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Letter to the editor: Effect of changing postoperative pain management on bleeding rates in tonsillectomy patients.
Am J Otolaryngol. 2018 Sep 30;:
Authors: Lou Z
PMID: 30473170 [PubMed - as supplied by publisher]
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Update on the diagnostic considerations for neurogenic nasal and sinus symptoms: A current review suggests adding a possible diagnosis of migraine.
Am J Otolaryngol. 2018 Oct 02;:
Authors: Godley FA, Casiano RR, Mehle M, McGeeney B, Gottschalk C
Abstract
BACKGROUND: Treatment of rhinosinusitis (RS) is one of the leading reasons for prescriptions of antibiotics, although they often fail to provide symptomatic relief. Appropriately diagnosing and treating patients presenting with RS for whom antibiotic therapy has failed or who have normal CT findings is a controversial topic. One explanation is that what these patients are experiencing is misinformation from the trigeminal nerve and autonomic nervous system. Midfacial pain and pressure with rhinorrhea and nasal congestion do not represent an infectious, or even inflammatory, condition within the sinus or nasal cavities, but a mirage that is best treated as a migraine variant. Observations Although there is not enough research to definitively prove this alternate etiology, we are reaching a tipping point where the clinical implications, real-world experience, and evolving literature support this possible alternate etiology. Four key factors support a midfacial migraine that mimics RS: 1) Pathophysiology: current pathophysiology literature offers a model of how migraine attacks could replicate clinical presentations of RS; 2) Clinical presentation: patients with infectious RS and midfacial migraine have similar symptomatic presentation, similar demographics, but poorly correlated radiological information; 3) Diagnosis: clinical studies support the proposition that there are alternative diagnostic tools for distinguishing patients with midfacial migraine; and 4) Prognosis: Select RS patients show significant improvement with migraine treatment.
CONCLUSIONS: We encourage medical professionals to consider migraine disease as a form of sensory misinformation and as a possible etiology of RS complaints. Clinicians can ask validated questions to determine if possible migraine could be an underlying cause, and there are standard preventative treatments for migraine that could alleviate patient symptoms. Dysfunctional vasomotor activity may be the root of the disturbances, particularly when antibiotic therapy fails and CT findings are discordant with symptoms. Until there is a diagnostic test for migraine, clinicians need to question a patient's self-diagnosis of rhinosinusitis. More research is needed to definitively answer this important question.
PMID: 30473169 [PubMed - as supplied by publisher]
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Audiological outcomes in sudden sensorineural hearing loss with presumed inner ear hemorrhage.
Am J Otolaryngol. 2018 Sep 26;:
Authors: Chen K, Wen L, Zong L, Liu M, Sun J, Wu X
Abstract
OBJECTIVE: To explore the hearing outcomes and prognostic factors in patients with sudden sensorineural hearing loss resulting from inner ear hemorrhage.
METHODS: 42 patients (22 male and 20 female) were recruited from January 2016 to December 2017. Intravenous methylprednisolone and/or intratympanic corticosteroid were used as salvage therapy. The main measures included systemic risk factors and audiometric outcomes as proposed by American Academy of Otolaryngology-Head and Neck Surgery Hearing Loss Scale. All individuals were assessed at baseline, discharge (2 weeks post-treatment) and at 1, 3 and 6 months.
RESULTS: The mean ages of patients were 39.3 ± 14.8 yrs. Cardiovascular disorders were seen in 19.0-33.3% of cases. Restoration of hearing and speech discrimination abilities were assessed at the first month post-treatment versus initial levels (95.5 ± 15.5 vs. 109.2 ± 9.6 dB, p = 0.000; and 17.6 ± 24.4 vs. 1.3 ± 4.0%, p = 0.003, respectively). Word recognition scores continued to recover at month 6 (38.7 ± 35.4%, p = 0.000), whereas puretone ceased to change (90.8 ± 16.2 dB, p = 0.139). The final percentages of complete, partial and no recovery were 0%, 57.1% and 42.9% respectively. The prognosis was independent of accompanying systemic risk factors as analyzed in this study. Intratympanic intervention was associated with improved word recognition scores, although intravenous corticosteroid was not.
CONCLUSIONS: Profound sudden sensorineural hearing loss caused by inner ear hemorrhage often has an unsatisfactory prognosis. However, this cohort did experience partial audiological recovery with delayed onset. Immediate and effective intratympanic corticosteroid may have therapeutic potential for this intractable disease.
PMID: 30473168 [PubMed - as supplied by publisher]
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The pedicled levator labii superioris alaeque nasi flap: A durable single-stage option for reconstruction of full-thickness nasal defects.
Am J Otolaryngol. 2018 Oct 02;:
Authors: Moore K, Thompson R, Lian T
Abstract
IMPORTANCE: Repair of full-thickness nasal defects can often be associated with multi-stage operations that can result in significant physical and psychological morbidity for patients. We present a single-stage option for reconstruction of these defects.
OBJECTIVE: Demonstrate the utility of the pedicled levator labii superioris alaeque nasi flap and consistency of its vascular pedicle.
DESIGN: Anatomical study using fresh cadavers.
SETTING: Academic medical center.
MAIN OUTCOME AND MEASURES: Evaluation of vascular anatomy of pedicled flap and measurements of distances with relationship to facial anatomic landmarks.
RESULTS: With few noted anatomic variations, the vascular pedicle of the pedicled levator labii superioris alaeque nasi flap arises from the superior labial artery and is reliably located within 1 cm lateral and inferior of the nasal sill.
CONCLUSIONS AND RELEVANCE: As a robust single-stage option, the pedicled levator labii superioris alaeque nasi flap can serve as a powerful option in the arsenal of the reconstructive surgeon. The technique for harvest is simple with attention to a few anatomic variations as described herein, and excellent results can be obtained with proper application.
PMID: 30473167 [PubMed - as supplied by publisher]
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Diagnostic accuracy of F-18 FDG PET or PET/CT for detection of lymph node metastasis in clinically node negative head and neck cancer patients; A systematic review and meta-analysis.
Am J Otolaryngol. 2018 Oct 23;:
Authors: Kim SJ, Pak K, Kim K
Abstract
OBJECTIVE: The purpose of the current study was to investigate the diagnostic performance of F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) for the detection of cervical lymph node (LN) metastasis in clinically node negative head and neck squamous cell cancer (cN0 HNSCC) patients through a systematic review and meta-analysis.
METHODS: The PubMed and EMBASE database, from the earliest available date of indexing through April 30, 2018, were searched for studies evaluating the diagnostic performance of F-18 FDG PET or PET/CT for the detection of LN metastasis in cN0 HNSCC patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (SROC) curves.
RESULTS: Across 18 studies (1044 patients), the pooled sensitivity for F-18 FDG PET or PET/CT for the detection of LN metastasis was 0.58 and a pooled specificity of 0.87 for patient based analysis. Neck side based analysis showed the pooled sensitivity of 0.67 and a pooled specificity of 0.85. Level based study demonstrated the pooled sensitivity of 0.53 and a pooled specificity of 0.97 (95% CI; 0.95-0.98). In meta-regression analysis, no definite variable was the source of the study heterogeneity.
CONCLUSION: The current meta-analysis showed the low sensitivity and moderate specificity of F-18 FDG PET/CT for the detection of cervical LN metastasis in cN0 HNSCC patients. Level based analysis of F-18 FDG PET or PET/CT has a high specificity and NPV for the detection of cervical metastatic LN detection.
PMID: 30473166 [PubMed - as supplied by publisher]
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Cardiopulmonary Responses During Clinical and Laboratory Gait Assessment in People With Chronic Stroke.
Phys Ther. 2018 Nov 26;:
Authors: Woodward JL, Connolly M, Hennessy PW, Holleran CL, Mahtani GB, Brazg G, Fahey M, Maganti K, Hornby TG
Abstract
Background: The 6-minute walk test (6MWT) is a common clinical assessment used to evaluate locomotor function in patients after stroke. Previous work suggests the 6MWT can estimate peak metabolic capacity (VO2peak) without cardiorespiratory assessments during graded exercise tests (GXTs) which may assist with exercise prescription. However, selected research also indicated increased heart rates (HRs) during 6MWTs beyond levels considered safe without GXTs.
Objective: The goal of this study was to examine cardiorespiratory responses during 6MWTs and GXTs in individuals with chronic stroke and their associations with demographic or clinical characteristics.
Design: The design was a cross-sectional observational study.
Methods: Cardiorespiratory responses were assessed during 6MWTs at self-selected velocity (SSV) and fastest velocity (FV), and during GXTs. Secondary assessments included the lower extremity Fugl-Meyer Assessment, Functional Gait Assessment, gait speeds, and daily stepping activity. Correlation and regression analyses were used to evaluate associations between locomotor performance, cardiorespiratory responses, and clinical and demographic characteristics.
