General Assembly, Prevention, Antimicrobials (Systemic): Proceedings of International Consensus on Orthopedic Infections

Question 1: Should patients with penicillin or cephalosporin allergies routinely undergo allergy testing, desensitization, or take a test dose before administering alternative antibiotic prophylaxis? (Source: The Journal of Arthroplasty)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

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Molecular and Biological Characterization of a Prepared Recombinant Human Interferon Alpha 2b Isoform.

In conclusion, the prepared rhIFN-α2b isoform has high purity, homogeneity, native like chemical and structural composition, high antiviral activity, and proper biological stability, which reduce its immunogenicity and raise its therapeutic efficiency. PMID: 30334171 [PubMed - as supplied by publisher] (Source: Applied Biochemistry and Biotechnology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CurkRQ

Endoscopic management of paediatric meningoencephaloceles: a case series

Abstract

Introduction

Congenital meningoencephaloceles represent a rare clinical entity, with its frequency being around 1 out of 4000–5000 live births. They usually present as a midline mass and the differential diagnosis includes dermoids, encephaloceles, and gliomas. Although the standard coronal approach with frontal craniotomy and pericranial flap has been considered the preferred method for several years, it is associated with risks and prolonged hospitalization. The endoscopic procedure is gaining ground and we are aiming to present our experience from five cases that were treated endoscopically.

Materials and methods

Five cases of paediatric meningoencephaloceles (age ranging from 2.5 to 10 years) were treated in our department between the years 2007–2017. Four children had a congenital and one child a post-traumatic meningoencephalocele. The presenting symptoms included nasal obstruction, meningitis and CSF leak. All patients had pre-operative imaging with CT and MRI scans and the preferred method of repair was multi-layered closure.

Results

All our patients had uneventful recovery, without any post-operative complications. The follow-up period ranges from 39 to 98 months. All five patients remain asymptomatic and recurrence-free.

Conclusion

Endoscopic management of paediatric meningoencephaloceles is a reliable and safe approach and it is known to have no adverse effects on facial growth. It carries a satisfactory success rate, reduces the in-hospital stay with lower cost of treatment, better cosmesis and lower morbidity than external procedures. It requires multidisciplinary team setting in a tertiary centre with experienced endoscopic anterior skull base surgeons. Pre-operative assessment and post-operative care are of paramount importance and larger series need to be studied to reach safe conclusions and establish management guidelines.

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Ultrahigh-resolution CT scan of the temporal bone

Abstract

Objective

Ultrahigh-resolution CT (U-HRCT) provides better spatial resolution than conventional multi-detector row CT (ConvCT) and could be expected to identify microstructures with its 0.25-mm collimation, 1792 channels and 160 detector rows, 0.4 × 0.5 mm focus size, and a 1024 matrix. The aim of the study was to evaluate key anatomic structures in temporal bone using U-HRCT comparing it to ConvCT.

Materials and methods

A total of 30 patients (14 males and 16 females; age range, 8–82 years; median 49 years) underwent both U-HRCT and ConvCT. All CT images were obtained with 0.5 mm section thickness and a 512 × 512 matrix, and field of view of 80 mm. Transverse scans were acquired in a plane parallel to the orbitomeatal plane in the helical mode with 120 kV. Images of the 30 temporal bones of unaffected side were reviewed by two independent neuroradiologists who rated the visibility of key anatomic structures for both U-HRCT and ConvCT. The ratings between U-HRCT and ConvCT were compared using Wilcoxon matched-pairs signed rank test. The interobserver agreement on the rating of stapedius tendon was evaluated using weighted κ statistics.

Results

Excellent interobserver agreement was shown for U-HRCT (κ = 0.920), whereas good agreement was obtained for ConvCT (κ = 0.733). According to both observers, stapedius tendon was more clearly visualized using U-HRCT than ConvCT (p < 0.0001). All other anatomic structures were well visualized using both CT scanners.

Conclusion

The anatomy of temporal bone is more conspicuous on U-HRCT than on ConvCT because of its ultra-high-resolution detector. U-HRCT may provide beneficial information for determining surgical indication or procedures.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q3AzBe

Chronic sinusitis in head and neck cancer patients who received radiotherapy or chemoradiotherapy

Abstract

Purpose

The aim of this study was to evaluate the status of paranasal sinus and to identify risk factors associated with the development of chronic sinusitis based on imaging studies in head and neck cancer patients.

Materials and methods

We retrospectively analyzed the medical records of 186 patients who were diagnosed with head and neck squamous cell carcinoma at Korea University Guro Hospital from February 2003 to July 2015. Only patients with at least 1 year of follow-up after treatment were included.

Results

Chronic sinusitis occurred in 32 patients (17.2%), including seven patients (16.3%) in non-radiotherapy group and 25 patients (17.5%) in radiotherapy group. Maxillary sinus was most commonly involved (56.9%), followed by ethmoid, frontal, and sphenoid sinuses. Age (1.006; 0.874–1.158; p = 0.936), TNM stage (0.104; 0.007–1.598; p = 0.105), and underlying disease (0.242; 0.036–1.646; p = 0.147) were not significantly associated with the need for surgery due to sinusitis. Although radiotherapy itself (1.319; 0.019–2.821; p = 0.251) was not significantly associated with surgery due to sinusitis, concurrent chemotherapy (10.729; 1.361–84.611; p = 0.024) was significantly associated with surgical procedures.

Conclusion

Higher T stage and concurrent chemotherapy with radiotherapy showed significant association with chronic sinusitis. Concurrent chemotherapy also showed significant association with surgical treatment in head and neck cancer patients. Therefore, more careful surveillance and aggressive treatment of chronic sinusitis is needed in head and neck cancer patients who receive radiotherapy with concurrent chemotherapy or higher T stage.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R61OGP

General Assembly, Prevention, Antimicrobials (Systemic): Proceedings of International Consensus on Orthopedic Infections

Question 1: Should patients with penicillin or cephalosporin allergies routinely undergo allergy testing, desensitization, or take a test dose before administering alternative antibiotic prophylaxis? (Source: The Journal of Arthroplasty)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ajmo0K

Molecular and Biological Characterization of a Prepared Recombinant Human Interferon Alpha 2b Isoform.

In conclusion, the prepared rhIFN-α2b isoform has high purity, homogeneity, native like chemical and structural composition, high antiviral activity, and proper biological stability, which reduce its immunogenicity and raise its therapeutic efficiency. PMID: 30334171 [PubMed - as supplied by publisher] (Source: Applied Biochemistry and Biotechnology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2CurkRQ

Functional identification of abductor and adductor branches for laryngeal transplantation

Abstract

Purpose

This is a feasibility study of functional identification of the abductor and adductor recurrent laryngeal nerve branches, which could be used in the donor's larynx for functional laryngeal transplantation.

Methods

The study was performed on swine (n = 3) and human (n = 4) models of a donor larynx. The recurrent laryngeal nerve and its branches were found. Using stimulator, abductor and adductor branches were identified, and glottis closing and opening were captured with an endoscope.

Results

The result was positive if two ENT specialists noticed at least one adduction and one abduction movement in the same subject. It was obtained in three out of three swine and three out of four humans.

Conclusions

This study shows a way of reinnervation of a transplanted larynx which might result in a functional organ. It describes the first step of the procedure: functional identification of the abductor and adductor branches of the recurrent laryngeal nerve in the donor before the larynx is excised for transplantation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R1iqzm

Evaluation of vestibular system with vHIT in industrial workers with noise-induced hearing loss

Abstract

Purpose

Industrial workers are frequently exposed to noise and the noise can cause hearing loss. The relationship between vestibular abnormalities and long-term exposure to occupational noise has been reported. The aim of this study was to use vHIT (video head impulse test) to evaluate the semicircular canal's function in industrial workers with noise-induced hearing loss.

Methods

In the present study, we included 36 male patients (aged 28–55 years, mean 44.4 ± 6.1 years) with hearing loss due to noise exposure from working in the steel and metal industry for at least 4 years, and a control group of 30 healthy men (aged 34–50 years, mean 41.1 ± 4.5 years) without hearing loss. The gain of the vestibulo-ocular reflex for all 6 semicircular canals was examined by vHIT in 66 patients.

Results

Canal deficit was detected in 20 (55.5%) of 36 patients in the noise exposure hearing loss group and was detected in 2 (6.6%) of 30 participants in the control group. There was significant loss of capacity for VOR gain in patients with noise exposure hearing loss.

Conclusions

In the present study we found that exposure to noise can cause vestibular dysfunction. And the vHIT is easily applicable, quick and practical and can individually evaluate all semicircular channels. Therefore, to evaluate vestibular function with vHIT is quick and practical.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q1RDY8

Endoscopic management of paediatric meningoencephaloceles: a case series

Abstract

Introduction

Congenital meningoencephaloceles represent a rare clinical entity, with its frequency being around 1 out of 4000–5000 live births. They usually present as a midline mass and the differential diagnosis includes dermoids, encephaloceles, and gliomas. Although the standard coronal approach with frontal craniotomy and pericranial flap has been considered the preferred method for several years, it is associated with risks and prolonged hospitalization. The endoscopic procedure is gaining ground and we are aiming to present our experience from five cases that were treated endoscopically.

