Myotoxicity of local anesthetics is equivalent in individuals with and without predisposition to malignant hyperthermia

Abstract

Purpose

Malignant hyperthermia (MH) is an inherited muscle disorder caused by abnormal elevations of intracellular calcium (Ca²⁺) in skeletal muscle. There are several reports of myotoxicity caused by local anesthetics, and the increased intracellular Ca²⁺ is considered to be an important cause. However, there is insufficient evidence regarding myotoxicity in MH-susceptible individuals when large doses of local anesthetics are administered. This study investigated the effect of MH predisposition on myotoxicity.

Methods

Human skeletal muscle samples were obtained from 22 individuals to determine susceptibility to MH, and were evaluated according to whether their Ca²⁺-induced Ca²⁺ release (CICR) rates were accelerated or not. This study was performed using surplus muscle that remained after the CICR rate test. We calculated the 50% effective concentration (EC₅₀) values of three local anesthetics, namely lidocaine, levobupivacaine, and ropivacaine using the ratiometric dye Fura-2 AM. Significance was tested using the unpaired t test.

Results

In the accelerated and unaccelerated groups, respectively, the mean ± SD of the EC₅₀ values were 1.52 ± 0.72 and 1.75 ± 0.37 mM for lidocaine (p = 0.42), 0.72 ± 0.36 and 0.79 ± 0.46 mM for levobupivacaine (p = 0.68), and 1.21 ± 0.35 and 1.62 ± 0.57 mM for ropivacaine (p = 0.06). These values were similar in individuals with and without MH predisposition.

Conclusion

The myotoxicity of local anesthetics was equivalent in individuals with and without predisposition to MH.

https://ift.tt/2KhUZPo

Rapid onset of action and reduced nasal hyperreactivity: new targets in allergic rhinitis management

This article summarizes a EUFOREA symposium, presented during the European Rhinology Research Forum in Brussels (9–10 November 2017; https://ift.tt/2IquVj9

https://ift.tt/2KkMOFg

Omalizumab chronic spontaneous urticaria: efficacy, safety, predictors of treatment outcome and time to response

Publication date: Available online 24 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): E. Nettis, L. Cegolon, E. Di Leo, F. Lodi Rizzini, A. Detoraki, W.G. Canonica




https://ift.tt/2Mkv6ik

The role of Scalpel‐bougie cricothyroidotomy in managing emergency Front of Neck Airway access. A review and technical update for ENT surgeons

https://ift.tt/2tyxCK8

Presenting symptoms and long‐term survival in head and neck cancer

https://ift.tt/2lv3YSl

Diagnostic accuracy of high‐resolution T2‐weighted MRI vs contrast‐enhanced T1‐weighted MRI to screen for cerebellopontine angle lesions in symptomatic patients

https://ift.tt/2tzYeKF

A systematic review of validated sinus surgery simulators

https://ift.tt/2lxFRCy

Hypopharyngeal evaluation in obstructive sleep apnea with awake flexible laryngoscopy: Validation and updates to Cormack‐Lehane and Modified Cormack‐Lehane scoring systems

https://ift.tt/2tzY7Pf

Psychosocial health of cochlear implant users compared to that of adults with and without hearing aids: Results of a nationwide cohort study

https://ift.tt/2lwmCcL

The effect of flurbiprofen oral spray and ibuprofen vs ibuprofen alone on postoperative tonsillectomy pain: An open, randomised, controlled trial

https://ift.tt/2tzY0TP

A novel succinate dehydrogenase subunit B germline variant associated with head and neck paraganglioma in a Dutch kindred: A family‐based study

https://ift.tt/2lvwymI

Socioeconomic deprivation and the burden of head and neck cancer—Regional variations of incidence and mortality in Merseyside and Cheshire, North West, England

https://ift.tt/2tzLLqF

A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus

https://ift.tt/2luIZiB

Deprivation in relation to urgent suspicion of head and neck cancer referrals in Glasgow

https://ift.tt/2tBlDeM

Predicting the hearing outcome in sudden sensorineural hearing loss via machine learning models

https://ift.tt/2lv3Kut

Clinical value of 18FDG PET/CT in screening for distant metastases in head and neck squamous cell carcinoma

https://ift.tt/2yAyX9e

Voice quality outcomes of idiopathic Parkinson's disease medical treatment: A systematic review

https://ift.tt/2lAjEUl

Assessment of narrative writing by Persian‐speaking students with hearing impairments

https://ift.tt/2tu1Bmu

Have reducing tonsillectomy rates in England led to increasing incidence of invasive Group A Streptococcus infections in children?

