Prognostic value of hypothyroidism in patients undergoing intensity‐modulated radiation therapy for nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader Prognostic value of hypothyroidism in patients undergoing intensity‐modulated radiation therapy for nasopharyngeal carcinoma Via Head & Neck Abstract Background The purpose of this study was to investigate the effect of hypothyroidism and thyroxine replacement therapy on the prognosis of nasopharyngeal carcinoma (NPC) patients. Methods The clinical data of 284 NPC patients, who received intensity-modulated radiation therapy (IMRT) between January 2011 and December 2016, were retrospectively analyzed. Results Hypothyroidism occurred in 38% of patients. Patients with hypothyroidism had significantly better disease-free survival (DFS) (p = 0.002) and relapse-free survival (RFS) (p = 0.008). Multivariate analysis showed that hypothyroidism was a positive independent prognostic factor (DFS and RFS). Among the patients with hypothyroidism, thyroxine replacement therapy did not yield inferior survival (DFS, RFS, all p > 0.05). Conclusions The NPC patients with complete response are at risk of hypothyroidism, which is attributable to escalating dose. These patients experienced clinical hypothyroidism could be adequately treated with thyroid hormone replacement. Further investigation of the underlying biological mechanism and potential therapeutic implications are required. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aryl Hydrocarbon Receptor/nuclear factor E2‐related factor 2 (AHR/NRF2) Signaling: A Novel Therapeutic Target for Atopic Dermatitis

xlomafota13 shared this article with you from Inoreader Aryl Hydrocarbon Receptor/nuclear factor E2‐related factor 2 (AHR/NRF2) Signaling: A Novel Therapeutic Target for Atopic Dermatitis Via Experimental Dermatology Abstract Aryl hydrocarbon receptor (AHR)/nuclear factor-erythroid 2-related factor 2 (NRF2) modulation are emerging as novel targets in the treatment of atopic dermatitis and other inflammatory skin disorders. Agonist activation of this pathway has downstream effects on epidermal barrier function, immunomodulation, oxidative stress reduction, and cutaneous microbiome modulation. Tapinarof, a dual agonist of the AHR/NRF2 signaling pathway, has shown promise in phase 2 trials for atopic dermatitis. In this review, we summarize current knowledge of the AHR/NRF2 pathway and implications in skin disease process. We also review the therapeutic potential of current AHR agonists and propose future directions to address knowledge gaps. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Liposomal Bupivacaine on Post-Operative Pain and Opioid Usage in Thyroidectomy

xlomafota13 shared this article with you from Inoreader Impact of Liposomal Bupivacaine on Post-Operative Pain and Opioid Usage in Thyroidectomy Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 16:34894221079095. doi: 10.1177/00034894221079095. Online ahead of print. ABSTRACT OBJECTIVES: Opioid analgesia has been integral in post-operative pain control for decades. The over-prescription of opioids, commonly in the surgical patient, has contributed to the current opioid epidemic. Liposomal bupivacaine (LB), a long-acting analgesia formulation, has demonstrated decreased post-operative pain and opioid requirements in patients treate d across multiple surgical subspecialties. The aims of this retrospective study are to assess post-operative pain and opioid use in patients who received LB at the time of thyroidectomy. METHODS: A cohort-matched retrospective review of patients who underwent thyroidectomy by 2 surgeons between January 2010 and December 2019 was performed. Patients were divided into those that received LB intraoperatively and those that did not. Statistical analyses were performed using the Chi-square or Fisher's exact test, and 2-sample T-test or Wilcoxon rank sum test. RESULTS: Of the 201 patients included in this study, 113 patients received LB and 88 did not. Patients who received LB had a lower median visual analog scale (VAS) pain score (2 vs 3, P = .2252), lower maximum VAS pain score (6 vs 7, P = .0898), were less likely to require opioid medications (73.5% vs 85.2%, P = .0434), and had a lower percentage of daily morphine milligram equivalent value � �45 (89.8% vs 95.3%, P = .1581) during the post-operative period when compared to those that did not. CONCLUSION: This study suggests a role for incisional infiltration with LB for post-operative pain management in patients undergoing transcervical thyroidectomy. We report reduced post-operative pain scores and opioid analgesia requirements in patients who received LB. PMID:35172629 | DOI:10.1177/00034894221079095 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Triazine-based porous organic polymers for reversible capture of iodine and utilization in antibacterial application

