Τρίτη 25 Ιανουαρίου 2022

Morphology of the ligaments located on the medial side of the ankle and on the plantar surface of the foot

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Surg Radiol Anat. 2022 Jan 25. doi: 10.1007/s00276-021-02872-w. Online ahead of print.

ABSTRACT

To have biodynamic features, the feet have bones located in a special posture, the joints that keep together those bones, the ligaments that provide linkage to those joints, and tendons of muscles particularly which end the foot. This study aimed to research the morphology of the medial side and plantar ligaments. The study was conducted on a total of 30 feet belonging to 2 women and 13 men cadavers that exist at the Anatomy Department of the Medical Faculty of Uludag University. After the dissections, 61 parameters that belonging to the ligaments and general features of the foot, were evaluated. The statistical analysis of the collected data was evaluated by SPSS 20.0. According to the findings, while the descriptive statistics of the foot and the ligaments related to the foot, the statistically significant difference of any of the parameters wasn't observed when they were compared between the right and left sides of the foot. In terms of the correlative relations, the parameters that showed high correlation were chosen and 28 formulas were developed using regression analysis. We foresee that our findings of the features belonging to normal anatomic structures will deepen our knowledge besides providing important benefits before or during orthopedic and plastic surgery operations related to the region. Also, our findings were discussed by comparing the find ings of similar studies belonging to many other researchers in literature, and our study's contribution to the literature was evaluated.

PMID:35075567 | DOI:10.1007/s00276-021-02872-w

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Utilisation of tracheostomy in patients with COVID‐19

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Abstract

Objectives

We aimed to characterise the use of tracheostomy procedures for all COVID-19 critical care patients in England and to understand how patient factors and timing of tracheostomy affected outcomes.

Design

A retrospective observational study using exploratory analysis of hospital administrative data.

Setting

All 500 National Health Service hospitals in England.

Participants

All hospitalised COVID-19 patients aged ≥ 18 years in England between March 1st and October 31st, 2020 were included.

Main outcomes and measures

This was a retrospective exploratory analysis using the Hospital Episode Statistics administrative dataset. Multilevel modelling was used to explore the relationship between demographic factors, comorbidity and use of tracheostomy and the association between tracheostomy use, tracheostomy timing and the outcomes.

Results

In total, 2,200 hospitalised COVID-19 patients had a tracheostomy. Tracheostomy utilisation varied across the study period, peaking in April-June 2020. In multivariable modelling, for those admitted to critical care, tracheostomy was most common in those aged 40-79 years, in males and in people of Black and Asian ethnic groups and those with a history of cerebrovascular disease. In critical care patients, tracheostomy was associated with lower odds of mortality (OR: 0.514 (95% CI 0.443 to 0.596), but greater length of stay (OR: 41.143 (95% CI 30.979 to 54.642). In patients that survived, earlier timing of tracheostomy (≤ 14 days post admission to critical care) was significantly associated with shorter length of stay.

Conclusions

Tracheostomy is safe and advantageous for critical care COVID-19 patients. Early tracheostomy may be associated with better outcomes, such as shorter length of stay, compared to late tracheostomy.

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Effectiveness of submucosal turbinoplasty in refractory obstructive rhinitis: a prospective comparative trial

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Eur Arch Otorhinolaryngol. 2022 Jan 25. doi: 10.1007/s00405-022-07267-0. Online ahead of print.

ABSTRACT

OBJECTIVE: Refractory inferior turbinate hypertrophy requires a surgical approach to address symptomatic complaints. Submucosal approaches demonstrated their efficacy in restoring respiratory function and respecting the nasal mucosa. Microdebrider-assisted turbinoplasty (MAT) tools effectively reduces the soft tissue, exploiting a very different principle from the kinetic energy of radiofrequency. Thus, we aimed to compare the microdebrider-assisted turbinoplasty and the quantum molecular resonance (QMR) to assess patients' perspectives and respiratory outcomes.

