Study protocol: the ear-nose-throat (ENT) prospective international cohort of patients with primary ciliary dyskinesia (EPIC-PCD)

xlomafota13 shared this article with you from Inoreader Study protocol: the ear-nose-throat (ENT) prospective international cohort of patients with primary ciliary dyskinesia (EPIC-PCD) Via Laryngologie BMJ Open. 2021 Oct 11;11(10):e051433. doi: 10.1136/bmjopen-2021-051433. ABSTRACT INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare, genetic, multiorgan disease with an estimated prevalence of 1 in 10 000. It affects mainly the upper and lower airways due to impaired mucociliary clearance. Almost all patients have sinonasal or otologic (ear-nose-throat, ENT) problems, although the ENT clinical phenotype may present great variability. Despite that, data on PCD ENT manifestations are scarce and based on small single-centre studies. To date, we know little about the spectrum and severity of PCD ENT disease, its association with lung disease, its course over life and its determinants of prognosis.This study protocol describes the aims and methods of the first prospective, observational, multinational cohort study focusing on ENT disease in patients with PCD. METHODS AND ANALYSIS: The ENT prospective international cohort of patients wi th PCD (EPIC-PCD) is a prospective standardised observational clinical cohort set up as a multinational multicentre study, embedded into routine patient care. It aims to longitudinally characterise ENT disease in patients with PCD and its association with lung disease, and to identify determinants of its prognosis. Patients of all ages, diagnosed with PCD who undergo an ENT clinical assessment at least once a year at one of the participating centres will be invited to participate. Collected data include diagnostic test results, results of ENT examinations, lung function measurements, information on management of ENT disease and patient-reported data on clinical symptoms and health-related quality of life (QoL). Data are collected using the standardised PCD-specific FOLLOW-PCD form and the validated QoL-PCD questionnaire. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Human Research Ethics Committees at all participating centres, based on local legisl ation. The results of the study will be published in scientific journals, presented at scientific conferences and disseminated to participants and national patient organisations. TRIAL REGISTRATION: NCT04611516. PMID:34635525 | DOI:10.1136/bmjopen-2021-051433 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extramedullary Solitary Plasmacytoma of Larynx: A Rare Entity and Therapeutic Challenge

xlomafota13 shared this article with you from Inoreader Extramedullary Solitary Plasmacytoma of Larynx: A Rare Entity and Therapeutic Challenge Via Otolaryngology Indian Abstract Solitary extramedullary plasmacytoma is a rare entity. The diagnosis is established by clinical evaluation, detailed radiological workup and histopathology with immunohistochemistry markers. There is no clear standard of care for a solitary laryngeal plasmacytoma. A case of solitary laryngeal plasmacytoma is being reported here with the rationale for the chosen treatment modality. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Migrated Foreign Body of Upper Digestive Tract—A Ten-Year Institutional Experience

xlomafota13 shared this article with you from Inoreader Migrated Foreign Body of Upper Digestive Tract—A Ten-Year Institutional Experience Via Otolaryngology Indian Abstract The ingested foreign body is one of the commonest emergencies encountered by otolaryngologists Depending on the shape and duration of impaction, a small number of foreign bodies (1–2%) can perforate the wall of the gastrointestinal Tract. A migrated foreign body may remain quiescent or cause life-threatening suppurative and vascular complications. Data were collected retrospectively from the hospital records in a tertiary care hospital in South India from 2010 to 2020. Fifteen patients diagnosed with migrated foreign body and who underwent neck exploration were included in the study. Demographic details, mode of presentation, clinical and radiological findings, rigid esophagoscopy findings, neck exploration techniques employed were noted. The mean age of the patients was 37.66 years. All patients had a history of dysphagia, odynophagia, and point tenderness. All the patients underwent a lateral neck radiograph, and it was positive in 12 patients (80%), whi le in 3 patients (20%), it was negative. All the patients had a positive finding in Contrast-Enhanced Computed Tomography. Esophagoscopy was done prior to neck exploration to identify the site of injury and the probable site of migration. All the patients underwent lateral neck exploration, and foreign body was removed. Migrated foreign body can cause significant morbidity and mortality if not diagnosed and managed early. Strong suspicion and a systematic approach are needed for the diagnosis and management. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Unusual Tumor in an Uncommon Site-Orbital Rosai–Dorfman Disease: A Case Report

