Evaluation of an electro-pneumatic device for artificial capillary pulse generation used in a prospective study in animals for surgical neck wound healing

The paper examines the development and testing of an electro-pneumatic device for wound healing therapy after surgery in the neck area. The device generates air pressure values in a miniaturized cuff using electronic circuitry to drive an electro-valve and air compressor. The device works in two distinct modes: continuous pressure mode and pulsating pressure mode. The pressure value setting can vary from 3 to 11 mmHg, and the pulsating pressure mode's operating frequency range is approximately 0.1 to 0.3 Hz. Laboratory measurements were conducted to evaluate the device's correct functioning in both continuous and pulsating pressure modes. A four-day prospective study with animals (n = 10) was also conducted to evaluate neck wound healing therapy using the electro-pneumatic device. Out of the twelve histological parameters analysed to reveal the differences between the experimental and control wounds, only one demonstrated a significant difference. Out of the ten animals treated with the device, three showed a significant difference in terms of benefit after therapy. We can therefore conclude that the device potentially improves the wound healing process in the neck area if the pre-set air pressure value does not exceed 8 mmHg.Web of Science9art. no. 983

Use of autologous material in Middle Ear Surgery

Use of Autologous Material in Middle Ear Surgery The use of autologous material in kofosurgery has been preferred to that of homologous or aloplastic materials in most situations. However, the use of autologous material in patients with cholesteatoma has been limited by the risk of harbouring residual disease. In the clinical part of the study we investigated the relationship between residual cholesteatoma and the method of reconstruction of the middle ear ossicles. Regarding the histological findings, two methods of middle ear ossicle treatment were suggested. The first method tested was mechanical clearance of the ossicles by stripping and burring their surfaces under microscopic view. The mechanical treatment was successful in all cases of mildly eroded ossicles. In cases of severely eroded ossicles, this method was unsuccessful. The second method tested was autoclaving of the ossicle for four minutes at 134 řC after mechanical cleaning. The combination of mechanical and thermal treatment eliminated the cholesteatoma entirely in all cases, including those with severely eroded ossicles. In the experimental part of the study we investigated the reaction of the middle ear mucosa after autoclaving the ossicles and also observed any changes to the ossicles over time since implantation. In an animal experiment..

Use of autologous material in Middle Ear Surgery

Use of Autologous Material in Middle Ear Surgery The use of autologous material in kofosurgery has been preferred to that of homologous or aloplastic materials in most situations. However, the use of autologous material in patients with cholesteatoma has been limited by the risk of harbouring residual disease. In the clinical part of the study we investigated the relationship between residual cholesteatoma and the method of reconstruction of the middle ear ossicles. Regarding the histological findings, two methods of middle ear ossicle treatment were suggested. The first method tested was mechanical clearance of the ossicles by stripping and burring their surfaces under microscopic view. The mechanical treatment was successful in all cases of mildly eroded ossicles. In cases of severely eroded ossicles, this method was unsuccessful. The second method tested was autoclaving of the ossicle for four minutes at 134 řC after mechanical cleaning. The combination of mechanical and thermal treatment eliminated the cholesteatoma entirely in all cases, including those with severely eroded ossicles. In the experimental part of the study we investigated the reaction of the middle ear mucosa after autoclaving the ossicles and also observed any changes to the ossicles over time since implantation. In an animal experiment..

Histological Changes of the Middle Ear Ossicles Harvested During Cholesteatoma Surgery

Background: In the cholesteatoma surgery ossicles can be replaced to reconstruct middle ear function. It is important that these ossicles are free of squamous epithelium, to prevent residual disease. This study focuses on the histological findings of the malleus and incus harvested during cholesteatoma surgery. Materials and Methods: Eighty middle ears ossicles were examined in vivo and histologically to consider the relationship of cholesteatoma to ossicles, grade of bone destruction and invasion of cholesteatoma to deeper layers of bone. Results: Serious ossicular destruction was observed more frequently in incus compared to malleus (p = 0.0065). Difference of ossicles destruction between children and adults was not significant (p = 0.3032). Deep invasion of cholesteatoma into the vascular spaces or inner core of the bone was not observed. Conclusions: Autograft ossicles from cholesteatomatous ears should not necessarily be rejected for reconstruction of the ossicular chain. Regarding the histological finding, the authors suggest mechanical cleaning of the ossicle surface to eliminate residual disease

Invasive Aspergillus infection of middle ear in a patient treated with secukinumab, methotrexate, and corticosteroids for psoriasis and psoriatic arthritis

Mucocutaneous mycotic infections are common complications in patients on IL-17 inhibitor therapy. We report a case of a 33-year-old male with severe psoriasis and psoriatic arthritis on secukinumab combined with methotrexate and prednisone with swelling, otorrhea, and pain of the right ear and external auditory canal. Due to progressive hypacusis, a surgical solution was chosen. Tissue samples taken during surgery revealed the presence of Aspergillus fumigatus. Aspergillosis should be suspected in prolonged otorrhea, especially in immunocompromised patients. Without intervention, the disease could be fatal

Screening sluchu u předškolních dětí: Porovnání řečové zkoušky šepotem a zkoušky audiometrií čistým tónem

