Fourteen years old as the best age cutoff to differentiate prepubertal from pubertal papillary thyroid carcinoma

alexandrossfakianakis shared this article with you from Inoreader Fourteen years old as the best age cutoff to differentiate prepubertal from pubertal papillary thyroid carcinoma via Head & Neck Abstract Background It is unclear whether differences in clinical presentation and/or prognosis exist between prepubertal papillary thyroid cancer (PTC) and pubertal PTC. At present, there is a lack of definition for the appropriate cutoff age to define prepubertal PTC. Methods This study retrospectively reviewed 227 pediatric PTC patients (aged ≤18 years) who underwent initial surgery from March 2000 to December 2018. The median duration of follow-up was 85 months (range, 8–258). Results The age range was basically linearly related to multiple risk factors, such as T3–T4 disease, distant metastasis. Age (p = 0.032) was an independent risk factor for recurrence and persistent disease. Patients aged <14 years had obviously higher rates of extensive disease. The 10-year disease-free survival (DFS) rate of patients aged <14 years was 59.5% and that of patients aged ≥14 years was 82.6% (p = 0.004). Conclusions Fourteen years of age may be an appropriate cutoff to differentiate prepubertal PTC from pubertal PTC. View on Web

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Association of Genre of Singing and Phonotraumatic Vocal Fold Lesions in Singers

alexandrossfakianakis shared this article with you from Inoreader Association of Genre of Singing and Phonotraumatic Vocal Fold Lesions in Singers via The Laryngoscope This study revealed previously unrecognized associations between singing genre and specific types of vocal fold injury. These findings help to inform mechanistic inferences surrounding the pathophysiology of specific phonotrauma. A combination of factors most likely account for these findings, including vocal technique, acoustic environment and performance schedules. Objectives/Hypothesis To determine if (1) the likelihood of presenting with phonotraumatic lesions differs by singing genre in treatment-seeking singers and (2) if the distribution of phonotraumatic lesion types differs by singing genre. Study Type Retrospective. Methods Records of singers who presented with a voice complaint over the course of 2.5 years (June 2017–December 2019) were reviewed to determine the proportion of those with phonotraumatic lesions as a function of genre (Study 1). Separately, the lesion types and genres of singers diagnosed with phonotraumatic lesions over a 9-year period (July 2011–March 2020) were determined (Study 2). Results In Study 1, 191 of 712 (26.8%) dysphonic singers were diagnosed with phonotraumatic lesions. Country/folk, gospel/jazz, and musical theater singers were more likely to present with phonotraumatic lesions. In Study 2, in 443 singers with phonotraumatic lesions, polyps and pseudocysts, but not nodules, were found to be distributed unequally across genres (χ 2 p = 0.006, p < 0.0001, p = 0.064, respectively). Praise/worship singers had significantly higher proportions of polyps compared to choral singers (OR 4.8 [95% CI 1.9–12.5]) or compared to musical theater singers (OR 7.2 [95% CI 2.5–20.8]). Opera singers had significantly higher proportions of pseudocysts than choral singers (OR 3.1 [95% CI 1.5–6.1]) or musical theater singers (OR 3.7 [95% CI 1.8–7.6]). Conclusions The higher incidence of polyps in praise/worship singers likely reflects the more emphatic nature of singing and the tendency for acute injury. The higher incidence of pseudocysts in opera singers may reflect a more chronic nature of injury. Level of Evidence 4 Laryngoscope, 2022 View on Web

