Mohs micrographic surgery for cutaneous malignancy of the hand & upper limb - Raising awareness of its applications and advantages

xlomafota13 shared this article with you from Inoreader Mohs micrographic surgery for cutaneous malignancy of the hand & upper limb - Raising awareness of its applications and advantages Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 7:S1748-6815(21)00467-8. doi: 10.1016/j.bjps.2021.09.030. Online ahead of print. ABSTRACT Mohs Micrographic Surgery (MMS) is primarily recognised for use in facial tumours, however it should also be considered to aid excision of tumours of the hand, where preservation of tissue and maintenance of function are key factors. Mohs surgery can serve to facilitate decision making both by the patient and surgeon. This can be particularly helpful when proposing more extensive surgery, or prior to complex reconstruction where confirmation of tumour clearance is paramount. We use case examples with medical images to illustrate the advantages of MMS over conventional excision. The establishment of an MMS hand service, delivered by a surgeon with specialist upper limb resection and reconstructive expertise, has allowed our unit to provide optimal treatment, governance, and outcomes for this group of patients . PMID:34686456 | DOI:10.1016/j.bjps.2021.09.030 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between Thyroid Function and Heart Rate Monitored by Wearable Devices in Patients with Hypothyroidism

xlomafota13 shared this article with you from Inoreader Association between Thyroid Function and Heart Rate Monitored by Wearable Devices in Patients with Hypothyroidism Via radioactive iodine Endocrinol Metab (Seoul). 2021 Oct 21. doi: 10.3803/EnM.2021.1216. Online ahead of print. ABSTRACT BACKGROUND: Heart rate (HR) monitored by a wearable device (WD) has demonstrated its clinical feasibility for thyrotoxicosis subjects. However, the association of HR monitored by wearables with hypothyroidism has not been examined. We assessed the association between serum thyroid hormone concentration and three WD-HR parameters in hypothyroid subjects. METHODS: Forty-four subje cts scheduled for radioactive iodine therapy (RAI Tx) after thyroid cancer surgery were included. Thirty subjects were prepared for RAI Tx by thyroid hormone withdrawal (hypothyroidism group) and 14 subjects by recombinant human thyrotropin (control group). Three WD-HR parameters were calculated from the HR data collected during rest, during sleep, and from 2:00 AM to 6:00 AM, respectively. We analyzed the changes in conventionally measured resting HR (On-site rHR) and WDHR parameters relative to thyroid hormone levels. RESULTS: Serum free thyroxine (T4) levels, On-site rHR, and WD-HR parameters were lower in the hypothyroid group than in the control group at the time of RAI Tx. WD-HR parameters also reflected minute changes in free T4 levels. A decrease in On-site rHR and WD-HR parameters by one standard deviation (On-site rHR, approximately 12 bpm; WD-HR parameters, approximately 8 bpm) was associated with a 0.2 ng/dL decrease in free T4 levels (P<0.01) and a 2-fold incre ase of the odds ratio of hypothyroidism (P<0.01). WD-HR parameters displayed a better goodness-of-fit measure (lower quasi-information criterion value) than On-site rHR in predicting the hypothyroidism. CONCLUSION: This study identified WD-HR parameters as informative and easy-to-measure biomarkers to predict hypothyroidism. PMID:34674500 | DOI:10.3803/EnM.2021.1216 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer Via radioactive iodine Diagnostics (Basel). 2021 Sep 22;11(10):1740. doi: 10.3390/diagnostics11101740. ABSTRACT Background: Radioactive 131I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131I retention data, which are used to indicate the time at which a 131I treated DTC patient can be released from the hospital, may bring some insight s regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131I whole-body retention in DTC patients during 131I therapy. Methods: We monitored 166 DTC patients to follow the 131I whole-body retention during 131I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131I effective half-life in each patient, and a relationship was sought between patients' clinical characteristics and whole-body effective 131I half-life. Results: The effective 131I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131I half-life was related to older age and extensive extra-thyroid disease. Conclusions: 131I effective half-life during 131I treatment in DTC patients is highly variable amon g patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131I. PMID:34679438 | PMC:PMC8535104 | DOI:10.3390/diagnostics11101740 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic Lymphocytic Thyroiditis and Aggressiveness of Pediatric Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Chronic Lymphocytic Thyroiditis and Aggressiveness of Pediatric Differentiated Thyroid Cancer Via radioactive iodine Laryngoscope. 2021 Oct 23. doi: 10.1002/lary.29908. Online ahead of print. ABSTRACT OBJECTIVES/HYPOTHESIS: Hashimoto's Thyroiditis (HT) is a common cause of hypothyroidism. Among adults with differentiated thyroid cancer (DTC), HT appears to be associated with less severe disease burden. In the absence of information regarding HT and disease burden among children with DTC, we assessed the relationship between pediatric DTC severity and HT. STUDY DESIGN: Retrospective cohort.< /p> METHODS: Charts from 90 pediatric patients who underwent surgical removal of DTC from 2002 to 2017 at tertiary-care children's hospital were reviewed. Demographic, clinical, surgical, pathology, and outcome details were compared between patients with and without HT. Consistency among diagnostic modalities of HT was also evaluated. RESULTS: Median age at presentation was 16.0 years (range 4.2-18.9 years). Twenty-two patients were male (24%). Forty-five patients (50%) had HT based on presence of thyroid autoantibodies and/or surgical pathology findings and 45 patients did not have HT. Patients with HT had increased odds of microcalcifications (odds ratio [OR]: 3.01, P = .031) and decreased odds of palpable nodules (OR: 0.212, P = .024) and T2 lesions (vs. T1) (OR: 0.261, P = .015) compared with non-HT. No significant differences in demographics and the incidence of multifocality, extrathyroidal extension, lymphovascular invasion, lymph node or pulmonary metastases, disease recurrence, or radioactive iodine treatment were found between the two groups. Thyroglobulin/thyroid peroxidase autoantibodies and surgical pathology indicative of HT were concordant in 82.4% (κ = 0.635, P < .001). CONCLUSION: HT was present in 50% of children with DTC. Patients with DTC and HT presented with smaller tumors compared to non-HT patients. No significant differences in other markers of disease aggressiveness were found between the two groups. LEVEL OF EVIDENCE: 3 Laryngoscope, 2021. PMID:34687456 | DOI:10.1002/lary.29908 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcome of the endoscopic repair of frontal sinus cerebrospinal fluid leak

