Evaluation of the Neuroanatomical Basis of Olfactory Dysfunction

xlomafota13 shared this article with you from Inoreader Message: Key Points Question What are the neuroanatomical correlates of olfactory function in the general population? Findings In this cross-sectional study of 541 participants who underwent brain imaging and olfactory assessment, olfactory bulb volume was independently associated with olfactory function and a robust mediator of the association between volumes of central olfactory structures (amygdala, hippocampus, insular cortex, and medial orbitofrontal cortex) and olfactory function. Meaning Olfactory dysfunction may primarily originate from the pathology of the olfactory bulb or more distal structures, whereas olfactory bulb volume may serve as a preclinical marker for the identification of individuals who are at an increased risk for developing neurodegenerative diseases later in life. Abstract Importance Olfactory dysfunction is a prodromal manifestation of many neurodegenerative disorders, including Alzheimer and Parkinson disease. However, its neuroanatomical basis is largely unknown. Objective To assess the association between olfactory brain structures and olfactory function in adults 30 years or older and to examine the extent to which olfactory bulb volume (OBV) mediates the association between central olfactory structures and olfactory function. Design, Setting, and Participants This cross-sectional study analyzed baseline data from the first 639 participants with brain magnetic resonance imaging (MRI) in the Rhineland Study, an ongoing population-based cohort study in Bonn, Germany. Participants were enrolled between March 7, 2016, and October 31, 2017, and underwent brain MRI and olfactory assessment. Data were analyzed from March 1, 2018, to June 30, 2021. Exposure Volumetric measures were derived from 3-T MRI T1-weighted brain scans, and OBV was manually segmented on T2-weighted images. The mean volumetric brain measures from the right and left sides were calculated, adjusted by head size, and normalized to all participants. Main Outcomes and Measures Performance on the 12-item smell identification test (SIT-12) was used as a proxy for olfactory function. Results A total of 541 participants with complete data on MRI-derived measures and SIT-12 scores were included. This population had a mean (SD) age of 53.6 (13.1) years and comprised 306 women (56.6%). Increasing age (difference in SIT-12 score, –0.04; 95% CI, –0.05 to –0.03), male sex (–0.26; 95% CI, –0.54 to 0.02), and nasal congestion (–0.28; 95% CI, –0.66 to 0.09) were associated with worse olfactory function (SIT-12 scores). Conversely, larger OBV was associated with better olfactory function (difference in SIT-12 score, 0.46; 95% CI, 0.29-0.64). Larger volumes of amygdala (difference in OBV, 0.12; 95% CI, 0.01-0.24), hippocampus (0.16; 95% CI, 0.04-0.28), insular cortex (0.12; 95% CI, 0.01-0.24), and medial orbitofrontal cortex (0.10; 95% CI, 0.00-0.20) were associated with larger OBV. Larger volumes of amygdala (volume × age interaction effect, 0.17; 95% CI, 0.03-0.30), parahippocampal cortex (0.17; 95% CI, 0.03-0.31), and hippocampus (0.21; 95% CI, 0.08-0. 35) were associated with better olfactory function only in older age groups. The age-modified association between volumes of central olfactory structures and olfactory function was largely mediated through OBV. Conclusions and Relevance This cross-sectional study found that olfactory bulb volume was independently associated with odor identification function and was a robust mediator of the age-dependent association between volumes of central olfactory structures and olfactory function. Thus, neurodegeneration-associated olfactory dysfunction may primarily originate from the pathology of peripheral olfactory structures, suggesting that OBV may serve as a preclinical marker for the identification of individuals who are at an increased risk of neurodegenerative diseases. Evaluation of the Neuroanatomical Basis of Olfactory Dysfunction Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cross-sectional study evaluates the role of the components of the olfactory pathway structures in impaired olfactory function. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Not-So-Simple Thyroid Nodule

xlomafota13 shared this article with you from Inoreader Message: A 50-year-old woman presented with a 2-month history of a neck mass that was associated with hoarseness of voice and globus sensation. Physical examination showed thyromegaly (right greater than left) with an approximately 5-cm palpable nodule in the right lobe. There was no tenderness or cervical lymphadenopathy. There was no prior radiation exposure to the head and neck area. Thyroid function test results were normal, and she did not take thyroid medications. A relative had received a diagnosis of papillary thyroid cancer at age 50 years. There was no other pertinent family history, including a history of multiple endocrine neoplasia. Ultrasonography results showed a multinodular goiter with a dominant 4.6-cm right thyroid nodule, 1.6-cm left-sided thyroid nodule, and suspect left level IV lymph node. Ultrasonography-guided fine-needle aspiration biopsy results showed papillary thyroid carcinoma (PTC ) (Bethesda VI) with a BRAFV600E variation in the left nodule and lymph node, and atypia of undetermined significance (Bethesda III) with a suspicious Afirma genomic sequence classifier in the right nodule. She underwent total thyroidectomy with modified left lateral neck dissection. Gross examination of the specimen showed a 2.9-cm pale-tan, partially circumscribed, soft nodule in the right thyroid lobe; a 1.4-cm pale-tan, fibrotic, centrally brown nodule in the left lobe; and a 1.8-cm pale-tan, rubbery, partially circumscribed nodule in the isthmus. Histologic examination of the right thyroid lesion was performed (Figure), with ancillary testing. A Not-So-Simple Thyroid Nodule Via JAMA Otolaryngology–Head & Neck Surgery Current Issue A 50-year-old woman presents with a 2-month history of a neck mass that was associated with hoarseness of voice and globus sensation and thyromegaly with a palpable nodule in the right lobe. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comments on Use of Diagnostic Testing and Intervention for Sensorineural Hearing Loss in US Children

