Biomedicine Hub最新文献

{"title":"Tattoo-Associated Basal Cell Carcinoma: Coincident or Coincidence.","authors":"Philip R Cohen,&nbsp;Christof P Erickson,&nbsp;Nathan S Uebelhoer,&nbsp;Antoanella Calame","doi":"10.1159/000508208","DOIUrl":"https://doi.org/10.1159/000508208","url":null,"abstract":"<p><p>Tattoos may be associated with medical complications including, albeit rarely, skin cancer. The features of a 46-year-old man who developed a basal cell carcinoma within a tattoo on his left scapula are described and the characteristics of the other 13 patients (7 men and 6 women) with tattoo-associated basal cell carcinoma are reviewed. The tumor usually occurs on the sun-exposed skin of individuals aged 60 years and older whose tattoo has often been present for 20 years or more. The pathogenesis of a basal cell carcinoma developing within a tattoo may merely be a coincidence. However, there is supporting evidence that the tattoo and the subsequent basal cell carcinoma may be coincident events whereby either tattoo injection-associated trauma or the tattoo pigments and dyes (in their native state or after ultraviolet radiation alteration) or both have a carcinogenic impact on the development of the basal cell carcinoma at that location.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000508208","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38440743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Delayed Surgical Recovery and Massive Bleeding in Skull Base Surgery.","authors":"Kenya Kobayashi, Fumihiko Matsumoto, Yasuji Miyakita, Masaki Arikawa, Go Omura, Satoko Matsumura, Atsuo Ikeda, Azusa Sakai, Kohtaro Eguchi, Yoshitaka Narita, Satoshi Akazawa, Shimpei Miyamoto, Seiichi Yoshimoto","doi":"10.1159/000507750","DOIUrl":"10.1159/000507750","url":null,"abstract":"<p><strong>Background: </strong>To determine factors that delay surgical recovery and increase intraoperative hemorrhage in skull base surgery.</p><p><strong>Methods: </strong>Factors related to delayed postoperative recovery were retrospectively reviewed in 33 patients who underwent open skull base surgery. Early and late recovery phases were assessed as \"days required to walk around the ward (DWW)\" and \"length of hospital stay (LHS),\" respectively. Intraoperative blood loss was cal-culated every hour and analyzed in 4 steps, i.e., craniotomy and intracranial manipulation, cranial fossa osteotomy, extracranial osteotomy, and reconstruction.</p><p><strong>Results: </strong>More than 4,000 mL of blood loss (<i>B</i> = 2.7392, Exp[<i>B</i>] = 15.4744; 95% CI 1.1828-202.4417) and comorbidi-ty (<i>B</i> = 2.3978, Exp[<i>B</i>]) = 10.9987; 95% CI 1.3534-98.3810) significantly prolonged the DWW; the occurrence of postoperative complications significantly delayed the LHS (<i>p</i> = 0.0316). Tumor invasion to the hard palate, the maxillary sinus, the pterygopalatine fossa, the base of the pterygoid process, the sphenoid sinus, the middle cranial fossa, and the cavernous sinus and a long operation time (>13 h) were associated with increased total hemorrhage. The optimal cut-off hemorrhage volume associated with total massive blood loss in craniotomy and intracranial manipulation (AUC = 0.8364), cranial fossa osteotomy (AUC = 0.8000), and extracranial osteotomy (AUC = 0.8545) was 1,111, 750, and 913 mL, respectively. Persistent infection (6%) and neuropsychiatric disorder (6%) are direct causes of delayed LHS.</p><p><strong>Conclusion: </strong>Blood loss, comorbidity, and postoperative complications were risk factors for delayed surgical recovery. Meticulous preoperative planning, intraoperative surefire hemostasis, and perioperative holistic management are prerequisites for safe skull base surgery.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392383/pdf/bmh-0005-0991.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38256668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnification Effect of Foveal Avascular Zone Measurement Using Optical Coherence Tomography Angiography.","authors":"Mika Suda,&nbsp;Yuji Yoshikawa,&nbsp;Gaku Terauchi,&nbsp;Soiti Matsumoto,&nbsp;Takuhei Shoji,&nbsp;Kei Shinoda,&nbsp;Atsushi Mizota,&nbsp;Yoshiharu Kobayashi","doi":"10.1159/000507501","DOIUrl":"https://doi.org/10.1159/000507501","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the foveal avascular zone (FAZ) of healthy subjects and examine the magnification effect.</p><p><strong>Methods: </strong>A total of 33 healthy volunteers were enrolled and all subjects were eligible for analysis. Optical coherence tomography angiography (OCTA) examination scanned 3 × 3 mm of the macular area. The FAZ area was measured on the superficial OCTA en face image with and without correction by axial length. The relationship between changes in the FAZ area after correction with the axial length was examined.