Evaluation of Recurrence Risk in Patients with Papillary Thyroid Cancer through Tumor-Node-Metastasis Staging: A Single-Center Observational Study in Taiwan

xlomafota13 shared this article with you from Inoreader Evaluation of Recurrence Risk in Patients with Papillary Thyroid Cancer through Tumor-Node-Metastasis Staging: A Single-Center Observational Study in Taiwan Via radioactive iodine Biomed J. 2021 Nov 19:S2319-4170(21)00169-4. doi: 10.1016/j.bj.2021.11.009. Online ahead of print. ABSTRACT BACKGROUND: Many patients with papillary thyroid cancer (PTC) demonstrate satisfactory outcomes. However, 8%-28% of patients with PTC show tumor recurrence, which may affect prognosis. Therefore, identifying factors associated with tumor recurrence in patients with PTC may be helpful to refine therapeutic strategies. PATIENTS AND METHODS: To identify factors associated with PTC recurrence, we retrospectively reviewed demographic features (sex and age), operation method, image character, serum thyroglobulin (Tg), accumulated radioactive iodine (I-131) therapeutic dose, I-131 uptake, and metastases at diagnosis in 829 patients with PTC. Patients were grouped into early (stage I and II; n = 698) and advanced (stage III and IV; n = 131) tumor-node-metastasis (TNM) stages. Recurrence rate, mortality rate, risk factors of recurrence, recurrent free survival and overall survival curve were compared between two groups. RESULTS: Patients in the early stage demonstrated a lower recurrence rate (7.2%) than did those in the advanced stage (28.2%, p < 0.05). The mortality rate of patients with recurrence in the advanced stage was higher than that of those in the early stage (51.4% vs. 12.0%). The major impact factors on tumor recurrence in early TNM stage were distant metastasis and lymph node metastasis, while in advanced TNM stage were distant metas tasis, male gender, total thyroidectomy with limited lymph node dissection, and a high serum Tg level. CONCLUSIONS: Strategies to monitor tumor recurrence might be refined according to the TNM stages of PTC patients. PMID:34808423 | DOI:10.1016/j.bj.2021.11.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Imaging of Treated Thyroid and Parathyroid Disease

xlomafota13 shared this article with you from Inoreader Imaging of Treated Thyroid and Parathyroid Disease Via radioactive iodine Neuroimaging Clin N Am. 2022 Feb;32(1):145-157. doi: 10.1016/j.nic.2021.08.014. ABSTRACT The thyroid and parathyroid glands are endocrine structures located in the visceral space of the infrahyoid neck. Imaging plays a critical role in the evaluation of patients with thyroid cancer, both in the pre and posttreatment setting. Disorders of thyroid function, that is, hyperthyroidism and hypothyroidism, are also fairly common, although imaging utilization is less frequent with these co nditions. Parathyroid dysfunction results in disordered calcium metabolism. Imaging is frequently applied in the preoperative assessment of these patients undergoing parathyroidectomy; however, routine imaging in the postoperative setting is uncommon. Parathyroid carcinoma is rare; however, imaging may be used in the pre and posttreatment setting. PMID:34809835 | DOI:10.1016/j.nic.2021.08.014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of preoperative radiation on free flap outcomes for head and neck reconstruction: An updated systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Effect of preoperative radiation on free flap outcomes for head and neck reconstruction: An updated systematic review and meta-analysis Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 23:S1748-6815(21)00482-4. doi: 10.1016/j.bjps.2021.09.050. Online ahead of print. ABSTRACT BACKGROUND: There is an ongoing debate about whether neoadjuvant radiation therapy is associated with higher rates of postoperative complications after head and neck reconstruction. Herle et al. conducted a systematic review in 2014 of 24 studies, finding higher complication rates in irradiated fields. We sought to perform an exhaustive updated systematic review and meta-analysis. METHODS: We conducted an updated systematic review of the literature, as outlined in our protocol, which was registered on PROSPERO. Databases included Medline, Embase, Cochrane Central, and Web of Science. There were no limits placed on the date range, place of publication, or origin. Exclusion criteria included patients less than 18 years of age, studies with less than 20 participants (n < 20), case studies, skull base reconstructions, and local tissue rearrangements. The combined results of the studies and relative risks (RR) were calculated. RESULTS: 53 studies were included for analysis, including 5,086 free flaps in an irradiated field, and 9,110 free flaps in a non-irradiated field. Of the 53 studies, 21 studies overlapped with those discussed in Herle et al.'s study, with a total of 32 additional studies. Neoadjuvant radiation was found to be a statistically significant risk factor for postoperative complications (RR 1.579, P < 0.001), total flap failure (RR, 1.565; P < 0.001), and fistula (RR, 1.810; P < 0.001). Our work reaffirmed the findings of the Herle et al. CONCLUSION: Preoperative radiation was associated with a statistically significant increase in the risk of total flap failure, fistula, and total complications but not partial flap failure. These high-morbidity complications must be taken into consideration when determining which patients should receive neoadj uvant radiation therapy. PMID:34810143 | DOI:10.1016/j.bjps.2021.09.050 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sex-specific effects of metformin and liraglutide on renal pathology and expression of connexin 45 and pannexin 1 following long-term high-fat high-sugar diet

