Varicella post-exposure management for pediatric oncology patients

xlomafota13 shared this article with you from Inoreader Varicella post-exposure management for pediatric oncology patients Via Association française pour l'étude du cancer Bull Cancer. 2022 Jan 26:S0007-4551(22)00004-2. doi: 10.1016/j.bulcan.2021.11.016. Online ahead of print. ABSTRACT INTRODUCTION: The objective was to evaluate health care providers' (HCP) adherence to and efficacy of varicella post-exposure prophylaxis (PEP) recommendations. It was an observational, prospective, multicenter study set in Ile-de-France, France. METHODS: All children under 18 with a cancer diagnosis, currently or within 3months of receiving cancer treatment, regardless of varicella zoster virus (VZV) serostatus or previous personal history of varicella, were eligible. Study participants with significant exposure were reviewed prospectively for PEP indications. Main outcome measures were the percentage of exposure situations for which HCP were guideline-compliant, the proportion of available VZV serostatuses and the incidence of breakthrough varicella after different PEP approaches. RESULTS: A total of 51 patie nts from 15 centers were enrolled after 52 exposure episodes. Median age at exposure was 5 years (range, 1-15). Exposure within the household led to 38% of episodes. Prophylactic treatment consisted in specific anti-VZV immunoglobulins (V-ZIG) (n=19) or in oral aciclovir (n=15). No prophylactic treatment was given for 18 patients (in compliance, n=16). In compliance with guidelines, 17 patients received V-ZIG, 11 did not develop varicella (65%, [95% CI, 39-90%]); 15 received aciclovir, 13 did not develop varicella (87%, [95% CI, 67-100%]). Breakthrough varicella occurred in 11 patients, with simple clinical course in all cases; in 8/47 (17%) episodes when PEP was guideline-compliant versus 3/5 (60%) when not. DISCUSSION: Recommendations have been respected and are efficient. PEP needs to be standardized and a study carried out to define the optimal approach. Anti-VZV immunization of seronegative family members should be encouraged. PMID:35093244 | DOI:10.1016/j.bulcan.2021.11.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Computed tomography-assessed variations of the carotid sinus

xlomafota13 shared this article with you from Inoreader Computed tomography-assessed variations of the carotid sinus Via radiol anat Surg Radiol Anat. 2022 Jan 30. doi: 10.1007/s00276-021-02871-x. Online ahead of print. ABSTRACT PURPOSE AND BACKGROUND: Previous studies have identified variations regarding the morphology and location of the carotid sinus, a phenomenon still not commonly approached or studied on computed tomography angiography (CTA). Detailed characterization of the carotid sinus was performed on CTAs, determining its position, diameter and length. METHODS: The study group included 43 patients with disease-free carotid trunks subjected to cervical CTA. We measured the terminal caliber of the common carotid artery (CCA), as well as the calibers of the internal (ICA) and external carotid arteries (ECA) at their origin. The diameters were correlated with the location and the shape of the carotid sinus. We also measured the length of the sinus dilatation (carotid bulb), in regard to its location on the terminal branches of the common carotid artery. RESULTS: Mean diameters of the studied arteries were 7.39 ± 1.04 mm for the CCA, 6.71 ± 1.49 mm for the ICA and, respectively, 4.27 ± 0.75 mm for the ECA. The classical position of the carotid sinus was seen in 80% of cases, the rest being considered anatomical variants. The length of the carotid bulb on the ICA was 9.99 ± 2.22 mm, showing variability between genders. CONCLUSIONS: The carotid sinus does not always extend to the ICA, presenting different distribution patterns that might be relevant in sinu s pathology from a clinical point of view, respectively from a surgical point of view during invasive or minimally invasive interventions on the carotid axis. PMID:35094129 | DOI:10.1007/s00276-021-02871-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of cardiovascular risk factors in superior vestibular neuritis: A cross-sectional study following STROBE guidelines

