Controversy: For or against thyroid lobectomy in >1 cm differentiated thyroid cancer?

xlomafota13 shared this article with you from Inoreader Controversy: For or against thyroid lobectomy in >1 cm differentiated thyroid cancer? Via radioactive iodine Ann Endocrinol (Paris). 2021 Mar 20:S0003-4266(21)00029-9. doi: 10.1016/j.ando.2021.03.004. Online ahead of print. ABSTRACT In this controversy article, the respective advantages of lobectomy vs total thyroidectomy in differentiated thyroid cancers are argued. The authors conclude that lobectomy has the same oncological prognosis as thyroidectomy in terms of specific survival or recurrence, in case of low risk of recurrence (T1-2N0). However, as a precaution, and taking into accoun t current data, thyroidectomy is recommended that in N0 thyroid papillary cancers with aggressive subtype, with even minimal infiltration of perithyroid tissue and/or vascular invasion, and in N1 cancers with more than 5 lymphadenopathies or lymphadenopathies with a major axis greater than or equal to 0.2 cm. Other forms of papillary cancer should be treated with lobectomy, as risk of morbidity is low and hospital stay is short. Lobectomy allows reliable monitoring, especially by ultrasound. On the other hand, total thyroidectomy, despite a higher rate of surgical complications due to the risk of recurrent paralysis and permanent hypoparathyroidism, is nevertheless preferable to lobectomy, the latter not always avoiding hormone replacement therapy, in particular for more precise monitoring by thyroglobulin assay, which is uninterpretable after lobectomy but allows early diagnosis of local or metastatic recurrence and reduces mortality. Thus, in situations where the diagnostic criter ia for high-risk cancer are not rigorously determined or taken into account, thyroidectomy is recommended. In addition, it will remain preferable as long as the recommendations for administration of radioactive iodine do not change in favor of use reserved for high-risk cancers as in US guidelines. PMID:33757822 | DOI:10.1016/j.ando.2021.03.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laparoscopic versus robotic‐assisted Heller myotomy for the treatment of achalasia: a systematic review with meta‐analysis

xlomafota13 shared this article with you from Inoreader Laparoscopic versus robotic‐assisted Heller myotomy for the treatment of achalasia: a systematic review with meta‐analysis Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Robotic‐assisted laparoscopic Heller myotomy has been proposed as an alternative minimally invasive approach to traditional laparoscopy for the treatment of achalasia. This systematic review aims to compare the safety and postoperative outcomes of the two procedures. Methods Systematic literature search was performed in MEDLINE through Ovid, Scopus, and Cochrane to identify clinical trials and retrospective analyses. Outcome measures used for meta‐analysis included operative time, estimated blood loss, length of stay, 30‐day readmission, intraoperative esophageal perforation, conversion, mortality, morbidity, symptom relief beyond one year, reintervention for recurrent symptoms, and gastroesophageal reflux during follow‐up rates. Results 7 studies were selected with a total of 3214 patients. The only factor to be statistically different is intraoperative esophageal perforation rate, which is lower in robotic‐assisted Heller myotomy compared to laparoscopic (OR = 0.1139; 95% CI, [0.0334, 0.3887]; P = 0.0005). Conclusions The results suggest a robotic approach is associated with improved patient safety. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review

