Tag: pubmed

Laryngoscope Investig Otolaryngol. 2025 Mar 4;10(2):e70116. doi: 10.1002/lio2.70116. eCollection 2025 Apr.

ABSTRACT

OBJECTIVES: To determine the prevalence of positional obstructive sleep apnea (pOSA) in children undergoing adenotonsillectomy (AT) for OSA and to assess whether pOSA improves following AT.

MATERIALS AND METHODS: Children with OSA diagnosed by polysomnography (PSG) at a tertiary care children’s hospital were included. Data was collected on demographics, PSG parameters, and surgical management. Statistical comparisons between groups for the prevalence of pOSA were performed with the χ2 test or Fisher’s exact test, for PSG parameters prior to AT with Student’s t-test or Mann-Whitney Rank Sum Test, and for PSG parameters before and after AT with paired t-test and Wilcoxon Signed Rank Test. p < 0.05 was considered significant.

RESULTS: Of the 1167 children (682 male, 485 female, median age = 5.7 years), 321 (28%) had pOSA. POSA children (median age = 7.4 years) were older than children with no pOSA (median = 5.2) (p ≤ 0.001). The prevalence of pOSA in the subgroups of gender and weight was not different. The prevalence of pOSA was significantly different amongst the race groups (p = 0.005). Compared with the Black/African American race, the white race had 1.4 times the odds of pOSA (95% CI, 1.07-1.98). The prevalence of pOSA was not significantly different between mild, moderate, and severe OSA groups (p = 0.7). Of the 66 POSA children who had PSG pre- and post-TA, 50 (76%) had resolution of pOSA. Children older than 6 years of age and children with obesity had a higher rate of persistent pOSA (p = 0.02 and p = 0.008, respectively).

CONCLUSION: POSA occurred frequently in OSA children undergoing AT. POSA is resolved in the majority of children after AT. Persistent pOSA was more prevalent in older and obese children. AT is used as the first-line treatment for pOSA in children. Future studies are needed to determine the role of positional therapy and other OSA therapies in the management of persistent pOSA after AT.

LEVEL OF EVIDENCE: 4.

PMID:40046983 | PMC:PMC11877339 | DOI:10.1002/lio2.70116

Laryngoscope Investig Otolaryngol. 2025 Mar 4;10(2):e70111. doi: 10.1002/lio2.70111. eCollection 2025 Apr.

ABSTRACT

OBJECTIVES: Transnasal endoscopic sphenopalatine artery ligation (TESPAL) has been proposed as a first-line therapy for intractable epistaxis before utilizing posterior nasal packing and embolization. A specific procedure code for TESPAL was newly introduced in 2018, adding to two prior codes for procedural control of epistaxis. This study compares all-time utilization of the TESPAL CPT code in Medicare beneficiaries with alternative procedural codes for epistaxis management.

METHODS: The publicly available data from the Centers for Medicare and Medicaid Services in the 2013-2022 period was analyzed for the reporting of TESPAL (31241), transcatheter permanent occlusion or embolization of noncentral nervous system, head, or neck (61626), and endoscopic control of epistaxis (31238) codes. Welch two sample t-test and linear regression were used to characterize CPT code utilization.

RESULTS: From 2018 to 2022, TESPAL CPT code reporting averaged 378 instances annually, with a stable utilization trend (p = 0.432). CPT codes 61626 and 31238 averaged 1429 and 3779 instances annually, respectively. CPT 31238 showed a significant decline (p < 0.001), and CPT 61626 showed a stable trend (p = 0.082). There was a significant decline in CPT code 31238 use after 2018 (p < 0.01). CPT 61626 showed a significant increase in usage post-2018 (t = 2.90, p = 0.044).

CONCLUSION: After an initial increase in 2019, TESPAL reporting flattened, while CPT 61626 (which includes all embolization in head and neck vessels) significantly increased post-2018. As recent studies show significant advantages of TESPAL over embolization, these findings warrant further attention and study.

LEVEL OF EVIDENCE: 3.

PMID:40046982 | PMC:PMC11877342 | DOI:10.1002/lio2.70111

Laryngoscope Investig Otolaryngol. 2025 Mar 4;10(2):e70108. doi: 10.1002/lio2.70108. eCollection 2025 Apr.

