Combined skin-sparing mastectomy and immediate implant-based breast reconstruction: Outcome following mantle field irradiation versus outcome following whole-breast irradiation

xlomafota13 shared this article with you from Inoreader Combined skin-sparing mastectomy and immediate implant-based breast reconstruction: Outcome following mantle field irradiation versus outcome following whole-breast irradiation Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Aug 18:S1748-6815(21)00378-8. doi: 10.1016/j.bjps.2021.08.003. Online ahead of print. ABSTRACT BACKGROUND: Mastectomy may be needed in the context of previous radiotherapy in cases of breast carcinoma following mantle field radiotherapy for Hodgkin lymphoma or in cases of local relapse or second primary tumours after breast conserving therapy including whole-breast irradiation (BCT). The outcome of combined skin-sparing mastectomy and immediate implant-based breast reconstruction (SSM-IIBR) has been reported to be unfavourable in these cases. PURPOSE: To compare the outcome of SSM-IIBR after mantle field radiotherapy to that after BCT and to compare both to the outcome observed in non-irradiated breasts. METHODOLOGY: The prevalences of short-term events, device loss, long-term corrections and secondary reconstructions, and reversion to autologous tissue techniques of 42 SSM-IIBRs performe d after mantle field irradiation were compared to those of 47 salvage SSM-IIBRs following BCT. Both outcomes were compared to the outcome in the contralateral, non-irradiated breast of the subgroup of 23 women in the BCT group. RESULTS: The groups were comparable in terms of patient- and procedure-related risk factors, except for time lapse after previous therapy, intraoperative device weight, and the fraction of immediate use of a definitive implant. The outcome of SSM-IIBR after mantle field irradiation significantly differs favourably from that after BCT. It matches the outcome observed in non-irradiated breasts. CONCLUSION: Skin-sparing mastectomy combined with immediate implant-based breast reconstruction is a fully justifiable option for women who previously underwent mantle field irradiation for Hodgkin lymphoma. We feel that the unfavourable outcome observed in women who previously underwent BCT necessitates an alternative reconstructive modality. PMID:34483080 | DOI:10.1016/j.bjps.2021.08.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

LINC00937 suppresses keloid fibroblast proliferation and extracellular matrix deposition by targeting the miR-28-5p/MC1R axis

xlomafota13 shared this article with you from Inoreader LINC00937 suppresses keloid fibroblast proliferation and extracellular matrix deposition by targeting the miR-28-5p/MC1R axis Via Cellular and Molecular Biology Histol Histopathol. 2021 Aug 23:11372. doi: 10.14670/HH-18-372. Online ahead of print. ABSTRACT Long noncoding RNAs (lncRNAs) are the most recently discovered class of noncoding RNAs. LncRNAs play a crucial role in multiple disorders. However, the role and mechanism of action of lncRNAs in keloids remain unclear. Here, qRT-PCR and western blotting assays were performed to determine the expression of genes and proteins, respectively. MTT assays were carried out to measure the proliferation of keloid fibroblasts. In addition, a luciferase activity assay was conducted to investigate the relationships between LINC00937 and miR-28-5p and between miR-28-5p and MC1R. The results showed that LINC00937 and MC1R were decreased, whereas miR-28-5p was increased in keloid tissues. LINC00937 overexpression in keloid fibroblasts could repress the extracellular matrix (ECM) deposition and cell proliferation and promote MC1R expression. Moreover, high expression of miR-28-5p and low expression of LINC00937 were detected in keloid fibroblasts. We further showed that LINC00937 promoted MC1R expression by sponging miR-28-5p. Finally, our data indicated that LINC00937 inhibited the ECM deposition and proliferation of keloid fibroblasts by inhibiting miR-28-5p and facilitating MC1R expression. Overall, LINC00937 suppressed the ECM deposition and proliferation of keloid fibroblasts by acting as an miR-28-5p sponge and promoting MC1R expression. Our data suggested that LINC00937 is a potential target for keloid treatment. PMID:34486677 | DOI:10.14670/HH-18-372 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Insurance Status Effect on Laryngeal Cancer Survival: A Population Based Study