xlomafota13 shared this article with you from Inoreader Sex-specific effects of metformin and liraglutide on renal pathology and expression of connexin 45 and pannexin 1 following long-term high-fat high-sugar diet Via histochem Acta Histochem. 2021 Nov 19;123(8):151817. doi: 10.1016/j.acthis.2021.151817. Online ahead of print. ABSTRACT The comparative effects of the two commonly used antidiabetic drugs metformin and liraglutide on renal pathology and expression of connexin 45 (Cx45) and pannexin 1 (Panx1) in adult obese rats fed high-fat high-sugar diet (HFHSD) were studied. Considering recent data on the profound influence of sex on metformin and liraglutide effects, we compared the effects of bot h drugs between male and female animals. 44-week-old Sprague-Dawley rats were separated into 4 groups that were fed: standard diet, HFHSD, HFHSD treated with metformin (s.c., 50 mg/kg/day) and HFHSD treated with liraglutide (s.c., 0.3 mg/kg/day). Treatment with metformin or liraglutide lasted for 14 weeks. Histology and immunohistochemistry were performed to quantify renal pathological changes and Cx45 and Panx1 expression. HFHSD caused thickening of the Bowman's capsule (BC). Both metformin and liraglutide failed to ameliorate the BC thickening; metformin even worsened it. Effects on the tubulointerstitial fibrosis score, BC thickness and Cx45 and Panx1 expression were sex-dependent. We found a 50% increase in mitochondria in proximal tubules of metformin- and liraglutide-treated HFHSD-fed rats, but these effects were not dependent on the sex. This is a first study showing that the effects of metformin and liraglutide on kidney pathology in rats fed HFHSD are mostly sex-dependent a nd that these effects are not necessarily beneficial. Both drugs changed the Cx45 and Panx 1 expression; hence their effects could be related to amelioration of disruptions in intercellular communication. PMID:34808525 | DOI:10.1016/j.acthis.2021.151817 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New onset of smell and taste loss are common findings also in patients with symptomatic COVID‐19 after complete vaccination

xlomafota13 shared this article with you from Inoreader New onset of smell and taste loss are common findings also in patients with symptomatic COVID‐19 after complete vaccination Via The Laryngoscope Abstract Objective To investigate the clinical profile of patients who developed coronavirus disease 2019 (COVID-19) after full vaccination. Methods Demographic, epidemiological and clinical data were collected through medical records and online patient-reported outcome questionnaire from patients who developed symptomatic SARS-CoV-2 infection, confirmed by nasopharyngeal swab, at least two weeks after completion of vaccination. Results 153 subjects were included. The most frequent symptoms were: asthenia (82.4%), chemosensory dysfunction (63.4%), headache (59.5%), runny nose (58.2%), muscle pain (54.9%), loss of appetite (54.3%) and nasal obstruction (51.6%). Particularly, 62.3% and 53.6% of subjects reported olfactory and gustatory dysfunction, respectively. Symptom severity was mild or moderate in almost all cases. Conclusions Chemosensory dysfunctions have been observed to be a frequent symptom even in subjects who contracted the infection after full vaccination. For this reason, the sudden loss of smell and taste could continue to represent a useful and specific diagnostic marker to raise the suspicion of COVID-19 even in vaccinated subjects. In the future, it will be necessary to establish what the recovery rate is in these patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The immunologic balance: three cases of rituximab-associated melanoma

