External ear canal exostectomy: influence of surgeon’s experience on 3-years recurrence and occurrence of complications

Background External ear canal exostoses are usually bilateral and broad-based, secondary to external ear canal chronic cold exposure, especially water. Objectives The objectives were to analyze the influence of the surgeon’s experience on the 3-year recurrence and on the complication. We also studied the influence of prolonged exposure to cold water on the incidence of recurrence. Material and Methods This monocentric retrospective study included 98 ears operated for canalplasty between 2009 and 2016 by nine different operators including one senior, a junior, and seven beginner surgeons. Senior, Junior, and Beginner groups were compared. Results 3-year recurrence rate was higher in the Beginner and Junior groups than in the Senior group (69% and 38% vs 18%, P = .001). Although there was a difference between the Beginner (69%) and Junior (38%) groups, it was not significant ( P = .407). Among the recurrences, 48% had continued exposure to cold water while only 7% of the ears without recidivism were still exposed ( P < .001, OR = 1.25 [4.4; 36.1]). The complication rates were similar between groups, concerning pain (8% vs 30% vs 12%), per procedure perforation (17% vs 10% vs 16%), scarring disorders (25% vs 20% vs 13%), and osteitis (8% vs 0% vs 1%). Hearing was unaffected. Conclusions This is the first study evaluating the risk of recurrence of external ear canal exostoses after canalplasty based on the surgeon’s experience. This risk of recurrence seems to decrease with the surgeon’s experience. There was no difference in complication rates.

Osteocyte Apoptosis Contributes to Cold Exposure-induced Bone Loss

Emerging evidence indicates that bone mass is regulated by systemic energy balance. Temperature variations have profound effects on energy metabolism in animals, which will affect bone remodeling. But the mechanism remains unclear. 2-month-old C57BL/6J male mice were exposed to cold (4°C) and normal (23°C) temperatures for 28 days and the effects of cold exposure on bone mass was investigated. Micro-computed tomography results showed that bone volume fraction was significantly reduced after 14 days of exposure to cold temperature, and it was recovered after 28 days. Ploton silver staining and immunohistochemical results further revealed that exposure to cold decreased canalicular length, number of E11-and MMP13-positive osteocytes after 14 days, but they returned to the baseline levels after 28 days, different from the normal temperature control group. In addition, change of Caspase-3 indicated that exposure to cold temperature augmented apoptosis of osteocytes. In vitro results confirmed the positive effect of brown adipocytes on osteocyte‘s dendrites and E11 expression. In conclusion, our findings indicate that cold exposure can influence bone mass in a time-dependent manner, with bone mass decreasing and recovering at 2 and 4 weeks respectively. The change of bone mass may be caused by the apoptosis osteocytes. Brown adipocyte tissue could influence bone remodeling through affecting osteocyte.

Experimental Studies of the Effect of Schisandrachinensis Extract on the State of Adaptive Capabilities of Rats under Chronic and General Exposure to Cold

Currently, there is an objective need to create fortified food products that allow not only to provide the body with energy, but also to replenish the deficiency of essential nutrients. A generalization of the information published by Rospotrebnadzor and the Institute of Nutrition of the Russian Academy of Medical Sciences indicates a deficiency in the diet of Russians of vitamins C, group B and β-carotene and minerals, including calcium and iron, regardless of the season of the year. The identified deviations lead to a violation of the immune status, a decrease in the body’s resistance to infections, and other unfavorable environmental factors, leading to an increase in the level of morbidity and a decrease in working capacity. The main unfavorable climatic factor that the population of the Far Eastern region has to face is low freezing temperatures. Adaptation to cold exposure is a complex process that requires a long period and may be accompanied by functional disorders and morphological changes in body tissues. In connection with the above, the problem of increasing the adaptive capabilities of a person to unfavorable environmental factors by means of correcting daily nutrition, providing the body with essential macro- and micronutrients, which is important in the prevention of possible diseases, is of particular importance. This study is aimed at assessing the effect of Schisandrachinensis extract on the adaptive capacity of rats in conditions of chronic and general cold. It was found that the extracts obtained from the fruits of Schisandra chinensis are characterized by a high content of biologically active substances. In experiments with determining the duration of running on the treadmill, a distinct act-protective effect was observed with the introduction of Schisandra chinensis extracts at a dose of 150 mg/day, against the background of reduced resistance to physical activity due to cold exposure. It was found that exposure to cold significantly reduced the swimming resistance of rats on all days of the study. The introduction of Schisandra chinensis extract into the diet led to an increase in resistance to fatigue and an increase in the duration of swimming on all days of the experiment. Conclusions: in this experimental model, a gradually increasing effect of increasing the physical performance of rats was demonstrated with prolonged (28 days) intake of the developed drinks, which coincides with the literature data on a number of other adaptogens and indicates the presence of cumulative properties of biologically active substances of Schisandra extract.

I am blue: a toddler’s Raynaud’s phenomenon

Raynaud’s phenomenon (RP) is a well-known disorder of self-limiting paroxysmal vasospasms occurring in small arteries of the digits, in the order of skin pallor (white), followed by cyanosis (blue), ending with hyperemia (red). These designative triphasic colour changes with exposure to cold, or emotional response is diagnostic in adults. RP is a very rare phenomenon in the young paediatric population as noted by Nigrovic et al with 123 patients <19 year old in a large children’s centre over 10 years and only 4 patients being <2 years old, with 69% of these being primary RP. To our knowledge, this is the youngest documented case of Raynaud’s disease that has not required treatment.

Correlation Knowledge to Hypothermic Handling Practices in Students

Hypothermia is a decrease in core body temperature to <35˚C due to heat loss. Factors causing hypothermia are cold weather, exposure to cold winds at high altitudes, immersion in cold water, and prolonged exposure to cold. Hypothermia is more common in hikers or mapala because they do activities exploring the highlands. The purpose of this study was to determine the relationship between knowledge of hypothermia and the practice of handling hypothermia in Mapala. This study used a correlation study method with a cross-sectional approach. The population in this study were Mapala UNISSULA, UNNES, and USM with a total of 52 students. The sampling technique was purposive sampling, the number of samples of this study was 30 students. The results of the Spearman Rank statistical test obtained a value of ρ value of 0.738 (ρ ≥ 0.05), so it was stated that there was no relationship between knowledge of hypothermia and the practice of handling hypothermia in Nature Lovers Students. Recommendations from research so that mapala members increase their knowledge and practice in handling emergency hypothermia by conducting ongoing training.