xlomafota13 shared this article with you from Inoreader Effectiveness of functional orthodontic appliances in obstructive sleep apnea treatment in children: literature review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 14:S1808-8694(21)00055-0. doi: 10.1016/j.bjorl.2021.02.010. Online ahead of print. ABSTRACT INTRODUCTION: Obstructive sleep apnea syndrome is a common condition in childhood and if left untreated can result in many health problems. An accurate diagnosis of the etiology is crucial for obstructive sleep apnea treatment success. Functional orthodontic appliances that stimulate mandibular growth by forward mandibular positioning are an alternative therapeutic option in growing patients. OBJECTIVE: To perform a literature review about the effects of functional orthodontic appliances used to correct the mandibular deficiency in obstructive sleep apnea treatment. METHODS: The literature search was conducted in June 2020 using Cochrane Library; PubMed, EBSCO (Dentistry & Oral Sciences Source), LILACS Ovid; SciELO Web of Science; EMBASE Bireme and BBO Bireme electronic databases. The search incl uded papers published in English, until June 2020, whose methodology referred to the types and effects of functional orthopedic appliances on obstructive sleep apnea treatment in children. RESULTS: The search strategy identified thirteen articles; only four articles were randomized clinical studies. All studies using the oral appliances or functional orthopedic appliances for obstructive sleep apnea in children resulted in improvements in the apnea-hypopnea index score. The cephalometric (2D) and tomographic (3D) evaluations revealed enlargement of the upper airway and increase in the upper airspace, improving the respiratory function in the short term. CONCLUSION: Functional appliances may be an alternative treatment for obstructive sleep apnea, but it cannot be concluded that they are effective in treating pediatric obstructive sleep apnea. There are significant deficiencies in the existing evidence, mainly due to absence of control groups, small sample sizes, lack of randomization and no long-term results. PMID:33757756 | DOI:10.1016/j.bjorl.2021.02.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of changing classification systems on prevalence and frequency distribution of odontogenic tumors in tertiary care center of Nagpur

xlomafota13 shared this article with you from Inoreader Impact of changing classification systems on prevalence and frequency distribution of odontogenic tumors in tertiary care center of Nagpur Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 7:S1808-8694(21)00027-6. doi: 10.1016/j.bjorl.2021.02.006. Online ahead of print. ABSTRACT INTRODUCTION: The classification of odontogenic tumors has been revised from time to time in order to provide unified terminology. This reclassification had considerable impact on their prevalence and frequency distribution. OBJECTIVES: This study was aimed to emphasize impact of changing classification systems on prevalence and relative frequency of odontogenic tumors. The secondary objective was to analyze demographics of various histological types of odontogenic tumors in comparison to published literature. Review of Indian studies (1992-2020) elaborating frequency of odontogenic tumors is summarized in the end. METHODS: This was a hospital-based retrospective study wherein case files of odontogenic tumors diagnosed from 1990 to 2019 period were retrieved. The classification system used originally at the time of diagnosis was retained and prevalence of odontogenic tumors in three different periods (1990-2004, 2005-2016 and 2017-2019) was compared. Further, prevalence, frequency distribution and demographics of all these tumors (1990-2019) were analyzed using latest World Health Organization 2017 classification. RESULTS: A total of 345 odontogenic tumors was diagnosed as per World Health Organization 2017 system of classification from 1990 to 2019. 96.81% tumors were benign and 3.81% constituted malignant odontogenic tumors. However, there was marked increase in prevalence of odontogenic tumors in 2005-2016 (6.2%) period as compared to 1990-2004 (3.87%) and 2017-2019 (3.47%). Ameloblastoma remained the most common tumor in three different periods, whereas keratocystic odontogenic tumor became second commonest tumor in 2005-2016 as compared to odontoma in 1990-2004 and adenomatoid odontogenic tumor in 2017-2019. CONCLUSIONS: The continuous evolving systems of classi fication may partly be responsible for inconsistency in odontogenic tumors, with inclusion of keratocystic odontogenic tumor,and has marked impact on prevalence and frequency distribution of odontogenic tumors. The geographical variations in demographics of odontogenic tumors might reflect genetic and environment influence; however it requires elucidation by further studies. PMID:33757753 | DOI:10.1016/j.bjorl.2021.02.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lysyl Oxidase Like-4 (LOXL4) as a tumor marker and prognosticator in advanced stage laryngeal cancer