https://ift.tt/2lv3Bap

Signs of electrocochleography on endolymphatic sac decompression for patients with Ménière's Disease: Our experience in 12 patients

https://ift.tt/2tvUqtS

Indications for transnasal flexible laryngooesophagoscopy in a head and neck clinic, our experience in one hundred and ninety‐four patients

https://ift.tt/2luNIRt

A differential diagnosis of a head and neck bony lesion: Review of a case series with 18 patients with extraintestinal features of familial adenomatous polyposis

https://ift.tt/2yEjswT

Accuracy of FDG PET‐CT response assessment following radiotherapy alone for head and neck squamous cell carcinoma: Retrospective analysis of 45 patients

https://ift.tt/2lwjfSY

Omalizumab chronic spontaneous urticaria: efficacy, safety, predictors of treatment outcome and time to response

Chronic spontaneous urticaria (CSU) is the most common subtype of urticaria, and is characterized by recurrent episodes of spontaneous wheals and/or angioedema with unknown triggers, lasting for more than six weeks.1 CSU generally affects 0.5–1.0% of people 20–40 years of age, with a disease duration of 1–5 years.2 Patients with CSU often experience sleep deprivation and psychiatric comorbidities like anxiety and depression, which compromise the health-related and overall quality of life of the affected individuals.

https://ift.tt/2yzvPdw

Effect of statin use on oncologic outcomes in head and neck squamous cell carcinoma

Head &Neck, EarlyView.


https://ift.tt/2Miot06

Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAFV600E mutation

Head &Neck, EarlyView.


https://ift.tt/2KjadXv

Cervical necrotizing fasciitis: Systematic review and analysis of 1235 reported cases from the literature

Head &Neck, EarlyView.


https://ift.tt/2MnqTe2

Transoral robotic‐assisted supracricoid partial laryngectomy with cricohyoidoepiglottopexy: Procedure development and outcomes of initial cases

Head &Neck, EarlyView.


https://ift.tt/2K3SqUQ

Systematic review of sentinel lymph node biopsy in Merkel cell carcinoma of the head and neck

Head &Neck, EarlyView.


https://ift.tt/2Irq41q

Accuracy of the HPV status site‐specific factor 10 (SSF‐10) variable for patients with oropharyngeal cancers in the Iowa Cancer Registry, 2010‐2014

Head &Neck, EarlyView.


https://ift.tt/2K3ShAM

Does the Angle of Rigid Endoscope Makes a Difference in Videolaryngoscopy

Abstract

Authors describe the technique of office based rigid video laryngoscopy with 0° endoscope and compare with technique of 70° 4 mm videolaryngoscopy. (1) To compare and assess the efficacy of techniques of 0° and 70° office based video laryngoscopy for examining laryngopharyngeal disorders at Ear Nose Throat (ENT) Out Patient Department level. (2) To assess whether the degree of angle of the rigid endoscope makes any difference in the visualisation in videolaryngoscopy. Prospective non randomised double blinded study of direct videolaryngoscopies using 0° and 70° 4 mm rigid endoscope (Karl Storz, Germany) done at M.I.M.E.R. Medical College and Sushrut ENT Hospital, Talegaon-D, Pune, India, during the period of October 2016 to February 2017. Patients with predominant complaints of change of voice and foreign body sensation in throat were subjected for Videolaryngoscopy by 0° and 70° 4 mm Endoscope. 375 patients were examined with both the techniques. After the end of the procedure, the patient preference or discomfort with any of the techniques was enquired. The unlabelled endoscopic recording of both techniques was visualised by the second author to compare and evaluate the 0° videolaryngoscopy with 70° in terms of extent of visualisation. The time taken for each technique was recorded. The data of all patients has been analysed in terms of patient and surgeon grading. On statistical analysis, both the techniques with 0° as well as 70° rigid endoscope videolaryngoscopy were found to be comparable. Our study concludes that both the endoscopes are equally efficient in comparable laryngeal visualization. Hence, the degree of angulation of the rigid endoscope makes no difference in videolaryngoscopy. With little practice, 0° videolaryngoscopy may be extended for routine use in laryngological examination.