METHODS: Subjects with persistent bilateral nasal blockage due to inferior turbinates hypertrophy were prospectively recruited from the University Medical Center. We randomly assigned the patients to each treatment and performed symptom evaluation via the visual analog score and endoscopic assessment at baseline and 30-, 90-, and 180-day post-treatment.

RESULTS: Seventy participants completed the evaluations, 35 in MAT and 35 in the QMR group. Nasal complaints were significantly reduced after 1 month using both methods. Although the MAT group reported higher postoperative bleeding and edema than QMR group, similar significant reductions were seen for turbinate size at long-term follow-up. Conversely, the MAT group reported greater VAS outcomes than QMR from the first postoperative month. In addition, MAT showed a longer operating time, although this difference was not statistically significant (p < 0.05).

CONCLUSION: MAT allows effective control of nasal symptoms by reducing the size of turbinates in patients with lower turbinate hypertrophy. Although QMR may cause fewer postoperative complications, functional results are comparable to long-term follow-up.

PMID:35076746 | DOI:10.1007/s00405-022-07267-0

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Pantoea dispersa rhinosinusitis: clinical aspects of a rare sinonasal pathogen

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Eur Arch Otorhinolaryngol. 2022 Jan 25. doi: 10.1007/s00405-022-07266-1. Online ahead of print.

ABSTRACT

PURPOSE: There is no report in the literature targeting the role of Pantoea dispersa in rhinosinusitis and P. dispersa has not been identified as a commensal bacterium in the sinonasal cavity. We aimed to investigate the role of P. dispersa in rhinosinusitis.

METHODS: We retrospectively reviewed the data of patients diagnosed with rhinosinusitis at a medical center in Taiwan.

RESULTS: A total of 274 rhinosinusitis patients underwent sinus culture between July 2017 and July 2019. All 23 patients with acute P. dispersa rhinosinusitis experienced purulent rhinorrhea; three (13%) had nasal obstruction, but none had olfactory dysfunction, facial pressure/pain and nasal polyp. The patients with P. dispersa received a significantly shorter duration of antibiotic treatment (19.9 ± 2.6 vs. 28.9 ± 2.5 days, P = 0.015) and had lo wer surgery rate (0% vs. 16.7%, P = 0.043) than other patients. Patients with olfactory dysfunction were more likely to receive surgical treatment (P = 0.018).

CONCLUSION: Acute rhinosinusitis caused by P. dispersa resulted in less surgical interventions and shorter treatment durations. Olfactory dysfunction may imply longer course and possibility for surgical intervention in chronic rhinosinusitis. The present study revealed that P. dispersa had the potential to colonize in human sinonasal cavities and cause rhinosinusitis.

PMID:35076743 | DOI:10.1007/s00405-022-07266-1

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Nutritional status at diagnosis is prognostic for pharyngeal cancer patients: a retrospective study

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Eur Arch Otorhinolaryngol. 2022 Jan 25. doi: 10.1007/s00405-021-07222-5. Online ahead of print.

ABSTRACT

BACKGROUND: Malnutrition in head and neck cancer (HNC) patients is associated with increased morbidity and mortality. Several nutrition indicators have been reported to be related to the prognosis of HNC. However, the prognostic effect of these multiple nutrition factors in HNC is not well elucidated. The aim of this study was to evaluate the prognostic effect of these factors, including the novel hemoglobin, albumin, lymphocyte, and platelet (HALP) score, for pharyngeal cancers.

MATERIAL AND METHODS: From 2008 to 2019, a total of 319 pharyngeal cancer patients were recruited. We collected adult patients with a diagnosis of nasopharyngeal carcinoma, oropharyngeal carcinoma and hypopharyngeal carcinoma. Patients who completed definite staging workup and treatment were selected for analysis. We traced nutritional and hematologic al parameters, including body mass index (BMI), albumin, and complete blood count, for survival analysis.

