Robotic‐Arm Assisted versus Manual Total Hip Arthroplasty: Systematic Review and Meta‐analysis of Radiographic Accuracy

xlomafota13 shared this article with you from Inoreader Robotic‐Arm Assisted versus Manual Total Hip Arthroplasty: Systematic Review and Meta‐analysis of Radiographic Accuracy Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background We systematically reviewed the radiological outcomes of studies comparing robotic-assisted (RA-THA) and manual total hip arthroplasty (mTHA) . Methods The PubMed, Embase, and Cochrane databases were queried from 1994-2021 for articles comparing radiographic outcomes between RA-THA and mTHA cohorts. A meta-analysis was conducted whenever sufficient data was present for common outcomes. Results Our analysis included 20 articles reporting on 4,140 patients (RA-THA: n=1,228; mTHA: n= 2,912). No differences were demonstrated for acetabular inclination or anteversion. However, RA-THA demonstrated higher rates of cup orientation within the Lewinnek and Callanan safe zones, improved femoral stem alignment, and lower global offset difference (GOD) and limb length discrepancy (all p-values <0.05). Superior femoral canal fill and combined offset were seen among RA-THA patients. Conclusion Our review found that the use of RA-THA yields superior radiographic outcomes compared to mTHA counterparts. This information can inform healthcare systems considering investing in and implementing these technologies. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complications of Robot‐assisted Thymectomy: A Single‐arm Meta‐analysis and Systematic Review

xlomafota13 shared this article with you from Inoreader Complications of Robot‐assisted Thymectomy: A Single‐arm Meta‐analysis and Systematic Review Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Recently, thymectomy using minimally invasive approaches has been increasing with the development of robotic video-assisted thoracoscopic surgery (R-VATS). Although multimodal approach is effective for robot assisted thymectomy, it is necessary to determine the approach (left, right or sub xiphoid) associated with the least complications. Methods An electronic retrieval from PubMed, Embase, Web of Science, GreyNet International, and The Cochrane Library. The single-arm meta-analysis was performed to compare the rate of complications of right and left-side approaches by R-VATS. Results A total of 21 studies including 930 patients were identified. The pooled incidence of total complications was 12.2% (CI: 10.0%−14.8%) for all studies. The overall complication rate was 17.3% for the right side compared with 7.4% for the left side (P<0.001, OR=2.484, 1.601−3.852). The pooled incidence of air leak was significantly higher for the right vs. left side (5.1% vs. 1.2%, respectively; P=0.004). The incidence of atrial fibrillation was higher for the right- compared with the left-side approach (4% vs. 1.2%, respectively; P=0.004). The open conversion rate was significantly higher for the right vs. the left side (6.5% vs. 2.9%, respectively; P=0.004). However, there was no significant difference in the pooled incidence of pleural effusion and thoracic duct fistula when comparing the right- and left-side approaches. In subgroup analysis, In the left approach, The incidence of overall complications (28.6% vs 5.5%, respectively;p=0.002) and pleural effusion(14.3% vs 1%, respectively;p=0.002) was higher for the "Old Age" group compared with the "Youth" group; there was no significant difference in the incidence of complications after thymectomy. Conclusion R-VATS can be performed on the left- and right-sides; However, complications are minimal with the left-side approach. These data demonstrate that the incidence of overall complications, atrial fibrillation, open conversion ratios, and air leak rate of left-side R-VATS thymectomy are lower than those of right-side. Further subgroup analysis showed that the incidence of postoperative complications was higher in the older group. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Comparative Study of Interventions of Middle Turbinate Medialization in Endoscopic Sinus Surgery

xlomafota13 shared this article with you from Inoreader A Comparative Study of Interventions of Middle Turbinate Medialization in Endoscopic Sinus Surgery Via Otolaryngology Indian Abstract The shape and position of middle turbinate play an important role in ventilation and drainage of the osteomeatal complex. The preservation of middle turbinate is one of the major goals of functional endoscopic sinus surgery (FESS). Middle turbinate intervention is essential to prevent obliteration of osteomeatal complex. The aim of this prospective study is to postulate which middle turbinate intervention is most effective and compare the results with conventional technique. In this randomized controlled study, 60 patients were included of the age group of 15–60 years who presented to the Otorhinolaryngology OPD of our institute between November 2017 to June 2019 with symptoms of chronic sinusitis with clinical and radiological evidence and who underwent FESS. The patients were divided into three group, Group A—Bolgerization (n = 20), Group B—Vicryl—conchopexy (n = 20) and Group C—No intervention, Control group (n = 20). The patency of middle meatus and the status of middle turbinate (medialized or lateralized or neither of the two) was ascertained postoperatively. Improvement in symptoms was also evaluated. The middle turbinate was medialized in 90% of Group A and 95% of Group B cases. The middle turbinate was neither medialized nor lateralized in 70% of patients in Group C. 70% of the patients in Group A and 80% of patients in Group B had complete improvement in symptoms with no recurrence of sinusitis compared to Group C in which only 50% of the patients had improvement in symptoms due to development of synechiae. Medialization of the middle turbinate should be considered as one of the essential steps of FESS as it helps in improving the surgical outcome. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

