Migration of Ventriculoperitoneal Shunt to Uterus In A Child: A Case Report

xlomafota13 shared this article with you from Inoreader Migration of Ventriculoperitoneal Shunt to Uterus In A Child: A Case Report Via leak of cerebrospinal fluid J Pediatr Adolesc Gynecol. 2021 Nov 26:S1083-3188(21)00343-0. doi: 10.1016/j.jpag.2021.11.004. Online ahead of print. ABSTRACT BACKGROUND: Ventriculo-peritoneal shunt (VPS) is usually placed inside the peritoneal cavity for cerebrospinal fluid drainage. Rarely, it can migrate to various pelvic visceral organs. Inside the pelvis, the distal end of the shunt can perforate anywhere from the uterus or adnexa to the vulva and migration through the uterus is extremely rare. CASE: A three-and-a-half-year-old girl presented with CSF leak through the vagina following uterine perforation by VPS. The diagnosis was made with an ultrasound. Her symptoms resolved following revision surgery. CONCLUSION: In a patient with a VPS in situ, presenting with a watery fluid leak through vagina, perforation of fornix or uterus must always be kept in mind. Timely diagnosis and intervention can result in the prevention of complications. PMID:34843976 | DOI:10.1016/j.jpag.2021.11.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comprehensive gene cluster analysis of head and neck squamous cell carcinoma TCGA RNA‐seq data defines B cell immunity‐related genes as a robust survival predictor

xlomafota13 shared this article with you from Inoreader Comprehensive gene cluster analysis of head and neck squamous cell carcinoma TCGA RNA‐seq data defines B cell immunity‐related genes as a robust survival predictor Via Head & Neck Abstract Background The authors aimed to define novel gene expression signatures that are associated with patients' survival with head and neck squamous cell carcinoma (HNSCC). Methods TCGA RNA-seq data were used for gene expression clusters extraction from 499 tumor samples by the "EPIG" method. Tumor samples were then partitioned into lower and higher than median level groups for survival relevant analysis by Kaplan–Meier estimator. Results We found that two gene clusters (_1, _2) are favorably, while two (_3, _4) are unfavorably, associated with patients' survival with HNSCC. Notably, most genes on the top lists of cluster_2 are associated with B cells. A gene expression signature with combined genes from cluster_2 and _4 was further determined to be associated with HNSCC survival rate. Conclusion Our work strongly supported a favorable role of B cells in patients' survival with HNSCC and identified a novel coexpressed gene signature as prognostic biomarker for patients' survival with HNSCC estimation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Geographic disparities in head and neck cancer survival

xlomafota13 shared this article with you from Inoreader Geographic disparities in head and neck cancer survival in Upstate New York 2011–2019 Via Head & Neck Abstract Purpose To examine the association between distance to care-center and urban–rural residence on 5-year overall survival (OS) from head and neck cancer (HNC). Materials and methods Five-year OS was retrospectively measured from date of initial diagnosis for patients with HNC treated at a single tertiary care center. Distances were calculated based on ZIP code of patient's residence and care center. Multilevel Weibull regression was used to adjust for confounders and identify disparities in 5-year all-cause mortality. Results A total of 670 patients included in study. Multivariable analysis revealed older age or late-stage cancer at diagnosis, and HPV negative status were associated with poorer OS. Patients residing in isolated small rural town (HR = 2.20, p = 0.015) or small rural town (HR = 2.07, p = 0.015) had lower OS. Distance to care center was not associated with OS (HR = 0.996, p = 0.11). Conclusions Greater rurality was associated with poorer OS among HNC patients in Upstate New York. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quercetin regulates inflammation, oxidative stress, apoptosis, and mitochondrial structure and function in H9C2 cells by promoting PVT1 expression

