scholarly journals Role of coblation in reducing pain and morbidity of adenoidectomy

2019 ◽  
Vol 6 (1) ◽  
pp. 123
Author(s):  
George Thomas ◽  
Jathin Sam Thekkethil ◽  
Sumin Mariyam Thomas ◽  
Shary Ramesh ◽  
Ann Mariam Varghese
Keyword(s):  
Hospital Stay ◽  
Upper Respiratory Tract ◽  
Surgical Risk ◽  
The Past ◽  
Disturbed Sleep ◽  
Post Operative Period ◽  
The Mean ◽  
Upper Respiratory ◽  
One Year

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the most commonly performed paediatric surgical procedure by otorhinolaryngologists. Over the past few decades, adenoidectomy has evolved and different techniques have been proposed to reduce morbidity and surgical risk. Controlled ablation or Coblation® is capable of low temperature molecular disintegration within soft tissue causing its dissolution. In this study, we report our experience of adenoidectomy using Coblation®, and its role in reducing pain, morbidity and its significant outcomes are discussed.</p><p class="abstract"><strong>Methods:</strong> A total number of 25 children aged 3-15 years, who underwent coblation adenoidectomy between March 2017 and April 2018 were included in this study.</p><p class="abstract"><strong>Results:</strong> The mean age was 7.8 years (males 7.79 years and females 7.81 years). Pre operatively 100% patients had sleep disturbance and after coblation adenoidectomy only 12% patients have disturbed sleep and the rest 88% patients have comfortable sleep. 80% patients did not have pain in immediate post-operative period and 88% had no pain when they visited hospital for first review. 76% patients had less than one day of hospital stay and 24% patients had more than one day of hospital stay. 68% patients had no episode of upper respiratory tract infection (URTI) within the first one year after surgery.</p><p class="abstract"><strong>Conclusions:</strong> Over the years, many different adenoidectomy techniques have evolved and is surgeon specific or centre specific. Endoscopic-assisted coblation adenoidectomy is a safe and effective method of adenoidectomy.</p><p> </p>

scholarly journals The Role of Self-Perceptions of Aging for Recovery of Older Adults After a Hospital Stay

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 588-588
Author(s):  
Anne Blawert ◽  
Ellen Freiberger ◽  
Susanne Wurm
Keyword(s):  
Older Adults ◽  
Hospital Stay ◽  
Physical Function ◽  
Fear Of Falling ◽  
Health Events ◽  
Self Perceptions ◽  
Perceptions Of Aging ◽  
One Year ◽  
Psychological Pathway

Abstract For older adults, a hospital stay can lead to loss of physical function and frailty. It is therefore important to investigate factors for recovery after hospitalization. Recent studies suggest negative self-perceptions of aging (SPA) as a potential risk factor in the context of serious health events. This ongoing longitudinal study investigates how negative SPA might contribute to worse physical recovery (assessed with the Short Physical Performance Battery) after hospital stay in a sample of 244 German adults aged 75 to 96. Preliminary mediation analysis based on available data of the first 50 participants indicate that negative SPA is related to increased fear of falling after 6 months, which predicts worse physical function one year after hospitalization (indirect effect: B = -0.70, SE = 0.41, p = .09). The results stress the importance of SPA for health recovery in old age and introduce fear of falling as a psychological pathway.

scholarly journals Toll-Like Receptors: Expression and Roles in Otitis Media

2021 ◽  
Vol 22 (15) ◽  
pp. 7868
Author(s):  
Su Young Jung ◽  
Dokyoung Kim ◽  
Dong Choon Park ◽  
Sung Soo Kim ◽  
Tong In Oh ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Otitis Media ◽  
Middle Ear ◽  
Upper Respiratory Tract Infection ◽  
Upper Respiratory Tract ◽  
Toll Like Receptors ◽  
Upper Respiratory

