scholarly journals Long-Term Histologic Changes in Nasal Mucosa after Total Laryngectomy

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Çiğdem Tepe Karaca ◽  
Erdoğan Gültekin ◽  
M. Kürşat Yelken ◽  
Ayşenur Akyıldız İğdem ◽  
Mehmet Külekçi
Keyword(s):  
Cancer Patients ◽  
Nasal Mucosa ◽  
Laryngeal Cancer ◽  
Total Laryngectomy ◽  
Group 3 ◽  
Histopathologic Changes ◽  
Group 2 ◽  
The Relationship ◽  
Histopathologic Findings

Objective. To determine the long-term histopathologic changes in nasal mucosa and the relationship between progression of the histopathologic changes and the duration without air current stimulation.Material and Method. Biopsies were taken from the inferior turbinates of 11 laryngeal cancer patients after total laryngectomy. Specimens were stained with hematoksilen-eosin and several histopathologic parameters were examined under light microscopy.Results. All of the patients demonstrated at least one histopathologic abnormality (100%,n=11). Goblet destruction and stromal fibrosis were the most common findings (81%,n=9), followed by focal epithelial atrophy and subepithelial seromusinous gland destruction (45%,n=5), neovascularization and congestion (36%,n=4), complete epithelial atrophy and mixoid degeneration (27%,n=3). According to the duration between laryngectomy and biopsy, patients were grouped in to three: group 1; less than 12 months (36%,n=4), group 2; 12–36 months (18%,n=2), and group 3; more than 36 months (45%,n=5). Only congestion was found to be decreased as the duration increased (P<.005).Conclusion. In laryngeal cancer patients histopathologic changes occur in nasal mucosa eventuate due to the cessation of air current stimulation, however there was no relation between progression of the histopathologic findings and the duration of cessation.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

scholarly journals Chronic kidney disease stage stratifies short- and long-term outcomes after aortic root replacement

2020 ◽  
Author(s):  
Tsuyoshi Yamabe ◽  
Yanling Zhao ◽  
Paul A Kurlansky ◽  
Suzuka Nitta ◽  
Saveliy Kelebeyev ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Aortic Root Replacement ◽  
Mortality Hazard ◽  
Group 3 ◽  
Group 2 ◽  
Mortality Hazard Ratio ◽  
Group 1

Abstract OBJECTIVES Chronic kidney disease (CKD) is prevalent in patients undergoing cardiovascular surgery, and it negatively impacts procedural outcomes; however, its influence on the outcomes of aortic surgery has not been well studied. This study aims to elucidate the importance of CKD on the outcomes of aortic root replacement (ARR). METHODS Patients who underwent ARR between 2005 and 2019 were retrospectively reviewed (n = 882). Patients were divided into 3 groups based on the Kidney Disease: Improving Global Outcomes criteria: Group 1 [estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2, n = 421); Group 2 (eGFR = 30–59 ml/min/1.73 m2, n = 424); and Group 3 (eGFR &lt; 30 ml/min/1.73 m2, n = 37). To reduce potential confounding, a propensity score matching was also performed between Group 1 and the combined group of Group 2 and Group 3. The primary end point was 10-year survival. Secondary end points were in-hospital mortality and perioperative morbidity. RESULTS Severe CKD patients presented with more advanced overall chronic and acute illnesses. Kaplan–Meier analysis showed a significant correlation between CKD stage and 10-year survival (log-rank P &lt; 0.001). The number of events for Group 1 was 15, Group 2 was 49 and Group 3 was 11 in 10 years. Group 3 had significantly higher in-hospital mortality (13.5% vs 3.5% in Group 2 vs 0.7% in Group 1, P &lt; 0.001) and stroke (8.1% vs 7.1% vs 1.2%, P &lt; 0.001) as well as introduction to new dialysis (27.0% vs 5.4% vs 1.7%, P &lt; 0.001). eGFR was shown to be an independent predictor of mortality (hazard ratio, 0.98; 95% confidence interval, 0.96–0.99). Comparison between propensity matched groups showed similar postoperative outcomes, and eGFR was still identified as a predictor of mortality (hazard ratio, 0.97; 95% confidence interval, 0.95–0.99). CONCLUSIONS Higher stage in CKD negatively impacts the long-term survival in patients who are undergoing ARR.

