86,856 research outputs found
Clarithromycin in the Management of Chronic Rhinosinusitis: Preliminary Results of a Possible Its New Use
No full textThe aim of this study is to evaluate the efficacy and safety of prolonged therapy with low-dose clarithromycin in patients with chronic rhinosinusitis with polyps (CRSwP) after endoscopic sinus surgery (ESS). A total of 10 patients with CRSwP were identified and subjected to bilateral ESS. In post-operative patients they were treated with nasal wash with saline solution and steroid sprays (beclomethasone). During follow-up, after 30–40 days after the operation (M = 35.4 SD = +4.33), patients reported a worsening of symptoms with onset of nasal obstruction; reduction/loss of smell; headache; onset of viscous secretions and therefore all patients continued therapy with saline nasal irrigation, topical steroid therapy and started macrolide (clarithromycin 500 mg/pill: 1 pill/day for 3 days a week for 1 month). 22-item SinoNasal Outcome Test (SNOT-22) and a score to the endoscopic evaluation (endoscopic appearance score, EAS) before and after treatment were performed to evaluate efficacy of treatment. The results of the SNOT-22 and EAS showed statistically significant improvements (p < 0.05) for some parameters such as: the need to blow nose, sneezing, hyposmia, viscous mucous secretions about the SNOT-22 and reduction of secretions and edema of the nasal mucosa about the EAS. The preliminary results of our study show that the low-dose clarithromycin for a period of 1 month can improve patient complaints with CRSwP not only through the antibacterial properties but also for the immunomodulatory characteristics
Pseudoaneurysm of superior thyroid artery following a transesophageal echocardiography: A case presentation
No full textThe pseudo-aneurysm is an encapsulated hematoma of post-traumatic origin which is in communication with the lumen of the artery of relevance. We present a rare case of pseudo-aneurysm occurring after superior thyroid trans-esophageal echocardiography (TEE) and external cardioversion. Singular occurrence in otolaryngology, if not recognized early a pseudo-aneurysm can result in dramatic events such cataclysmic bleeding or acute occlusion of the upper airway
Nasal packing in sphenopalatine artery bleeding: therapeutic or harmful?
No full textThe aim of this study is to present our management protocol of sphenopalatine artery bleeding, demonstrating that nasoendoscopic cautery (NC) was a more effective method than the nasal packing, in terms of shorter inpatient stay and reduced complications rate. We present ten posterior epistaxis not resolved by nasal packing. Tabotamp® was placed in the area of sphenopalatine foramen and/or in those parts of the posterior nasal cavity, where it was suspected that bleeding origins. In two cases, the bleeding was resolved in this way, instead eight cases needed of subperiosteal cauterization of sphenopalatine artery by Dessi bipolar forceps (MicroFrance®). 4 of these 8 patients evidenced a remarkable bleeding removing nasal packing (Hb before-nasal packing = 15 ± 0.69 versus Hb after-nasal packing = 13.3 ± 0.81; t student = 2.94; p value = 0.025). These four patients showed a deviation of the nasal septum ipsilateral to epistaxis, and according our experience, a traumatism of sphenopalatine area can be caused by Merocel® nasal packing in this condition. During follow-up, no recurrences of nasal bleeding have been observed in such patients. Nasal packing must be considered if posterior epistaxis is severe, but always taking into account the specific anatomy of patient and in particular septal spurs that can further compromise sphenopalatine artery. In our experience, the endoscopic endonasal cauterization of the sphenopalatine branches represented a safe and effective procedure.
Prognostic Value of 18 F-Fluorocholine PET Parameters in Metastatic Castrate-Resistant Prostate Cancer Patients Treated with Docetaxel
No full textBackground and Aim. The availability of new treatments for metastatic castrate-resistant prostate cancer (mCRPC) patients increases the need for reliable biomarkers to help clinicians to choose the better sequence strategy. The aim of the present retrospective and observational work is to investigate the prognostic value of 18 F-fluorocholine ( 18 F-FCH) positron emission tomography (PET) parameters in mCRPC. Materials and Methods. Between March 2013 and August 2016, 29 patients with mCRPC were included. They all received three-weekly docetaxel after androgen deprivation therapy, and they underwent 18 F-FCH PET/computed tomography (CT) before and after the therapy. Semi-quantitative indices such as maximum standardized uptake value (SUV max ), mean standardized uptake value (SUV mean ) with partial volume effect (PVC-SUV) correction, metabolically active tumour volume (MATV), and total lesion activity (TLA) with partial volume effect (PVC-TLA) correction were measured both in pre-treatment and post-treatment 18 F-FCH PET/CT scans for each lesion. Whole-body indices were calculated as sum of values measured for each lesion (SSUV max , SPVC-SUV, SMATV, and STLA). Progression-free survival (PFS) and overall survival (OS) were considered as clinical endpoints. Univariate and multivariate hazard ratios for whole-body 18 F-FCH PET indices were performed, and p<0.05 was considered as significant. Results. Cox regression analysis showed a statistically significant correlation between PFS, SMATV, and STLA. No correlations between OS and 18 F-FCH PET parameters were defined probably due to the small sample size. Conclusions. Semi-quantitative indices such as SMATV and STLA at baseline have a prognostic role in patients treated with docetaxel for mCRPC, suggesting a potential role of 18 F-FCH PET/CT imaging in clinical decision-making
The endoscopic diving technique in pituitary and cranial base surgery: Technical note
