Transoral endoscopic thyroidectomy submental vestibular approach for early-stage papillary thyroid carcinoma: a systematic review and meta-analysis.

PURPOSE: Our study aimed to compare the effectiveness and complications of the transoral endoscopic thyroidectomy submental vestibular approach (TOETSMVA) versus the transoral endoscopic thyroidectomy vestibular approach (TOETVA) or conventional open thyroidectomy (COT) in patients with early-stage papillary thyroid carcinoma (PTC). METHODS: We searched online databases up to January 2024. The outcomes were analyzed using RevMan 5.4 and inverse variance. RESULTS: Seven studies (two RCTs and five retrospective cohort studies) were included. We established higher significance differences for TOETSMVA in comparison with TOETVA in terms of all primary outcomes; operation time, hospital stay, number of resected lymph nodes [MD -21.05, 95% CI= -30.98, -11.12; p < 0.0001], [MD -1.76, 95% CI= -2.21, -1.32, p < 0.00001], [MD -2.99, 95% CI= -19.75, 13.76, p < 0.73], [MD -0.83, 95% CI = -1.19 to -0.47; p < 0.00001], respectively, except the drainage volume, it showed no difference [MD -2.99, 95% CI= -19.75, 13.76, p < 0.73]. In secondary outcomes, it was favored only in mandibular numbness and return to normal diet outcomes. Additionally, TOETSMVA compared with COT showed a significant difference in drainage volume, pain, cosmetic effect, and satisfaction score. CONCLUSIONS: TOETSMVA showed a significant improvement compared to the TOETVA in operation time, hospital stay, number of resected lymph nodes, mandibular numbness, and return to normal diet but did not show a difference in drainage volume. However, TOETSMVA was better in cosmetic effect, drainage volume, satisfaction, and pain scores compared with COT. Further RCTs with larger sample size, multicentral, and longer follow-up are necessary to evaluate the limitations.

Enhancing physical characteristics and antibacterial efficacy of chitosan through investigation of microwave-assisted chemically formulated chitosan-coated ZnO and chitosan/ZnO physical composite.

This study investigates the creation and analysis of chitosan-zinc oxide (CS-ZnO) nanocomposites, exploring their effectiveness in inhibiting bacteria. Two synthesis approaches, physical and chemical, were utilized. The CS-ZnO nanocomposites demonstrated strong antibacterial properties, especially against Staphylococcus aureus, a Gram-positive bacterium. Chemically synthesized nanocomposites (CZ10 and CZ100) exhibited larger inhibition zones (16.4 mm and 18.7 mm) compared to physically prepared CS-Z5 and CS-Z20 (12.2 mm and 13.8 mm) against Staphylococcus aureus. Moreover, CZ nanocomposites displayed enhanced thermal stability, with decomposition temperatures of 281°C and 290°C, surpassing CS-Z5 and CS-Z20 (260°C and 258°C). The residual mass percentages at 800°C were significantly higher for CZ10 and CZ100 (58% and 61%) than for CS-Z5 and CS-Z20 (36% and 34%). UV-Visible spectroscopy revealed reduced band gaps in the CS-ZnO nanocomposites, indicating improved light absorption. Transmission electron microscopy (TEM) confirmed uniform dispersion of ZnO nanoparticles within the chitosan matrix. In conclusion, this research underscores the impressive antimicrobial potential of CS-ZnO nanocomposites, especially against Gram-positive bacteria, and highlights their enhanced thermal stability. These findings hold promise for diverse applications in industries such as medicine, pharmaceuticals, and materials science, contributing to the development of sustainable materials with robust antimicrobial properties.

International pediatric otolaryngology group (IPOG) consensus on approach to aspiration.

OBJECTIVE: To provide recommendations for a comprehensive management approach for infants and children presenting with symptoms or signs of aspiration. METHODS: Three rounds of surveys were sent to authors from 23 institutions worldwide. The threshold for the critical level of agreement among respondents was set at 80 %. To develop the definition of "intractable aspiration," each author was first asked to define the condition. Second, each author was asked to complete a 5-point Likert scale to specify the level of agreement with the definition derived in the first step. RESULTS: Recommendations by the authors regarding the clinical presentation, diagnostic considerations, and medical and surgical management options for aspiration in children. CONCLUSION: Approach to pediatric aspiration is best achieved by implementing a multidisciplinary approach with a comprehensive investigation strategy and different treatment options.

Effective purification of human chorionic gonadotropin and production of highly specific polyclonal anti-ßHCG as a component of radioimmunoassay kit.