xlomafota13 shared this article with you from Inoreader Prevalence of cardiovascular risk factors in superior vestibular neuritis: A cross-sectional study following STROBE guidelines Via oto-rhino-laryngologie Eur Ann Otorhinolaryngol Head Neck Dis. 2022 Jan 26:S1879-7296(22)00004-7. doi: 10.1016/j.anorl.2022.01.002. Online ahead of print. ABSTRACT OBJECTIVE: To compare the prevalence of cardiovascular risk factors (CVRF) in patients with superior vestibular neuritis (SVN) versus the general French population, and to examine the possibility of vascular etiology in acute superior vestibular deficit. MATERIAL AND METHODS: A single-center retrospective study compared the prevalence of hypercholesterolemia, hypertension, diabetes, smoking, cardiovascular disease and atrial fibrillation between patients with SVN and the French general population. Inclusion criteria comprised: rotatory vertigo lasting several days, without hearing impairment or neurological signs, with anterior and lateral semicircular canal involvement on video-Head-Impulse-Test (vHIT). A senior radiologist analyzed superior vestibular nerve and inner ear structure enhancement on cerebellopontine MRI. RESULTS: One hundred and eighteen cases of SVN were included from May 2016 to February 2020. Statistical analyses concerned 106 cases. The SVN population had significantly less hypercholesterolemia (RR=0.40) than the general French population. There was no significant difference concerning other CVRFs. Superior vestibular nerve enhancement was observed on 84% of MRIs. CONCLUSION: Prevalence of CVRF was not higher in patients with SVN than in the general population. The present study highlighted involvement of the superior vestibular nerve more than of the anterior vestibular artery in SVN. PMID:35093295 | DOI:10.1016/j.anorl.2022.01.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterolateral advancement palatoplasty with tonsillectomy for retropalatal obstruction in selected cases of obstructive sleep apnea

xlomafota13 shared this article with you from Inoreader Anterolateral advancement palatoplasty with tonsillectomy for retropalatal obstruction in selected cases of obstructive sleep apnea 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. 2022 Jan 31. doi: 10.1007/s00405-021-07235-0. Online ahead of print. ABSTRACT PURPOSE: This study tried to assess the surgical outcome of anterolateral advancement palatoplasty (ALP) with simultaneous tonsillectomy for the treatment of retropalatal obstruction in selected cases of obstructive sleep apnea (OSA). METHODS: In this clinical trial, 22 adult OSA patients having predominant retropalatal collapse were managed by ALP and tonsillectomy.Thirteen patients had positional OSA (PP) and 9 patients had non-positional (NPP). ALP entailed the stripping of a horizontal trapezoid area of mucosa/submucosa of the soft palate and suturing with one central simple suture and two paramedian sutures made as an anterolateral parallelogram. Uvula was not jeopardized and no lateral mucosal cuts were made. RESULTS: Postoperative data of the study group showed high significant improvement (p < 0.001) as regard s apnea-hypopnea index (AHI), mean lowest oxygen saturation level (LO2), Epworth sleepiness scale (ESS) and snoring visual analog scale (VAS-s). The overall percentage of improvement as regards the AHI was 60%.On comparison of postoperative data of PP and NPP, significant difference was reported as regards AHI (p = 0.009), while non-significant differences were reported (p > 0.05) as regards LO2, ESS and VAS-s. Postoperative means of AHI in supine position showed a significant difference (p = 0.03). Upon comparison of means of ODI and T90% of PP and NPP, a highly significant difference was reported in both pre- and postoperative comparison (< 0.001). CONCLUSION: Anterolateral advancement palatoplasty seems to be an easy, effective and low-cost procedure. More favorable outcomes were reported among positional-dependent subjects. The procedure could be employed in multilevel, single-stage surgery for patients with OSA. PMID:35098334 | DOI:10.1007/s00405-021-07235-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ocular findings from otoneurological examinations in children with and without dyslexia: a systematic review with meta-analysis

xlomafota13 shared this article with you from Inoreader Ocular findings from otoneurological examinations in children with and without dyslexia: a systematic review with meta-analysis Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Nov 25:S1808-8694(21)00190-7. doi: 10.1016/j.bjorl.2021.10.006. Online ahead of print. ABSTRACT OBJECTIVE: To investigate ocular movements measures of vectoelectro-nystagmography and video-nystagmography in dyslexic children and compare with measures of typical children. METHODS: A systematic review of observational studies comparing the ocular movements differences between dyslexic and typical children with no publication date or language restriction. The literature survey included the bibliographic databases MEDLINE, ScienceDirect, Scopus, Web of Science, SciELO, Lilacs and CENTRAL. Gray literature databases were also searched, including: OpenGrey.eu, DissOnline.de, The New York Academy of Medicine and WorldCat. The meta-analysis was performed using software RevMan 5.3 (Cochran Collaboration). RESULTS: A total of 2375 articles were found of which 113 fell within the inclusion criteria. Among these, 52 were duplicates (found in more than one research source), and 45 articles were selected for reading in full. Thirteen (13) articles were included for analysis and discussion. Meta-analysis showed statistical differences between the two groups for the total number of saccades and duration of fixation. CONCLUSION: The study revealed that children with dyslexia have longer duration of fixation and fewer saccades during ocular movements on vectoelectro-nystagmography and video-nystagmography when compared to children without dyslexia. PMID:35094959 | DOI:10.1016/j.bjorl.2021.10.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-Resolution CT Imaging of the Temporal Bone: A Cadaveric Specimen Study

