Prognostic Value of Facial Nerve Antidromic Evoked Potentials in Bell Palsy: A Preliminary Study

To analyze the value of facial nerve antidromic evoked potentials (FNAEPs) in predicting recovery from Bell palsy.Study Design. Retrospective study using electrodiagnostic data and medical chart review.Methods. A series of 46 patients with unilateral Bell palsy treated were included. According to taste test, 26 cases were associated with taste disorder (Group 1) and 20 cases were not (Group 2). Facial function was established clinically by the Stennert system after monthly follow-up. The result was evaluated with clinical recovery rate (CRR) and FNAEP. FNAEPs were recorded at the posterior wall of the external auditory meatus of both sides.Results. Mean CRR of Group 1 and Group 2 was 61.63% and 75.50%. We discovered a statistical difference between two groups and also in the amplitude difference (AD) of FNAEP. Mean±SD of AD was−6.96%±12.66% in patients with excellent result,−27.67%±27.70% with good result, and−66.05%±31.76% with poor result.Conclusions. FNAEP should be monitored in patients with intratemporal facial palsy at the early stage. FNAEP at posterior wall of external auditory meatus was sensitive to detect signs of taste disorder. There was close relativity between FNAEPs and facial nerve recovery.

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Assessment of the outcome of fracture proximal humerus transdeltoid versus deltopectoral approach with PHILOS

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20204964 ◽

2020 ◽

Vol 7 (1) ◽

pp. 25

Author(s):

Rajeev Anand ◽

Amit Dwivedi ◽

Apoorve Agarwal ◽

Fenil Shah

Keyword(s):

Proximal Humerus ◽

Excellent Result ◽

Greater Tuberosity ◽

Fair Result ◽

Excellent Outcome ◽

Good Outcome ◽

Humerus Fractures ◽

Group 2 ◽

Deltopectoral Approach ◽

Group 1

Introduction: Fracture proximal humerus accounts for 4 percent of all fractures. Out of all the humerus fractures, proximal fractures accounts for 26%. According to the Neer’s classification, 2, 3- and 4-part fracture are difficult to achieve stable fixation. In this study, we want to assess whether the different surgical approach, deltopectoral and transdeltoid approach, used for the stabilization of the fracture proximal humerus effects on the outcome of the surgery.Method: A total of 30 patients with fracture proximal humerus 2, 3 and 4-part were included in this study and were divided into 2 groups. In group 1, 15 patients were taken and were operated by deltopectoral approach, while in group 2, 15 patients were taken and operated by transdeltoid approach. All the fixation was done by PHILOS.Result: In group 1, out of 3 patients having 2-part fracture, 2 had excellent result and 1 had fair result. Out of 4 patients having 3-part fracture, 3 had good outcome and 1 had fair result. Out of 6 patients having 4-part fracture, 1 had good outcome. In group 2, out of the 3 patients having 2-part fracture, 1 had excellent outcome and 2 had good outcome. Out of the 4 patients having 3-part fracture, 1 had excellent outcome, 3 had good outcome. Out of the 6 patients having 4-part fracture, 3 had good result.Conclusions: Deltopectoral approach is recommended for calcar reconstruction that provides better visibility of medial calcar reduction while transdeltoid approach is recommended for greater tuberosity reduction that provides better visibility of greater tuberosity.

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Quality of life and pain in dogs with early-stage mammary tumours

Acta Veterinaria Hungarica ◽

10.1556/004.2015.042 ◽

2015 ◽

Vol 63 (4) ◽

pp. 451-457 ◽

Cited By ~ 1

Author(s):

Larissa C. Faustino ◽

Maria Anete Lallo

Keyword(s):

Quality Of Life ◽

Early Stage ◽

Descriptive Study ◽

Pain Scale ◽

Stage I ◽

Mammary Tumour ◽

Mammary Tumours ◽

Group 2 ◽

Group 1

Quality of life (QOL) was evaluated in bitches with mammary tumours (MTs) by applying a scale to assess QOL in dogs with pain secondary to cancer. Two groups were constituted: Group 1 with 80 bitches with MT, oncologically classified as stage I (mean age ± SD = 9.9 ± 3.8 years), and Group 2 consisting of 80 healthy bitches without MT (mean age: 7.7 ± 1.8 years). The results were based on responses from owners using a standardised, internationally accepted pain-scale questionnaire. This prospective and descriptive study showed that 63% of the dogs in Group 1 had a change in QOL due to the presence of MT. The risk of QOL impairment was 2.1 times higher in Group 1 animals than in bitches without MT. Mammary tumour increased the presence of pain 8.3 times and defecation difficulties 10 times. It can be concluded that even small MTs can elicit pain in dogs, which interferes with their quality of life.