xlomafota13 shared this article with you from Inoreader Lysyl Oxidase Like-4 (LOXL4) as a tumor marker and prognosticator in advanced stage laryngeal cancer Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 13:S1808-8694(21)00054-9. doi: 10.1016/j.bjorl.2021.02.009. Online ahead of print. ABSTRACT INTRODUCTION: Lysyl oxidase-like 4 is an amine oxidase from the lysyl oxidase family that was previously shown to be overexpressed in head and neck cancer and upregulated in response to hypoxia. The possible role of lysyl oxidase-like 4 as a tumor marker in advanced stage larynx cancer was investigated. OBJECTIVE: To investigate the expression of lysyl Oxidase-Like 4 protein in advanced stage laryngeal cancer and elucidate its possible role as a tumor marker, predictor of treatment response and prognosticator. METHODS: Diagnostic specimens of 72 patients treated for stage III-IV laryngeal squamous cell carcinoma were evaluated for lysyl oxidase-like 4 expression by immunohistochemistry. RESULTS: Lysyl oxidase-like 4 expression was correlated with advanced tumor stage (p = 0.041) and better diff erentiation (p = 0.025) but was independent of tumor diameter (p = 0.456). Response to induction chemotherapy or the need for salvage laryngectomy were not affected by lysyl oxidase-like 4 expression (p = 0.999, p = 0.070 respectively). Increased lysyl oxidase-like 4 expression was associated with better 2 year overall survival in both univariate (p = 0.036) and multivariate analyses (p = 0.014). CONCLUSION: Lysyl oxidase-like 4 expression emerges with advancing stages, is lost with worsening differentiation, and may have tumor suppressive properties in larynx cancer. PMID:33757755 | DOI:10.1016/j.bjorl.2021.02.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ototoxic effects of antineoplastic drugs: a systematic review

xlomafota13 shared this article with you from Inoreader Ototoxic effects of antineoplastic drugs: a systematic review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 13:S1808-8694(21)00053-7. doi: 10.1016/j.bjorl.2021.02.008. Online ahead of print. ABSTRACT INTRODUCTION: Platinum-based chemotherapeutics play an important role in the treatment of cancer at different levels and are the most cited ototoxic agents when scientific evidence is analyzed. OBJECTIVE: To present scientific evidence based on a systematic literature review, PRISMA, in order to systematize information on the ototoxic effects of using antineoplastic drugs. METHODS: For the selection of studies, the combination based on the Medical Subject Heading Terms (MeSH) was used. The Medline (Pubmed), LILACS, SciELO, SCOPUS, WEB OF SCIENCE and BIREME databases were used, without restriction of language, period, and location. Evaluation of the quality of the articles was carried out, which included articles with a minimum score of 6 in the modified scale of the literature. The designs of the sel ected studies were descriptive, cohort, and cross-sectional, which were related to the research objective. RESULTS: Three articles were included in this systematic review. The ototoxicity caused by cisplatin alone varied from 45% to 83.3%, while that caused by the use associated with carboplatin varied from 16.6% to 75%. There was a significant variation in the cumulative doses of these antineoplastic agents, both in isolated and in combination. Auditory changes, especially at high frequencies, were evident after completion of treatment. CONCLUSION: Auditory changes after the use of platinum-based antineoplastic drugs were found, however, there was an important heterogeneity regarding the frequency of ototoxicity and the cumulative dose of the drugs used. PMID:33757754 | DOI:10.1016/j.bjorl.2021.02.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

