Wideband Absorbance in Ears with Retraction Pockets and Cholesteatomas: A Preliminary Study

Author(s):  
Sreedevi Aithal ◽  
Venkatesh Aithal ◽  
Joseph Kei ◽  
Shane Anderson

Abstract Objectives The objective of this study was to describe wideband absorbance (WBA) findings in patients with cholesteatomas and retraction pockets (RPs). Design In this prospective study, tympanometry, audiometry, and wideband tympanometry (WBT) were performed on 27 ears with an RP (eight with epitympanic RP and 19 ears with mesotympanic RP), 39 ears with a cholesteatoma (23 ears with epitympanic and 16 ears with mesotympanic cholesteatomas [MCs]), and 49 healthy ears serving as controls. Results Mean WBA at ambient pressure (WBAamb) of both experimental groups was reduced significantly between 0.8 and 5 kHz relative to the control group. The difference between mean WBAamb and mean WBA at tympanometric peak pressure (WBATPP) was greater for the RP (0.12–0.16 between 0.5 and 1.5 kHz) than for the cholesteatoma group (0.03–0.11 between 0.6 and 3 kHz). Mean WBAamb of both epitympanic RP (ERP) and epitympanic cholesteatoma (EC) subgroups was significantly lower than that of the control group. Mean WBATPP of the ERP subgroup attained normal levels as per the control group, while mean WBATPP of EC subgroup was significantly lower than that of the control group at 0.8 to 1.5 kHz and 4 to 5 kHz. In contrast, both mesotympanic RP and MC subgroups demonstrated similar mean WBAamb and WBATPP values. No significant differences in WBAamb and WBATPP results between the RP and cholesteatomas groups were observed. Receiver operating characteristic (ROC) analyses indicated that the area under the ROC curve for distinguishing between the RP and cholesteatomas groups ranged from 0.44 to 0.60, indicating low accuracy in separating the two groups. Conclusion While it is not possible to distinguish between the RP and cholesteatomas groups based on the WBAamb and WBATPP results, it is potentially feasible to differentiate between the EC and ERP conditions. Further study using a large clinical sample is recommended to determine the sensitivity and specificity of the WBA test to identify the EC and ERP conditions.

2021 ◽  
Author(s):  
Qiong Lin ◽  
Renmin Zhou ◽  
Hao Wujuan ◽  
Zhumeng Ni ◽  
Xiaozhong Li

Abstract Objective: To evaluate the diagnostic value of eosinophil (EO) count and platelet-to-lymphocyte ratio (PLR) in eosinophilic gastroenteritis (EGE). Methods: In total, 91 patients with EGE and 83 age–sex matched patients without EGE were selected as study subjects during January 2018 to December 2020. Data on blood cell count, and serum, C-reactive protein (CRP), and albumin levels were obtained from the Wuxi children's hospital electronic medical record system; the neutrophil-to-lymphocyte ratio (NLR), PLR, and CRP-to-albumin ratio (CAR) in the peripheral blood were recorded. Independent sample t-test, non-parametric test, or χ2 test was used according the data type to compare the difference between two groups, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value for EGE. Results: The EO counts and PLR were significantly higher in the EGE group than those in the control group, whereas differences in the white blood cell, lymphocyte, neutrophil, and platelet counts, and the CRP level, NLR, and CAR were not significant. After treatment(Corticosteroids, 1mg/kg.d, lasting for 2 weeks), the EO counts and PLR in the EGE group decreased gradually and the difference was significant. The diagnostic value of EO counts and PLR was determined with an area under the ROC curve as 0.756 and 0.616, sensitivity was 75.00% and 34.29%, and specificity was 74.29% and 92.31%, respectively. Conclusions EO and PLR represent potential predictive markers for diagnosing EGE.


2020 ◽  
Vol 134 (8) ◽  
pp. 717-720 ◽  
Author(s):  
MH Hussain ◽  
M Mair ◽  
P Rea

AbstractObjectiveTo evaluate the prevalence of severe acute respiratory syndrome coronavirus-2 infection in patients presenting with epistaxis to a tertiary otolaryngology unit.MethodsA prospective study was conducted of 40 consecutive patients presenting with epistaxis referred to our tertiary otolaryngology unit. A group of 40 age-matched controls were also included. All patients underwent real-time reverse transcriptase polymerase chain reaction testing for severe acute respiratory syndrome coronavirus-2. Symptoms of fever, cough and anosmia were noted in the study group.ResultsThe mean age was 66.5 ± 22.4 years in the study group. There were 22 males (55 per cent) and 18 females (45 per cent). The mean age in the control group was 66.3 ± 22.4 years (p = 0.935). There were six positive cases for severe acute respiratory syndrome coronavirus-2 (15 per cent) in the epistaxis group and one case (2.5 per cent) in the control group. The difference was statistically significant (p = 0.05).ConclusionEpistaxis may represent a presenting symptom of severe acute respiratory syndrome coronavirus-2 infection. This may serve as a useful additional criterion for screening patients.