scholarly journals Effective use of various minimally invasive technologies eliminating vertical reflux in the treatment of chronic diseases of the lower limb veins

2020 ◽  
Vol 73 (2) ◽  
pp. 329-331
Author(s):  
Serhiy I. Savolyuk ◽  
Valentyn A. Khodos ◽  
Roman A. Herashchenko ◽  
Vladyslav S. Horbovets
Keyword(s):  
Lower Limb ◽  
High Frequency ◽  
Long Term Results ◽  
Laser Coagulation ◽  
Results Of Treatment ◽  
Functional Classes ◽  
Group 3 ◽  
Group 2 ◽  
Effective Use

The aim: To analyze and evaluate the efficacy of CDLLV treatment, using high-frequency endovascular welding (EVW), endovenous laser coagulation (EVLC) and catheter microfoam echosclerotherapy. Materials and methods: We have treated 329 patients with CDLLV C2-C6 functional classes according to the Clinical Etiological Anatomical Pathophysiology. Of these, 102 patients had vertical reflux eliminated by EVW, in 112 – by EVLC, and in 115 – by catheter microfoam echosclerotherapy. Results: In the EVW group 3 patients (2.94%) had a partial recanalization of coagulated veins 3 months after the procedure. In EVLC group 2 patients (1.79%) also had partial recanalization group after 6 months. In the group of catheter microfoam echosclerotherapy partial recanalization occurred in 3 patients during 3 months of observation, in the period of 6 months – in 2, in the period of 12 months – in 9, in total – in 14 patients (12.17%). The EVW and EVLC methods showed high efficacy of vertical reflux elimination on the great and small subcutaneous veins (GSV/SSV) in CDLLV and have no fundamental differences in the immediate and long-term results of treatment. Microfoam catheter echosclerotherapy leads to a greater number of recanalisations, compared with EVW and EVLC. Conclusions: High-frequency endovenous welding results in complete fibrotic GSV/SSV transformation in 97.06% of patients. Endovascular laser coagulation results in complete fibrotic GSV/SSV transformation in 98.21% of patients. Elimination of vertical reflux by microfoam echosclerotherapy results in complete fibrotic GSV/SSV transformation in 87.83% of patients.

scholarly journals Inverse Relationship between Adenoid Size and Asthma or Atopy in Children: A Preliminary Study

2020 ◽  
Vol 63 (9) ◽  
pp. 409-414
Author(s):  
Yangseop Noh ◽  
Ji-Eun Choi ◽  
Kyung Eun Lee ◽  
Seung-Kyu Chung ◽  
Sang Duk Hong ◽  
...  
Keyword(s):  
Medical Center ◽  
Allergic Sensitization ◽  
Allergic Diseases ◽  
Adenoid Hypertrophy ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Diagnosis Criteria ◽  
The Relationship ◽  
Group 1

Background and Objectives One of the most common surgical procedures in children is adenoidectomy, but the causes of adenoid hypertrophy are not fully understood. Some studies have found that allergies can be a risk factor for adenoid hypertrophy, asthma being one of these allergic diseases. This study aimed to investigate the relationship between adenoid size and asthma in a group of children.Subjects and Method This study reviewed a total of 2063 pediatric patients with or without atopy and asthma who visited the Otorhinolaryngology and Pediatric unit at a tertiary medical center from January 2011 to June 2016. We classified these patients into 4 groups according to the presence of asthma or atopy and randomly selected 100 patients from each group (to a total of 400 pts): group 1 (asthma-, atopy-); group 2 (asthma-, atopy+); group 3 (asthma+, atopy-) and group 4 (asthma+, atopy+). The presence of allergic sensitization (atopy) was evaluated by CAP test and total IgE. Asthma was diagnosed according to the diagnosis criteria in the Korean guideline for asthma. Adenoid size was evaluated with the adenoidal-nasopharyngeal ratio (A/N ratio) by the adenoid view.Results The four groups did not differ from each other significantly in age or sex. There was a negative correlation between adenoid size and atopic and asthmatic condition. Group 1 had a significantly larger A/N ratio than the other groups (group 1=0.534±0.138; group 2=0.469± 0.140; group 3=0.476±0.135; group 4=0.482±0.128, <i>p</i><0.05). However, group 4 showed nearly identical results to groups 2 and 3, despite the combination of asthma and atopy in group 4.Conclusion Large adenoids were negatively associated with atopy and asthma. This finding may be explained by a decrease in adenoid stimulation by nasal obstruction and a difference in the immune system, including allergic immune reactions. Further studies are needed.