xlomafota13 shared this article with you from Inoreader An Unusual Tumor in an Uncommon Site-Orbital Rosai–Dorfman Disease: A Case Report Via Otolaryngology Indian Abstract Rosai–Dorfman disease (RDD) is also known as Sinus Histiocytosis with Massive Lymphadenopathy. It is a rare, benign, self-limiting disease of phagocytic histiocytes presenting with massive painless cervical lymphadenopathy. RDD can present as a nodal disease and also extra-nodal involvement with episodes of exacerbation and remissions and relapses after treatment. Its etiology remains poorly understood and is highly variable in its clinical presentation and response to treatment. Its treatment is poorly defined but the prognosis is usually fair. Here we are reporting a rare, unusual clinical presentation of infraorbital soft tissue mass diagnosed as RDD with cyto-histopathological correlation. Only a few such cases have been reported in the literature. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gait and Age‐Related Hearing Loss Interactions on Global Cognition and Falls

xlomafota13 shared this article with you from Inoreader Gait and Age‐Related Hearing Loss Interactions on Global Cognition and Falls Via The Laryngoscope Objectives Age-related hearing loss (ARHL) is considered a risk factor for cognitive impairment and falls. The association may be modulated by gait performance because ARHL is related to mobility decline, which strongly contributes to cognitive impairment and falls. We investigated the interactive effects of gait and ARHL on global cognition and falls among older adults. Study Design Retrospective cohort study. Methods The auditory acuity of 810 community-dwelling older adults was measured using a pure-tone average of hearing thresholds at 1,000 and 4,000 Hz in the better-hearing ear. Participants were then stratified as follows: normal hearing, ≤25 dB; mild hearing loss (HL), >25 and ≤40 dB; and moderate to severe HL, >40 dB. Gait speed was assessed as an indicator of gait performance and fall occurrence within the previous year. Global cognition was determined using the Montreal Cognitive Assessment (MoCA) test. Results A total of 320 (39.5%) and 233 (28.8%) participants had mild and moderate to severe HL, respectively. Hierarchical multiple and logistic regression analyses showed interactions between gait performance and moderate hearing loss on both global cognition and the occurrence of falls. Specifically, older adults with moderate hearing loss who walked slowly showed lower MoCA scores and a higher incidence of falls, whereas those with decent gait speed did not show such a tendency. Conclusion Our results suggest that poor gait performance might modulate the effects of ARHL, leading to cognitive decline and falls. Poor cognitive performance and falls may be prevalent in older adults with ARHL, especially in those with slower gait and moderate hearing loss. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Hospital Volume on Outcomes Following Head and Neck Cancer Surgery and Flap Reconstruction

xlomafota13 shared this article with you from Inoreader Impact of Hospital Volume on Outcomes Following Head and Neck Cancer Surgery and Flap Reconstruction Via The Laryngoscope Objective/Hypothesis Utilization of flaps for reconstruction of large head and neck cancer (HNCA) defects has become more prevalent. The present study aimed to assess the impact of center experience as measured by annual hospital caseload on mortality, major complications, resource utilization, and 90-day readmissions following HNCA resection with flap reconstruction. Study Design Non-Randomized Controlled Cohort Study. Methods All adult patients undergoing elective HNCA resection with flap reconstruction were identified utilizing the 2010 to 2018 Nationwide Readmissions Database. Hospitals were subsequently classified as low-, medium-, or high-volume based on annual institutional surgical caseload tertiles. Multivariable regression models were implemented to assess the independent association of hospital volume with the outcomes of interest. Results Over the nine-year study period, the proportion of HNCA resection with flap reconstruction gradually increased (12.8% in 2010 vs. 17.3% in 2018, P < .001). Although increasing hospital volume did not alter the odds of mortality, patients treated at high-volume centers were less likely to experience both surgical (adjusted odds ratio [AOR] 0.81, 95% confidence interval [CI] 0.67–0.97, P = .025) and medical complications (AOR 0.70, 95% CI 0.57–0.85, P < .001). Furthermore, these patients had shorter hospitalizations (−2.1 days, 95% CI −2.7 to −1.4 days, P < .001) and decreased costs (−$8,100, 95% CI −11,400 to −4,700, P < .001) compared to counterparts at low-volume centers. However, hospital volume did not impact 90-day readmissions. Conclusion Patients undergoing HNCA resection with flap reconstruction at high-volume centers were less likely to experience surgical and medical complications while incurring shorter hospitalizations and lower costs. Implementation of volume standards may be appropriate to improve outcomes in this surgical population. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sentinel Lymph Node Biopsy Versus Elective Node Dissection in Stage cT1‐2N0 Oral Cavity Cancer

