Magnussenbitsch4174

To evaluate frontal sinus complications developed after previous external craniotomies requiring frontal sinus reconstruction and their treatment with an endoscopic approach.

We retrospectively evaluated 22 patients who referred to Sant'Orsola-Malpighi University Hospital and Bellaria Hospital (Bologna, Italy) between 2005 and 2017. All patients presented with frontal sinus disease after frontal craniotomy with sinus reconstruction performed to treat various pathological conditions. We reported our experience in the endoscopic management of such complications and we reviewed the current literature concerning the endoscopic treatment of these conditions.

In total, 14 frontal mucoceles, 4 cases of chronic frontal sinusitis, 2 mucopyoceles and 2 fungus ball of the frontal sinus were identified. Endoscopic surgical treatment included 7 DRAF IIa, 1 DRAF IIb, 11 DRAF III and 3 DRAF IIc (modified DRAF III) approaches. The success rate of the surgical procedure was 86% (19/22 patients). Recurrence of the initiaditions, such as mucoceles and frontal sinus inflammation. Its management is still debated and requires recovery of the patency of nasal-frontal route. Our study confirms that the endoscopic endonasal approach may offer a valid solution with low morbidity avoiding re-opening of the craniotomic access. For selected cases, endoscopic approach could also be performed simultaneously to craniotomy as a combined surgery to reduce the risk of short- and long-term complications. Long-term follow-up is mandatory in patients with a history of opened and reconstructed frontal sinus and should include imaging and endoscopic outpatient evaluation.

Evaluating the effectiveness of intraoperative auditory brainstem responses (ABRs) to stimulation by the Vibrant Soundbridge (VSB) active middle ear implant for quantifying the implant's floating mass transducer (FMT) coupling quality.

In a diagnostic multicentric study, patients (> 18years) who received a VSB with different coupling modalities were included. Pre- and postoperative bone conduction thresholds, intraoperative VSB-evoked ABR thresholds (VSB-ABR) using a modified audio processor programmed to preoperative bone conduction thresholds, postoperative vibrogram thresholds, and postoperative VSB-ABR thresholds were measured. Coupling quality was calculated from the difference between the pure tone average at 1000, 2000, and 4000 Hz (3PTA) vibrogram and postoperative 3PTA bone conduction thresholds.

Twenty-three patients (13 males, 10 females, mean age 56.6 (± 12.5) years) were included in the study. Intraoperative VSB-ABR response thresholds could be obtained in all except one patient where the threshold was > 30dB nHL. Postoperatively, an insufficient coupling of 36.7dB was confirmed in this patient. In a Bland-Altman analysis of the intraoperative VSB-ABRs and coupling quality, the limits of agreement exceeded ± 10dB, i.e., the maximum allowed difference considered as not clinically important but the variation was within the general precision of auditory brainstem responses to predict behavioral thresholds. Five outliers were identified. In two patients, the postoperative VSB-ABR thresholds were in agreement with the coupling quality, indicating a change of coupling before the postoperative testing.

The response thresholds recorded in this set-up have the potential to predict the VSB coupling quality and optimize postoperative audiological results.

The response thresholds recorded in this set-up have the potential to predict the VSB coupling quality and optimize postoperative audiological results.Exotic species are known to become invasive in several ecosystems, including areas undergoing restoration. But does that always happen? We monitored the tree layer, seed rain, and regenerating layer of 10-year and 20-year-old forests under restoration in southeast Brazil to verify if planted exotic trees were behaving as invasive; if they were influencing the species richness and abundance of regenerating native plants; and the probabilities of exotic trees perpetuating over time. Data from the three forest components (trees, seed rain, and regenerating) were collected in 12 permanent plots of 100 m2 each in each study area. Collected data were analyzed through generalized linear models (GLM) and Markov chains. We verified that exotic species were not behaving as invasive species. Of the five species planted, Acacia mangium, Syzygium cumini, and Psidium guajava were dispersing seeds but recruiting only six new individuals. In general, the species richness and abundance of exotic trees were not related to the richness and abundance of regenerating native plants. In addition, the chances of individuals' transition between forest components were in most cases nil, so that exotic species should continue not to spread in the 10- and 20-year-old forests. We assume that biotic resistance was occurring in the assembled communities and this prevented exotic trees from behaving as invaders. Monitoring of forest components helped to better understand the role of non-native species in the dynamics of these novel ecosystems. Monitoring also indicated that not all recovering forests need management actions against exotic trees after a decade or two of restoration.The immune checkpoints associated with the CTLA-4 and PD-1 pathways are critical modulators of immune activation. UK 5099 order These pathways dampen the immune response by providing brakes on activated T cells, thereby ensuring more uniform and controlled immune reactions and avoiding immune hyper-responsiveness and autoimmunity. Cancer cells often exploit these regulatory controls through a variety of immune subversion mechanisms, which facilitate immune escape and tumor survival. Immune checkpoint inhibitors (ICI) effectively block negative regulatory signals, thereby augmenting immune attack and tumor killing. This process is a double-edged sword in which release of regulatory controls is felt to be responsible for both the therapeutic efficacy of ICI therapy and the driver of immune-related adverse events (IrAEs). These adverse immune reactions are common, typically low-grade and may affect virtually every organ system. In the early clinical trials, lung IrAEs were rarely described. However, with ever-expanding clinical applications and more complex ICI-containing regimens, lung events, in particular, pneumonitis, have become increasingly recognized.