Tonsillectomy vs Modified Uvulopalatopharyngoplasty for Hypertrophy and Obstructive Sleep Apnea

alexandrossfakianakis shared this article with you from Inoreader Tonsillectomy vs Modified Uvulopalatopharyngoplasty for Hypertrophy and Obstructive Sleep Apnea via JAMA Otolaryngology–Head & Neck Surgery Online First This randomized clinical trial examines whether modified uvulo palatopharyngoplasty is more effective than tonsillectomy alone for treating adults with tonsillar hypertrophy and moderate to severe obstructive sleep apnea. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vaccine effectiveness against influenza A(H3N2)-associated hospitalized illness, United States, 2022

alexandrossfakianakis shared this article with you from Inoreader Vaccine effectiveness against influenza A(H3N2)-associated hospitalized illness, United States, 2022 via Clinical Infectious Diseases Advance Access Abstract Background The COVID-19 pandemic was associated with historically low influenza circulation during the 2020–2021 season, followed by increase in influenza circulation during the 2021–2022 US season. The 2a.2 subgroup of the influenza A(H3N2) 3C.2a1b subclade that predominated was antigenically different from the vaccine strain. Methods To understand the effectiveness of the 2021–2022 vaccine against hospitalized influenza illness, a multi-state sentinel surveillance network enrolled adults aged ≥18 years hospitalized with acute respiratory illness (ARI) and tested for influenza by a molecular assay. Using the test-negative design, vaccine effectiveness (VE) was measured by comparing the odds of current season influenza vaccination in influenza-positive case-patients and influenza-negative, SARS-CoV-2-negative controls, adjusting for confounders. A separate analysis was performed to illustrate bias introduced by includin g SARS-CoV-2 positive controls. Results A total of 2334 patients, including 295 influenza cases (47% vaccinated), 1175 influenza- and SARS-CoV-2 negative controls (53% vaccinated), and 864 influenza-negative and SARS-CoV-2 positive controls (49% vaccinated), were analyzed. Influenza VE was 26% (95%CI: -14 to 52%) among adults aged 18-64 years, -3% (95%CI: -54 to 31%) among adults aged ≥65 years, and 50% (95%CI: 15 to 71%) among adults 18-64 years without immunocompromising conditions. Estimated VE decreased with inclusion of SARS-CoV-2-positive controls. Conclusions During a season where influenza A(H3N2) was antigenically different from the vaccine virus, vaccination was associated with a reduced risk of influenza hospitalization in younger immunocompetent adults. However, vaccination did not provide protection in adults ≥65 years of age. Improvements in vaccines, antivirals, and prevention strategies are warranted. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perioperative Anaphylaxie – alte Zöpfe und Neues zu den Auslösern

alexandrossfakianakis shared this article with you from Inoreader Perioperative Anaphylaxie – alte Zöpfe und Neues zu den Auslösern via Laryngo-Rhino-Otologie Laryngorhinootologie 2022; 101: 882-885 DOI: 10.1055/a-1861-7011 Perioperative Anaphylaxien werden mit mindestens 1:6000 angegeben. Neue Kenntnisse der Pathophysiologie der anaphylaktischen Reaktionen beziehen die Auslösung über das Mastzell-related G-Protein und die Komplementaktivierungs-abhängige Pseudoallergie mit ein. Neu beschriebene Auslöser sind das Chlorhexidin oder Gelatine-Produkte, eingesetzt zur Blutstillung oder blaue Farbstoffe zur intraoperativen Markierun g. Wachsamkeit ist in Hinblick auf biphasische Reaktionen geboten. Propofol darf mittlerweile bei Ei- und Sojaallergikern eingesetzt werden. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Die Schnittstelle der Logopädie im Prozess der Geschlechtsangleichung von Mann zu Frau

