Long-Term Laryngotracheal Complications After Inhalation Injury: A Scoping Review.

Long-term laryngotracheal complications (LTLC) after inhalation injury (II) are an under-recognized condition in patients with burns. The purpose of this study was to systematically review all available evidence on LTLC after II and identify gaps in knowledge to guide the direction of future research. A scoping review was performed to synthesize all available evidence on LTLC after II, as guided by the question, "What are the LTLC after II, in patients with or without a history of translaryngeal intubation and/or tracheostomy?". MEDLINE, Web of Science, Ovid Embase, Cochrane Library, and Google Scholar were searched for publications on this topic. Of the 3567 citations screened, a total of 153 full-text articles were assessed for eligibility and 49 were included in the scoping review. The overall level of evidence was low, with case reports constituting 46.7% of all included human studies. The lesions were most frequently in the trachea (36.9%), followed by the glottis (34.7%) and subglottis (19.0%). LTLC occur in 4.8 to 6.5% of patients after II and these complications are under-recognized in burns patients. The risk factors for LTLC include high-grade II, elevated initial inflammatory responses, prolonged translaryngeal intubation, and a history of tracheostomy. The goal of management is to restore airway patency, preserve voice quality, and restore normal diet and swallow function. There is limited high-level evidence on LTLC, particularly with regards to long-term functional morbidity in voice and swallow. Large, prospective studies are required to address this gap in knowledge.

A progressive scholarly acceptance analysis of robot-assisted arthroplasty: a review of the literature and prediction of future research trends.

Robot-assisted arthroplasty (RAA) is increasingly practised in orthopaedic surgery. The aim of this study was to perform a bibliometric analysis of all published primary research into RAA and to apply the Progressive Scholarly Acceptance (PSA) model to evaluate its acceptance as an orthopaedic surgical technique. A literature search was performed that included all peer-reviewed, primary, English language publications on RAA from its introduction in 1992 up to 2019. RAA was defined as robot-assisted hip or knee arthroplasty. A bibliometric analysis was performed to categorise articles by type of study and level of evidence. Studies were also categorised as initial investigations (II) or refining studies (RS). A PSA analysis was performed, with the end-point being defined as the point in time when the number of RS exceeded the number of II. Of the 199 studies originating from 19 countries and 101 institutions, only 16 (8.04%) were randomised-controlled trials. Fifty-one percent of studies had been published since 2015. Using PSA analysis, 161 (80.9%) studies were categorised as II and 38 (19.1%) were categorised as RS. This demonstrates that RAA has not yet reached the point of scholarly acceptance. Scholarly acceptance of RAA as an orthopaedic surgical technique has yet to be reached. However, there has been an exponential increase in the number of publications on RAA in the last 5 years, reflecting renewed interest this technique. We predict that, for the next 5 years, RAA will remain in the experimental phase due to the rapid development of new technology in this field.

3 Tesla MRI brain scanning under general anaesthesia in a paediatric 3 Tesla-compatible cochlear implant recipient, first reported case: Clinical considerations and implications for future practice.

OBJECTIVES: To demonstrate the safety and feasibility of the first reported case of a 3 Tesla MRI scan in a paediatric 3 Tesla-compatible cochlear implant recipient under general anaesthesia. MATERIALS AND METHODS: A three-year-old child with bilateral optic pathway glioma treated with chemotherapy, who subsequently received a right sided 3 Tesla-compatible cochlear implant for sensorineural hearing loss was examined. The CI device chosen was implanted due to its purported MRI compatibility. Following informed consent and hospital executive approval, the child underwent a 3 Tesla MRI scan to assess for growth of the optic pathway glioma. RESULTS: A 3 Tesla MRI scan of the brain was performed under general anaesthesia. There was expected artefact due to the magnet of the receiver stimulator. There was no malfunction of the implant noted after the procedure, and no neurological or otological complications. The child had five more uneventful 3 Tesla MRI scans of the brain without complications. CONCLUSION: This is the first reported case of a child with a 3 Tesla-compatible cochlear implant undergoing a 3 Tesla MRI scan of the brain under general anaesthesia. Provided manufacturer guidelines are adhered to, 3 Tesla MRI scanning should not be contraindicated in paediatric cochlear implant recipients with a compatible device.

MiR-205 in cancer: an angel or a devil?

MicroRNAs (MiRNAs) are small non-coding RNAs that regulate their target genes expression at the post-transcriptional level. As accumulating properties of miR-205 have been identified, complex roles of miR-205 in tumor initiation and progression are emerging. MiR-205 acts either as a tumor suppressor through inhibiting proliferation and invasion, or as an oncogene through facilitating tumor initiation and proliferation, depending on the specific tumor context and target genes. In this review, we focus on the properties of miR-205 in cancers to shed light on better management of various fatal malignancies. Moreover, we discuss epigenetics that may account for the fluctuation of miR-205 expression. In addition, we sketch a network of miR-205 and its targets to further elucidate the mechanisms through which miR-205 exerts its multiple functions.