xlomafota13 shared this article with you from Inoreader Quercetin regulates inflammation, oxidative stress, apoptosis, and mitochondrial structure and function in H9C2 cells by promoting PVT1 expression Via histochem Acta Histochem. 2021 Nov 26;123(8):151819. doi: 10.1016/j.acthis.2021.151819. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the effect and potential mechanism of quercetin on inflammation, oxidative stress, apoptosis, and mitochondrial structure and function in H9C2 cells. MATERIALS AND METHODS: H9C2 cells were obtained from the Shanghai Institutes for Biological Sciences, Chinese Academy of Science, and randomly divided into six groups: control, model, PVT 1 overexpression (OV), quercetin, OV + quercetin, and NAC groups. The CCK-8 assay was performed to examine cell proliferation. Flow cytometry was used to examine cell apoptosis, cell membrane potential, and ROS levels. The expression of endothelial nitric oxide synthase (eNOS), malondialdehyde (MDA), and superoxide dismutase (SOD) was measured by ELISA and a Biochemical kit. Western blotting was used to determine the levels of p-DRP1 (s637), MFN2, NF-kB, p-NF-kB, IkB, and p-IkB. IL-6, IL-10, TNF-α, and IL-1β mRNA expression was examined by RT-PCR. Electron microscopy was used to observe the structure of mitochondria in H9C2 cells. RESULTS: MDA, p-NF-κB, p-IKB, IL-6, IL-1β, and TNF-α expression levels, and the cell apoptosis rate were significantly higher in the model group than in the control group (P < 0.05). In contrast, the cell proliferation rate and IL-10, SOD, eNOS, and ATP levels were significantly lower in the model group (P < 0.05). Moreover, MDA expression was significantly lower in the OV, quercetin, quercetin + OV, and NAC groups than in the model group (P < 0.05), while SOD, eNOS, and ATP levels were higher. The electron microscopy results showed that PVT1 overexpression or quercetin treatment could inhibit inflammation-induced mitochondrial fission and promote mitochondrial fusion. CONCLUSION: Quercetin promotes the proliferation of H9C2 cells, while inhibiting inflammation, oxidative stress, and cell apoptosis, and alleviating the structural and functional dysfunction of mitochondria. These effects are achieved by promoting PVT1 expression. PMID:34844154 | DOI:10.1016/j.acthis.2021.151819 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Heads up reconstructive microsurgery: Utilisation of the three-dimensional microscope in microvascular procedures

xlomafota13 shared this article with you from Inoreader Heads up reconstructive microsurgery: Utilisation of the three-dimensional microscope in microvascular procedures Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 15:S1748-6815(21)00575-1. doi: 10.1016/j.bjps.2021.11.036. Online ahead of print. ABSTRACT BACKGROUND: Since the earliest use of microscopes in surgery, several modifications have been made to improve the ergonomics of movement and posture, increase the resolution, and expand the visual field. The three-dimensional microscopes are latest innovation in this field. Despite the wider use of 3D microscopes in other specialities, their use in the reconstructive microsurgery in the United Kingdom is still limited. Reconstructive microsurgeons are highly skilled surgeons that are trained to operate utilising the microscope for long hours. This poses an occupational risk with a specific pattern of work-related conditions. AIMS AND METHODS: We aim in this report to demonstrate our experience utilising 3D microscopes in small cohort of patients matched to a control of patients operated utilising the traditional microscopes. Patients were matched by age, comorbidities, oncologic procedures. This was complemented by a survey completed by the operating surgeons. RESULTS: Nine patients were included in each group. There was no significant difference in operative or ischemia time and no significant post-operative complications in both groups. The surgeons reported better ergonomics, improved staff engagement, and a better teaching experience when utilising the 3D microscopes compared to traditional microscopes. CONCLUSION: The utilisation of the 3D microscopes in reconstructive microsurgery has shown to provide comfort, improve ergonomics of movement and posture without significant clinical implications in this series. PMID:34844881 | DOI:10.1016/j.bjps.2021.11.036 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of respiratory epithelial adenomatoid hamartomas (REAH) associated with nasal polyposis: an epidemiological study - how to diagnose

xlomafota13 shared this article with you from Inoreader Prevalence of respiratory epithelial adenomatoid hamartomas (REAH) associated with nasal polyposis: an epidemiological study - how to diagnose Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Nov 10:S1808-8694(21)00183-X. doi: 10.1016/j.bjorl.2021.09.009. Online ahead of print. ABSTRACT OBJECTIVES: To highlight the prevalence of respiratory epithelial adenomatoid hamartomas in the olfactory cleft of patients with nasal polyposis. To demonstrate characteristics indicative of hamartoma on the CT scans of paranasal sinuses during surgery and in histopathological exams. METHOD: Cross-sectional study carried out in Hospital das Clínicas da UFMG and Núcleo de Otorrino BH. We performed 114 nasal endoscopic surgeries for polyposis, between February 2015 and November 2019. We assessed the olfactory cleft width in all preoperative CT scans. Upon seeing an indication of hamartoma on the CT scan, we took a tissue sample from the olfactory cleft during the surgery and sent for histopathological exam. We referred the samples to a pathologist experienced in the anatomopathological diagnosis of respira tory epithelial adenomatoid hamartomas. RESULTS: Of the 114 patients with polyposis, 54 (47.4%) had olfactory cleft enlargement and, 100% of them had tissue with a dense and hardened polypoid aspect, with a slight cerebriform appearance in this region during the surgery. Histology confirmed a respiratory epithelial adenomatoid hamartoma. CONCLUSION: This observation suggests that the presence of hamartomas in polyposis is common, but underdiagnosed. LEVEL OF EVIDENCE: Step 3 (Level 3). PMID:34844870 | DOI:10.1016/j.bjorl.2021.09.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proximal tibial dimensions in a formalin-fixed neonatal cadaver sample: an intraosseous infusion approach