scholarly journals Evaluation of Some Male and Female Rats’ Reproductive Hormones Following Administration of Aspartame With or Without Vitamin C or E

2021 ◽  
Vol 45 (2) ◽  
pp. 14-20
Author(s):  
Omar H Azeez
Keyword(s):  
Vitamin C ◽  
Reproductive Hormones ◽  
Female Rats ◽  
Control Group ◽  
Male And Female ◽  
Group 4 ◽  
Male And Female Rats ◽  
Group 3 ◽  
Group 2

Aspartame (ASP) is a sugar substitute. Its use rose because it has been demonstrated to have deleterious effects after being metabolized. In the presence of antioxidant vitamins C or E, the effects of ASP on reproductive hormones of adult male and female Albino Wister rats were investigated. A total of eighty male and female rats were used in this study. The rats were divided into four groups: group 1, received no treatment; group 2, received ASP at 40 mg/kg BW; group 3, received ASP at 40 mg/kg BW with vitamin C at 150 mg/kg BW; and group 4, received ASP at 40 mg/kg BW and vitamin E at 100 mg/kg BW. All treatments were given orally by gavage needle once daily for consecutive 90 days. The levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone hormone (TH) were measured after 90 days in blood plasma. In comparison with the control group, ASP treatment resulted in lower levels of E2, FSH, and LH in male and female rats. When the antioxidants vitamin C or E was given, the effects of ASP were reversed, and the levels of E2, LH, and FSH were increased. The testosterone hormone was likewise significantly increased by ASP, but testosterone hormone concentrations were decreased by vitamin C or E treatments. Long-term ASP consumption caused interfering with testicular and ovarian hormonal activity, while vitamins C and E on the other hand, overcome longstanding consumption ASP's effects.

Abstract 9411: Urine Aquaporin-2 Level is a Novel Marker for the Better Prognosis After Long-Term Tolvaptan Treatment in Patients With Advanced Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Teruhiko Imamura ◽  
Koichiro Kinugawa ◽  
Takeo Fujino ◽  
Toshiro Inaba ◽  
Hisataka Maki ◽  
...  
Keyword(s):  
Heart Failure ◽  
De Novo ◽  
Collecting Duct ◽  
Initial Response ◽  
Aquaporin 2 ◽  
Long Term Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction: Preserved function of collecting duct is essential for the response to tolvaptan (TLV), and urinary level of aquaporin 2 (U-AQP2) can be a marker for vasopressin-dependent activity of collecting duct. Hypothesis: Higher levels of U-AQP2 in proportion to plasma levels of vasopressin (P-AVP) may be associated with better initial responses to TLV and eventually result in the improved prognosis after long-term treatment of TLV. Methods: Consecutive 60 in-hospital patients with stage D heart failure (HF) who received TLV on a de novo basis were enrolled during 2011-2013. We also selected 60 HF patients by propensity score matching who were hospitalized during the same period but never treated with TLV. Events were defined as death and/or HF re-hospitalization. Results: TLV (3.75-15 mg/day) was continuously administered except death or ventricular assist device implantation occurred. There were 41 patients (group 1) who had increases in UV over the first 24 h after TLV initiation, and all of them had U-AQP2/P-AVP ≥0.5 х103 with higher U-AQP2 levels (5.42 ± 3.54 ng/mL) before TLV treatment. On the other hand, UV rather decreased even after TLV initiation in 19 patients over the first 24 h (group 2). Those in the group 2 universally had U-AQP2/P-AVP <0.5 х103, extremely low U-AQP2 levels (0.76 ± 0.59 ng/mL, p<0.001 vs. group 1), and similar P-AVP with the group 1 at baseline. The 41 and 19 patients without TLV treatment (group 3 and 4) were respectively matched to the group 1 and 2 by propensity scores. Interestingly, every patient in the group 3 had U-AQP2/P-AVP ≥0.5 х103, and vice versa in the group 4. Among the four groups, congestion-related symptoms were only improved in the group 1 after 1 month of enrollment. The patients in the group 1 had significantly better event-free survival over 2-year by TLV treatment compared with the group 3 (76% vs. 43%, p<0.014). In contrast, the patients in the group 2 and 4 had very poor prognoses regardless of TLV treatment (7% vs. 11%, p=0.823). Conclusions: U-AQP2/P-AVP is a novel predictor for the initial response to TLV in HF patients. Patients with higher U-AQP2/P-AVP may enjoy a better prognosis by long-term TLV treatment probably due to efficient resolution of congestion.