Materials and methods

Five cases of paediatric meningoencephaloceles (age ranging from 2.5 to 10 years) were treated in our department between the years 2007–2017. Four children had a congenital and one child a post-traumatic meningoencephalocele. The presenting symptoms included nasal obstruction, meningitis and CSF leak. All patients had pre-operative imaging with CT and MRI scans and the preferred method of repair was multi-layered closure.

Results

All our patients had uneventful recovery, without any post-operative complications. The follow-up period ranges from 39 to 98 months. All five patients remain asymptomatic and recurrence-free.

Conclusion

Endoscopic management of paediatric meningoencephaloceles is a reliable and safe approach and it is known to have no adverse effects on facial growth. It carries a satisfactory success rate, reduces the in-hospital stay with lower cost of treatment, better cosmesis and lower morbidity than external procedures. It requires multidisciplinary team setting in a tertiary centre with experienced endoscopic anterior skull base surgeons. Pre-operative assessment and post-operative care are of paramount importance and larger series need to be studied to reach safe conclusions and establish management guidelines.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QXYjlw

Ultrahigh-resolution CT scan of the temporal bone

Abstract

Objective

Ultrahigh-resolution CT (U-HRCT) provides better spatial resolution than conventional multi-detector row CT (ConvCT) and could be expected to identify microstructures with its 0.25-mm collimation, 1792 channels and 160 detector rows, 0.4 × 0.5 mm focus size, and a 1024 matrix. The aim of the study was to evaluate key anatomic structures in temporal bone using U-HRCT comparing it to ConvCT.

Materials and methods

A total of 30 patients (14 males and 16 females; age range, 8–82 years; median 49 years) underwent both U-HRCT and ConvCT. All CT images were obtained with 0.5 mm section thickness and a 512 × 512 matrix, and field of view of 80 mm. Transverse scans were acquired in a plane parallel to the orbitomeatal plane in the helical mode with 120 kV. Images of the 30 temporal bones of unaffected side were reviewed by two independent neuroradiologists who rated the visibility of key anatomic structures for both U-HRCT and ConvCT. The ratings between U-HRCT and ConvCT were compared using Wilcoxon matched-pairs signed rank test. The interobserver agreement on the rating of stapedius tendon was evaluated using weighted κ statistics.

Results

Excellent interobserver agreement was shown for U-HRCT (κ = 0.920), whereas good agreement was obtained for ConvCT (κ = 0.733). According to both observers, stapedius tendon was more clearly visualized using U-HRCT than ConvCT (p < 0.0001). All other anatomic structures were well visualized using both CT scanners.

Conclusion

The anatomy of temporal bone is more conspicuous on U-HRCT than on ConvCT because of its ultra-high-resolution detector. U-HRCT may provide beneficial information for determining surgical indication or procedures.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q3AzBe

A comparison of phonatory outcome between trans-oral CO 2 Laser cordectomy and radiotherapy in T1 glottic cancer

Abstract

Purpose

This study aimed at comparing phonatory outcomes between Trans-oral Laser Surgery and Radiotherapy in T1 glottic cancer.

Introduction

Early glottic carcinoma, i.e. T1 stage, can be treated using trans-oral surgery, radiotherapy, or partial open surgery. Trans-oral laser (TOL) surgical techniques and Radiotherapy (RT) have undergone significant advancement in the past few years leading to a decrease in open procedures. Various studies have been published comparing voice quality after TOL surgery and RT. There are few works which consider patients' opinions, i.e. subjective parameters regarding functional voice quality post treatment. This study uses both subjective and objective parameters to evaluate phonatory outcome of both treatment options.

Methods

Phonatory outcomes were measured in patients who underwent RT and CO₂ Laser excision for early laryngeal cancer. VHI, GRBAS and MDVP were used to measure the vocal outcome of treatment modality after 1 year of cancer-free survival. A comparison was then made between the outcomes in the two groups.

Results

Superior vocal outcomes in G, R and S criteria of the GRBAS scale, a better VHI index, and better jitter, shimmer and NHR were found in patients who underwent CO₂ laser excision as compared to patients who underwent RT. Other parameters were comparable between the two groups.

Conclusions

TOL surgery provides excellent vocal outcome as compared to RT in management of early glottic cancer and should be considered as the first line of management for the same.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q3AzkI

Chronic sinusitis in head and neck cancer patients who received radiotherapy or chemoradiotherapy

Abstract

Purpose

The aim of this study was to evaluate the status of paranasal sinus and to identify risk factors associated with the development of chronic sinusitis based on imaging studies in head and neck cancer patients.

Materials and methods

We retrospectively analyzed the medical records of 186 patients who were diagnosed with head and neck squamous cell carcinoma at Korea University Guro Hospital from February 2003 to July 2015. Only patients with at least 1 year of follow-up after treatment were included.

Results

Chronic sinusitis occurred in 32 patients (17.2%), including seven patients (16.3%) in non-radiotherapy group and 25 patients (17.5%) in radiotherapy group. Maxillary sinus was most commonly involved (56.9%), followed by ethmoid, frontal, and sphenoid sinuses. Age (1.006; 0.874–1.158; p = 0.936), TNM stage (0.104; 0.007–1.598; p = 0.105), and underlying disease (0.242; 0.036–1.646; p = 0.147) were not significantly associated with the need for surgery due to sinusitis. Although radiotherapy itself (1.319; 0.019–2.821; p = 0.251) was not significantly associated with surgery due to sinusitis, concurrent chemotherapy (10.729; 1.361–84.611; p = 0.024) was significantly associated with surgical procedures.

Conclusion

Higher T stage and concurrent chemotherapy with radiotherapy showed significant association with chronic sinusitis. Concurrent chemotherapy also showed significant association with surgical treatment in head and neck cancer patients. Therefore, more careful surveillance and aggressive treatment of chronic sinusitis is needed in head and neck cancer patients who receive radiotherapy with concurrent chemotherapy or higher T stage.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R61OGP

The (templar) knight cap: a new and simple way to prevent hair interference during ear surgery

Abstract

Introduction

Hair interference is a critical problem in ear surgery. The hair around the surgical area can get stuck unwantedly, making the surgeon habitually struggling with this hair rather than the surgery itself. Hair shaving can cause psychological discomfort, especially for women and data about shaving efficacy are conflicting. With the aim of solving this problem, we developed a new way to clear hair from the operating field named "The (Templar) Knight cap".

Technical description

This is a medical elastic stocking open at the ear to be treated and at the face that recalls the typical cap worn by Templar knight. This cap allows good hair retention and marks the surgical site. It is easy to wear does not require additional time for clinical staff.

Conclusions

The described cap could be a valid instrument during ear surgery with a low cost pricing, making it applicable in very poor settings, such as developing countries.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R5gndH

Role of leptin in allergic rhinitis during sublingual immunotherapy

Abstract

Objective

Increasing evidence suggests that leptin is upregulated during allergic reactions in the airway and related to the severity of disease in allergic rhinitis (AR). In this study, we aimed to investigate the expression of leptin during sublingual immunotherapy (SLIT) in AR patients.

Methods

Forty AR patients without obesity were recruited in this study. Twenty patients received house dust mite (HDM) allergen extract for SLIT and twenty patients received placebo randomly. Protein expression of leptin in serum and nasal lavage was tested by enzyme-linked immuno sorbent assay (ELISA) 1 and 2 years after SLIT treatment, respectively. Peripheral blood mononuclear cells (PBMCs) and human nasal epithelial cell were prepared and stimulated by recombinant leptin after 24 months' SLIT treatment and the induction of Th2 cytokines (IL-4/IL-5/IL-13) were detected by ELISA.

Results

SLIT treatment decreased the expression of leptin protein in serum and nasal lavage significantly compared with placebo group 1 and 2 years after SLIT treatment. Nasal leptin level was correlated to decreased Th2 response (IL-4/IL-5/IL-13) and enhanced Treg (IL-10/TGF-beat) response after 2 years' SLIT. We also found that SLIT decreased the ability of leptin in promoting Th2 cytokines expression by PBMCs and human nasal epithelial cell after 2 years' SLIT treatment.

Conclusion

Changes of leptin expression in serum and nasal lavage may be correlated with Th2/Treg regulation during SLIT. Our results suggested that leptin served as an important biomarker during SLIT.

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Functional identification of abductor and adductor branches for laryngeal transplantation

Abstract

Purpose

This is a feasibility study of functional identification of the abductor and adductor recurrent laryngeal nerve branches, which could be used in the donor's larynx for functional laryngeal transplantation.

Methods

The study was performed on swine (n = 3) and human (n = 4) models of a donor larynx. The recurrent laryngeal nerve and its branches were found. Using stimulator, abductor and adductor branches were identified, and glottis closing and opening were captured with an endoscope.

Results

The result was positive if two ENT specialists noticed at least one adduction and one abduction movement in the same subject. It was obtained in three out of three swine and three out of four humans.

Conclusions

This study shows a way of reinnervation of a transplanted larynx which might result in a functional organ. It describes the first step of the procedure: functional identification of the abductor and adductor branches of the recurrent laryngeal nerve in the donor before the larynx is excised for transplantation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R1iqzm

Evaluation of vestibular system with vHIT in industrial workers with noise-induced hearing loss

Abstract

Purpose

Industrial workers are frequently exposed to noise and the noise can cause hearing loss. The relationship between vestibular abnormalities and long-term exposure to occupational noise has been reported. The aim of this study was to use vHIT (video head impulse test) to evaluate the semicircular canal's function in industrial workers with noise-induced hearing loss.