Results: Average HRs during 6MWT-FV were 72% to 76% of the age-predicted maximum (HRmax), with 20% of participants exceeding 85% predicted HRmax. When normalized to HRs during GXTs, HRs during 6MWT-FV were 86% to 88% of the observed HRmax. Primary predictors of increased HRs during 6MWTs were resting HR, body mass index, and daily stepping. Distance during 6MWT-FV was a significant predictor of VO2peak in combination with other variables. Electrocardiographic abnormalities were observed in > 80% of participants at rest and an additional 31% demonstrated distinct abnormalities during GXTs, which were not related to 6MWT or GXT performance.
Limitations: In addition to sample size, a primary limitation involved the ability to accurately predict or measure HRmax in patients with motor dysfunction after stroke.
Conclusions: Cardiac responses were higher than anticipated during 6MWTs and often exceeded recommended HR thresholds. Clinicians should closely monitor cardiorespiratory responses during 6MWTs.
PMID: 30476281 [PubMed - as supplied by publisher]
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Low-Level Laser Therapy and Electrotherapy for Neck Pain: "Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain," Bier JD, Scholten-Peeters WGM, Staal JB, et al. Phys Ther. 2018;98:162-171.
Phys Ther. 2018 Nov 26;:
Authors: da Silva ÉR, Bellew JW, Pinfildi CE, Guerra RLS, Liebano RE
PMID: 30476228 [PubMed - as supplied by publisher]
47 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2018/11/27
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
16 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2018/11/27
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
| Related Articles |
External accelerated partial breast irradiation for ductal carcinoma in situ: long-term follow-up from a phase 3 randomized trial.
Tumori. 2018 Nov 26;:300891618811278
Authors: Becherini C, Meattini I, Livi L, Garlatti P, Desideri I, Scotti V, Orzalesi L, Sanchez LJ, Bernini M, Casella D, Nesi S, Nori J, Bianchi S, Pallotta S, Marrazzo L
Abstract
INTRODUCTION:: For a long time, accelerated partial breast irradiation (APBI) effectiveness for ductal carcinoma in situ (DCIS) has been debated, due to conflicting published results. Recent encouraging data from phase 3 trials reopened new perspectives for this radiation approach. The aim of the present study was to analyze the long-term efficacy and safety results of the series of patients with DCIS enrolled in the APBI arm of the APBI-IMRT-Florence phase 3 trial (NCT02104895).
METHODS:: Patients were treated in a phase 3 randomized trial comparing whole breast irradiation (50 Gy in 25 fractions to the whole breast, plus 10 Gy in 5 fractions to the tumor bed) to APBI (30 Gy in 5 nonconsecutive fractions) using the intensity-modulated radiotherapy technique.
RESULTS:: Overall, 22 patients were treated in the APBI arm. Median age was 62 years (mean 59; range 42-75 years). At a median follow-up of 9.2 years (mean 8.8; range 3.8-12.1 years), no contralateral invasive/DCIS occurrence, distant metastasis, or breast cancer-related death were recorded. The 5- and 10-year local recurrence, distant metastasis-free survival, and breast cancer-specific survival were 100%. The 10-year overall survival rate was 90.9%. No late toxicity at 5 and 10 years was recorded.
CONCLUSIONS:: Waiting for pending studies and mature follow-up, we confirmed the efficacy and safety of APBI for low-risk DCIS.
PMID: 30474504 [PubMed - as supplied by publisher]
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Time to systemic treatment and prognosis in patients with recurrent and metastatic head and neck squamous cell cancer.
Tumori. 2018 Nov 26;:300891618811276
Authors: Siano M, Espeli V, Joerger M
Abstract
BACKGROUND:: Delay of systemic treatment in recurrent/metastatic head and neck squamous cell cancer (r/mHNSCC) has never been assessed. Whether time span to start systemic treatment affects survival and whether referral to a medical oncologist is important has not been explored.
METHODS:: We analyzed our head and neck database to assess the prognostic impact of time between diagnosis of r/mHNSCC and start of systemic treatment (time to treatment [TTT]). Secondarily, we assessed the prognostic impact of time to referral to a medical oncologist (referral time). For this purpose, we used pairwise correlation analysis and multivariate Cox regression analysis as statistical tests.
RESULTS:: A total of 110 patients with r/mHNSCC were evaluable for analysis. TTT correlated significantly with OS from r/mHNSCC diagnosis ( R = .43, p < .0001). A nonsignificant, positive correlation was found between referral time and OS ( R = .17, p = .10).
CONCLUSIONS:: Results of this retrospective analysis suggest that longer TTT is not associated with worse prognosis. Referral time seems not to have an impact on prognosis.
PMID: 30474503 [PubMed - as supplied by publisher]
| Related Articles |
Patients' understanding of clinical research: An Italian cancer patient survey.
Tumori. 2018 Nov 26;:300891618811281
Authors: Rudnas B, Montanari E, Dall'Agata M, Petracci E, Nanni O
Abstract
INTRODUCTION:: Patients' awareness of clinical research and their involvement in clinical trials is of great importance, but it is difficult to estimate the extent of knowledge on the research being undertaken.
METHODS:: We evaluated the level of knowledge about clinical research using a self-reporting survey distributed to 967 adult patients with cancer attending the Departments of Medical Oncology and Onco-Haematology Units of IRST IRCCS and 4 hospitals in the region of Emilia-Romagna, Italy. The questionnaire was composed of 10 specific items on research knowledge. Patients responding correctly to at least 8 of the 10 items were considered to have a good understanding of clinical research.
RESULTS:: The questionnaire was completed by 769 patients (response rate 79.5%). Only 19% of patients were found to have a good understanding of clinical research. Patients with higher education and those who had previous clinical trial experience showed a significantly better understanding. Fifty-three percent of patients said that they would be willing to participate in a trial studying a new drug and 75% expressed an interest in taking part in informative meetings/events about clinical studies.
CONCLUSIONS:: Our results show that patients' understanding of clinical research is limited and highlight an interest in learning more.
PMID: 30474502 [PubMed - as supplied by publisher]
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Frequent blood donations alter susceptibility of red blood cells to storage- and stress-induced hemolysis.
Transfusion. 2018 Nov 26;:
Authors: Kanias T, Stone M, Page GP, Guo Y, Endres-Dighe SM, Lanteri MC, Spencer BR, Cable RG, Triulzi DJ, Kiss JE, Murphy EL, Kleinman S, Gladwin MT, Busch MP, Mast AE, NHLBI Recipient Epidemiology Donor Evaluation Study (REDS)-III Program
Abstract
BACKGROUND: Frequent whole blood donations increase the prevalence of iron depletion in blood donors, which may subsequently interfere with normal erythropoiesis. The purpose of this study was to evaluate the associations between donation frequency and red blood cell (RBC) storage stability in a racially/ethnically diverse population of blood donors.
STUDY DESIGN: Leukoreduced RBC concentrate-derived samples from 13,403 donors were stored for 39 to 42 days (1-6°C) and then evaluated for storage, osmotic, and oxidative hemolysis. Iron status was evaluated by plasma ferritin measurement and self-reported intake of iron supplements. Donation history in the prior 2 years was obtained for each subject.
RESULTS: Frequent blood donors enrolled in this study were likely to be white, male, and of older age (56.1 ± 5.0 years). Prior donation intensity was negatively associated with oxidative hemolysis (p < 0.0001) in multivariate analyses correcting for age, sex, and race/ethnicity. Increased plasma ferritin concentration was associated with increased RBC susceptibility to each of the three measures of hemolysis (p < 0.0001 for all), whereas self-reported iron intake was associated with reduced susceptibility to osmotic and oxidative hemolysis (p < 0.0001 for both).
CONCLUSIONS: Frequent blood donations may alter the quality of blood components by modulating RBC predisposition to hemolysis. RBCs collected from frequent donors with low ferritin have altered susceptibility to hemolysis. Thus, frequent donation and associated iron loss may alter the quality of stored RBC components collected from iron-deficient donors. Further investigation is necessary to assess posttransfusion safety and efficacy in patients receiving these RBC products.
PMID: 30474858 [PubMed - as supplied by publisher]
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Why articles continue to be cited after they have been retracted: An audit of retraction notices.
Int J Nurs Stud. 2018 Nov 10;90:11-12
Authors: Gray R, Al-Ghareeb A, McKenna L
Abstract
BACKGROUND: Papers continue to be cited by authors even after they have been retracted. Retraction notices provide readers with information about retracted papers and may help minimise post-retraction citation. To date, a review of the quality of retraction notices in nursing science has not been reported.
DESIGN: An audit of retraction notices associated with 29 retracted manuscripts published in nursing science journals.
METHODS: Retraction notices were reviewed again using the Committee on Publication Ethics (COPE) guidelines.