RESULTS: We found that multiple nutritional markers, including BMI, hemoglobin, albumin, prognostic nutritional index (PNI), nutritional risk index (NRI) and HALP score, were important predictors for pharyngeal cancers in univariate Cox regression analysis. In multivariate analysis, we found that the HALP score was still an independent factor (HR: 1.62, 1.13-2.32 for overall survival [OS]) after adjusting of gender, age, cancer site, clinical stage, and BMI. The PNI was the most important independent factor for OS (HR: 3.12, 2.18-4.47) and cancer-specific survival (HR: 2.88, 1.88-4.41) in multivariate analysis.

CONCLUSION: We found that multiple nutrition markers, including BMI, hemoglobin, albumin, PNI, NRI and HALP score, are important predictors for pharyngeal cancers. This is the first report confirming the prognostic effect of the HALP score for HNCs. Nutritiona l status at diagnosis should be given more attention in pharyngeal cancer patients.

PMID:35076744 | DOI:10.1007/s00405-021-07222-5

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The differences in distant metastatic patterns and their corresponding survival between thyroid cancer subtypes

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Abstract

Introduction

This study aimed to systematically elucidate the metastatic patterns and their corresponding survival of each thyroid cancer subtype at time of diagnosis.

Methods

We accessed the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2018 to search for primary thyroid cancers with DM at presentation (M1).

Results

We included 2787 M1 thyroid cancers for statistical analyses and the incidence of DM at presentation was 2.4%. Lung was the most common metastatic site for anaplastic thyroid carcinoma (ATC), poorly differentiated thyroid carcinoma (PDTC), papillary thyroid carcinoma (PTC), and oncocytic (Hurthle) cell carcinoma (HCC) whereas bone is the favorable disseminated site of follicular thyroid carcinoma (FTC) and medullary thyroid carcinoma (MTC). Patients with multi-organ metastases had the worst survival whereas bone metastases were associated with a favorable outcome (p < 0.001).

Conclusion

There are significant differences in DM patterns of thyroid cancer subtypes and their corresponding survival.

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A study of 285 cases of cranial vault suture closure in Chinese adults

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Surg Radiol Anat. 2022 Jan 25. doi: 10.1007/s00276-021-02854-y. Online ahead of print.

ABSTRACT

PURPOSE: To examine the presence and characteristics of cranial vault suture closure in Chinese adults and to explore whether craniosacral therapy (CST) manipulation is rational from the anatomical perspective.

METHODS: Anthropological non-metric observation and craniometry were used to study 285 dry skull specimens of Chinese adults.

RESULTS: A total of 91 specimens w ith closed extracranial sutures were observed, with an occurrence rate of 31.93%. Based on the mode of closure, there were 32 cases of single type closure, with sagittal suture closure predominating with 20 cases (21.98%); 59 cases of composite closure, with a partial closure of coronal suture + sagittal suture + lambdoid suture predominating with 26 cases (28.57%). In terms of the degree of closure, there were 13 cases (14.28%) of sagittal suture grade 0 closure and 78 cases (85.72%) of grade 1 - 4 closure; 34 cases (37.36%) of coronal suture grade 0 closure and 57 cases (62.64%) of grade 1 - 4 closure; 47 cases (51.65%) of lambdoid suture grade 0 closure and 44 cases (48.35%) of grade 1 - 4 closure. The segment and degree of coronal suture closure (46, 80.7%) and lambdoid suture (31, 70.45%) were mostly left-right symmetrical. The bone surfaces on either side of the cranial vault sutures are embedded in each other, forming a rough, complex and interlocking bone-suture-bone structu re.

CONCLUSION: This study observed the closure of the cranial vault suture, summarized its characteristics, and explored the irrationality of the CST manipulation. The anatomical characteristics of the cranial suture dictate that manipulation cannot push the cranial suture at will.

PMID:35076751 | DOI:10.1007/s00276-021-02854-y

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