Methods

In the present study, we included 36 male patients (aged 28–55 years, mean 44.4 ± 6.1 years) with hearing loss due to noise exposure from working in the steel and metal industry for at least 4 years, and a control group of 30 healthy men (aged 34–50 years, mean 41.1 ± 4.5 years) without hearing loss. The gain of the vestibulo-ocular reflex for all 6 semicircular canals was examined by vHIT in 66 patients.

Results

Canal deficit was detected in 20 (55.5%) of 36 patients in the noise exposure hearing loss group and was detected in 2 (6.6%) of 30 participants in the control group. There was significant loss of capacity for VOR gain in patients with noise exposure hearing loss.

Conclusions

In the present study we found that exposure to noise can cause vestibular dysfunction. And the vHIT is easily applicable, quick and practical and can individually evaluate all semicircular channels. Therefore, to evaluate vestibular function with vHIT is quick and practical.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q1RDY8

Posterior pillar mucosal suspension technique for posttonsillectomy pain and wound healing: a prospective, randomized, controlled trial

Abstract

Objectives/hypothesis

To investigate the efficacy of a simple and feasible suturing technique on posttonsillectomy pain control and wound healing.

Methods

A prospective, randomized, controlled trial was conducted on a sample of 121 children between 3 and 10 years of age. Group A comprised children undergoing surgery with bipolar cautery and the posterior pillar mucosal suspension technique. Bipolar alone (Group B) and cold dissection tonsillectomy (Group C) were used as control groups. Pain was assessed at 1, 3, 5, 7, and 10 days postoperatively via visual analog scale scores. Peritonsillar edema, erythema, and granulation tissue in the tonsillar fossa were evaluated by direct visual examination for wound healing on days 1, 3, 5, 7, and 10.

Results

There were consecutive 121 patients which were included, with mean ages being 6.2 ± 2.5, 6.1 ± 2.4, and 6.1 ± 2.6 in groups A, B, and C, respectively. Postoperative pain scores on days 1 and 3 were significantly lower in Group A than Group B and C (P < .001) and scores were 0.87 ± 1.1, 3.83 ± 2.29, and 4.29 ± 2.48 on day 1 and 0.38 ± 0.88, 2.25 ± 2.13, and 2.76 ± 2.12 on day 3 respectively. The wound-healing scores on postoperative 1st, 3rd, 5th, and 7th days were significantly lower in Group A than control groups (P < .001). The wound-healing score on postoperative day 10 was only different than Group C (P = .020).

Conclusions

The posterior pillar mucosal suspension technique is an effective and comparable method in terms of wound healing, maintains the preoperative anatomical structures, and enables a better pain control with reduced analgesic/opioid usage.

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The effect of electrolyte balance on the voice in hemodialysis patients

Abstract

Objective

The aim of the study was to demonstrate the effect of blood electrolytes on the voice in chronic hemodialysis patients.

Methods

The study included a total of 59 hemodialysis patients. Pre- and post-dialysis voice recordings were performed. In the analysis of vocal acoustic parameters, fundamental frequency (F0), jitter, shimmer, the noise-to-harmonics ratio (NHR), and F0 minimum and F0 maximum were measured. The Voice Handicap Index-10 (VHI-10), and maximum phonation time (MPT) were evaluated. For perceptual evaluation, the GRBAS scale was used. The duration of dialysis (years) and changes in weight during dialysis were recorded for each patient. From venous blood samples, measurements were taken of hemoglobin (Hb), albumin, Na+, K+, creatinine, uric acid, phosphorus, Ca++, and parathormone.

Results

The difference in the pre and post-dialysis values of F0, shimmer, NHR and MPT were found to be statistically significant (p = 0.001). The only variable determined to have an effect on the change in F0 values was uric acid, and the change in the F0 values was statistically significant (p = 0.009). The only variable determined to have an effect on the change in shimmer values was sodium, and the change was statistically significant (p = 0.034). The only variable determined to have an effect on the change in NHR values was creatinine, and the change in the NHR values was statistically significant (p = 0.028). Hb and the duration of dialysis were determined to have a statistically significant effect on the change in MPT values (p = 0.001).

Conclusions

The results showed that uric acid was the agent creating a reduction in vocal cord vibration, the agent increasing the difference between vibration waves was Na+, and creatinine increased the NHR rate. The effect of these variables can be considered important in the understanding of vocal cord physiology.

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Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy?

Abstract

A preoperative cytologic or histologic diagnosis of parotid gland neoplasms is mandatory to decide which surgical procedure would be appropriate. Open biopsies are contraindicated because of the risk of recurrence secondary to tumour cell seeding; furthermore a subsequent curative parotid surgery can be complicated by a previous open biopsy. While fine-needle aspiration cytology (FNAC) was the only preoperative diagnostic procedure to distinguish benign versus malignant neoplasms over the past decades, core needle biopsy (CNB) has been increasingly used over the last few years. This created a debate as to whether FNAC or CNB should be the preoperative procedure of choice. The focus of this editorial is to analyse the advantages and disadvantages of FNAC and CNB, and to discuss which procedure is more appropriate in the preoperative work-up of parotid neoplasms.

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A comparison of phonatory outcome between trans-oral CO 2 Laser cordectomy and radiotherapy in T1 glottic cancer

Abstract

Purpose

This study aimed at comparing phonatory outcomes between Trans-oral Laser Surgery and Radiotherapy in T1 glottic cancer.

Introduction

Early glottic carcinoma, i.e. T1 stage, can be treated using trans-oral surgery, radiotherapy, or partial open surgery. Trans-oral laser (TOL) surgical techniques and Radiotherapy (RT) have undergone significant advancement in the past few years leading to a decrease in open procedures. Various studies have been published comparing voice quality after TOL surgery and RT. There are few works which consider patients' opinions, i.e. subjective parameters regarding functional voice quality post treatment. This study uses both subjective and objective parameters to evaluate phonatory outcome of both treatment options.

Methods

Phonatory outcomes were measured in patients who underwent RT and CO₂ Laser excision for early laryngeal cancer. VHI, GRBAS and MDVP were used to measure the vocal outcome of treatment modality after 1 year of cancer-free survival. A comparison was then made between the outcomes in the two groups.

Results

Superior vocal outcomes in G, R and S criteria of the GRBAS scale, a better VHI index, and better jitter, shimmer and NHR were found in patients who underwent CO₂ laser excision as compared to patients who underwent RT. Other parameters were comparable between the two groups.

Conclusions

TOL surgery provides excellent vocal outcome as compared to RT in management of early glottic cancer and should be considered as the first line of management for the same.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q3AzkI

Facial nerve dysfunction after superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring: a prospective randomized pilot study

Abstract

Purpose

There are no randomized trials comparing the incidence or severity of facial nerve dysfunction after superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring. This pilot study aimed to assess the variability in outcomes to help determine the needs and possible ethical issues in a full-scale study.

Methods

Prospective randomized pilot study comparing the incidence and grade of facial nerve dysfunction among 106 patients subjected to superficial parotidectomy with or without continuous four channels electromyographic neuromonitoring (52 monitored patients and 54 controls).

Results

The incidences of immediate (38.3% vs. 51.8%, p = 0.1) and late facial dysfunction, up to 180 days following surgery, (3.8% vs. 5.5%, p = 0.4) were similar between monitored patients and controls. Immediate facial nerve dysfunction with a House–Brackmann ≥ grade III was more frequent among the non-monitored patients (57.8% vs. 30%, p = 0.2), and outcomes were significantly poorer in this group (mean sum score of 68.7 vs. 81.5, p = 0.002), when assessed with the regional Sunnybrook scale. A full-scale prospective randomized study to detect a significant reduction in the incidence of immediate facial nerve dysfunction with the use of continuous intraoperative electromyographic neuromonitoring, with 80% power and a 5% significant level, would require 560 patients allocated to the monitored and control groups. Considering a mean rate of 30 patients/year/center, such a study would require the participation of five centers for 4 years.

Conclusions

In the present pilot study, the incidences of immediate and late facial nerve dysfunction were similar between patients with benign parotid tumors subjected to superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring. However, immediate facial dysfunction was more severe among the non-monitored patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2q0OTKL

The (templar) knight cap: a new and simple way to prevent hair interference during ear surgery

Abstract

Introduction

Hair interference is a critical problem in ear surgery. The hair around the surgical area can get stuck unwantedly, making the surgeon habitually struggling with this hair rather than the surgery itself. Hair shaving can cause psychological discomfort, especially for women and data about shaving efficacy are conflicting. With the aim of solving this problem, we developed a new way to clear hair from the operating field named "The (Templar) Knight cap".

Technical description

This is a medical elastic stocking open at the ear to be treated and at the face that recalls the typical cap worn by Templar knight. This cap allows good hair retention and marks the surgical site. It is easy to wear does not require additional time for clinical staff.