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Modified Kocher-Langenbeck Approach for the Treatment of Posterior Wall or Column Acetabular Fractures: The One-Incision Two-Window Method

10.21203/rs.3.rs-58691/v1 ◽

2020 ◽

Author(s):

Tien-Yu Yang ◽

Po-Yao Chuang ◽

Tsan-Wen Huang ◽

Kuo-Chin Huang

Keyword(s):

Posterior Wall ◽

Acetabular Fractures ◽

Fracture Group ◽

Satisfaction Rate ◽

Posterior Wall Fracture ◽

The Mean ◽

Group 2 ◽

The One ◽

Group 1

Abstract Background: The Kocher-Langenbeck (K-L) approach is the standard method for the treatment of posterior wall or column acetabular fractures. This approach allows direct access to the posterior structures of the acetabulum, but is limited cranially and caudally by the neurovascular bundle. The present study was conducted to assess the quality of reduction and the incidence of complications in patients who underwent the modified “one-incision two-window” K-L approach.Methods : This is a Retrospective case series with recruited thirteen consecutive patients from 2015 to 2017 who sustained an acute, displaced posterior wall or column acetabular fracture. All patients were treated with modified “one-incision two-window” K-L approach.Results: The mean operation time, mean intraoperative blood loss, and mean incision wound length were estimated to be 103.8 min (60-120 min), 373.1 mL (100-700 mL), and 9.7 cm (8.0-13.0 cm), respectively. The radiographic quality of reduction was graded as anatomical reduction (maximum residual displacement [MRD] ≤ 2 mm) in all cases, according to Matta’s criteria. Concerning the incidence of complications, there were no iatrogenic neurovascular injury, no surgical site infections, and no osteonecrosis of the femoral head or heterotopic ossification in this cohort. One patient with transverse posterior wall fracture (group 1) experienced deep vein thrombosis in the lesion leg. Another two patients with solitary posterior wall fracture (group 2) developed posttraumatic osteoarthritis, with one diagnosed as Tonnis grade I lesion and the other as Tonnis grade III lesion. With respect to the clinical treatment outcome, the mean visual analogue scale (VAS), mean modified Harris Hip Score (mHHS) and subjective satisfaction rate were 1.7 (1.0-2.0), 90.6 (81-100), and 84.6% (80%-90%), respectively. Although there was no significant difference in the satisfaction rate (82.9% vs. 87.0%, P = 0.941) at 12 months after surgery, group 1 patients had more increased VAS score (2.0 vs. 1.2, P = 0.016) and more decreased mHHS (87.7 vs. 94.6, P = 0.014) than group 2 patients. Conclusions: Our pilot study confirmed that the “one-incision two-window” K-L approach is a simple, safe, reliable, and effective way to manage acute, displaced posterior wall or column acetabular fractures.Level of evidence: Therapeutic study, level IV.

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Results of upfront therapy for marginal zone lymphoma (MZL).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e19510 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e19510-e19510

Author(s):

Fernando Cabanillas ◽

Jose Luis Ortega ◽

Noridza Rivera-Rodriguez ◽

Blanca Rodriguez ◽

Wandaly Ibis Pardo ◽

...