This prospective study compares the efficiency of two hearing screening tests performed on preschool children. These tests are known as whispered voice test and pure tone audiometry. Standard hearing screenings were performed on five-year old children using a whispered voice test followed by ENT examination with pure tone audiometry. A total of 827 children were included in the study. Hearing loss (>25 dB) was observed in 5.8% of the evaluated children (n = 48), being bilateral in only 1.6% (n = 13) of these cases. Slight hearing impairment (hearing loss of 16–25 dB) was observed in 25.4% (n = 210) of the children, with 14.5% bilateral cases (n = 120). Interestingly, 62 children (7.5%) were under suspicion of hearing loss by their parents; however, an audiogram revealed the poor consistency of this diagnosis (sensitivity 20.8%, Cohen's kappa coefficient of 0.048). The whispered voice test (6 m distance) throwed a hearing impairment diagnosis in 807 (48.8%) of examined ears; however, its sensitivity was of only 56.5%, with a specificity of 51.6% and Cohen's kappa coefficient of 0.0254 (poor). The hearing loss incidence in preschool children coupled with the low efficacy of whispered voice tests and the parents' unreliability during the hearing impairment survey advocate for a more efficient audiometric hearing screening before beginning school attendance.Tato prospektivní studie porovnává účinnost dvou screeningových testů sluchu prováděných u dětí předškolního věku. Tyto testy jsou známé jako řečová zkouška šepotem a audiometrie čistého tónu. Děti, které dosáhly pěti let věku, podstoupily standardní screeningové vyšetření sluchu řečovou zkouškou šepotem. Následně absolvovaly audiometrické vyšetření sluchu ENT. Incidence sluchového postižení dětí v předškolním věku a nízká výtěžnost screeningového vyšetření sluchu řečovou zkouškou šepotem svědčí pro smysluplnost audiometrického screeningu sluchu před zahájením povinné školní docházky

Respiratory Epithelial Adenomatoid Hamartoma.

Respirační epiteliální adenomatoidní hamartom (REAH) patří do skupiny benigních sinonazálních lézí; projevuje se jako izolovaná afekce v nosní dutině a vedlejších nosních dutinách či v souvislosti s chronickou rinosinusitidou s polypy, výskyt může být oboustranný.Respiratory epithelial adenomatoid hamartoma (REAH) belongs to the group of benign sinonasal lesions, manifesting as an isolated lesion or in coincidence with chronic rhinosinusitis with polyps. Objective: Herein, we present clinical data of our REAH patients and provide an overview of the literature on the subject. Materials and Methods: Retrospective analysis of age, sex, symptoms, imaging examination, operation methods, and recurrence. Results: During the period 2013--2018, six REAH patients aged 48--76 (median 61.5 years) were diagnosed at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralové. Before the diagnosis of REAH, the smell disorder was detected in five cases, nasal obstruction and secretion in five patients as well. In isolated form, REAH was found once at the posterior edge of the septum, twice in the olfactory cleft. In association with chronic rhinosinusitis with polyps, REAH was detected twice in olfactory cleft and once in ethmoids. Five patients have been operated by endonasal endoscopic surgery, four patients under general anesthesia and one patient under local anesthesia. Five patients are followed-up without recurrence (range 5 months -- 5 years, median 48 months). One patient refused surgery and is not followed-up. Conclusion: Respiratory epithelial adenomatoid hamartoma is a benign sinonasal lesion. Histological examination is essential for the differential diagnosis of lesions needing other treatment strategies. After complete surgical removal, recurrence is rar

Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry

BACKGROUND AND OBJECTIVES: COVID-19 related inflammation, endothelial dysfunction and coagulopathy may increase the bleeding risk and lower efficacy of revascularization treatments in patients with acute ischemic stroke. We aimed to evaluate the safety and outcomes of revascularization treatments in patients with acute ischemic stroke and COVID-19. METHODS: Retrospective multicenter cohort study of consecutive patients with acute ischemic stroke receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021, tested for SARS-CoV-2 infection. With a doubly-robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). RESULTS: Of a total of 15128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19. 5848 (38.7%) patients received IVT-only, and 9280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted odds ratio [OR] 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour (OR 2.47; 95% CI 1.58-3.86) and 3-month mortality (OR 1.88; 95% CI 1.52-2.33).COVID-19 patients also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60). DISCUSSION: Patients with acute ischemic stroke and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 treated patients. Current available data does not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in COVID-19 patients, or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring and establishing prognosis

Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry.

BACKGROUND AND OBJECTIVES COVID-19 related inflammation, endothelial dysfunction and coagulopathy may increase the bleeding risk and lower efficacy of revascularization treatments in patients with acute ischemic stroke. We aimed to evaluate the safety and outcomes of revascularization treatments in patients with acute ischemic stroke and COVID-19. METHODS Retrospective multicenter cohort study of consecutive patients with acute ischemic stroke receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021, tested for SARS-CoV-2 infection. With a doubly-robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT). RESULTS Of a total of 15128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19. 5848 (38.7%) patients received IVT-only, and 9280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted odds ratio [OR] 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour (OR 2.47; 95% CI 1.58-3.86) and 3-month mortality (OR 1.88; 95% CI 1.52-2.33).COVID-19 patients also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60). DISCUSSION Patients with acute ischemic stroke and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 treated patients. Current available data does not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in COVID-19 patients, or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring and establishing prognosis