Conclusions

The described cap could be a valid instrument during ear surgery with a low cost pricing, making it applicable in very poor settings, such as developing countries.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R5gndH

Outcome of compartment resection of locally advanced oral cancers extending to infratemporal fossa: a tertiary rural hospital experience

Abstract

Locally advanced oral cancers extending to infratemporal fossa (ITF) are a challenge to head and neck surgeons. These tumors are classified as T_4b whenever the masticator space (MS), pterygoid muscles (PM), and pterygoid plates (PP) are involved according to AJCC classification. Until recently, these tumors were considered inoperable and treated only with palliative intent. However, a few studies in the last decade showed that many of these tumors could be resected with a reasonably favorable prognosis by compartment resection of ITF, particularly when the tumor was below sigmoid notch of mandible. A few studies attempted to downstage these tumors by neo-adjuvant chemotherapy before attempting resection. Oral Squamous cell carcinoma has a high prevalence in South India. Majority of these patients are females addicted to tobacco quid chewing and present with locally advanced disease. In this retrospective analysis, we evaluated the outcome of treatment of oral squamous cell carcinoma extending to ITF and staged T_4b in 52 patients. All patients underwent Composite resection including compartment resection of ITF followed by adjuvant treatment. 20 patients had received neo-adjuvant chemotherapy. Pectoralis major myocutaneous flap was the mainstay of reconstruction. After mean follow-up of 2 years, 31 patients are alive and disease free. 14 patients had local recurrence in ITF and 2 patients had recurred in cervical nodes. 8 patients died due to disease and 6 are on palliative care. Neo-adjuvant chemotherapy did not benefit the outcome. Close margins of resection, extra nodal spread from lymph nodes and supra notch and involvement of posterior part of ITF were factors which predisposed to recurrence.

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Role of leptin in allergic rhinitis during sublingual immunotherapy

Abstract

Objective

Increasing evidence suggests that leptin is upregulated during allergic reactions in the airway and related to the severity of disease in allergic rhinitis (AR). In this study, we aimed to investigate the expression of leptin during sublingual immunotherapy (SLIT) in AR patients.

Methods

Forty AR patients without obesity were recruited in this study. Twenty patients received house dust mite (HDM) allergen extract for SLIT and twenty patients received placebo randomly. Protein expression of leptin in serum and nasal lavage was tested by enzyme-linked immuno sorbent assay (ELISA) 1 and 2 years after SLIT treatment, respectively. Peripheral blood mononuclear cells (PBMCs) and human nasal epithelial cell were prepared and stimulated by recombinant leptin after 24 months' SLIT treatment and the induction of Th2 cytokines (IL-4/IL-5/IL-13) were detected by ELISA.

Results

SLIT treatment decreased the expression of leptin protein in serum and nasal lavage significantly compared with placebo group 1 and 2 years after SLIT treatment. Nasal leptin level was correlated to decreased Th2 response (IL-4/IL-5/IL-13) and enhanced Treg (IL-10/TGF-beat) response after 2 years' SLIT. We also found that SLIT decreased the ability of leptin in promoting Th2 cytokines expression by PBMCs and human nasal epithelial cell after 2 years' SLIT treatment.

Conclusion

Changes of leptin expression in serum and nasal lavage may be correlated with Th2/Treg regulation during SLIT. Our results suggested that leptin served as an important biomarker during SLIT.

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The lamellar cell: a radiological study and a new classification proposal

Abstract

Purpose

A pneumatized middle turbinate is called concha bullosa. Bolger classified it in bulbous, lamellar, and extensive. Lamellar cells could have a variable extension. We propose the first radiologic classification of lamellar cells.

Methods

195 CT sinonasal scans were included in the study. Lamellar cells were classified into four categories according to their degree of aeration.

Results

Lamellar cells were found in 47.7% of patients: unilateral in 14.9% of cases and bilateral in the remaining 32.8%. The most common lamellar cell is type 1, followed by types 3, 2, and 4; there were no statistically significant differences regarding side. A subgroup analysis was performed in 106 patients with no inflammatory diseases of the nasal cavity; there were no significant differences.

Conclusion

Cell types 3 and 4 are a complete pneumatization of the insertion of the middle turbinate; these cells are rare and could be associated with middle turbinate instability.

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Posterior pillar mucosal suspension technique for posttonsillectomy pain and wound healing: a prospective, randomized, controlled trial

Abstract

Objectives/hypothesis

To investigate the efficacy of a simple and feasible suturing technique on posttonsillectomy pain control and wound healing.

Methods

A prospective, randomized, controlled trial was conducted on a sample of 121 children between 3 and 10 years of age. Group A comprised children undergoing surgery with bipolar cautery and the posterior pillar mucosal suspension technique. Bipolar alone (Group B) and cold dissection tonsillectomy (Group C) were used as control groups. Pain was assessed at 1, 3, 5, 7, and 10 days postoperatively via visual analog scale scores. Peritonsillar edema, erythema, and granulation tissue in the tonsillar fossa were evaluated by direct visual examination for wound healing on days 1, 3, 5, 7, and 10.

Results

There were consecutive 121 patients which were included, with mean ages being 6.2 ± 2.5, 6.1 ± 2.4, and 6.1 ± 2.6 in groups A, B, and C, respectively. Postoperative pain scores on days 1 and 3 were significantly lower in Group A than Group B and C (P < .001) and scores were 0.87 ± 1.1, 3.83 ± 2.29, and 4.29 ± 2.48 on day 1 and 0.38 ± 0.88, 2.25 ± 2.13, and 2.76 ± 2.12 on day 3 respectively. The wound-healing scores on postoperative 1st, 3rd, 5th, and 7th days were significantly lower in Group A than control groups (P < .001). The wound-healing score on postoperative day 10 was only different than Group C (P = .020).

Conclusions

The posterior pillar mucosal suspension technique is an effective and comparable method in terms of wound healing, maintains the preoperative anatomical structures, and enables a better pain control with reduced analgesic/opioid usage.

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Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy?

Abstract

A preoperative cytologic or histologic diagnosis of parotid gland neoplasms is mandatory to decide which surgical procedure would be appropriate. Open biopsies are contraindicated because of the risk of recurrence secondary to tumour cell seeding; furthermore a subsequent curative parotid surgery can be complicated by a previous open biopsy. While fine-needle aspiration cytology (FNAC) was the only preoperative diagnostic procedure to distinguish benign versus malignant neoplasms over the past decades, core needle biopsy (CNB) has been increasingly used over the last few years. This created a debate as to whether FNAC or CNB should be the preoperative procedure of choice. The focus of this editorial is to analyse the advantages and disadvantages of FNAC and CNB, and to discuss which procedure is more appropriate in the preoperative work-up of parotid neoplasms.

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Facial nerve dysfunction after superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring: a prospective randomized pilot study

Abstract

Purpose

There are no randomized trials comparing the incidence or severity of facial nerve dysfunction after superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring. This pilot study aimed to assess the variability in outcomes to help determine the needs and possible ethical issues in a full-scale study.

Methods

Prospective randomized pilot study comparing the incidence and grade of facial nerve dysfunction among 106 patients subjected to superficial parotidectomy with or without continuous four channels electromyographic neuromonitoring (52 monitored patients and 54 controls).

Results

The incidences of immediate (38.3% vs. 51.8%, p = 0.1) and late facial dysfunction, up to 180 days following surgery, (3.8% vs. 5.5%, p = 0.4) were similar between monitored patients and controls. Immediate facial nerve dysfunction with a House–Brackmann ≥ grade III was more frequent among the non-monitored patients (57.8% vs. 30%, p = 0.2), and outcomes were significantly poorer in this group (mean sum score of 68.7 vs. 81.5, p = 0.002), when assessed with the regional Sunnybrook scale. A full-scale prospective randomized study to detect a significant reduction in the incidence of immediate facial nerve dysfunction with the use of continuous intraoperative electromyographic neuromonitoring, with 80% power and a 5% significant level, would require 560 patients allocated to the monitored and control groups. Considering a mean rate of 30 patients/year/center, such a study would require the participation of five centers for 4 years.

Conclusions

In the present pilot study, the incidences of immediate and late facial nerve dysfunction were similar between patients with benign parotid tumors subjected to superficial parotidectomy with or without continuous intraoperative electromyographic neuromonitoring. However, immediate facial dysfunction was more severe among the non-monitored patients.

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Outcome of compartment resection of locally advanced oral cancers extending to infratemporal fossa: a tertiary rural hospital experience

Abstract

Locally advanced oral cancers extending to infratemporal fossa (ITF) are a challenge to head and neck surgeons. These tumors are classified as T_4b whenever the masticator space (MS), pterygoid muscles (PM), and pterygoid plates (PP) are involved according to AJCC classification. Until recently, these tumors were considered inoperable and treated only with palliative intent. However, a few studies in the last decade showed that many of these tumors could be resected with a reasonably favorable prognosis by compartment resection of ITF, particularly when the tumor was below sigmoid notch of mandible. A few studies attempted to downstage these tumors by neo-adjuvant chemotherapy before attempting resection. Oral Squamous cell carcinoma has a high prevalence in South India. Majority of these patients are females addicted to tobacco quid chewing and present with locally advanced disease. In this retrospective analysis, we evaluated the outcome of treatment of oral squamous cell carcinoma extending to ITF and staged T_4b in 52 patients. All patients underwent Composite resection including compartment resection of ITF followed by adjuvant treatment. 20 patients had received neo-adjuvant chemotherapy. Pectoralis major myocutaneous flap was the mainstay of reconstruction. After mean follow-up of 2 years, 31 patients are alive and disease free. 14 patients had local recurrence in ITF and 2 patients had recurred in cervical nodes. 8 patients died due to disease and 6 are on palliative care. Neo-adjuvant chemotherapy did not benefit the outcome. Close margins of resection, extra nodal spread from lymph nodes and supra notch and involvement of posterior part of ITF were factors which predisposed to recurrence.