RESULTS: In total, 28 retraction notices were retrieved and reviewed (one retracted paper did not have a retraction notice). Details of the retracted manuscripts were included in all reviewed notices and, in all but two, author names were reported. Details of the time between a paper being published and retracted were not reported and generally there was a little information in notices about how the retraction decisions were made. All retraction notices were freely available. Seven notices stated who had made the decision to retract. Twenty-two (77%) notices stated the reason for retraction. Notices were brief and contained factual information. The webpages of three retracted articles did not clearly indicate that the paper had been retracted.
CONCLUSION: More detailed and informative retraction notices will inform readers and may help reduce post- retraction citation.
PMID: 30476725 [PubMed - as supplied by publisher]
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Variation in the barriers to compassion across healthcare training and disciplines: A cross-sectional study of doctors, nurses, and medical students.
Int J Nurs Stud. 2018 Oct 26;90:1-10
Authors: Dev V, Fernando AT, Kirby JN, Consedine NS
Abstract
BACKGROUND: Despite the established importance of compassion in health, studies examining the specific barriers to compassionate care in healthcare are few. Recent work suggests that examining differences as a function of professional development and identifying variation in barriers to compassionate care across professions may highlight the origins of barriers and inform the development of compassion-enhancing interventions suited to the unique challenges of different professions and stages of training.
OBJECTIVES: To explore whether the barriers to compassion vary (a) between physicians and nurses and (b) across samples of physicians and medical students (i.e., as a function of development and clinical experience). It was expected that medical students would report greater barriers than physicians and that nurses would generally report lower barriers to compassion, other than for external barriers.
METHODS: Registered nurses, physicians, and medical students were recruited using convenience sampling in New Zealand. Following consent, 1700 participants (801 nurses, 516 physicians, and 383 medical students) completed a survey including the Copenhagen Burnout Inventory and the Barriers to Physician Compassion questionnaire.
RESULTS: As expected, medical students reported greater barriers to compassion than physicians and nurses, with both professions generally reporting lower barriers. However, and also consistent with hypotheses, nurses reported greater work-environment-related barriers relative to physicians.
DISCUSSION: Students reported greater barriers than physicians. While nurses generally reported lower barriers than physicians, they specifically reported greater work environment-related barriers. For nurses, results highlight the importance of implementing interventions that reduce external barriers to compassion, specifically the need to alleviate the structural barriers and restrictions that nurses face. For medical students and younger healthcare professionals, the results highlight the importance of mentorship, support, and ongoing professional and emotional development.
PMID: 30476724 [PubMed - as supplied by publisher]
96 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
upper respiratory tract infection
These pubmed results were generated on 2018/11/27
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
| Related Articles |
Lingual ectopic papillary thyroid carcinoma: Two case reports and review of the literature.
Oral Oncol. 2018 Nov 22;:
Authors: Huang NS, Wei WJ, Qu N, Wang YL, Wang Y, Ji QH
Abstract
Ectopic thyroid occurs when it is not located on the normal thyroid compartment. While 90% of the ectopic thyroids were located at the base of the tongue, only 1% were lingual thyroid carcinoma (LTC). Only 56 LTC cases have been reported so far. Here we reported two cases of LTC. Patient 1 was a 47-year-old female with LTC and co-current sub-hyoid ectopic thyroid. She experienced major hematemesis and dyspnea requiring emergent tracheotomy. Patient 2 was a 61-year old female who was presented with LTC with multiple lymph node metastasis and bilateral lung metastasis. Both of the patients' lingual masses were removed via trans-submaxillary excisions. Pathology revealed ectopic papillary thyroid carcinoma. Then they were treated with radio-active iodine (RAI). These patients had full recovery and there were no complications. A review of literature was also presented.
PMID: 30473413 [PubMed - as supplied by publisher]
| Related Articles |
Folate receptor-targeted novel boron compound for boron neutron capture therapy on F98 glioma-bearing rats.
Radiat Environ Biophys. 2018 Nov 24;:
Authors: Kanemitsu T, Kawabata S, Fukumura M, Futamura G, Hiramatsu R, Nonoguchi N, Nakagawa F, Takata T, Tanaka H, Suzuki M, Masunaga SI, Ono K, Miyatake SI, Nakamura H, Kuroiwa T
Abstract
Folic acid (FA) has high affinity for the folate receptor (FR), which is limited expressed in normal human tissues, but over-expressed in several tumor cells, including glioblastoma cells. In the present work, a novel pteroyl-closo-dodecaborate conjugate (PBC) was developed, in which the pteroyl group interacts with FR, and the efficacy of boron neutron capture therapy (BNCT) using PBC was investigated. Thus, in vitro and in vivo studies were performed using F98 rat glioma cells and F98 glioma-bearing rats. For the in vivo study, boronophenylalanine (BPA) was intravenously administered, while PBC was administered by convection-enhanced delivery (CED)-a method for direct local drug infusion into the brain of rats. Furthermore, a combination of PBC administered by CED and BPA administered by intravenous (i.v.) injection was also investigated. In the biodistribution experiment, PBC administration at 6 h after CED termination showed the highest cellular boron concentrations (64.6 ± 29.6 µg B/g). Median survival time (MST) of untreated controls was 23.0 days (range 21-24 days). MST of rats administered PBC (CED) followed by neutron irradiation was 31 days (range 26-36 days), which was similar to that of rats administered i.v. BPA (30 days; range 25-37 days). Moreover, the combination group [PBC (CED) and i.v. BPA] showed the longest MST (38 days; range 28-40 days). It is concluded that a significant MST increase was noted in the survival time of the combination group of PBC (CED) and i.v. BPA compared to that in the single-boron agent groups. These findings suggest that the combination use of PBC (CED) has additional effects.
PMID: 30474719 [PubMed - as supplied by publisher]
23 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2018/11/27
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
| Related Articles |
Lingual ectopic papillary thyroid carcinoma: Two case reports and review of the literature.
Oral Oncol. 2018 Nov 22;:
Authors: Huang NS, Wei WJ, Qu N, Wang YL, Wang Y, Ji QH
Abstract
Ectopic thyroid occurs when it is not located on the normal thyroid compartment. While 90% of the ectopic thyroids were located at the base of the tongue, only 1% were lingual thyroid carcinoma (LTC). Only 56 LTC cases have been reported so far. Here we reported two cases of LTC. Patient 1 was a 47-year-old female with LTC and co-current sub-hyoid ectopic thyroid. She experienced major hematemesis and dyspnea requiring emergent tracheotomy. Patient 2 was a 61-year old female who was presented with LTC with multiple lymph node metastasis and bilateral lung metastasis. Both of the patients' lingual masses were removed via trans-submaxillary excisions. Pathology revealed ectopic papillary thyroid carcinoma. Then they were treated with radio-active iodine (RAI). These patients had full recovery and there were no complications. A review of literature was also presented.
PMID: 30473413 [PubMed - as supplied by publisher]
17 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2018/11/27
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
| Related Articles |
Common left carotid bifurcation at C7-Th1 level: a rare anatomical variant.
Surg Radiol Anat. 2018 Nov 24;:
Authors: Charalambous S, Hatzidakis A, Peteinarakis I, Megremis S, Karantanas A
Abstract
The left common carotid artery usually bifurcates to the internal and external carotids at or near the superior border of thyroid cartilage. In head and neck surgery, the common carotid arteries are important landmarks, defining the plane of dissection during radical neck surgeries. According to the literature, many variations exist regarding the carotid bifurcation. Anatomical knowledge of these variants is important for surgical approaches in the head and neck regions, to avoid devastating complications that may occur, mainly during anterior neck dissections. We report an interesting case of a 75-year-old male patient with low bifurcation of the left common carotid artery, accidentally found during a routine carotid Doppler ultrasonography. Bifurcation was located at the C7-Th1 intervertebral disc height, approximately 4 cm from the aortic arch.
PMID: 30474710 [PubMed - as supplied by publisher]
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Costochondral Grafting for Nasal Airway Reconstruction in an Infant With Frontonasal Dysplasia.
J Craniofac Surg. 2018 Nov 20;:
Authors: Fujisawa K, Watanabe S, Kato M, Utsunomiya H, Watanabe A
Abstract
Frontonasal dysplasia (FND) is a congenital malformation of the central portion of the face, including the eyes, nose, and forehead. Owing to its rarity and wide spectrum of phenotypes, the optimal timing and technique of surgery remain controversial. Here, we report a case of a patient with FND, who presented with respiratory distress. The deformed nostrils were so small that the patient could not normally breathe through the nose immediately after birth. Rhinoplasty using a costochondral graft was performed at 16 months of age. After surgery, the nostrils enlarged and the appearance of the nose improved. Although congenital nasal deformity is frequently corrected during adolescence, surgery at an early stage can be considered when important issues are noted, such as inability to breathe through the nose.
