Survey of endoscopic skull base surgery practice patterns among otolaryngologists

Background Endoscopic skull base surgery (ESBS) is a rapidly expanding field. Despite divergent reported preferences for reconstructive techniques and perioperative management, limited data exist regarding contemporary practice patterns among otolaryngologists performing ESBS. This study aims to elucidate current practice patterns, primarily the volumes of cases performed and secondarily a variety of other perioperative preferences. Methods An anonymous 32-item electronic survey examining perioperative ESBS preferences was distributed to the American Rhinologic Society membership. Statistical significance between variables was determined utilizing Student t, chi-square, and Fisher exact tests. Results Seventy otolaryngologists completed the survey. The effective response rate was approximately 22.5%. Sixty percent of respondents were in full-time academic practice and 70% had completed rhinology/skull base fellowships. Annually, 43.3 mean ESBS cases were performed (29.1 private practice vs. 52.9 academic practice, P = .009). Academic practice averaged 24.1 expanded cases versus only 11 in private practice (P = .01). Of respondents, 55.7% stood on the same side as the neurosurgeon and 72.9% remained present for the entire case. Current procedural terminology coding and antibiotic regimens were widely divergent; 31.4% never placed lumbar drains preoperatively, while 41.4% did so for anticipated high-flow cerebrospinal fluid leaks. While considerable variation in reconstructive techniques were noted, intradural defect repairs utilized vascularized flaps 86.3% of the time versus only 51.3% for extradural repairs (P < 0.001). Major complications were rare. Postoperative restrictions varied considerably, with most activity limitations between 2–8 weeks and positive airway pressure use for 2–6 weeks. Most respondents started saline irrigations 0–2 weeks postoperatively. Conclusions Based on responses from fellowship- and non-fellowship-trained otolaryngologists in various practice settings, there remains considerable variation in the perioperative management of patients undergoing ESBS. Level of Evidence

Electrochemical and Colorimetric Nanosensors for Detection of Heavy Metal Ions: A Review

Human exposure to acute and chronic levels of heavy metal ions are linked with various health issues, including reduced children’s intelligence quotients, developmental challenges, cancers, hypertension, immune system compromises, cytotoxicity, oxidative cellular damage, and neurological disorders, among other health challenges. The potential environmental HMI contaminations, the biomagnification of heavy metal ions along food chains, and the associated risk factors of heavy metal ions on public health safety are a global concern of top priority. Hence, developing low-cost analytical protocols capable of rapid, selective, sensitive, and accurate detection of heavy metal ions in environmental samples and consumable products is of global public health interest. Conventional flame atomic absorption spectroscopy, graphite furnace atomic absorption spectroscopy, atomic emission spectroscopy, inductively coupled plasma–optical emission spectroscopy, inductively coupled plasma–mass spectroscopy, X-ray diffractometry, and X-ray fluorescence have been well-developed for HMIs and trace element analysis with excellent but varying degrees of sensitivity, selectivity, and accuracy. In addition to high instrumental running and maintenance costs and specialized personnel training, these instruments are not portable, limiting their practicality for on-demand, in situ, field study, or point-of-need HMI detection. Increases in the use of electrochemical and colorimetric techniques for heavy metal ion detections arise because of portable instrumentation, high sensitivity and selectivity, cost-effectiveness, small size requirements, rapidity, and visual detection of colorimetric nanosensors that facilitate on-demand, in situ, and field heavy metal ion detections. This review highlights the new approach to low-cost, rapid, selective, sensitive, and accurate detection of heavy metal ions in ecosystems (soil, water, air) and consumable products. Specifically, the review highlights low-cost, portable, and recent advances in smartphone-operated screen-printed electrodes (SPEs), plastic chip SPES, and carbon fiber paper-based nanosensors for environmental heavy metal ion detection. In addition, the review highlights recent advances in colorimetric nanosensors for heavy metal ion detection requirements. The review provides the advantages of electrochemical and optical nanosensors over the conventional methods of HMI analyses. The review further provides in-depth coverage of the detection of arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn) ions in the ecosystem, with emphasis on environmental and biological samples. In addition, the review discusses the advantages and challenges of the current electrochemical and colorimetric nanosensors protocol for heavy metal ion detection. It provides insight into the future directions in the use of the electrochemical and colorimetric nanosensors protocol for heavy metal ion detection

Biocompatibility and pharmacokinetics of fluticasone-eluting sinus implant in a rabbit model

Background: A novel, bioabsorbable, fibrinogen-based implant has been developed as a mucosal dressing after endoscopic sinus surgery (ESS). This implant can be formulated with fluticasone propionate (FP) for local elution of corticosteroid to reduce postoperative inflammation and promote mucosal healing. Objective: This study investigated the biocompatibility and pharmacokinetics of the implant in a rabbit model. Methods: Implants with and without FP were placed on both intact and demucosalized maxillary sinuses of 33 New Zealand White rabbits. Sinuses with either intact or denuded bone without implants acted as controls. Histopathologic assessments were carried out at 5, 15, and 28 days. Concentrations of FP in the maxillary sinus mucosa, nasal cavity mucosa, and plasma were measured for up to 44 days. Results: Implants placed on intact mucosa or denuded bone were grossly integrated within 15 days. Minimal foreign body reaction was seen with negligible differences for inflammation, fibrosis, or bone remodeling among controls, sinuses with the implant, or sinuses with the implant plus FP, at all time points. All samples also showed complete or near-complete percentage reepithelialization at 28 days, although the denuded bone controls demonstrated greater percentage reepithelialization at 5 days compared with denuded bone with the implant or implant plus FP (p 140 ng/g up to 44 days. Plasma concentrations of FP were generally very low and were undetectable after day 7. Conclusions: The implant and the implant plus FP seemed to be biocompatible in rabbits. The implant plus FP effectively eluted steroid locally over at least 44 days, with negligible plasma concentrations. Further studies are warranted regarding potential therapeutic applications in patients undergoing ESS for chronic rhinosinusitis.Vishal S. Patel, Evan Walgama, Alkis Psaltis, Francois Lavigne, Steven D. Pletcher, Peter H. Hwan