ABSTRACT

OBJECTIVES: In ultrasonography, gels are used as conduction media to improve sound transmission and to obtain high-quality images; however, gels are rarely used in hearing devices. The application of gel to couple the transducer to the ear could potentially improve the benefits of hearing aids, particularly cartilage conduction (CC) hearing aids, which deliver sound through vibrating the aural cartilage. This study aimed to investigate the effects of gel application on the performance of CC hearing aids.

METHODS: Twenty-three patients (30 ears) with aural atresia or severe canal stenosis were treated with CC hearing aids. The aided thresholds, maximum speech recognition scores (SRSs), and hearing levels at which the maximum SRS (dB [Max]) was observed were compared before and after gel application to the transducer of the CC hearing aids.

RESULTS: Thresholds > 1 kHz significantly decreased (improved) when the gel was applied to the transducer (p < 0.05). The threshold improvement at 1 kHz was significantly better than that at 0.5 kHz, and that at 4 kHz was significantly better than at 0.25 and 0.5 kHz. No significant differences were observed in the maximum SRS or dB (Max).

CONCLUSIONS: Gel application, which is considered to have minimum risk, showed statistically significant improvements in hearing levels at higher frequencies. Therefore, the application of gel can be considered a beneficial option to enhance the performance of CC hearing aids by improving the coupling conditions.

LEVEL OF EVIDENCE: 4.

PMID:40046981 | PMC:PMC11877327 | DOI:10.1002/lio2.70108

Neurophysiol Clin. 2025 Mar 4;55(3):103064. doi: 10.1016/j.neucli.2025.103064. Online ahead of print.

ABSTRACT

OBJECTIVES: We sought retrospectively to assess outcomes in bilateral temporal lobe epilepsy (BTLE) patients undergoing resective temporal lobe surgery following invasive EEG lateralization in comparison to unilateral TLE (UTLE).

METHODS: Patients undergoing surgical intervention for TLE (the vast majority being mesial temporal lobe epilepsy) during a 7-year period were retrospectively categorized as suspected BTLE (sBTLE) or UTLE. Temporal lobectomy was performed in the sBTLE group on the side of maximum number of intracranial EEG seizure onsets. EEG, MRI, laterality of iEEG ictal onset (in sBTLE), seizure outcome and drug tapering data were retrospectively analyzed.

RESULTS: Of 148 adult patients undergoing temporal lobe epilepsy surgery, 24 (16.2 %) fit the criteria of sBTLE, amongst whom iEEG ictal onset proved to be unilateral in 14 (uBTLE, 58.3 %) and bilateral in 10 (dBTLE, 41.7 %). Of operated patients in the dBTLE group, the first seizure onset was ipsilateral to the resection in 4 patients (57.1 %) and contralateral in 3 (42.9 %). In the UTLE group, seizure freedom (Engel 1) was achieved in 87.8 % at mean follow-up of 59.2 ± 27.9 months. Seizure freedom was achieved in 92.9 % of uBTLE patients at 52.8 ± 36.6 months. Seven of 10 dBTLE patients underwent resection on the side of maximum number of iEEG seizure onset, and 6 (85.7 %) remained seizure-free at 40.14 ± 25 months. There was no statistically significant difference in seizure-free outcome between UTLE and sBTLE (Pearson Chi-Square test, p-value = 0.67).

CONCLUSION: High seizure freedom rates were observed in both unilateral and bilateral disease following standard temporal lobectomy. However, the study lacks pre- and post-resection neuropsychological data to conclude on the cognitive sequelae of resective surgery in established bilateral mesiotemporal epilepsy.

PMID:40043337 | DOI:10.1016/j.neucli.2025.103064

Vet Parasitol. 2025 Feb 23;335:110425. doi: 10.1016/j.vetpar.2025.110425. Online ahead of print.

