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Cureus May 2024The purpose of this study was to assess the awareness of ototoxicity among medical doctors in Arar City, Saudi Arabia.
OBJECTIVES
The purpose of this study was to assess the awareness of ototoxicity among medical doctors in Arar City, Saudi Arabia.
METHODS
This is a cross-sectional study based on a pre-formed validated questionnaire (Appendix) that included three sections covering participants' demographic data (three questions), their attitudes (five questions), and knowledge (13 questions) regarding drug-induced ototoxicity.
RESULTS
After obtaining their informed consent, 213 physicians from government and private sector health facilities in Arar were enrolled in the study. Interns and general practitioners represented 57.8% of the participants; consultants represented 17.8%. Only 71.8% of participants were interested in drug-induced ototoxicity, while 26.3% considered ototoxicity a rare complication. Approximately 90% of the participants were knowledgeable about the adverse effects of drugs on the vestibulocochlear system, and 26.7% reported having experienced cases of drug-induced ototoxicity in their practice. Participants showed an overall knowledge score about ototoxicity of 9.3±3.27 (out of 14). The knowledge score was significantly higher (p-value=0.0007) for participants with more years of clinical experience. The most widely known ototoxic drug for participants was frusemide (72.3%), followed by aminoglycoside (68.5%), while acetaminophen (44.1%) ototoxicity was the least known among participants.
CONCLUSION
Awareness of drug-induced ototoxicity is satisfactory among physicians in the Northern Borders region. However, workshops about all types of drugs with ototoxic effects and the main lines for the management of drug-induced ototoxicity are recommended to increase awareness.
PubMed: 38882992
DOI: 10.7759/cureus.60429 -
Journal of Food Protection Jun 2024The 2021 FSIS Stabilization Guidelines for Meat and Poultry Products (Appendix B) Option 1.2 limits Phase 1 cooling from 48.8 to 26.7 °C in uncured meats to 1 h....
The 2021 FSIS Stabilization Guidelines for Meat and Poultry Products (Appendix B) Option 1.2 limits Phase 1 cooling from 48.8 to 26.7 °C in uncured meats to 1 h. However, this time restriction is impractical to achieve in large-diameter whole-muscle products. The objective of this study was to compare the inhibitory effect of commercial dry vinegars (DVs) and cultured sugar-vinegar blends (CSVs) on Clostridium perfringens and Bacillus cereus in uncured beef and poultry products during extended cooling. Treatments (beef: 72-73% moisture, pH 6.2-6.3, 0.85-0.95% NaCl; turkey: 76-77% moisture, pH 6.5-6.7, 1.3-1.6% NaCl) included Controls without antimicrobials, and four DV and four CSV, each tested at 0.75 and 1.25%. Batches were inoculated with 2.5-log C. perfringens or B. cereus spores, vacuum-packaged, and cooked to 73 °C. Packages were cooled from 48.8 to 27 °C (Phase 1) in 3, 4, or 5 h; Phase 2 (27-12.8 °C) and Phase 3 (12.8-4 °C) were standardized for 5-h cooling each. Pathogens were enumerated on selective agar in triplicate samples assayed at precook, postcook, and at the end of Phase 1, 2, and 3 cooling. Experiments were conducted twice. B. cereus did not grow (<0.5-log increase) in any treatment when Phase 1 cooling was extended to 5 h. C. perfringens grew rapidly (2.5 to >4.5 log) in Control treatments when Phase 1 cooling was extended to ≥3 h. All 1.25% DV ingredients limited C. perfringens growth to ≤1-log when Phase 1 cooling was extended to 3 h but supported a >1-log increase when Phase 1 cooling was extended to 5 h. All 1.25% CSV inhibited growth under 3-h Phase 1 cooling; 1.25% CSV-A and ≥0.75% CSV-D inhibited growth in turkey during 5-h Phase 1 cooling, but inhibition with 1.25% CSV-C was inconsistent in beef. This study revealed that formulating uncured meats with 1.25% DV or certain CSV can extend Phase 1 cooling to 3 h. Although all ingredients inhibited growth when used at 0.75% or greater compared to a control, greater variability of inhibition was observed among CSV than for DV.
