Purpose
The objectives of this meta-analysis were to summarize the key surgical procedures for UVCP and to evaluate which of these is associated with better results in terms of vocal improvement.
...Methods
A systematic review of the literature was conducted in search of articles focused on the comparison of voice outcome between different techniques for the UVCP treatment. Then, a quantitative analysis was carried out for papers published from 2013 onwards, reporting only adult patients with unilateral paralysis for each study, and each surgical technique was evaluated for its capability of achieving good functional outcomes in terms of GRBAS-I scale and maximum phonation time in seconds (MPT).
Results
The search identified 1853 publications. A total of 159 articles were stratified and included according to our selection criteria. 21 out of 159 articles were selected for quantitative synthesis. For trans-oral techniques: the mean GRBAS-I scale were 2.33 before injection and 0.41 after injection. The mean MPT before injection were 4.78 and 12.50 after injection. For open techniques the mean GRBAS-I scale were 2.43 before surgery and 0.68 after surgery. For open technique, the mean MPT were 3.50 before surgery and 12.40 after surgery.
Conclusions
The two types of techniques lead to an improvement in terms of vocal outcomes emphasizing that from the examined literature an indication emerges to perform an early injection because this could reduce the possible need for a more invasive intervention of permanent medialization in the future.
Abstract Childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) are strongly associated with women's alcohol use and the rates of both alcohol use and sexual assault history are ...higher among lesbian and bisexual women than heterosexual women. Although descriptive drinking norms are one of the highest predictors of alcohol use in emerging adults, this is the first study to examine the relationship between sexual assault history, drinking norms, and alcohol use in lesbian and bisexual women. We found that CSA severity was associated with a higher likelihood of experiencing more severe alcohol-involved ASA, more severe physically forced ASA, and was indirectly associated with more drinking behavior and higher drinking norms. Additionally, more severe alcohol-involved ASA was associated with higher drinking norms and more drinking behavior, but physically forced ASA was not. These findings help explain previous contradictory findings and provide information for interventions.
Attention-deficit hyperactivity disorder (ADHD) has been found to co-occur frequently with obesity, although the reasons for this association are unknown. The aim of this study was to compare the ...nutritional profile of a Brazilian cohort of ADHD patients with that of the general population and to analyze the association between ADHD drug treatment (with methylphenidate), nutritional status, and height of these individuals. In the first phase of the study, we designed the nutritional and height profile of 93 ADHD patients (5.1 to 13.8 years old) and compared it to a control group. In the second phase, we analyzed the association of the use of methylphenidate with nutritional status and height. The results showed that the prevalence of overweight/obesity was statistically higher in the cohort of ADHD patients compared to controls (40.9% vs. 34.7%; P<0.05). After treating ADHD patients with methylphenidate, a statistically significant decrease in the BMI z-score was observed (0.695 vs. 0.305; P<0.01). On the other hand, no significant impact on height was detected after treatment (0.189 vs. 0.248; P=0.298). In conclusion, the results suggest that the use of methylphenidate in patients who have ADHD and obesity is relevant not only for controlling ADHD symptoms but also for improving the nutritional status of these individuals. Moreover, the treatment did not affect the patients’ height.
We describe a case of chronic hepatitis E virus (HEV) infection in a 13-year-old female liver transplant recipient with recurrent increased aminotransferase levels and acute cellular rejection. This ...finding demonstrates that chronic HEV infection can occur and should be further investigated in immunocompromised patients in Latin America.
Human herpesvirus 6 (HHV-6) may cause severe complications after
haematopoietic stem cell transplantation (HSCT). Monitoring this virus
and providing precise, rapid and early diagnosis of related ...clinical
diseases, constitute essential measures to improve outcomes. A
prospective survey on the incidence and clinical features of HHV-6
infections after HSCT has not yet been conducted in Brazilian patients
and the impact of this infection on HSCT outcome remains unclear. A
rapid test based on real-time quantitative polymerase chain reaction
(qPCR) has been optimised to screen and quantify clinical samples for
HHV-6. The detection step was based on reaction with Taq- Man®
hydrolysis probes. A set of previously described primers and probes
have been tested to evaluate efficiency, sensitivity and
reproducibility. The target efficiency range was 91.4% with linearity
ranging from 10-106 copies/reaction and a limit of detection of five
copies/reaction or 250 copies/mL of plasma. The qPCR assay developed in
the present study was simple, rapid and sensitive, allowing the
detection of a wide range of HHV-6 loads. In conclusion, this test may
be useful as a practical tool to help elucidate the clinical relevance
of HHV-6 infection and reactivation in different scenarios and to
determine the need for surveillance.
Background: Inflammation plays a pivotal role in atherothrombosis. Recent data indicate that serum levels of neopterin, a marker of inflammation and immune modulator secreted by ...monocytes/macrophages, are elevated in patients with acute coronary syndromes and seem to be a prognostic marker for major cardiovascular events. The aim of the present study was to determine whether neopterin might affect the thrombotic and atherosclerotic characteristics of human coronary artery endothelial cells (HCAECs). Methods and results: In HCAECs, neopterin induced TF‐mRNA transcription as demonstrated by real time polymerase chain reaction and expression of functionally active tissue factor (TF) as demonstrated by procoagulant activity assay, and of cellular adhesion molecules (CAMs) as demonstrated by FACS analysis, in a dose‐dependent fashion. These neopterin effects were prevented by lovastatin, a HMG‐CoA reductase inhibitor. Neopterin‐induced TF and CAMs expression was mediated by oxygen free radicals through the activation of the transcription factor, nuclear factor‐kappa B (NF‐κB), as demonstrated by electrophoretic mobility shift assay and by suppression of CAMs and TF expression by superoxide dismutase and by NF‐κB inhibitor, pyrrolidine‐dithio‐carbamate ammonium. Conclusions: These data indicate that neopterin exerts direct effects on HCAECs by promoting CAMs and TF expression and support the hypothesis that neopterin, besides representing a marker of inflammation, might be an effector molecule able to induce a pro‐atherothrombotic phenotype in cells of the coronary circulation.
Brazil is a non-endemic country for hepatitis E virus (HEV) infection with seroprevalence from 1% to 4% in blood donors and the general population. However, data on seroprevalence of HEV in the ...country are still limited. This study evaluated the prevalence of past or present HEV infection in a group of blood donors representative of the general population of the city of Sao Paulo, Southeastern Brazil. Serum samples from 500 blood donors were tested from July to September 2014 by serological and molecular methods. Anti-HEV IgG antibodies were detected in 49 (9.8%) subjects and categorized age groups revealed an age-dependent increase of HEV seroprevalence. Among the anti-HEV IgG positive subjects, only 1 had anti-HEV IgM while none tested positive for HEV-RNA. The present data demonstrate a higher seroprevalence of anti-HEV IgG than previously reported in the region.
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