Level of Evidence Level 4.

https://ift.tt/2txhGYL

Long Term Outcomes of Intratympanic Dexamethasone in Intractable Unilateral Meniere’s Disease

Abstract

To evaluate the long term effect of Intratympanic dexamethasone in intractable Meniere's disease. 30 patients with refractory Meniere's disease which did not respond to the standard medical management, were treated with Intratympanic dexamethasone injections. Post treatment hearing outcome and dizziness scores were compared with the pretreatment values respectively. The mean dizziness handicap inventory (DHI) score was reduced from 91.58 (range 80–100) to be 31.00 (p = 0.00) at 3 months of treatment. With the successive follow-up periods, the mean DHI scores were reduced to 51.50, 46.6, and 50.90 at the end of, 6, 12, and 24 months (p = 0.04, 0.35, and 0.49 respectively). Again at the end of 24 months, 23.80% of patients were free of vertigo (p = 0.01). No patient had improvement in the hearing (> 10 dB) in any of the follow-up periods and 6.6% demonstrated deterioration in hearing. There were no major intraoperative or postoperative complications detected. Intratympanic injection of steroid is a safe and effective method for treating intractable Meniere's disease. Although short term improvement in the vertigo is well documented, still in 23% of the patients were found to be free of vertigo at even the end of 24 months. There was no significant improvement in hearing noticed, either in short term or in long term.

https://ift.tt/2MTYr4s

Differential Diagnosis of Post Auricular Swelling with Mastoid Bone Involvement

Abstract

Post auricular swelling with mastoid bone involvement most commonly occurs as a cranial complication of chronic or acute suppurative otitis media. Aim of this study, to detect etiology of postauricular swelling with mastoid bone involvement. This is a retrospective study which was done on all patients whom underwent mastoidectomy for post auricular swelling with mastoid bone involved in El Minia University Hospital from January 2014 to June 2017. A total of 49 patients were identified in this study, 23 males and 26 females, their ages ranged 5–28 years old with a mean of 25.8 years old. Group A: these were 45 patients with a history of otorrhea (chronic suppurative otitis media), of 3 months to 4 years duration. Group B: these were four patients without any history of otorrhea. Two patients diagnosed as acute otitis media, one patient diagnosed as Langerhans cell histiocytosis and one patient diagnosed as fungal mastoiditis. Chronic suppurative otitis media is the most common causes of postauricular swelling. Langerhans cell histiocytosis of the temporal bone and fungal mastoiditis are considered a rare presentation of postauricular swelling.

https://ift.tt/2yG1gTG

Incidence of vulval squamous cell carcinoma in women with vulval lichen sclerosus in an Australian tertiary referral centre

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kkgnqu

Leishmania tropica successfully treated with photodynamic therapy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KjFFSq

Treating melanoma in situ and lentigo maligna with Mohs micrographic surgery in Australia

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kl16ph

Clinical characteristics and prognostic factors of sinonasal undifferentiated carcinoma: a multicenter study

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2MiinNg

Cosensitization to profilin is associated with less severe reactions to foods in nsLTPs and storage proteins reactors and with less severe respiratory allergy

Allergy, EarlyView.


https://ift.tt/2In6yTE

Cowpox virus infection in two brothers with possible human‐to‐human transmission

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2yD6yPA

Transposition cutaneous flap and split skin mesh graft as combined optimal treatment approach for giant neglected multicentric BCC of the shoulder