2021 ◽  
Vol 62 (7) ◽  
pp. 873-880
Author(s):  
Taesung Joo ◽  
Jin-Ho Joo ◽  
In-Ki Park ◽  
Jae-Ho Shin

Purpose: To compare eyelid blink characteristics between patients with ptosis and healthy controls using a smartphone camera. Methods: The ptosis group consisted of 20 senile aponeurotic ptosis patients with margin reflex distance1 ≤2.5 mm and the control group consisted of 10 healthy subjects without ptosis. The ptosis group was further divided into two groups based on an age cutoff of 70 years. Palpebral fissure height, levator function, margin reflex distance1, inter-blink interval, blink duration, blink rate, and blink velocity were measured and compared between the three groups based on photographs of the eyelids and videos of blinking taken with a smartphone camera. Results: The palpebral fissure height, levator function, margin reflex distance1, and blink velocity were lower in the ptosis groups than in the control group but these values did not differ between the two ptosis groups. The palpebral fissure height, levator function, and margin reflex distance1 were correlated with blink velocity. In the receiver operating characteristic (ROC) curve of blink velocity, the area under the receiver operating characteristic (AUROC) curve value was as high as 0.969 and the cut-off value was 32.36 mm/s. Conclusions: It is possible to analyze eyelid blink characteristics using a smartphone camera and the results confirmed that palpebral fissure height, levator function, margin reflex distance1, and blink velocity were lower in the senile aponeurotic ptosis group than in the healthy control group and were unaffected by age. Additionally, blink velocity is valuable for diagnosis of ptosis due to the correlation between the degree of ptosis, blink velocity, and the ROC curve of blink velocity.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21056-e21056
Author(s):  
Eric Gremillet ◽  
Claude Soler ◽  
Catherine Bouteille ◽  
Aline Steiner ◽  
Benjamin Geissler

e21056 Background: In the field of sentinel lymph node (SLN) for patients with previously breast surgery, opinions are not definitive. On the first hand, the ASCO in 2005 recommended that SLN biopsy should not be performed in patients with previous mammaplasty or axillary surgery, but, on the other hand, the same panelists of the ASCO guideline suggested that a preliminary lymphoscintigraphy (LSG) could be done when considering a SLN biopsy in patients with previous mammaplasty, with the objective of verifying the integrity of axillary nodes. We started a prospective study in January 2009, to evaluate the location of sentinel lymph node (SLN) before and after mammaplasty. The preliminary results of the first 20 patients were presented in June 2010 (Chicago, ASCO), however it was to be necessary to have more patients to validate these encouraging results. The results of additional study is presented here. Methods: 40 patients who underwent mammaplasty were evaluated by LSG acquired with a SPECT-CT immediately after intradermal periareolar injections of 99mTc -labelled sulphur colloid at two time points: before mammaplasty (Pre-LSG) and between 40 to 60 days after mammaplasty (Post- LSG). Results: The localisation of hot SN was evaluated as in the first study, using the SPECT-CT images : - antero-posterior distance was estimated in centimeter from SLN region to dorsal vertebrae spine center. - SLN’s coronal position was compared to rib cage. The average value of 40 antero-posterior distance before and after surgery was 14.2 vs 14.4 centimeters, in the preliminary study it was 13.6 vs 13.8 centimeters, the difference keeps the same between 2 studies (2 millimeters). As in the first study, SN was in the same position in relation to grill rib. The binomial test did not show statistical difference in lymphatic drainage patterns between Pre-LSG and Post-LSG. Conclusions: after evaluating the impact of the previous mammaplasty surgery on the SLN position, we observed that surgery did not modify lymphatic mapping and thus that it may be possible to propose SLN biopsy even after mammaplasty. This study confirms the results of our preliminary study.