External Auditory Canal Pleomorphic Adenoma: A Rare Case Presentation

xlomafota13 shared this article with you from Inoreader External Auditory Canal Pleomorphic Adenoma: A Rare Case Presentation Via Otolaryngology Indian Abstract Pleomorphic adenoma originating from the external auditory canal is extremely rare, benign tumor. Ceruminal glands are modified sweat glands of the skin, present in the external auditory canal that may give rise to (a) benign tumors such as ceruminous adenoma, pleomorphic adenoma, and syringocystadenoma papilliferum, or (b) malignant tumors such as ceruminous adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma. We report a case where a 25-year-old woman presented with right aural swelling and otalgia since 1 year. A canal-filling aural mass was noted on clinical examination. Computed tomography imaging showed no intracranial extension or any association with the adjacent parotid gland. Subsequent excision biopsy and histologic examination revealed features suggestive of pleomorphic adenoma. Similar to the pleomorphic adenoma of salivary glands, recurrence or malignant degeneration with cellular atypia and metastasis can occur on rare occasions. Care must be taken to distinguish this from adenoid cystic carcinomas, ceruminous adenocarcinomas, and mucoepidermoid carcinomas. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safety of surgical tracheostomy under continued antithrombotic therapy: a retrospective cohort study

xlomafota13 shared this article with you from Inoreader Safety of surgical tracheostomy under continued antithrombotic therapy: a retrospective cohort study Via Clinical Otolaryngology Abstract Objective Although various guidelines have been established for the management of antithrombotic therapy during surgical treatments, surgical tracheostomy (ST) under continued antithrombotic therapy (CAT) remains a challenge. We investigated the risk factors for complications after ST by focusing on CAT use during ST. Method Patients' medical records from 2009 to 2020 were reviewed in this retrospective study. We selected patients who underwent ST at the Department of Otolaryngology of our hospital. Patient demographics, complications, and blood test values were recorded and statistically analyzed to identify the risk factors for postoperative complications. Results We identified 288 patients (median age: 64 years; 184 men [64%]), among whom 40 (median age: 67 years; 29 men [73%]) underwent CAT. Although the patients undergoing CAT had significantly higher values of activated partial thromboplastin time (p = 0.002) and prothrombin time-international normalized ratio (p = 0.006) than those of antithrombotic naïve patients, no statistically significant intergroup differences were observed in the risks of bleeding, infection, or subcutaneous emphysema. Instead, ST under local anesthesia (p = 0.01) and ST for airway emergency (p = 0.02) significantly increased the risk of early postoperative complications. Conclusion The results of the present study suggest that ST under CAT can be safely performed without any increased risk of postoperative complications. Nevertheless, surgeons should be extra cautious about early complications after ST under local anesthesia without intubation or ST for airway emergency. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stratum corneum lipidomics analysis reveals altered ceramide profile in atopic dermatitis patients across body sites with correlated changes in skin microbiome

xlomafota13 shared this article with you from Inoreader Stratum corneum lipidomics analysis reveals altered ceramide profile in atopic dermatitis patients across body sites with correlated changes in skin microbiome Via Experimental Dermatology Abstract Background Atopic dermatitis (AD) is driven by the interplay between a dysfunctional epidermal barrier and a skewed cutaneous immune dysregulation. As part of the complex skin barrier dysfunction, abnormalities in lipid organization and microbiome composition have been described. We set out to systematically investigate the composition of the stratum corneum lipidome, skin microbiome and skin physiology parameters at three different body sites in patients with AD and healthy volunteers. Methods We analysed tape strips from different body areas obtained from 10 adults with AD and 10 healthy volunteers matched for FLG mutation status for 361 skin lipid species using the Metabolon mass spectrometry platform. 16S rRNA data were available from all probands. Results Our study showed that the lipid composition differs significantly between body sites and between AD patients and healthy individuals. Ceramide species NS was significantly higher in AD patients compared to healthy volunteers and was also higher in AD patients with a FLG mutation compared to AD patients without a FLG mutation. The correlation analysis of skin lipid alterations with the microbiome showed that Staphylococcus colonization in AD is positively correlated with ceramide subspecies AS, ADS, NS and NDS. Conclusion This is the first study to reveal site-specific lipid alterations and correlations with the skin microbiome in AD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characterization of the microbiome in the infant diapered area: Insights from healthy and damaged skin