This study aimed to purify human chorionic gonadotropin (HCG) from the urine of pregnant women with high biological activity (10811 IU/mg) and purity (98.2%), by simple capturing of HCG using DEAE Sepharose FF and polishing using Sephacryl S200 HR. The HCG obtained was characterized by SDS-PAGE and dissociated into alpha and beta subunits using the urea treatment method. The ßHCG subunits were injected into rabbits for the production of highly specific polyclonal anti-ßHCG antisera. The polyclonal anti-ßHCG was locally produced in rabbits and assessed for binding titer (1/10000), displacement (84.8%), and specificity (98.8%). Purified HCG along with locally prepared polyclonal anti-ßHCG antisera were used as basic components of the in-house Radioimmunoassay system for quantitative estimation of HCG in human serum.

The prevalence of swallowing dysfunction in children with laryngomalacia: a systematic review.

OBJECTIVES: Laryngomalacia (LM) is commonly diagnosed in infants and children with upper aerodigestive symptoms. In the literature, the focus has been on the respiratory impairment, with fewer studies addressing swallowing dysfunction (SwD). The objective of this study is to systematically review the literature for evidence on the prevalence of SwD in children diagnosed with LM. METHODS: A search was conducted on the following databases: OVID Medline, Ovid EMBASE, EBSCO CINAHL, PROSPERO, and Cochrane Library. We included all the studies that reported on children with LM and documented objective swallowing assessment using fiberoptic endoscopic evaluation of swallowing (FEES) or videofluoroscopic swallowing study (VFSS). Two authors independently screened all the studies, assessed the level of evidence in the included studies, and extracted data. Risk of bias assessment and pooled data analysis were performed. RESULTS: The search yielded 512 abstracts. Four studies met the selection criteria representing 425 children. Three studies were retrospective uncontrolled case series and one was a prospective cohort study. In all studies but one, an instrumental assessment of swallowing was selectively performed in patients with clinical indicators of SwD. The pooled estimate (range) of prevalence of SwD was 49% (13.9-90.6%). CONCLUSION: The literature suggests a high prevalence of SwD in children with LM, however the level of evidence is low and generalizability is poor. The wide range of prevalence figures suggests a significant variability in the threshold and indications to assess swallowing in children with LM.

Xylariaceae on the fringe.

The Xylariaceae is one of the best-known pyrenomycete families (Ascomycota) and is distributed throughout the world. The majority are wood inhabitants and are prevalent in tropical and subtropical regions. Halorosellinia oceanicum is the most widely distributed in mangroves and can be regarded as truly manglicolous being frequently recorded as the dominant member of the family in such environments in S.E. Asia. In Malaysian mangroves, members of the Xylariaceae have been found to be numerically important with up to 9% present in one mangrove ecosystem. A further twelve xylariaceous genera are reported as occurring as their teleomorphs in mangrove forest and their immediate surroundings including Anthostomella, Astrocystis, Biscogniauxia, Camillea, Daldinia, Fasciatispora, Hypoxylon, Kretzschmaria, Nemania, Nipicola, Rosellinia and Xylaria. Furthermore, the presence of species from a number of these taxa, especially species of Anthostomella and Xylaria, are regularly isolated as endophytes from a variety of mangrove plant species. Mangrove Xylariaceae are also well known for their ability to produce novel and often bioactive metabolites.

CD4+CD25+ regulatory T cells (TREG) in systemic lupus erythematosus (SLE) patients: the possible influence of treatment with corticosteroids.

Systemic Lupus Erythematosus (SLE) is a chronic, systemic autoimmune disease characterized by loss of tolerance to self-antigens. Regulatory T cells (T(REG)) are those CD4+ T cells that constitutively express high levels of CD25 and exhibit powerful suppressive properties. The aim of this work was to quantify CD4+CD25+ (T(REG)) cells and the Mean Fluorescence Index (MFI) of T(REG) in the peripheral blood of patients with SLE and to correlate these findings with their disease activity scores and drug therapy. This study included 24 SLE patients with various disease activity scores (SLEDAI) and 24 healthy age and sex matched controls. Flow cytometry was used to examine the frequency of CD4+CD25+ T cells and the MFI of CD4+CD25+(high) T cells (T(REG)). CD4+CD25+ T cells % and MFI of CD4+CD25+(high) T cells were higher in SLE patients than controls (p value=0.62 and=0.037 respectively) and both CD4+CD25+ T cell % and the MFI of CD4+CD25+(high) T cells showed highly significant correlation with SLEDAI scores (both with a p value<0.001) and were higher in patients taking glucocorticoids than those not on glucocorticoids (p= 0.023, 0.048 respectively). We conclude that the increase in T(REG) cells in our patients may be due to corticosteroid treatment.