Keyword(s):

Marginal Zone ◽

Early Stage ◽

Prospective Trial ◽

Advanced Stage ◽

Watch And Wait ◽

Curative Intent ◽

Free Survival ◽

Group 2 ◽

Group 1

e19510 Background: MZL is an indolent NHL composed of 3 subtypes: extranodal (MALT), splenic marginal zone (SMZL) and nodal marginal zone (NML). While MALT usually presents with early stage, the others frequently present with advanced disease. Early stage MALT is usually treated with XRT or antibiotics with ~85-90% failure free survival (FFS) and overall survival (OS), while for SMZL watch and wait or splenectomy (Spl) have been the mainstay of therapy. Spl leads to improvement but rarely to CR. 5 yr FFS and OS with Spl have been 45% and 80%. At 10 yrs FFS and OS are 22% and 62%. NML is usually managed with watch and wait. The 5 yr FFS and OS for NML have been 30% and 60%. Watch and wait and Spl are used in part because advanced MZL is considered incurable. Rituximab (R) as well fludarabine (F) are active in this disorder but traditionally are given after relapse. Methods: Instead of watch and wait or Spl, we have used upfront chemo with curative intent for SMZL and NML as well as for advanced MALT. For early stage MALT we used either XRT alone or antibiotics. We hereby report on 44 pts with MZL of which 31 were MALT, 9 SMZL, 4 NMZL. For the purpose of analysis we divided the pts in 2 groups. Group 1 consists of 22 early stage MALT who were all treated with either XRT (N=17) or antibiotics +/- surgery (N=5). Group 2 consists of 22 cases who were treated with chemo alone. This group is made up of 9 MALT (4 advanced stage, 3 early stage but with transformation, 2 early stage but in whom XRT was contraindicated), 9 advanced stage SMZL, 4 NML. Chemo for group 2 consisted of F, mitoxantrone, dexamethasone, rituximab (FND-R) (N=14) or R-CHOP (N=8). Maintenance R was used in 70% of group 2. Results: Of the whole group, 100% were CR and only 2 relapsed at 70 and 75 months; both relapses were stage I MALT and had received XRT only. Both were salvaged with FND-R and remain NED 27 and 39 months from relapse. At 10 yrs, FFS was 80% and OS=100%. None of the 22 in group 2 have relapsed. The long-term toxicity has been acceptable. Conclusions: The excellent FFS and OS using upfront chemotherapy in group 2, suggests that this disorder is curable and our results should be confirmed in a prospective trial. For those with early stage MALT, XRT alone +/- antibiotics and when necessary salvage with FND-R, should be tested.

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Effect of Lisinopril and Verapamil on Angiopoietin 2 and Endostatin in Hypertensive Diabetic Patients with Nephropathy: A Randomized Trial

Hormone and Metabolic Research ◽

10.1055/a-1517-6643 ◽

2021 ◽

Vol 53 (07) ◽

pp. 470-477

Author(s):

Al-Aliaa M. Sallam ◽

Mohamed Salem ◽

Eman Abdel-Aleem ◽

Hala O. El-Mesallamy

Keyword(s):

Early Stage ◽

Controlled Trial ◽

Fasting Blood Glucose ◽

Diabetic Patients ◽

Converting Enzyme Inhibitors ◽

Angiogenic Proteins ◽

Group 2 ◽

Angiopoietin 2 ◽

Group 1

AbstractAngiogenesis is a multistep process implicated in the pathophysiology and progression of diabetic nephropathy (DN). Angiotensin-converting enzyme inhibitors (ACEI) and calcium channel blockers (CCB) have an important role in DN. We performed a randomized-controlled trial of lisinopril alone (an ACEI) or in combination with verapamil (a CCB) as a therapy for DN in type 2 diabetes mellitus (T2DM) patients with hypertension (HTN) and urinary albumin creatinine ratio (UACR) (30–300 mg/g) also to evaluate their effect on UACR, the angiogenic proteins: Angiopoietin 2 (Ang-2) and Endostatin (EST). Forty T2DM patients with microalbuminuria, aged 45–65 years were included. Patients were randomly assigned into group 1 receiving oral lisinopril and group 2 receiving oral lisinopril and verapamil once daily. After 3 months follow-up fasting blood glucose (FPG), HbA1c, lipid profile, UACR, serum urea and creatinine levels were assessed. EST and Ang-2 were measured using ELISA technique. Baseline Ang-2 and EST levels were elevated in both groups compared with controls (p<0.001). After follow-up, group 2 had significantly decreased FPG, HbA1c, UACR, EST and Ang-2 compared with their baseline levels (p<0.001 for all comparisons) and with group 1 (p<0.001). No adverse reactions were reported. Baseline EST and Ang-2 were positively correlated to UACR (r=0.753, p<0.001) (r=0.685, p<0.001). Lisinopril/verapamil combination enhanced glycemic control and kidney function via diminishing EST and Ang-2. This combination can be considered as a safe and effective approach for early stage nephropathy therapy in T2DM.

