Navigation and non-navigation CT scan of the sinuses: comparison of the effective doses of radiation in children and adults

xlomafota13 shared this article with you from Inoreader Navigation and non-navigation CT scan of the sinuses: comparison of the effective doses of radiation in children and adults Via Laryngologie J Otolaryngol Head Neck Surg. 2021 Nov 19;50(1):66. doi: 10.1186/s40463-021-00541-x. ABSTRACT BACKGROUND: The advent of 3D navigation imaging has opened new borders to the endoscopic surgical approaches of naso-sinusal inflammatory and neoplastic disease. This technology has gained in popularity among otolaryngologists for endoscopic sinus and skull base surgeries in both adults and children. However, the increased tissue radiation required for data acquisition associated with 3D navigation protocols CT scans is a source of concern because of its potential health hazards. We aimed to compare the effective doses of radiation between 3D navigation protocols and standard protocols for sinus computed tomography (CT) scans for both the adult and pediatric population. METHODS: We performed a retrospective cohort study through electronic chart review of patients undergoing sinus CT scans (standard and 3D navigation protocols) from May 2019 to December 2019 using a Siemens Drive (VA62A) CT scanner. The effective dose of radiation was calculated in mSv for all exams. Average irradiation doses were compared using a Student's T-Test or a Kruskall-Wallis test when appropriate. RESULTS: A total of 115 CT scans were selected for analysis, of which 47 were standard protocols and 68 were 3D navigation protocols CT scans. Among these, 31 exams were performed on children and 84 exams on adults. For the total population, mean effective dose in the non-navigation CT scans was 0.37 mSv (SD: 0.16, N = 47) and mean effective dose in the 3D navigation sinus CT group was 2.33 mSv (SD: 0.45, N = 68). The mean difference between the two groups was statistically significant 1.97 mSv (CI 95% - 2.1 to - 1.83; P < 0.0001). There was a sixfold increase in radiation with utilization of 3D navigation protocols. The ratio was identical when the pediatric as well as the adult subset of patients were analyzed. CONCLUSION: In our center , utilization of 3D navigation sinus CT protocols significantly increases radiation exposure. Otolaryngologists should be aware of this significant increase and should attempt to decrease the radiation exposure of their patients by limiting unnecessary scan orders and by evaluating 3D acquisition protocols locally with radiation physicists. LEVEL OF EVIDENCE: Level IV. PMID:34798901 | DOI:10.1186/s40463-021-00541-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three‐Dimensional Endoscopic Endonasal Surgery: A Systematic Review

xlomafota13 shared this article with you from Inoreader Three‐Dimensional Endoscopic Endonasal Surgery: A Systematic Review Via The Laryngoscope Objectives To compare participant performance and preference in the use of three-dimensional (3D) endoscopy compared to traditional two-dimensional (2D) endoscopy. Methods PubMed, Embase, Medline, ClinicalKey, BMJ Case Reports, and the Cochrane library were systematically searched for English-language articles published between 2005 and 2020. Studies reporting comparisons of outcomes between 3D and 2D endoscopes were identified. Data relating to performance-related outcomes, as well as the participants' preferred endoscope were extracted, and pooled using meta-analysis models. Results Ten studies were included in the qualitative synthesis. Six studies reported results of participants completing simulated tasks with endoscopes, while four reported full procedures. Peg transfer tasks (n = 4 cohorts) were found to be completed significantly faster with the 3D versus 2D endoscope (pooled mean difference 6.8 seconds, 95% confidence interval [CI]: 2.3–11.3), while no significant difference in times taken was observed for touch tasks (n = 4; pooled mean difference 3.7 seconds, 95% CI: −1.9 to 9.2). The secondary outcome of participant preference was reported by five studies, in which a significant preference for the 3D endoscope was observed (P = .010), with a pooled total of 72% (95% CI: 59–83) of participants preferring this to the 2D endoscope. Conclusions There is a growing body of evidence in support of 3D visualization in endoscopy. We have demonstrated 3D endoscopy to be associated with a significantly shorter time to performing simulated, reproducible and controlled tasks, and to be the preference of participants. This study provides grounds for further evaluation of the technology, and the potential for a greater widespread use. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia

xlomafota13 shared this article with you from Inoreader A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia Via swallowing exercises J Oral Rehabil. 2021 Nov 20. doi: 10.1111/joor.13274. Online ahead of print. ABSTRACT BACKGROUND: Rehabilitative treatments for oropharyngeal dysphagia, including oromotor exercises and sensory stimulation, have been widely adopted in clinical practice. However, the effects of these treatments are mainly supported by exploratory studies. As such, their clinical efficacy remains uncertain. OBJECTIVE: Our systematic review and meta-analysis aimed to evaluate the efficacy of int raoral treatments for neurogenic oropharyngeal dysphagia based on evidence from randomised controlled trials (RCTs). METHODS: Six electronic databases were systematically searched between January 1970 and July 2021. Data were extracted and analysed by two independent reviewers. The outcome measure was change in (any) relevant clinical swallowing-related characteristic. RESULTS: Data from 285 dysphagic patients were collected from 8 RCT studies across a range of intraoral dysphagia treatments. The pooled effect size of all intraoral dysphagia treatments was non-significant compared to control comparators (SMD [95%CI] = 0.23 [-0.22, 0.69], p=0.31; I2 =73%). Subgroup analysis revealed that the pooled effect sizes were also non-significant for oromotor exercises (device-facilitated lip resistance exercises and tongue exercises) (SMD [95%CI] = 0.11 [-0.76, 0.97]; p=0.81; I2 =88%) and sensory stimulation (thermal-tactile, thermo-chemical and electrical st imulation) (SMD [95%CI] = 0.35 [-0.03, 0.72]; p=0.07; I2 =0%). CONCLUSIONS: Our results showed that overall, intraoral dysphagia treatments, including oromotor exercises and sensory stimulation, do not show beneficial effects for neurogenic oropharyngeal dysphagia. The evidence for these treatments remains weak and currently inadequate to support clinical use. Large scale, multi-centre randomised controlled trials are warranted to fully explore their clinical efficacy. PMID:34800341 | DOI:10.1111/joor.13274 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Right vertebral artery arising from the right common carotid artery without association with an aberrant right subclavian artery and entering the C3 transverse foramen