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Prosody perception and production by children with cochlear implants.

In conclusion, increasing time in sound might facilitate vocal emotional expression, possibly requiring independently maturing emotion perception skills. PMID: 30334510 [PubMed - as supplied by publisher] (Source: Journal of Child Language)

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Prosody perception and production by children with cochlear implants.

In conclusion, increasing time in sound might facilitate vocal emotional expression, possibly requiring independently maturing emotion perception skills. PMID: 30334510 [PubMed - as supplied by publisher] (Source: Journal of Child Language)

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A novel treatment of temporomandibular joint arthritis as a complication in familial Mediterranean fever —literature review and a case report

ConclusionsThe adverse effect of TMJ arthritis in FMF patients can be avascular necrosis and destruction of the mandibular condylar head. TMJ arthroscopy allows lysis and lavage of the joint with minimal operative and postoperative complication, resulting with satisfactory results. Thus, in case of TMJ arthritis in FMF, we recommend TMJ arthroscopy as soon as possible, following aggressive physiotherapy in order to gain normal mouth opening.Clinical relevanceFMF rates have been described among the Mediterranean and Middle Eastern population ranging from 1:5 to 1:3; thus, TMJ involvement due to the disease is not so rare in this region, and a clear treatment protocol is needed. (Source: Oral and Maxillofacial Surgery)

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A novel treatment of temporomandibular joint arthritis as a complication in familial Mediterranean fever —literature review and a case report

ConclusionsThe adverse effect of TMJ arthritis in FMF patients can be avascular necrosis and destruction of the mandibular condylar head. TMJ arthroscopy allows lysis and lavage of the joint with minimal operative and postoperative complication, resulting with satisfactory results. Thus, in case of TMJ arthritis in FMF, we recommend TMJ arthroscopy as soon as possible, following aggressive physiotherapy in order to gain normal mouth opening.Clinical relevanceFMF rates have been described among the Mediterranean and Middle Eastern population ranging from 1:5 to 1:3; thus, TMJ involvement due to the disease is not so rare in this region, and a clear treatment protocol is needed. (Source: Oral and Maxillofacial Surgery)

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Dysfunction of immune system in the development of large granular lymphocyte leukemia.

CONCLUSION: A better understanding of the immune dysregulation triggered by LGL leukemia will be beneficial to explore the pathogenesis and potential therapeutic targets for this disease. PMID: 30334691 [PubMed - as supplied by publisher] (Source: Hematology)

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Anaphylactic shock to bacitracin irrigation during breast implant surgery

We report on a case of severe intra-operative anaphylactic shock immediately following irrigation of breast tissue with bacitracin solution. Sequential skin testing with dilutions of bacitracin ointment was used to confirm IgE-mediated drug allergy to bacitracin. (Source: Annals of Allergy, Asthma and Immunology)

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Dysfunction of immune system in the development of large granular lymphocyte leukemia.

CONCLUSION: A better understanding of the immune dysregulation triggered by LGL leukemia will be beneficial to explore the pathogenesis and potential therapeutic targets for this disease. PMID: 30334691 [PubMed - as supplied by publisher] (Source: Hematology)

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Anaphylactic shock to bacitracin irrigation during breast implant surgery

We report on a case of severe intra-operative anaphylactic shock immediately following irrigation of breast tissue with bacitracin solution. Sequential skin testing with dilutions of bacitracin ointment was used to confirm IgE-mediated drug allergy to bacitracin. (Source: Annals of Allergy, Asthma and Immunology)

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General population norms for the EQ-5D-3 L in Norway: comparison of postal and web surveys

The EQ-5D-3 L instrument is a standardized questionnaire which was developed as a simple, generic measure of health for clinical and economic appraisal. To aid in the interpretation, scores are often compared ...

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Content validity of the PROMIS® pediatric family relationships measure for children with chronic illness

Families play a critical role in supporting the health and well-being of children with chronic illnesses, who face a lifetime of responsibility for self-management of their condition. Our goal was to investiga...

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Defining the minimally clinically important difference of the SF-36 physical function subscale for paediatric CFS/ME: triangulation using three different methods

Defining the minimally clinically important difference (MCID) is important for the design and analysis of clinical trials and ensures that findings are clinically meaningful. Studies in adult populations have ...

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Content validity of the PROMIS® pediatric family relationships measure for children with chronic illness

Families play a critical role in supporting the health and well-being of children with chronic illnesses, who face a lifetime of responsibility for self-management of their condition. Our goal was to investiga...

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Defining the minimally clinically important difference of the SF-36 physical function subscale for paediatric CFS/ME: triangulation using three different methods

Defining the minimally clinically important difference (MCID) is important for the design and analysis of clinical trials and ensures that findings are clinically meaningful. Studies in adult populations have ...

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A Case of Crohn's Disease with Mesalazine Allergy that was Difficult to Differentiate from Comorbid Ulcerative Colitis.

Authors: Tsuboi R, Matsumoto S, Miyatani H, Mashima H Abstract An 18-year-old man diagnosed with ileocolonic Crohn's disease with circumferential strictures of the ascending colon started treatment with mesalazine and subsequently underwent right hemicolectomy. After surgery, the patient was started on adalimumab, and the clinical course was favorable. Nine months postoperatively, colonoscopy revealed granular mucosa with circumferential and continuous involvement from the transverse colon down to the rectum, findings which resembled ulcerative colitis. Mesalazine allergy was suspected, and the inflammatory findings resolved after discontinuing mesalazine. In patients of inflammatory bowel disease receiving mesalazine with an atypical clinical course, the possibility of mesalazine ...

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A Case of Crohn's Disease with Mesalazine Allergy that was Difficult to Differentiate from Comorbid Ulcerative Colitis.

Authors: Tsuboi R, Matsumoto S, Miyatani H, Mashima H Abstract An 18-year-old man diagnosed with ileocolonic Crohn's disease with circumferential strictures of the ascending colon started treatment with mesalazine and subsequently underwent right hemicolectomy. After surgery, the patient was started on adalimumab, and the clinical course was favorable. Nine months postoperatively, colonoscopy revealed granular mucosa with circumferential and continuous involvement from the transverse colon down to the rectum, findings which resembled ulcerative colitis. Mesalazine allergy was suspected, and the inflammatory findings resolved after discontinuing mesalazine. In patients of inflammatory bowel disease receiving mesalazine with an atypical clinical course, the possibility of mesalazine ...

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Esthetic and functional result of crooked nose treatment; internal microperforating osteotomy and subtotal septal reconstruction

Abstract

Crooked nose is mostly characterized by a deviation of both the bone and the cartilaginous parts of the nose. In order to obtain proper functional and improved esthetic results, both of these parts have to be corrected. The objective of this study is to evaluate the esthetical and the functional outcomes following correction procedures of the bone pyramid through internal microperforating technique and the cartilaginous part through subtotal septal reconstruction. The medical records of 158 patients who have undergone through primary septorhinoplasty for crooked nose treatment during the period of 21 June 2016 and 31 July 2017 have been reviewed. Functional results have been evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scores and the esthetical results through Rhinoplasty Outcome Evaluation (ROE) scores. The observation times have been arranged preoperatively as 6 months–1 year (group 1) and 1–2 years (group 2). Septorhinoplasty procedure has been performed on 158 patients with crooked noses. Out of this number, 104 of the patients (65.8%) were women and 54 were men (34.2%). The average age of the patients was 31.59 (9.3%), all of who have undergone this procedure. There was a significant improvement (P < 0.001) in the NOSE and the ROE scores of group 1 and group 2, which was statistically significant. There was no difference between group 1 and group 2. In crooked nose treatment, correction of the deviated bone pyramid using internal microperforating osteotomy and correction of the severely deviated septum using subtotal septal reconstruction yield improved functional and esthetic results.

Level of Evidence: Level V, therapeutic study.

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Esthetic and functional result of crooked nose treatment; internal microperforating osteotomy and subtotal septal reconstruction

Abstract

Crooked nose is mostly characterized by a deviation of both the bone and the cartilaginous parts of the nose. In order to obtain proper functional and improved esthetic results, both of these parts have to be corrected. The objective of this study is to evaluate the esthetical and the functional outcomes following correction procedures of the bone pyramid through internal microperforating technique and the cartilaginous part through subtotal septal reconstruction. The medical records of 158 patients who have undergone through primary septorhinoplasty for crooked nose treatment during the period of 21 June 2016 and 31 July 2017 have been reviewed. Functional results have been evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scores and the esthetical results through Rhinoplasty Outcome Evaluation (ROE) scores. The observation times have been arranged preoperatively as 6 months–1 year (group 1) and 1–2 years (group 2). Septorhinoplasty procedure has been performed on 158 patients with crooked noses. Out of this number, 104 of the patients (65.8%) were women and 54 were men (34.2%). The average age of the patients was 31.59 (9.3%), all of who have undergone this procedure. There was a significant improvement (P < 0.001) in the NOSE and the ROE scores of group 1 and group 2, which was statistically significant. There was no difference between group 1 and group 2. In crooked nose treatment, correction of the deviated bone pyramid using internal microperforating osteotomy and correction of the severely deviated septum using subtotal septal reconstruction yield improved functional and esthetic results.