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Decompression of the labyrinthine segment of the facial nerve in acoustic neuroma surgery: a consideration for minimizing postoperative delayed facial nerve dysfunction

Neurosurgical FOCUS ◽

10.3171/foc.1998.5.3.12 ◽

1998 ◽

Vol 5 (3) ◽

pp. E11 ◽

Cited By ~ 1

Author(s):

Michael J. Holliday ◽

Prakash Sampath

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Internal Auditory Canal ◽

Acoustic Neuromas ◽

Microsurgical Resection ◽

Nerve Dysfunction ◽

Group 2 ◽

Acoustic Tumor ◽

Group 1

Delayed facial nerve palsy, a condition characterized by spontaneous deterioration of facial nerve function in patients who had otherwise normal or near-normal facial function in the immediate postoperative period, has been reported in 15 to 29% of patients undergoing microsurgical resection of vestibular schwannomas. One putative mechanism for its occurrence suggests that edematous entrapment of the facial nerve in the meatal foramen (the narrowest segment of the internal auditory canal) may lead to nerve ischemia or necrosis and subsequent facial nerve dysfunction. To assess whether meatal decompression may help reduce the incidence of delayed facial nerve palsy during microsurgical resection of acoustic tumors, we compared 25 patients undergoing translabyrinthine removal of acoustic neuromas who received prophylactic decompression of the labyrinthine segment of the facial nerve (Group 1) with 40 patients who did not receive facial nerve decompression (Group 2). No patients in Group 1 had a delayed progressive facial paralysis with degeneration. In contrast, when Group 2 patients with larger, average-sized tumors were reviewed, eight patients (20%) developed delayed degeneration. These findings suggest that decompression of the labyrinthine segment may be of value in acoustic tumor surgery in reducing delayed facial nerve dysfunction. Further study is indicated in this important area.

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Significance of Ovarian Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001136 ◽

2018 ◽

Vol 28 (1) ◽

pp. 11-18 ◽

Cited By ~ 10

Author(s):

Jeong-Yeol Park ◽

Dae-Yeon Kim ◽

Dae-Shik Suh ◽

Jong-Hyeok Kim ◽

Yong-Man Kim ◽

...

Keyword(s):

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Early Stage ◽

Stage I ◽

Ovarian Clear Cell Carcinoma ◽

Ovarian Endometriosis ◽

Early Stage Disease ◽

Group 2 ◽

Group 1

IntroductionThe aim of this study was to evaluate the significance of ovarian endometriosis on the prognosis of ovarian clear cell carcinoma (OCCC).MethodsPatients with OCCC were divided into 2 groups according to the presence of ovarian endometriosis: group 1, no coexisting ovarian endometriosis; group 2, clear cell carcinoma arising from ovarian endometriosis or the presence of ovarian endometriosis elsewhere in the ovary. Clinicopathologic characteristics, disease-free survival (DFS), and overall survival (OS) were compared between the 2 groups.ResultsOf 155 patients with OCCC, 77 were categorized into group 1 and 78 into group 2. Group 2 patients were younger than group 1 (median age, 48 vs 51 years; P = 0.005) and had higher incidence of early-stage disease (stage I, 77% vs 58%; P = 0.001) and lower incidence of lymph node metastasis (4% vs 17%; P = 0.008). Group 2 patients were observed to have a significantly higher 5-year DFS (P < 0.001) and OS (P = 0.001) compared with group 1. In stage I disease, group 2 had a significantly higher 5-year DFS (P = 0.004) and OS (P = 0.016) than did group 1. In the multivariate analysis, coexisting endometriosis and advanced International Federation of Obstetrics and Gynecology stage were significant factors for both DFS and OS rates.ConclusionsOvarian clear cell carcinoma with endometriosis was found more frequently in younger women and had a higher incidence of early-stage disease and a lower incidence of lymph node metastasis compared with OCCC without endometriosis. Ovarian endometriosis was associated with improved prognostic factors and a better DFS and OS even in stage I disease. Ovarian endometriosis was an independent prognostic factor for OCCC.