2021 ◽  
Vol 7 (5) ◽  
pp. 4324-4331
Author(s):  
Lei Dai ◽  
Yongyong Wang ◽  
Mingwu Chen

Lung cancer (LC) is a common malignant tumor with high morbidity and mortality. The development of new molecular markers and the early diagnosis of LC and the exploration of emerging targeted therapies are of great significance. Therefore, this study systematically evaluates the correlation between peripheral serum MIC-1 levels and LC. Search PubMed, Web of Science, Medline and other databases, the search time is from the establishment of the database to July 2021. The LC group included LC patients, the Non-cancer group included patients with benign lung diseases (BLD), and the control group included healthy people. The serum MIC-1 levels of LC group and control group, LC group and Non-cancer group were compared respectively, and the correlation between serum MIC-1 and clinical characteristics of LC patients was evaluated and analyzed, and the ROC curve of MIC-1 in prediction of LC. Finally, 5 articles were included, including 1179 patients with LC, 109 patients with BLD, and 1020 healthy people. Meta-analysis results: the level of MIC-1 in LC group was overtop that in healthy group, and the difference was obvious [SMD=1.97, 95%CI (1.35, 2.59), PC0.00001]. The level of MIC-1 in LC group was overtop that in Non-cancer group, and the difference was obvious [SMD=382.97,95%CI (313.74, 452.19), PC0.00001]. The descriptive evaluation analyzes the correlation between MIC-1 and the clinical characteristics of LC group, and the results show that MIC-1 has a certain correlation with the stage of LC group. The AUC of serum MIC-1 in the identification of LC group and the control group was greater than 0.5. The AUC value of MIC-1 in the diagnosis of LC was 0.851-0.906, and the best sensitivity range was 63.50%-99.00%. The best specificity is in the range of 70.4%-95.80%. The Meta-analysis indicated that the serum MIC-1 level in LC group is overtop that in BLD and healthy people, and has a obvious correlation with LC stage staging; and the ROC curve shows that it has important significance in the diagnosis and prognosis of LC.


Author(s):  
Karl-Gösta Ljungström

At Danderyd’s Hospital a controlled clinical trial of dextran 70 using phlebography in all patients demonstrated a significant reduction in postoperative deep venous thrombosis (DVT) from 52% in the untreated control group to 4% in the dextran group. Johnson et al. 1968. As a consequence, routine prophylaxis of postoperative DVT with dextran 70 was instituted for all patients over 50 years of age undergoing abdominal, orthopedic or urological surgery. A retrospective investigation of. the result of this two-year period of routine prevention with dextran 70, which was preceded and superceded by 2 two-year periods when no dextran was given, revealed the following sequence of fatal PE verified at autopsy over the six-year period:15 (no prophylaxis), 6 (dextran) and 15 (no prophylaxis), Ljungström, 1975.At this stage a prospective study for a new two-year period was started. Infusion of 100 ml of dextran 70 was started during operation in all patients filling one of the following criteria: 1. All patients over 50 years of age undergoing abdominal, orthopedic or urological surgery. 2. All patients undergoing re-operation regardless of age. 3. All patients undergoing major surgery with a history of previous thromboembolic disease regardless of age.During this last two-year period only 3 patients died of fatal postoperative PE. The difference between 15 fatal PE in the non-dextran and 3 in the dextran group was significant, P 0.05. A comparable number of surgical operations were performed during each year of the eight-year period.


2017 ◽  
Vol 1 (2) ◽  
pp. 79-84
Author(s):  
Yayang Kharistik Almasith ◽  
Fresthy Astrika Yunita ◽  
Agus Eka Nurma Yunita

Menstrual pain can reduce activities. A preliminary study showed that 80% of the students of STIKES Aisyiyah Surakarta experienced the menstrual pain. A non-pharmacological intervention to reduce the menstrual pain can be done through the execution of warm compress and back massage. The aim of this study was to investigate the difference of pain reduction between warm compress and back massage on menstrual pain among the students of STIKES Aisyiyah Surakarta. This was a quasy experimental research with the non-randomized control group pretest posttest design. Thirdty students STIKES Aisyiah became the research subject. The result of Paired T Test showed that the mean of warm compress= 2.400, with the p-value= 0.000 was greater than that of back massage= 1.267 with the p-value= 0.002.This indicated that there was a difference between the two methods as the warm compress was more effective than back massage on reducing menstrual pain. In time to come, midwifes should conduct counseling on menstrual pain with natural and safe warm compress.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaopeng Zhu ◽  
Jing Tang ◽  
Huandong Lin ◽  
Xinxia Chang ◽  
Mingfeng Xia ◽  
...  