xlomafota13 shared this article with you from Inoreader Proximal tibial dimensions in a formalin-fixed neonatal cadaver sample: an intraosseous infusion approach Via radiol anat Surg Radiol Anat. 2021 Nov 29. doi: 10.1007/s00276-021-02843-1. Online ahead of print. ABSTRACT PURPOSE: Methods to administer intramedullary medication and fluid infusion in both adults and children date to the early twentieth century. Studies have shown that intraosseous access in the proximal tibia is ideal for resuscitation efforts as fewer critical structures are at risk, and neither is the blood flow to the lower limbs compromised. Insertion of a needle in children you nger than 5 years does have the risk to damage to the epiphyseal growth plate. Therefore, the aim of this study was to determine the ideal intraosseous insertion site distal to the epiphyseal growth plate in neonates. METHODS: The samples consisted of both the left and right sides of 15 formalin-fixed neonatal cadavers. The dimensions were measured on the superior surfaces of each section, anteromedial border, cortical thickness, and medullary space. RESULTS: The most desirable location to gain vascular access is at 10 mm inferior to the tibial tuberosity. CONCLUSION: The smallest cortical thickness (1.32 mm), the largest medullary space (4.50 mm), and the largest anteromedial surface (7.72 mm) were observed at 10 mm inferior to the tibial tuberosity. It is imperative that health care professionals are familiar with the osteological sites that could be safely used for an intraosseous infusion procedure. PMID:34845509 | DOI:10.1007/s00276-021-02843-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effects of cigarette smoking and nicotine on the therapeutic potential of mesenchymal stem cells

xlomafota13 shared this article with you from Inoreader The effects of cigarette smoking and nicotine on the therapeutic potential of mesenchymal stem cells Via Cellular and Molecular Biology Histol Histopathol. 2021 Nov 30:18400. doi: 10.14670/HH-18-400. Online ahead of print. ABSTRACT Due to their immunoregulatory properties and capacity for multi-lineage differentiation, mesenchymal stem cells (MSCs) have been used as new therapeutic agents in regenerative medicine. Numerous lifestyle habits and behavioral risk factors may modulate metabolic and cell growth signaling pathways in MSCs, affecting their phenotype and function. Accordingly, identification of these factors and minimization of their influence on viability and function of transplanted MSCs may greatly contribute to their better therapeutic efficacy. A large number of experimental and clinical studies have demonstrated the detrimental effects of cigarette smoke and nicotine on proliferation, homing, chondrogenic and osteogenic differentiation of MSCs. Cigarette smoke down-regulates expression of chemokine receptors and modulates activity of anti-oxidative enzyme s in MSCs, while nicotine impairs synthesis of transcriptional factors that regulate the cell cycle, metabolism, migration, chondrogenesis and osteogenesis. In this review article, we summarize current knowledge about molecular mechanisms that are responsible for cigarette smoke and nicotine-dependent modulation of MSCs' therapeutic potential. PMID:34845711 | DOI:10.14670/HH-18-400 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multidimensional assessment of voice quality after injection augmentation of the vocal fold with autologous adipose tissue or calcium hydroxylapatite

xlomafota13 shared this article with you from Inoreader Multidimensional assessment of voice quality after injection augmentation of the vocal fold with autologous adipose tissue or calcium hydroxylapatite Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Nov 30. doi: 10.1007/s00405-021-07193-7. Online ahead of print. ABSTRACT PURPOSE: The purpose of this study was to evaluate short- and long-term outcome of injection augmentation with autologous adipose tissue (AAT) and calcium hydroxylapatite injection (CAHA) in patients with a unilateral vocal fold paralysis (UVFP). DESIGN/METHODS: A retrospective cohort study was performed in patients diagnosed with UVFP, who had received injection augmentation with AAT or CAHA. Multidimensional voice analysis was performed before, 3 and 12 months after injection. This analysis included patient self-assessment (Voice Handicap Index-30), perceptual (overall dysphonia grade according to the GRBAS scale), aerodynamic (MPT, s/z ratio) and acoustic (fundamental frequency, dynamic range) parameters. Effects were assessed using a linear mixed model analysis. RESULTS: Forty-six patients were available for evaluati on, with a total of 53 injection augmentations (AAT n = 39; CAHA n = 14). We found significant improvement of patient self-assessment and perceptive voice outcome at 3 months, which were maintained at 12 months. In the CAHA group, s/z ratio and dynamic range of extreme frequencies also improved significantly over time. No statistically significant differences were found between the two treatments (AAT vs. CAHA). No major complications were reported. CONCLUSION: This study, using a guide-line recommended panel of outcome parameters, shows a high success rate of injection augmentation with AAT or CAHA for patients with UVFP at 12 months with significant improvement in most voice outcome parameters, although voices do not completely normalize. There is no significant difference in outcome between the two materials. PMID:34846572 | DOI:10.1007/s00405-021-07193-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association Between Insurance Type and Outcomes of Reconstructive Head and Neck Cancer Surgery