Level of Evidence: Level V, therapeutic study.

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Esthetic and functional result of crooked nose treatment; internal microperforating osteotomy and subtotal septal reconstruction

Abstract

Crooked nose is mostly characterized by a deviation of both the bone and the cartilaginous parts of the nose. In order to obtain proper functional and improved esthetic results, both of these parts have to be corrected. The objective of this study is to evaluate the esthetical and the functional outcomes following correction procedures of the bone pyramid through internal microperforating technique and the cartilaginous part through subtotal septal reconstruction. The medical records of 158 patients who have undergone through primary septorhinoplasty for crooked nose treatment during the period of 21 June 2016 and 31 July 2017 have been reviewed. Functional results have been evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scores and the esthetical results through Rhinoplasty Outcome Evaluation (ROE) scores. The observation times have been arranged preoperatively as 6 months–1 year (group 1) and 1–2 years (group 2). Septorhinoplasty procedure has been performed on 158 patients with crooked noses. Out of this number, 104 of the patients (65.8%) were women and 54 were men (34.2%). The average age of the patients was 31.59 (9.3%), all of who have undergone this procedure. There was a significant improvement (P < 0.001) in the NOSE and the ROE scores of group 1 and group 2, which was statistically significant. There was no difference between group 1 and group 2. In crooked nose treatment, correction of the deviated bone pyramid using internal microperforating osteotomy and correction of the severely deviated septum using subtotal septal reconstruction yield improved functional and esthetic results.

Level of Evidence: Level V, therapeutic study.

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Esthetic and functional result of crooked nose treatment; internal microperforating osteotomy and subtotal septal reconstruction

Abstract

Crooked nose is mostly characterized by a deviation of both the bone and the cartilaginous parts of the nose. In order to obtain proper functional and improved esthetic results, both of these parts have to be corrected. The objective of this study is to evaluate the esthetical and the functional outcomes following correction procedures of the bone pyramid through internal microperforating technique and the cartilaginous part through subtotal septal reconstruction. The medical records of 158 patients who have undergone through primary septorhinoplasty for crooked nose treatment during the period of 21 June 2016 and 31 July 2017 have been reviewed. Functional results have been evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scores and the esthetical results through Rhinoplasty Outcome Evaluation (ROE) scores. The observation times have been arranged preoperatively as 6 months–1 year (group 1) and 1–2 years (group 2). Septorhinoplasty procedure has been performed on 158 patients with crooked noses. Out of this number, 104 of the patients (65.8%) were women and 54 were men (34.2%). The average age of the patients was 31.59 (9.3%), all of who have undergone this procedure. There was a significant improvement (P < 0.001) in the NOSE and the ROE scores of group 1 and group 2, which was statistically significant. There was no difference between group 1 and group 2. In crooked nose treatment, correction of the deviated bone pyramid using internal microperforating osteotomy and correction of the severely deviated septum using subtotal septal reconstruction yield improved functional and esthetic results.

Level of Evidence: Level V, therapeutic study.

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Sensors, Vol. 18, Pages 3554: American Sign Language Recognition Using Leap Motion Controller with Machine Learning Approach

Authors: Teak-Wei Chong Boon-Giin Lee Sign language is intentionally designed to allow deaf and dumb communities to convey messages and to connect with society. Unfortunately, learning and practicing sign language is not common among society; hence, this study developed a sign language recognition prototype using the Leap Motion Controller (LMC). Many existing studies have proposed methods for incomplete sign language recognition, whereas this study aimed for full American Sign Language (ASL) recognition, which consists of 26 letters and 10 digits. Most of the ASL letters are static (no movement), but certain ASL letters are dynamic (they require certain movements). Thus, this study also aimed to extract features from finger and hand motions to differentiate between the static and ...

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Vestibular Neurectomy for Intractable Vertigo: Case Series and Evaluation of Role of Endoscopic Assistance in Retrolabyrinthine Craniotomy

Conclusion RLVNS is a safe and efficacious procedure for the treatment of vertigo; the surgical endoscope may be a useful adjunct in selected cases. Patients with MD may expect the greatest benefit from surgery. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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Sensors, Vol. 18, Pages 3554: American Sign Language Recognition Using Leap Motion Controller with Machine Learning Approach

Authors: Teak-Wei Chong Boon-Giin Lee Sign language is intentionally designed to allow deaf and dumb communities to convey messages and to connect with society. Unfortunately, learning and practicing sign language is not common among society; hence, this study developed a sign language recognition prototype using the Leap Motion Controller (LMC). Many existing studies have proposed methods for incomplete sign language recognition, whereas this study aimed for full American Sign Language (ASL) recognition, which consists of 26 letters and 10 digits. Most of the ASL letters are static (no movement), but certain ASL letters are dynamic (they require certain movements). Thus, this study also aimed to extract features from finger and hand motions to differentiate between the static and ...

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Vestibular Neurectomy for Intractable Vertigo: Case Series and Evaluation of Role of Endoscopic Assistance in Retrolabyrinthine Craniotomy

Conclusion RLVNS is a safe and efficacious procedure for the treatment of vertigo; the surgical endoscope may be a useful adjunct in selected cases. Patients with MD may expect the greatest benefit from surgery. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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THCB Spotlights: Livio AI

Today we are featuring another #TechCrunchDisrupt2018 THCB Spotlight. Matthew Holt interviews LivioAI, which is an AI hearing aid created by Starkey Technologies. Worldwide, there are 700 Million people with hearing loss but only 10% wear a device to help them. That number is appalling especially because there are a number of co-morbid illnesses linked with hearing loss, like cognitive and physical decline. That is where LivioAI comes in to play. LivioAI is completely controlled by your iPhone, tracks all types of movements (it is always counting your steps so the steps you miss when you put down are also accounted for), classifies acoustic environments to measure your social engagement (it can register the difference between a noisy restaurant and a library to figure out how much you are ...

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New Director Named for OSEP

The U.S. Department of Education has named special educator Laurie VanderPloeg as the new director for the Office of Special Education Programs (OSEP). According to the announcement, VanderPloeg has nearly four decades of experience working in special education. She taught middle and high school for 15 years, then moved into administration. VanderPloeg leaves her most recent role as director of special education for the Kent Intermediate School District—an organization operating as an intermediary between local districts and the state—in western Michigan to become the new OSEP director. A school-based SLP continually called on to update team members about changing federal regulations now serves as an official special-education legal expert. What can we do about billions of dollars in ...

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New Director Named for OSEP

The U.S. Department of Education has named special educator Laurie VanderPloeg as the new director for the Office of Special Education Programs (OSEP). According to the announcement, VanderPloeg has nearly four decades of experience working in special education. She taught middle and high school for 15 years, then moved into administration. VanderPloeg leaves her most recent role as director of special education for the Kent Intermediate School District—an organization operating as an intermediary between local districts and the state—in western Michigan to become the new OSEP director. A school-based SLP continually called on to update team members about changing federal regulations now serves as an official special-education legal expert. What can we do about billions of dollars in ...

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New Director Named for OSEP

The U.S. Department of Education has named special educator Laurie VanderPloeg as the new director for the Office of Special Education Programs (OSEP). According to the announcement, VanderPloeg has nearly four decades of experience working in special education. She taught middle and high school for 15 years, then moved into administration. VanderPloeg leaves her most recent role as director of special education for the Kent Intermediate School District—an organization operating as an intermediary between local districts and the state—in western Michigan to become the new OSEP director. A school-based SLP continually called on to update team members about changing federal regulations now serves as an official special-education legal expert. What can we do about billions of dollars in ...

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Ambulante Cochlea-Implantation: was führt zur stationären Aufnahme?

