Quality improvement intervention to reduce time to postoperative radiation in head and neck free flap patients

xlomafota13 shared this article with you from Inoreader Quality improvement intervention to reduce time to postoperative radiation in head and neck free flap patients Via Head & Neck Abstract Background Best-practice guidelines for head and neck cancer patients advise postoperative radiation therapy (PORT) initiation within 6 weeks of surgery. We report our institutional experience improving timeliness of adjuvant radiation in free-flap patients. Methods Thirty-nine patients met inclusion criteria in the 2017–2019 study period. We divided into "Early" (n = 19) and "Late" (n = 20) time-period groups to compare performance over time. The primary endpoint was time to PORT initiation, with success defined as <6 weeks. Results The number of patients achieving timely PORT improved from 10.5% in the Early group to 50.0% in the Late group (p = 0.014). Patients undergoing concurrent adjuvant chemoradiation were more likely to meet the PORT target in the Late group (p = 0.012). Conclusions We ascribe this quality improvement in free-flap patients to increased communication among multidisciplinary care teams, proactive consultation referrals, and a targeted patient-navigator intervention. Though work is needed to further improve performance, insight gained from our experience may benefit other teams. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Health‐Related Quality of Life, Dysphagia, Voice Problems, Depression, and Anxiety After Total Laryngectomy

xlomafota13 shared this article with you from Inoreader Health‐Related Quality of Life, Dysphagia, Voice Problems, Depression, and Anxiety After Total Laryngectomy Via The Laryngoscope Objectives/Hypothesis The aims were to determine health-related quality of life (HRQoL), including voice problems, dysphagia, depression, and anxiety after total laryngectomy (TL), and investigate the associations between HRQoL and the late effects. Study Design Cross-sectional study. Methods 172 participants having received a TL 1.6 to 18.1 years ago for laryngeal/hypopharyngeal cancer filled in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire, Core and Head and Neck module (EORTC QLQ-C30, EORTC QLQ-H&N35), Voice-Related Quality of Life questionnaire (V-RQOL), M.D. Anderson Dysphagia Inventory (MDADI), and Hospital Anxiety and Depression Scale (HADS) questionnaires. Results Participants scored worse than normative reference populations on all scales/items of the EORTC questionnaires, except one, and almost half of the scales/items showed a clinically relevant difference. Moderate/severe dysphagia was present in 46%, moderate/severe voice problems in 57%, depression in 16%, and anxiety in 20%. Decreasing age, increasing numbers of comorbidities, increasing voice problems, increasing dysphagia, and increasing depression symptoms, were associated with a lowered EORTC QLQ-C30 summary score. Conclusion A substantial proportion of participants experienced clinically significant late effects and increasing levels of these were associated with a lowered HRQoL. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Supra-normal skills in processing of visuo-auditory prosodic information by cochlear-implanted deaf patients

xlomafota13 shared this article with you from Inoreader Supra-normal skills in processing of visuo-auditory prosodic information by cochlear-implanted deaf patients Via oto-rhino-laryngologie Hear Res. 2021 Aug 6;410:108330. doi: 10.1016/j.heares.2021.108330. Online ahead of print. ABSTRACT Cochlear implanted (CI) adults with acquired deafness are known to depend on multisensory integration skills (MSI) for speech comprehension through the fusion of speech reading skills and their deficient auditory perception. But, little is known on how CI patients perceive prosodic information relating to speech content. Our study aimed to identify how CI patients use MSI between visual and auditory information to process paralinguistic prosodic information of multimodal speech and the visual strategies employed. A psychophysics assessment was developed, in which CI patients and hearing controls (NH) had to distinguish between a question and a statement. The controls were separated into two age groups (young and aged-matched) to dissociate any effect of aging. In addition, the oculomotor strategies used when facing a speaker in this prosodic de cision task were recorded using an eye-tracking device and compared to controls. This study confirmed that prosodic processing is multisensory but it revealed that CI patients showed significant supra-normal audiovisual integration for prosodic information compared to hearing controls irrespective of age. This study clearly showed that CI patients had a visuo-auditory gain more than 3 times larger than that observed in hearing controls. Furthermore, CI participants performed better in the visuo-auditory situation through a specific oculomotor exploration of the face as they significantly fixate the mouth region more than young NH participants who fixate the eyes, whereas the aged-matched controls presented an intermediate exploration pattern equally reported between the eyes and mouth. To conclude, our study demonstrated that CI patients have supra-normal skills MSI when integrating visual and auditory linguistic prosodic information, and a specific adaptive strategy developed as it participates directly in speech content comprehension. PMID:34492444 | DOI:10.1016/j.heares.2021.108330 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stability and radioactive gaseous iodine-131 retention capacity of binderless UiO-66-NH(2) granules under severe nuclear accidental conditions