PubMed: 38878899
DOI: 10.1016/j.jfp.2024.100317 -
The Journal of Thoracic and... Jun 2024Lung cancers that present as radiographic subsolid nodules represent a subtype with distinct biological behavior and outcomes. The objective of this document is to...
OBJECTIVE
Lung cancers that present as radiographic subsolid nodules represent a subtype with distinct biological behavior and outcomes. The objective of this document is to review the existing literature and report consensus among a group of multidisciplinary experts, providing specific recommendations for the clinical management of subsolid nodules.
METHODS
The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international, multidisciplinary expert panel composed of radiologists, pulmonologists, and thoracic surgeons with established expertise in the management of subsolid nodules. A focused literature review was performed with the assistance of a medical librarian. Expert consensus statements were developed with class of recommendation and level of evidence for each of 4 main topics: (1) definitions of subsolid nodules (radiology and pathology), (2) surveillance and diagnosis, (3) surgical interventions, and (4) management of multiple subsolid nodules. Using a modified Delphi method, the statements were evaluated and refined by the entire panel.
RESULTS
Consensus was reached on 17 recommendations. These consensus statements reflect updated insights on subsolid nodule management based on the latest literature and current clinical experience, focusing on the correlation between radiologic findings and pathological classifications, individualized subsolid nodule surveillance and surgical strategies, and multimodality therapies for multiple subsolid lung nodules.
CONCLUSIONS
Despite the complex nature of the decision-making process in the management of subsolid nodules, consensus on several key recommendations was achieved by this American Association for Thoracic Surgery expert panel. These recommendations, based on evidence and a modified Delphi method, provide guidance for thoracic surgeons and other medical professionals who care for patients with subsolid nodules.
PubMed: 38878052
DOI: 10.1016/j.jtcvs.2024.02.026 -
Ear, Nose, & Throat Journal Jun 2024Laryngocele, an abnormal dilation of the appendix of the laryngeal ventricle filled with air, is a rare condition predominantly presenting unilaterally. However,...
Laryngocele, an abnormal dilation of the appendix of the laryngeal ventricle filled with air, is a rare condition predominantly presenting unilaterally. However, bilateral occurrences are exceedingly rare. In this article, we present a case of bilateral laryngocele along with a comprehensive literature review. A 57-year-old male presented with dyspnea, stridor, and bilateral neck masses. His medical history included chronic cough and intermittent hoarseness. Over a 3 month period, the neck masses progressively enlarged, resulting in respiratory distress. Interestingly, he denied experiencing weight loss, decreased appetite, or fever. Clinical examination revealed sizable, soft masses on both sides of the neck, obstructing lymph node assessment. Computed tomography (CT) imaging confirmed the presence of a left combined laryngopyocele and a right combined laryngocele. Subsequently, the patient underwent tracheostomy. Benign biopsy results excluded malignancy. Surgical excision of bilateral laryngoceles resulted in an uneventful recovery. The term "laryngocele" was introduced by Virchow in 1867 to describe the abnormal dilation of the saccule associated with Morgagni's ventricle. Diagnosis involves a thorough patient history, physical examination, and radiological imaging, notably CT, to differentiate laryngoceles from other conditions. Typically asymptomatic, they are often incidentally discovered around age 50, although symptoms such as voice changes or breathing difficulties can manifest. A review of the literature identified 77 documented cases, primarily in males, exhibiting various symptoms and treatment modalities. This case underscores the rarity of bilateral combined laryngocele, emphasizing the importance of timely diagnosis and surgical intervention for favorable outcomes. Comprehensive research reveals diverse clinical aspects, highlighting the necessity for continued investigation to enhance management strategies.