To evaluate the role of Feracrylum (1%) as hemostatic agent in Tonsillectomy

xlomafota13 shared this article with you from Inoreader To evaluate the role of Feracrylum (1%) as hemostatic agent in Tonsillectomy Via Otolaryngology Indian Abstract Tonsillectomy is a common procedure performed globally. It is associated with morbidities like hemorrhage and pain. Various methods are employed to reduce them. The present study is aimed to evaluate the role of Feracrylum (1%) in traditional cold steel tonsillectomy and to measure the outcomes in terms of intra-operative bleed, intra-operative time and post operative pain and recovery. A prospective study was conducted in Department of ENT, ESI Medical College, Kalburgi Karnataka, India, for a period of two years between January 2019 to December 2020 In this study, a total of 60 patients were involved and divided them into two groups after fulfilling the inclusion and exclusion criteria. Thirty patients each undergoing tonsillectomy with the use of Feracrylum considered as Group I and without the use of Feracrylum in the tonsillar fossae considered as Group II. The study has been approved by Ethics committee and informed consent was obtained from all the study s ubjects. The amount of blood loss is calculated. Post operative pain based on VAS (Visual Analogue Scale) is assessed in both the groups. Assessment of recovery in days is estimated in both groups by reduced pain, gaining normal activity and normal food intake. In this study, intra-operative time in group I was 19.83 ± 3.93 min and in group II 27.16 ± 3.35 min (P < 0.001). The intra-operative blood loss in group I was 26.67 ± 4.81 ml and in group II 44.70 ± 7.59 ml (P < 0.001). Patients recovered from pain, resumed normal activity and food intake within 2–3 days in Group I and in contrast it took about 3–5 days on an average in group II. In this study, majority of the patients experienced mild pain in Group I when Feracrylum was used during hemostasis. In our study, the time taken by the patients to recover from pain, resume their normal activity and also with regard to normal food intake was rapid . On an average of 2–3 days was seen in Group I. Group II patients required 3–5 days to recover from pain and resuming normal activity and food intake. The P value of < 0.001 was highly significant. Our study has stressed that use of Feracrylum in cold steel tonsillectomy is relatively safe. Its use is associated with a significant decrease in surgical time and blood loss. Rapid recovery makes it favourable to be used in cold steel tonsillectomy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fat and Fibrin Glue: Quo Vadis?

xlomafota13 shared this article with you from Inoreader Fat and Fibrin Glue: Quo Vadis? Via leak of cerebrospinal fluid Turk Neurosurg. 2021;31(2):238-246. doi: 10.5137/1019-5149.JTN.29712-20.2. ABSTRACT AIM: To analyze the effectiveness of fat and fibrin glue to prevent postoperative cerebrospinal fluid (CSF) leak in pituitary surgery. MATERIAL AND METHODS: Two hundred and eleven patients affected by pituitary adenoma entered this study. Patients that underwent a microscopic transsphenoidal approach between January 2013 and April 2019 were included. All the patients that developed intraoperative CSF leak were treated with fat and fibrin glue. The presence or absence of postoperative CSF leak was considered as a parameter to test the effectiveness of the intraoperative reconstruction technique used. RESULTS: Postoperative CSF leak was observed in 5 patients (2.4%). Among patients with an intraoperative low- grade CSF leak (1 or 2), 97.9% did not develop a postoperative CSF leak. In contrast, those who presented an intraoperative CSF leak of grade 3 , had a worse prognosis. CONCLUSION: Fat and fibrin glue is currently an effective method in the treatment of low-grade intraoperative CSF leak. In case of intraoperative CSF leak of grade 3, it should be used combined with the nasoseptal flap technique to obtain a safer reconstruction. PMID:33624276 | DOI:10.5137/1019-5149.JTN.29712-20.2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Herpes simplex virus 1 proteins can induce skin inflammation in an atopic dermatitis‐like mouse model