</p><p><strong>Results: </strong>The mean age was 21.9 ± 0.6 years. The mean axial length was 24.87 ± 1.17 mm and mean spherical equivalent (SE) value was -3.64 ± 2.83 diopters (D). The FAZ area was 0.26 ± 0.10 mm² before the axial length correction and 0.27 ± 0.10 mm² after the correction. In the eyes that had an axial length longer than or equal to 26 mm or SE less than or equal to -6 D, the FAZ area after correction was significantly larger than that before correction (<i>p</i> < 0.01). The change of FAZ area after correction with axial length was significantly correlated with the axial length (<i>R</i> ² = 0.88, <i>p</i> < 0.01) or SE value (<i>R</i> ² = 0.55, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>FAZ areas were comparable to previous reports. In high myopic cases, the magnification effect needs to be considered when evaluating the FAZ area.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000507501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38256667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of External Auditory Canal Sebaceous Carcinoma: Literature Review and Treatment Discussion.","authors":"Robert Saadi,&nbsp;Michael Pennock,&nbsp;Aaron Baker,&nbsp;Huseyin Isildak","doi":"10.1159/000508058","DOIUrl":"https://doi.org/10.1159/000508058","url":null,"abstract":"<p><p>Sebaceous neoplasms are a rare type of skin cancer that may occur in any area with sebaceous glands, including the outer third of the external auditory canal. However, documentation of the tumor originating in this location is limited to scarce case reports. In this location, malignancies can invade the temporal bone, typically requiring en bloc resection and radiation therapy. We describe a case managed with limited surgical excision based on criteria for primary squamous cell carcinoma of the external auditory canal with only close observation following surgery. Margins were free of disease following excision and histology demonstrated a favorable prognosis. The patient was disease free after a follow-up period of over 3 years postoperatively. A review of relevant literature is utilized to discuss clinical characteristics, staging, treatment, and prognosis to assist in clinical decision making for these patients.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000508058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38256663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19: How to Use a Jet Nebulizer for Drug Administration in Ventilated Patients without Putting the Healthcare Workers at Risk.","authors":"Arieh Eden,&nbsp;Tzipora Gashi,&nbsp;Irina Bergman,&nbsp;Dmitry Kompaniets,&nbsp;Avinoam Shiran","doi":"10.1159/000508845","DOIUrl":"https://doi.org/10.1159/000508845","url":null,"abstract":"Dear Editor, A jet nebulizer is frequently used in ventilated patients to administer inhalations with bronchodilators and hypertonic saline. In ventilated COVID-19 patients, this can be beneficial to reduce airway blockage with viscous secretions and to decrease the need for bronchoscopy due to airway obstruction. However, the use of a nebulizer requires frequent disconnections of the ventilator circuit. In ventilated COVID-19 patients, this action can greatly increase the risk of airborne infection for healthcare workers through aerosol formation. The SARS-CoV-2 virus can remain viable and infectious in aerosols for hours [1]. It has been recommended that nebulization of medications should be avoided in ventilated COVID-19 patients to reduce the risk of infection for healthcare workers [2]. Usually, the use of a nebulizer requires disconnection of the heat and moisture exchanger (HME) filter (located between the endotracheal tube and the ventilator circuit) and the nebulizer itself for each inhalation (Fig. 1, showing standard configuration). We propose using a one-way valve (BTS1241A; WILAmed GmbH, Kammerstein, Germany) in the nebulizer T-piece (Fig. 2), which will enable disconnection of the nebulizer cup for medication loading Received: April 30, 2020 Accepted: May 22, 2020 Published online: June 2, 2020","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000508845","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38169341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propelling Health Care into the Twenties.","authors":"Denis Horgan, Bettina Borisch, Etienne Richer, Chiara Bernini, Dipak Kalra, Mark Lawler, Gennaro Ciliberto, Hendrik Van