Endoscopic third ventriculostomy before surgery of third ventricle and posterior fossa tumours decreases the risk of secondary hydrocephalus and early postoperative complications

xlomafota13 shared this article with you from Inoreader Endoscopic third ventriculostomy before surgery of third ventricle and posterior fossa tumours decreases the risk of secondary hydrocephalus and early postoperative complications Via leak of cerebrospinal fluid Neurosurg Rev. 2021 Jul 22. doi: 10.1007/s10143-021-01570-w. Online ahead of print. ABSTRACT Endoscopic third ventriculostomy (ETV) is an effective treatment for obstructive hydrocephalus (HCP) at the level of third or fourth ventricle. To date, there is no consensus regarding its role as intervention preceding the operation of tumour removal. The aim of this prospective open-label controlled study is to assess if ETV prevents secondary HCP after tumour removal and if ETV influences the early results of tumour surgery. The study was performed on 68 patients operated for tumours of the third ventricle and posterior fossa. In 30 patients, ETV was performed several days before tumour removal, while in 38 patients, the tumour was removed during a one-stage procedure without ETV. Patients who did not receive ETV before the tumour removal procedure had a higher probability of developing postoperative HCP (n = 12, p = 0.03). They also demonstrated a substantially higher rate of early postoperative complications (n = 20, p = 0.002) and a lower Karnofsky score (p = 0.004) than patients in whom ETV was performed before tumour removal. The performance of external ventricular drainage in the non-ETV group did not prevent secondary HCP (p = 0.68). Postoperative cerebellar swelling (p = 0.01), haematoma (p = 0.04), cerebrospinal fluid leak (p = 0.04) and neuroinfection (p = 0.04) were the main risk factors of persistent HCP. Performance of ETV before tumour removal is not only beneficial for control of acute HCP but also prevents the occurrence of secondary postoperative HCP and may also minimize early postoperative complications. PMID:34291350 | DOI:10.1007/s10143-021-01570-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vestibular Physical Therapy and Fall Risk Assessment

xlomafota13 shared this article with you from Inoreader Vestibular Physical Therapy and Fall Risk Assessment Via Otolaryngologic Clinics of North America Vestibular physical therapy (VPT) is a specialized form of evidence-based therapy designed to alleviate primary (vertigo, dizziness, imbalance, gait instability, falls) and secondary (deconditioning, cervical muscle tension, anxiety, poor quality of life, fear of falling/fear avoidance behavior) symptoms related to vestibular disorders. This article provides an overview of VPT, highlighting various exercise modalities used to treat a variety of vestibular disorders. Patient safety and fall prevention are paramount; therefore, fall risk assessment and treatment are also addressed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Dizzy Child

xlomafota13 shared this article with you from Inoreader The Dizzy Child Via Otolaryngologic Clinics of North America Dizziness occurs in children with an estimated prevalence of 0.45% to 15.0%. Vestibular disorders in the pediatric population can impact gross motor function development, visual acuity, and contribute to psychological distress. Appropriate case history and focused direct examination can be helpful when determining the etiology of dizziness. Vestibular testing can be completed in children and guide management of suspected vestibular dysfunction. Vestibular dysfunction is commonly seen in patients with sensorineural hearing loss. Migraine disorders are the most common cause of dizziness in childhood. Etiologies of dizziness in children differ from those commonly seen in adults. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CircRIP2 promotes NSCLC progression by sponging for miR-671-5p to regulate FOXM1 expression

xlomafota13 shared this article with you from Inoreader CircRIP2 promotes NSCLC progression by sponging for miR-671-5p to regulate FOXM1 expression Via Cellular and Molecular Biology Histol Histopathol. 2021 Jul 22:18360. doi: 10.14670/HH-18-360. Online ahead of print. ABSTRACT Lot of attention had been paid to the role of circular RNAs (circRNAs) in carcinogenesis recently. However, knowledge about circRNAs in NSCLC development is far from satisfactory. In this study, we aimed to provide a novel insight into the circRIP2 in NSCLC development. We used NSCLC tissues, as well as cell lines to elucidate the expression and location of circRIP2 in NSCLC. We also established the circRIP2 overexpression cells A549-circRIP2 and repression cells HCC827-shcircRIP2 for further functional and mechanism studies. The pro-tumorigenic role of circRIP2 was tested by using CCK-8, BrdU and transwell assays. The interaction between circRIP2 and miR-671-5p were validated by luciferase reporter assay, RIP assay, as well as RNA pull down assay. We showed circRIP2 is differentially expressed NSCLC, and acted as a predictor for overall sur vival (OS) and disease-free survival (DFS). CircRIP2 promoted NSCLC progression by acting as a miRNA sponge for miR-671-5p, thus facilitating its target gene FOXM1 expression. Targeting circRIP2 could be potentially beneficial for NSCLC patients in the future. PMID:34291441 | DOI:10.14670/HH-18-360 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic Yield of Intrathecal Gadolinium MR Myelography for CSF Leak Localization

