Svanethomasen3546
A wide range of neurological complications of coronavirus disease 2019 (COVID-19) is increasingly recognised. Although the majority of these remain ischaemic and haemorrhagic events, various disorders are being reported. In particular, several cases of diffuse acute leukoencephalopathy have been observed in critically ill patients with COVID-19 disease. We report the case of a 59-year-old man with multiple comorbidities and severe COVID-19 pneumonia who developed a diffuse leukoencephalopathy with microhaemorrhages and extensive associated white matter necrosis. Although this is the first documented case of extensive COVID-19-associated white matter necrosis, we highlight the relatively constant features of this injury similar to previously reported cases, including symmetrical involvement of the supratentorial white matter, sparing of the peripheral subcortical regions except in the precentral gyri, frequently associated microhaemorrhages, relative sparing of the deep gray matter structures and infratentorial structures, and lack of enhancement.
To determine whether common otolaryngology procedures generate viable aerosolized virus through a murine cytomegalovirus (mCMV) model for infection.
mCMV model of infection.
University of Utah laboratory.
Three-day-old BALB/c mice were inoculated with mCMV or saline. Five days later, each mouse underwent drilling, microdebrider, coblation, and electrocautery procedures. Particle size distribution and PM
(particulate matter <2.5 µm) concentration were determined with a scanning mobility particle sizer and an aerosol particle sizer in the range of 15 nm to 32 µm. Aerosolized samples from these procedures were collected with an Aerosol Devices BioSpot sampler for viral titer based on polymerase chain reaction and for viable virus through viral culture.
As compared with the background aerosol concentrations, coblation and electrocautery showed statistically significant increases in airborne aerosols (Tukey-adjusted
value <.040), while microdebrider and drilling at 30,000 rpm did not (.870 <oblation procedures warrants the need for appropriate protection against droplet and aerosol exposure.
To evaluate the characteristics of orthodontic cases at the General Dental Council's (GDC) Professional Conduct Committee (PCC).
Review of data from the GDC website for orthodontically related hearings or those involving orthodontic treatment providers during 2015-2018.
Observational descriptive study.
Data were accessed from the GDC website by a single researcher to retrieve orthodontic cases. The press office of the GDC was contacted to ensure all data were captured. selleck inhibitor For each case that met the inclusion criteria, demographic details of the registrant, the charges proved/not proved and final outcome of the case were recorded.
A total of 23 registrant cases involved orthodontics and this was 8% of the total number of PCC hearings during 2015-2018. Nine (39%) of the registrants had a Membership in Orthodontics qualification although only 7 (30%) were registered as orthodontists on the UK GDC Specialist List in Orthodontics. Charges related to clinical assessment, consent and record keeping were mostly proved for dentists (13/16 hearings for each) whereas a poor standard of treatment and not cooperating with the GDC were mostly proved for orthodontists (4/7 hearings for each). Overall, conditions were imposed in 10 (44%) cases, erasure in 7 (30%) cases, suspension in 5 (22%) cases and a reprimand in 1 (4%) case.
The GDC continue to view misdemeanours seriously and it would be prudent for registrants to be familiar with the nature of these hearings to reduce the risk of finding themselves in such a predicament.
The GDC continue to view misdemeanours seriously and it would be prudent for registrants to be familiar with the nature of these hearings to reduce the risk of finding themselves in such a predicament.
To determine how communicative participation is affected in patients with oral and oropharyngeal head and neck cancers (HNCs) pretreatment and whether communication function predicts HNC-specific quality of life (QOL) before treatment, beyond known demographic, medical, psychosocial, and swallowing predictors.
Cross-sectional study.
Tertiary care academic medical center.
Eighty-seven patients with primary oral (40.2%) or oropharyngeal (59.8%) HNC were recruited prior to treatment. T stage, tumor site, and p16 status were extracted from medical records. Demographic and patient-reported measures were obtained. Communicative participation was measured using the Communicative Participation Item Bank (CPIB) General short form. A hierarchical regression analysis included demographic, medical, psychosocial, and functional measures of swallowing and communication as predictors; the University of Washington Quality of Life (UW-QOL v4) composite score was the predicted variable.
Median (SD) baseline CPIB scores were 71.0 (11.83); patients with oral cancers reported worse scores. A final sequential hierarchical regression model that included all variables explained 71% of variance in QOL scores. Tumor site, T stage, and p16 status accounted for 28% of variance (
< .001). Perceived depression predicted an additional 28% of the variance (
< .001). Swallowing and communicative participation together predicted an additional 12% of variance (
= .005). Tumor site, perceived depression, swallowing, and communication measures were unique predictors in the final model. Finally, communicative participation uniquely predicted QOL, above and beyond other predictors.
Pretreatment communication predicted QOL and was negatively affected in some oral and oropharyngeal patients with HNC.
Pretreatment communication predicted QOL and was negatively affected in some oral and oropharyngeal patients with HNC.
The aim of this study is to assess the association between clinical and radiological features as well as of isocitrate dehydrogenase 1 and 2 (
1,2) mutations with outcome in head and neck chondrosarcomas.
Retrospective study.
Tertiary referral center.
Clinical, histological, and molecular data of patients with head and neck chondrosarcomas treated by surgery were collected.
Forty-six patients were included. The mean age at diagnosis was 56 years (range, 17-78). The tumor originated from the skull base (52.2%), facial bones (28.2%), or laryngotracheal area (19.6%). At last follow-up (median 52.5 months), 38 patients were alive, 30 of which were disease free, whereas 8 had died, 4 of disease progression and 4 of other causes. Fourteen (30.4%) had local recurrence and 2 (4.3%) had lung metastasis. All cases were negative for cytokeratin AE1/AE3, brachyury, and IDH1 at immunohistochemistry, while Sanger sequencing identified IDH1/2 point mutations, typically IDH1 R132C, in 9 (37.5%) tumors arising from the skull base.