PubMed: 38877649
DOI: 10.1177/01455613241261455 -
IEEE Transactions on Pattern Analysis... Jun 2024As the most fundamental scene understanding tasks, object detection and segmentation have made tremendous progress in deep learning era. Due to the expensive manual...
As the most fundamental scene understanding tasks, object detection and segmentation have made tremendous progress in deep learning era. Due to the expensive manual labeling cost, the annotated categories in existing datasets are often small-scale and pre-defined, i.e., state-of-the-art fully-supervised detectors and segmentors fail to generalize beyond the closed vocabulary. To resolve this limitation, in the last few years, the community has witnessed an increasing attention toward Open-Vocabulary Detection (OVD) and Segmentation (OVS). By "open-vocabulary", we mean that the models can classify objects beyond pre-defined categories. In this survey, we provide a comprehensive review on recent developments of OVD and OVS. A taxonomy is first developed to organize different tasks and methodologies. We find that the permission and usage of weak supervision signals can well discriminate different methodologies, including: visual-semantic space mapping, novel visual feature synthesis, region-aware training, pseudo-labeling, knowledge distillation, and transfer learning. The proposed taxonomy is universal across different tasks, covering object detection, semantic/instance/panoptic segmentation, 3D and video understanding. The main design principles, key challenges, development routes, methodology strengths, and weaknesses are thoroughly analyzed. In addition, we benchmark each task along with the vital components of each method in appendix and updated online at awesome-ovd-ovs. Finally, several promising directions are provided and discussed to stimulate future research.
PubMed: 38875096
DOI: 10.1109/TPAMI.2024.3413013 -
Annals of Surgical Oncology Jun 2024Mucinous adenocarcinoma of the appendix (MACA) follows a complex disease course with variable survival. Large-scale predictive modeling may determine subtle yet...
BACKGROUND
Mucinous adenocarcinoma of the appendix (MACA) follows a complex disease course with variable survival. Large-scale predictive modeling may determine subtle yet important prognostic factors otherwise unseen in smaller cohort analyses.
METHODS
Patients with MACA were identified from the Surveillance, Epidemiology, and End Results (SEER) Research Plus database (2005-2019). Primary, secondary, and tertiary outcomes were disease-specific survival (DSS), overall survival (OS), and average annual percent change (AAPC) in incidence.
RESULTS
Among 4,258 included patients, MACA was most frequently diagnosed at 50 to 69 years (52.0%), with female preponderance (55.9%). MACA incidence AAPC was 3.8 (95% confidence interval [CI] 1.9-5.9). For patients with exclusive, first-diagnosis MACA included in survival analysis (3,222 patients), median DSS and OS were 118 and 88 months, respectively. In DSS-based multivariable analysis, worse prognosis was associated with non-Hispanic Black background (HR 1.36, 95% CI 1.02-1.82; p = 0.036), high grade (grade 3 HR 3.10, 95% CI 2.44-3.92; p < 0.001), lymphatic spread (HR 2.73, 95% CI 2.26-3.30; p < 0.001), and distant metastasis (HR 5.84, 95% CI 3.86-8.83; p < 0.001). In subcohort analysis of patients with rationale for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC, 2,387 patients), CRS-HIPEC was associated with survival benefit compared with surgery alone but only for moderate-grade tumors (median DSS/OS 138/138 vs. 116/87 months; p < 0.001).
CONCLUSIONS
Mucinous adenocarcinoma of the appendix incidence is increasing in the United States. Survival rates are affected by both demographics and classical risk factors, and CRS-HIPEC-associated survival benefit predominantly occurs in moderate-grade tumors. Further exploration of biologic and clinicopathologic features may enhance risk stratification for this disease.
PubMed: 38874874
DOI: 10.1245/s10434-024-15526-z -
Surgical Case Reports Jun 2024Neoplasms derived from remnant appendix are rarely described, with most cases arising from the appendiceal "stump". Here, we present two surgical cases of appendiceal...