xlomafota13 shared this article with you from Inoreader The immunologic balance: three cases of rituximab-associated melanoma Via Melanoma Research - Published Ahead-of-Print Currently, there is no known clinical evidence that rituximab increases the rate of subsequent primary malignancies; however, some studies have raised the question of increased melanoma risk following rituximab treatment for non-Hodgkin lymphoma. We report three interesting cases of suspected rituximab-induced melanoma. We hypo thesize that this association is secondary to rituximab-driven shifts in the immunologic balance. Based on these cases, it is possible that the number of post-rituximab melanoma cases is underreported. Further mechanistic research into individual cases and population-level studies are required to better define association and risk; however, given the increasing prevalence of oncologic and nononcologic rituximab use, awareness across all fields is essential. Received 27 September 2021 Accepted 28 October 2021 Correspondence to Anastasios Dimou, MD, Division of Medical Oncology, Mayo Clinic, 200 1st St NW, Rochester, MN 55902, USA, Tel: 507 773 0569; e-mail: dimou.anastasios@mayo.edu Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic Accuracy Outcomes of Office‐Based (Outpatient) Biopsies in patients with Laryngopharyngeal Lesions: A Systematic Review

xlomafota13 shared this article with you from Inoreader Diagnostic Accuracy Outcomes of Office‐Based (Outpatient) Biopsies in patients with Laryngopharyngeal Lesions: A Systematic Review Via Clinical Otolaryngology Abstract Introduction In-office biopsy (IOB) using local anaesthetic for laryngopharyngeal tumours has become an increasingly popular approach since the advent of distal chip endoscopes. Although a wide range of studies advocate use in clinical practice, the widespread application of the procedure is hampered by concerns regarding diagnostic accuracy. Methods A systematic review following the PRISMA guidelines was conducted to assess the diagnostic accuracy of IOBs performed via flexible endoscopy. In addition, an analysis of potentially modifiable factors that may affect diagnostic accuracy was performed. PubMed, EMBASE, The Cochrane Library, Web of Science, CINAHL were used in the literature database search. Results 875 studies were identified, 16 of which were included into the systematic review. 1572 successful biopsies were performed using flexible endoscopy. 1283 cases were accurately diagnosed in the outpatient setting (81.6%). 289 samples did not provide an accurate diagnosis (18.4%). The median sensitivity of IOBs was 73%, the specificity was 96.7%. Analysis of variable factors did not show any significant differences in method of approach, size of equipment (forceps), additional lighting system or learning curve. Conclusion IOBs are a viable tool for diagnostic workup of laryngopharyngeal tumours. Clinicians should be wary of reported limitations of IOBs when benign or pre-malignant diagnoses are made. In cases suspicious of malignancy, confirmatory investigation should be conducted. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Direct Oral Anticoagulants versus Vitamin K Antagonists in epistaxis patients: a systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Direct Oral Anticoagulants versus Vitamin K Antagonists in epistaxis patients: a systematic review and meta‐analysis Via Clinical Otolaryngology Abstract Objective Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiologic and hematologic guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome. Design/Setting A systematic review and meta-analysis were performed according to the PRISMA 2020 statement using the PubMed and Cochrane Library databases. Continuous data was analysed and standardized mean difference (SMD) was calculated according to Hedges' g. Dichotomous data was analysed and the Mantel-Haenszel method was applied to establish the odds ratio (OR). Heterogeneity was assessed according to the I2 statistics. Main Outcome/Results A total of 8 reports covering 1390 patients were included in the final synthesis. The pooled analysis demonstrated significantly shorter hospital stays in the DOAC group (SMD= -0.22, 95% CI -0.42 to -0.02, P= .03) and a significantly higher rate of posterior bleeding in the VKA group (OR= .39, 95% CI .23 to .68, P= .001). No statistically significant differences with regard to recurrence rates, admission rates, the need for transfusion, or surgical intervention (P= .57, .12, .57 and .38 respectively) were found. Conclusion According to this meta-analysis, epistaxis patients taking DOACs have a more favourable outcome than patients taking VKAs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tongue Edema Secondary to Suspension Laryngoscopy

