Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration

xlomafota13 shared this article with you from Inoreader Effect of TSH stimulation protocols on adequacy of low-iodine diet for radioiodine administration Via radioactive iodine PLoS One. 2021 Sep 7;16(9):e0256727. doi: 10.1371/journal.pone.0256727. eCollection 2021. ABSTRACT Low-iodine diet (LID) is a crucial preparation for radioactive iodine (RAI) treatment or scan in thyroid cancer. The aim of this study is to analyze the influence of thyroid stimulating hormone (TSH) stimulation protocols and other clinical factors on LID adequacy. Thyroid cancer patients who underwent LID for RAI scan or treatment were retrospectively analyzed. Patients were guided t o have LID for 2 weeks before RAI administration and urine iodine/creatinine ratio (UICR, μg/g Cr) was measured. TSH stimulation was conducted using either thyroid hormone withdrawal (THW) or recombinant human TSH (rhTSH) injection. Adequacy of LID was classified by UICR as 'excellent (< 50)', 'adequate (50-100)', 'inadequate (101-250)' and 'poor (> 250)'. A total of 1715 UICR measurements from 1054 patients were analyzed. UICR was significantly higher in case of rhTSH use than THW (72.4 ± 48.1 vs. 29.9 ± 45.8 μg/g Cr, P < 0.001). In patients who underwent LID twice using both TSH stimulation protocols alternately, UICR was higher in case of rhTSH than THW regardless of the order of method. Among clinical factors, female, old-age, and the first LID were significant factors to show higher UICR. Although the adequacy of LID was 'adequate' or 'excellent' in most patients, multivariate analysis demonstrated that THW method, male, young age, and prior LID-experience were sig nificant determinants for achieving 'excellent' adequacy of LID. In conclusion, UICR was higher and the proportion of 'excellent' LID adequacy was lower with rhTSH than with THW. UICR was higher also in women, old-age, and LID-naïve patients. Further researches are required to suggest effective methods to reduce body iodine pool in case of rhTSH use and to validate the efficacy of such methods on outcomes of RAI treatment. PMID:34492048 | DOI:10.1371/journal.pone.0256727 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Retrospective Analyses of 18FDG-PET/CT Thyroid Incidentaloma in Adults: Incidence, Treatment, and Outcome in a Tertiary Cancer Referral Center

xlomafota13 shared this article with you from Inoreader Retrospective Analyses of 18FDG-PET/CT Thyroid Incidentaloma in Adults: Incidence, Treatment, and Outcome in a Tertiary Cancer Referral Center Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Use of Tele Practice in Assessment of Middle Ear Function in Adults Living with HIV During the COVID-19 Pandemic

xlomafota13 shared this article with you from Inoreader The Use of Tele Practice in Assessment of Middle Ear Function in Adults Living with HIV During the COVID-19 Pandemic Via Otolaryngology Indian Abstract Coronavirus disease (COVID-19) pandemic is the latest threat to global health that causes severe acute respiratory syndrome (SARS). Tele-practice has inadvertently sprung to the forefront to become a common practice amongst healthcare providers during COVID-19. Limited evidence exists on the use of tele-practice in assessing middle ear function in adults living with HIV during the COVID-19 pandemic. The aims of this study were to investigate the use of tele-practice for assessment of middle ear function in adults with HIV during the COVID-19 pandemic. A quantitative observational, cross-sectional design was adopted. A total of 134 adults diagnosed with HIV were purposively selected from the HIV clinic. An audiology researcher, in the role of site-facilitator, captured video otoscopic images of the tympanic membrane using a video otoscopy for all participants through asynchronous tele-practice. All captured images were sent to two independent otorhinolaryngologist s for diagnosis. Findings of this study indicated that tele-practice can be used to assess middle ear function in adults living with HIV during COVID-19 pandemic. When asynchronous tele-practice was used, there was a moderate diagnostic agreement (k = 0.58) between the two otorhinolaryngologists on abnormality versus normality, but poor agreement (k = 0.15) on the nature of abnormality (e.g. OME vs CSOM). Current findings highlight the urgent need for a widespread use of tele-practice during the continued clinical follow up and management of adults living with HIV, and the implementation of tele-practice, particularly in low- and middle-income countries (LMICs) where capacity versus demand challenges related to ear and hearing care continue to exists. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term complications of microtia reconstruction: A systematic review