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Outcomes of Non‐Mucosa Sparing Endoscopic Sinus Surgery (Partial Reboot) in Refractory Chronic Rhinosinusitis with Nasal Polyposis: An Academic Hospital Experience

alexandrossfakianakis shared this article with you from Inoreader Outcomes of Non‐Mucosa Sparing Endoscopic Sinus Surgery (Partial Reboot) in Refractory Chronic Rhinosinusitis with Nasal Polyposis: An Academic Hospital Experience via The Laryngoscope We investigated the role of non-mucosa sparing endoscopic sinus surgery (partial reboot) in pluri-operated patients affected by chronic rhinosinusitis with nasal polyps. According to our results, partial reboot should be considered as a therapeutic option in those patients, allowing lower recurrence rate, longer clinical remission, improved quality of life and zeroing oral corticosteroids uptake, as compared to standard endoscopic sinus surgery. Objective The reboot approach could be an effective treatment option to lower recurrence rates (RRs) in recalcitrant Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). The purpose of this study was to investigate RR, recurrence-free survival (RFS), quality of life (QoL) improvement, and oral corticosteroid (OCS) intake in pluri-operated CRSwNP patients treated with partial reboot surgery. Methods A consecutive sample of patients with recalcitrant CRSwNP, ineligible for monoclonal antibodies, underwent partial reboot surgery. The 22-item SinoNasal Outcome Test (SNOT-22), Visual Analogue Scales (VAS) scores, OCS intake, and endoscopic Nasal Polyp Score (NPS) were collected pre and postoperatively. The main outcomes were RR and RFS, and comparison of disease-free time with previous endoscopic surgeries. Results Thirty pluri-operated patients were enrolled. Before the reboot, all had experienced disease recurrence at a mean recurrence time of 8.08 ± 2.83 months after surgery. After reboot, 7 (23.3%) had recurrence at a mean time of 16.67 ± 3.07 months (p = 0.02); none needed additional revision surgery till time of data collection. RR at 12, 18, and 24 months follow-up resulted significantly lower for reboot than other previous surgeries (p = 0.010, p = 0.002, p = 0.016, respectively); RFS difference resulted significant (log-rank test = 4.16; p = 0.04). Differences between pre-and post-operative total and single-items scores of SNOT-22 were significant (p = 0.001), as well as VAS scores (p = 0.001). Before the reboot, 21 patients (70%) took ≥2 OCS courses per year; at the latest follow-up visit, none had taken any course of OCS after reboot. Conclusions The reboot approach showed lower RR, longer RFS, improved QoL, and zeroing of OCS uptake. Larger samples and longer follow-up studies are needed to assess long-term efficacy and safety of this procedure. Level of Evidence Level 4. According to the Oxford Center for Evidence-Based Medicine 2011 level of evidence guidelines, this non-randomized retrospective cohort study is classified as level 4 evidence Laryngoscope, 2022. Laryngoscope, 2022 View on Web

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Perioperative Hypercoagulability in Free Flap Reconstructions Performed for Intracranial Tumors

alexandrossfakianakis shared this article with you from Inoreader Perioperative Hypercoagulability in Free Flap Reconstructions Performed for Intracranial Tumors via The Laryngoscope Patients with intracranial tumors have a higher risk of thromboembolic events. A multi-institutional retrospective chart review was performed of patients who underwent free tissue transfer for scalp/cranial reconstruction. There is an increase in perioperative flap thrombosis in patients with intracranial tumors undergoing free tissue scalp reconstruction, and anticoagulation appears to mitigate this risk. Objective(s) Patients with intracranial tumors have a higher risk of thromboembolic events. This risk increases at the time of surgical intervention. We have noted an anecdotal increase in perioperative flap thrombosis in patients undergoing free tissue transfer for intracranial tumor resection. This study aims to formally evaluate this risk. Methods A multi-institutional retrospective chart review was performed of patients who underwent free tissue transfer for scalp/cranial reconstruction. Perioperative thrombosis and free flap outcomes were evaluated. Results The 209 patients who underwent 246 free tissue transfers were included in the study. The 28 free flap scalp reconstructions were associated with intracranial tumors, 19 were performed following composite cranial resections with associated dural resection/reconstruction, and 199 were performed in the absence of intracranial tumors (control group). There was a significantly higher incidence of perioperative flap thrombosis in the intracranial tumor group (11/28, 39%) when compared to controls (38/199, 19%) (p = 0.0287). This was not seen when scalp tumors extended to the dura alone (4/19, 21%, p = 0.83). Therapeutic anticoagulation used for perioperative thrombosis (defined as intraoperative or in the immediate postoperative phase up to 5 days) was associated with a lower risk of flap failure, although this was not statistically significant (p = 0.148). Flap survival rates were equivalent between flaps performed for intracranial pathology (93.3%) and controls (95%). Conclusion There is an increase in perioperative flap thrombosis in patients with intracranial tumors undergoing free tissue scalp reconstruction. Anticoagulation appears to mitigate this risk. Level of Evidence This recommendation is based on level 3 evidence (retrospective case–control studies, systematic review of retrospective studies, and case reports) Laryngoscope, 2022 View on Web