xlomafota13 shared this article with you from Inoreader Stability and radioactive gaseous iodine-131 retention capacity of binderless UiO-66-NH(2) granules under severe nuclear accidental conditions Via radioactive iodine J Hazard Mater. 2021 Aug 15;416:125890. doi: 10.1016/j.jhazmat.2021.125890. Epub 2021 Apr 15. ABSTRACT In the present work, we aim to investigate the ability of the zirconium-based MOF-type compound UiO-66-NH2, to immobilize molecular gaseous iodine under conditions analogous to those encountered in an operating Filtered Containment Venting System (FCVS) line. Typically, the UiO-66-NH2 particles were exposed to 131I (beta and gamma emitters) and sub mitted to air/steam at 120 °C, under gamma irradiation (1.9 kGy h-1). In parallel to this experiment under simulated accidental conditions, the stability of the binderless UiO-66-NH2 granules under steam and gamma irradiation was investigated. In order to fit with the specifications required by typical venting systems, and to compare the efficiency of the selected MOF to porous materials commonly used by the industry, scale-up syntheses and UiO-66-NH2 millimetric-size shaping were realized. For this task, we developed an original binderless method, in order to analyze solely the efficiency of the UiO-66-NH2 material. The shaped MOF particles were then submitted separately to gamma irradiation, steam and temperature, for confirming their viability in a venting process. Their structural, textural and mechanical behaviors were characterized by the means several techniques including gas sorption, powder X-ray diffraction, infrared spectroscop y and crushing tests. Promising results were obtained to trap gaseous molecular iodine in severe accidental conditions. PMID:34492828 | DOI:10.1016/j.jhazmat.2021.125890 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review

xlomafota13 shared this article with you from Inoreader The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 7:34894211045262. doi: 10.1177/00034894211045262. Online ahead of print. ABSTRACT OBJECTIVES: This qualitative systematic review evaluates the evidence in support of the use of oral corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis. DESIGN: Qualitative systematic review. METHODS: A literature search was conducted from January 1985 and September 2020. Inclusion criteria embraced pe er-reviewed articles in which adult patients undergoing interventional sialendoscopy for obstructive salivary gland disease received oral corticosteroids. The results were initially screened based on title and abstract, and the remaining articles were reviewed for eligibility. RESULTS: About 218 papers were selected by title and abstract, 96 were selected for full-text review, and 9 met the inclusion criteria. Eight published reports were retrospective observational studies and 1 was a prospective comparative study. Overall, the heterogeneity of clinical data stood out in this systematic review. The pooled success rate in the studies was 873/979 (89%). Only 5 studies described a rationale for oral corticosteroid use as part of the post-operative management. In 4 studies, a prednisone total daily dose of 40 to 50 mg was used. One study clearly showed a lower recurrence rate in patients who received oral steroids for more than 7 days in addition to sialendoscopy for management o f ductal stenoses. CONCLUSION: This systematic review showed that most centers that prescribe oral corticosteroids after sialendoscopy are unaware of the specific results with this treatment. For ductal stenoses, only 1 paper clearly showed the benefits of oral corticosteroids after sialendoscopy but more high-quality evidence is required in the form of a comparative study or randomized controlled trial, with appropriate long-term follow up. PMID:34493105 | DOI:10.1177/00034894211045262 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Simultaneous immobilization of aqueous co-contaminants using a bismuth layered material