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Effect of Bumetanide on Facial Nerve Regeneration in Rat Model

Otolaryngology ◽

10.1177/0194599820937670 ◽

2020 ◽

pp. 019459982093767

Author(s):

Ecem Sevim Longur ◽

Özgür Yiğit ◽

Çiğdem Kalaycık Ertugay ◽

Ela Araz Server ◽

Turgut Adatepe ◽

...

Keyword(s):

Facial Nerve ◽

Nerve Regeneration ◽

Facial Paralysis ◽

Control Group ◽

Treatment Groups ◽

Group 4 ◽

Nerve Recovery ◽

Electron And Light Microscopy ◽

Group 2 ◽

Group 1

Objective We investigated the effects of bumetanide alone and in combination with dexamethasone on facial nerve regeneration in rats with facial paralysis. Study Design A prospective controlled animal study. Setting An animal laboratory. Subjects and Methods Facial paralysis was induced in 32 Wistar rats that we then divided into 4 groups: group 1, control; group 2, bumetanide; group 3, dexamethasone; group 4, bumetanide and dexamethasone. Electroneurography was performed 1, 2, and 4 weeks later, and nerve regeneration was evaluated by electron and light microscopy and Western blotting in week 4. Results Regarding the comparison between preoperative values and week 4, the latency difference in group 1 (1.25 milliseconds) was significantly higher than those of groups 2 to 4 (0.56, 0.34, and 0.10 milliseconds, respectively; P = .001). The latency increment in groups 2 and 3 was higher than that of group 4 ( P = .002 and P = .046) in week 4, whereas groups 2 and 3 did not differ significantly ( P = .291). Amplitude difference was not statistically significant from week 4 among all groups (all P > .05). The number of myelinated axons was significantly higher in all treatment groups than in the control group ( P = .001). Axon number and intensity were significantly higher in group 4 as compared with groups 2 and 3 ( P = .009, P = .005). Conclusion After primary neurorrhaphy, dexamethasone and bumetanide alone promoted nerve recovery based on electrophysiologic and histologic measures. Combination therapy was, however, superior.

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P4421Increased circulating levels of VCAM-1 correlate with left atrial remodeling in highly trained athletes

European Heart Journal ◽

10.1093/eurheartj/ehz745.0823 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

L Gabrielli ◽

L Garcia ◽

R Fernandez ◽

J Vega ◽

M P Ocaranza ◽

...

Keyword(s):