xlomafota13 shared this article with you from Inoreader Right vertebral artery arising from the right common carotid artery without association with an aberrant right subclavian artery and entering the C3 transverse foramen Via radiol anat Surg Radiol Anat. 2021 Nov 20. doi: 10.1007/s00276-021-02861-z. Online ahead of print. ABSTRACT The right vertebral artery (VA) rarely arises from the right common carotid artery (CCA); however, the majority of anomalous right VAs are seen in combination with an aberrant right subclavian artery (SA). Independent (or isolated) right VA of the right CCA origin is extremely rare, with only a few cases reported previously. We herein report an additional case diagnosed incidental ly using computed tomography angiography. This patient had a left VA arising from the aortic arch between the origins of the left CCA and left SA. The bilateral VAs took an anterior course and entered the C3 transverse foramina, at an extremely high level. PMID:34800153 | DOI:10.1007/s00276-021-02861-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study

xlomafota13 shared this article with you from Inoreader Anatomical variants of the medioplantar oblique ligament and inferoplantar longitudinal ligament: an MRI study Via radiol anat Surg Radiol Anat. 2021 Nov 20. doi: 10.1007/s00276-021-02860-0. Online ahead of print. ABSTRACT PURPOSE: The spring ligament complex (SL) is the chief static stabilizer of the medial longitudinal foot arch. The occurrence of normal anatomical variants may influence radiological diagnostics and surgical treatment. The aim of this study was to evaluate anatomical variants of the part of SL located inferior to the talar head (i-SL), medioplantar oblique ligament (MPO) and infer oplantar longitudinal ligament (IPL). METHODS: We included 220 MRI examinations of the ankle performed on a 3.0 T engine. Only patients with a normal SL were included. Two musculoskeletal radiologists assessed the examinations and Cohen's kappa was used to assess agreement. Differences between groups were assessed using the chi-squared test; p < 0.05 was considered as significant. The final decision was made by consensus. RESULTS: Most commonly, i-SL was composed of the two ligaments IPL and MPO n = 167 (75.9%); in this group, bifid ligaments occurred in 19.2%, most commonly in the MPO. A branch to the os cuboideum was seen in n = 17 (10.2%). Three ligaments were seen in n = 52 (23.6%). In this group, bifid ligaments occurred in 13.5%; most commonly, the IPL was bifid and a branch to the os cuboideum was noted in n = 6 (11.5%). In one case, n = 1 (0.04%), we identified MPO, IPL and two accessory ligaments. No significant relationship was noted between the number of li gaments, the presence of bifid ligaments and side or gender (p > 0.05). CONCLUSION: More than two aligaments were seen in 24.1% of examined cases, the most common variant was the presence of MPO, IPL and one accessory ligament. PMID:34800154 | DOI:10.1007/s00276-021-02860-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative depth of sedation and associated outcomes in free flap transfers to the head and neck

xlomafota13 shared this article with you from Inoreader Postoperative depth of sedation and associated outcomes in free flap transfers to the head and neck Via Head & Neck Abstract Background To evaluate the impact of postoperative depth of sedation in free flap transfers to the head and neck. Methods A single center, retrospective cohort of 92 patients were stratified by depth of sedation, light sedation (RASS −1 or greater) or deep sedation (RASS less than −1), and analyzed for postoperative flap and medical complications. Results Of the 92 patients 45 were included in the light sedation and 47 in the deep sedation group. Flap complication requiring return to the operating room occurred in 8 (22.2%) patients in light sedation compared to 12 (27.7%) (p = 0.450) patients in deep sedation. A composite outcome of flap and medical complications occurred less frequently in the light sedation group 14 (31.8%) compared to deep sedation 32 (69.6%) (p < 0.001). Conclusion There was no difference in return to the operating room between the two groups. Light sedation had reduced incidence of medical complications compared to deep. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Circadian clock and cell cycle: Cancer and chronotherapy

xlomafota13 shared this article with you from Inoreader Circadian clock and cell cycle: Cancer and chronotherapy Via histochem Acta Histochem. 2021 Nov 17;123(8):151816. doi: 10.1016/j.acthis.2021.151816. Online ahead of print. ABSTRACT The circadian clock is an endogenous timing system that ensures that various physiological processes have nearly 24 h circadian rhythms, including cell metabolism, division, apoptosis, and tumor production. In addition, results from animal models and molecular studies underscore emerging links between the cell cycle and the circadian clock. Mutations in the core gene s of the circadian clock' can disrupt the cell cycle, which in turn increases the possibility of tumors. At present, tumor chronotherapy, which relies on a circadian clock mechanism, is developing rapidly for optimizing the time of drug administration in tumor treatment to improve drug efficacy and safety. However, the relationship between the circadian clock and the cell cycle is extremely complicated. This review summarizes the possible connection between the circadian clock and the cell cycle. In addition, the review provides evidence of the influence of the circadian clock on senescence and cancer. PMID:34800857 | DOI:10.1016/j.acthis.2021.151816 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.