Κυριακή 17 Ιανουαρίου 2021

Herpes simplex laryngitis: Comparison between pediatric and adult patients.

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Herpes simplex laryngitis: Comparison between pediatric and adult patients.

Int J Pediatr Otorhinolaryngol. 2020 Dec 24;142:110596

Authors: Bachrach K, Levi JR, Tracy LF

Abstract
OBJECTIVES: Infection with herpes simplex virus (HSV) typically causes limited oral and genital symptoms, however HSV can also affect the larynx and result in severe aerodigestive symptoms. Due to the rarity of HSV laryngitis, the symptoms and clinical course of are not well understood. This study aims to more completely characterize HSV laryngitis in order to aid clinicians in understanding and recognition of HSV laryngitis.
METHODS: Comprehensive literature search of MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews to identify articles relating to HSV laryngitis. Patient demographics, presenting signs and symptoms, treatment and clinical course were extracted from the selected manuscripts.
RESULTS: There were 31 studies on HSV laryngitis that identified 36 patients (17 pediatric, 19 adult). The average age for pediatric patients was 11 months (9 M, 8F) and 52 years for adults (11 M, 8F). In the pediatric population, stridor was more common at presentation in comparison to the adult population (p < .01). Adults more commonly presented with dysphagia (p = .03) and dysphonia (p < .01) Adult patients were significantly more likely to undergo tracheotomy than pediatric patients (p = .047). The mean length of inpatient hospital stay was 21.2 days in pediatric patients and 15.8 days for adult patients.
CONCLUSION: HSV laryngitis has a unique presentation in pediatrics and adults, but is nonspecific in both populations leading to delays in diagnosis and treatment. HSV laryngitis is associated with significant morbidity including multi-week hospital stay and risk for needing tracheostomy in both adults and pediatric population which demonstrates need for clinical awareness of this complication of HSV infection.

PMID: 33434698 [PubMed - as supplied by publisher]

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DNA methylation biomarkers in peripheral blood of patients with head and neck squamous cell carcinomas. A systematic review

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journal.pone.0244101.g001&size=inline

by Christian Sander Danstrup, Mette Marcussen, Inge Søkilde Pedersen, Henrik Jacobsen, Karen Dybkær, Michael Gaihede

Background

Head and neck squamous cell carcinomas (HNSCC) are often diagnosed in advanced stages. In search of new diagnostic tools, focus has shifted towards the biological properties of the HNSCC, and the number of different biomarkers under investigation is rapidly growing.

Objectives

The objective was to review the current literature regarding aberrantly methylated DNA found in peripheral blood plasma or serum in patients with HNSCC and to evaluate the diagnostic accuracy of these changes.

Methods

The inclusion criteria were clinical studies involving patients with verified HNSCC that reported findings of aberrantly methylated DNA in peripheral blood serum or plasma. We systematically searched PubMed, OVID Embase and Cochrane Library. In addition to the search, we performed forward and backward chaining in references and Web of Science. The protocol was registered in PROSPERO: CRD42019135406. Two authors independently extracted data. The quality and the risk of b ias of the included studies were assessed by the QUADAS-2 tool.

Results

A total of 1,743 studies were found eligible for screening, while ultimately seven studies were included. All studies were found to have methodological weaknesses, mainly concerning patient selection bias. The best individual marker of HNSCC was Septin 9 in plasma with a sensitivity of 57% and a specificity of 95%.

Conclusions

None of the aberrantly methylated genes found in the retrieved studies are applicable as single diagnostic markers for HNSCC and the best gene-panels still lack diagnostic accuracy. Future studies may benefit from newer sequencing techniques but validation studies with well-designed cohorts are also needed in the process of developing epigenetic based diagnostic tests for HNSCC.

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Intraoperative ketorolac for pediatric tonsillectomy

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This is in response to the Letter to the Editor for our publication "Intraoperative ketorolac for pediatric tonsillectomy: Effect on post-tonsillectomy hemorrhage and perioperative analgesia" submitted by Pinchman et al. (IJPORL-D-20-01791).

Int J Pediatr Otorhinolaryngol. 2020 Dec 28;:110588

Authors: Rabbani CC, Pflum ZE, Ye MJ, Gettelfinger JD, Sadhasivam S, Matt BH, Dahl JP

PMID: 33436271 [PubMed - as supplied by publisher]

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Red ear syndrome in children

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Red ear syndrome in children: Review of literature and report of three cases.

Int J Pediatr Otorhinolaryngol. 2021 Jan 06;142:110615

Authors: D'Amico A, Galati C, Manzo ML, Reina F, Nocera GM, Raieli V

Abstract
BACKGROUND: Red ear syndrome (RES) is a neurological syndrome that is characterized by attacks of redness and pain that is localized in the earlobe, accompanied by a burning sensation, swelling or otalgia. The exact pathophysiology of RES is not known. Several pediatric cases have been described. They show an extreme variability in clinical presentation and therapeutic response, and therefore there are numerous difficulties in the diagnostic-therapeutic approach and in the comprehension of the physiopathology. The goal of this report is to present three clinical cases of red ear syndrome in children. These cases show various characteristics that can give useful indications regarding the differential diagnosis and the pathogenetic mechanisms that are involved, particularly when they are compared with cases published in the literature.
CASE-REPORTS: We report three pediatric RES cases: 1) a boy whose condition offered a typical example of the association that occurs between migraine and RES. 2) a girl with idiopathic RES. 3) a child who suffered RES attacks that showed many similarities with trigeminal autonomic cephalalgias.
CONCLUSION: Our clinical series shows the different ways in which RES can be expressed and they support the reported scientific literature. We suggest that the different forms of RES have a common final autonomic pathogenetic mechanism that is activated by parasympathetic hyperactivity and sympathetic inhibition. The different temporal characteristics, frequency, etc. may depend on the activation of distinct physiopathological modules that are related to the pain circuits, as suggested by the modular theory which describes that groups of neurons are defined as a module, where each module is responsible for a symptom and the individual's headache is defined by the activated modules.