xlomafota13 shared this article with you from Inoreader Sentinel Lymph Node Biopsy Versus Elective Node Dissection in Stage cT1‐2N0 Oral Cavity Cancer Via The Laryngoscope Objective To compare overall survival (OS) and disease-free survival (DFS) between sentinel lymph node biopsy (SNB) and elective neck dissection (END) in the surgical management of cT1-2N0 oral cavity squamous cell carcinoma (OCSCC). Methods English full-text articles were searched in PubMed and Embase on May 9, 2021. Articles had to compare SNB with END in cT1-T2N0 OCSCC patients; report hazard ratios (HRs), Kaplan–Meier curves, or P-values with total number of events for survival outcomes; be from a clinical trial, cohort, or case–control study. Two reviewers reviewed articles and a third settled disagreements. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Risk of Bias in Non-randomized Studies of Interventions tool and revised Cochrane risk-of-bias tool for randomized trials were used. The generic inverse variance method with a random-effect model was used for meta-analysis. Results Ten studies, five retrospective, three prospective, and two randomized controlled trials, were included (total number of patients [n] = 10,498, END n = 9102, SNB n = 1396). No significant differences were found in OS (HR = 0.92; 95% confidence interval [CI]: 0.65–1.31) or DFS (HR = 0.70; 95% CI: 0.41–1.20). Heterogeneity was not detected in pooled OS analysis (P = .18; I 2 = 30%), but was in pooled DFS analysis (P = .003; I 2 = 66%). Conclusions No statistically significant differences in OS or DFS were observed between SNB and END in cT1-2N0 OCSCC, suggesting that SNB might be an alternative to END in the management of early-stage, clinically node-negative OCSCC. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perioperative Complication Profile of Skull Base Meningioma Resection in Older versus Younger Adult Patients

xlomafota13 shared this article with you from Inoreader Perioperative Complication Profile of Skull Base Meningioma Resection in Older versus Younger Adult Patients Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1736408 Objectives To better understand the risk-benefit profile of skull base meningioma resection in older patients, we compared perioperative complications among older and younger patients. Design Present study is based on retrospective outcomes comparison. Setting The study was conducted at a single neurosurgery institute at a quaternary center. Participants All older (age ≥ 65 years) and younger (<65 years) adult patients treated with World Health Organization grade 1 skull base meningiomas (2008–2017). Main Outcome Measures Perioperative complications and patient functional status are the primary outcomes of this study. Results The analysis included 287 patients, 102 older and 185 younger, with a mean (standard deviation [SD]) age of 72 (5) years and 51 (9) years (p < 0.01). Older patients were more likely to have hypertension (p < 0.01) and type 2 diabetes mellitus (p = 0.01) but other patient and tumor factors did not differ (p ≥ 0.14). Postoperative medical complications were not significantly different in older versus younger patients (10.8 [11/102] vs. 4.3% [8/185]; p = 0.06) nor were postoperative surgical complications (13.7 [14/102] vs. 10.8% [20/185]; p = 0.46). Following anterior skull base meningioma resection, diabetes insipidus (DI) was more common in older versus younger patients (14 [5/37] vs. 2% [1/64]; p = 0.01). Among older patients, a decreasing preoperative Karnofsky performance status score independently predicted perioperative complications by logistic regression analysis (p = 0.02). Permanent neurologic deficits were not signific antly different in older versus younger patients (12.7 [13/102] vs. 10.3% [19/185]; p = 0.52). Conclusion The overall perioperative complication profile of older and younger patients was similar after skull base meningioma resection. Older patients were more likely to experience DI after anterior skull base meningioma resection. Decreasing functional status in older patients predicted perioperative complications. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identifying distinct risks of treatment failure in nasopharyngeal carcinoma: A study based on the dynamic changes in peripheral blood lymphocytes, monocytes, N classification, and plasma Epstein‐Barr virus DNA