xlomafota13 shared this article with you from Inoreader Outcome of the endoscopic repair of frontal sinus cerebrospinal fluid leak Via leak of cerebrospinal fluid Ann Med Surg (Lond). 2021 Sep 23;70:102887. doi: 10.1016/j.amsu.2021.102887. eCollection 2021 Oct. ABSTRACT INTRODUCTION: and Objectives: Leakage of cerebrospinal fluid (CSF) from the frontal sinus is a challenging condition facing the ENT surgeon. Repair of this condition has been changed nowadays due to the newer instruments and techniques of nasal endoscopy. This study aims to evaluate the outcome of frontal sinus CSF leak endoscopic repair. PATIENTS AND METHODS: Twenty-seven patients who had frontal sinus CSF leaks were included in this study. They were 9 females and 18 males. They underwent endoscopic repair of the leak site at the period of five years from 2015 to 2020. A retrospective evaluation of these patients includes reconstructive procedures, complications, and postoperative follow-up. RESULTS: The frontal leaks were present in the frontal recess (8 patients, 29.6%), ethmoidal roof (5 patients, 18.5%), and the majorit y was in the posterior wall (14 patients, 51.9%); 11 in the medial side and 3 in the lateral side. All cases, 27 (100%) were treated successfully, no failed treatment was observed. Postoperative complications were minimal; two patients had elevated intracranial pressure (ICP), infection with fever were found in four patients (7.4%), and meningitis was observed in only two cases (7.4%), treated conservatively. CONCLUSION: For frontal sinus CSF leak repair, the endonasal endoscopic approach is the treatment of choice due to higher success rates and lower morbidity profile. A favorable result is possible with proper diagnosis, precise localization, and an appropriate strategy. PMID:34691428 | PMC:PMC8519771 | DOI:10.1016/j.amsu.2021.102887 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Imaging of Acquired Skull Base Cerebrospinal Fluid Leaks