PMID: 33440309 [PubMed - as supplied by publisher]

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Translation and validation of the LittlEars auditory questionnaire

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Translation and validation of the LittlEars auditory questionnaire in Kannada.

Int J Pediatr Otorhinolaryngol. 2020 Dec 31;142:110598

Authors: Umashankar A, B T, Prabhu P

Abstract
OBJECTIVE: The aim of the study was to translate and validate the LittlEARS Auditory Questionnaire (LEAQ) in Kannada.
METHOD: The translation procedure followed a traditional translation, back translation, and content validity process before administering. The finalized version was administered on 87 children with 67 normal hearing children and 20 hearing-impaired children.
RESULTS: The tool had good internal consistency, good reliability, and a norm curve could be established. The Cronbach alpha value for item correlation ranged from 0.26 to 0.79. A significant difference was found between normal hearing individuals and hearing impaired.
CONCLUSION: The LEAQ tool has been translated and validated for the Kannada speaking population and can be used as a screening tool for children up to two years of age and as a subjective outcome measuring tool for hearing aid and Cochlear Implant user.

PMID: 33440310 [PubMed - as supplied by publisher]

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PulmCrit- RCTs don’t justify using convalescent plasma or antibody cocktails

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Passive immunity refers to the infusion of antibodies (either polyclonal antibodies in the form of convalescent plasma, or engineered monoclonal antibodies).  The goal is to neutralize viral particles, reduce viral replication, and thereby improve clinical outcomes.  This is a promising theory, but it requires evidentiary support in the form of randomized controlled trials.  So far, […]

EMCrit Project by Josh Farkas.

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Protocol for outpatient management in cleft lip and palate repair.

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Protocol for outpatient management in cleft lip and palate repair.

Int J Pediatr Otorhinolaryngol. 2021 Jan 11;142:110592

Authors: Santos M, García J, Graf S, Giugliano C

Abstract
Cleft lip is a common malformation in Chile. The standard care for cleft lip and palate repair is inpatient admission; this is mainly to observe complications and administer intravenous fluids, antibiotics, and analgesics. In our center, however, a strict selection of patients undergo ambulatory surgeries. In this paper, we illustrate our experience managing outpatient cleft lip and palate repair and show that it is possible to carry out a successful ambulatory surgery with few to no complications in children and adults with cleft lip and palate.

PMID: 33444960 [PubMed - as supplied by publisher]

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Development of a novel mandibular distraction osteogenesis simulator using Computer Aided Design and 3D printing.

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Development of a novel mandibular distraction osteogenesis simulator using Computer Aided Design and 3D printing.

Int J Pediatr Otorhinolaryngol. 2021 Jan 04;142:110616

Authors: Reighard CL, Powell AR, Zurawski TY, Rooney DM, Keilin CA, Zopf DA

Abstract
INTRODUCTION: Micrognathia, a component of Robin Sequence, can cause glossoptosis, failure of palatal fusion, and critical obstruction of the airway. Mandibular distraction osteogenesis (MDO) is at times offered to anteriorly translate the mandible and tongue, relieving airway obstruction. MDO is an intricate reconstructive procedure that may be ideal for teaching using a high-fidelity educational simulator, allowing early hands-on experience in a zero-risk environment.
OBJECTIVES: To design a novel, low-cost, high-fidelity neonatal MDO simulator that can be used for trainee education and refinement of surgical technique.
METHODS: A novel MDO simulator was developed using additive manufacturing techniques. Three experts in MDO surgery completed a 20-item survey, rating the simulator's physical attributes, the realism of experience, the simulator's value, its relevance to practice and the surgeon's ability to perform tasks on a 4-point Likert scale.
RESULTS: Computer Aided Design (CAD) and 3D printing allowed for the production of a realistic surgical simulator that emulates important aspects of MDO surgery. This preliminary evaluation indicated adequate means across the five domains relevant to the simulator's fidelity and usability (M = 3.33 to 3.75) out of a maximum of 4 points. Lowest rated items were consistent with expert comments allowing future refinement on subsequent iterations. Consumable material costs per model were $9.39 USD.
CONCLUSIONS: The MDO model demonstrated adequate fidelity and holds promise as a skill-development tool for surgeons in training. Further studies are planned to determine its utility as a training and assessment tool.

PMID: 33444961 [PubMed - as supplied by publisher]

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Morbidity Associated With the Timing of Lymphadenectomy for Sentinel Lymph Node Metastasis in Melanoma: A Clarification Concerning the Available Evidence

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A. Piñero-Madrona
Actas Dermosifiliogr. 2021;112:97-8

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Agminated blue nevus: GNAQ mutations and beyond

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P. Rodríguez-Jiménez, F. Mayor-Sanabria, A. Rütten, J. Fraga, M. Llamas-Velasco
Actas Dermosifiliogr. 2021;112:95-7

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Treatment and Management of Cellulitis»

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D. Fernández-Nieto, D. Ortega-Quijano, J. Jiménez-Cauhé, M. Fernández-Guarino
Actas Dermosifiliogr. 2021;112:93-4

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Using the Common Terminology Criteria for Adverse Events (CTCAE – Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies

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A. Freites-Martinez, N. Santana, S. Arias-Santiago, A. Viera
Actas Dermosifiliogr. 2021;112:90-2

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