PMID: 30475292 [PubMed - as supplied by publisher]
 | Related Articles |
Techniques in Septoplasty: Traditional Versus Endoscopic Approaches.
Otolaryngol Clin North Am. 2018 Oct;51(5):909-917
Authors: Shah J, Roxbury CR, Sindwani R
Abstract
This article provides a review of modern techniques in the surgical management of the deviated septum with emphasis on the comparison of traditional versus endoscopic septoplasty approaches. Relevant anatomy and physiology of the nasal septum are discussed. A brief history of the evolution of the surgical approaches for the correction of a deviated septum is provided. Traditional and endoscopic septoplasty techniques are reviewed; the indications, advantages, and limitations of each approach are highlighted. Potential complications of septoplasty, with a focus on prevention and management, are also discussed.
PMID: 30025848 [PubMed - indexed for MEDLINE]
| | Related Articles |
Office-Based Procedures for Nasal Airway Obstruction.
Otolaryngol Clin North Am. 2018 Oct;51(5):957-969
Authors: Bikhazi N, Atkins JH
Abstract
Treatment of common rhinologic problems with in-office surgical procedures has increased dramatically in response to patient preference, evolving insurance patterns, and changes in coding and reimbursement. Because this is an emerging practice, there is not a lot of evidence published about how to best perform these techniques. This article provides practical advice from experienced surgeons related to logistics and anesthetic techniques for conducting in-office surgical treatment of nasal airway obstruction; an overview of office set-up and necessary equipment; and specific procedural considerations. Attention also is paid to pharmacologic issues. Logistics and clinical considerations for common office-based procedures for obstructive pathology are reviewed.
PMID: 30017095 [PubMed - indexed for MEDLINE]
| | Related Articles |
Surgical Management of Nasal Valve Collapse.
Otolaryngol Clin North Am. 2018 Oct;51(5):929-944
Authors: Samra S, Steitz JT, Hajnas N, Toriumi DM
Abstract
Nasal valve collapse has multiple causes, including congenital, traumatic, and, unfortunately, iatrogenic. Recognition of the causes of nasal valve collapse and the methodology for treatment is paramount not only for the otolaryngologist but also for any physician managing the nasal airway. This article focuses on the cause and surgical management of internal and external nasal valve collapse.
PMID: 30017094 [PubMed - indexed for MEDLINE]
| | Related Articles |
Anatomy and Physiology of Nasal Obstruction.
Otolaryngol Clin North Am. 2018 Oct;51(5):853-865
Authors: Hsu DW, Suh JD
Abstract
Nasal obstruction is a common presenting symptom to clinicians and affects up to one-third of the population. There are several factors that cause nasal obstruction, including anatomic, physiologic, and pathophysiologic factors. The anatomy and physiology of nasal obstruction is complicated and is influenced by patency of nasal passages, mucociliary function, airflow receptors, autonomic function, and degree of mucosal inflammation. Common anatomic causes include internal nasal valve stenosis/collapse, septal deviation, and turbinate hypertrophy. Common physiologic causes include sinonasal inflammatory disorders and iatrogenic causes.
PMID: 29941182 [PubMed - indexed for MEDLINE]
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[Application of thin-ribbed cartilage with the perichondrium in correction of secondary cleft lip nasal deformity as lateral crural onlay graft].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 May 01;32(5):601-606
Authors: Yuan J, Wang W, Yang T, Li T, Geng Y, Gao H, Shao Y
Abstract
Objective: To explore the application and effectiveness of thin-ribbed cartilage with the perichondrium in the correction of secondary cleft lip nasal deformity as the lateral crural onlay graft.
Methods: A retrospective study was performed based on the data of 28 patients with secondary nasal deformity of cleft lip between October 2015 and April 2017. There were 16 males and 12 females with an average age of 24 years (range, 18-31 years). There were 11 cases with secondary nasal deformities on the left side, 13 cases on the right side, and 4 cases on both sides. Three-dimensional stereotaxy of the nasolabial muscles was used to correct the deformity. The costal cartilage as the support was used to perform nasal columella and nasal dorsum while the thin-ribbed cartilage with the perichondrium was used as wing cartilage support. The photography of nasal position was taken before operation and at 6-8 months after operation. The midpoint of the junction between the nasal columella and the upper lip was marked point O; the lateral horizontal line passing through the point O was marked as X-line, and the longitudinal line (the midline) as Y-line. The distance of the highest point of the affected nostril to the X-line, the distance of the nostril's outermost point to the Y-line, the symmetries of both the most lateral and the highest point of the bilateral nostrils, and the distance of the highest point of the nasal tip to the X-line were measured.
Results: All incisions healed by first intention. All patients were followed up 6 to 24 months with an average of 12 months. The size and shape of the noses were stable, and no compli cation, such as cartilage exposure, hematoma, or infection occurred during the postoperative follow-up. There were 4 cases with obvious incision scars, 3 cases with nostril and alar asymmetry, and 1 case of lateral side of the nose without well positioned. The symmetry of the highest points of bilateral nostrils was 57.643%±27.491% before operation and 90.246%±18.769% after operation. The symmetry of the most lateral points of the bilateral nostrils was 77.391%±30.628% before operation and 92.373%±21.662% after operation. And there were significant differences between pre- and post-operation ( P<0.05). There were also significant differences in the distance of highest point of the affected nostril to the X-line, the distance of the nostril's outermost point to the Y-line, and the distance of the highest point of the nasal tip to the X-line ( P<0.05). No thoracic contour change occurred at the costal cartilage donor site.
Conclusion: The thin-ribbed cartilage with the perichondrium has good support and long-term stability, and it can be used as one of the ideal materials for nasal alar cartilage transplantation for nasal deformity secondary to cleft lip.
PMID: 29806350 [PubMed - indexed for MEDLINE]
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Can a Saddle Nose Deformity of Granulomatosis with Polyangiitis be Repaired?
Aesthetic Plast Surg. 2017 12;41(6):1463-1464
Authors: Ito O, Yano T, Ito M
PMID: 28493095 [PubMed - indexed for MEDLINE]
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Oral health, academic performance, and school absenteeism in children and adolescents: A systematic review and meta-analysis.
J Am Dent Assoc. 2018 Nov 22;:
Authors: Ruff RR, Senthi S, Susser SR, Tsutsui A
Abstract
BACKGROUND: The authors conducted a systematic review and meta-analysis to provide a summary estimate of the association between oral health and academic performance.
TYPES OF STUDIES REVIEWED: The authors conducted a systematic search of PubMed, Embase, and Google Scholar for studies on oral health, school absence, and academic achievement published in English from January 1945 through December 2017. Exposures included subjectively or objectively measured caries, oral pain, and periodontitis. Outcomes included school absence and school achievement.
RESULTS: The authors screened a total of 2,041 studies, from which they extracted data from 14 studies of 139,989 children (12 cross-sectional studies, 1 case-control study, and 1 longitudinal study). Five studies had school absence as the primary outcome, and 7 studies had student achievement as the primary outcome. Three studies included both outcomes. The authors found no studies for periodontitis. The average modified Newcastle-Ottawa Scale score was 3.93. The authors rated 10 studies as having a low risk of bias and 4 as having a high risk of bias. Qualitative synthesis suggested that poor oral health may have negative effects on student absenteeism and achievement, but study quality was highly variable. Results from meta-analyses indicated that poor oral health was significantly associated with increased odds of poor academic performance (pooled odds ratio, 1.52; 95% confidence interval, 1.20 to 1.83) and absenteeism (pooled odds ratio, 1.43; 95% confidence interval, 1.24 to 1.63).
CONCLUSIONS AND PRACTICAL IMPLICATIONS: Increased focus on the broader implications of improvements in oral health for children, such as educational or socioemotional development, is of further interest to practicing dentists owing to the greater connection between oral health and general health. The authors of this study found that caries or tooth pain had a negative association with academic achievement and school absenteeism. However, study quality was limited by inconsistent exposure and outcome definitions and a predominance of cross-sectional designs. Thus, causal conclusions are not supported.
PMID: 30473200 [PubMed - as supplied by publisher]
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Clinical characteristics of acromegalic patients with paradoxical growth hormone response to oral glucose load.
J Clin Endocrinol Metab. 2018 Nov 23;:
Authors: Mukai K, Otsuki M, Tamada D, Kitamura T, Hayashi R, Saiki A, Goto Y, Arita H, Oshino S, Morii E, Saitoh Y, Shimomura I
Abstract
Context: Paradoxical GH response to oral glucose (OG) is often found in acromegaly. However, the clinical characteristics of acromegalic patients with paradoxical GH response to OG (OG responders) remains unclear.
Objective: The aim of the present study was to define the clinical characteristics of OG responders with acromegaly.
