Supraclinoid internal carotid artery blister-like aneurysms: hypothesized pathogenesis and microsurgical clipping outcomes

xlomafota.13 shared this article with you from Inoreader Supraclinoid internal carotid artery blister-like aneurysms: hypothesized pathogenesis and microsurgical clipping outcomes Via Latest Results for Chinese Neurosurgical Journal Abstract Background Blister-like aneurysms (BLAs) on the supraclinoid segment of the internal carotid artery (ICA) are an enigma of cerebrovascular disease. Neither has a definite pathogenesis been so far identified, nor have uniform treatment guidelines been established for them. Our aim was to develop a hypothesis regarding the evolution of BLAs according to their macroscopic morphologies and to evaluate the efficacy of microsurgical clipping. Methods The clinical data and morphological features of 15 consecutive patients with 16 BLAs on the supraclinoid ICA were retrospectively reviewed. The treatment strategies were analyzed, and functional outcomes were evaluated using the modified Rankin scale (mRS). Favorable outcomes were defined as a mRS score of 0–2. Results Morphologically, aneurysm growth with expansion of the aneurysm neck before the surgical procedure occurred in two ruptured and one unruptured aneurysm. Daughter bleb formation was observed in two ruptured and five unruptured aneurysms. A varied degree of parent artery sclerosis was observed in nine patients. Thirteen patients were treated with direct surgical clipping, one patient was treated with clipping and wrapping, and the remaining patient was treated with an encircling clipping graft. Favorable and unfavorable outcomes were observed in 13 and two cases, respectively. Follow-up angiograms revealed 4 cases of stenosis with respective degree of mild, 30%, 50%, and 80% without any neurological dysfunction. Conclusions We suggest a hypothesis that BLAs on the supraclinoid ICA may share different evolving mechanisms between ruptured and unruptured lesions. A majority of them can be reliably and safely obliterated by direct clipping technique, except for the aneurysms accompanied with severely atherosclerotic parent walls. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Annular Flow in the Upper Esophageal Sphincter Demonstrated with Dynamic 320-row Area Detector Computed Tomography

Greek DailyNews shared this article with you from Inoreader Annular Flow in the Upper Esophageal Sphincter Demonstrated with Dynamic 320-row Area Detector Computed Tomography Via Dysphagia Abstract Understanding bolus flow patterns in swallowing (rheology, the study of flow) is fundamental to assessment and treatment of dysphagia. These patterns are complex and poorly understood. A liquid swallow is typically biphasic, including air, so the actual bolus has both liquid and gas phases. We report a novel observation of annular two-phase flow (a ring of liquid around a core of air) as thin liquids passed through the upper esophageal sphincter (UES). Dynamic CT was performed on 27 healthy asymptomatic volunteers swallowing liquid barium in a semi-reclining position. Each subject swallowed 3, 10, and 20 ml of either thin (14 subjects) or thick liquid (13 subjects). Sagittal and axial images were analyzed. Flow patterns in the UES were assessed on cross-sectional images. Annular flow was seen in the majority of subjects with thin liquid but few with thick liquid swallows. The percentage of Annular flow during UES opening was 3 ml 58%, 10 ml 58%, 20  ml 56% in thin and 3 ml 0%, 10 ml 4%, 20 ml 1% in thick. Annular flow was usually observed from the second or third frames after onset of UES opening. The other pattern, Plug flow was seldom seen with thin but was typical with thick liquid swallows. Annular flow was the most common pattern for thin liquids (but not thick liquids) passing through the UES. Annular flow has been defined as a liquid continuum adjacent to the channel wall with a gas continuum (core) in the center of the channel. The two regions are demarcated by a gas–liquid interface. Annular flow is typical for two-phase gas–liquid flow in a vertical or inclined channel. It results from the interaction of viscosity with cohesive and adhesive forces in the two phases. We infer that the difference in flow pattern between thin liquid–air and thick liquid–air boluses resulted from the differing magnitudes of viscous forces. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary diffuse large B-cell lymphoma of the major salivary glands: Increasing incidence and survival