xlomafota13 shared this article with you from Inoreader Comments on Use of Diagnostic Testing and Intervention for Sensorineural Hearing Loss in US Children Via JAMA Otolaryngology–Head & Neck Surgery Current Issue To the Editor The article by Qian et al is interesting and has several valid points. But there are some limitations that can influence the interpretation of the findings. First, the authors based the qualifying patient search on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes of which almost half were listed as "unspecified." It may well be that these unspecified diagnosis codes represent children who had normal hearing outcomes. When the diagnostic conclusion is normal, we are required to code the type of problem that represents either the chief complaint or the primary concern that caused us to do the diagnostic test. For my part, I will code "sensorineural hearing loss, laterality unspecified" under the ICD-10 system when hearing sensitivity is normal. One of the major drawback s in the ICD coding system is that no one is allowed to be normal. The working assumption is that a valid health-related complaint caused the individual to seek health care services for which we must document. As a result of using ICD codes for participant selection, the percentages reported for the diagnostics need to be taken with a grain of salt. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Nocturnal Enuresis After Adenotonsillectomy in Children With Obstructive Sleep Apnea

xlomafota13 shared this article with you from Inoreader Evaluation of Nocturnal Enuresis After Adenotonsillectomy in Children With Obstructive Sleep Apnea Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This secondary analysis of a randomized clinical trial of children who underwent adenotonsillectomy for nonsevere obstructive sleep apnea evaluates the prevalence of nocturnal enuresis after the operation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Multifocality With Prognosis of Papillary Thyroid Carcinoma

xlomafota13 shared this article with you from Inoreader Association of Multifocality With Prognosis of Papillary Thyroid Carcinoma Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This systematic review with meta-analysis examines 26 studies of nearly 34 000 patients with papillary thyroid carcinoma for a difference between the risk of recurrence and cancer-specific survival rates among those with multifocal vs unifocal tumors. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neck Mass in an Adolescent......

xlomafota13 shared this article with you from Inoreader Message: A 13-year-old male presented to the pediatric otolaryngology clinic with a 2-year history of a right neck mass that had slowly increased in size. He denied any associated symptoms of pain, fevers, chills, malaise, night sweats, unintentional weight loss, prior history of neck masses, recent upper respiratory tract infections, or skin lesions. He was the product of a full-term pregnancy with up-to-date immunizations. Physical examination revealed a 2.5-cm firm, ovoid, mobile, and nontender mass at the apex of the posterior triangle of the right neck without any associated overlying skin changes. The remainder of the head and neck examination was unremarkable. Doppler ultrasonography revealed a 1.9 × 1.8 × 0.9-cm hypoechoic mass, and subsequent fine-needle aspirates demonstrated cells with elongated nuclei and eccentric blue cytoplasm in a background of myxoid stroma. The mass was excised in en tirety without issue. At the time of surgery, the deep surface of the mass was found to be adherent to the sternocleidomastoid muscle. The lesion was resected with a cuff of muscle and sent for permanent histopathological examination. This revealed proliferation of bland spindle cells with plump nuclei and eosinophilic cytoplasm arranged as loose fascicles in a background of myxoid stroma (Figure 1). These cells were positive for mucin 4 (MUC4), epithelial membrane antigen (EMA), and transducing-like enhancer of split 1 (TLE1) immunohistochemical stains. Fluorescence in situ hybridization (FISH) revealed a positive FUS (16p11) gene rearrangement. A t(7;16)(q34;p11) translocation, yielding a FUS/CREB3L2 fusion gene, has been identified in approximately 80%-90% of deep soft tissue LGFMS.https://pubmed.ncbi.nlm.nih.gov/21399449/ Neck Mass in an Adolescent Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This case report describes a 13-year-old male who presented with a 2-year history of a right neck mass that had slowly increased in size. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory Bulb Volume—A Novel Preclinical Biomarker for Smell Loss and Neurodegenerative Disease

xlomafota13 shared this article with you from Inoreader Olfactory Bulb Volume—A Novel Preclinical Biomarker for Smell Loss and Neurodegenerative Disease Via JAMA Otolaryngology–Head & Neck Surgery Current Issue Neurodegenerative disorders, such as Alzheimer dementia and Parkinson disease, are disabling diseases that present a burden on society that rivals the costs of cancer and heart disease. Although current therapies are often unsuccessful at reversing the progression of these diseases, early detection in patients who are at risk of neurodegenerative disease could allow for timely interventions to delay and minimize the loss of brain function over time. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.