Thursday, November 11, 2021

Arterial calcification on preoperative computed tomography imaging as a risk factor for pharyngocutaneous fistula formation after total laryngectomy

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Abstract

Background

Research in esophageal surgery showed that computed tomography (CT) assessed arterial calcification (AC) is associated with postoperative complications. We investigated the association between AC and pharyngocutaneous fistula (PCF) formation after laryngectomy.

Methods

This was a retrospective cohort study of patients undergoing laryngectomy. AC was scored at 10 different anatomical locations on CT imaging, blinded for PCF occurrence. Association with PCF was investigated using logistic regression.

Results

The 224 patients were included; 62 (27.7%) developed a PCF. Moderate to severe AC was widespread in patients undergoing TL; 7.1% of patients had at most mild AC, of whom 1 experienced a PCF (p = 0.05). A higher cumulative calcification score was associated with PCF in univariable (OR 1.11, p = 0.04) and multivariable analysis (OR 1.14, p = 0.05).

Conclusion

AC is widespread in patients undergoing laryngectomy and its burden is associated with PCF. Extensive AC on preoperative imaging may be considered a risk factor for PCF.

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Iron deficiency and high-intensity running interval training do not impact femoral or tibial bone in young female rats

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Br J Nutr. 2021 Nov 11:1-22. doi: 10.1017/S0007114521004426. Online ahead of print.

ABSTRACT

In the US, as many as 20% of recruits sustain stress fractures during basic training. In addition, approximately one-third of female recruits develop iron deficiency upon completion of training. Iron is a cofactor in bone collagen formation and vitamin D activation, thus we hypothesized iron deficiency may be contributing to altered bone microarchitecture and mechanics during 12-weeks of in creased mechanical loading. Three-week old female Sprague Dawley rats were assigned to one of four groups: iron adequate sedentary, iron deficient sedentary, iron adequate exercise, and iron deficient exercise. Exercise consisted of high-intensity treadmill running (54 min 3×/week). After 12-weeks, serum bone turnover markers, femoral geometry and microarchitecture, mechanical properties and fracture toughness, and tibiae mineral composition and morphometry were measured. Iron deficiency increased the bone resorption markers C-terminal telopeptide type I collagen and tartate-resistant acid phosphatase 5b (TRAcP 5b). In exercised rats, iron deficiency further increased bone TRAcP 5b, while in iron adequate rats, exercise increased the bone formation marker procollagen type I N-terminal propeptide. In the femur, exercise increased cortical thickness and maximum load. In the tibia, iron deficiency increased the rate of bone formation, mineral apposition, and zinc content. These data s how that the femur and tibia structure and mechanical properties are not negatively impacted by iron deficiency despite a decrease in tibiae iron content and increase in serum bone resorption markers during 12-weeks of high-intensity running in young growing female rats.

PMID:34758890 | DOI:10.1017/S0007114521004426

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Sensitivity of Communicative Participation Item Bank for Measuring Unilateral Vocal Fold Immobility

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This case series examines differences in patients' score s on the Communicative Participation Item Bank before and after treatment of unilateral vocal fold immobility and how the scores compare with qualitative self-reports of treatment outcomes.
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Persistent Postthyroidectomy Hypoparathyroidism in the Netherlands

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This cohort study examines the incidence of postoperative , persistent hypoparathyroidism after total or completion thyroidectomy in Dutch patients.
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Cystic Neck Mass

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A 44-year-old woman presented with a 6-month history of a right neck mass with compressive symptoms. What is your diagnosis?
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Thyroid Lobectomy for T1 Papillary Thyroid Carcinoma in Pediatric Patients

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This cohort study assesses the use of thyroid lobectomy fo r the treatment of papillary thyroid cancer in pediatric patients.
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Levels of Triamcinolone Acetonide in Human Perilymph and Plasma After Intratympanic Application

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This randomized clinical trial compares levels of triamci nolone acetonide in perilymph and plasma after intratympanic injection.
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Clinical Staging to Estimate the Probability of Postoperative Complications in Vestibular Schwannoma

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This cohort study presents a staging system to predict se vere surgical complications in patients who undergo surgical resection of vestibular schwannoma.
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Nonsurgical Risk Factors Associated With Pharyngocutaneous Fistula After Laryngectomy

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This multicenter cohort study of adult patients with lary ngeal cancer uses data from a national database to identify nonclinical risks associated with the formation of pharyngocutaneous fistula after total laryngectomy.
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An Unusual Case of Bilateral Chylothorax After Neck Dissection

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This case report describes a woman in her 30s who underwe nt total thyroidectomy with modified radical neck dissection due to papillary thyroid cancer and was subsequently diagnosed with bilateral chylothorax secondary to cervical thoracic duct injury.
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Hearing Loss and Impaired Physical Function, Frailty, and Disability in Older Adults

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This cross-sectional study examines the association betwe en hearing loss and impaired lower extremity function, frailty syndrome, and disability in older adults.
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Long-term Outcomes of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

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This cohort study investigates the association between long-te rm use of hypoglossal nerve stimulation for obstructive sleep apnea and improved patient-reported outcomes, particularly insomnia and depression indices, and compares these outcomes with those for positive airway pressure therapy.
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