BACKGROUND
Neoplasms derived from remnant appendix are rarely described, with most cases arising from the appendiceal "stump". Here, we present two surgical cases of appendiceal neoplasms derived from appendiceal "tip" remnants.
CASE PRESENTATION
The first patient was a 71-year-old man who had undergone laparoscopic appendectomy for acute appendicitis 12 years prior. During appendectomy, the appendiceal root was ligated, but the appendix was not completely removed due to severe inflammation. At the most recent presentation, computed tomography (CT) was performed to examine choledocholithiasis, which incidentally revealed a cystic lesion of approximately 90 mm adjacent to the cecum. A retrospective review revealed that the cystic lesion had increased in size over time, and laparoscopic ileocecal resection was performed. Pathology revealed no continuity from the appendiceal orifice to the cyst, and a diagnosis of low-grade appendiceal mucinous neoplasm (LAMN) was made from the appendiceal tip remnant. The patient was discharged without complications. The second patient was a 65-year-old man who had undergone surgery for peritonitis due to severe appendicitis 21 years prior. During this operation, the appendix could not be clearly identified due to severe inflammation; consequently, cecal resection was performed. He was referred to our department with a chief complaint of general fatigue and loss of appetite and a cystic lesion of approximately 85 mm close to the cecum that had increased over time. CT showed irregular wall thickening, and malignancy could not be ruled out; therefore, laparoscopic ileocecal resection with D3 lymph node dissection was performed. The pathological diagnosis revealed mucinous adenocarcinoma (TXN0M0) arising from the remnant appendiceal tip. The patient is undergoing follow-up without postoperative adjuvant chemotherapy, with no evidence of pseudomyxoma peritonei or cancer recurrence for 32 months postoperatively.
CONCLUSIONS
If appendicitis-associated inflammation is sufficiently severe that accurate identification of the appendix is difficult, it may remain on the apical side of the appendix, even if the root of the appendix is ligated and removed. If the appendectomy is terminated incompletely, it is necessary to check for the presence of a residual appendix postoperatively and provide appropriate follow-up.
PubMed: 38867137
DOI: 10.1186/s40792-024-01936-4 -
Science Advances Jun 2024Mucosal-associated invariant T (MAIT) cells are antimicrobial T cells abundant in the gut, but mechanisms for their migration into tissues during inflammation are poorly...
Mucosal-associated invariant T (MAIT) cells are antimicrobial T cells abundant in the gut, but mechanisms for their migration into tissues during inflammation are poorly understood. Here, we used acute pediatric appendicitis (APA), a model of acute intestinal inflammation, to examine these migration mechanisms. MAIT cells were lower in numbers in circulation of patients with APA but were enriched in the inflamed appendix with increased production of proinflammatory cytokines. Using the patient-derived appendix organoid (PDAO) model, we found that circulating MAIT cells treated with inflammatory cytokines elevated in APA up-regulated chemokine receptors, including CCR1, CCR3, and CCR4. They exhibited enhanced infiltration of -pulsed PDAO in a CCR1-, CCR2-, and CCR4-dependent manner. Close interactions of MAIT cells with infected organoids led to the PDAO structural destruction and death. These findings reveal a previously unidentified mechanism of MAIT cell tissue homing, their participation in tissue damage in APA, and their intricate relationship with mucosal tissues during acute intestinal inflammation in humans.
Topics: Humans; Appendicitis; Mucosal-Associated Invariant T Cells; Inflammation; Cytokines; Acute Disease; Lymphocyte Activation; Organoids; Cell Movement; Child; Male; Female; Intestinal Mucosa; Appendix
PubMed: 38865451
DOI: 10.1126/sciadv.adn6331 -
The British Journal of Dermatology Jun 2024
PubMed: 38865426
DOI: 10.1093/bjd/ljae200 -
Annals of Surgical Oncology Jun 2024
PubMed: 38862838
DOI: 10.1245/s10434-024-15617-x