No full textObjective: We used the diving technique to go beyond mere visualization of the surgical field and used it as an important step in removing the lesion itself, improving the optical field, and optimizing visualization with a dynamic fluid film lens. Likewise, having extended endoscopic endonasal surgery to the entire base of the skull and in particular to the sinus cavity, "diving surgery" has proven to be effective in visualizing and dissecting more extended tumors. Methods: We performed diving surgery in more than 350 surgical procedures to remove lesions in the sellar, sinus cavity, and clival regions. Intrasellar hydroscopy was performed in all cases to check that the lesion was removed completely and to gently dissect any intracavitary residual tumoral tissue. Diving surgery can be performed in the sellar cavity, in the cavernous sinus, and at the level of the posterior cranial fossa in the cavity obtained after clivectomy. Results: The hydrodissection and continuous flushing of the sellar cavity, together with better control of bleeding, allow the surgeon to perform piecemeal removal of the lesion with direct control of the cleavage plane and tumor residue and avoid blind curettage near the pituitary gland. This technique is particularly useful in identifying small infiltrations of the cavernous sinus and in checking the integrity of the pituitary stalk when instruments are introduced into the sella. Conclusion: Diving surgery is a useful step in dealing with minor complications that can occur during endonasal endoscopic surgical procedures. Copyright © 2010 by the Congress of Neurological Surgeons
The minimally invasive sinus surgery technique
No full textThe minimally invasive sinus technique, (MIST) is different from minimally invasive sinus surgery. MIST implies a treatment philosophy and surgical model that is quite different from functional endoscopic sinus surgery (FESS). The goals of this article are to discuss the origins of functional sinus surgery as it relates to the evolution of FESS and MIST, define MIST as a philosophy and surgical model, discuss treatment of surgical sinus disease, and challenge the rationale for our departure from Messerklinger's "functional" concepts into what will be referred to as "contemporary FESS. " Many authors address the reduced revision rate (compared with FESS) following initial intervention with MIST, the potential to markedly reduce the rate of intranasal synechiae, and the reduction in immediate postoperative morbidity
Synthesis, modeling and binding affinity of an ester analogue of the terminal trisaccharide of the tumor-associated antigen globo-H-1
No full textThe synthesis of the trisaccharide α-L-Fucp-(1→2)-β-D-Galp-(1→3)- β-D-Galp2AcOPr (3), mimicking the globo-H terminal trisaccharide unit (2), is described. The conformational properties of 3 were investigated with the aid of molecular mechanics energy minimizations, molecular dynamics simulations, and 1H-NMR spectroscopic analysis and resulted in strict analogy with those of 2. Nevertheless, analysis of MBr1 binding to these compounds indicate that substitution of the acetamido group at C-2 with the ester group lowers the affinity, thus suggesting that the amide hydrogen atom of 2 is involved in intermolecular interactions with the MBr1 antibody
Prognostic Value of 18 F-Fluorocholine PET Parameters in Metastatic Castrate-Resistant Prostate Cancer Patients Treated with Docetaxel
No full textBackground and Aim. The availability of new treatments for metastatic castrate-resistant prostate cancer (mCRPC) patients increases the need for reliable biomarkers to help clinicians to choose the better sequence strategy. The aim of the present retrospective and observational work is to investigate the prognostic value of F-18-fluorocholine (F-18-FCH) positron emission tomography (PET) parameters in mCRPC. Materials and Methods. Between March 2013 and August 2016, 29 patients with mCRPC were included. They all received three-weekly docetaxel after androgen deprivation therapy, and they underwent F-18-FCH PET/computed tomography (CT) before and after the therapy. Semi-quantitative indices such as maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean) with partial volume effect (PVC-SUV) correction, metabolically active tumour volume (MATV), and total lesion activity (TLA) with partial volume effect (PVC-TLA) correction were measured both in pre-treatment and post-treatment F-18-FCH PET/CT scans for each lesion. Whole-body indices were calculated as sum of values measured for each lesion (SSUVmax, SPVC-SUV, SMATV, and STLA). Progression-free survival (PFS) and overall survival (OS) were considered as clinical endpoints. Univariate and multivariate hazard ratios for whole-body F-18-FCH PET indices were performed, and p<0.05 was considered as significant. Results. Cox regression analysis showed a statistically significant correlation between PFS, SMATV, and STLA. No correlations between OS and F-18-FCH PET parameters were defined probably due to the small sample size. Conclusions. Semi-quantitative indices such as SMATV and STLA at baseline have a prognostic role in patients treated with docetaxel for mCRPC, suggesting a potential role of F-18-FCH PET/CT imaging in clinical decision-making
The role of Leptin in laryngeal squamous cell carcinoma
No full textLeptin is a peptide produced by peptidergic cells or those able to process and secrete peptides. Originally, this function was considered proper and exclusive of certain neurons of the magnocellular and parvicellular hypothalamus. These cells originated from a common precursor, namely neural crest cells, which have the ability to produce hormonal neuropeptides. From this primitive neuroectodermal site, cells migrate to other organs: the gastro-entero-pancreatic system (GEP), the lung, heart, reproductive and urinary systems. Leptin is considered the typical neuropeptide with an anorexic function, and is also called the “satiety hormone” because it plays a key role in the control of energy expenditure and food intake. Leptin was identified for the first time in white and brown adipocytes. Although initially thought to be exclusively expressed and secreted by adipocytes, leptin has been identified in other tissues related with nutritional homeostasis, such as gastric and salivary glands. In addition, leptin or its receptors have been observed in gastric, colorectal and breast cancers. It is believed to have a role in stimulating cell proliferation, and is associated with a risk of developing cancer as well as progression and invasiveness. To date, the role of leptin in the development of the carcinoma of the larynx has been poorly investigated. The principal endpoint of this chapter was to evidence the peptidergic immunohistochemical expression of leptin in laryngeal SCCs, its possible role in cell proliferation and the prognostic factor and predictor of locoregional recurrences
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