Left Atrial ◽

Posterior Wall ◽

Serum Levels ◽

P Value ◽

Atrial Remodeling ◽

Marathon Runners ◽

Potential Biomarker ◽

Increased Risk ◽

Group 2 ◽

Group 1

Abstract Introduction Reports have shown increased risk of atrial fibrillation (AF) in athletes. Vascular cell adhesion molecule-1 (VCAM1) is associated with new onset AF in general population. VCAM1 and its relation with left atrial (LA) remodeling have not been investigated in athletes. Purpose To study VCAM1 and LA remodeling in marathon runners. Methods Study of 36 male marathon runners in the training period previous to race (42 km) and 18 sedentary controls with no risk factors. Athletes were divided in two groups according to highest training intensity reached (group 1, >100 km/week; group 2, 50–100 km/week). Previous to race in all subjects, VCAM1 serum levels were measured by ELISA and an echocardiogram was performed. In athletes, VCAM1 was measured immediately post-race. Wilcoxon and Spearman were used. Results See table. Group 1 showed a significant increment in VCAM1 post-race (651±350 to 905±373 ng/mL; p=0.002) as compared to group 2 with no increment (533±133 to 651±138 ng/mL; p=0.117). In athletes, a moderate correlation between LA volume and VCAM1 was found (rho: 0.483; p=0.007). Baseline characteristics Group 1 (n=18) Group 2 (n=18) Controls (n=18) p value Age (years) 37±6 38±5 36±4 0.373 Heart rate (bpm) 53±8 57±7 69±6 * 0.001 Body surface area (m2) 1.8±0.1 1.8±0.1 1.9±0.1 0.075 LV diastolic diameter (mm) 49±5 48±5 46±4 0.404 LV systolic diameter (mm) 29±5 30±5 30±4 0.879 Septal wall (mm) 9.1±1.2† 8.2±1.1 8.1±0.8 0.005 Posterior wall (mm) 9.3±2.1† 8.5±1.2 7.6±0.8 0.001 Ejection fraction (%) 55±3 55±6 57±4 0.110 LV mass index (g/m2) 106±27† 78±18 58±11 0.001 LA volume (mL/m2) 42±8† 30±11 25±9 0.001 E wave (cm/sec) 78±13 84±12 77±15 0.217 A wave (cm/sec) 50±12 53±10 48±16 0.438 DT (msec) 233±65 229±65 221±66 0.184 VCAM1 (ng/mL) 651±350† 533±133 440±98 0.022 Mean ± SD. *p<0.05 vs group 1 and 2 post Kruskall-Wallis; †p<0.05 vs other groups post Kruskall-Wallis. LV, left ventricle; LA, left atrium; DT, deceleration time. Conclusions Most trained athletes had increased levels of VCAM1 as compared to controls and less trained athletes. They also showed an increment post-effort. VCAM1 is related to LA remodeling in athletes. VCAM1 could be a potential biomarker of AF in athletes which should be confirmed. Acknowledgement/Funding FONDECYT 1170963 (LG); FONDAP 15130011 (LG,SL)

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The effects of Kinesio Tape application with different verbal input given to with patients with rotator cuff tear

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00058 ◽

2017 ◽

Vol 5 (2_suppl2) ◽

pp. 2325967117S0005

Author(s):

Yıldız Analay Akbaba ◽

Ebru Kaya Mutlu ◽

Süleyman Altun ◽

Gözde Gümüşoğlu ◽

Derya Çelik

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Effect Size ◽

Functional Limitations ◽

Excellent Result ◽

Kinesio Tape ◽

Cuff Tear ◽

Group 3 ◽

Group 2 ◽

Group 1

Purpose: Rototor cuff tears are most common of shoulder pain.and functional limitations. Kinesio tape (KT) are frequently used in the conservative treatment of shoulder pathology. Even if some studies showed that KT is effective on pain, we think that it is due to positive thoughts of the patients about KT. The aim of the study to investigate the effectiveness KT aplication with different verbal inputs on pain, function and range of motion (ROM) on patient with rotator cuff tear. Materials-Methods: 97 patients (Group 1, n=32; Group 2, n=33, Group 3, n=32) were randomized into 3 groups according to verbal input given to patients about the effectiveness of KT; Group 1 (it has been limited evidence of KT is effective), Group 2 (it has been not known that KT is effective or not), Group 3 (it has been known that KT has excellent result). The same standard KT was applied to 3 groups. The rest, night and pain in activity were assessed by VAS before, after 30 min and 24 hours after KT application. ROM assessed by goniometer and the function was evaluated by Disabilities of the Arm, Shoulder and Hand (DASH) and ASES before and 24 hours of KT application. Minimal clinically important difference and effective were calculated for the assessments used in the study. Results: Demographic variables were not different between groups. Resting pain did not change in Group 1 and Group 2 (pË‚0,05), however all pain parameters was significantly reduced in Group 3 (p = 0.001). Intra-group changes of ROM were not significant in all groups. DASH and ASES were significantly improved only Group 2 and 3. However, there were not significant different in terms of VAS, ROM, DASH and ASES among three groups (pËƒ0,05). The effect size was found in only positive verbal given group (Group 3) higher than the other groups, but the effect size was found very low. Conclusions: According to our result, KT application with positive input was found effective on pain and function. However effect size was very weak. In addition this improvement was not clinically significant.

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