Design: Retrospective study.
Setting: Hospitalized care at Osaka University Hospital.
Patients and methods: Sixty-three acromegalic patients admitted to our hospital between January 2006 and January 2017 were classified into OG responders (n=19) and non-responders (n=44). The clinical characteristics of these groups were compared.
Results: Before surgery, OG responders had significantly higher IGF-1 SD scores than non-responders although there was no difference in basal GH levels between the two groups. With regard to glucose metabolism, 120-min PG and IRI after OG administration, and HbA1c were significantly higher in OG responders than non-responders. GH levels during octreotide or bromocriptine tests were decreased more significantly in OG responders than non-responders. The proportion of pituitary tumors with hypointensity on T2-weighted MRI was significantly higher in OG responders than non-responders. The difference in IGF-1 and parameters of glucose metabolism described above disappeared between the two groups after surgery.
Conclusions: Paradoxical GH response reflected the clinical characteristics, especially IGF-I levels, glucose metabolism and drug efficacy in acromegaly. Paradoxical GH response, in addition to the nadir GH levels, to OG load can be potentially useful for evaluation of the clinical characteristics of acromegaly.
PMID: 30476255 [PubMed - as supplied by publisher]
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Early Clinical Indicators of Addison's Disease in Adults with Type 1 Diabetes: a Nationwide, Observational, Cohort Study.
J Clin Endocrinol Metab. 2018 Nov 21;:
Authors: Chantzichristos D, Persson A, Miftaraj M, Eliasson B, Svensson AM, Johannsson G
Abstract
Context: Patients with type 1 diabetes mellitus (T1DM) have an increased risk of Addison's disease (AD) development but prediction of those at risk is not possible.
Objective: To determine whether there are early clinical indicators that may denote the development of AD in adults with T1DM.
Design: Observational, matched-cohort study.
Setting: Patient data from Swedish national registries (National Diabetes Register [NDR], Inpatient Register, Prescription Drug Register).
Participants: All T1DM patients diagnosed with concomitant AD (n=66) among the 36,514 adult patients with T1DM in the NDR between 1998-2013. Each case was matched to five controls with T1DM alone (n=330).
Main outcome measures: Clinical data and drug prescriptions were assessed prior to baseline (inclusion into the study) and prior to AD diagnosis. Analysis of covariance and estimated group proportions were used for comparisons.
Results: Prior to baseline, cases had a higher frequency of thyroid/antithyroid drug prescription than controls (9.1% vs 1.8%). Prior to AD diagnosis, cases had higher frequencies of diabetic retinopathy (12.1% vs 2.1%), infections requiring hospital admission (16.7% vs 2.1%), thyroid/antithyroid drug prescription (28.8% vs 7.0%), and glucagon prescription (18.2% vs 6.4%). There was no difference in glycated hemoglobin between the groups prior to baseline or prior to AD diagnosis.
Conclusions: These data suggest that medical treatment for thyroid disease, a severe infection, and glucagon prescription for severe hypoglycemia should raise the suspicion of AD development in adults with T1DM. Development of diabetic retinopathy might also be associated with glucocorticoid deficiency and the development of AD among patients with T1DM.
PMID: 30476180 [PubMed - as supplied by publisher]
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Impact of Route of Estrogen Administration on Bone Turnover Markers in Oligoamenorrheic Athletes and its Mediators.
J Clin Endocrinol Metab. 2018 Nov 23;:
Authors: Singhal V, Ackerman KE, Bose A, Torre Flores LP, Lee H, Misra M
Abstract
Objective: Transdermal, but not oral, estrogen replacement improves bone mineral density (BMD) in athletes with oligo-amenorrhea (OA). Our objective was to determine mechanisms that may explain the impact of route of estrogen administration on bone outcomes.
Methods: 73 OA between 14-25 years old received (i) a 17β-estradiol transdermal patch continuously with cyclic oral micronized progesterone (PATCH), (ii) a combined ethinyl estradiol and desogestrel pill (PILL), or (iii) no estrogen/progesterone (NONE) for 12-months. We evaluated morning fasting levels of a marker of bone formation [N-terminal propeptide of type 1 procollagen (P1NP)], a marker of bone resorption [N-telopeptide (NTX)], insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP3), total testosterone, estradiol, sex hormone-binding globulin (SHBG), sclerostin, preadipocyte factor-1 (Pref-1), brain-derived neurotrophic factor (BDNF), calcium, 25(OH) vitamin D, and parathyroid hormone (PTH) levels at baseline and 12-months.
Results: Groups did not differ for age, weight, exercise activity or markers of bone formation at baseline. Over 12 months, P1NP decreased the most in PILL group (p=0.03) associated with a decrease in IGF-1 levels (r=0.37; p=0.003). Sclerostin, Pref-1 and BDNF decreased in the PATCH group over 12 months. PATCH had the greatest increases in estradiol (p=<0.0001), and estradiol increases were associated with increases in bone density.
Conclusion: Transdermal 17β-estradiol given over 12 months does not cause the decrease in IGF-1 observed with oral ethinyl estradiol. It also leads to decreases in sclerostin, Pref-1 and BDNF, which may mediate the beneficial effects of estrogen.
PMID: 30476179 [PubMed - as supplied by publisher]
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Fascin-1 is a Novel Prognostic Biomarker Associated with Tumor Invasiveness in Adrenocortical Carcinoma.
J Clin Endocrinol Metab. 2018 Nov 23;:
Authors: Poli G, Ruggiero C, Cantini G, Canu L, Baroni G, Armignacco R, Jouinot A, Santi R, Ercolino T, Ragazzon B, Assie G, Mannelli M, Nesi G, Lalli E, Luconi M
Abstract
CONTEXT: Novel tumor markers are urgently needed to better stratify adrenocortical cancer (ACC) patients and improve therapies for this aggressive neoplasm.
OBJECTIVE: To assess the diagnostic and prognostic value of the actin-bundling protein fascin-1 (FSCN1) in adrenocortical tumors.
DESIGN, SETTING AND PARTICIPANTS: A local series of 37 malignant/37 benign adrenocortical tumors at Careggi University Hospital and two independent validation ACC cohorts (Cochin, TCGA) from the European Network for the Study of Adrenal Tumors were studied.
MAIN OUTCOME MEASURES: FSCN1 expression was quantified by immunohistochemistry, Western Blot and quantitative RT-PCR analyses in ACC specimens; overall and disease-free survival associated with FSCN1 expression were assessed by Kaplan-Meier analysis and compared with that of Ki67 labelling index and tumor stage.
RESULTS: In spite of the low diagnostic power, in the Florence ACC series, FSCN1 immunohistochemical detection appeared as an independent prognostic factor, also refining results obtained with staging and Ki67 labelling index. The robust prognostic power of FSCN1 levels was further confirmed in two independent ACC cohorts. A positive correlation was found between FSCN1 and Steroidogenic Factor-1 (SF-1), with a significant higher expression of both factors in ACCs at advanced stages and with at least one of the three Weiss score parameters associated with invasiveness. Moreover, we demonstrated FSCN1 role in promoting cell invasion in a human ACC cell line only in the case of increased SF-1 dosage.
CONCLUSIONS: These findings show that FSCN1 is a novel independent prognostic marker in ACC and may serve as a potential therapeutic target to block tumor spread.
PMID: 30476173 [PubMed - as supplied by publisher]
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Pubertal Development and Pregnancy Outcomes in 46,XX Patients with Nonclassic Lipoid Congenital Adrenal Hyperplasia.
J Clin Endocrinol Metab. 2018 Nov 23;:
Authors: Hatabu N, Amano N, Mori J, Hasegawa Y, Matsuura H, Sumitomo N, Nishizawa K, Suzuki M, Katakura S, Kanamoto N, Kamimaki T, Ishii T, Hasegawa T
Abstract
Context: Lipoid congenital adrenal hyperplasia (LCAH) is characterized by a disorder of steroidogenesis in both adrenal glands and gonads. 46,XX patients with classic LCAH usually have thelarche and menarche, but show anovulatory menstruations and subsequent premature menopause. Only three patients with classic LCAH have been reported to successfully achieve delivery with the aid of assisted reproductive therapies for conception and progesterone replacement therapy during early pregnancy. In contrast, pubertal development and pregnancy outcomes in patients with nonclassic LCAH have not been fully elucidated.
Case description: We report four Japanese women who were diagnosed as having primary adrenal insufficiency during infancy or childhood and carried compound heterozygous STAR mutations (p.Gln258* and p.Arg188His, p.Gln258* and p.Met225Thr, and p.Gln258* and p.Arg272Cys). In all four patients, thelarche and menarche spontaneously occurred from 10 to 11 years of age and from 12 to 14 years of age, respectively. Subsequently, their menstruation cycles were regular at almost 1-month intervals. Patient 1 conceived naturally twice, and Patient 2 conceived using clomiphene citrate for ovulation induction. These two patients maintained the pregnancies without progesterone replacement therapy and successfully delivered children.
