Self‐reported medication adherence in differentiated thyroid cancer survivors: Role of illness perception and medication beliefs

xlomafota13 shared this article with you from Inoreader Self‐reported medication adherence in differentiated thyroid cancer survivors: Role of illness perception and medication beliefs Via Head & Neck Abstract Background To investigate medication adherence (MA) to Levothyroxine in differentiated thyroid cancer survivors and analyze the related factors for nonadherence. Methods The Medication Adherence Report Scale (MARS), Hospital Anxiety and Depression Scale (HAD), Brief Illness Perception Questionnaire (B‐IPQ), and Beliefs about Medicines Questionnaire (BMQ) were used to assess MA. Results Nonadherence was reported in 77 of 197 patients (39.1%). Socioeconomic status and education levels were found to be significantly related to MA. The HAD scores, all items of B‐IPQ, and BMQ were associated with MA and showed a correlation with the MARS scores. The primary predictors of MA were greater confidence in treatment modality (odds ratio [OR]: 0.48, 95% confidence interval (CI): 0.37‐0.63) and greater belief that the medication had minimal risk of harm (OR: 3.35, 95% CI: 1.50‐7.49). Conclusions Special attention should be paid to educational programs for differentiated thyroid carcinoma patients concerning the effectiveness and low risk of harm of medication in order to improve MA. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The importance of smoking status at diagnosis in human papillomavirus‐associated oropharyngeal cancer

xlomafota13 shared this article with you from Inoreader The importance of smoking status at diagnosis in human papillomavirus‐associated oropharyngeal cancer Via Head & Neck Abstract Background Smoking status at point of diagnosis is not used in defining risk groups for human papillomavirus (HPV)‐associated oropharyngeal cancer (OPC) despite its prognostic value in head and neck cancer. Methods Retrospective analysis of consecutive patients treated with chemoradiotherapy between January 2005 and July 2017 was performed with multivariable analysis to explore the impact of smoking status at diagnosis (current/former/never) on overall survival (OS), cancer‐specific survival (CSS) and progression‐free survival (PFS). Results Median follow‐up was 61 months. Four hundred and four patients were included. Current smokers had inferior OS versus never and former smokers [adjusted HR 2.37 (95% CI 1.26–4.45, p < 0.01) and 2.58 (95% CI 1.40–4.73, p < 0.01), respectively] and inferior PFS versus never smokers [adjusted HR 1.83 (95% CI 1.00–3.35, p = 0.04)]. Smoking status did not predict for CSS. Conclusion Detailed smoking behavior should be considered in refining risk groups in HPV‐associated OPC treated with radiotherapy and in future trial design eligibility and stratification. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of the temporoparietal fascia free flap in salvage total laryngectomy

xlomafota13 shared this article with you from Inoreader Role of the temporoparietal fascia free flap in salvage total laryngectomy Via Head & Neck Abstract The procedure for salvage total laryngectomy (STL) is burdened by a high rate of postoperative complications as a result of delayed wound healing in previously irradiated tissue. Several observational studies have investigated the role of prophylactic vascularized flaps to aid pharyngeal closure after STL and prevent the development of PCF. The use of a temporoparietal fascia free flap (TFFF) as an overlay flap for STL has been described previously in two published studies and both sets of authors agreed that the most obvious benefit of the TFFF in STL is a reduced PCF rate with low site morbidity and good functional outcomes. The aim of this video is to illustrate the use of the temporoparietal fascia flap to provide an adjunctive reinforcement layer in the reconstruction of the pharynx. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle turbinate mucosal flap: A low‐morbidity option in the management of skull base defects

xlomafota13 shared this article with you from Inoreader Middle turbinate mucosal flap: A low‐morbidity option in the management of skull base defects Via Head & Neck Abstract Background To describe the low morbidity of middle turbinate mucosal flap (MTMF) to repair anterior skull base defects. Methods Skull base endonasal endoscopic surgeries performed at a tertiary hospital between 2015 and 2018 were analyzed. Patients were divided into two groups according the existence or not of a significant intraoperative cerebrospinal fluid (CSF) leak. In Group 1 (n = 28), gasket seal and a pedicled endonasal flap were used to repair the defect: 13 nasoseptal flaps (NSF), 8 inferolateral wall flaps (ILF), and 7 MTMF. In Group 2 only an endonasal flap was used: 9 NSF, 4 ILF, and 18 MTMF. Surgical and recovery time were analyzed (Student's t test). Our favorite surgical technique is described. Results Fifty‐nine patients were included. Average surgical time was 27.7, 41.6, and 11.3 min for NSF, ILF, and MTMF, respectively. MTMF showed a faster recovery. Conclusion MTMF is a safe reconstructive option for anterior skull base defects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What is the best method for prevention of postparotidectomy Frey syndrome?