scholarly journals Interaction Between Age and Change in Velocity During a Baseball Training Program

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092793
Author(s):  
Christopher Antonacci ◽  
Thomas R. Atlee ◽  
Peter N. Chalmers ◽  
Christopher Hadley ◽  
Meghan E. Bishop ◽  
...  
Keyword(s):  
Training Program ◽  
Age Groups ◽  
Maximum Velocity ◽  
Age Group ◽  
Significant Difference ◽  
Group 3 ◽  
Baseball Pitchers ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

Background: Pitching velocity is one of the most important metrics used to evaluate a baseball pitcher’s effectiveness. The relationship between age and pitching velocity after a lighter ball baseball training program has not been determined. Purpose/Hypothesis: The purpose of this study was to examine the relationship between age and pitching velocity after a lighter ball baseball training program. We hypothesized that pitching velocity would significantly increase in all adolescent age groups after a lighter baseball training program, without a significant difference in magnitude of increase based on age. Study Design: Cohort study; Level of evidence, 2. Methods: Baseball pitchers aged 10 to 17 years who completed a 15-week training program focused on pitching mechanics and velocity improvement were included in this study. Pitchers were split into 3 groups based on age (group 1, 10-12 years; group 2, 13-14 years; group 3, 15-17 years), and each group trained independently. Pitch velocity was assessed at 4 time points (sessions 3, 10, 17, and 25). Mean, maximum, and mean change in pitch velocity between sessions were compared by age group. Results: A total of 32 male baseball pitchers were included in the analysis. Mean/maximum velocity increased in all 3 age groups: 3.4/4.8 mph in group 1, 5.3/5.5 mph in group 2, and 5.3/5.2 mph in group 3. While mean percentage change in pitch velocity increased in all 3 age groups (group 1, 6.5%; group 2, 8.3%; group 3, 7.6%), the magnitude of change was not significantly different among age groups. Program session number had a significant effect on mean and maximum velocity, with higher mean and maximum velocity seen at later sessions in the training program ( P = .018). There was no interaction between age and program session within either mean or maximum velocity ( P = .316 and .572, respectively). Conclusion: Age had no significant effect on the magnitude of increase in maximum or mean baseball pitch velocity during a velocity and mechanics training program in adolescent males.

scholarly journals Reduction in daily hydrocortisone dose improves bone health in primary adrenal insufficiency

2016 ◽  
Vol 174 (4) ◽  
pp. 531-538 ◽  
Author(s):  
Julia Schulz ◽  
Kathrin R Frey ◽  
Mark S Cooper ◽  
Kathrin Zopf ◽  
Manfred Ventz ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Crisis ◽  
Mineral Density ◽  
Primary Adrenal Insufficiency ◽  
Group Reduction ◽  
Group 3 ◽  
Group 2 ◽  
Over Time ◽  
Group 1