Conclusion: Patients with nonclassic LCAH preserve ovarian function, which enables normal pubertal development and a successful pregnancy outcome without progesterone replacement therapy.
PMID: 30476142 [PubMed - as supplied by publisher]
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Post Mortem Findings in a Young Male with Congenital Generalized Lipodystrophy, Type 4 due to CAVIN1 mutations.
J Clin Endocrinol Metab. 2018 Nov 21;:
Authors: Patni N, Vuitch F, Garg A
Abstract
Context: Congenital generalized lipodystrophy, type 4 (CGL4) is a rare autosomal recessive disorder caused by CAVIN1 mutations. Patients with CGL4 also have myopathy and cardiomyopathy with a predisposition for sudden death due to ventricular arrhythmias. However, underlying pathology for these morbidities remains unknown. Therefore, we report the first autopsy of a Hispanic boy with CGL4.
Case description: Our patient had early onset generalized lipodystrophy, feeding difficulties, myopathy, atlanto-axial dislocation and learning disabilities. He was diagnosed with catecholaminergic polymorphic ventricular tachycardia (CPVT) at age 8, had poor compliance with medications, and died suddenly at age 15.3 years. Autopsy showed marked loss of subcutaneous and omental fat with no inflammatory cells in adipose tissue and normal adipocytes in the parathyroid glands. There were adipocytes inter-digitating cardiac muscle fibers, with fibro-fatty infiltration in the right ventricle, near coronary sinus and atrioventricular node. There was no evidence of coronary heart disease. Quadriceps femoris muscle did not show any adipocyte infiltration, inflammation or fibrosis. Muscularis mucosa layer was thickened in esophagus and gastro-duodenal junction, and esophagus had prominent, large nerves in the subserosa. The liver was 3,000 g with minimal chronic inflammation and steatosis in 40% of parenchyma, primarily in zones 2 and 3. Interestingly, there was no spermatogenesis in the spermatic tubules.
Conclusions: Our data suggest that fibro-fatty infiltration of right ventricle may contribute to CPVT in CGL4 patients. Thick muscularis mucosa and large nerves in esophagus likely contributed to dysphagia and dysmotility. Lack of spermatids suggests infertility in the affected males.
PMID: 30476128 [PubMed - as supplied by publisher]
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Insulin Reduces Reaction of Follicular Granulosa Cell to FSH Stimulation in Obesity-Related Infertility Women during IVF.
J Clin Endocrinol Metab. 2018 Nov 21;:
Authors: Xu P, Huang BY, Zhan JH, Liu MT, Fu Y, Su YQ, Sun QY, Wang WH, Chen DJ, Liu JQ
Abstract
Context: Obese women usually need larger doses of FSH for ovarian stimulation, resulting in poor outcomes; however, the mechanism is still unclear.
Objective: To investigate the molecular regulation of FSH receptor (FSHR) expression associated with obesity.
Design: Case-control study to improve IVF outcomes.
Patients: Eighty-two obese and 457 overweight women undergoing IVF and 1,790 age-matched controls with normal weight from our reproductive medicine center.
Intervention: No special.
Main Outcome Measures: FSHR expression was decreased in parallel with BMI, while the oestradiol (E2) level on the hCG trigger day was significantly lower.
Results: FSHR expression in hGCs, both mRNA (P = 0.02) and protein (P = 0.001) levels, was decreased in overweight/obese women. Both insulin (P < 0.001) and glucose (P = 0.0017) levels were positively correlated with BMI in fasting blood and follicle fluids(FF) but not with FF leptin level. Treated KGN cells with insulin, E2 production was compromised, the level of p-Akt2 decreased while p-GSK3 increased, similar changes in hGCs from obese women. Stimulated hGCs from obese women with CP21, an inhibitor of GSK3β, resulting in upregulated β-catenin activation and increased FSHR expression. CP21 also increased the expression of IRS-1 and PI3K as well as the p-Akt2.
Conclusions: Obesity was associated with reduced FSHR expression and E2 production in IVF women, caused by dysfunctional insulin pathway. Decreased FSHR expression in hGCs from obese women and insulin-treated KGN could be rescued by inhibition of GSK3β, which might be a potential target for improving the impaired FSH response in obese women.
PMID: 30476103 [PubMed - as supplied by publisher]
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Nomograms for incident risk of postpartum type 2 diabetes in Chinese women with gestational diabetes.
Clin Endocrinol (Oxf). 2018 Nov 26;:
Authors: Janus E, Dunbar J
Abstract
Worldwide the prevalence of type 2 diabetes (T2D) is increasing. Using the 2010 ADA criteria, the burden for China is already especially high. Gestational diabetes mellitus (GDM) is one of the major predictors of subsequent diabetes. A systematic review assessed the risk as seven-fold but the studies were heterogenous2 Incidence varies with socioeconomic status and ethnicity. This article is protected by copyright. All rights reserved.
PMID: 30474200 [PubMed - as supplied by publisher]
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QUANTITATIVE ESTIMATION OF EXPOSURE INHOMOGENEITY IN TERMS OF EYE LENS AND EXTREMITY MONITORING FOR RADIATION WORKERS IN THE NUCLEAR INDUSTRY.
Radiat Prot Dosimetry. 2018 Nov 23;:
Authors: Yoshitomi H, Kowatari M, Hagiwara M, Nagaguro S, Nakamura H
Abstract
To manage the equivalent doses for radiation workers, exposure inhomogeneity is an important factor in the decision-making process related to protection measures and additional monitoring. Our previous study proposed the methodology to evaluate the inhomogeneity of exposure quantitatively. In this study, we applied proposed method to five different types of actual exposure situations encountered in the nuclear industry. Two of them were conventionally characterized as homogeneous exposure, and the other three were conventionally characterized as inhomogeneous exposure. The evaluation of homogeneity exposure was conducted using Monte Carlo calculations with two simplified models, which were then verified with phantom experiments. Consequently, all of the evaluations reproduced the experimental results, implying that our proposed method would be applicable for actual work conditions in the nuclear industry. Furthermore, the two presumed homogeneous exposure situations were found to be rather inhomogeneous because of the contribution of positrons and the limited source region. The results also show that the worker's posture has an impact on the inhomogeneity rather than the energy of incident radiation in nuclear works. The investigation also implies that obtaining the information on the most probable posture of the exposed worker, as well as the existence of the weekly penetrating radiation such as β± ray as a main source of exposure would be the key for more precise estimation.
PMID: 30476336 [PubMed - as supplied by publisher]
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Prevalence of oral squamous cell carcinoma in Bareilly Region: A seven year institutional study.
J Exp Ther Oncol. 2018 Nov;12(4):323-330
Authors: Astekar M, Taufiq S, Sapra G, Agarwal A, Murari A, Putthia H
Abstract
Background: Oral squamous cell carcinoma is a major contributor to disability and death caused by malignant tumors. Variations in social, cultural, and geographic factors affect the tumor behavior and response to treatment. In this study, we undertake a seven years institutional review and analysis of Oral squamous cell carcinoma cases in Bareilly.
Materials and Methods: A total of 1938 histologically diagnosed cases during the period of seven years i.e. from 2010 to 2016 were extracted from the archives of Department of Oral & Maxillofacial Pathology, Institute of Dental Sciences, Bareilly and evaluated to know the prevalence of Oral squamous cell carcinoma. The details like age, sex, habits and anatomical site were also recorded from the archived patient's case sheets.
Results: Out of the total 1938 cases, 318 were found to be Oral squamous cell carcinoma of which 232 were males and 86 were females. Incidence was highest in 40-49 year age group. The most common site was buccal mucosa (190 cases), followed by tongue (68 cases). Most lesions were well differentiated Oral squamous cell carcinoma (230 cases). Patients with poorly differentiated lesions had a comparatively lower mean age than their counterparts with other histological varieties.
Conclusion: The pattern of Oral squamous cell carcinoma differs from that of previous studies in relation to incidence and age correlation with the grade of carcinoma. The majority of the lesions were well differentiated. There is a need for intensive oral health awareness to encourage early presentation to cancer center as early detection will further enhance prognosis.
PMID: 30476389 [PubMed - in process]
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Comparison of axitinib and sunitinib as first-line therapies for metastatic renal cell carcinoma: a real-world multicenter analysis.