xlomafota13 shared this article with you from Inoreader Herpes simplex virus 1 proteins can induce skin inflammation in an atopic dermatitis‐like mouse model Via Experimental Dermatology Abstract Herpes simplex virus type 1 (HSV‐1) can induce in certain individuals with atopic dermatitis (AD) severe cutaneous infections that can spread throughout the entire body, a condition named as AD complicated by eczema herpeticum (ADEH). It has been recently found that ADEH patients can produce specific IgE against HSV‐1 proteins, which may contribute to lower protection against HSV‐1. However, little is known about the capacity of these HSV‐1 proteins to produce an inflammatory response at the skin level. In this study, using a mouse model of AD‐like dermatitis, three HSV‐1 proteins (glycoprotein D ‐gD‐, glycoprotein B ‐gB‐ and VP22) were applied on tape‐stripped back skin mice in three exposures periods. Ovalbumin (OVA) and 0.9% NaCl were used as positive and negative controls, respectively. Skin samples were obtained for analysis of specific cell components of skin infiltration. The results showed that the viral protein gD induced a statistically significant increase in the number of dermal infiltrating CD3+, CD4+ cells and mast cells compared with the negative control group. gD was also able to induce epidermal thickening and epidermal infiltration of T cells closely related to the one produced in mice sensitized with OVA. However, VP22 and gB contributed to a lesser extent to skin inflammation. These results showed that proteins from HSV‐1, especially gD, can have per se an important T cell and mast cell‐driven inflammatory potential at the skin level. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Increased angiogenesis and migration of dermal microvascular endothelial cells from patients with psoriasis

xlomafota13 shared this article with you from Inoreader Increased angiogenesis and migration of dermal microvascular endothelial cells from patients with psoriasis Via Experimental Dermatology Abstract Psoriasis displays both increased angiogenesis and microvascular dilation in the skin, while human dermal microvascular endothelial cells (HDMECs) are involved in angiogenesis and microvascular dilation. Whether the functions of HDMECs are altered in psoriatic skin versus healthy skin remain unknown. Here, we isolated HDMECs from the skin of 10 patients with psoriasis and 10 healthy subjects and compared angiogenesis, proliferation, migration and cell metabolism between psoriatic HDMECs and normal HDMECs. We found that the morphology of primary HDMECs was comparable between psoriatic HDMECs and normal HDMECs. After passage, psoriatic HDMECs displayed larger cell size and wider intercellular space. In addition to DiI‐Ac‐LDL (DiI‐labelled acetylated low‐density lipoprotein) uptake, expression levels of CD31, vWF (von Willebrand factor) and LYVE‐1 were comparable in psoriatic HDMECs versus normal HDMECs. However, psoriatic HDMECs exhibited increased tube formation (numbers of nodes and meshes, p < 0.05) and migration (numbers of migrated cells, p < 0.001) and reductions in proliferation (growth rates, p < 0.05) and energy metabolism (oxygen consumption rate and extracellular acidification rate, p < 0.05) compared with normal HDMECs. Therefore, psoriatic HDMECs display an increased angiogenesis and migration and decreased proliferation and metabolic activity, suggesting a pathogenic role of HDMECs in psoriasis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of gut microbiota signatures in symptomatic dermographism

xlomafota13 shared this article with you from Inoreader Identification of gut microbiota signatures in symptomatic dermographism Via Experimental Dermatology Abstract Symptomatic dermographism (SD) is a recurrent inflammatory skin disease related to immunity; however, the details remain elusive. In view of the important role of gut microbiota in immune regulation, the purpose of this study is to investigate the alterations of gut microbiota in SD and explore the potential bacterial biomarkers for diagnosis. A case‐control study including SD patients and normal controls (NCs) was carried out. Gut microbiota of the participants was analysed by the 16S rDNA sequencing of faecal samples. The linear discriminant analysis effect size and the receiver operating characteristic curve (ROC) analysis were used to identify the bacterial biomarkers. Forty‐four participants were included in this study. The alpha‐diversity and beta‐diversity of gut microbiota differed significantly between SD patients and NCs. The abundance of Verrucomicrobia, Ruminococcaceae and their subordinate taxa were reduced in SD patients, while Enterobacteriales and its subor dinate taxon exhibited higher relative abundance compared with NCs. Subdoligranulum and Ruminococcus bromii showed a potential diagnostic value for SD, and Prevotella stercorea was negatively relevant to duration of SD. Furthermore, the pyruvate, butyric acid and histamine metabolism pathway were likely to be involved in the pathogenesis of SD. Our results revealed that the gut microbiota of SD patients experienced obvious changes, and Verrucomicrobia, Ruminococcaceae and Enterobacteriales were microbiota signatures for SD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.