ABSTRACT

The strategic control of equine gastrointestinal nematodes is based on epidemiology. The aim is the reduction of the population of parasites as a whole in the hosts and environment while seeking the number of treatments that achieves the balance between not risking animal health and not exerting selection pressure for resistant parasites. This is the first study in a tropical region to assess a strategic control protocol for equines. The study was conducted in the municipality of Anastácio in the state of Mata Gross do Sul, Brazil, over a two-year period from April 2021 to March 2023, involving two groups of horses – control and treated. The animals in the treated group received oral ivermectin in the months of May and September in each year of the experiment. Every 28 days, feces were collected, the animals were weighed, the body condition score was calculated, eggs per gram (EPG) of feces were counted, and larval counts were performed in the pasture. Eggs were analyzed using real-time polymerase chain reaction for the identification of the species Strongylus vulgaris. Treatment reduced the EPG count (p < 0.05) and did not affect the weight or body condition score of the animals. The most prevalent taxon was Cyathostominae. Treatment was a protection factor against S. vulgaris (p < 0.05). A significant difference was found in the dry season between the control and treated groups in the analysis of larvae in the pasture. In conclusion, strategic control with two treatments during the year was capable of reducing the egg count, number of larvae in the pasture, and the presence of S. vulgaris without affecting health indicators, such as weight and body condition score.

PMID:40043333 | DOI:10.1016/j.vetpar.2025.110425

Knee. 2025 Mar 4;54:136-145. doi: 10.1016/j.knee.2025.01.006. Online ahead of print.

ABSTRACT

BACKGROUND: Our aim was to compare posterior tibial slope (PTS) values, distribution, deviation from manufacturer’s recommended value and restoration of this value in total knee arthroplasty (TKA) with tibial component placement using intramedullary (IM) and extramedullary (EM) methods, and to analyze factors affecting these values.

METHODS: A total of 151 knees operated with Zimmer-Biomet NexGen® LPS Fixed Bearing Knee TKA between 2022 and 2024 were retrospectively investigated. Knees were grouped by method of tibial component placement (IM or EM). Pre-operative descriptive data, postoperative PTS, scatteredness of PTS, difference between pre-operative and postoperative PTS, deviation from 7° which was claimed by the manufacturer and rate of outliers were compared between groups. Factors that might affect postoperative PTS in the EM group were analyzed.

RESULTS: Ninety-five knees (62.9%) in the EM group and 56 knees (37.1%) in the IM group were analyzed. Mean PTS decreased from 8.8 ± 3.5° to 6.7 ± 2.7° (P < 0.001) in the EM group, and from 10 ± 4.1° to 4.9 ± 2.6° (P < 0.001) in the IM group. Postoperative PTS was significantly lower in the IM group (P < 0.001). Mean deviation from 7° claimed by the manufacturer was 2.4 ± 1.4° for the EM group and 2.8 ± 1.8° for the IM group (P = 0.14). In 15 of 151 patients (9.9%), postoperative PTS was above 10°. Linear regression analysis revealed a moderate effect of pre-operative PTS and weight in the EM group.

CONCLUSIONS: Although not statistically significant, the EM method is closer to the manufacturer’s recommendation for sagittal alignment. However, both groups had a wide range of PTS and a large number of outliers. Both methods are not reliable in terms of PTS reproducibility and consistency.

PMID:40043327 | DOI:10.1016/j.knee.2025.01.006

Neurol Res. 2025 Mar 5:1-6. doi: 10.1080/01616412.2025.2472841. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD) is the leading cause of major neurodegenerative cognitive impairment. The risk of developing AD is influenced by a complex interaction of genetic predisposition and environmental factors. Among the genetic risk factors, the APOE ɛ4 allele is the most significant, while variants in the TREM2 (Triggering Receptor Expressed on Myeloid Cells 2) and ABCA7 (ATP-binding cassette transporter A7) genes have also been associated with an increased risk of AD.

OBJECTIVE: This study aimed to investigate the association of APOE ɛ4, TREM2 gene variants (rs75932628 [p.R47H] and rs2234253 [p.T96K]), and ABCA7 gene variants (rs142076058 and rs115550680) with sporadic AD in the Tunisian population. Methods: A case-control study was conducted including 222 Tunisian patients diagnosed with sporadic AD and 99 cognitively healthy controls. Genotyping was performed to assess the presence and association of the selected genetic variants with AD. Statistical analyses were conducted to determine the significance of genetic associations.

RESULTS: A significant association was found between the TREM2 rs2234253 (p.T96K) variant and AD, with the T allele identified as a risk factor in the Tunisian population. The APOE ɛ4 allele was also associated with an increased risk of developing AD. However, no significant association was observed for the ABCA7 gene variants or the TREM2 rs75932628 (p.R47H) variant in either the AD or control groups.