xlomafota13 shared this article with you from Inoreader Long-term complications of microtia reconstruction: A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Aug 17:S1748-6815(21)00376-4. doi: 10.1016/j.bjps.2021.08.001. Online ahead of print. ABSTRACT BACKGROUND: Microtia is a rare disorder characterized by malformation or even complete absence of the auricle. Reconstruction is often performed using autologous costal cartilage (ACC) or porous polyethylene implants (PPE). However, the long-term outcomes of both methods are unclear. OBJECTIVE: This systematic review aimed to analyze long-term complications and suggest minimal reporting criteria for future original data studies. METHODS: A systematic literature search was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included provided that the follow-up period was at least one year. This publication focused on long-term complications reported in patients with a postoperative follow-up period of at least one year. RESULTS: Twenty-nine publications reported on complications during long-term follow-up. Overall long-term complication rates were not reported. The incidence of individual complications during long-term follow-up was less than 10% after ACC reconstruction and less than 15% in PPE reconstruction. Framework resorption and wire exposure were reported even after an extended follow-up of more than five years after ACC reconstruction, while reports on the extended long-term results of PPE reconstruction are limited. Data synthesis was limited due to heterogeneity and poor study quality. CONCLUSIONS: Future studies should report on long-term complications including framework exposure or extrusion, graft loss, framework resorption, wire exposure and scalp and auricular scar complications. We recommend a surgical follow-up of at least five years. PMID:34481742 | DOI:10.1016/j.bjps.2021.08.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

3D-printed template and optical needle navigation in CT-guided iodine-125 permanent seed implantation

xlomafota13 shared this article with you from Inoreader 3D-printed template and optical needle navigation in CT-guided iodine-125 permanent seed implantation Via radioactive iodine J Contemp Brachytherapy. 2021 Aug;13(4):410-418. doi: 10.5114/jcb.2021.108595. Epub 2021 Aug 24. ABSTRACT PURPOSE: To preliminarily verify the accuracy of navigation-assisted seed implantation by comparing pre-operative and actual differences in puncture characteristics and dosimetry in computed tomography (CT)-guided, navigation-assisted radioactive iodine-125 seed implantation, using 3D-printed templates for malignant tumors' treatment. MATERIAL AND METHODS: A total of 27 t umor patients, who were treated with seed implantation under combination guidance in our hospital between December 2019 and December 2020 were enrolled in this study. Navigation needles (n = 1-3) were placed in each patient to obtain pre-operative and intra-operative puncture information, such as angle, depth, insertion point, and tip position. Moreover, dosimetry parameters in pre-operative and post-operative plans, including D90, V100, V150, V200, minimum peripheral dose (MPD), conformal index, external index, and homogeneity index of target area were investigated. RESULTS: Mean errors of the angle, depth, insertion point, and tip position were 0.5 ±0.5°, 4.0 ±2.0 mm, 1.7 ±1 mm, and 3.1 ±1.8 mm, respectively. There were no significant differences between intra-operative and pre-operative angles (p = 0.271), but there was a significant difference in the depth (p = 0.002). Errors of the angle, depth, and ins ertion point were larger for the pelvic/retroperitoneal area than for the head and neck/chest wall (p < 0.05). With the exception of MPD, there was no significant difference in dosimetry indices between post-operative and preoperative plans (p > 0.05). CONCLUSIONS: Seed implantation under combination guidance showed good accuracy, and the actual intra-operative puncture information and post-operative doses were in agreement with those in the pre-operative plan, thereby demonstrating promising prospects for further development. PMID:34484355 | PMC:PMC8407253 | DOI:10.5114/jcb.2021.108595 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Insurance Status Effect on Laryngeal Cancer Survival: A Population Based Study

xlomafota13 shared this article with you from Inoreader Insurance Status Effect on Laryngeal Cancer Survival: A Population Based Study Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 4:34894211044231. doi: 10.1177/00034894211044231. Online ahead of print. ABSTRACT OBJECTIVE: To analyze insurance status effect on overall survival (OS) and disease-specific survival (DSS) in laryngeal cancer. STUDY DESIGN: Cross-sectional population analysis. SETTING: Surveillance, Epidemiology, and End Results (SEER) database. PARTICIPANTS: Laryngeal cancer patients from 2007 to 2016. MAIN OUTCOME MEASURES: Kaplan- Meier method with log-rank statistic analyzed OS and DSS by insurance status. Multivariable cox proportional hazard modeling generated survival prognostic factors. RESULTS: Of 19 667 laryngeal cancer cases, initial disease presentation was stage I: 7770 patients (39.5%), stage II: 3337 patients (17.0%), stage III: 3289 patients (16.7%), and stage IV: 5226 patients (26.6%). Patients had non-Medicaid insurance (15 523, 78.9%), had Medicaid (3306, 16.8%), or were uninsured (891, 4.5%). Mean and median OS for insured, Medicaid, and uninsured patients were 60.5, 49.6, and 56.6 and 74.0, 40.0, and 65.0 months, respectively. Following multivariable analysis, OS for insured, Medicaid, and uninsured patients was stage I: 87.9, 82.8, and 88.4 (P < .001), stage II: 79.1, 75.1, and 78.3 (P = .12), stage III: 68.7, 66.1, and 72.1 (P = .11), and stage IV: 57.1, 51.7, and 50.3 (P < .001) months. DSS mean survival times were 77.0, 65.8, and 67.7 months (P< /i> < .001) for insured, Medicaid, and uninsured patients. Age (HR: 1.02/year, P < .001) and black (HR: 1.15, P = .001) compared to white race predicted worse survival. Compared to insured status, Medicaid insurance carried a death hazard ratio of 1.40 (P < .001) and uninsured status had a death hazard ratio of 1.40 (P < .001). CONCLUSION: Insured laryngeal cancer patients had prolonged OS and DSS compared to Medicaid and uninsured patients. Medicaid patients had equivalent survival outcomes to uninsured patients. LEVEL OF EVIDENCE: 2c. PMID:34486418 | DOI:10.1177/000 34894211044231 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-sensitivity FEES® with the professional image enhancement technology 'PIET'

