Severe malnutrition after single anastomosis sleeve jejunal bypass (SASJ) surgery due to a rare surgical complication: Report of the case

xlomafota13 shared this article with you from Inoreader Severe malnutrition after single anastomosis sleeve jejunal bypass (SASJ) surgery due to a rare surgical complication: Report of the case Via swallowing exercises Int J Surg Case Rep. 2022 Feb 12;92:106824. doi: 10.1016/j.ijscr.2022.106824. Online ahead of print. ABSTRACT INTRODUCTION: Bariatric procedures rates are increased due to the epidemic in obesity. Up to 50% of patients operated with vertical banded gastroplasty (VBG) procedures experience failure or complications in the mid- and long-term and present for revision bariatric surgery. Despite the increase in revisions, their safety and efficacy remain controversial. CASE PRESENTA TION: A 44-year-old female patient with severe malnutrition after single anastomosis sleeve jejunal bypass (SASJ) surgery was referred to this center. SASJ was the chosen bariatric procedure for her after the first failed VBG. She was unable to swallow anything. Upper GI endoscopy was done and the laparoscopic prolene mesh used in the first bariatric surgery (VBG) was seen inside the gastric lumen. Total parental nutrition was initiated and continued for 12 days in this medical center and then she was candidate for exploratory laparoscopy. CLINICAL DISCUSSION: Using prophylactic preperitoneal Prolene mesh during wound closure in bariatric surgery is safe and effective in preventing incisional hernia development. During the revision bariatric surgeries, surgeons should be careful about the used mesh in the first bariatric surgery. CONCLUSION: Surgeons should be aware of the management of rare surgical complications that might lead to malnutrition which is insidious. LEVEL OF EVIDENCE: V. PMID:35176582 | DOI:10.1016/j.ijscr.2022.106824 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of Laryngopharyngeal Reflux and Obstructive Sleep Apnea: A Population‐Based Study

xlomafota13 shared this article with you from Inoreader Assessment of Laryngopharyngeal Reflux and Obstructive Sleep Apnea: A Population‐Based Study Via The Laryngoscope Objectives/Hypothesis To evaluate the presence of laryngopharyngeal reflux (LPR) and the potential association between presence of LPR symptoms and obstructive sleep apnea (OSA) in a representative sample from a population-based study. Study Design Cross-sectional study. Methods Participants of the follow-up of the Epidemiological Sleep Study were evaluated. Sleep was assessed through questionnaires and polysomnography. The presence of LPR was based on the questionnaire Reflux Score Index (RSI), and scores higher than 13 were suggestive of LPR. A general linear model test was used for comparison of continuous data and Pearson's chi-square test was used to compare categorical variables. Predictors of LPR were obtained by regression analysis. Results 701 were enrolled (54.8% female, 45.2% male; mean age, 50.2 ± 13.3 years). The mean apnea-hypopnea index score was 17 ± 18.3 events/hr, and the mean RSI score was 7.0 ± 8.1. LPR was found in 17% of the volunteers, whereas OSA was present in 38.5% of the sample. Specifically, in those patients with OSA, the prevalence of LPR was 45.4%; however, there was no statistically significant association between LPR and the presence of OSA. The severity of OSA was not associated with RSI score. The presence of LPR was associated with older age, smoking, excessive daytime sleepiness and worse quality of life and sleep scores questionnaires. Conclusions Age, smoking, but not body mass index, were associated with LPR. There was not statistically significant association of LPR with OSA. Individuals with symptoms of LPR had greater drowsiness and worse quality of life and sleep. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Botulinum Toxin A in the Management of Pediatric Sialorrhea: A Systematic Review