Poppel, Angelo Paradiso, Peter Riegman, Stefano Triberti, Andres Metspalu, Arturo Chiti, Elizabeth Macintyre, Stefania Boccia, Fabien Calvo, Desmond Schatz, Jasmina Koeva-Balabanova, Bengt Jonsson","doi":"10.1159/000508300","DOIUrl":"10.1159/000508300","url":null,"abstract":"<p><p>The scope and potential of personalised health care are underappreciated and underrealised, often because of resistance to change. The consequence is that many inadequacies of health care in Europe persist unnecessarily, and many opportunities for improvement are neglected. This article identifies the principal challenges, outlines possible approaches to resolving them, and highlights the benefits that could result from greater adoption of personalised health care. It locates the discussion in the context of European policy, focusing particularly on the most recent and authoritative reviews of health care in the EU Member States, and on the newly acquired spirit of readiness and pragmatism among European officials to embrace change and innovative technologies in a new decade. It highlights the attention now being given by policymakers to incentives, innovation, and investment as levers to improve European citizens' prospects in a rapidly evolving world, and how these distinct and disruptive themes contribute to a renaissance in thinking about delivering optimal health care in Europe. It explores the chances offered to patients by specific initiatives in health domains such as cancer and antimicrobial resistance, and by innovative science, novel therapies, earlier diagnosis tools, and deeper understanding of health promotion and prevention. And it reflects on how health care providers could benefit from a shift towards better primary care and towards deploying health data more effectively, including the use of artificial intelligence, coupled with a move to a smoother organisational/regulatory structure and realigned professional responsibilities. The conclusion is that preparing Europe's health care systems for the inevitable strains of the coming years is both possible and necessary. A more courageous approach to embracing personalised health care could guarantee the sustainability of Europe's health care systems before rising demands and exponential costs overwhelm them - an exercise in future-proofing, in ensuring that they are equipped to withstand whatever lies ahead. A focus on the potential and implementation of personalised care would permit more efficient use of resources and deliver better quality health-preserving care.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392387/pdf/bmh-0005-0001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38256669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in the Management of Cervical Thoracic Duct Cyst.","authors":"Edgardo Abelardo,&nbsp;Priyanka Shastri,&nbsp;Vinod Prabhu","doi":"10.1159/000507275","DOIUrl":"https://doi.org/10.1159/000507275","url":null,"abstract":"<p><p>We present an uncomplicated case report of a cervical thoracic duct cyst (CTDC) in a 61-year-old woman treated with surgical excision. We reviewed 47 similar cases since it was first described in 1964 and evaluated the different diagnostic and management approaches. Previously believed to be the gold standard tool for evaluation, lymphangiography is now less popular due to advent of high-resolution imaging combined with aspiration techniques. CTDC treatment includes observation, low-fat diet, repeated aspirations, external pressure, sclerotherapy, embolisation, and surgical intervention. The preferred management of choice to date is surgical excision.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000507275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38248294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meningocele of the Internal Auditory Canal Requiring Facial-Nerve Decompression.","authors":"Jeffrey Liaw,&nbsp;Huseyin Isildak","doi":"10.1159/000507420","DOIUrl":"https://doi.org/10.1159/000507420","url":null,"abstract":"<p><p>In this case report, we present the case of a 14-month-old boy with a history of left facial palsy which developed at a very young age. CT of the temporal bone revealed a cystic lesion of the left petrous apex, and sedated auditory testing revealed a profound hearing loss on the same side. Following his first episode of left facial palsy, his symptoms nearly fully resolved and he was lost to follow-up. However, he was seen 5 months later due to recurrent and sudden left-sided facial paralysis. MRI was performed due to suspicion of an epidermoid cyst. The patient was subsequently taken to the operating room for facial-nerve decompression. Intraoperatively, no obvious cystic lesion was identified. Tissue biopsied from the internal auditory canal demonstrated benign glial tissue and fibrous tissue consistent with a meningocele.