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Effect of sacubitril/valsartan on cognitive impairment in colchicine‐induced Alzheimer’s model in rats

alexandrossfakianakis shared this article with you from Inoreader Effect of sacubitril/valsartan on cognitive impairment in colchicine‐induced Alzheimer's model in rats via Fundamental & Clinical Pharmacology Abstract Background Alzheimer's disease (AD) is a complex neurodegenerative disease. There is epidemiological evidence that heart failure (HF) patients are at higher risk of developing AD and the impact of sacubitril/valsartan, the first angiotensin receptor-neprilysin inhibitor (ARNI) approved for HF, on cognitive functions is still controversial. Objective To investigate the effect of sacubitril/valsartan on cognitive functions in colchicine-induced AD rat model. Methods Forty adult male Wistar rats were equally allocated into four groups (each of 10 rats). Group I: normal control, Group II: intracerebroventricular injection of colchicine (15μg/5μl/bilaterally), Group III: colchicine (15μg/5μl/bilaterally, icv) + oral sacubitril/valsartan (100 mg/kg/day) for 25 days and Group IV: colchicine (15μg/5μl/bilaterally, icv) + oral valsartan (50 mg/kg/day) for 25 days. Behavioral assessment was done using Morris water maze and passive avoidance tasks. Biochemically, β-amyloid (1-40 and 1-42) peptides, oxidative stress (malondialdehyde and superoxide dismutase) and inflammatory (tumor necrosis factor-alpha) parameters were measured in hippocampus and prefrontal cortex. Results Sacubitril/valsartan exaggerated colchicine-induced cognitive impairment in both Morris water maze and passive avoidance tasks, and was associated with significant increase in β-amyloid accumulation, oxidative stress and inflammation versus valsartan. Conclusion Sacubitril/valsartan caused deleterious effect on cognitive impairment and biochemical alterations in colchicine-induced AD rat model. Hence, special caution should be taken following long-term intake of ARNI on cognitive functions. View on Web

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Protective assessment of progesterone and its receptor on experimental diabetic neuropathy: Anti‐oxidant and anti‐inflammatory effects

alexandrossfakianakis shared this article with you from Inoreader Protective assessment of progesterone and its receptor on experimental diabetic neuropathy: Anti‐oxidant and anti‐inflammatory effects via Fundamental & Clinical Pharmacology Abstract Introduction Diabetes induces a disorder in mitochondrial activity, which causes damage to the nuclear and mitochondrial DNA, and ultimately increases the release of inflammatory cytokines and damages the sciatic nerve and dorsal root ganglion and induces neuropathy. It has been shown that progesterone has anti-inflammatory and anti-oxidative effects and prevents nerve cell damage. Therefore, the aim of this experiment was to investigate the effect of progesterone receptor neuroprotection on diabetic neuropathy. Methods Forty male Sprague-Dawley rats were divided into 4 groups, including control group, diabetic control group, diabetic control group+Progesterone(30mg/kg), diabetic control group+combination of Progesterone(30mg/kg) and RU486(10mg/kg). After the induction of diabetes, blood glucose level, body weight, behavioral tests, electrophysiological tests, oxidative and inflammatory factors, and histological parameters were measured. Results Progesterone treatment significantly reduced the level of sensitivity to hot plate without significant effect on glucose level, and significant changes were also observed in the results of tail flake test. In addition, the results showed that the administration of progesterone can improve MNCV and significantly reduce the serum levels of oxidative stress and inflammatory factors, as well as inflammation and edema around the sciatic nerve. However, RU486 inverted the beneficial effects of progesterone. Conclusion Progesterone can be considered as a protective agent in reducing DN because of its ability to reduce inflammation and nerve damage. In addition, RU486, a progesterone receptor blocker, inhibits the beneficial effects of progesterone on the DN, thus progesterone receptors play an important role in the neuroprotective effect of progesterone. View on Web