ObjectiveIndividuals with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) receive life-long glucocorticoid (GC) replacement therapy. Current daily GC doses are still higher than the reported adrenal cortisol production rate. This GC excess could result in long-term morbidities such as osteoporosis. No prospective trials have investigated the long-term effect of GC dose changes in PAI and CAH patients.MethodsThis is a prospective and longitudinal study including 57 subjects with PAI (42 women) and 33 with CAH (21 women). Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry at baseline and after 2 years. Subjects were divided into three groups (similar baseline characteristics) depending on changes in daily hydrocortisone equivalent dose (group 1: unchanged 25.2±8.2 mg (mean±s.d., n=50); group 2: increased 18.7±10.3 to 25.9±12.0 mg (n=13); group 3: decreased 30.8±8.5 to 21.4±7.2 mg (n=27)).ResultsSubjects in group 1 showed normal lumbar and femoral Z-scores which were unchanged over time. Group 2 subjects showed a significant decrease in femoral neck Z-scores over time (−0.15±1.1 to −0.37±1.0 (P<0.05)), whereas group 3 subjects showed a significant increase in lumbar spine and hip Z-scores (L1–L4: −0.93±1.2 to –0.65±1.5 (P<0.05); total hip: −0.40±1.0 to −0.28±1.0 (P<0.05)). No changes in BMI over time were seen within any group. Reduction in GC dose did not increase the risk of adrenal crisis.ConclusionThis study demonstrates for the first time that cautious reduction in hydrocortisone equivalent doses leads to increases in BMD, whereas dose increments reduced BMD. These data emphasize the need for the lowest possible GC replacement dose in AI patients to maintain health and avoid long-term adverse effects.

Earlier surgery improves long-term survival compared to class I surgical indications and infective endocarditis surgery for isolated severe tricuspid regurgitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.K.M Wang ◽  
K Akyuz ◽  
B Xu ◽  
M Gillinov ◽  
G Pettersson ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Mortality Rates ◽  
Valve Surgery ◽  
Severe Tricuspid Regurgitation ◽  
Class 1 ◽  
Esc Guidelines ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Isolated tricuspid surgery has markedly higher mortality rates (9–10%) in contemporary national registries compared to other single-valve operations. The optimal timing and indications remain controversial, and earlier surgery before developing ESC guidelines class 1 indications may improve the survival for isolated severe tricuspid regurgitation. Purpose We aimed to compare the characteristics and outcomes of isolated tricuspid regurgitation (TR) surgery by indication. Methods Consecutive patients undergoing isolated tricuspid valve surgery for TR without other concomitant valve surgery at Cleveland Clinic from 2004 to 2019 were studied. Indications were divided into group 1: ESC guidelines class 1 (severe symptomatic TR), group 2: infective endocarditis, and group 3: non-class 1 (asymptomatic severe TR with or without right ventricular dilation and/or dysfunction) and no endocarditis, for comparative analyses of characteristics and outcomes. Results The study included 207 patients (group 1: 115, group 2: 48 and group 3: 44) with mean age 54.1±17.8 years, 116 (56.0% females and 151. Tricuspid repair was performed in 72.9% (73.0%, 66.7% and 79.5% for Groups 1–3, P=0.381). Group 3 patients were younger, had higher prevalence of primary TR, lower prevalence of heart failure, atrial fibrillation, chronic lung disease, cirrhosis, renal impairment, right ventricular and left ventricular dysfunction than Group 1. Overall operative mortality rates were 4.9% ( group 1: 7.0%, group 2: 4.2% and group 3: 0.0%), while mortality during follow-up of 3.3±4.0 years was lower for group 3 than for groups 1 or 2 (Figure 1). Independent predictors of long-term mortality were Group 1 compared to Group 3 and reduced estimated glomerular filtration rate. Conclusion Patients without class I or endocarditis indications had superior unadjusted and adjusted survival compared to those with these indications. The high mortality rate of isolated TR surgery may be reduced by both earlier surgery and being performed at an experienced cardiac surgery center. Figure 1. Kaplan-Meier survival curves Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): National Heart Foundation of New Zealand - Overseas Clinical and Research Fellowship

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