xlomafota13 shared this article with you from Inoreader Triazine-based porous organic polymers for reversible capture of iodine and utilization in antibacterial application Via radioactive iodine Sci Rep. 2022 Feb 16;12(1):2638. doi: 10.1038/s41598-022-06671-0. ABSTRACT The capture and safe storage of radioactive iodine (129I or 131I) are of a compelling significance in the generation of nuclear energy and waste storage. Because of their physiochemical properties, Porous Organic Polymers (POPs) are considered to be one of the most sought classes of materials for iodine capture and storage. Herein, we report on the preparation and characterization of tw o triazine-based, nitrogen-rich, porous organic polymers, NRPOP-1 (SABET = 519 m2 g-1) and NRPOP-2 (SABET = 456 m2 g-1), by reacting 1,3,5-triazine-2,4,6-triamine or 1,4-bis-(2,4-diamino-1,3,5-triazine)-benzene with thieno[2,3-b]thiophene-2,5-dicarboxaldehyde, respectively, and their use in the capture of volatile iodine. NRPOP-1 and NRPOP-2 showed a high adsorption capacity of iodine vapor with an uptake of up to 317 wt % at 80 °C and 1 bar and adequate recyclability. The NRPOPs were also capable of removing up to 87% of iodine from 300 mg L-1 iodine-cyclohexane solution. Furthermore, the iodine-loaded polymers, I2@NRPOP-1 and I2@NRPOP-2, displayed good antibacterial activity against Micrococcus luteus (ML), Escherichia coli (EC), and Pseudomonas aeruginosa (PSA). The synergic functionality of these novel polymers makes them promising materials to the environment and public health. PMID:35173259 | DOI:10.1038/s41598-022-06671-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Subclinical breast lymphedema as a possible risk of breast angiosarcoma

xlomafota13 shared this article with you from Inoreader Subclinical breast lymphedema as a possible risk of breast angiosarcoma Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 2:S1748-6815(22)00049-3. doi: 10.1016/j.bjps.2022.01.041. Online ahead of print. NO ABSTRACT PMID:35172950 | DOI:10.1016/j.bjps.2022.01.041 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Midline epigastric scars can be associated with higher umbilical complications following DIEP flap harvest

xlomafota13 shared this article with you from Inoreader Midline epigastric scars can be associated with higher umbilical complications following DIEP flap harvest Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Jan 21:S1748-6815(22)00040-7. doi: 10.1016/j.bjps.2022.01.023. Online ahead of print. ABSTRACT BACKGROUND: Umbilical complications can be relatively common after breast reconstruction with deep inferior epigastric perforator (DIEP) flaps. The medial umbilical ligaments and the ligamentum teres hepatis can be the sole blood supply to the umbilicus after a DIEP flap harvest. Prior incisions along the epigastric midline may disrupt the ligamentum teres hepatis. In this retrospective study, we assess the influence of previous midline epigastric scars on umbilical complications after DIEP flap harvest. METHODS: All patients who underwent breast reconstruction with DIEP flaps were identified at an academic institution over six years. Relevant sociodemographic and clinicopathologic factors were reviewed in the electronic medical records. Univariate and multivariate analyses were performed to determine the role of clinical variables to predict the chance of umbilical complications. RESULTS: A total of 243 patients met inclusion criteria, with 39 patients (16%) having prior surgery utilizing midline epigastric incisions. Twenty-one patients had umbilical complications. No significant difference in patient characteristics was found between patients with and without prior midline epigastric scars. Patients with a history of previous midline epigastric scars had a higher rate of umbilical complications (20.5% vs. 6.4%, p < 0.01). Bilateral medial row perforator-based DIEP flap harvest was also related to a higher rate of umbilical complications (18.4% vs. 6.2% p < 0.01). CONCLUSION: Previous midline epigastric scars are associated with higher rates of umbilical complications after DIEP flap harvest. Bilateral medial row perforator-based DIEP flap harvest exacerbates the rate of umbilical complications and should be avoided in patients with prior midline epigastric i ncision whenever possible. PMID:35172949 | DOI:10.1016/j.bjps.2022.01.023 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association Between Body Mass Index and Thyroid Cancer in Children With Thyroid Nodules