xlomafota13 shared this article with you from Inoreader Imaging of Acquired Skull Base Cerebrospinal Fluid Leaks Via leak of cerebrospinal fluid Neuroimaging Clin N Am. 2021 Nov;31(4):509-522. doi: 10.1016/j.nic.2021.05.009. ABSTRACT Acquired skull base cerebrospinal fluid (CSF) leaks can result from trauma, tumors, iatrogenic causes, or may be spontaneous. Spontaneous skull base CSF leaks are likely a manifestation of underlying idiopathic intracranial hypertension. The initial assessment of rhinorrhea or otorrhea which is suspected to be due to an acquired skull base CSF leak requires integration of clinical assessment and biochemical confirmation of CSF. Imaging with high-resolution CT is performed to locate osseous defects, while high-resolution T2w MRI may detect CSF traversing the dura and bony skull base. When leaks are multiple or if samples of fluid cannot be obtained for testing, then recourse to invasive cisternography may be necessary. PMID:34689930 | DOI:10.1016/j.nic.2021.05.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Imaging of Skull Base Trauma: Fracture Patterns and Soft Tissue Injuries

xlomafota13 shared this article with you from Inoreader Imaging of Skull Base Trauma: Fracture Patterns and Soft Tissue Injuries Via leak of cerebrospinal fluid Neuroimaging Clin N Am. 2021 Nov;31(4):599-620. doi: 10.1016/j.nic.2021.06.003. ABSTRACT This article provides an overview of the patterns of skull base trauma and provides a review of the pertinent soft tissue injuries and complications that can ensue. A brief review of skull base anatomy is provided with subsequent focus on the important findings in anterior, central, and posterior skull base trauma. PMID:34689935 | DOI:10.1016/j.nic.2021.06.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reusable surgical drapes in Plastic surgery: What is the sticking point?

xlomafota13 shared this article with you from Inoreader Reusable surgical drapes in Plastic surgery: What is the sticking point? Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 7:S1748-6815(21)00468-X. doi: 10.1016/j.bjps.2021.09.027. Online ahead of print. NO ABSTRACT PMID:34688592 | DOI:10.1016/j.bjps.2021.09.027 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparative study of porous polyethylene versus absorbable polydextro- and polylevolactic-lactide plate in reconstruction of isolated medial orbital wall fracture

xlomafota13 shared this article with you from Inoreader A comparative study of porous polyethylene versus absorbable polydextro- and polylevolactic-lactide plate in reconstruction of isolated medial orbital wall fracture Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 17:S1748-6815(21)00410-1. doi: 10.1016/j.bjps.2021.08.023. Online ahead of print. ABSTRACT BACKGROUND: Several materials for medial orbital wall reconstruction have been mentioned in the literature. Our main purpose was to investigate postoperative enophthalmos and diplopia after medial orbital wall reconstruction with polydextro- and polylevolactic (poly-L/DL) acid (P[L/DL]LA) mesh plates and porous polyethylene plates. METHODS: Using a retrospective study design, we enrolled a cohort of isolated medial blowout fracture patients treated during a 58-month interval. The predictor variable was medial orbital wall reconstruction materials (P(L/DL)LA mesh plate and porous polyethylene plate. The main outcome variables included the occurrence of postoperative enophthalmos and diplopia at 1 week, 1, 3, 6, and 12 months post-surgery . Appropriate descriptive, uni- and bivariate statistics were computed, and P < 0.05 was considered significant. RESULTS: Three hundred-two isolated medial blowout fracture patients were included (24.5% females, 67% treated with P(L/DL)LA mesh plate). Exophthalmos measured highest in both groups 1 week after surgery and decreased steadily for 6 months postoperatively. Statistically significant differences were observed between both groups at 1 week, 1 month, and 3 months after surgery, with a higher incidence of exophthalmos observed in the P(L/DL)LA mesh plate group (P < 0.001). No significant differences were observed at 6 and 12 months after surgery. CONCLUSION: The occurrence of enophthalmos after medial blowout fracture reconstruction with P(L/DL)LA mesh plate is comparable with the use of porous polyethylene plate. Both P(L/DL)LA mesh and porous polyethylene plates are, th erefore, reliable implants for medial orbital wall reconstruction. PMID:34690092 | DOI:10.1016/j.bjps.2021.08.023 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spatial geochemical differentiation of the iodine-induced health risk and distribution of thyroid cancer among urban and rural population of the Central Russian plain affected by the Chernobyl NPP accident