alexandrossfakianakis shared this article with you from Inoreader Die Schnittstelle der Logopädie im Prozess der Geschlechtsangleichung von Mann zu Frau via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1940-9794 Hintergrund Die Stimme ist für die Geschlechtsidentifikation während des Transitionsprozesses entscheidend, da die Stimmfeminisierung einen bedeutenden Anteil zum Gelingen des Passing hat. Um die Rolle der Logopädie während des interdisziplinären Geschlechtsangleichungsprozesses von MzF-Trans* einordnen zu können, bedarf es möglicher Handlungsempfehlungen für die Zusammenarbeit mit den beteiligten Ärzten. Material und Methoden Vier Experteninterviews aus den Bereichen der Phonochirurgie, Phoniatrie, Endokrinologie sowie plastischen Chirurgie wurden durchgeführt. Auf Grundlage dieser Interviews wurde ein potenzieller Leitlinienkonsens zur Einordnung der Rolle der Logopädie im Prozess der Geschlechtsangleichung von MzF-Trans* erstellt. Ergebnisse Anhand der Expertengespräche wird einheitlich empfohlen, die logopädische Stimmtherapie schon zu Beginn der Transition zu berücksichtigen. Primär sollte eine konservative Therapie berücksichtigt werden, um z.B. irreversible Operationen des Larynx zu vermeiden. Der Fokus logopädischer Stimmtherapie bei Stimmfeminisierung obliegt zentral bei der Anpassung der mittleren Sprechstimmlage. In postoperativen Fällen sollte die logopädische Stimmtherapie das Sprechverhalten an die neue Anatomie anpassen und Komplikationen, wie z.B. eine unökonomische Stimm- und Sprechgebung, vorbeugen. Schlussfolgerung Die aktuellen Interviews stellen einen ersten Einblick in die Kooperation von Logopäden und den medizinischen Fachbereichen zur Behandlung von MzF-Trans* dar. Um die Empfehlungen aus den Experteninterviews für einen potenziellen Leitlinienkonsens implementieren zu können, bedarf es Rücksprachen mit den hierzu beteiligten Fachgesellschaften sowie mehr randomisierter Studien zu spezifischen logopädischen Stimmtherapien. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Xanthomatous erosive arthritis: A new disease entity?

alexandrossfakianakis shared this article with you from Inoreader Xanthomatous erosive arthritis: A new disease entity? via Pediatric Blood & Cancer View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Concurrence of a kinase‐dead BRAF and an oncogenic KRAS gain‐of‐function mutation in juvenile xanthogranuloma

alexandrossfakianakis shared this article with you from Inoreader Concurrence of a kinase‐dead BRAF and an oncogenic KRAS gain‐of‐function mutation in juvenile xanthogranuloma via Pediatric Blood & Cancer View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute In Vitro and In Vivo Effects of Dexamethasone in the Vocal Folds: a Pilot Study

alexandrossfakianakis shared this article with you from Inoreader Acute In Vitro and In Vivo Effects of Dexamethasone in the Vocal Folds: a Pilot Study via The Laryngoscope Atrophy has been reported following dexamethasone injection into the vocal folds. Dexamethasone increased MuRF-1 gene expression in TA myoblasts. A single injection of dexamethasone, however, did not alter atrogene expression, TA morphology, or epithelial thickness in vivo. Objectives/Hypothesis Glucocorticoids (GC)s are commonly employed to treat vocal fold (VF) pathologies. However, VF atrophy has been associated with intracordal GC injections. Dexamethasone-induced skeletal muscle atrophy is well-documented in other tissues and believed to be mediated by increased muscle proteolysis via upregulation of Muscle Ring Finger (MuRF)-1 and Atrogin-1. Mechanisms of dexamethasone-mediated VF atrophy have not been described. This pilot study employed in vitro and in vivo models to investigate the effects of dexamethasone on VF epithelium, thyroarytenoid (TA) muscle, and TA-derived myoblasts. We hypothesized that dexamethasone will increase atrophy-associated gene expression in TA muscle and myoblasts and decrease TA muscle fiber size and epithelial thickness. Study Design In vitro, pre-clinical. Methods TA myoblasts were isolated from a female Sprague–Dawley rat and treated with 1 μM dexamethasone for 24-h. In vivo, 15 New Zealand white rabbits were randomly assigned to three treatment groups: (1) bilateral intracordal injection of 40 μL dexamethasone (10 mg/ml; n = 5), (2) volume-matched saline (n = 5), and (3) untreated controls (n = 5). Larynges were harvested 7-days post-injection. Across in vivo and in vitro experimentation, MuRF-1 and Atrogin-1 mRNA expression were measured via RT-qPCR. TA muscle fiber cross-sectional area (CSA) and epithelial thickness were also quantified in vivo. Results Dexamethasone increased MuRF-1 gene expression in TA myoblasts. Dexamethasone injection, however, did not alter atrophy-associated gene expression, TA CSA, or epithelial thickness in vivo. Conclusion Dexamethasone increased atrogene expression in TA myoblasts, providing foundational insight into GC induced atrophic gene transcription. Repeated dexamethasone injections may be required to elicit atrophy in vivo. Level of Evidence N/A Laryngoscope, 2022 View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spatial‐temporal dynamics and time series prediction of HFRS in mainland China: a long‐term retrospective study