xlomafota13 shared this article with you from Inoreader What is the best method for prevention of postparotidectomy Frey syndrome? Network meta‐analysis Via Head & Neck Abstract Background Prevention of Frey syndrome (FS) after parotidectomy using an interposition barrier has long been gaining a wide popularity; however, there is no clear evidence regarding which preventive technique is more effective. The aim of this network meta‐analysis (NMA) is to answer the question: What is the best method for prevention of FS after parotidectomy? Methods A comprehensive search of the PubMed, Embase, SCOPUS, and Cochrane library was conducted to identify the eligible studies. The outcome was the incidence of subjective Frey syndrome (SFS) and objective Frey syndrome (OFS). The Bayesian NMA accompanied with a random effects model and 95% credible intervals (CrIs) were calculated using GeMTC R package. Results Thirty‐four studies (n = 2987 patients) with five interventions, namely Alloderm (ADM), temporoparietal fascia (TPF), sternocleidomastoid muscle (SCM), superficial musculoaponeurotic system (SMAS), and free fat graft (FFG), were compared together and with no interposition barrier (NB). The results of NMA showed a statistically significant reduction in both SFS and OFS when ADM, TPF, SMAS, FFG, and SCM were compared with NB. No statistical differences were observed when comparing ADM, SCM, SMAS, FFG, and TPF. TPF ranked the best of all treatments (59.4%) and was associated with the least incidence of SFS; whereas ADM ranked the best of all treatments (61.1%) and was associated with the least incidence of OFS. Conclusions All interventions (TPF flap, ADM, FFG, SMAS, and SCM) were associated with a significant reduction in the incidence of FS when compared with NB. TPF and ADM showed the best outcome with the least incidence of SFS and OFS, respectively. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal soft tissue sarcoma

xlomafota13 shared this article with you from Inoreader Laryngeal soft tissue sarcoma: A systematic review and individual patient data analysis of 300 cases Via Head & Neck Abstract Background Laryngeal sarcoma is rare. We performed a systematic review and individual patient analysis to evaluate the patterns of care, prognostic factors, and role of radiotherapy in laryngeal soft tissue sarcoma. Methods A systematic search on PubMed and Google scholar was done. An individual patient data analysis was done. Results Of the 300 cases of laryngeal sarcoma, 80% underwent surgery. 44% underwent larynx preservation surgery and 25% received radiotherapy with surgery. Median progression free survival (PFS) was 48 months and overall survival (OS) of 224 months for the entire cohort. Patients with large primary, cartilage invasion, and positive margins had numerically worse PFS. Cartilage invasion and primary tumor size >3 cm were the most common risk factors for adjuvant radiation therapy. Patients receiving radiotherapy were not associated with better survival. Conclusion Laryngeal sarcoma associated with a good survival. Larynx preservation surgery is feasible in nearly half patients. Adjuvant radiotherapy may be warranted in patients poor prognostic factors. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dental radiation dosimetric maps from intensity‐modulated radiation therapy planning for head and neck cancers

xlomafota13 shared this article with you from Inoreader Dental radiation dosimetric maps from intensity‐modulated radiation therapy planning for head and neck cancers Via Head & Neck Abstract Background The purpose of this study was to create dental radiation maps to calculate the mean dose to individual teeth, maxilla and mandible using intensity‐modulated radiation therapy (IMRT). Methods Eighteen common clinical settings were chosen. Radiation plans were extracted, and each tooth was contoured at its junction with the gingiva and labeled based on the Universal/American numbering system. Results All patients were treated with prescribed doses of 50–70 Gy in 1.66–2 Gy/fraction. Patients receiving mean doses >50 Gy to the teeth, mandible, and maxilla included those with advanced tumors of the oral cavity and gross lymphadenopathy of level 1b. Conclusion We believe this to be the first study generating dosimetric maps of estimated doses to each tooth and each third of the mandible and the maxilla for common examples of head and neck cancer faced by radiation oncologists. Adoption of these dental maps may help improve clinical workflow efficiency. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.