xlomafota13 shared this article with you from Inoreader High-sensitivity FEES<sup>®</sup> with the professional image enhancement technology "PIET" 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 6. doi: 10.1007/s00405-021-07067-y. Online ahead of print. ABSTRACT PURPOSE: Flexible endoscopic evaluation of swallowing (FEES®) is a standard diagnostic tool in dysphagia. The combination of FEES® and narrow band light (narrow band imaging; NBI) provides a more precise and detailed investigation method. So far, this technique could only be performed with the NBI illumination. The new version of the "professional image enhancement technique" (PIET) provides another image enhancing system. This study investigates the eligibility of PIET in the FEES® procedure. METHODS: Both techniques, NBI and PIET, were compared using a target system. Furthermore, the image enhancement during FEES® was performed and recorded with the two systems during daily routine. RESULTS: Performing an image enhancement during FEES® is possible with both sys tems PIET and NBI. On the target system, the contrast of the PIET showed a brighter and a more detailed picture. In dysphagia patients, no difference between PIET and NBI was detected. CONCLUSIONS: PIET proved to be non-inferior to NBI during image enhancement FEES®. So far, image enhancement FEES® was exclusively connected to NBI. With the PIET system, an alternative endoscopy technology is available for certain indications. PMID:34487219 | DOI:10.1007/s00405-021-07067-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomes

xlomafota13 shared this article with you from Inoreader Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomes 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 6. doi: 10.1007/s00405-021-07061-4. Online ahead of print. ABSTRACT PURPOSE: To report the outcomes and the patients' subjective experience of cochlear implantation (CI) performed under local anesthesia (LA). To describe a new form of intraoperative cochlear monitoring based on the patients subjective sound perception during CI. METHODS: In this retrospective case-cohort study, 117 patients underwent CI under LA with (n = 58) or without conscious sedation (n = 59). Included were primarily elderly patients with elevated risks for general anesthesia and recently patients with residual hearing eligible for electro-acoustic stimulation (EAS) (n = 27), in whom hearing could be monitored during the electrode insertion. A 500 Hz test tone was presented and the patient reported of subjective changes in loudness, leading to a modification of the insertion. A questionnaire was sent to all patients in whi ch they assessed their subjective experience. RESULTS: All patients were successfully operated under LA without the need to intraoperatively convert to general anesthesia. 90% of the patients reported that the surgery was a positive experience. The vast majority, 90% of patients were satisfied with the overall treatment and with intraoperative pain management and 84% of the patients would opt for local anesthesia again. Cochlear monitoring by the patients' subjective sound perception enabled for atraumatic insertions as all EAS patients could hear the test tone up to the end of the surgery. CONCLUSIONS: CI under LA was well tolerated and recommended by the vast majority of patients. In addition, it offers the possibility to monitor the patients' hearing during the electrode insertion, which may help to prevent insertion trauma. PMID:34487218 | DOI:10.1007/s00405-021-07061-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Prospective Study of the Effect of Tinnitus Sound Matching Degree on the Efficacy of Customized Sound Therapy in Patients with Chronic Tinnitus