xlomafota13 shared this article with you from Inoreader High-Resolution CT Imaging of the Temporal Bone: A Cadaveric Specimen Study Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1741006 Objective Super-high and ultra-high spatial resolution computed tomography (CT) imaging can be advantageous for detecting temporal bone pathology and guiding treatment strategies. Methods Six temporal bone cadaveric specimens were used to evaluate the temporal bone microanatomic structures utilizing the following CT reconstruction modes: normal resolution (NR, 0.5-mm slice thickness, 5122 matrix), high resolution (HR, 0.5-mm slice thickness, 1,0242 matrix), super-high resolution (SHR, 0.25-mm slice thickness, 1,0242 matrix), and ultra-high resolution (UHR, 0.25-mm slice thickness, 2,0482 matrix). Noise and signal-to-noise ratio (SNR) for bone and air were measured at each reconstruction mode. Two observers assessed visualization of seven small anatomic structures using a 4-point scale at each reconstruction mode. Results Noise was significantly higher and SNR significantly lower with increases in spatial resolution (NR, HR, and SHR). There was no statistical difference between SHR and UHR imaging with regard to noise and SNR. There was significantly improved visibility of all temporal bone osseous structures of interest with SHR and UHR imaging relative to NR imaging (p < 0.001) and most of the temporal bone osseous structures relative to HR imaging. There was no statistical difference in the subjective image quality between SHR and UHR imaging of the temporal bone (p ≥ 0.085). Conclusion Super-high-resolution and ultra-high-resolution CT imaging results in significant improvement in image quality compared with normal-resolution and high-resolution CT imaging of the temporal bone. This preliminary study also demonstrates equivalency between super-high and ultra-high spatial resolution temporal bone CT imaging protocols for clinical use. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract   |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-Resolution CT Imaging of the Temporal Bone: A Cadaveric Specimen Study

xlomafota13 shared this article with you from Inoreader High-Resolution CT Imaging of the Temporal Bone: A Cadaveric Specimen Study Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1741006 Objective Super-high and ultra-high spatial resolution computed tomography (CT) imaging can be advantageous for detecting temporal bone pathology and guiding treatment strategies. Methods Six temporal bone cadaveric specimens were used to evaluate the temporal bone microanatomic structures utilizing the following CT reconstruction modes: normal resolution (NR, 0.5-mm slice thickness, 5122 matrix), high resolution (HR, 0.5-mm slice thickness, 1,0242 matrix), super-high resolution (SHR, 0.25-mm slice thickness, 1,0242 matrix), and ultra-high resolution (UHR, 0.25-mm slice thickness, 2,0482 matrix). Noise and signal-to-noise ratio (SNR) for bone and air were measured at each reconstruction mode. Two observers assessed visualization of seven small anatomic structures using a 4-point scale at each reconstruction mode. Results Noise was significantly higher and SNR significantly lower with increases in spatial resolution (NR, HR, and SHR). There was no statistical difference between SHR and UHR imaging with regard to noise and SNR. There was significantly improved visibility of all temporal bone osseous structures of interest with SHR and UHR imaging relative to NR imaging (p < 0.001) and most of the temporal bone osseous structures relative to HR imaging. There was no statistical difference in the subjective image quality between SHR and UHR imaging of the temporal bone (p ≥ 0.085). Conclusion Super-high-resolution and ultra-high-resolution CT imaging results in significant improvement in image quality compared with normal-resolution and high-resolution CT imaging of the temporal bone. This preliminary study also demonstrates equivalency between super-high and ultra-high spatial resolution temporal bone CT imaging protocols for clinical use. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract   |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid Disease in Pregnancy: A Touch of Clarity

xlomafota13 shared this article with you from Inoreader Thyroid Disease in Pregnancy: A Touch of Clarity Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Tissue Engineered Construct for Laryngeal Regeneration: A Proof‐of‐Concept Device Design Study