Otitis media is mainly caused by upper respiratory tract infection and eustachian tube dysfunction. If external upper respiratory tract infection is not detected early in the middle ear, or an appropriate immune response does not occur, otitis media can become a chronic state or complications may occur. Therefore, given the important role of Toll-like receptors (TLRs) in the early response to external antigens, we surveyed the role of TLRs in otitis media. To summarize the role of TLR in otitis media, we reviewed articles on the expression of TLRs in acute otitis media (AOM), otitis media with effusion (OME), chronic otitis media (COM) with cholesteatoma, and COM without cholesteatoma. Many studies showed that TLRs 1–10 are expressed in AOM, OME, COM with cholesteatoma, and COM without cholesteatoma. TLR expression in the normal middle ear mucosa is absent or weak, but is increased in inflammatory fluid of AOM, effusion of OME, and granulation tissue and cholesteatoma of COM. In addition, TLRs show increased or decreased expression depending on the presence or absence of bacteria, recurrence of disease, tissue type, and repeated surgery. In conclusion, expression of TLRs is associated with otitis media. Inappropriate TLR expression, or delayed or absent induction, are associated with the occurrence, recurrence, chronicization, and complications of otitis media. Therefore, TLRs are very important in otitis media and closely related to its etiology.

Evaluation of Transient Elastography in Prediction Of De novo Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nadia abdelaty Abdelkader ◽  
Moustafa Hamed Abdelaleem ◽  
Mohammed El-Gharib Abo El- maaty ◽  
Heba Ismail Aly ◽  
Sayed Ahmed Sayed
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Transient Elastography ◽  
P Value ◽  
Hepatic Decompensation ◽  
Non Invasive ◽  
Prediction Of Mortality ◽  
The Mean ◽  
One Year

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and it is also a common cause of death in patients with chronic liver disease. The curative treatment options for HCC that are currently available are surgical resection, liver transplantation and radiofrequency ablation .Despite progressive improvements in the efficacy of RFA, the survival of patients with HCC who undergo RFA remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after RFA. Aim of the work To evaluate the role of transient elastography (as an indirect indicator to degree of liver fibrosis) in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation in hepatitis C related hepatocellular carcinoma .And to compare between transient elastography and other non invasive fibrosis indices in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation hepatitis C related hepatocellular carcinoma Patients and methods This prospective cohrt study was conducted on hepatocellular carcinoma patient, who underwent radiofrequency ablation in Tropical Medicine Department in Eldemerdash and Ain Shams Specialized Hospital, HCC clinic Ain Shams University Hospitals, Cairo, Egypt between march, 2017 and May, 2019. Data of the patient, who underwent radiofrequency ablation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and underwent radiofrequency ablation were followed up for 12 months. Results TE revealed 28 patients with F4 and only 2 patients with F3, the mean measurement of liver stiffness was (22.45 ± 10.36) KPa. There was a significant negative correlation between LS and denovo recurrence of HCC (mean of LS in patients with complete response was 17.19 ± 3.32 and the mean of LS in patient with denovo recurrence was 36,94 ± 5.93,with the The best cut off value ≥24.65 (p value &lt; 0.001)). There was no significant correlation between CDC, FIB4, API scores and denovo recurrence of HCC. Also it was found that the LS was significantly associated with prediction of manifestation of hepatic decompensation after RFA (means of LS in patient without manifestation decompensation after RFA (p value &lt;0.001) .Regarding prediction of mortality, LS at cut off value &gt; 42 .75 (p value = 0,031) was significantly associated with prediction of mortality after one year of RFA. As regard serum non invasive fibrosis indices our results showed correlation between FIB4 score and hepatic decompensation after one year of intervention (the mean of FIB4 score in patients ascites and jaundice was 6.05 ± 4.71 (p value = 0.05) ).Therewas no statistically significant correlation between CDS and API with hepatic decompensation after RFA .As regard role of serum non invasive fibrosis indices in prediction of mortality after RFA, FIB4 score, CDS and API were statistically non significant. Conclusion Our data suggest that LS measurement is a useful predictor of HCC de novorecurrence overall survival and possibility of hepatic decompensation after RFA

scholarly journals A role of oropharyngeal microbiota in developing acute and chronic diseases of the upper respiratory tract