Med Oncol. 2018 Nov 24;36(1):6
Authors: Konishi S, Hatakeyama S, Tanaka T, Ikehata Y, Tanaka T, Fujita N, Ishibashi Y, Yamamoto H, Yoneyama T, Hashimoto Y, Yoshikawa K, Kawaguchi T, Masumori N, Kitamura H, Ohyama C
Abstract
We aimed to compare oncological outcomes and safety of axitinib and sunitinib in patients with treatment-naïve metastatic renal cell carcinoma (mRCC). We retrospectively evaluated 169 patients with mRCC who were treated with axitinib or sunitinib as the first-line therapy in five hospitals between October 2008 and August 2018. Oncological outcomes and safety were compared between axitinib (n = 68) and sunitinib (n = 101) groups. Inverse probability of treatment weighted (IPTW)-adjusted Cox regression analysis was performed to evaluate effects of first-line therapies on progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). Patients in the axitinib group were significantly older (66 vs. 72 years) than those in the sunitinib group. Median relative dose intensity was significantly higher in the axitinib group (94 ± 62%) than in the sunitinib group (65 ± 20%; P = 0.001). Objective response rate was significantly higher in the axitinib group (21%) than in the sunitinib group (10%; P = 0.042). IPTW-adjusted Cox regression analysis revealed significant differences in CSS and OS but not in PFS between the two groups. Safety in terms of grade ≥ 3 adverse events was significantly different between the axitinib (34%) and sunitinib (55%) groups (P = 0.006). Compared with sunitinib, axitinib significantly prolonged CSS and OS and showed a safer profile as the first-line therapy for treatment-naïve mRCC.
PMID: 30474747 [PubMed - in process]
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Differentiating Transition Zone Cancers From Benign Prostatic Hyperplasia by Histogram Analysis of Apparent Diffusion Coefficient Maps With Standard and Ultrahigh b-value Diffusion-weighted MR Imaging.
J Comput Assist Tomogr. 2018 Nov 20;:
Authors: Lu ZH, Ji LB, Zhao WL, Zhang YS, Wu JF, Li X, Shen JK
Abstract
OBJECTIVE: To compare the diagnostic performance of standard and ultrahigh b-value Diffusion-weighted Imaging (DWI) using volumetric histogram analysis in differentiating transition zone (TZ) cancer from benign prostatic hyperplasia (BPH).
METHODS: 57 TZ cancer and 61 BPH patients received standard (1000 s/mm) and ultrahigh b-value (2000 s/mm) DWI. The diagnostic ability of ADC histogram parameters derived from two DWI for differentiating TZ cancer from BPH was determined by receiver operating characteristic curve.
RESULTS: Median, minimum, the 10th, 25th percentile ADC in both ADC1000 and ADC2000 and skewness in ADC2000 had significant differences between TZ cancer and BPH (for all, P < 0.05).The 10th percentile ADC showed highest area under the ROC curve (AUC) in both ADC1000 and ADC2000.The 10th percentile ADC of ADC2000 showed significantly higher AUC than did ADC1000 (P = 0.0385).
CONCLUSIONS: The 10th percentile ADC obtained from ultrahigh b-value DWI performed better for differentiating TZ cancer from BPH.
PMID: 30475249 [PubMed - as supplied by publisher]
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Impact Analysis of the Routine Use of Dual-Energy Computed Tomography for Characterization of Incidental Renal Lesions.
J Comput Assist Tomogr. 2018 Nov 20;:
Authors: Wortman JR, Shyu JY, Fulwadhva UP, Sodickson AD
Abstract
OBJECTIVE: The aim of this study was to quantify the prevalence of incidental, indeterminate renal lesions on routine contrast-enhanced abdominal computed tomography (CT) and the proportion of such lesions that could be exonerated by dual-energy CT (DECT) postprocessing as benign hyperdense cysts.
METHODS: The reports for 2729 consecutive contrast-enhanced DECT scans in the emergency department setting were reviewed for the mention of any renal lesion. For scans with a reported lesion, images were reviewed to assess for the presence of an indeterminate lesion that could not be definitively characterized as benign. All indeterminate lesions were reviewed with DECT postprocessing by 2 radiologists to assess for enhancement and other imaging characteristics and characterized by readers as benign or not definitively benign. Agreement between readers was assessed statistically, and disagreement was resolved by consensus.
RESULTS: Two thousand seven hundred twenty-nine scans were performed in 2406 unique patients; a renal lesion was reported in 805 unique patient scans (33.4%). Review of these 805 scans led to discovery of 137 indeterminate lesions in 125 scans (5.2% of patients). Of the 137 lesions, 70 (51.1%) were classified as benign hyperdense cysts by readers, with the remaining 67 lesions classified as not definitively benign (43 solid masses, 9 Bosniak IIF cysts, 8 Bosniak III cysts, 7 Bosniak IV cysts).
CONCLUSIONS: Incidental indeterminate renal lesions are common on routine contrast-enhanced CT. More than half of these lesions could potentially be exonerated with DECT as benign Bosniak II cysts, which could avert the need for further workup in 2.8% of patients undergoing routine abdominal CT.
PMID: 30475248 [PubMed - as supplied by publisher]
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Preoperative Parathyroid Imaging: Trends in Utilization and Comparative Accuracy of Sonography, Scintigraphy, and 4-Dimensional Computed Tomography.
J Comput Assist Tomogr. 2018 Nov 20;:
Authors: Bahl M
Abstract
OBJECTIVE: The purposes of this study were to describe trends in parathyroid imaging utilization and to compare the sensitivities of sonography, scintigraphy, and 4-dimensional computed tomography (4DCT) in different imaging algorithms.
METHODS: A retrospective review of consecutive patients who underwent parathyroid surgery from 2009 to 2014 was performed. Utilization and accuracy were compared for sonography, scintigraphy, and 4DCT.
RESULTS: The study population was composed of 604 patients with 850 adenomas or hyperplastic glands. Sonography was the most common imaging modality, performed in 91.2% (551/604) of patients. The utilization of 4DCT increased in the study period from 1.5% (2/133) in 2009-2010 to 75.8% (72/95) in 2013-2014 (P < 0.01). The overall sensitivities of sonography, scintigraphy, and 4DCT, regardless of order of imaging or imaging algorithm, were 58.6% (456/778), 49.1% (317/645), and 82.3% (121/147), respectively (P < 0.01).
CONCLUSIONS: Four-dimensional CT has the highest sensitivity for localization of parathyroid adenomas regardless of order of imaging or imaging algorithm.
PMID: 30475247 [PubMed - as supplied by publisher]
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STIM promotes the epithelial-mesenchymal transition of podocytes through regulation of FcγRII activity in diabetic nephropathy.
Histol Histopathol. 2018 Nov 26;:18068
Authors: Jin J, Ye M, Hu K, Gong J, He Q
Abstract
BACKGROUND: Diabetic nephropathy (DN) is a serious complication in diabetic patients and has been considered as the main cause of end-stage renal disease. However, there are no studies on the role of stromal interaction molecule (STIM) and its two subtypes, STIM1 and STIM2, in the epithelial-to-mesenchymal transition (EMT) of podocytes induced by diabetic kidney disease (DKD). The present study suggests for the first time that STIM inhibition decreases DKD-induced EMT.
METHODS: All DKD patients were diagnosed based on renal biopsies carried out at the Department of Nephrology, Zhejiang Provincial People's Hospital and selected using the Mayo Clinic/Renal Pathology Society Consensus Report on Pathologic Classification, Diagnosis, and Reporting of GN. Images were taken and the number of positive puncta in cells was analyzed using software equipped for immunofluorescence microscopy. STIM1, STIM2, FcγRIIa, FcγRIIb, Nephrin, CTGF, and α-SMA protein levels were detected by Western blotting analysis using the corresponding antibodies. The viability of cells was measured using CCK-8 assays. Absorbance at 450 nm was measured with a Multiskan FC Microplate Reader (Thermo Scientific, USA) and the results were normalized to those of untreated cells. All statistical analyses were performed using SPSS 19.0 software (Stanford University, Stanford, CA, USA).
RESULTS: A total of 30 DKD patients and 30 control patients were enrolled in the study. We found that the level of urine protein in patients and db/db diabetic mice is higher than control group and the levels of STIM1 and 2 significantly increased in DKD groups. We also demonstrated that STIM is upregulated during DKD injury. Next, we discovered that DKD-induced podocyte EMT is related to STIM overexpression in vivo and in vitro. Further research demonstrated that STIM siRNA reverses podocytes from DKD-induced injury and EMT and reverses FcγRII activity in HG-treated podocytes.
CONCLUSION: Our study suggests that STIM and FcγRII play an essential role in the regulation of DKD-induced podocyte EMT. STIM is an essential component of FcγR activation and inhibition of STIM-mediated signaling pathway might be a new strategy to treat IgG-dependent renal diseases.
PMID: 30475382 [PubMed - as supplied by publisher]
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The evolving role of the chaperone in medicine-protection and training: A plastic surgery perspective.