xlomafota13 shared this article with you from Inoreader Characterization of the microbiome in the infant diapered area: Insights from healthy and damaged skin Via Experimental Dermatology Abstract It has been recognized for nearly a century that human beings are inhabited by a remarkably dense and diverse microbial ecosystem, yet we are only just beginning to understand and appreciate the many roles that these microbes play in human health and development. Establishment of the microbiome begins at birth, but many previous studies on infant skin health have focused on Candida species. Little is known on the full microbial composition across different areas and even less is known on how these communities change during disease/inflammatory states. In this clinical study, infants were recruited during periods of diaper dermatitis (DD) and health to characterize the skin microbiome in these two states. Substantial shifts in the skin microbiome were observed across four sites in the diapered area (genitals, intertriginous, buttocks and perianal), as well as during periods of DD. As DD scores increased, there was a shift in relative abundance that demonstrated higher community per centages of faecal coliforms, such as Enterococcus, and lower percentages of Staphylococcus strains. In high-rash samples, the predominant Staphylococcus species is S aureus, potentially implicating S aureus as a DD aetiological agent. This study provides new information related to the microbiome on infant skin in the diapered area and provides insights into the role of the microbiome in the development of DD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of the skin microbiota in acne and rosacea

xlomafota13 shared this article with you from Inoreader Comparison of the skin microbiota in acne and rosacea Via Experimental Dermatology Abstract Acne and rosacea, despite their similar clinical presentations, follow distinct clinical courses, suggesting that fundamental differences exist in their pathophysiology. We performed a case-control study profiling the skin microbiota in rosacea and acne patients compared to matched controls. Nineteen rosacea and eight acne patients were matched to controls by age ± 5 years, sex and race. DNA was extracted from facial skin swabs. The V3V4 region of the bacterial 16S rRNA gene was sequenced using Illumina MiSeq and analysed using QIIME/Metastats 2.0 software. The mean relative abundance of Cutibacterium acnes in rosacea with inflammatory papules and pustules (20.454% ±16.943%) was more similar to that of acne (19.055% ±15.469%) than that of rosacea without inflammatory papules and pustules (30.419% ±21.862%). C acnes (P = .048) and Serratia marcescens (P = .038) were significantly enriched in individuals with rosacea compared to acne. Investigating the differences between the skin microbiota in acne and rosacea can provide important clues towards understanding the disease progression in each condition. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Retrospective analysis of adjuvant therapy using dabrafenib plus trametinib in Japanese patients with advanced melanoma: analysis of 36 cases

xlomafota13 shared this article with you from Inoreader Retrospective analysis of adjuvant therapy using dabrafenib plus trametinib in Japanese patients with advanced melanoma: analysis of 36 cases Via Melanoma Research - Published Ahead-of-Print Patients with resected stage IIIB, IIIC and IIID melanomas have a high risk of recurrence. Therefore, an appropriate protocol for stage III melanoma is needed. Since adjuvant dabrafenib plus trametinib (D+T) combined therapy and anti-PD1 antibody (Ab) therapy reduce the risk of recurrence in patients with resected st age III BRAF-mutated melanoma, selecting the adjuvant therapy for BRAF-mutated melanoma is controversial. The efficacy and safety profiles of D+T combined therapy in the adjuvant setting were retrospectively analyzed in 36 Japanese. BRAF-mutated advanced melanoma patients. The relapse-free rate (RFR) at 12 months was 82.1% (95% confidential interval (CI), 63.9–92.6%). In the 21 patients who completed the protocol, the RFR at 12 months was 85.7% (95% CI, 64.5–95.9%). In the seven patients whose protocol was interrupted by adverse events, the RFR was 71.4% (95% CI, 35.2–92.4%). The incidence rate of any AEs for all patients was 69.7% (95% CI, 52.5–82.8%), including 13 cases of pyrexia, five cases of skin rash and four cases of liver dysfunction. The present study suggested that D+T therapy in the adjuvant setting is a useful and very tolerable protocol for BRAF-mutated melanoma in the Japanese population. Received 8 June 2021 Accepted 14 July 2021 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Correspondence to Taku Fujimura, MD, PhD, Department of Dermatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan, Tel: +81 22 717 7271; fax: +81 22 717 7361; e-mail: tfujimura1@mac.com Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lower melanoma pulmonary metastatic burden in obese mice: role of FGF-21