xlomafota13 shared this article with you from Inoreader Association Between Body Mass Index and Thyroid Cancer in Children With Thyroid Nodules Via JAMA Otolaryngology–Head & Neck Surgery Online First This cross-sectional study examines whether body mass index in children with thyroid nodules is associated with thyroid cancer and a greater likelihood of undergoing thyroid surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Leveraging Molecular Assays to Aid Decision-making in Large Indeterminate Thyroid Nodules

xlomafota13 shared this article with you from Inoreader Leveraging Molecular Assays to Aid Decision-making in Large Indeterminate Thyroid Nodules Via JAMA Otolaryngology–Head & Neck Surgery Online First To the Editor We read with great interest the recently published article by Dublin et al in JAMA Otolaryngology–Head & Neck Surgery, where it was shown that for indeterminate nodules larger than 4 cm, the positive-predictive value of a genomic classifier test (ThyroSeq) was 50% and the negative predictive value (NPV) was 89%. These values were noted to be improved relative to the test's performance on smaller nodules. The authors point out that the 2015 American Thyroid Association guidelines suggest that total thyroidectomy may be preferred for indeterminate nodules that are large (>4 cm) to limit completion thyroidectomy and conclude from their analysis that thyroid lobectomy may be sufficient for genomic classifier-negative indeterminate nodules. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal High-Speed Videoendoscopy with Laser Illumination: A Preliminary Report

xlomafota13 shared this article with you from Inoreader Laryngeal High-Speed Videoendoscopy with Laser Illumination: A Preliminary Report Via Polyps Otolaryngol Pol. 2021 Sep 7;75(6):1-10. doi: 10.5604/01.3001.0015.2575. ABSTRACT <br><b>Introduction:</b> Advances in computer image analysis have enabled the use of new functional imaging methods in the diagnosis of laryngeal diseases. Particularly interesting techniques of dynamic laryngeal imaging involve High Speed Videoendoscopy (HSV). This still-developed technique allows to overcome the limitations of laryngovideostroboscopy (LVS) and a more detailed analysis of the glottal function based on the image of the actual vibrations of the vocal folds. It also enables the determination of objective coefficients parameterizing phonatory vibrations of the vocal folds.</br> <br><b>Aim:</b> The aim of this pilot study was to evaluate the use of a high-speed videoendoscopy set with laser illumination for the diagnosis of glottic pathology in ENT practice.</br> <br><b>Material and methods: </b> The study included 40 patients who underwent LVS followed by HSV. The modern HSV examination kit - Advanced Larynx Imager System (ALIS), used for the first time in a clinical setting in Poland, is characterized by significantly improved, compared to the previously used high-speed cameras, operational parameters - a light head, the possibility of continuous lighting operation without excessive heating of the head tip, registration of the image in full color scale. Thanks to such modernization, the safety and course of the examination do not differ from laryngoscopy conducted with commonly used recorders. The device owes some of these improvements to a laser illuminator which was used for the first time as the main light source in a high-speed camera. In the study, two cases were selected to present the results of HSV and the analysis of the generated kymograms - a woman with no glottic pathology and a man with a polyp of the right vocal fold. In the first case, the HSV exa mination compared with the LVS revealed a discrete glottis functional disorder in the form of a tendency to hyperphonation. The patient with an organic lesion had a clearly visible irregularity of vocal fold vibrations, which also allowed to trace mucosal wave disturbances related to its reflection from the pathological structure of the glottis and the formation of a return wave, both on the fold affected by the lesion and, to a lesser extent, contralaterally. The glottic dysfunctions observed in the studied patients were confirmed in the generated kymograms and the graphs of the glottal width waveform (GWW), as well as in the parameters calculated on their basis, assessing the frequency and amplitude of phonatory vibrations.</br> <br><b>Conclusions:</b> The use of high-speed videoendoscopy allows for a much more accurate assessment of the phonatory function of the glottis than in laryngovideostroboscopy. The presented HSV system allows for obtaining high qua lity kinematic images of the larynx, color fidelity, and contrast. The use of this technology in laryngological practice enables precise structural and functional assessment of the glottis and detection of discrete phonation disorders that elude the techniques used so far.</br&gt. PMID:35175220 | DOI:10.5604/01.3001.0015.2575 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patulous Eustachian tube: Deep breath for a diagnosis