Laryngo-Rhino-Otol 2018; 97: 664-665
DOI: 10.1055/a-0651-3971

Patel TA et al. Clinical Indicators of Admission for Pediatric Cochlear Implant Procedures. Ann Otol Rhinol Laryngol 2018; 127: 470–474 Eine ambulante Cochlea-Implantation bei Kindern gilt als sicher. Allerdings wird eine Minderheit über Nacht stationär aufgenommen. In Studien wird nahezu ausschließlich über postoperative Komplikationen und Behandlungsergebnisse und kaum über prognostische Indikatoren des Outcomes berichtet. Daher suchten amerikanische HNO-Ärzte nach Parametern, die mit der stationären Aufnahme korrelieren und prüften die Auswirkungen auf das klinische Ergebnis.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Larynxpapillomatose

Laryngo-Rhino-Otol 2018; 97: 670-671
DOI: 10.1055/a-0652-6483

Humane Papillomviren verursachen den gutartigen Epitheltumor, der bei Kehlkopfbefall zu Heiserkeit und Atemnot führt. Die Larynxpapillomatose ist nicht heilbar, gegenwärtig ist die phonochirurgische Behandlung das Mittel der Wahl.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Mesenchymale Stammzellen: Tumorfördernde oder -hemmende Eigenschaften – Ein aktueller Überblick

Laryngo-Rhino-Otol 2018; 97: 678-687
DOI: 10.1055/a-0650-4673

Eine multimodale Tumortherapie richtet sich nicht nur gegen die Tumorzellen, sondern beeinflusst auch das tumorumgebende Stroma. Das Tumorstroma beherbergt verschiedene nicht-maligne Zellen, unter anderem Fibroblasten, Immunzellen, aber auch mesenchymalen Stammzellen (MSC). MSC haben die Fähigkeit der Migration in Richtung Tumorgewebe. Welche Einflüsse MSC auf Tumorzellen ausüben wird in der gängigen Literatur kontrovers diskutiert. Die meisten Publikationen berichten von tumorfördernden Eigenschaften der MSC, welche über vier Hauptmechanismen ermöglicht werden: Die Sekretion löslicher Mediatoren verbunden mit Zell-Zell-Kontakten, die Transdifferenzierung der MSC in tumorassoziierte Fibroblasten, die Verbesserung der Neoangiogenese und zuletzt die Einleitung einer Immunsuppression durch MSC. In dieser Übersicht wird über den aktuellen Stand der Literatur referiert.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Mundhöhlenkarzinom: Optionen zum Erhalt der Unterkieferspeicheldrüse

Laryngo-Rhino-Otol 2018; 97: 666-668
DOI: 10.1055/a-0651-4005

Cakir Cetin A et al. Submandibular gland invasion and feasibility of gland-sparing neck dissection in oral cavity carcinoma. J Laryngol Otol 2018; 132: 446–451 Ärzte der medizinischen Fakultät der Universität in Izmir untersuchten Inzidenz und relevante Faktoren die mit der Beteiligung Unterkieferspeicheldrüse am Mundhöhlenkarzinom assoziiert sind. Insbesondere deswegen, um herauszufinden, ob in einem frühen Stadium des Plattenepithelkarzinoms der Mundhöhle die Möglichkeit besteht, die Unterkieferspeicheldrüse zu erhalten.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Anmerkungen zur Minimal-invasiven Otoplastik (MIO)

Laryngo-Rhino-Otol 2018; 97: 672-677
DOI: 10.1055/a-0671-4010

Die minimal-invasive Otoplastik (MIO) ist nach unseren inzwischen sehr umfangreichen Erfahrungen eine zuverlässige Technik zur Korrektur abstehender Ohren. Sie bringt bei richtiger Indikation ästhetisch ansprechende natürliche und dauerhafte Ergebnisse. Die Grenzen der minimalinvasiven Technik müssen allerdings erkannt und berücksichtigt werden. Neue Instrumente erleichtern den Eingriff und verringern Komplikationsraten. V. a. Keloide und große hypertrophe Narben infolge ausgedehnter Hautinzisionen und -resektionen auf der Ohrmuschelrückseite sind mit der MIO fast ausgeschlossen.Wir stellen unser über zwei Jahrzehnte gewachsenes operatives Konzept vor.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Expertise Plastische Chirurgie

Laryngo-Rhino-Otol 2018; 97: 669-669
DOI: 10.1055/a-0674-8368

© Georg Thieme Verlag KG Stuttgart · New York

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Rechtliche Aspekte der Digitalisierung in der Medizin

Laryngo-Rhino-Otol 2018; 97: 713-716
DOI: 10.1055/a-0652-6505

© Georg Thieme Verlag KG Stuttgart · New York

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Diagnostik und operative Therapie der Otosklerose

Laryngo-Rhino-Otol 2018; 97: 717-734
DOI: 10.1055/a-0652-6494

Für die – oft in Diagnostik und Therapie anspruchsvolle – Otosklerose kann bei richtiger Diagnosestellung eine operative oder apparative Hörrehabilitation mit sehr hohen Erfolgschancen in Aussicht gestellt werden. Der erste Teil des Fortbildungsbeitrags umfasste Grundlagen, Diagnostik und Differenzialdiagnostik, im zweiten Teil soll auf therapeutische Aspekte und Nachsorge eingegangen werden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2018; 97: 735-736
DOI: 10.1055/a-0652-6516

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
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Anmerkungen zur Minimal-invasiven Otoplastik (MIO)

Laryngo-Rhino-Otol 2018; 97: 672-677
DOI: 10.1055/a-0671-4010

Die minimal-invasive Otoplastik (MIO) ist nach unseren inzwischen sehr umfangreichen Erfahrungen eine zuverlässige Technik zur Korrektur abstehender Ohren. Sie bringt bei richtiger Indikation ästhetisch ansprechende natürliche und dauerhafte Ergebnisse. Die Grenzen der minimalinvasiven Technik müssen allerdings erkannt und berücksichtigt werden. Neue Instrumente erleichtern den Eingriff und verringern Komplikationsraten. V. a. Keloide und große hypertrophe Narben infolge ausgedehnter Hautinzisionen und -resektionen auf der Ohrmuschelrückseite sind mit der MIO fast ausgeschlossen.Wir stellen unser über zwei Jahrzehnte gewachsenes operatives Konzept vor.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2018; 97: 660-661
DOI: 10.1055/a-0652-6450

© Georg Thieme Verlag KG Stuttgart · New York

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Serratus anterior plane block for minimal invasive heart surgery

Abstract

Background

Minimal invasive heart surgery (MIHS) presents several benefits, but provides intense and prolonged post-operative pain. Our objective was to compare efficacy of serratus anterior plane block (SAPB) with continuous wound infiltration (CWI) for management of post-operative pain following MIHS.

Methods

It's retrospective, monocentric study between November 2016 to April 2017. The study was performed at the University hospital of Dijon, Burgundy, France. All patients scheduled for MIHS was included. Data was collected retrospectively. During this period, 20 patients had SAPB and 26 had CWI. SAPB was performed before extubation with a single injection of 0.5 mg/kg of ropivacaïne (5 mg/ml). In the CWI group, catheter was inserted in the subcutaneous space by the surgeon at the end of the procedure. A 10 ml bolus of ropivacaïne (7.5 mg/mL) was followed by a continuous infusion (2 mg/ml) between 7 and 12 ml/h for 48 h. Morphine consumption and visual analog score (VAS) were recorded for 48 h. Length of stay in intensive care unit and hospital was also collected.

Results

Morphine consumption and VAS score were significantly lower in SAPB group (p < 0.01). Length of stay in intensive care and hospital was significantly was decreased in SAPB group.

Conclusion

SAPB appears effective in reducing postoperative MIHS pain.

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Rechtliche Aspekte der Digitalisierung in der Medizin

Laryngo-Rhino-Otol 2018; 97: 713-716
DOI: 10.1055/a-0652-6505

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2018; 97: 735-736
DOI: 10.1055/a-0652-6516

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

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Lily Pads

Okay, so let 's get this out of the way first. I was wrong. I was very, very wrong.A few years ago, I wrote a blog piece about something I saw online, a photo of a group of speech language professionals seated around a table, communicating with each other using AAC devices. To my reactionary eye, the photo was troubling. It felt like just one more exercise for able-bodied people to "get" what it must be like to have a speech disorder like Schuyler's. It looked bad to me in part because I was seeing it linked on the Facebook page of an AAC company, which felt unseemly to me. Worse to my eyes was the fact that they seemed to be having a lot of fun. My indignation raced out ahead of my brain.I posted a blog entry with my observations about what I perceived to be an ill-conceived stunt...

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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2018; 97: 660-661
DOI: 10.1055/a-0652-6450

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

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Serratus anterior plane block for minimal invasive heart surgery

Abstract

Background

Minimal invasive heart surgery (MIHS) presents several benefits, but provides intense and prolonged post-operative pain. Our objective was to compare efficacy of serratus anterior plane block (SAPB) with continuous wound infiltration (CWI) for management of post-operative pain following MIHS.

Methods

It's retrospective, monocentric study between November 2016 to April 2017. The study was performed at the University hospital of Dijon, Burgundy, France. All patients scheduled for MIHS was included. Data was collected retrospectively. During this period, 20 patients had SAPB and 26 had CWI. SAPB was performed before extubation with a single injection of 0.5 mg/kg of ropivacaïne (5 mg/ml). In the CWI group, catheter was inserted in the subcutaneous space by the surgeon at the end of the procedure. A 10 ml bolus of ropivacaïne (7.5 mg/mL) was followed by a continuous infusion (2 mg/ml) between 7 and 12 ml/h for 48 h. Morphine consumption and visual analog score (VAS) were recorded for 48 h. Length of stay in intensive care unit and hospital was also collected.

Results

Morphine consumption and VAS score were significantly lower in SAPB group (p < 0.01). Length of stay in intensive care and hospital was significantly was decreased in SAPB group.

Conclusion

SAPB appears effective in reducing postoperative MIHS pain.

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The ultrasound-guided selective nerve block in the upper arm: an approach of retaining the motor function in elbow

Abstract

Background

Proximal brachial plexus blocks can lead to an extended period of motor paralysis and delay the return of motor function. This could influence patient satisfaction, and extend hospitalizations. The aim of the study is to compare a selective distal nerve block of the arm to a proximal axillary block, both ultrasound-guided, in terms of their motor block intensity of the elbow. Our hypothesis is that a selective nerve block of the arm would result in a different motor block of the elbow, compared to the axillary block.

