Long-term follow-up of patients managed conservatively for acute traumatic CSF rhinorrhoea

xlomafota13 shared this article with you from Inoreader Long-term follow-up of patients managed conservatively for acute traumatic CSF rhinorrhoea Via leak of cerebrospinal fluid World Neurosurg. 2022 Feb 19:S1878-8750(22)00211-X. doi: 10.1016/j.wneu.2022.02.065. Online ahead of print. ABSTRACT OBJECTIVE: Conservative management of acute traumatic cerebrospinal fluid rhinorrhoea (TCR) results in cessation of the leak in most patients. The objective of this study was to estimate the incidence of recurrent cerebrospinal fluid (CSF) rhinorrhoea and meningitis in these patients on long-term follow-up and to determine the risk factors associated with them. METHODS: Data on 50 patients with acute TCR who were successfully treated with conservative management between 2013 and 2015 and had long term follow-up was retrieved from our head injury database. Patient variables were analysed to determine the risk factors associated with recurrence of CSF rhinorrhoea and meningitis. RESULTS: All patients in our series developed CSF rhinorrhoea within 48 hours of trauma. The mean duration of follow-up was 6.3 ± 1.3 years. CSF rhinorrhoea recurred in 16 (32%) patients, 15 (93.8%) of whom developed it within 3 years of trauma. Meningitis occurred in 5 (10%) patients and one of them died. Sphenoid sinus fractures and features of raised intracranial pressure on computerised tomography (CT) of the brain at admission were significantly associated with the development of meningitis. There were no risk factors identified for the recurrence of CSF rhinorrhoea. CONCLUSIONS: Patients with acute TCR in whom rhinorrhoea subsides with conservative therapy, have the highest risk for recurrence of leak or meningitis within three years of the trauma. Therefore, we recommend that these patients be counselled about the need for periodic follow up for several years. PMID:35192972 | DOI:10.1016/j.wneu.2022.02.065 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Value of six comorbidity scales for predicting survival of patients with primary surgery for oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Value of six comorbidity scales for predicting survival of patients with primary surgery for oral squamous cell carcinoma Via Head & Neck Abstract Background Comorbidities influence treatment outcome of oral squamous cell carcinoma (OSCC). This study compared the predictive performance of six comorbidity scales for overall survival after surgery for OSCC. Methods We retrospectively analyzed OSCC patients, surgically treated at an academic center in Belgium between January 01, 2000 and January 01, 2020. Validity of the scales was evaluated using the area under the curve (AUC) of receiver operating characteristic curves. Results Three hundred and twenty three patients were included. Elixhauser Comorbidity Index (AUC = 0.74, 95% CI: 0.55–0.92; AUC = 0.73, 95% CI: 0.55–0.80), modified Elixhauser Comorbidity Index (AUC = 0.72, 95% CI: 0.54–0.91; AUC = 0.69, 95% CI: 0.51–0.77), and Combined Comorbidity Index (AUC = 0.76, 95% CI: 0.58–0.84; AUC = 0.76, 95% CI: 0.59–0.84) were meaningful predictors for 2 and 5-year survival, respectively. Conclusion Selected comorbidity scales were capable of predicting overall survival for OSCC patients 2 and 5 years after primary surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Necrotising Otitis Externa Antibiotic therapy complications: A retrospective cohort analysis

xlomafota13 shared this article with you from Inoreader Necrotising Otitis Externa Antibiotic therapy complications: A retrospective cohort analysis Via Clinical Otolaryngology Abstract NOE is a rare but life-threatening condition. Treatment is long-term intravenous antibiotics. However, there is no evidence on the complications of antibiotic treatment in this complex cohort of patients In our study, patients on average are treated with two different antibiotic regimes 63% of these changes in regimen are due to direct adverse effects from treatment including drug intolerance and lack of significant clinical response leading to deterioration and morbid complications Patients requiring multiple antibiotic regimes have a statistically longer duration of treatment. These adverse effects appear to occur more frequently in patients with additional comorbidities. This novel data provides information clinicians can use when initiating treatment for NOE and counsel patients appropriately View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radioactive and non-radioactive seeds as surgical localization method of non-palpable breast lesions