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000507420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38256662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital Outcomes and Trends of Tricuspid Valve Surgery in Heart Transplant Patients.","authors":"Moghniuddin Mohammed,&nbsp;Aniket S Rali,&nbsp;Tyler Buechler,&nbsp;Venkat Vuddanda,&nbsp;Juwairiya Arshi,&nbsp;Seyed Hamed Hosseini Dehkordi,&nbsp;Jonathan Chandler,&nbsp;Robert Weidling,&nbsp;Travis Abicht,&nbsp;Nicholas Haglund,&nbsp;Andrew Sauer,&nbsp;Zubair Shah","doi":"10.1159/000507179","DOIUrl":"https://doi.org/10.1159/000507179","url":null,"abstract":"<p><strong>Introduction: </strong>Tricuspid valve (TV) regurgitation is the most common valvular pathology after orthotopic heart transplant (OHT). The number of transplants being performed is increasing with patients living longer after heart transplant. Data on TV surgery in OHT recipients is limited.</p><p><strong>Methods: </strong>We sought to analyze the outcomes of patients undergoing TV surgery from a large diverse, multicentric, nationwide cohort using the Nationwide Inpatient Sample (NIS) database.</p><p><strong>Results: </strong>A total of 42,766 TV repair or replacement (bioprosthetic and mechanical) involving adult patients (age ≥18 years) between 2007 and September 2015 were identified. Of these, 366 were performed in patients with OHT. TV repair was the most common surgery performed in both groups (OHT group and native heart group). Compared to the native group, patients with OHT had a significantly higher incidence of cardiogenic shock (20 vs. 11%, <i>p</i> = 0.024), acute kidney injury (AKI) (59 vs. 30%, <i>p</i> < 0.001), and AKI requiring hemodialysis (13 vs. 4%, <i>p</i> < 0.001). Also, the mean length of stay for the index admission was significantly longer in the OHT group (27 vs. 17 days, <i>p</i> = 0.008). The mortality rate was similar between the two groups (7 vs. 8%, <i>p</i> = 0.753). The number of TV surgeries performed in OHT patients from 2007 to 2014 have remained stable (<i>p</i> = 0.803) compared to those in native heart patients which showed a significantly increasing trend (<i>p</i> = 0.019) during the same time period.</p><p><strong>Conclusions: </strong>TV surgery remains an important treatment modality among the OHT population and carries a similar mortality during index hospitalization as that in native heart patients undergoing TV surgery.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000507179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38248292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Responses on the Modified Clinical Test of Sensory Interaction and Balance on Medium Firm and Medium Density Foam in Healthy Controls and Patients with Vestibular Disorders.","authors":"Helen S Cohen,&nbsp;Haleh Sangi-Haghpeykar","doi":"10.1159/000507180","DOIUrl":"https://doi.org/10.1159/000507180","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether foam density affects modified Romberg balance test performance.</p><p><strong>Materials and methods: </strong>Controls and patients with vestibular disorders performed Romberg tests on medium and medium firm foam, with their eyes closed and the head still and moving in yaw and pitch. The trial duration and number of head movements were measured.</p><p><strong>Results: </strong>Subjects aged >60 years performed longer and with more head movements on medium firm foam than on medium foam. Older controls did not differ between medium firm and medium foam. Older patients had higher scores on head-still and head-yaw trials on medium firm foam versus medium foam but pitch trials did not differ. Females, controls, and patients had longer trial durations and more head movements on medium firm foam than on medium density foam; male controls did not differ by foam density. Male patients differed in yaw trials.</p><p><strong>Conclusion: </strong>Foam density affects scores. Clinical decision-making may be adversely affected if the clinician uses foam of a density that is not the same as that of the foam that was used in the studies that developed descriptive statistics, sensitivity, and specificity.</p>","PeriodicalId":9075,"journal":{"name":"Biomedicine Hub","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000507180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38248293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}