xlomafota13 shared this article with you from Inoreader Spatial geochemical differentiation of the iodine-induced health risk and distribution of thyroid cancer among urban and rural population of the Central Russian plain affected by the Chernobyl NPP accident Via radioactive iodine Environ Geochem Health. 2021 Oct 23. doi: 10.1007/s10653-021-01133-4. Online ahead of print. ABSTRACT The main goal was to study the spatial distribution of thyroid cancer (THYC) among the population of urban and rural settlements of four regions of Russia, which were characterized by different contents of stable iodine in soils and exposed to radioactive fallout of 131I from the Chernobyl NPP. Using GIS technologies, zoning of territories for the deficiency of 127< /sup>I and pollution with 131I was performed. The resulting risk maps were compared with the THYC distribution. The association between the spatial distribution of the total (natural and man-made) risk assessment and the incidence of THYC at the district level tended to have a higher positive correlation (r = 0.505, p < 0.001, n = 94) compared with the correlation of the latter parameter with a fallout density of 131I (r = 0.468, p < 0.001). After latent period, the incidence of THYC among residents of urban settlements of the Bryansk region was considerably higher than in rural, the difference increasing with time. The correlation between the assessed total risk and THYC distribution in risk zones was significant and higher in the rural areas than in the urban ones. A tendency for a negative significant correlation (r = - 0.55, p = 0.01) between daily iodine intake (based on the main components of the diet) and THYC cases among the rural population was f ound. A definite difference in the influence of geochemical environmental factors on the distribution of THYC among urban and rural populations deserves more detailed study to prevent this disease. PMID:34689286 | DOI:10.1007/s10653-021-01133-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Papillary Thyroid Cancer Affecting Multiple Family Members: A Case Report and Literature Review of Familial Nonmedullary Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Papillary Thyroid Cancer Affecting Multiple Family Members: A Case Report and Literature Review of Familial Nonmedullary Thyroid Cancer Via radioactive iodine Case Rep Endocrinol. 2021 Oct 15;2021:3472000. doi: 10.1155/2021/3472000. eCollection 2021. ABSTRACT Familial nonmedullary thyroid cancer (FNMTC) represents 5-10% of NMTC cases. Many controversies are associated with the FNMTC, namely, the minimum required number of affected family members to define the condition, aggressiveness, prognosis, and treatment and screening recommendations. Moreover, the genetic basis of the FNMTC has not yet been identified. We report a family diagnosed with FNMTC and present a comprehensive literature review of the condition. The index case was a 26-year-old male who was diagnosed with locally advanced papillary thyroid cancer (PTC). Then, his family members became worried and asked for a neck ultrasound. Four of his six siblings, in addition to his father, were diagnosed with PTC. In addition, two of his cousins were diagnosed. The patient underwent total thyroidectomy with bilateral neck dissection, and he received 2 doses of radioactive iodine (100 mCi each). Furthermore, one of his siblings required a second surgery with repeated radioactive iodine therapy. The index case genetic screening and whole-exome sequencing did not show any abnormalities. Future genetic and clinical research should focus on kindred with 3 or more affected individuals for better identification of the FNMTC susceptibility genes and to better guide management and screening recommendations. PMID:34691791 | PMC:PMC8536453 | DOI:10.1155/2021/3472000 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.