xlomafota13 shared this article with you from Inoreader Radioactive and non-radioactive seeds as surgical localization method of non-palpable breast lesions Via radioactive iodine Rev Esp Med Nucl Imagen Mol (Engl Ed). 2022 Feb 19:S2253-8089(22)00002-7. doi: 10.1016/j.remnie.2022.01.002. Online ahead of print. ABSTRACT The increasingly early diagnosis of breast disease and the more widespread use of primary systemic therapy leads to an increasing number of surgeries for non-palpable breast lesions (NPL) in clinical practice. Breast-conserving surgery often requires the use of an image-guided preoperative localization procedure, in which a device is placed wit hin the lesion to be removed to guide the surgeon during surgery. These are patients with small, non-palpable tumors detected in the population screening mammogram, cases with significant reduction of the lesion after neoadjuvant chemotherapy and sometimes it is even necessary to mark axillary lymphadenopathies prior to systemic treatment. For decades, wire localization has been the standard for preoperative marking in breast cancer. Due to the external component of this device, extreme care must be taken not to alter its position before surgery, which is why it is placed hours before surgery and entails complex and limited flexibility in surgical programming. Intraoperative ultrasound improves this drawback but has the limitation that it can only be performed in those NPLs that have ultrasound translation. The Radioguided Occult Lesion Localization (ROLL) technique, although it is another alternative adopted by many institutions, is not without complications, among which the possib ility of diffusion of the radiotracer into healthy tissue stands out. To overcome these problems, more recently, 125I radioactive seeds began to be used. Subsequently, thanks to technological advances, non-radioactive seed alternatives such as radar reflectors, magnetic seeds and radio frequency markers have emerged. These locating devices can be placed days before surgery, avoiding wire-related problems and complications. They are introduced percutaneously and identified intraoperatively using a detector device. There is no perfect intraoperative localization method for NPL excision, but fortunately, we have multiple techniques with different advantages and disadvantages that must be assessed and adapted to the center's own resources, the type of surgery, and always to the benefit of the patient. PMID:35193816 | DOI:10.1016/j.remnie.2022.01.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Measured and self-reported olfactory function

xlomafota13 shared this article with you from Inoreader Measured and self-reported olfactory function in voluntary Norwegian adults Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Feb 23. doi: 10.1007/s00405-022-07298-7. Online ahead of print. ABSTRACT PURPOSE: The lack of epidemiological data on the proportion of olfactory dysfunction (OD) using comprehensive olfactory assessment in healthy adults in Scandinavia motivated to the present study which aimed to explore the proportion of OD in voluntary healthy Norwegian adults, assessed by Sniffin' Sticks, and its correlation to self-reported olfactory function. Furthermore, sociodemographic and clinical factors associated with olfactory function were analysed. METHODS: The sample included 405 Norwegian participants, aged 18-78 years, 273 women and 132 men, who underwent olfactory testing with extensive Sniffin' Sticks test, allergy testing, clinical examination with nasal endoscopy and completed a self-administered questionnaire, including self-evaluation of olfactory function on a 100 mm Visual Analogue Scale. RESULTS: We found that 37% had OD, of which 1.2% had anosmia assessed with extensive Sniffin' Sticks test. The proportion of hyposmia and anosmia increased with age. Men and participants with low education had poorer olfactory function scores. Allergy, smoking status, general health and endoscopic findings were not associated with measured olfactory function. We found no correlation between self-reported and measured olfactory function. CONCLUSIONS: This study has identified that a large proportion of our sample of voluntary healthy Norwegian adults have OD, considerably more common in older adults and somewhat more common in men and individuals with low education. The lack of correlation between self-reported and measured olfactory function highlights the importance of using validated tests for a reliable olfactory evaluation. PMID:35195760 | DOI:10.1007/s00405-022-07298-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hyperintense areas in the cisternal segments of the cranial nerves: a magnetic resonance imaging study

xlomafota13 shared this article with you from Inoreader Hyperintense areas in the cisternal segments of the cranial nerves: a magnetic resonance imaging study Via radiol anat Surg Radiol Anat. 2022 Feb 23. doi: 10.1007/s00276-022-02902-1. Online ahead of print. ABSTRACT PURPOSE: The study aimed to explore hyperintense areas in the cisternal segments of the cranial nerves using magnetic resonance imaging (MRI). METHODS: Seventy outpatients underwent thin-sliced, coronal constructive interference steady-state (CISS) sequence and sagittal T2-weighted MRI following conventional MRI examination. RESULTS: With the coronal CISS sequence, hype rintense areas were located in the central parts of the olfactory bulbs in 65.7% of patients. For the intracranial optic nerve and optic chiasm, hyperintense areas were detected in 98.6% of the CISS sequences and 100% of the T2-weighted images. In the optic tract, hyperintense areas were detected in 51.4% of cases. In 35% of the patients who underwent the CISS sequence, the intracranial optic nerves were considerably compressed by the internal carotid and anterior cerebral arteries, with hyperintense areas similar to those in patients without vascular compression. Hyperintense areas of the cisternal segments of the oculomotor nerve and trigeminal root were identified in 52.9% and 87.1% of the patients, respectively. CONCLUSIONS: The hyperintense areas found within the cisternal segments of the cranial nerves delineated on the coronal CISS sequence and sagittal T2-weighted imaging may indicate the intracranial part of the glymphatic pathway through the cranial nerves. The crani al nerves may function as part of the glymphatic pathway. PMID:35195771 | DOI:10.1007/s00276-022-02902-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.