xlomafota13 shared this article with you from Inoreader Diagnostic Yield of Intrathecal Gadolinium MR Myelography for CSF Leak Localization Via leak of cerebrospinal fluid Clin Neuroradiol. 2021 Jul 22. doi: 10.1007/s00062-021-01060-y. Online ahead of print. ABSTRACT PURPOSE: Intrathecal gadolinium magnetic resonance (MR) myelography can be used to localize various types of spinal cerebrospinal fluid (CSF) leaks; however, its diagnostic yield is not well known. We sought to determine the diagnostic yield of MR myelography in patients with spontaneous intracranial hypotension. METHODS: A retrospective review was performed on all patients who had undergone intrathecal gadolinium MR myelography at our institution from 2002 to 2020 for suspected spinal CSF leak. The MR myelography images were reviewed for the presence or absence of a spinal CSF leak site. Images were also evaluated for the presence an extradural fluid collection. RESULTS: A total of 97 patients were included in the final cohort. The average age was 52.6 years; 67.0% were female, 4 patients underwent 2 examinations each, yielding a total of 101 MR myelograms. The source of a spinal CSF leak was localized in 14 patients. The diagnostic yield for CSF leak localization on intrathecal gadolinium MR myelography was 14/101 (13.9%) per GdM examination and 14/97 (14.4%) per patient. Among the subset of patients without extradural fluid collections, the yield was 15.7% per examination. All detected leaks were either CSF-venous fistulas or distal nerve root sleeve tears. CONCLUSION: Intrathecal gadolinium MR myelography is capable of localizing CSF-venous fistulas and distal nerve root sleeve tears; however, our data show that it has a limited diagnostic yield. We suggest that other modalities may be a better first step before attempting intrathecal gadolinium MR myelography. PMID:34292360 | DOI:10.1007/s00062-021-01060-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of carbonation of liquids on penetration-aspiration and residue management

xlomafota13 shared this article with you from Inoreader Effects of carbonation of liquids on penetration-aspiration and residue management 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 Jul 22. doi: 10.1007/s00405-021-06987-z. Online ahead of print. ABSTRACT OBJECTIVE: Carbonation as a sensory enhancement strategy for prevention of aspiration of thin liquids has not been thoroughly studied. The aim of our study was to examine the effect of carbonation on penetration-aspiration and pharyngeal residue in dysphagia patients using Fiber-Optic Endoscopic Evaluation of Swallowing (FEES) and to identify parameters associated with a response to carbonation. METHODS: A cross-sectional study of patients undergoing FEES in a dysphagia clinic. Patients were offered 100 cc of dyed water. Penetration-aspiration was scored using the penetration-aspiration scale (PAS). Residue was scored using the Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS). Patients with a PAS ≥ 2 for water were subsequently offered 100 cc of carbonated water. PAS, YPR-SRS and residue clearance were compared betwee n thin and carbonated liquids. Multivariate logistic regression analysis was used to identify predictors for good response to carbonation. RESULTS: 84 patients were enrolled, 77.4% males, with diverse dysphagia etiologies (58.3% neurogenic, 11.9% radiation-induced, 23.8% deconditioning-induced, and 6% neck surgery induced). Median PAS was 7 (IQR 4-8) for thin liquids and 4.5 (IQR 2-8) for carbonated liquids (P = 0.0001). YPR-SRS was reduced for carbonated compared to thin liquids in the vallecula (1.58 ± 0.83 vs 1.76 ± 0.93, P = 0.001) and piriform sinuses (1.5 ± 0.87 vs 1.67 ± 0.9, P = 0.002). 31 patients had improvement in PAS with carbonation. Deconditioning as a dysphagia etiology was found to predict good response to carbonation on multivariate logistic regression analysis. CONCLUSION: Carbonation may prevent aspiration and improve residue management for some patients with dysphagia for liquids. LEVEL OF EVIDENCE: IV. PMID:34292401 | DOI:10.1007/s00405-021-06987-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The integrity and barrier function of porcine vocal fold epithelium: its susceptibility to damage by deoxycholic acid compared with pepsin

xlomafota13 shared this article with you from Inoreader The integrity and barrier function of porcine vocal fold epithelium: its susceptibility to damage by deoxycholic acid compared with pepsin 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 Jul 22. doi: 10.1007/s00405-021-06997-x. Online ahead of print. ABSTRACT PURPOSE: In this study, we aim to systematically evaluate the damaging role of gastric (pepsin and acid) and duodenal ingredients (bile acids) on vocal fold epithelium in excised porcine larynges. METHODS: Fresh ex vivo porcine larynges were exposed to one of five experimental conditions for 1 h. These conditions will be referred to as alkaline deoxycholic acid, acidic pepsin, acid pH3 only, acid pH5 only, and control, respectively. A Franz diffusing cell was used to evaluate the barrier function of vocal fold epithelium by measuring the permeability to fluorescein isothiocyanate dextran of 4 kDa. Histological changes were observed using transmission electron microscopy. RESULTS: After immersing the fresh porcine larynges in the five solution groups, we found that the vocal fold epithelium in the deoxycholic acid group h ad more permeability to FD4 than the pepsin group (P < 0.001). Fragmentation and desquamation of dead cell layers were observed in both the pepsin and deoxycholic acid groups, but were more severe in the deoxycholic acid group than the pepsin group. The thickness of the dead epithelial cell layer gradually increased with increasing acid concentration (P < 0.05). Additionally, the thickness of the dead epithelial cell layer in the deoxycholic acid group was significantly higher than that in the pepsin group (P < 0.01). CONCLUSION: Deoxycholic acid in a weakly acidic condition is more likely than pepsin to induce apoptosis in ex vivo porcine vocal fold epithelium, destroy the link proteins between epithelial cells, and affect their integrity and barrier function. PMID:34292400 | DOI:10.1007/s00405-021-06997-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.