Methods

A sample size of 24 patients who were undergoing elective surgery (ASA I-III) of the wrist, hand or forearm was randomly divided into two groups: Arm Group (n = 12) and Axillary Group (n = 12). The Arm Group received ultrasound-guided block of the median, ulnar, and medial antebrachial cutaneous nerves at the level of upper-median 1/3 of the arm, and a block of the radial and musculocutaneous nerves at the level of low-median 1/3 of the arm, while the Axillary Group received ultrasound-guided axillary brachial plexus blocks. Both blocks used in combination with general anesthesia.

Results

Our results demonstrated that the incidence of motor block at the elbow in the Arm Group was lower than in the Axillary Group. Compared with the Axillary Group, the duration of motor block at the elbow and the onset time of sensory block in the Arm Group were shortened. The patient satisfaction was increased in the Arm Group. There were no differences in the duration of the sensory block, the effect on postoperative analgesia, or in the duration of the motor block at the shoulder between both groups.

Conclusion

Our study showed that ultrasound-guided selective nerve block in the upper arm allowed improved retention of motor function at the elbow compared to axillary block. Secondarily, the ultrasound-guided selective nerve block seemed to provide similar analgesia after surgery of the hand or forearm with an enhanced patient satisfaction.

Trial registration

Chinese Clinical Trial Registry, ChiCTR-IOR-16008769. Registered 3 July 2016.

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Lily Pads

Okay, so let 's get this out of the way first. I was wrong. I was very, very wrong.A few years ago, I wrote a blog piece about something I saw online, a photo of a group of speech language professionals seated around a table, communicating with each other using AAC devices. To my reactionary eye, the photo was troubling. It felt like just one more exercise for able-bodied people to "get" what it must be like to have a speech disorder like Schuyler's. It looked bad to me in part because I was seeing it linked on the Facebook page of an AAC company, which felt unseemly to me. Worse to my eyes was the fact that they seemed to be having a lot of fun. My indignation raced out ahead of my brain.I posted a blog entry with my observations about what I perceived to be an ill-conceived stunt...

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Bio-synthesis of Barleria gibsoni leaf extract mediated zinc oxide nanoparticles and their formulation gel for wound therapy in nursing care of infants and children

Publication date: Available online 18 October 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Feng Shao, AiJun Yang, Dong Mei Yu, Juan Wang, Xue Gong, Hong Xiao TianAbstractBio-synthesis of nano-metal oxide particles is gaining lot of significance and recommended as promising substitute not only physical methods but also chemical methods. Here in, we demonstrate the nano-zinc oxide (nano-ZnO) particles were successfully prepared by an eco-friendly process using plant Barleria gibsoni (B. gibsoni) aqueous leaf extract. The water leaf extract of B. gibsoni responsible for not only reducing source but also protective agent. The prepared nano-ZnO particles were studied by UV–Vis diffuse reflectance (UV-DRS), Photoluminescence (PL), Fourier transform (FT-IR) infrar...

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The Impact of Stuttering on Development of Self-Identity, Relationships, and Quality of Life in Women Who Stutter

Conclusions Stuttering has a pervasive impact on all aspects of women's lives and affects how they view themselves, their relationships, their career potential, and their perceptions of how others view them in society. The women interviewed in this study often had negative self-perceptions and felt that their quality of life had been impacted by their stuttering. However, the women's stories and experiences of stuttering were shaped by a broader context of perceived sociocultural expectations of females in society. Strong verbal communication was highlighted as a crucial factor in developing identity and forming relationships. This study highlights the need to be aware of the experiences of, and issues facing, women who stutter for clinicians to be more equipped, focused, and successful in...

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Nurturing a Resilient Mindset in School-Aged Children Who Stutter

Conclusions The role of parents is key in modeling resilient responses to children and creating a resilience-rich environment. As children who stutter may be more vulnerable to adversity, some may benefit from targeted support to build their resilience, in order to enhance their ability to overcome challenges and thrive. (Source: American Journal of Speech-Language Pathology)

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Bio-synthesis of Barleria gibsoni leaf extract mediated zinc oxide nanoparticles and their formulation gel for wound therapy in nursing care of infants and children

Publication date: Available online 18 October 2018Source: Journal of Photochemistry and Photobiology B: BiologyAuthor(s): Feng Shao, AiJun Yang, Dong Mei Yu, Juan Wang, Xue Gong, Hong Xiao TianAbstractBio-synthesis of nano-metal oxide particles is gaining lot of significance and recommended as promising substitute not only physical methods but also chemical methods. Here in, we demonstrate the nano-zinc oxide (nano-ZnO) particles were successfully prepared by an eco-friendly process using plant Barleria gibsoni (B. gibsoni) aqueous leaf extract. The water leaf extract of B. gibsoni responsible for not only reducing source but also protective agent. The prepared nano-ZnO particles were studied by UV–Vis diffuse reflectance (UV-DRS), Photoluminescence (PL), Fourier transform (FT-IR) infrar...

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Introduction to the Special Issue: The 11th Oxford Dysfluency Conference

Purpose The purpose of this introduction is to provide an overview of the articles in this special issue ofAJSLP. These articles originated from the presentations at the 11th Oxford Dysfluency Conference in September 2017. (Source: American Journal of Speech-Language Pathology)

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Improving Polish Stuttering Attitudes: An Experimental Study of Teachers and University Students

Conclusions This experimental study demonstrated that it is possible to positively modify stuttering attitudes of teachers as well as university students. It has implications for the length, content, and experiential components of interventions designed to improve public attitudes toward stuttering. (Source: American Journal of Speech-Language Pathology)

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We Have a Voice: Exploring Participants' Experiences of Stuttering Modification Therapy

Conclusions The qualitative analyses confirmed positive speech and attitude changes consequent on participants' attendance at stuttering modification therapy. These changes, further corroborated by quantitative measures, were linked to reports of improved quality of life. Further research is required to investigate the effectiveness of this form of therapy empirically and from the client's perspective. (Source: American Journal of Speech-Language Pathology)

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Methods in Stuttering Therapy for Desensitizing Parents of Children Who Stutter

Conclusion Desensitization activities can be implemented with parents of CWS to help them recognize and manage their emotional reactions to their child's stuttering, to support parents to feel knowledgeable and confident in managing their child's stuttering, and ultimately to enhance the child's progress in therapy. (Source: American Journal of Speech-Language Pathology)

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Behavior Assessment Battery: Normative and Psychometric Investigation Among Polish Adults Who Do and Do Not Stutter

Conclusions The Polish version of the BAB for adults confirms data collected in previous cross-cultural investigations. The results once again differentiate PWS from PWNS in a powerful way. Compared to PWNS, PWS report significantly more anxiety and speech breakdown when speaking in particular speech situations. They also report their attitude toward speech to be significantly more negative compared to the typical speaker and indicate using a significant number of coping behaviors to avoid or escape difficult speaking conditions. The BAB test battery, in its totality, assists in multidimensional assessment, pre- and posttreatment comparison, and identification of treatment targets based on the answers of PWS to each test item. (Source: American Journal of Speech-Language Pathology)

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Covert Stuttering: Investigation of the Paradigm Shift From Covertly Stuttering to Overtly Stuttering

Conclusion The evidence suggests the various intricacies of the experiences of persons who are covert. Clinical implications of these findings for assessing and treating individuals who covertly stutter are discussed. (Source: American Journal of Speech-Language Pathology)

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The Role of Attention in Therapy for Children and Adolescents Who Stutter: Cognitive Behavioral Therapy and Mindfulness-Based Interventions

Conclusions Although a nascent field, MBIs may be useful as a part of therapy for children and adolescents who stutter. The concepts highlighted by MBIs may also help to resolve some clinical issues. (Source: American Journal of Speech-Language Pathology)

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Palin Parent –Child Interaction Therapy: The Bigger Picture

Conclusions The results demonstrate that, over a year, children who attend a course of Palin Parent –Child Interaction show reduced stuttering frequency and a more positive attitude to speech. In addition, parents observe these improvements in the child, feel more confident in managing the stuttering, and are less worried about it. The different times at which specific variables significantly im proved provides insight to a process of change over time. Results suggest that parents' ability to notice positive change in fluency and the impact that these observations have on both the child and the family are linked to their confidence in how to support the child. The preliminary findings with regard to response to treatment suggest that children can benefit from this program even with facto...

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We Have a Voice: Exploring Participants' Experiences of Stuttering Modification Therapy

Conclusions The qualitative analyses confirmed positive speech and attitude changes consequent on participants' attendance at stuttering modification therapy. These changes, further corroborated by quantitative measures, were linked to reports of improved quality of life. Further research is required to investigate the effectiveness of this form of therapy empirically and from the client's perspective. (Source: American Journal of Speech-Language Pathology)

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The Most Important Therapy Outcomes for School-Aged Children Who Stutter: An Exploratory Study

Conclusions Participants identified a range of outcomes that were important to achieve as a result of speech and language therapy. The findings suggest a need for a more holistic view of what is meant by successful therapy, incorporating improvements in the ability to communicate and participate in daily situations. The findings suggest that an integrated or holistic approach to intervention would be required to achieve these goals and should include significant others from the child's environment. The important statements identified in this study could be used to inform the content of therapy and to evaluate change over time.Supplemental Materialhttps://doi.org/10.23641/asha.7144205 (Source: American Journal of Speech-Language Pathology)

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