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2lu4LTy

Expanding the differential diagnosis of raccoon eyes: sweet syndrome

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2yDYE8V

Atypical maculopapular cutaneous mastocytosis showing a nevus spilus‐like lesion

Pediatric Dermatology, EarlyView.


https://ift.tt/2Ikj9XH

Childhood atopic dermatitis—An Indian perspective

Pediatric Dermatology, EarlyView.


https://ift.tt/2Kk6PvE

Divided or kissing nevus of the penis: A new case with dermoscopic findings

Pediatric Dermatology, EarlyView.


https://ift.tt/2KlQ540

Impact of naevus association on survival for nodular and superficial spreading melanomas

British Journal of Dermatology, EarlyView.


https://ift.tt/2Mi9Nhw

Issue Information

Clinical and Experimental Dermatology, Volume 43, Issue 5, Page i,511-512, July 2018.


https://ift.tt/2yzhD4e

NDRG1 and FOXO1 regulate endothelial cell proliferation in infantile haemangioma

Experimental Dermatology, Volume 27, Issue 6, Page 690-693, June 2018.


https://ift.tt/2tAiImL

Corrigendum

Experimental Dermatology, Volume 27, Issue 6, Page 697-697, June 2018.


https://ift.tt/2MTzrtS

No evidence for follicular keratinocyte hyperproliferation in acne lesions as compared to autologous healthy hair follicles

Experimental Dermatology, Volume 27, Issue 6, Page 668-671, June 2018.


https://ift.tt/2yAwdIR

A guide to studying human dermal adipocytes in situ

Experimental Dermatology, Volume 27, Issue 6, Page 589-602, June 2018.


https://ift.tt/2tt8HIE

Clinical Snippets

Experimental Dermatology, Volume 27, Issue 6, Page i-i, June 2018.


https://ift.tt/2yAw7kt

Issue Information

Experimental Dermatology, Volume 27, Issue 6, Page 587-588, June 2018.


https://ift.tt/2tqao9Z

Methadone—Not a magic bullet in melanoma therapy

Experimental Dermatology, Volume 27, Issue 6, Page 694-696, June 2018.


https://ift.tt/2yDRGAN

Digital analysis yields more reliable and accurate measures of dermal and epidermal thickness in histologically processed specimens compared to traditional methods

Experimental Dermatology, Volume 27, Issue 6, Page 687-690, June 2018.


https://ift.tt/2tt8oxu

Generalized morphea in the setting of pembrolizumab

International Journal of Dermatology, EarlyView.


https://ift.tt/2ltfQV8

Trigeminal trophic syndrome: an updated review

International Journal of Dermatology, EarlyView.


https://ift.tt/2yJP9om

A giant mass on the scalp: an unusual presentation of lupus vulgaris

International Journal of Dermatology, EarlyView.


https://ift.tt/2luLAJj

Infantile Hemangioma Presenting as Colocolic Intussusception in an Infant Case Report with Review of Pathologic Lead Points

Infantile hemangioma (IH) is one of the most common vascular anomalies of early childhood and is usually recognized in the first few weeks to months of life as a solitary cutaneous lesion. This report documents our experience with a GLUT-1 positive IH presenting as the pathologic lead point in a colocolic intussusception in a 10-week-old infant who had no skin lesions. Literature suggests approximately 2% of all children presenting with an intussusception require surgical intervention; however, an IH as the pathologic lead point is unique.

https://ift.tt/2ImhYa8

Efficient decellularization of rabbit trachea to generate a tissue engineering scaffold biomatrix