xlomafota13 shared this article with you from Inoreader Association Between Insurance Type and Outcomes of Reconstructive Head and Neck Cancer Surgery Via The Laryngoscope Objectives/Hypothesis Although the benefits of expanding health insurance coverage are clear, there are limited studies comparing the different types of insurance. This study aims to determine the association between insurance type and outcomes in patients with head and neck cancer undergoing reconstructive surgery in the United States. Methods Population-based cross-sectional study of the 2012–2014 National Inpatient Sample. We identified 1,314 patients with head and neck cancers undergoing tumor ablative surgery followed by pedicled or free flap reconstruction of oncologic defects. Insurance type was classified as private, Medicare, Medicaid, self-pay, or other. The primary outcome was extended length of stay (LOS), defined as greater than 14 days, which represented the 75th percentile of the study sample. Secondary outcomes included acute medical complications, surgical complications, morbidities, and costs. Analyses were adjusted for gender, geographic location, and various medical comorbidities. Results In univariate analysis, insurance type was associated with extended LOS (P = .001), medical complications (P = <.001), and mortalities (P = .020). After controlling for other covariates in the multivariate analysis, compared to private insurance, Medicare and Medicaid were both associated with significantly higher odds of extended LOS (adjusted odds ratio [OR] [95% confidence interval (CI)] = 1.73 [1.09–2.76] and 2.22 [1.38–3.58], respectively). Medicare was associated with significantly higher odds of medical complications, but Medicaid was not (adjusted OR [95% CI] = 1.53 [1.02–2.31] and 1.64 [0.97–2.78], respectively). Conclusions Medicaid and Medicare were independently associated with extended LOS after reconstructive head and neck cancer surgery. Medicare was associated with higher rates of medical complications. Efforts to address LOS should target care planning and coordination. Level of Evidence NA Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role of fat grafting on contracted breast implant capsules: A retrospective comparative histological and immunohistochemical study

xlomafota13 shared this article with you from Inoreader The role of fat grafting on contracted breast implant capsules: A retrospective comparative histological and immunohistochemical study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 19:S1748-6815(21)00472-1. doi: 10.1016/j.bjps.2021.09.035. Online ahead of print. ABSTRACT Capsular contracture, a common complication of breast implant reconstruction following postmastectomy radiotherapy (PMRT), represents a challenge for plastic surgeons. Regenerative surgery with multiple autologous fat grafts (lipobed) before replacing the implant has been proven to be a satisfactory approach in the radio-damaged breast. Currently, in literature, there are no data available on the histological features of irradiated capsules after regenerative surgery. We enrolled 80 patients after immediate subpectoral alloplastic breast reconstruction, with indication for revision surgery due to grade IV capsular contracture developed after PMRT. Forty patients were undergoing multiple fat grafting (lipobed group, mean age 48) and 40 patients were not undergoing multiple fat grafting (non-regenerative surg ery (NRS) group, mean age 49). The removed capsules were addressed to histological and immunohistochemical assessment. The capsules of the lipobed group patients compared with NRS group patients showed: a lower mean thickness (602.17 versus 670.43 µm; P = 0.013), a lower collagen fiber alignment (median value of angle deviation: 30.34 versus 18.38; P = 0.001), a lower immunohistochemical positivity for myofibroblasts (α-smooth muscle actin [α-SMA] expression: 12.5% versus 52.5%; P = 0.00), a higher immunohistochemical positivity for estrogen receptor-β (ER-β; 80% versus 20%; P = 0.00), and a lower immunohistochemical positivity for estrogen receptor-α (ER-α; 53.3% versus 16.7%; P = 0.00). The histological and immunohistochemical differences found are possibly due to alterations in the extracellular microenvironment determined by grafted fat. PMID:34838502 | DOI:10.1016/j.bjps.2021.09.035 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.