xlomafota13 shared this article with you from Inoreader Lower melanoma pulmonary metastatic burden in obese mice: role of FGF-21 Via Melanoma Research - Published Ahead-of-Print Obesity is a risk factor for malignant melanoma. The lungs are main target organs for metastization and their immune response is a key modulator of this mechanism. The concept that the metastatic potential of some types of cancer is reduced or inhibited by obesity, known as the obesity paradox, drives major concerns on the prognosis of metastasized patients. The aim of this study was to investigate how high-fat diet (HFD)-induced obesity affects melanoma metastization. C57Bl6/J mice were fed with HFD or standard diet for 180 days and inoculated intravenously with B16F10 melanoma cells. Upon 21 days of inoculation, lung tissue of overweight and lean mice was assessed for histology and immunohistochemistry assays. Adipokine antibody arrays were performed in mice serum. In vitro RAW 264.7 macrophage cultures were established and incubated with FGF-21 and/or lipopolysaccharide (LPS). Conditioned media was added to B16F10 cells for viability quantification. HFD-fed mice presented a reduced number of metastases with lower proliferative rates. The high content of inflammatory foci observed in noninoculated obese mice was significantly decreased upon B16F10 inoculation, concurrent with a slight fibrosis reduction. Plasma levels of fibroblast growth factor-21 (FGF-21), an endocrine regulator, were elevated in noninoculated HFD mice and the expression of FGF receptor 1 (FGFR-1) was significantly upregulated after inoculation. FGF-21 reduced melanoma viability in LPS-stimulated macrophages. Altogether, these findings suggest that higher amounts of FGF-21 are able to counterbalance the proinflammatory effects associated with obesity, protecting the lungs from melanoma metastization. Received 17 December 2020 Accepted 17 August 2021 Correspondence to Pedro Coelho, PhD, Chemical Sciences and Biomolecules, School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400 4200 - 072 Porto, Portugal, Tel: +351 222 061 000; e-mail: pvc@ess.ipp.pt Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Glycerol Administration on ECochG and VEMP Findings in Individual with Meniere's Disease

xlomafota13 shared this article with you from Inoreader Effect of Glycerol Administration on ECochG and VEMP Findings in Individual with Meniere's Disease Via Otolaryngology Indian Abstract The present study aimed to find the effect of glycerol administration on Electrocochleography (ECochG), cervical and ocular Vestibular Evoked Myogenic Potential (c-VEMP, o-VEMP) findings in individual with Meniere's disease. Sixteen participants (32 ears) diagnosed with Meniere's disease underwent ECochG, c-VEMP and o-VEMP for both pre and 1 h post-glycerol administration. Paired t-test indicated that the SP/AP ratio of ECochG measures was significantly improved with post-glycerol administration. There was no significant difference in the mean amplitude of o-VEMP and c-VEMP between pre and post-glycerol administration. However, while individual differences were compared, 75% of the participants reported either improvement in c-VEMP amplitude or newly emerging c-VEMP& o-VEMP. Based on the recommendation by Adams et al. (Otolaryngol Clin North Am 43(5):995–1009, 2010), the improvement on these tests results with post glycerol administration were cons idered as a significant indicator for the presence of Meniere's disease.With post glycerol administration, the present study found that 84%of participants were found to have an improvement in the amplitude for ECochG measures. There was an improvement in the amplitude measures of o-VEMP and c-VEMP, which were observed in 75% and 68%of participants respectively with post-glycerol administration. Improvement in the amplitude of test measures with post-glycerol administration were observed to be more for cochlear potentials of ECochG followed by vestibular potentials of c-VEMP and o-VEMP. Thus, improvement of ECochG amplitude with post-glycerol administration might serve as an additional indicator for the presence of Meniere's disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Efficacy of Septal Quilting Sutures Versus Nasal Packing in Septoplasty

xlomafota13 shared this article with you from Inoreader The Efficacy of Septal Quilting Sutures Versus Nasal Packing in Septoplasty Via Otolaryngology Indian Abstract Nasal packing is the classic method adopted by many otolaryngologists to stabilize the nasal septum and decrease the occurrence of postoperative bleeding and septal hematoma after septoplasty. However, because of its associated postoperative morbidity, many surgeons started to adopt alternative methods. This study aimed to assess the outcome and benefits of septal quilting sutures in comparison to nasal packing after septoplasty. A prospective non-randomized comparative interventional study was carried out at two teaching hospitals in Mosul city from January 2020 to January 2021. A total of 60 patients who were candidates for septoplasty, were included in the study. According to the surgeon's preference; 30 patients had placement of septal quilting sutures (group A), and in the other 30 patients nasal packing was performed (group B). Patients were assessed for postoperative morbidity and early outcome in the first 24 h, 1 week and 1 month postopera tively. In the first 24 h after septoplasty, patients in group B had significantly higher levels of nasal/facial pain, headache, sleep disturbance, breathing difficulties and swallowing difficulties compared to group A (p < 0.001). Over the follow up period of 1 month, no significant differences were recorded regarding postoperative bleeding, hematoma, infection, adhesions formation and septal perforation between the two groups (p > 0.05). Septal quilting sutures technique is more favorable in the early period in terms of patient discomfort after septoplasty, better nasal block and nasal/facial pain, the absence of misery on pack removal, with minimal bleeding after surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.