xlomafota13 shared this article with you from Inoreader A Tissue Engineered Construct for Laryngeal Regeneration: A Proof‐of‐Concept Device Design Study Via The Laryngoscope Objectives/Hypothesis Develop a patient-specific tissue engineered construct for laryngeal reconstruction following a partial laryngectomy. Study Design Bench and animal research. Methods A construct made from a porous polyethylene scaffold shaped in a canine-specific configuration and seeded with autologous canine adipose-derived stem cells in fibrin glue was implanted in a canine following a partial laryngectomy. After 1 year, the construct was first evaluated in vivo with high-speed imaging and acoustic–aerodynamic measures. It was then explanted and evaluated histologically. Results The canine study at 1 year revealed the construct provided voicing (barking) with acoustic and aerodynamic measures within normal ranges. The canine was able to eat and breathe normally without long-term support. The construct was integrated with epithelialization of all areas except the medial portion of the vocal fold structure. No anti-infective agents were needed after the standard perioperative medications were completed. Conclusion This study provided a successful first step toward developing a patient-specific composite construct for patients undergoing partial laryngectomies. Level of Evidence Not Applicable Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mucosal melanocytic lesion in the middle ear extending to the inner ear and nasopharynx

xlomafota13 shared this article with you from Inoreader Mucosal melanocytic lesion in the middle ear extending to the inner ear and nasopharynx Via ear nose throat Ear Nose Throat J. 2022 Jan 28:1455613211068571. doi: 10.1177/01455613211068571. Online ahead of print. ABSTRACT Benign dendritic melanocytic proliferation is usually observed in the skin. We report an extremely rare case of a melanocytic lesion in the middle ear mucosa. Only 3 cases of melanocytic lesions in the middle ear have been reported. Our report is the only one that describes an adult with a melanocytic lesion in the middle ear that extended to the inner ear and nas opharyngeal mucosa. A 23-year-old female presented with profound sensory neural hearing loss and recurrent discharge from the right ear. Examination revealed a blue right tympanic membrane with a small perforation. Computed tomography scans and magnetic resonance imaging were performed. After surgical exploration and histopathological examination, the patient was found to have a benign melanocytic lesion in the right middle ear. Melanocytic lesions are commonly found in the skin. There are no previous reports have described adult patients with melanocytic lesions in the middle ear that extend to the inner ear and nasopharynx, which cause profound hearing loss with recurrent ear discharge. These patients require regular follow-up to assess the progression of the lesion and to watch for any malignant behavior. PMID:35088612 | DOI:10.1177/01455613211068571 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A new classification of maxillary defect and simultaneous accurate reconstruction

xlomafota13 shared this article with you from Inoreader A new classification of maxillary defect and simultaneous accurate reconstruction Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):8-14. doi: 10.3760/cma.j.cn115330-20210724-00484. ABSTRACT Objective: To select the preferred flaps for the reconstruction of different maxillary defects and to propose a new classification of maxillary defects. Methods: A total of 219 patients (136 males and 83 females) underwent the simultaneous reconstruction of maxillary defects in the Beijing Tongren Hospital, Capital Medical University, between January 2005 and December 2018 were reviewed. Age ranged from 16 to 78 years. Based on the proposed new classification of the maxillary defects, 22 patients with class Ⅰ defects (inferior maxillectomy), 44 patients with class Ⅱ defects (supperior maxillectomy), 132 patients with class Ⅲ defects (total maxillectomy) and 21 patients with class Ⅳ defects (extensive maxillectomy) were enrolled. Survival rate, functional and aesthetic outcomes of flaps were ev aluated. Survival analysis was performed in 169 patients with malignant tumor, Kaplan-Meier method was used to calculate the survival rate, and Log-rank method was used to compare the difference of survival rate in each group. Results: A total of 234 repairs for maxillary defects were performed in 219 patients. Fibula flaps were used in 4/13 of class Ⅰ defects; temporal muscle flaps (11/24, 45.8%) and anterolateral thigh flaps (6/24, 25.0%) used in class Ⅱ defects; temporal muscle flaps (71/128, 55.5%), anterolateral thigh flaps (6/24, 25.0%) and fibula flaps (12/128, 9.4%) used in class Ⅲ defects; and anterolateral thigh flaps (8/20, 40.0%) and rectus abdominis flaps (8/20, 40.0%) used in class Ⅳ defects. The success rate of local pedicled flaps was 95.6% (109/114) and that of free flaps was 95.8% (115/120). Thrombosis(10/234,4.3%) was a main reason for repair failure. Among the followed-up 88 patients, swallowing and speech functions recovered, 82 (93.2%) of them we re satisfied with appearance, and 75 (85.2%) were satisfied with visual field. The 3-year and 5-year overall survival rates were 66.5% and 63.6%, and the 3-year and 5-year disease-free survival rates were 57.1% and 46.2%, respectively, in the 169 patients with malignant tumors. Conclusion: A new classification of maxillary defects is proposed, on which suitable flaps are selected to offer patients good functional and aesthetic outcomes and high quality of life. PMID:35090203 | DOI:10.3760/cma.j.cn115330-20210724-00484 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.