xlomafota13 shared this article with you from Inoreader A Prospective Study of the Effect of Tinnitus Sound Matching Degree on the Efficacy of Customized Sound Therapy in Patients with Chronic Tinnitus Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Objectives: The aim of this study was to explore and compare the customized sound therapy effect between tinnitus sound matching and nonmatching patients in tinnitus customized sound therapy and therapy-related influencing factors. Methods: This prospective study investigated a total of 100 patients with unilateral chronic tinnitus who received customized sound therapy. The participants were dichotomously divided into matching (group A) and nonmatching (group B) groups after 4 stages of tinnitus matching via the tinnitus assistant ap p (provided by Sound Ocean Company, SuZhou, China). Each group consists of 50 participants. Before and 6 months after the treatment, Hospital Anxiety and Depression Scale (HADS), tinnitus handicap inventory (THI), and tinnitus loudness Visual Analog Scale (VAS) were used to evaluate the customized sound therapy effect and explore other related influencing factors. Results: (1) The HADS-A, HADS-D, THI, and VAS scores of 2 groups were both significantly decreased after treatment. (2) The HADS-A and THI scores improved markedly in group A than that in group B, which could be related to the hearing loss of the tinnitus side ear before treatment; the lighter the degree of hearing loss, the better the improvement. No statistically significant differences were detected in HADS-D and VAS scores between the 2 groups, and also, these were not related to the degree of hearing loss. The differences in age, gender, and tinnitus duration did not show any statistically significant ef fect on the improvement of the 2 groups. Conclusions: Both tinnitus sound matching and nonmatching of the customized sound therapy brought a significant effect to tinnitus participants. Our study also suggests that THI and HADS-A scores of those with tinnitus matching participants improved markedly as compared to those of nonmatching participants, and the customized sound therapy effect is negatively correlated with the severity of hearing loss. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Investigation of Adult Post‐Tonsillectomy Hemorrhage Rates and the Impact of NSAID Use

xlomafota13 shared this article with you from Inoreader Investigation of Adult Post‐Tonsillectomy Hemorrhage Rates and the Impact of NSAID Use Via The Laryngoscope Objectives/Hypothesis Tonsillectomy is one of the most common ambulatory surgeries performed in the United States, yet the incidence of post-tonsillectomy hemorrhage (PTH) in adults remains unclear. In addition, any association between non-steroidal anti-inflammatory drugs (NSAIDs) and PTH in adults is currently unknown. The aim of this study is to examine the incidence and management of adult PTH at a single academic center and to assess for any association between NSAID use and PTH in adults. Study Design Retrospective chart review. Methods We conducted a retrospective chart review of adult tonsillectomies performed at our institution between January 1, 2012, and December 30, 2019. Demographics, past medical history, medications, NSAID use, surgical indication, bleeding events, and interventions were documented. The rate of PTH was calculated, logistic regression was performed to assess for any predictive factors, and odds ratios were calculated for NSAID use and PTH. Results A total of 1,057 adult tonsillectomies were performed within the aforementioned time period. A total of 126 patients experienced 163 bleeding events for a postoperative hemorrhage rate of 11.9%. Most were controlled with bedside interventions, while 29 (23%) bled more than once. The hemorrhage rate for those who were not prescribed NSAIDs postoperatively (n = 625) was 11.7%, compared to 12.6% for those who did receive NSAIDs postoperatively (n = 432), which was not significantly different (adjusted odds ratio 1.01, 95% confidence interval 0.69–1.49; P = .95). Conclusions This retrospective cohort study of 1,057 adult patients found the incidence of PTH to be 11.9%. This study found no association between the use of NSAIDs and the rate of PTH, although a higher-powered study is needed. Level of Evidence Level 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

One year into the COVID‐19 pandemic: What do we know so far from studies assessing risk and mitigation of droplet aerosolisation during endonasal surgery? A systematic review

xlomafota13 shared this article with you from Inoreader One year into the COVID‐19 pandemic: What do we know so far from studies assessing risk and mitigation of droplet aerosolisation during endonasal surgery? A systematic review Via Clinical Otolaryngology Abstract Objectives As we pass the anniversary of the declaration of a global pandemic by the World Health Organisation, it invites us to reflect upon the inescapable changes that coronavirus has wrought upon ENT and, in particular, rhinological practice. As it remains unclear when we will globally emerge from the shadow of COVID-19, a critical analysis of the evidence base on both the assessment and mitigation of risk is vital for ENT departments worldwide. This article presents a systematic review of the literature examining articles which consider either the quantification of risk or strategies to mitigate risk specifically in the setting of rhinological surgery. Design Systematic literature review. Results The literature search yielded a total of 3406 returns with 24 articles meeting eligibility criteria. A narrative synthesis stratified results into two broad themes: (1) those which made an assessment as to the aerosolisation of droplets during sinus surgery, further subdivided into work which considered macroscopically visible droplets and that which considered smaller particles; (2) and those studies which examined the mitigation of this risk. Conclusion Studies considering the aerosolisation of both droplets and smaller particles suggest endonasal surgery carries significant risk. Whilst results both highlight a range of innovative adjunctive strategies and support suction as an important variable to reduce aerosolisation, appropriate use of personal protective equipment (PPE) should be considered mandatory for all healthcare professionals involved in rhinological surgery given studies have demonstrated that close adherence to PPE use is effective at preventing COVID-19 infection. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.