xlomafota13 shared this article with you from Inoreader Reply to Tongue Edema Secondary to Suspension Laryngoscopy Via Journal of Voice In our article titled "Tongue Edema Secondary to Suspension Laryngoscopy," we presented two patients who underwent prolonged suspension micro laryngoscopy (SML) and developed edema of the tongue that was severe enough that intensive care unit admission with airway monitoring was required.1 At the time of its acceptance for publication in the Journal of Voice on September 23, 2019, the complication of tongue edema following SML had not been reported. We were surprised that this problem had not been described in the literature. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reweighting of Binaural Localization Cues in Bilateral Cochlear-Implant Listeners

xlomafota13 shared this article with you from Inoreader Reweighting of Binaural Localization Cues in Bilateral Cochlear-Implant Listeners Via Journal of the Association for Research in Otolaryngology Abstract Normal-hearing (NH) listeners rely on two binaural cues, the interaural time (ITD) and level difference (ILD), for azimuthal sound localization. Cochlear-implant (CI) listeners, however, rely almost entirely on ILDs. One reason is that present-day clinical CI stimulation strategies do not convey salient ITD cues. But even when presenting ITDs under optimal conditions using a research interface, ITD sensitivity is lower in CI compared to NH listeners. Since it has recently been shown that NH listeners change their ITD/ILD weighting when only one of the cues is consistent with visual information, such reweighting might add to CI listeners' low perceptual contribution of ITDs, given their daily exposure to reliable ILDs but unreliable ITDs. Six bilateral CI listeners completed a multi-day lateralization training visually reinforcing ITDs, flanked by a pre- and post-measurement of ITD/ILD weights without visual reinforcement. Using direct electric stimulation, we p resented 100- and 300-pps pulse trains at a single interaurally place-matched electrode pair, conveying ITDs and ILDs in various spatially consistent and inconsistent combinations. The listeners' task was to lateralize the stimuli in a virtual environment. Additionally, ITD and ILD thresholds were measured before and after training. For 100-pps stimuli, the lateralization training increased the contribution of ITDs slightly, but significantly. Thresholds were neither affected by the training nor correlated with weights. For 300-pps stimuli, ITD weights were lower and ITD thresholds larger, but there was no effect of training. On average across test sessions, adding azimuth-dependent ITDs to stimuli containing ILDs increased the extent of lateralization for both 100- and 300-pps stimuli. The results suggest that low-rate ITD cues, robustly encoded with future CI systems, may be better exploitable for sound localization after increasing their perceptual weight via training. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas

xlomafota13 shared this article with you from Inoreader Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas Via hno HNO. 2021 Nov 23. doi: 10.1007/s00106-021-01116-y. Online ahead of print. ABSTRACT The data of 86 patients with retrosigmoid microsurgical resection of vestibular schwannoma in tumor stage Koos II-IV were evaluated. In more than two thirds of the cases it was shown that the cochlear nerve followed the facial nerve, which is easily identified by electroneurography, in recurrent similar patterns in the region of the internal auditory canal. Starting from the fundus, this facil itated early identification and thus preservation of continuity of the cochlear nerve in the course of the internal auditory canal. This was of particular importance when safe functional preservation could not be guaranteed due to tumor size or formation despite intraoperative derivation of somatosenoric potentials, but when the possibility of subsequent hearing rehabilitation with a cochlear implant should be granted. Preoperative MRI sequences gave an indication of the possible nerve courses in some cases, but intraoperative imaging in the internal auditory canal was superior to MRI. PMID:34812915 | DOI:10.1007/s00 106-021-01116-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.