Dalsgaardjohannesen1063
and Objectives Leakage of cerebrospinal fluid (CSF) from the frontal sinus is a challenging condition facing the ENT surgeon. Repair of this condition has been changed nowadays due to the newer instruments and techniques of nasal endoscopy. MCC950 This study aims to evaluate the outcome of frontal sinus CSF leak endoscopic repair.
Twenty-seven patients who had frontal sinus CSF leaks were included in this study. They were 9 females and 18 males. They underwent endoscopic repair of the leak site at the period of five years from 2015 to 2020. A retrospective evaluation of these patients includes reconstructive procedures, complications, and postoperative follow-up.
The frontal leaks were present in the frontal recess (8 patients, 29.6%), ethmoidal roof (5 patients, 18.5%), and the majority was in the posterior wall (14 patients, 51.9%); 11 in the medial side and 3 in the lateral side. All cases, 27 (100%) were treated successfully, no failed treatment was observed. Postoperative complications were minimal; two patients had elevated intracranial pressure (ICP), infection with fever were found in four patients (7.4%), and meningitis was observed in only two cases (7.4%), treated conservatively.
For frontal sinus CSF leak repair, the endonasal endoscopic approach is the treatment of choice due to higher success rates and lower morbidity profile. A favorable result is possible with proper diagnosis, precise localization, and an appropriate strategy.
For frontal sinus CSF leak repair, the endonasal endoscopic approach is the treatment of choice due to higher success rates and lower morbidity profile. A favorable result is possible with proper diagnosis, precise localization, and an appropriate strategy.
The treatment of a fractures in tibial distal metaphyseal remained controversial. The purpose of this study was to assess the results and complications of minimally invasive medial plate osteosynthesis for distal metaphyseal tibial fractures.
From April 2014 to December 2019, 70 patients were enrolled in the study who were underwent MIPPO for metaphyseal tibial fractures using a medial distal tibial locking plate in our hospital. Wound healing, alignment, full weight bearing time, function, and complications were recorded.
All wounds primarily healed, just one fibular plating wound was deeply infected. All tibial fractures were solid union without secondary displacement. The average time back to walk without a crutch was 12,5 weeks. The mean AOFAS score was 89at a mean of 15 months follow-up. link2 There were seven cases of late infection, 14 patients of skin impingement by implants and nine cases of broken screws, who were older than 65 years old. No case was varus, valgus or rotation >5°.
Minimally invasive medial plate osteosynthesis for the distal metaphyseal tibial fracture is safe and effective. This technique decreases the incidence of complications and can help patients to resume their function early. The implant impingement, late wound infections and screw breakage were the quite common complications in old patients but these complications could be simply resolved and did not affect the overall rehabilitation and functions of the patient.
Minimally invasive medial plate osteosynthesis for the distal metaphyseal tibial fracture is safe and effective. This technique decreases the incidence of complications and can help patients to resume their function early. The implant impingement, late wound infections and screw breakage were the quite common complications in old patients but these complications could be simply resolved and did not affect the overall rehabilitation and functions of the patient.
Hepatic epithelioid hemangioendothelioma (HEHE) is a rare tumor of vascular origin. Liver involvement is often multinodular simulating metastases. Herein, we report a rare case of HEHE mimicking liver metastases in a female patient.
A 43-years-old female patient, presented with complaints of pain in the right upper quadrant. Laboratory tests were all within the normal range. Abdominal ultrasound revealed multiple heterogeneous hypoechoic liver lesions. A thoracic and abdominopelvic computed tomography showed bilateral pulmonary micronodules with multiple hypodense hepatic nodules involving both lobes. Percutaneous ultrasound-guided biopsy with pathological study and immunohistochemistry staining revealed the diagnosis of hepatic epithelioid hemangioendothelioma.
HEHE usually involves both liver lobes with three radiological presentations single nodular, multiple nodular, or diffuse types, the diffuse type reflects an advanced stage. 3/4 of the cases are initially misdiagnosed as liver metastases or primary liver tumors. The pathological study with the immunochemistry stainings confirms the diagnosis. There is no standard treatment for HEHE due to its rarity and lack of prospective randomized studies.
HEHE is a rare tumor of vascular origin of unknown etiology with malignant potential and unpredictable course. The therapeutic management of this rare condition is not codified and is discussed on a case-by-case basis. Surgical treatment remains the best option with an excellent outcome.
HEHE is a rare tumor of vascular origin of unknown etiology with malignant potential and unpredictable course. The therapeutic management of this rare condition is not codified and is discussed on a case-by-case basis. Surgical treatment remains the best option with an excellent outcome.
Intracranial infection is a major cause of emergency and death in children. To assist clinical decision-making in patient management, we conducted a study about factors associated with mortality. This study aimed to evaluate factors associated with mortality in pediatric patients with intracranial infection.
We performed a cohort retrospective study in our tertiary hospital to evaluate the outcomes of patients admitted to the pediatric intensive care unit (PICU) from 2014 to 2018. The Chi-square test was performed to determine the significance of the predictor, and
<0.05 was considered to indicate a statistically significant result. We used multivariate logistic regression to determine relative risk (RR) with 95% confidence interval (CI).