xlomafota13 shared this article with you from Inoreader Botulinum Toxin A in the Management of Pediatric Sialorrhea: A Systematic Review Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 18:34894221078365. doi: 10.1177/00034894221078365. Online ahead of print. ABSTRACT OBJECTIVE: Botulinum toxin A is known to be effective and safe in managing sialorrhea in pediatric patients; however, there is no consensus on a protocol for optimal injection sites and appropriate dosing for injection. METHODS: This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. PubMed, EMBAS E, and other databases were queried to identify articles that evaluated botulinum toxin type A for the treatment of sialorrhea in the pediatric population. A total of 405 studies were identified. After applying inclusion and exclusion criteria, 31 articles were included for review. RESULTS: A total of 14 studies evaluated 2-gland injections, and 17 studies evaluated 4-gland injections. Of the 31 studies included, one study assessed incobotulinumtoxinA (Xeomin®) the remaining all used onabotulinumtoxinA (Botox®). For 2-gland injection studies, a combined total of 899 participants were reviewed, where 602 participants received 50 units into their submandibular glands, while 262 participants received 30 to 50 units. Among 4-gland injection studies, there was a combined total of 388 participants, with the most prevalent dosage utilized being 60 to 100 units in 230 participants, followed by 100 units total in 77 participants. The most common adverse event wa s dysphagia which resolved in nearly all cases. Three studies aimed to examine 2-gland versus 4-gland injections, with 2 of the studies concluding 4-gland injection was superior. CONCLUSIONS: The strength of evidence suggests that the dosing of 50 units total of onabotulinumtoxinA to the submandibular glands is safe and effective in the pediatric population. For 4-gland injections, bilateral submandibular and parotid gland injections of 60 to 100 units total is the safe and effective dosage. There is no substantial evidence comparing 4-gland injections to 2-gland injections, but research thus far suggests 4-gland injections to be superior. Future study is needed to evaluate incobotulinumtoxinA and abobotulinumtoxinA dosages in the pediatric population. PMID:35176902 | DOI:10.1177/00034894221078365 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of noise on the amplitude and morphology of cortical auditory evoked potentials

xlomafota13 shared this article with you from Inoreader The effect of noise on the amplitude and morphology of cortical auditory evoked potentials Via cortical auditory Braz J Otorhinolaryngol. 2021 Dec 7:S1808-8694(21)00197-X. doi: 10.1016/j.bjorl.2021.11.006. Online ahead of print. ABSTRACT OBJECTIVE: To analyze the effect of noise on electrophysiological measurements (P1-N1-P2 complex) of cortical auditory evoked potentials in normal hearing individuals of different ages. METHODS: The inclusion criteria for the study were young individuals, adults and elderly, aged 18-75 years, with auditory thresholds up to 25 dB. Participants were separated according to their age group: G1 (18-25 years old), G2 (31-59 years old) and G3 (60-75 years old). Cortical auditory evoked potentials were elicited with synthetic speech stimulus /da/ presented in two conditions: without masking and with masking (Delta-t 64 ms). The results were expressed and analyzed using statistical measures. RESULTS: High latencies and reduced amplitudes were observed in the Delta-t 64 ms condition, in all age groups. There were sign ificant differences between the groups, both in P1 latencies for the two conditions and in N1 latencies in the Delta-t 64 ms condition. P1 latencies in the condition without masking were lower in G1 and P1 and N1 latencies in the Delta-t 64 ms condition were higher in G3. The described results show the influence of noise on cortical responses in all age groups, with G3 being the most affected by the masking presentation. CONCLUSION: The latency and amplitude measurements vary according to the stimulus presentation condition and age group. The forward masking phenomenon occurred with greater precision in G3. LEVEL OF EVIDENCE: (2c). PMID:35177355 | DOI:10.1016/j.bjorl.2021.11.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of recurrent acquired choanal atresia with radial forearm free flap transfer

xlomafota13 shared this article with you from Inoreader Management of recurrent acquired choanal atresia with radial forearm free flap transfer Via ear nose throat Ear Nose Throat J. 2022 Feb 17:1455613211070894. doi: 10.1177/01455613211070894. Online ahead of print. ABSTRACT Acquired choanal atresia is a rare complication of pharyngeal surgical interventions. Here, we report the case of a 72-year-old woman who was treated in our institution for acquired choanal atresia after failed previous treatments. We have excised the obstructing fibrotic scar tissue and then reconstructed the area using a mucosal local flap and free radial forearm flap transfer. Choanal stenosis caused by abnormal granulation was identified in the months after surgery; however, this was treated with endoscopic dilatation and steroid injections in the outpatient setting. No restenosis was identified 1 year after the operation. Postoperative evaluation of speech was satisfactory. Free flap transfer could be an option for refractory choanal atresia, and endoscopic dilatation with local steroid injections may be an effective method to treat postoperative restenosis. PMID:35176899 | DOI:10.1177/01455613211070894 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prophylactic mastectomy - Correlation between skin flap thickness and residual glandular tissue evaluated postoperatively by imaging