Publication date: September 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 112
Author(s): Paul Hong, Michael Bezuhly, M. Elise Graham, Paul F. Gratzer
ObjectivesMost tracheal decellularization protocols are lengthy and can lead to reduced biomechanical stability. The objectives of this study were: 1) to generate a tracheal extracellular matrix scaffold using an efficient decellularization process and 2) to characterize the decellularized scaffold to assess its suitability for tissue engineering applications.MethodsTwelve rabbit tracheae underwent a decellularization process that involved enzymatic-detergent treatments. For characterization, fresh (control) and decellularized tissues underwent histological, immunohistochemical, and biochemical analyses. Tensile testing, scanning electron microscopy, and biocompatibility assay were also conducted.ResultsPost-decellularization, the tracheal tissue had significantly less genetic material while the structural integrity was maintained. Specifically, the deoxyribonucleic acid content was significantly reduced and the glycosaminoglycan content was unchanged. Cell and cellular components were largely removed; at the same time the tensile properties and surface ultrastructural characteristics were unaltered. Biocompatibility was confirmed by contact cytotoxicity assay.ConclusionsOverall, an efficient decellularization process was used to treat rabbit tracheal tissue. The effectiveness of the decellularization process was demonstrated and at the same time there was preservation of the underlying extracellular matrix structure. This decellularized material may serve as a potential scaffold for tracheal tissue engineering.



https://ift.tt/2yCapwp

Erratum to “Severe Drug-Induced Agranulocytosis Successfully Treated with Recombinant Human Granulocyte Colony-Stimulating Factor”

https://ift.tt/2MlzrSB

Validation and assessment of discordance of the 8th edition AJCC (American Joint Committee on Cancer) clinical and pathologic staging systems in patients with p16+ oropharyngeal cancer treated with surgery and adjuvant radiation at a single institution

Publication date: August 2018
Source:Oral Oncology, Volume 83
Author(s): Piyush Gupta, Jocelyn C. Migliacci, Ashley Hay, Matthew Rosenthal, Ximena Mimica, Nancy Lee, Richard J. Wong, Jatin Shah, Snehal Patel, Ian Ganly




https://ift.tt/2yAwc7R

A Case of Sirenomelia Associated with Hypoplastic Left Heart with a Healthy Co-Twin: A Rare Entity

Sirenomelia is a rare developmental malformation and is incompatible to life. The incidence of sirenomelia, as recorded in the literature, is estimated to be approximately between 1.5 and 4.2 per 1,00,000 births. Around 15% of sirenomelia cases are associated with twin pregnancy, most often in monozygotic cases with an incidence of 7%. In monozygotic twins, the risk of sirenomelia is nearly 100–150 times higher as compared to dizygotic twins or singleton pregnancies. Until now, only two cases of sirenomelia associated with hypoplastic left heart have been reported in the literature. Here, we present a monozygotic twin pregnancy, where one fetus was diagnosed with sirenomelia associated with hypoplastic left heart syndrome and the co-twin was absolutely healthy.

https://ift.tt/2K2wYQ4

Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year-Old Girl

Atopic dermatitis (AD) is a chronic inflammatory disease affecting children and adolescence. The traditional therapeutic options for AD, including emollients topically and immune modulatory agents systemically focusing on reducing skin inflammation and restoring the function of the epidermal barrier, are proven ineffective in many cases. Several studies have linked vitamin D supplementation with either a decreased risk to develop AD or a clinical improvement of the symptoms of AD patients. In this report, we present a girl with severe AD who under adequate supplementation with cholecalciferol was treated with calcitriol and subsequently with paricalcitol. She had significant improvement—almost healing of her skin lesions within 2 months, a result sustained for more than 3 years now. Because of hypercalciuria as a side effect from calcitriol therapy, treatment was continued with paricalcitol, a vitamin D analogue used in secondary hyperparathyroidism in chronic kidney disease. Calcitriol therapy may be considered as a safe and efficacious treatment option for patients with severe AD, particularly for those with refractory AD, under monitoring for possible side effects. Treatment with paricalcitol resolves hypercalciuria, is safe, and should be further investigated as an alternative treatment of atopic dermatitis and possibly other diseases of autoimmune origin.

https://ift.tt/2ImoU7k

X-Linked Chronic Granulomatous Disease: Initial Presentation with Intracranial Hemorrhage from Vitamin K Deficiency in Infant