Antibacterial activities of endophytic fungi isolated from six Sri Lankan plants of the family Cyperaceae

In a study designed to determine the antibacterial potential of endophytic fungi inhabiting plants of Cyperaceae family, 72 morphologically distinct endophytic fungi were isolated from six plants and their antibacterial activities against two Gram positive and three Gram negative pathogenic bacterial species were examined. Two antibacterial metabolites from two endophytes were also isolated and their chemical structures and minimum inhibitory concentrations were determined. Sixty six fungal extracts (92%) were active against at least one bacterium tested. Butyrolactone I isolated from the Aspergillus terreus and 9-epi viridol isolated from Trichoderma virens exhibited MIC values in the range 128-256 µg/mL against Gram positive Bacillus subtilits, Staphylococcus aureus, methicillin resistant S. aureus (MRSA) and Escherichia coli. Both compounds were inactive against other micro-organisms tested. This study confirmed that Cyperaceae plants harbor numerous endophytes that produce antibacterial metabolites active against both Gram positive and, to a lesser extent, Gram negative bacteria. Video Clip of Methodology: Column Chromatogrpahy: 15 min 34 sec   Full Screen   Alternat

QCM Sensor Arrays, Electroanalytical Techniques and NIR Spectroscopy Coupled to Multivariate Analysis for Quality Assessment of Food Products, Raw Materials, Ingredients and Foodborne Pathogen Detection: Challenges and Breakthroughs

Quality checks, assessments, and the assurance of food products, raw materials, and food ingredients is critically important to ensure the safeguard of foods of high quality for safety and public health. Nevertheless, quality checks, assessments, and the assurance of food products along distribution and supply chains is impacted by various challenges. For instance, the development of portable, sensitive, low-cost, and robust instrumentation that is capable of real-time, accurate, and sensitive analysis, quality checks, assessments, and the assurance of food products in the field and/or in the production line in a food manufacturing industry is a major technological and analytical challenge. Other significant challenges include analytical method development, method validation strategies, and the non-availability of reference materials and/or standards for emerging food contaminants. The simplicity, portability, non-invasive, non-destructive properties, and low-cost of NIR spectrometers, make them appealing and desirable instruments of choice for rapid quality checks, assessments and assurances of food products, raw materials, and ingredients. This review article surveys literature and examines current challenges and breakthroughs in quality checks and the assessment of a variety of food products, raw materials, and ingredients. Specifically, recent technological innovations and notable advances in quartz crystal microbalances (QCM), electroanalytical techniques, and near infrared (NIR) spectroscopic instrument development in the quality assessment of selected food products, and the analysis of food raw materials and ingredients for foodborne pathogen detection between January 2019 and July 2020 are highlighted. In addition, chemometric approaches and multivariate analyses of spectral data for NIR instrumental calibration and sample analyses for quality assessments and assurances of selected food products and electrochemical methods for foodborne pathogen detection are discussed. Moreover, this review provides insight into the future trajectory of innovative technological developments in QCM, electroanalytical techniques, NIR spectroscopy, and multivariate analyses relating to general applications for the quality assessment of food products

Qcm sensor arrays, electroanalytical techniques and nir spectroscopy coupled to multivariate analysis for quality assessment of food products, raw materials, ingredients and foodborne pathogen detection: Challenges and breakthroughs\u3csup\u3e†\u3c/sup\u3e

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Quality checks, assessments, and the assurance of food products, raw materials, and food ingredients is critically important to ensure the safeguard of foods of high quality for safety and public health. Nevertheless, quality checks, assessments, and the assurance of food products along distribution and supply chains is impacted by various challenges. For instance, the development of portable, sensitive, low-cost, and robust instrumentation that is capable of real-time, accurate, and sensitive analysis, quality checks, assessments, and the assurance of food products in the field and/or in the production line in a food manufacturing industry is a major technological and analytical challenge. Other significant challenges include analytical method development, method validation strategies, and the non-availability of reference materials and/or standards for emerging food contaminants. The simplicity, portability, non-invasive, non-destructive properties, and low-cost of NIR spectrometers, make them appealing and desirable instruments of choice for rapid quality checks, assessments and assurances of food products, raw materials, and ingredients. This review article surveys literature and examines current challenges and breakthroughs in quality checks and the assessment of a variety of food products, raw materials, and ingredients. Specifically, recent technological innovations and notable advances in quartz crystal microbalances (QCM), electroanalytical techniques, and near infrared (NIR) spectroscopic instrument development in the quality assessment of selected food products, and the analysis of food raw materials and ingredients for foodborne pathogen detection between January 2019 and July 2020 are highlighted. In addition, chemometric approaches and multivariate analyses of spectral data for NIR instrumental calibration and sample analyses for quality assessments and assurances of selected food products and electrochemical methods for foodborne pathogen detection are discussed. Moreover, this review provides insight into the future trajectory of innovative technological developments in QCM, electroanalytical techniques, NIR spectroscopy, and multivariate analyses relating to general applications for the quality assessment of food products