We recruited 112 patients who were admitted to the PICU of our tertiary hospital. A total of 38.4% were diagnosed with encephalitis, 9.8% meningitis and 51.8% meningoencephalitis. Of the 112 patients who met the inclusion criteria, 28 (25%) patients died in the PICU. The need of mechanical ventilation support variable had a statistically significant association with mortality (RR 22
76; 95% CI 3
88-51.45).
Recognition of conditions that exacerbate intracranial infection in children needs to be done as early as possible. Moreover, the need of mechanical ventilation support in the PICU needs more attention.
Recognition of conditions that exacerbate intracranial infection in children needs to be done as early as possible. Moreover, the need of mechanical ventilation support in the PICU needs more attention.
Deformities resulting from nasal continuous positive airway pressure delivered using prongs can cause functional and aesthetic issues for patients. Resultant severe tissue damage to the nasal structures often requires surgical intervention and techniques continue to evolve.
This case report describes a 6-year-old male presenting with a full-thickness columella defect; contracture causing deformities involving the nasal tip, ala nasi, and left nasal cavity wall; missing left lateral-medial cruris cartilage; and partially missing right medial cruris cartilage. The abnormalities initially appeared when the patient was 7 days old after receiving treatment by nasal continuous positive airway pressure for 7 days. A one-stage procedure was performed as follows left ala nasi reconstruction with skin excision followed by an ear cartilage graft; a nasal cartilage shield graft to form the nasal tip; reconstruction of the columella with a cartilage graft combined with bilateral soft tissue flaps taken from the nasal e and offers surgeons an alternative approach for managing nasal deformities.
External auditory canal (EAC) cholesteatoma is a lesion lined with stratified squamous epithelium containing proliferative keratin with bony erosion in EAC which can spread to the tympanic cavity, mastoid, and surrounding organ. External cholesteatoma can occur in patients with congenital abnormalities such as congenital aural atresia (CAA).
This case series was reported using the 2020 PROCESS Guideline. The design of this study used a retrospective study during the 2015-2020 period.
3 participants aged 10.67±2.31 years with CAA had other complaints of ear infections. All participants experienced sensorineural hearing loss with an average threshold of 59.33±36.68 dB and suspicious cholesteatoma from a CT scan. Canal wall down, meatoplasty, and/or canaloplasty were performed based on the findings.
Surgical procedure in CAA with cholesteatoma aimed on preventing further complications and recurrence.
Surgical procedure in CAA with cholesteatoma aimed on preventing further complications and recurrence.
Traumatic brain injury (TBI) is a complicated condition that is the primary cause of death and disability in children and young adults in developed countries. Various kinds of therapy have been carried out in the management of brain injury, one of which is the administration of erythropoietin (EPO). There are not many studies in Indonesia have proven that EPO administration is effective on parameters such as stromal cell-derived factor 1 (SDF-1), brain-derived neurotrophic factor (BDNF mRNA), and neuron-specific enolase (NSE) in brain injury patients. The purpose of this study was to see how EPO affected BDNF mRNA expression, SDF-1 serum levels, and NSE levels in experimental rats with TBI.
This study was conducted using a rat head injury model. Fifteen rats were randomly assigned to one of three groups A, B, or C. EPO was administered subcutis with a dose of 30.000 U/kg. Blood samples were taken after brain injury (H0), 12h (H12), and 24h (H24) after brain injury. Serum level of SDF-1 and NSE were measured using mRNA BDNF gene expression was measured with Real-Time-PCR, and ELISA.
This study found EPO increase BDNF mRNA expression in group C at H-12 (7,92±0.51 vs 6.45±0.33) compared to group B, and at H-24 (9.20±0.56 vs 7.22±0.19); increase SDF-1 levels in group C at H-12 (7,56±0,54) vs 4,62±0,58) compared to group B, and at H-24 (11,32±4,55 vs 2,55±0,70)
decrease serum NSE levels in group C at H-12 (17,25±2,02 vs 29,65±2,33) compare to group B and at H-24 (12,14±2,61 vs 37,31±2,76); the values are significantly different with p<0,05.
EPO may have neuroprotective and anti-inflammatory properties in TBI by increasing mRNA BDNF expression and serum SDF-1 levels, and decrease serum NSE levels.
EPO may have neuroprotective and anti-inflammatory properties in TBI by increasing mRNA BDNF expression and serum SDF-1 levels, and decrease serum NSE levels.
Cycling is a physical exercise that is widely performed to improve physical fitness. Regular physical exercise will lead to adaptations to exercise. This adaptation is useful in suppressing the production of reactive oxygen stress (ROS) generated in response to cellular metabolism that uses oxygen. Transforming growth factor beta-1 (TGF-β1) plays a role in increasing the production of ROS, thus, when the concentration is low, it would lead to an improvement in physical fitness. link3 This study aims to compare levels of TGF-β1 between recreational cyclists and sedentary groups. In addition, this research also compares several other parameters, which are fasting blood sugar levels and lipid profiles (triglycerides, total cholesterol, HDL cholesterol, and LDL cholesterol) between cyclists and sedentaries.
This was an observational analytical study with a cross-sectional design. The research subjects consisted of 2 groups, each consisting of 21 participants, namely the recreational cyclist and the sedentary group.