J Plast Reconstr Aesthet Surg. 2018 Nov 13;:
Authors: Touil LL, Sofos S, Gill P, James MI
PMID: 30473405 [PubMed - as supplied by publisher]
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Association of Hospital Volume With Laryngectomy Outcomes in Patients With Larynx Cancer.
JAMA Otolaryngol Head Neck Surg. 2018 Nov 21;:
Authors: Gourin CG, Stewart CM, Frick KD, Fakhry C, Pitman KT, Eisele DW, Austin JM
Abstract
Importance: A volume-outcome association exists for larynx cancer surgery, but to date it has not been investigated for specific surgical procedures.
Objectives: To characterize the volume-outcome association specifically for laryngectomy surgery and to identify a minimum hospital volume threshold associated with improved outcomes.
Design, Setting, and Participants: In this cross-sectional study, the Nationwide Inpatient Sample was used to identify 45 156 patients who underwent laryngectomy procedures for a malignant laryngeal or hypopharyngeal neoplasm between January 2001 and December 2011. The analysis was performed in 2018. Hospital laryngectomy volume was modeled as a categorical variable.
Main Outcomes and Measures: Associations between hospital volume and in-hospital mortality, complications, length of hospitalization, and costs were examined using multivariate logistic regression analysis.
Results: Among 45 156 patients (mean age, 62.6 years; age range, 20-96 years; 80.2% male) at 5516 hospitals, higher-volume hospitals were more likely to be teaching hospitals in urban locations; were more likely to treat patients who had hypopharyngeal cancer, were of white race/ethnicity, were admitted electively, had no comorbidity, and had private insurance; and were more likely to perform flap reconstruction or concurrent neck dissection. After controlling for all other variables, hospitals treating more than 6 cases per year were associated with lower odds of surgical and medical complications, with a greater reduction in the odds of complications with increasing hospital volume. High-volume hospitals in the top-volume quintile (>28 cases per year) were associated with decreased odds of in-hospital mortality (odds ratio, 0.45; 95% CI, 0.23-0.88), postoperative surgical complications (odds ratio, 0.63; 95% CI, 0.50-0.79), and acute medical complications (odds ratio, 0.63; 95% CI, 0.48-0.81). A statistically meaningful negative association was observed between very high-volume hospital care and the mean incremental length of hospitalization (-3.7 days; 95% CI, -4.9 to -2.4 days) and hospital-related costs (-$4777; 95% CI, -$9463 to -$900).
Conclusions and Relevance: Laryngectomy outcomes appear to be associated with hospital volume, with reduced morbidity associated with a minimum hospital volume threshold and with reduced mortality, morbidity, length of hospitalization, and costs associated with higher hospital volume. These data support the concept of centralization of complex care at centers able to meet minimum volume thresholds to improve patient outcomes.
PMID: 30476965 [PubMed - as supplied by publisher]
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HPV-associated neuroendocrine carcinomas of the head and neck in FNA biopsies: Clinicopathologic features of a rare entity.
Cancer Cytopathol. 2018 Nov 26;:
Authors: Jo VY, Krane JF, Pantanowitz L, Monaco SE
Abstract
BACKGROUND: The majority of human papillomavirus (HPV)-associated oropharyngeal carcinomas are squamous cell carcinomas; however, there are rare reports of HPV-associated neuroendocrine carcinomas (HPV-NECs) in the upper aerodigestive tract. The aim of this study was to characterize the diagnostic features of fine-needle aspiration (FNA) cases of head and neck HPV-NEC.
METHODS: Cytology cases of HPV-NEC were identified over a 3-year period from 2 institutions. Clinical, cytomorphologic, and ancillary test results were evaluated.
RESULTS: Five FNA cases of HPV-NEC were identified from 4 patients with cervical lymph node metastases with primaries in the oropharynx (n = 2), nasopharynx (n = 1), and larynx (n = 1). Three cases showed mixed small cell and large cell neuroendocrine morphologies; 1 case was a small cell carcinoma, and the last case appeared as a large cell neuroendocrine carcinoma. All tumors were strongly positive for synaptophysin and p16 and negative for p63/p40. Two cases tested for INSM1 showed diffuse nuclear staining. HPV was confirmed by in situ hybridization in 4 cases, and HPV-18 was detected by polymerase chain reaction in the fifth case. Retinoblastoma (Rb) staining was moderate to weak (5/5), and p53 was weakly positive (5/5).
CONCLUSIONS: Head and neck HPV-NEC is a rare, aggressive entity that can show mixed small and large cell features and p16 upregulation; p53 and Rb are variable with limited diagnostic utility. Because p16 positivity can be nonspecific, confirmatory HPV testing is required and may be helpful in determining the primary site for neuroendocrine carcinoma of an unknown primary. The accurate diagnosis of HPV-NEC is also important because of its worse prognosis in comparison with HPV-associated squamous cell carcinoma.
PMID: 30475447 [PubMed - as supplied by publisher]
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Do I sound dry? Comparative voice analysis of primary Sjögren's syndrome.
Clin Exp Rheumatol. 2018 May-Jun;36 Suppl 112(3):130-136
Authors: Kim SY, Lee J, Choi YS, Kim JW, Kwok SK, Park YH, Sun DI, Park SH
Abstract
OBJECTIVES: Desiccation of the vocal tract can cause many voice problems. Therefore, we aimed to investigate whether patients with primary Sjögren's syndrome (pSS) with dry mouth have more voice-related problems than controls without the disease and to determine the factors affecting voice in pSS patients.
METHODS: Patients with pSS and controls complaining of voice-related symptoms underwent acoustic analysis, aerodynamic study and stroboscopic analysis. They also completed the voice handicap index (VHI) questionnaire and perceptual voice analysis (GRBAS). Various disease-related parameters were obtained from pSS registry data.
RESULTS: Fifty-five pSS patients and 52 controls were analysed. The subjects were all female, and mean age was 53.9 years. VHI score was significantly higher in the pSS patient group (median [interquartile range], 11 [3-30] vs. 5.5 [0- 15.75], p=0.014). However, the results of acoustic analysis aerodynamic study and stroboscopic findings were not different between the two groups. Disease-related parameters were available in 47 pSS patients. Correlation analysis revealed that jitter value positively correlated with ESSDAI (spearman's rho = 0.29, p=0.048) and patient global assessment (rho=0.3, p= 0.04). High VHI score was associated with low quality of life measured by EQ5D (rho=-0.493, p=0.0001). Of note, patients with longer disease duration (≥ 40 months) showed higher noise-to-harmonics ratio (NHR).
CONCLUSIONS: Patients with pSS had higher VHI score, which was associated with low quality of life and longer disease duration was associated with increased noise in pSS patients. The likelihood of voice problems should be addressed with pSS patients, and vocal hygiene education will be important in those patients.
PMID: 30156538 [PubMed - indexed for MEDLINE]
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[Progress of surgical treatment for T1a glottic carcinoma].
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 May 05;31(9):725-728
Authors: Huang GJ, Luo MS, Zhang JX, Liu HB
Abstract
T1a glottic laryngeal carcinoma is early laryngeal cancer,involving unilateral vocal cord. T he main surgical treatments are transoral laser surgery,open surgery,transoral robotic surgery and radiofrequency ablation technique. In this paper,progress of surgical treatment for T1a glottic carcinoma were reviewed.
PMID: 29871360 [PubMed - indexed for MEDLINE]
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[The adhesion separation operation with CO₂ laser combined withtriamcinolone acetonide vocal cord submucosal injection for the treatment to vocal cord adhesion].
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 May 05;31(9):700-702
Authors: Li LH, Hu WP, Zhang ZL, Liu JG, Luo G, Liu YH
Abstract
Objective:To investigate the effect of adhesion separation operation with CO₂ laser via prop-up laryngoscope combine with triamcinolone acetonide submucosal injection via electrolaryngoscope to vocal cords adhesion.Method:Sixteen cases of vocal cord adhesion patients(2 cases of children,14 cases of adult) were enrolled in the study. Fourteen patients had the history of surgery(Reinke edema,vocal polyp,pediatric laryngeal papilloma,laryngeal cancer),2 cases were diagnosed as laryngeal tuberculosis. Adhesion separation operation and triamcinolone acetonide submucosal injection(once a week,three weeks) were conducted. All patients were examined with electronic laryngoscope every month for six monthes.Result:Fourteen patients had good triangle shape of glottis vocalis and good sound voice. One cases of laryngeal cancer and 1 cases of laryngeal tuberculosis patients still had adhesion in the anterior commissure of the vocal cords,but with the improvement in breathing and pronunciation.Conclusion:Adhesion separation operation with CO₂ laser via prop-up laryngoscope combine with triamcinolone acetonide submucosal injection via electrolaryngoscope were effective for treatment to vocal cord adhesion,whichimprove the patient's breathing and voice with little trauma and few complications.
PMID: 29871351 [PubMed - indexed for MEDLINE]