xlomafota13 shared this article with you from Inoreader Prophylactic mastectomy - Correlation between skin flap thickness and residual glandular tissue evaluated postoperatively by imaging Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 23:S1748-6815(22)00046-8. doi: 10.1016/j.bjps.2022.01.031. Online ahead of print. ABSTRACT BACKGROUND: Women with an increased hereditary risk of breast cancer can undergo risk-reducing prophylactic mastectomy. However, there is a balance between how much subcutaneous tissue should be resected to achieve maximal reduction of glandular tissue, while leaving viable skin flaps. METHODS: Forty-five women previously operated with prophylactic mastectomy underwent magnetic resonance tomography (MRT) and ultrasound (US) to investigate the correlation between skin flap thickness and residual glandular tissue. Residual glandular tissue was documented as being present or not present, but not quantified, as the amount of residual glandular tissue in many cases was considered too small to make reliable volume quantifications with available tools. Since a mastectomy skin flap thickness of 5 mm is discus sed as an oncologically safe thickness in the literature, this was used as a cut-off. RESULTS: Following prophylactic mastectomy, residual glandular tissue was detected in 39.3% of all breasts and 27.9% of all the breast quadrants examined by MRT, and 44.1% of all breasts and 21.7% of all the breast quadrants examined by US. Residual glandular tissue was detected in 6.9% of the quadrants in skin flaps ≤ 5 mm and in 37.5% of the quadrants in skin flaps > 5 mm (OR 3.07; CI = 1.41-6.67; p = 0.005). Furthermore, residual glandular tissue increased significantly already when the skin flap thickness exceeded 7 mm. CONCLUSIONS: This study highlights that complete removal of glandular breast tissue during a mastectomy is difficult and suggests that this is an unattainable goal. We demonstrate that residual glandular tissue is significantly higher in skin flaps > 5 mm in comparison to skin flaps ≤ 5 mm, and that residual glandular tissue increases significantly already when the flap thickness exceeds 7 mm. PMID:35177362 | DOI:10.1016/j.bjps.2022.01.031 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delay of initial radioactive iodine therapy beyond 3 months has no effect on clinical responses and overall survival in patients with thyroid carcinoma: A cohort study and a meta-analysis

xlomafota13 shared this article with you from Inoreader Delay of initial radioactive iodine therapy beyond 3 months has no effect on clinical responses and overall survival in patients with thyroid carcinoma: A cohort study and a meta-analysis Via radioactive iodine Cancer Med. 2022 Feb 18. doi: 10.1002/cam4.4607. Online ahead of print. ABSTRACT BACKGROUND: More than a third of thyroid carcinoma (TC) patients require treatment with radioactive iodine (RAI), but the timing of initial RAI therapy after thyroidectomy remains controversial. METHODS: We included 1224 differentiated thyroid carcinoma (DTC) patients during 2015-2019, divided them into the early (≤3 months) and the delayed (>3 months) groups based on the interval between su rgery and the initial RAI. Clinical outcomes were assessed within 6-8 months of treatment with RAI, including excellent response (ER), indeterminate response (IDR), biochemical incomplete (BIR) and structural incomplete response (SIR). Further transformed them into dichotomous outcomes, we therefore introduced the ordered/binary logistic regression to assess the relation of time interval and quaternary/dichotomous outcomes, respectively. Finally, we conducted a meta-analysis for cohort study to investigate the effect of timing of RAI therapy on the prognosis of TC. RESULTS: Delay RAI therapy beyond 3 months reduced the IR (BIR + SIR) rate in the present cohort study (RR = 0.67, 95% CI: 0.49-91). Following meta-analysis including 38,688 DTC patients confirmed these results (RR = 0.77, 95% CI: 0.66-0.91), further revealed the duration of treatment does not influence OS (pooled RR = 1.05, 95% CI: 0.83-1.33). CONCLUSION: Delayed initial RAI therapy beyond 3 months but no lat er than 6 months did not impair the prognosis of TC. PMID:35179295 | DOI:10.1002/cam4.4607 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vocal Fry Patterns While Reading

xlomafota13 shared this article with you from Inoreader Vocal Fry Patterns While Reading Via Journal of Voice The use of vocal fry is common in running speech and has potential psychosocial and vocal health consequences. Determining the different patterns of vocal fry is relevant to differentiating phonatory function, understanding cultural and linguistic use of vocal fry, and clinical diagnostics and intervention. The purpose of this project was to study and categorize patterns of vocal fry in running speech. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical characteristics and treatment of chest submammary accessory breasts