xlomafota13 shared this article with you from Inoreader Simultaneous immobilization of aqueous co-contaminants using a bismuth layered material Via radioactive iodine J Environ Radioact. 2021 Oct;237:106711. doi: 10.1016/j.jenvrad.2021.106711. Epub 2021 Aug 10. ABSTRACT The remediation of co-located contaminants in the vadose zone can be challenging due to accessibility and responses of different contaminants to remedial actions. At the Hanford Site (WA, USA), multiple radionuclides and other hazardous contaminants are present in the vadose zone and groundwater, including iodine-129 (I), technetium-99 (Tc), uranium-238 (U), chromium (Cr), and ni trate (NO3-). We evaluated a layered Bi oxyhydroxide material for its potential to remove individual and co-located contaminants with a series of batch experiments that investigated a range of plume conditions, followed by solid phase characterization of the reacted bismuth material. The results demonstrated successful removal of four contaminants (>98% removal of I, Tc, U, and Cr from the aqueous phase after 30 days) when tested individually. When contaminants were combined, a slight decrease in Tc removal occurred (-6%p). The addition of sediment decreased the removal for Tc and I, but U and Cr removal was unaffected. The results of these batch tests demonstrated that the bismuth based oxy-hydroxide material is a promising material for sequestering multiple contaminants in situ. PMID:34388522 | DOI:10.1016/j.jenvrad.2021.106711 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detectability of 18F-choline PET/MR in primary hyperparathyroidism

xlomafota13 shared this article with you from Inoreader Detectability of 18F-choline PET/MR in primary hyperparathyroidism Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 8. doi: 10.1007/s00405-021-07046-3. Online ahead of print. ABSTRACT PURPOSE: We aimed to evaluate the power of 18F-fluorocholine (FCH) positron emission tomography/magnetic resonance (PET/MR) imaging in unlocalized primary hyperparathyroidism. METHODS: Thirty-four patients were included. In 17/34 patients, PET/MR was performed immediately after a negative 18F-FCH PET/CT. Sensitivity, specificity, positive and negative predictive values were calculated for MR only (blinded to PET data) and PET only (blinded to MR data) findings. RESULTS: 18F-FCH PET/MR was positive in 26/34 (76%) patients. PET/MR was also positive in 12/17 (71%) patients with a negative PET/CT. Among 11/34 (32%) patients where 18F-FCH PET-only and MR-only results were discordant, MR was false positive in 7/11 patients (3/7 of the lesions were not 18F-FCH avid and in 4/7 of them PET and MRI pointed different locations. Post operative histopathology revealed that 18F-FCH-positive ones were true positives). Sensitivity, specificity, PPV, NPV and accuracy of neck MR evaluated blinded to PET data were 80%, 50%, 70%, 64% and 68%, respectively, and all were calculated as 100% for PET/MR. CONCLUSION: 18F-FCH PET/MR is very effective in preoperative localization of parathyroid adenomas even if 18F-FCH PET/CT is negative. Neck MR alone is insufficient in detecting parathyroid adenomas but PET/MR combination helps in precise localisation. PMID:34495350 | DOI:10.1007/s00405-021-07046-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two Bonebridge bone conduction hearing implant generations: audiological benefit and quality of hearing in children

xlomafota13 shared this article with you from Inoreader Two Bonebridge bone conduction hearing implant generations: audiological benefit and quality of hearing in children Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 8. doi: 10.1007/s00405-021-07068-x. Online ahead of print. ABSTRACT PURPOSE: The study aimed to evaluate audiological benefits, quality of hearing and safety of two Bonebridge generation: BCI601 and BCI602 (MED-EL, Innsbruck, Austria) in children. METHODS: Twelve children were implanted: five BCI601 and seven BCI602 comprising of ten conductive hearing loss, and two single sided deaf SSD subjects. Audiological outcomes tested were sound field audiometry, functional gain, speech recognition threshold (SRT50), speech recognition in noise (SPRINT) and localisation abilities. Subjective measures were Speech, Spatial and Qualities of Hearing Scale (SSQ12). RESULTS: The mean FG with the BCI601 was 25.0 dB and with the BCI602 28.0 dB. The benefit in SRT50 was 23.2 dB and 33.8 dB, respectively. The mean benefit in SPRINT was 15% and 6.7% and the localisation ability improved from 33.3° to 16° a nd from 26.2° to 17.6°, respectively. The two SSD subjects reported a FG of 17 dB, a benefit in SRT50 of 22.5 and a benefit in SPRINT of 20%. Subjective outcomes improved significantly and even exceeded the values of their age-and sex matched normal hearing peers. One revision was reported: a retroauricular emphysema above the implant occurred 12 months post-OP, it was resolved operatively with the implant still being functional. CONCLUSION: The pediatric cohort reports significant audiological benefit, even exceeding that of the age- and sex matched control. The combination of the high safety and audiological benefit makes the Bonebridge a comfortable and effective option in hearing rehabilitation in children. PMID:34495 351 | DOI:10.1007/s00405-021-07068-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.