xlomafota13 shared this article with you from Inoreader Insurance Status Effect on Laryngeal Cancer Survival: A Population Based Study Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 4:34894211044231. doi: 10.1177/00034894211044231. Online ahead of print. ABSTRACT OBJECTIVE: To analyze insurance status effect on overall survival (OS) and disease-specific survival (DSS) in laryngeal cancer. STUDY DESIGN: Cross-sectional population analysis. SETTING: Surveillance, Epidemiology, and End Results (SEER) database. PARTICIPANTS: Laryngeal cancer patients from 2007 to 2016. MAIN OUTCOME MEASURES: Kaplan- Meier method with log-rank statistic analyzed OS and DSS by insurance status. Multivariable cox proportional hazard modeling generated survival prognostic factors. RESULTS: Of 19 667 laryngeal cancer cases, initial disease presentation was stage I: 7770 patients (39.5%), stage II: 3337 patients (17.0%), stage III: 3289 patients (16.7%), and stage IV: 5226 patients (26.6%). Patients had non-Medicaid insurance (15 523, 78.9%), had Medicaid (3306, 16.8%), or were uninsured (891, 4.5%). Mean and median OS for insured, Medicaid, and uninsured patients were 60.5, 49.6, and 56.6 and 74.0, 40.0, and 65.0 months, respectively. Following multivariable analysis, OS for insured, Medicaid, and uninsured patients was stage I: 87.9, 82.8, and 88.4 (P < .001), stage II: 79.1, 75.1, and 78.3 (P = .12), stage III: 68.7, 66.1, and 72.1 (P = .11), and stage IV: 57.1, 51.7, and 50.3 (P < .001) months. DSS mean survival times were 77.0, 65.8, and 67.7 months (P< /i> < .001) for insured, Medicaid, and uninsured patients. Age (HR: 1.02/year, P < .001) and black (HR: 1.15, P = .001) compared to white race predicted worse survival. Compared to insured status, Medicaid insurance carried a death hazard ratio of 1.40 (P < .001) and uninsured status had a death hazard ratio of 1.40 (P < .001). CONCLUSION: Insured laryngeal cancer patients had prolonged OS and DSS compared to Medicaid and uninsured patients. Medicaid patients had equivalent survival outcomes to uninsured patients. LEVEL OF EVIDENCE: 2c. PMID:34486418 | DOI:10.1177/000 34894211044231 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-sensitivity FEES® with the professional image enhancement technology 'PIET'

xlomafota13 shared this article with you from Inoreader High-sensitivity FEES<sup>®</sup> with the professional image enhancement technology "PIET" 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. 2021 Sep 6. doi: 10.1007/s00405-021-07067-y. Online ahead of print. ABSTRACT PURPOSE: Flexible endoscopic evaluation of swallowing (FEES®) is a standard diagnostic tool in dysphagia. The combination of FEES® and narrow band light (narrow band imaging; NBI) provides a more precise and detailed investigation method. So far, this technique could only be performed with the NBI illumination. The new version of the "professional image enhancement technique" (PIET) provides another image enhancing system. This study investigates the eligibility of PIET in the FEES® procedure. METHODS: Both techniques, NBI and PIET, were compared using a target system. Furthermore, the image enhancement during FEES® was performed and recorded with the two systems during daily routine. RESULTS: Performing an image enhancement during FEES® is possible with both sys tems PIET and NBI. On the target system, the contrast of the PIET showed a brighter and a more detailed picture. In dysphagia patients, no difference between PIET and NBI was detected. CONCLUSIONS: PIET proved to be non-inferior to NBI during image enhancement FEES®. So far, image enhancement FEES® was exclusively connected to NBI. With the PIET system, an alternative endoscopy technology is available for certain indications. PMID:34487219 | DOI:10.1007/s00405-021-07067-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomes

xlomafota13 shared this article with you from Inoreader Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomes 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. 2021 Sep 6. doi: 10.1007/s00405-021-07061-4. Online ahead of print. ABSTRACT PURPOSE: To report the outcomes and the patients' subjective experience of cochlear implantation (CI) performed under local anesthesia (LA). To describe a new form of intraoperative cochlear monitoring based on the patients subjective sound perception during CI. METHODS: In this retrospective case-cohort study, 117 patients underwent CI under LA with (n = 58) or without conscious sedation (n = 59). Included were primarily elderly patients with elevated risks for general anesthesia and recently patients with residual hearing eligible for electro-acoustic stimulation (EAS) (n = 27), in whom hearing could be monitored during the electrode insertion. A 500 Hz test tone was presented and the patient reported of subjective changes in loudness, leading to a modification of the insertion. A questionnaire was sent to all patients in whi ch they assessed their subjective experience. RESULTS: All patients were successfully operated under LA without the need to intraoperatively convert to general anesthesia. 90% of the patients reported that the surgery was a positive experience. The vast majority, 90% of patients were satisfied with the overall treatment and with intraoperative pain management and 84% of the patients would opt for local anesthesia again. Cochlear monitoring by the patients' subjective sound perception enabled for atraumatic insertions as all EAS patients could hear the test tone up to the end of the surgery. CONCLUSIONS: CI under LA was well tolerated and recommended by the vast majority of patients. In addition, it offers the possibility to monitor the patients' hearing during the electrode insertion, which may help to prevent insertion trauma. PMID:34487218 | DOI:10.1007/s00405-021-07061-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multiple skull base defects: features of pathogenesis, diagnosis and treatment

xlomafota13 shared this article with you from Inoreader Multiple skull base defects: features of pathogenesis, diagnosis and treatment Via leak of cerebrospinal fluid Zh Vopr Neirokhir Im N N Burdenko. 2021;85(4):58-63. doi: 10.17116/neiro20218504158. ABSTRACT OBJECTIVE: To determine the risk factors of multiple skull base defects, as well as features of diagnosis and treatment of this pathology. MATERIAL AND METHODS: A retrospective analysis included 39 patients who underwent surgery for nasal CSF leakage at the Burdenko Neurosurgical Center in 2000-2019. The study recruited patients with multiple simultant skull base defects. RESULTS: Traumatic defects were observed in 23 (59%) patients, spontaneous defects - in 16 (41%) cases. All patients underwent endoscopic endonasal closure of skull base defects with autografts. CONCLUSION: Multiple defects are more common in severe traumatic brain injury. The main risk factors of multiple spontaneous defects are female sex and overweight. Adequate diagnosis implies high-resolution CT (slice width 0.5-1 mm), as well as intraoperative control of all suspicious and «weak» areas. Endoscopic endonasal technique is effective and safe for multiple skull base defects (efficiency 97%). PMID:34463451 | DOI:10.17116/neiro20218504158 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Prospective Study of the Effect of Tinnitus Sound Matching Degree on the Efficacy of Customized Sound Therapy in Patients with Chronic Tinnitus

xlomafota13 shared this article with you from Inoreader A Prospective Study of the Effect of Tinnitus Sound Matching Degree on the Efficacy of Customized Sound Therapy in Patients with Chronic Tinnitus Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Objectives: The aim of this study was to explore and compare the customized sound therapy effect between tinnitus sound matching and nonmatching patients in tinnitus customized sound therapy and therapy-related influencing factors. Methods: This prospective study investigated a total of 100 patients with unilateral chronic tinnitus who received customized sound therapy. The participants were dichotomously divided into matching (group A) and nonmatching (group B) groups after 4 stages of tinnitus matching via the tinnitus assistant ap p (provided by Sound Ocean Company, SuZhou, China). Each group consists of 50 participants. Before and 6 months after the treatment, Hospital Anxiety and Depression Scale (HADS), tinnitus handicap inventory (THI), and tinnitus loudness Visual Analog Scale (VAS) were used to evaluate the customized sound therapy effect and explore other related influencing factors. Results: (1) The HADS-A, HADS-D, THI, and VAS scores of 2 groups were both significantly decreased after treatment. (2) The HADS-A and THI scores improved markedly in group A than that in group B, which could be related to the hearing loss of the tinnitus side ear before treatment; the lighter the degree of hearing loss, the better the improvement. No statistically significant differences were detected in HADS-D and VAS scores between the 2 groups, and also, these were not related to the degree of hearing loss. The differences in age, gender, and tinnitus duration did not show any statistically significant ef fect on the improvement of the 2 groups. Conclusions: Both tinnitus sound matching and nonmatching of the customized sound therapy brought a significant effect to tinnitus participants. Our study also suggests that THI and HADS-A scores of those with tinnitus matching participants improved markedly as compared to those of nonmatching participants, and the customized sound therapy effect is negatively correlated with the severity of hearing loss. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.