xlomafota13 shared this article with you from Inoreader Identifying distinct risks of treatment failure in nasopharyngeal carcinoma: A study based on the dynamic changes in peripheral blood lymphocytes, monocytes, N classification, and plasma Epstein‐Barr virus DNA Via Head & Neck Abstract Background To evaluate the prognostic value of the dynamic change in absolute lymphocyte counts (ALCs) and absolute monocyte counts (AMCs) and identify patients with N stage and plasma Epstein-Barr virus (EBV) DNA levels in nasopharyngeal carcinoma (NPC) who are at risk of treatment failure. Methods A total of 1124 eligible patients with Stage II–IVb NPC treated with concurrent chemoradiotherapy (CCRT) were enrolled. Percentage changes in the ALC (ΔALC%) and AMC (ΔAMC%) were calculated. Results Patients with high ΔALC% were correlated with poorer 5-year overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) rates than those with low ΔALC%. Likewise, high ΔAMC% was significantly associated with worse outcome than low ΔAMC% (OS, p = 0.001; PFS, p = 0.001; DMFS, p = 0.034). Multivariate analyses revealed that ΔALC% (p = 0.046), ΔAMC% (p = 0.019), and EBV DNA level (p < 0.001) were independent prognostic factors for OS. With respect to PFS, ΔALC% (p = 0.036), ΔAMC% (p = 0.011), N classification (p = 0.016), and EBV DNA level (p < 0.001) were also independent prognosticators. Based on the aforementioned independent risk factors (ΔALC% ≥ 83.33%, ΔAMC% ≥ 40.00%, Stage N2–3, EBV DNA ≥ 4000 copies/ml), patients were divided into three differen t risk groups (low-risk group [with <1 risk factor], intermediate risk group [with 1–3 risk factors], and high-risk group [with 4 risk factors]) that correlated with disparate risks of death (p < 0.001), disease progression (p < 0.001), and distant metastasis (p < 0.001). Conclusions High ΔALC% and ΔAMC% were correlated with poor prognosis in patients with NPC. Risk stratification based on ΔALC%, ΔAMC%, N classification, and plasma EBV DNA levels could provide potential utility for risk-adapted therapeutic strategies for NPC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

miR‐29a‐3p promotes migration and invasion in ameloblastoma via Wnt/β‐catenin signaling by targeting catenin beta interacting protein 1

xlomafota13 shared this article with you from Inoreader miR‐29a‐3p promotes migration and invasion in ameloblastoma via Wnt/β‐catenin signaling by targeting catenin beta interacting protein 1 Via Head & Neck Abstract Background Ameloblastoma (AB) is a common epithelial odontogenic tumor. The Wnt/β-catenin pathway has been found to be related to AB invasion. Methods The alteration expression of microRNAs (miRNAs) and messenger RNAs (mRNAs) was performed by miRNA and mRNA microarray analysis and validated by quantitative real-time polymerase chain reaction (RT-PCR). The effects of miR-29a-3p on migration and invasion in AB cells were evaluated by a transwell assay. Bioinformatic prediction was conducted using the miRSystem and validated by quantitative RT-PCR, western blot, and a luciferase reporter assay. Results miR-29a-3p was overexpressed in AB tissues, which promoted the migration and invasion of AB cells in vitro. Catenin beta interacting protein 1 (CTNNBIP1), a negative regulator of the Wnt/β-catenin pathway, was predicted to be a target of miR-29a-3p. miR-29a-3p inhibited the expression of CTNNBIP1 and promoted the expression of the downstream molecules of the Wnt/β-catenin pathway. Conclusions miR-29a-3p promoted migration and invasion in AB via Wnt/β-catenin signaling by targeting CTNNBIP1. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Investigating Hearing Function in Pediatric Patients with Renal Dysfunction: In Pursuit of Preventive Audiology Outcomes