alexandrossfakianakis shared this article with you from Inoreader Spatial‐temporal dynamics and time series prediction of HFRS in mainland China: a long‐term retrospective study via Journal of Medical Virology Abstract Hemorrhagic fever with renal syndrome (HFRS) is highly endemic in mainland China. The current study aims to characterize the spatial-temporal dynamics of HFRS in mainland China during a long-term period (1950-2018). A total of 1,665,431 cases of HFRS were reported with an average annual incidence of 54.22 cases/100,000 individuals during 1950-2018. The joint regression model was used to define the global trend of the HFRS cases with an increasing-decreasing-slightly increasing-decreasing-slightly increasing trend during the 68 years. Then spatial correlation analysis and wavelet cluster analysis were used to identify four types of clusters of HFRS cases located in central and northeastern China. Lastly, the Prophet model predicts that 14,223 cases of HFRS will occur in mainland China during 2019-2038. Our findings will help reduce the knowledge gap on the transmission dynamics and distribution patterns of the HFRS in mainland China and facilitate to take rel evant preventive and control measures for the high-risk epidemic area. This article is protected by copyright. All rights reserved. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immunological mechanisms and treatable traits of chronic rhinosinusitis

alexandrossfakianakis shared this article with you from Inoreader Immunological mechanisms and treatable traits of chronic rhinosinusitis in Asia– a Narrative Review via Clinical Otolaryngology Abstract Objectives To review the current literature on immunological mechanisms and treatable traits of chronic rhinosinusitis (CRS) in Asia. Design This is a narrative review of published data on the immunological mechanisms and treatable traits of CRS in Asia. Published English literature on CRS in Asian and Western countries was reviewed. Where available, the data extracted included epidemiology, immunology, bacterium, phenotype, endotype, and treatment. Results and Conclusion CRS is a heterogeneous disease characterized by persistent locoregional mucosal inflammation of the paranasal sinuses. The inflammatory signatures of CRS vary across patients with distinct racial and ethnic backgrounds and geographic areas. Compared to CRS patients in Western countries, Asian CRS patients display less eosinophilic and type 2 inflammation, which is associated with lower asthma and allergic rhinitis comorbidities. In contrast, Asian patients with CRS have more prominent non-eosinophilic inflammation than those in Western countries. In addition, Asian CRS patients may have different bacterial colonization than patients in Western countries. Our review suggests that the distinct immunological mechanisms between Asian and Western CRS patients may influence the clinical phenotype, responses to treatment, and outcomes. The treatable trait is a new strategy and therapeutic target identified by phenotype or endotype and has been proposed as a new paradigm for the managemen t of diseases. Improved understanding of CRS phenotypic and endotypic heterogeneity and incorporation of treatable traits into clinical care pathways may facilitate more effective selections of therapeutic interventions, including surgery and biologics. This article is protected by copyright. All rights reserved. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of clinical features and surgical outcomes between hypopnea‐ and apnea‐predominant obstructive sleep apnea

alexandrossfakianakis shared this article with you from Inoreader Comparison of clinical features and surgical outcomes between hypopnea‐ and apnea‐predominant obstructive sleep apnea via Clinical Otolaryngology Abstract Objectives This study is aimed to investigate the differences in the clinical features and surgical outcomes between hypopnea- and apnea-predominant obstructive sleep apnea (OSA). Design Cohort study Setting Single tertiary care center Participants This study included 190 patients with OSA who underwent multilevel upper airway surgery between September 2012 and September 2021. The patients were divided into two groups according to the proportion of each respiratory event: hypopnea-predominant (n = 102) and apnea-predominant (n = 88). Main outcome measures The primary outcome measure was the percentage improvement in the apnea-hypopnea index (AHI) from baseline AHI after surgery. Results The apnea-predominant group included more male patients and had higher AHI, respiratory disturbance index (RDI), and oxygen desaturation index (ODI) than the hypopnea-predominant group. Both groups showed significant improvements in AHI, apnea index, RDI, supine AHI, REM AHI, non-REM AHI, ODI, lowest O2 saturation, and Epworth Sleepiness Scale scores following the surgery. Notably, hypopnea index increased after surgery in the apnea-predominant OSA group. Although the improvement in the absolute value of AHI by surgery was significantly greater in the apnea-predominant group than in the hypopnea-predominant group, the two groups showed no significant difference in the percentage improvement in AHI from baseline AHI. Conclusion Patients with apnea-predominant OSA had more severe disease than those with hypopnea-predominant OSA; however, surgical outcomes, as evaluated by percentage AHI improvement, were comparable between the two groups. In addition, multilevel upper airway surgery may induce the transition from apnea to hypopnea in patients with apnea-predominant OSA. View on Web

Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.