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International variations in soft tissue sarcoma incidence in children and adolescents

alexandrossfakianakis shared this article with you from Inoreader International variations in soft tissue sarcoma incidence in children and adolescents via Japanese Journal of Clinical Oncology - current issue In order to compare the subtype distribution of soft tissue sarcoma in children and adolescents between Japan and other countries, we extracted information on cancer incidence in children and adolescents from the third volume of the International Incidence of Childhood Cancer series (IICC-3) (1). The IICC-3 reports the number or incidence rates of cancers diagnosed in childhood and adolescence, from cancer registries (regional or national) worldwide. We analysed soft tissue sarcoma incidence in four countries in Asia (Japan, China, the Republic of Korea and Thailand), two countries in Africa (Egypt and Uganda), four countries in the Americas (North: The United States of America and Canada, Latin and Caribbean: Brazil and Colombia), three countries in Europe (the United Kingdom [UK], France and Germany) and two countries in Oceania (Australia and New Zealand ). Information from the Republic of Korea, USA, UK, Australia and New Zealand was obtained at the national level, and that from the other countries was extracted from one or multiple regional cancer registries. The years of incidence included in the analyses varied from country to country, ranging from 1990 to 2014, with the shortest being 12 years (Egypt: 1999–2010, UK: 2000–2011) and the longest being 24 years (Japan and China: both 1990–2013). In this study, we compared the incidence and proportional distribution of soft tissue sarcoma subtypes in children (0–14 years old) and adolescents (15–19 years old) between these countries. View on Web

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LEUKOTRIENE METABOLISM AND PROIFLAMMATORY CYTOKINES IN CRIMEAN CONGO HEMORRHAGIC FEVER

alexandrossfakianakis shared this article with you from Inoreader LEUKOTRIENE METABOLISM AND PROIFLAMMATORY CYTOKINES IN CRIMEAN CONGO HEMORRHAGIC FEVER via Journal of Medical Virology Abstract Crimean-Congo hemorrhagic fever (CCHF) is an emerging acute viral infection disease, yet its pathophysiology remains largely uncharacterized. Lipid mediators are molecules that play numerous roles in the physiologic and pathophysiologic conditions in certain viral diseases. No previous study evaluated the status of cysteinyl leukotrienes (CYSLT) and 5-lipoxygenase (5-LO) and their relationship with proinflammatory cytokines in CCHF. A total of 90 subjects including 60 CCHF patients and 30 healthy controls were enrolled the study. Serum CYSLT, 5-LO, interleukin-6 (IL-6) and ferritin levels were determined in the study population. Lower median 5-LO level was determined in patients compared to healthy controls (p = 0.0004). Higher ferritin (p < 0.001) and IL-6 (p < 0.001) levels in patients than healthy controls. No statistically significant difference was observed between patients and controls in terms of CYSLT levels. No statistically significant differ ences were observed between mild, moderate, and severe groups in terms of both 5-LO and CYSLT levels. IL-6 and ferritin levels were higher in severe group compared mild and moderate groups. In conclusion, changes in 5-LO enzyme and increased inflammation are related with the disease molecular mechanism. Higher inflammatory status contributes to the impaired hemostatic balance in CCHF. Thus, treatment strategies to reduce inflammation may help to prevent bleeding and DIC in patients. IL-6 and ferritin can be used to as an additional biomarker in the estmation of the prognosis and diagnosis of the patients. This article is protected by copyright. All rights reserved. View on Web