xlomafota13 shared this article with you from Inoreader Investigating Hearing Function in Pediatric Patients with Renal Dysfunction: In Pursuit of Preventive Audiology Outcomes Via Otolaryngology Indian Abstract Chronic kidney is being increasingly recognized as a global health problem with effects that have implications for both mortality and morbidity; with hearing loss being one of the effects that has an impact on quality of life. This study aimed to describe hearing function in a group of children with chronic renal dysfunction receiving treatment in an academic hospital in Johannesburg, South Africa. One hundred children between the ages 5 and 18 years (mean age 11.68) were included in the study. A cross-sectional, descriptive, quantitative research design was employed. All participants underwent a case history interview and an audiological examination which included otoscopy, immittance testing, pure tone audiometry including extended high frequency testing up to 16 kHz as well as diagnostic distortion product otoacoustic emission testing. A medical record review was also done. Both descriptive and inferential statistics were used to analyze the collecte d data. Results revealed that there was a high prevalence of hearing loss in this group. The most common hearing loss was a low and high to ultrahigh frequency mild sensorineural hearing loss. No relationship between the severity of hearing loss and the severity of renal dysfunction, or the duration of renal dysfunction and the duration of treatment was found. However, a relationship between the severity of hearing loss and certain treatments was found. These were v hemodialysis and the use of ototoxic medication such as loop diuretics, tuberculosis medication, and antimalarial medication. Current findings highlight the importance of extended high frequency audiometry as well as diagnostic distortion product otoacoustic emission testing for early detection of hearing impairment, in pursuit of preventive audiology outcomes, in ototoxic monitoring in this population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Autologous reconstructions are associated with greater overall medium-term care costs than implant-based reconstructions in the Finnish healthcare system: A retrospective interim case-control cohort study

xlomafota13 shared this article with you from Inoreader Autologous reconstructions are associated with greater overall medium-term care costs than implant-based reconstructions in the Finnish healthcare system: A retrospective interim case-control cohort study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 17:S1748-6815(21)00407-1. doi: 10.1016/j.bjps.2021.08.020. Online ahead of print. ABSTRACT PURPOSE: Previous studies have mainly reported the short-term costs of different reconstruction techniques. Revision operations may increase costs in longer follow-up. Authors report medium-term data on different reconstruction methods. We hypothesised that the reconstruction method would affect not only the duration of reconstruction process but also total costs. METHODS: The reconstruction database was reviewed from 2008 to 2019. Women with autologous (deep inferior epigastric perforator, transverse musculocutaneous gracilis and latissimus dorsi [LD] without implant) and implant-based (implant and LD with implant) reconstructions were included. Variables evaluated included age, body mass index, smoking, comorbidities, radiotherapy, complications and readmissions. Risk factors for multiple revision s urgeries were analysed. Time to definitive reconstruction and related costs were also calculated. RESULTS: In total, 591 patients with autologous reconstructions and 202 with implant-based reconstructions were included. The median follow-up time was 73 months. Definitive reconstruction was obtained in 443 days in implant-based reconstructions and in 403 days in autologous reconstructions (P = 0.050). Independent risk factors for multiple surgeries were younger age (P < 0.001) and comorbidity (P = 0.008). No statistically significant difference was observed in the rate of overall surgical procedures (P = 0.098), but implant-based reconstructions were more commonly associated with two or more planned operations (P = 0.008). Autologous reconstructions were associated with greater total cost ($22 052 vs. $18 329, P < 0.001). CONCLUSIONS: This review of reconstructions over a 12-year study period revealed that autologous reconstructions are associated with greater overa ll costs, but there is no statistically significant difference in reconstruction time or rate of surgical procedures. However, a full cost assessment between reconstructive techniques requires a much longer follow-up period. PMID:34627717 | DOI:10.1016/j.bjps.2021.08.020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.