Vitamin K deficiency bleeding (VKDB) is a life-threatening condition and can be found in children as early as neonatal period with early onset intracranial hemorrhage (ICH). Here, we reported a 1-year-old boy who initially presented with intracranial hemorrhage secondary to vitamin K deficiency since 3 months of age and later found to have XL-CGD which was complicated by malabsorption due to severe vaccine-associated mycobacterial disease.

https://ift.tt/2K6tqwn

Acute Hemolytic Transfusion Reaction in Group B Recipient Associated with Group A Apheresis Platelet Donor: Case Report and Literature Review

Acute hemolytic transfusion reaction is a known but rare potential adverse event related to platelet transfusion. Most reported cases of platelet-related hemolytic transfusion reaction have resulted from transfusion of platelets from group O donor to group A recipient. We identified only one prior case report in the literature of hemolytic transfusion reactions resulting from transfusion of apheresis platelets from group A donor to group B recipient. In that case report, two platelet units were obtained from a single donation and transfused into two separate patients. Both patients exhibited acute hemolytic reactions. The donor is reported to have high anti-B titers, as well as report of probiotic use. We report a case of acute hemolytic reaction in group B recipient following transfusion of apheresis platelets from group A donor with high-titer anti-B but unknown status of probiotic use. This case demonstrates that while low, there still exists potential risk for hemolysis from out-of-group A plasma transfusion.

https://ift.tt/2MUnMv4

An Unusual Case of Gullo’s Syndrome Concomitant with Serious Endometriosis Disease in a Postmenopausal Woman

Gullo's syndrome is a singular physiological phenomenon defined by an abnormal increase in serum pancreatic enzyme levels that may occur in healthy subjects in the absence of pancreatic disorders. During routine health examination in a 54-year-old postmenopausal woman with severe endometriosis, elevated values of serum amylase and lipase were fortuitously observed (198 and 1461 U/L, resp.). Over five years of regular pancreas surveillance, all clinical, biological, and imaging investigations were normal. However, the pancreatic enzyme levels have shown considerable fluctuations including some episodic transient normalization. The description of this benign pancreatic hyperenzymemia case incidentally associated with endometriosis disease is a very rare clinical situation. More in-depth documentation of this phenomenon may help clinicians to avoid unnecessary diagnostic management approaches and reassure the concerned patients that this affection would not be so worrying.

https://ift.tt/2yBTF8q

Natural course of new-onset urticaria: Results of a 10-year follow-up, nationwide, population-based study

Publication date: Available online 23 June 2018
Source:Allergology International
Author(s): Sang Jun Eun, Jin Yong Lee, Do-Yeop Kim, Hyun-Sun Yoon
BackgroundPrevious epidemiologic studies of the natural course of urticaria mainly focused on chronic spontaneous urticaria and were conducted at hospitals. The natural course of new-onset urticaria in the general population is unknown.MethodsPatients with new-onset urticaria were identified from the National Health Insurance Service–National Sample Cohort data. Patients who had at least one visit for urticaria in 2002 and 2003 were excluded and the study cohort consisted of 1,027,620 subjects with no history of urticaria. We analyzed cumulative incidences of urticaria, chronic urticaria, and chronic urticaria remission using the life table estimation method from 2004 to 2013. Their association with related factors was analyzed using the Cox proportional hazards analysis.ResultsFrom 2004 to 2013, a total of 49,129 patients with new-onset urticaria were identified. The 10-year cumulative incidence rate of urticaria for the general population was 4.9% and that of chronic urticaria among patients with new-onset urticaria was 7.8%. Remission rates of chronic urticaria were 52.6% at 1 year and 88.9% at 5 years. Age, sex, residential area, and autoimmune thyroid disease were significantly associated with urticaria or chronic urticaria, but not with chronic urticaria remission, after adjusting for covariates. Female individuals were more likely to have new-onset urticaria but less likely to develop chronic urticaria compared with male individuals.ConclusionsDuring the 10-year follow-up period, only a small proportion of patients with new-onset urticaria developed chronic urticaria. Remission was achieved in the majority of patients with chronic urticaria regardless of demographic characteristics or accompanying thyroid disease.



https://ift.tt/2IndOi5