Abstract Background Screening for prediabetes and asymptomatic diabetes is important for preventing development to an irreversible stage. The current diagnosis of prediabetes and diabetes is based on blood glucose or HbA1c (an invasive method). The aim of this study was to assess the efficacy and safety of DS21, a new noninvasive technology, for noninvasive screening for prediabetes and diabetes. Methods A total of 939 subjects were divided into a normal control group (NC, n = 308), impaired glucose regulation group (IGR, n = 312), and diabetes (DM) group (n = 319). All subjects underwent the DS21 test, and mean hands–feet, hand, and feet conductance values were analyzed. The diagnostic accuracy of the conductance value was analyzed by receiver-operating characteristic (ROC) curve. Results The conductance values for hands–feet, hands, and feet in the DM and IGR groups were significantly lower than those in the NC group (all P < 0.01). The area under the ROC curve  (AUCROC) for distinguishing NC/IGR was highest when using hands–feet conductance values (0.766 [95% confidence interval, CI 0.730, 0.803]). However, the AUCROCs of distinguishing NC/abnormal glucose metabolism (AGM, including IGR+DM), non-diabetes (NDM)/DM, and IGR/DM were highest when using conductance values for hands at 0.782 [95% CI 0.752, 0.812], 0.688 [95% CI 0.653, 0.723] and 0.573 [95% CI 0.528, 0.617], respectively (all P < 0.01). Hand conductance of values 75.0 (sensitivity 0.769, specificity 0.660), 77.1 (sensitivity 0.718, specificity 0.695), 68.4 (sensitivity 0.726, specificity 0.555), and 58.1 (sensitivity 0.384, specificity 0.744) were recommended as the screening thresholds for NC/AGM, NC/IGR, NDM/DM, and IGR/DM, respectively. A hand conductance value 66.0 was also recommended to distinguish NC/AGM due to its high sensitivity and high PPV. No adverse events occurred in the test. Conclusions DS21 is fast, noninvasive, low cost, reliable and safe, which makes it a feasible device for screening for prediabetes and diabetes, especially in a large population.


2021 ◽  
Vol 9 ◽  
Author(s):  
Kan Huijuan ◽  
Dong Yaping ◽  
Wang Bo ◽  
Hou Miao ◽  
Qian Guanghui ◽  
...  

Objective: To evaluate the value of combined interferon β (IFN-β) and platelet (PLT) detection for Kawasaki disease (KD) identification.Methods: Forty-four children who were newly diagnosed with KD were selected as the KD group. They were divided into acute phase of KD and subacute phase of KD. They were also separated into groups with and without coronary artery disease (CAD) (CAD+ and CAD–, respectively). Meanwhile, 44 children hospitalized with febrile disease and 44 healthy children were selected as a febrile control group and normal control group, whom were attended to at Children's Hospital of Soochow University at the same time. We detected the concentration of IFN-β and PLT of peripheral blood serum for all three groups and analyzed the difference.Results: At acute and subacute phases of KD, both IFN-β and PLT are higher than both the febrile control group and healthy control group, especially at subacute phase; the difference between groups was statistically significant, P &lt; 0.05. Receiver operating characteristic (ROC) curve showed that the areas under the ROC curve (AUCs) of IFN-β and PLT at acute phase of KD were 0.81 and 0.72, respectively; the sensitivity and specificity were 97.22 and 63.64%, and 57.89 and 73.86%, respectively. The AUCs of combined IFN-β and PLT were 0.81 at acute phase and 0.96 at subacute phase of KD, with sensitivity and specificity of 97.22 and 55.26%, and 86.36 and 100%, respectively. The cutoff value of combined IFN-β and PLT detection was IFN-β = 3.51 pg/ml and PLT = 303 × 109/L at acute phase of KD, IFN-β = 4.21 pg/ml and PLT = 368 × 109/L at subacute phase from plot vs. criterion values. However, there are no significant differences between the CAD– group and the CAD+ group for combined IFN-β and PLT, both P &gt; 0.5, neither at acute nor at subacute phase of KD.Conclusion: Combined IFN-β and PLT detection is an efficient biomarker for KD identification. The cutoff values are IFN-β = 3.51 pg/ml and PLT = 303 × 109/L at acute phase of KD and IFN-β = 4.21 pg/ml and PLT = 368 × 109/L at subacute phase.


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