wall that travel through the soft tissue and into the sub-dermal plexus to perfuse the flap. Examples include the lateral intercostal and lateral thoracic artery perforators (LICAP and LTAP, respectively). Cross-sectional imaging of perforating vessels is not routinely performed, and vessels are mapped pre- and peri-operatively using a hand-held acoustic doppler device. As many breast cancer patients undergo pre-operative MRI scanning for oncological purposes, we investigated the role of MRI in mapping the vascular anatomy to aid with the surgical planning o f CWPFs. We collated data retrospectively on a cohort of breast cancer patients who underwent breast MRI as part of routine pre-operative imaging. Axial 3D high-resolution dynamic contrast-enhanced MRI sequences with multiplanar reconstructions were analysed by a consultant radiologist. The presence and calibre of lateral chest wall perforator vessels were assessed. Fifty patients were suitable for inclusion. A consistent pattern of lateral chest wall vasculature was observed. Forty-eight patients (96%) demonstrated a bilateral lateral thoracic artery (LTA) descending inferiorly along the chest wall with two-thirds of these communicating with perforating intercostal vessels. True independent LICAP vessels were identified in six patients. From our observations, lateral CWPFs are dependent on an intricate intercommunication between intercostal vessels and the LTA which in turn supply perforators to the lateral chest wall donor site.

PMID:35063384 | DOI:10.1016/j.bjps.2021.11.092

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The management and outcome of large volume liposarcomas encasing the sciatic nerve

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J Plast Reconstr Aesthet Surg. 2021 Oct 22:S1748-6815(21)00505-2. doi: 10.1016/j.bjps.2021.09.070. Online ahead of print.

ABSTRACT

This paper outlines the oncological outcomes of patients with large volume liposarcomas of the posterior thigh who underwent nerve-preserving surgery utilising epineural dissection. Thirty-seven consecutive patients (group I) with a mean age of 66.2 (31-96) were surgically treated with a planned marginal resection and epineurectomy for liposarcoma with known sciatic nerve involvement between March 1997 and January 2015. The mean follow-up was 79 months (15-192). All patients underwent multidisciplinary team (MDT) pre-operative assessment and staging, with follow-up in Sarcoma Clinic. Pre-operative function was assessed by applying the Toronto extremity salvage score (TESS). Oncological and functional outcomes were recorded. In grades 1, 2, and 3, 24, 6, and 7 liposarcomas, respectively, were included with m ean volume 1859 cm3. Sciatic nerve involvement extended for 13-30 cm; in one case, the nerve was abutting the tumour throughout its length. Soft tissue reconstructive surgery was required in three cases. The remainder underwent direct primary closure. Seventeen patients underwent post-operative adjuvant radiotherapy 46-60 Gy and three received chemotherapy. There was local recurrence of disease in three patients. One patient had post-radiation wound breakdown treated non-operatively. Three patients died of an unrelated cause. When compared to a cohort of 37 patients without sciatic nerve involvement (group II), there were no significant differences in local and systemic recurrence rate or post-operative survival. In conclusion, sciatic nerve-preserving surgery is both possible and safe when using a planned epineural dissection in large volume tumours encasing the sciatic nerve.

PMID:35063385 | DOI:10.1016/j.bjps.2021.09.070

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