Greek DailyNews shared this article with you from Inoreader Primary diffuse large B-cell lymphoma of the major salivary glands: Increasing incidence and survival Via American Journal of Otolaryngology Publication date: Available online 28 January 2021 Source: American Journal of Otolaryngology Author(s): Avigeet Gupta, Joshua A. Lee, Shaun A. Nguyen, Eric J. Lentsch View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Why Clinicians Choose Their Language Intervention Approach: An International Perspective on Intervention for Children with Developmental Language Disorder

Greek DailyNews shared this article with you from Inoreader Why Clinicians Choose Their Language Intervention Approach: An International Perspective on Intervention for Children with Developmental Language Disorder Via Folia Phoniatrica et Logopaedica Purpose: Considerable progress has been made in recent years in generating external evidence underpinning interventions for children with developmental language disorder (DLD), but less is known about the practitioner decision-making process underpinning such interventions and whether such decisions are context specific or are internationally generalizable. Methods: An online survey about clinical practice was developed by members of COST Action IS1406, an EU-funde d research network, which included representation from 39 countries. The participants were 2,408 practitioners who answered questions in relation to their decision making for a specific child of their choosing with DLD. Analysis of open-ended questions was undertaken, and data were converted into codes for the purpose of quantitative analysis. Results: Although a wide range of intervention approaches and rationales were reported, the majority of responses referenced a client-centred approach. Level of functioning was used as a rationale only if a child had severe DLD. Practitioners with university level education or above were less likely to report basing intervention on client-centred factors. A number of differently named interventions with variable theoretical and empirical underpinnings were used in different countries. Conclusions: Specific client and practitioner characteristics have an impact on the intervention approaches and rationales adopted ac ross countries. A limited number of practitioners reported use of external scientific evidence, which suggests that there should be more initiatives in basic training of practitioners and continuing professional development to encourage the uptake of scientific evidence-based practice. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Biomarkers in atopic dermatitis - a review on behalf of the international eczema council

Greek DailyNews shared this article with you from Inoreader Biomarkers in atopic dermatitis - a review on behalf of the international eczema council Via Journal of Allergy and Clinical Immunology Atopic dermatitis (AD) is a common yet complex skin disease, posing a therapeutic challenge with increasingly recognized different phenotypes among variable patient populations. As therapeutic response may vary based on the heterogenous clinical and molecular phenotypes, a shift towards precision medicine approaches may improve AD management. Herein we will consider biomarkers as potential instruments in the toolbox of precision medicine in AD and will review the process of biomarker development and validation, the opinion of AD experts on the use of biomarkers, types of biomarkers, encompassing biomarkers that may improve AD diagnosis, biomarkers reflecting disease severity, and those potentially predicting AD development, concomitant atopic diseases or therapeutic response, and current practice of biomarkers in AD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skin-resident natural killer T cells participate to cutaneous allergic inflammation in atopic dermatitis

Greek DailyNews shared this article with you from Inoreader Skin-resident natural killer T cells participate to cutaneous allergic inflammation in atopic dermatitis Via Journal of Allergy and Clinical Immunology Skin-resident CXCR4+ NKT cells have a role in atopic dermatitis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute Laryngeal Injury After Intubation

Greek DailyNews shared this article with you from Inoreader Acute Laryngeal Injury After Intubation Via JAMA Otolaryngology–Head & Neck Surgery Online First Although intubation is often necessary and lifesaving, there are known laryngotracheal consequences. Otolaryngologists are all too familiar with the vocal-fold damage and inflammatory conditions that are associated with prolonged intubation because patients often present in the hospital or clinic with dysphonia or dyspnea. The size of the endotracheal tube and the duration of intubation are known to be risk factors for postintubation damage. The pathophysiology is well understood to be caused by pressure-induced damage to the mucosal and car tilaginous structures of the larynx. However, despite this knowledge, laryngeal damage is often considered unavoidable, accrued as a result of a lifesaving stay in an intensive care unit. The resulting disease state can be so functionally devastating and difficult to treat that many otolaryngologists are left wondering: is there something we can do to prevent this from happening? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.