2020 ◽  
Vol 10 (2) ◽  
pp. 359-367
Author(s):  
I. I. Ababii ◽  
L. A. Danilov ◽  
M. K. Maniuc ◽  
P. I. Ababii ◽  
S. S. Ghinda ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Chronic Tonsillitis ◽  
Upper Respiratory Tract Infections ◽  
Control Group ◽  
Healthy Children ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Currently, a rise in incidence of polyethological inflammation of the upper respiratory tract mucosa paralleled by altered resident and transient microbiota displaying in many cases increased antibiotic resistance has been noted. Opportunistic microbes play a major role in developing inflammatory process in Pirogov–Waldeyer’s ring. An inflammatory process occurring in the tonsillar lymphatic tissue results in host systemic complications. Fighting against acute and chronic infections of the upper respiratory tract holds the main task in pediatric otorhinolaryngology, as they can consequently elicit the cardiovascular, genitourinary and musculoskeletal complications. The results of studies examining this issue remain very contradictory, which accounted for a need to conduct our study on the territory of Moldova featured with mixed climatic conditions. Here, we wanted to study a role of microbial factor in etiopathogenesis of chronic tonsillitis in children. Bacteriological microbiota data for superficial palatine tonsils were obtained form 608 children subdivided into 5 groups: group I — 333 children with compensated chronic tonsillitis; group II — 87 children with decompensated chronic tonsillitis; group III — 91 children with acute upper respiratory tract infections (comparison group); group IV — 48 children with acute upper respiratory tract infections treated with antibiotic therapy; group V — 49 apparently healthy children (control group). It was found that β-hemolytic streptococcus exerting high sensitivity to virtually all antibiotics groups was detected in 17.4% of children with acute tonsilar inflammatory processes and decompensated defense in the lymphatic pharyngeal ring compared to 3.5% in control group. Streptococcus pneumoniae was isolated in all study groups ranging within 4.8–21.7%, including 14% in apparently healthy children characterized by reduced antibiotics sensitivity. The data obtained suggest that sickly children with acute and chronic upper respiratory tract infections constitute a risk group for developing somatic diseases. The high incidence of Streptococcus pneumoniae indicates a need for performing immunoprophylaxis, use of therapeutic vaccination as a up-to-date, combined approach in treatment of such pediatric cohort.

scholarly journals Role of the Dermonecrotic Toxin of Bordetella bronchiseptica in the Pathogenesis of Respiratory Disease in Swine

2002 ◽  
Vol 70 (2) ◽  
pp. 481-490 ◽  
Author(s):  
Susan L. Brockmeier ◽  
Karen B. Register ◽  
Tibor Magyar ◽  
Alistair J. Lax ◽  
Gillian D. Pullinger ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Disease ◽  
Bordetella Bronchiseptica ◽  
Atrophic Rhinitis ◽  
Upper Respiratory Tract ◽  
Dermonecrotic Toxin ◽  
Etiologic Agents ◽  
Upper Respiratory ◽  
Phosphate Buffered Saline

ABSTRACT Bordetella bronchiseptica is one of the etiologic agents causing atrophic rhinitis and pneumonia in swine. It produces several purported virulence factors, including the dermonecrotic toxin (DNT), which has been implicated in the turbinate atrophy seen in cases of atrophic rhinitis. The purpose of these experiments was to clarify the role of this toxin in respiratory disease by comparing the pathogenicity in swine of two isogenic dnt mutants to their virulent DNT+ parent strains. Two separate experiments were performed, one with each of the mutant-parent pairs. One-week-old cesarean-derived, colostrum-deprived pigs were inoculated intranasally with the parent strain, the dnt mutant strain, or phosphate-buffered saline. Weekly nasal washes were performed to monitor colonization of the nasal cavity, and the pigs were euthanized 4 weeks after inoculation to determine colonization of tissues and to examine the respiratory tract for pathology. There was evidence that colonization of the upper respiratory tract, but not the lower respiratory tract, was slightly greater for the parent strains than for the dnt mutants. Moderate turbinate atrophy and bronchopneumonia were found in most pigs given the parent strains, while there was no turbinate atrophy or pneumonia in pigs challenged with the dnt mutant strains. Therefore, production of DNT by B. bronchiseptica is necessary to produce the lesions of turbinate atrophy and bronchopneumonia in pigs infected with this organism.

