Risk Factors for Recurrent Anaphylaxis-Related ED Visits in the United States

Publication date: Available online 3 September 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Megan S. Motosue, M. Fernanda Bellolio, Holly K. Van Houten, Nilay D. Shah, Ronna L. Campbell

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Tri-dimensional model for ventilation tube permeability

Abstract

Purpose

Ventilation tubes (VT) in the tympanic membrane expose the middle ear (ME) to the external auditory canal and its content. It carries the risk of penetration of contaminated material and could provide a pathway for the delivery of drugs into the ME. The aim of this study was to use a printed 3D-model of the external auditory canal (EAC) and ME to assess the permeability of various VTs to different fluids.

Methods

CT scan of the external and ME was 3D-reconstructed and printed. Five different types of VT were inserted in the model's tympanic membrane and the minimal pressure for penetration to the ME was measured. Liquids with different viscosities, including commonly used ear drops, were tested.

Results

Water passed through the standard 1.14 mm diameter VTs after filling the EAC with a volume of 2 ml and through a narrower grommet or a T-tube after filling the canal with 2.5 ml. Soapy-water had the highest penetration in all VTs (1–2 ml). The initial volume of dexamethasone needed for penetration was 2.5 ml in the standard tubes. It did not pass at any volume through the narrow grommet or the T-tube.

Conclusion

In the printed 3D-model, the volume of most solutions, including water, required to provide enough pressure in order to pass through the VTs was as high as the EAC volume or exceeded it. Soapy water had the highest penetrance while Dexamethasone needed volume of 2.5 ml to pass through the VT, questioning its reliability as a passive drug delivery channel to the ME.

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Ultrasonographic features associated with false-negative and false-positive results of extrathyroidal extensions in papillary thyroid microcarcinoma

Abstract

Purpose

To assess the ultrasonographic features affect accuracy of extrathyroid extension (ETE) evaluation on preoperative ultrasonography (US) in papillary thyroid microcarcinoma (PTMC).

Methods

Of the total patients who underwent thyroid surgery, 516 patients with a tumor measuring less than 1 cm on preoperative US were enrolled in this study. One blinded head and neck radiologist reviewed the preoperative US images to evaluate the US features of PTMC, and the pathologic reports were reviewed. The diagnostic accuracy rates, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were calculated, and the factors associated with false-negative and false-positive results for ETE were analyzed.

Results

The sensitivity, specificity, PPV, NPV, and accuracy for predicting ETE according to sonographic criteria were 32.8%, 87.5%, 51.0%, 76.6%, and 71.7%, respectively. Non-adjacent to the trachea and unilateral lesion on US were significant factors associated with false-negative results.

Conclusion

Size, shape, and location of PTMC on US are important factors that affect the US results in ETE evaluation.

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Analysis of key genes and signaling pathways involved in Helicobacter pylori‐associated gastric cancer based on The Cancer Genome Atlas database and RNA sequencing data

Helicobacter, EarlyView.


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Mycobacterium abscessus infection following penetrations through wetsuits

Australasian Journal of Dermatology, EarlyView.


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Adjuvant treatment of chronic plaque psoriasis in adults by a herbal combination: Open German trial and review of the literature

Dermatologic Therapy, EarlyView.


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Sudanese Association of Dermatologists Special Meeting, Khartoum, Sudan

Dermatologic Therapy, EarlyView.


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