xlomafota13 shared this article with you from Inoreader Patulous Eustachian tube: Deep breath for a diagnosis Via ear nose throat Ear Nose Throat J. 2022 Feb 17:1455613211051793. doi: 10.1177/01455613211051793. Online ahead of print. ABSTRACT Significance Statement: Eustachian tube disorders are common outpatient otologic presentations that can present a diagnostic challenge due to overlapping symptoms. This article will focus on patulous Eustachian tube, how the symptoms can overlap with those of Eustachian tube dysfunction, and the diagnostic insight offered by a close inspection of the tympan ic membrane. PMID:35175873 | DOI:10.1177/01455613211051793 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postextubation dysphagia in intensive care patients : Current findings and clinical recommendations

xlomafota13 shared this article with you from Inoreader Postextubation dysphagia in intensive care patients : Current findings and clinical recommendations Via swallowing exercises Anaesthesist. 2022 Feb 15. doi: 10.1007/s00101-022-01092-0. Online ahead of print. ABSTRACT BACKGROUND: A considerable number of critically ill and mechanically ventilated intensive care patients show pronounced dysphagia after extubation. Many studies have shown that postextubation dysphagia (PED) leads to a significant decline of outcome. The awareness, timely diagnostic procedures and integration of suitable treatment methods in intensive care units are therefore of great import ance. OBJECTIVE: Current basic findings on PED, diagnostic possibilities, therapeutic methods as well as the development of concrete recommendations for clinical practice. METHODS: A selective literature search was performed in PubMed, Medline and Cochrane using keywords. RESULTS: In the literature the incidence PED is reported very heterogeneous but is probably at least 10% in intensive care patients after mechanical ventilation. The duration of intubation plays a critical role here. A multifactorial interaction of several factors is assumed to be the cause, whereby the impairment of laryngeal structures is of particular relevance. A PED leads to longer hospital stays, higher mortality, more reintubation and a higher number of patients with tube feeding. With respect to diagnostics, screening by trained nurses, clinical swallowing examinations and, in particular, the use of instrumental examinations by flexible endoscopic evaluation of swallowing (FEES) are recomm ended. The treatment should include adaptive measures in the sense of an adapted diet but also functional exercises. Innovative approaches, such as electrical stimulation are also conceivable. The aim is primarily to avoid penetration and aspiration in order to counteract respiratory complications. CONCLUSION: In many intensive care units the clinical picture of PED is still neglected despite clear evidence. A simple algorithm in the treatment of intensive care patients can contribute to early detection and initiation of further steps. These should be integrated into clinical treatment standards. PMID:35166868 | DOI:10.1007/s00101-022-01092-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.