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Current immunoassays and detection of antibodies elicited by Omicron SARS‐CoV‐2 infection

alexandrossfakianakis shared this article with you from Inoreader Current immunoassays and detection of antibodies elicited by Omicron SARS‐CoV‐2 infection via Journal of Medical Virology Abstract Objectives To determine whether current commercial immunoassays are adequate for detecting anti-Omicron antibodies. Methods We analyzed the anti-SARS-CoV-2 antibody response of 23 unvaccinated individuals 1-2 months after an Omicron infection. All blood samples were tested with a live virus neutralization assay using a clinical Omicron BA.1 strain and 4 commercial SARS-CoV-2 immunoassays. We assessed three anti-Spike immunoassays (SARS-CoV-2 IgG II Quant (Abbott S), Wantaï anti-SARS-CoV-2 antibody ELISA (Wantaï), Elecsys Anti-SARS-CoV-2 S assay (Roche)) and one anti-Nucleocapsid immunoassay (Abbott SARS-CoV-2 IgG assay (Abbott N)). Results Omicron neutralizing antibodies were detected in all samples with the live virus neutralization assay. The detection rate of the Abbott S, Wantai, Roche and Abbott N immunoassays were 65.2%, 69.6%, 86.9% and 91.3%, respectively. The sensitivities of Abbott S and Wantai immunoassays were significantly lower t han that of the live virus neutralization assay (p=0.004, p=0.009; Fisher's exact test). Antibody concentrations obtained with anti-S immunoassays were correlated with Omicron neutralizing antibody concentrations. Conclusion These data provide clinical evidence of the loss of performance of some commercial immunoassays to detect antibodies elicited by Omicron infections. It highlights the need to optimize these assays by adapting antigens to the circulating SARS-CoV-2 strains. This article is protected by copyright. All rights reserved. View on Web

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‘Like ships in the night’: A qualitative investigation of the impact of childhood cancer on parents’ emotional and sexual intimacy

alexandrossfakianakis shared this article with you from Inoreader 'Like ships in the night': A qualitative investigation of the impact of childhood cancer on parents' emotional and sexual intimacy via Pediatric Blood & Cancer Abstract Background Childhood cancer is highly distressing for families and can place strain on parents' relationships. Parental functioning and cohesiveness are important predictors of family functioning and adaptation to stress. This qualitative study investigated the perceived impact of childhood cancer on parents' relationship with their partner, with a focus on emotional and sexual intimacy. Methods We conducted semi-structured interviews with 48 parents (42 mothers, six fathers) of children under the age of 18 who had completed curative cancer treatment. We analysed the interviews using thematic analysis. Results At interview, parents were on average 40.7 years old (SD = 5.5, range: 29–55 years), and had a child who had completed cancer treatment between 3 months and 10.8 years previously (M = 22.1 months). All participants were living with their partner in a married/de facto relationship. Most parents reported that their child's cancer treatment had a negative impact on emotional and sexual intimacy with their partner, with some impacts extending to the post-treatment period. Reasons for compromised intimacy included exhaustion and physical constraints, having a shifted focus, and discord arising from different coping styles. Some parents reported that their relationship strengthened. Parents also discussed the impact of additional stressors unrelated to the child's cancer experience. Conclusions Parents reported that childhood cancer had a negative impact on aspects of emotional and sexual intimacy, although relationship strengthening was also evident. It is important to identify and offer support to couples who experience ongoing relationship stress, which may have adverse effects on family functioning and psychological wellbeing into survivorship. View on Web

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