CONCLUSION: Our findings suggest that the TREM2 rs2234253 (p.T96K) variant is a significant genetic risk factor for late-onset AD (LOAD) in the Tunisian population. Further studies with larger cohorts are needed to validate these findings and explore potential gene-gene interactions contributing to AD risk.

PMID:40043316 | DOI:10.1080/01616412.2025.2472841

Am J Respir Crit Care Med. 2025 Mar 5. doi: 10.1164/rccm.202501-0093RL. Online ahead of print.

NO ABSTRACT

PMID:40043304 | DOI:10.1164/rccm.202501-0093RL

Am J Respir Crit Care Med. 2025 Mar 5. doi: 10.1164/rccm.202409-1752OC. Online ahead of print.

ABSTRACT

Rationale: There is no broadly accessible treatment for patients with refractory chronic cough, a disease characterized by chronic cough that persists despite treatment for other cough-related etiologies or has no identified underlying cause. Objectives: SOOTHE (NCT04678206), a Phase 2b, randomized, placebo-controlled trial, evaluated the efficacy and safety of P2X3 antagonist camlipixant in adults with refractory chronic cough (cough duration ≥1 year; baseline awake cough frequency ≥25 coughs/hour). Methods: After a single-blind, 16-day placebo run-in, patients were randomized (1:1:1:1) to receive camlipixant 12.5, 50, or 200 mg twice-daily, or placebo for 4 weeks. The primary endpoint was change from baseline to Day 28 in objective 24-hour cough frequency. Secondary endpoints included cough severity and cough-related quality of life. Measurements and Main Results: Overall, 310 patients were randomized. A statistically significant reduction in placebo-adjusted 24-hour cough frequency was seen in the 50 mg (-34.4%; 95% confidence interval: -50.5 to -13.3; P=0.0033) and 200 mg (-34.2%; 95% confidence interval: -50.7 to -12.2; P=0.0047) camlipixant arms. All camlipixant arms showed a trend for greater improvement in Cough Severity Visual Analog Scale and Leicester Cough Questionnaire over placebo. Camlipixant was well tolerated with no serious treatment emergent adverse events reported. Taste alteration occurred in 4.8-6.5% of patients in camlipixant arms (vs. 0% with placebo); these were usually mild-moderate. Conclusions: Camlipixant treatment reduced cough frequency and improved patient reported outcomes in patients with refractory chronic cough, with an acceptable safety profile. Clinical trial registration available at www.clinicaltrials.gov, ID: NCT04678206.

PMID:40043302 | DOI:10.1164/rccm.202409-1752OC

J Craniofac Surg. 2025 Mar 5. doi: 10.1097/SCS.0000000000011179. Online ahead of print.

ABSTRACT

OBJECTIVE: Accurate assessment of the periodontal ligament (PDL) is critical for developing effective treatment plans in periodontics, orthodontics, prosthodontics, and maxillofacial surgical. This study aimed to investigate the influence of cone-beam computed tomography (CBCT) voxel size (0.3 and 0.1 mm) on the accuracy of PDL surface area measurements.

METHODS: Thirty-nine teeth, including both single-rooted and multirooted types, were obtained from 5 human skulls and imaged using CBCT and high-resolution computed tomography (CT). The PDL was segmented and reconstructed using Mimics and 3-matic software to determine surface area measurements. Statistical analyses included paired t tests (P<0.05) to identify significant differences and Bland-Altman plots to evaluate agreement between measurements obtained at different voxel sizes.

RESULTS: Paired t tests demonstrated a statistically significant difference in PDL surface area measurements based on voxel size (t=4.959, P=0.001). Bland-Altman analysis revealed that measurements obtained with a voxel size of 0.1 mm were, on average, 5.07 mm² larger than those obtained with a voxel size of 0.3 mm.

CONCLUSIONS: Voxel size significantly affects the precision of PDL surface area measurements, with smaller voxels yielding greater surface detail and higher surface area values. High-resolution CT provided more accurate and reliable measurements of PDL surface area compared with CBCT.

PMID:40043300 | DOI:10.1097/SCS.0000000000011179