xlomafota13 shared this article with you from Inoreader Clinical characteristics and treatment of chest submammary accessory breasts Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 31:S1748-6815(22)00066-3. doi: 10.1016/j.bjps.2022.01.051. Online ahead of print. ABSTRACT Accessory breast tissue is remnant mammary gland tissue resulting from a failure of regression during the embryonic development and can occur anywhere along the mammary ridge. Patients with accessory breast tissue may also have chest submammary accessory breasts, which are rare and painless, but are often removed for cosmetic reasons. Herein, we report the clinical characteristics and treatment of patients with chest submammary accessory breasts. This retrospective study included 104 women who had undergone liposuction for chest submammary accessory breast from January 2014 to December 2019. chest submammary accessory breasts were diagnosed by ultrasonography and physical examination. The overall satisfaction of patients with chest submammary accessory breast was evaluated using a 5-point Likert scale. The mean operation time was mean 20.7 min and the mean liposuction volume was mean 223.3 mL. The overall satisfaction score (incisional scar, pain and cosmesis) 6 months after chest submammary accessory breast liposuction was 4.7 (range 4-5). The chest submammary accessory breast consisted mainly of fatty tissue rather than mammary gland tissue; thus, chest submammary accessory breasts are painless and are treated purely for cosmetic reasons. In conclusion, liposuction is therefore a simple and effective treatment for chest submammary accessory breast. PMID:35181247 | DOI:10.1016/j.bjps.2022.01.051 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A predictor of a postoperative fistula after double-opposing Z-plasty in bilateral cleft lip and palate patients

xlomafota13 shared this article with you from Inoreader A predictor of a postoperative fistula after double-opposing Z-plasty in bilateral cleft lip and palate patients Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 31:S1748-6815(22)00053-5. doi: 10.1016/j.bjps.2022.01.038. Online ahead of print. ABSTRACT Furlow double-opposing Z-plasty (FDOZ) as primary palatoplasty for the bilateral cleft lip and palate (BCLP) closure often leads to a palatal fistula formation in cases with wide clefts. We examined the utility of the calculated maximum closable cleft width to determine the feasibility of a direct palatal closure without lateral incisions. In this retrospective study, we analyzed consecutive patients with a BCLP who were treated for 5 years from 2009. In sixty-three BCLP patients, the following dimensions were measured preoperatively: an actual distance between maxillary tuberosities (Actual X); actual cleft height, calculated from the line joining the maxillary tuberosities to the cleft edge (Actual Y); and actual cleft width at the hard-soft palate junction (Actual Z) and calculated maximum cleft width re quiring a direct closure (CMZ). Six months postoperatively, the relationships between the fistula occurrence and actual Z/CMZ were examined. Median values (interquartile range) of Actual X, Y, and Z and CMZ were 35.0 (33.0-39.0) mm, 7.0 (6.0-8.0) mm, 10.0 (8.0-11.0) mm, and 4.6 (2.7-5.7) mm, respectively. The median age at operation was 8.0 (7.0-17.0) months. Fistulae at the hard-soft palate junction developed postoperatively in three cases with more than a 10-mm cleft width (4.76%). A receiver operating characteristic (ROC) curve analysis indicated that actual Z was a better predictor of a postoperative fistula formation than CMZ. An actual cleft width was a better predictor of the fistula occurrence than a calculated maximum cleft width after FDOZ for a BCLP repair. The low fistula rate of FDOZ suggested that FDOZ could be used to close the palate with less than a 10-mm cleft width. PMID:35181246 | DOI:10.1016/j.bjps.2022.01.038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Effect of Phonation into a Glass Tube Immersed in Water Compared to Other Interventions on General Degree of Vocal Deviation, Fundamental Frequency, Sound Pressure Level, and Vocal Self-assessment in Vocally Healthy Individuals: A Systematic Review and Meta-analysis

xlomafota13 shared this article with you from Inoreader The Effect of Phonation into a Glass Tube Immersed in Water Compared to Other Interventions on General Degree of Vocal Deviation, Fundamental Frequency, Sound Pressure Level, and Vocal Self-assessment in Vocally Healthy Individuals: A Systematic Review and Meta-analysis Via Journal of Voice To analyze the effect of phonation in a glass tube immersed in water compared to other interventions on general degree of vocal deviation, fundamental frequency, sound pressure level, and vocal self-assessment in vocally healthy individuals. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.