Mortality after proximal hip fracture in the Singapore population

2005 ◽  
Vol 15 (3) ◽  
pp. 166-170 ◽  
Author(s):  
K.H. Lin ◽  
Y.W. Lim ◽  
Y.J. Wu ◽  
K.S. Lam
Keyword(s):  
Hip Fracture ◽  
Mortality Risk ◽  
Cox Regression ◽  
Regional Hospital ◽  
Age Group ◽  
Risk Of Death ◽  
The Past ◽  
The Mean ◽  
One Year

The aims were to prospectively assess the mortality risk following proximal hip fractures, identify factors predictive of increased mortality and to investigate the time trends in mortality with comparison to previous studies. Prospectively collected data from 68 consecutive patients who had been admitted to a regional hospital from May 2001 to September 2001 were reviewed. The mean age of the patients was 79.3 years old (range, 55–98) and 72.1% females. Patients were followed prospectively to determine the mortality risk associated with hip fracture over a two-year follow-up period. The acute in-hospital mortality rate at six months, one year and two years was 5.9% (4/68), 14.7% (10/68), 20.6% (14/68) and 25% (17/68) respectively. One-year and two-year mortality for those patients who were 80 or older was significantly higher than for other patients and the number of co-morbid illnesses also had significant effect. Cox regression was performed to determine the significant predictors for survival time. It was noted that patients 80 years or older were at higher risk of death compared with those less than 80 years as well as those with higher number of co-morbid illnesses. Our mortality rates have not declined in the past 10 years when compared with previous local studies. We conclude that for this group of patients studied, their mortality at one year and two years could be predicted by their age group and their number of co-morbid illnesses.

scholarly journals Inflammatory Cell Infiltration of Adrenals in COVID-19

2020 ◽  
Vol 52 (09) ◽  
pp. 639-641 ◽  
Author(s):  
Vsevolod A. Zinserling ◽  
Natalya Yu. Semenova ◽  
Alexander G. Markov ◽  
Oksana V. Rybalchenko ◽  
Jun Wang ◽  
...  
Keyword(s):  
Inflammatory Cell ◽  
Adrenal Glands ◽  
Virus Entry ◽  
Upper Respiratory Tract ◽  
Angiotensin Converting Enzyme 2 ◽  
Cd8 T Lymphocytes ◽  
The World ◽  
Upper Respiratory ◽  
Perivascular Infiltration

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was originated in November–December 2019 in Wuhan, China, and has rapidly spread around the world causing severe health and socioeconomical damage to the entire civilization. The key feature of coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is upper respiratory tract infection, which may be complicated by bilateral pneumonia. Angiotensin converting enzyme 2 (ACE2) has been identified as a key host factor, required for virus entry into cells. Interestingly, ACE2 is expressed not only in the respiratory system, but also in the other organs and systems including adrenal glands. Here we provide the first description of the pathomorphological changes in adrenal glands in patients with severe COVID-19 characterized by perivascular infiltration of CD3+ and CD8+ T-lymphocytes. Due to the central role of the adrenals in the stress response of the organism, this finding is of potential clinical relevance, because infection with the SARS-CoV-2 virus might critically impair adrenal function under pathophysiological conditions.

The Role of Bacterial Interference in Otitis, Sinusitis and Tonsillitis

2005 ◽  
Vol 133 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Itzhak Brook
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antimicrobial Agents ◽  
Bacterial Flora ◽  
Upper Respiratory Tract ◽  
Bacterial Strains ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Bacterial Interference

Bacterial interactions that include antagonism (interference) and synergism help maintain balance between the members of the normal endogenous flora. Alpha-streptococci that predominate in the normal respiratory tract flora attracted most attention in studies of bacterial interference. Other organisms that possess interfering characteristics in upper respiratory tract infections (URTIs) are nonhemolytic streptococci, and Prevotella and Peptostreptococcus spp. The production of bacteriocins by some microorganisms is one of the important mechanisms of interference. The role of bacterial interference in the development of URTI and its effect on the eradication of these infections is discussed. These infections include pharyngo-tonsillitis, otitis media, and sinusitis. Treatment with various antimicrobial agents can affect the balance between members of the oro-pharyngeal bacterial flora and interfering organisms. Implantation into the indigenous microflora of low virulence bacterial strains that are potentially capable of interfering with colonization and infection with other more virulent organisms has been used in preliminary studies as a means of coping with the failure of antimicrobials in the treatment of several URTI.

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