Differentiated Thyroid Cancer Presenting With Solitary Bony Metastases to the Frontal Bone of the Skull

xlomafota13 shared this article with you from Inoreader Differentiated Thyroid Cancer Presenting With Solitary Bony Metastases to the Frontal Bone of the Skull Via radioactive iodine Cureus. 2021 Oct 13;13(10):e18735. doi: 10.7759/cureus.18735. eCollection 2021 Oct. ABSTRACT A 75-year-old lady was referred to the oral and maxillofacial surgery (OMFS) team with a painless swelling in the midline of her forehead. Investigations diagnosed it as a solitary metastasis of thyroid cancer. Follicular thyroid cancers are known to metastasise to bone; however, bony metastasis to the frontal bone of the skull is very rare. This case highlights how the effective use of a m ultidisciplinary team can lead to better patient outcomes. The patient went on to have a total thyroidectomy and received both radioactive iodine therapy and radiotherapy to the bony metastasis. PMID:34790486 | PMC:PMC8586824 | DOI:10.7759/cureus.18735 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Targeting the mTOR Pathway in Hurthle Cell Carcinoma Results in Potent Anti-Tumor Activity

xlomafota13 shared this article with you from Inoreader Targeting the mTOR Pathway in Hurthle Cell Carcinoma Results in Potent Anti-Tumor Activity Via radioactive iodine Mol Cancer Ther. 2021 Nov 17:molcanther.0224.2021. doi: 10.1158/1535-7163.MCT-21-0224. Online ahead of print. ABSTRACT Hurthle cell carcinomas (HCC) are refractory to radioactive iodine and unresponsive to chemotherapeutic agents, with a fatality rate that is the highest among all types of thyroid cancer after anaplastic thyroid cancer. Our previous study on the genomic landscape of HCCs identified a high incidence of disruptions of mTOR pathway effectors. Here, we report a detaile d analysis of mTOR signaling in cell line and patient-derived xenograft (PDX) mouse models of HCCs. We show that mTOR signaling is upregulated and that targeting mTOR signaling using mTOR inhibitors suppresses tumor growth in primary tumors and distant metastasis. Mechanistically, ablation of mTOR signaling impaired the expression of p-S6 and cyclin A2, resulting in the decrease of S phase and blocking of cancer cell proliferation. Strikingly, mTOR inhibitor treatment significantly reduced lung metastatic lesions, with the decreased expression of Snail in xenograft tumors. Our data demonstrates that mTOR pathway blockade represents a novel treatment strategy for HCC. PMID:34789562 | DOI:10.1158/1535-7163.MCT-21-0224 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of ENT emergency patients during the COVID-19 pandemic in Germany

xlomafota13 shared this article with you from Inoreader Analysis of ENT emergency patients during the COVID-19 pandemic in Germany Via hno HNO. 2021 Nov 17. doi: 10.1007/s00106-021-01121-1. Online ahead of print. ABSTRACT BACKGROUND: This retrospective observational study was undertaken to assess the ENT emergency workload during the COVID-19 pandemic caused by the severe acute respiratory coronavirus‑2 (SARS-CoV-2). MATERIALS AND METHODS: All 3230 patients who were treated as an emergency from 23.01.2020 to 06.08.2020 in the Department of Otolaryngology at the SLK-Kliniken Heilbronn were included in thi s study. Demographic data, diagnostics, diagnosis, and treatment (in-/outpatient) were retrospectively retrieved. Not only did the physicians on call triage the emergency department (ED) ENT patients, but the patients also self-assessed their urgency of treatment. RESULTS: The number of patients consulting our ED decreased significantly during the pandemic, by 42.2%. However, the top diagnoses remained almost constant, with epistaxis being the most frequent diagnosis before, during, and after COVID-19. Facial trauma remained the second most frequent consultation reason. The hospitalization rate decreased from 21.9% before COVID-19 to 16.2% during the pandemic. Surgical therapy was necessary in 17.6% of patients before COVID-19 and this increased to 23.5% during COVID-19. The self-referral rate increased from 61 to 66% during the pandemic. More men than women consulted the ED during COVID-19. Regarding the triage assessment by the physician on call and the patient's self-assess ment, a significant discrepancy was noted before, during, and after COVID-19. CONCLUSION: The reasons for reduction in ENT ED visits are multifactorial. The clinical consequences of decreased hospitalizations remain uncertain. However, health authorities need to advocate the safety of the hospital environment to limit potential damage. PMID:34791514 | DOI:10.1007/s00106-021-01121-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intensive dysphagia rehabilitation program for patients with head and neck cancer

xlomafota13 shared this article with you from Inoreader Intensive dysphagia rehabilitation program for patients with head and neck cancer Via swallowing exercises ANZ J Surg. 2021 Nov 18. doi: 10.1111/ans.17365. Online ahead of print. ABSTRACT BACKGROUND: In response to the pathophysiology and expected trajectory of dysphagia that arises following treatment for head and neck cancer (HNC), an intensive and progressive approach to dysphagia is warranted. This pilot study evaluates the recovery of swallowing function following the implementation of an exercise-based approach to dysphagia rehabilitation. METHODS: Consecutive recruitment wa s carried out prospectively at a quaternary referral centre. Participants were aged 18 years and older and had completed treatment for HNC. Dysphagia was assessed pre and post a 10-week rehabilitation program using videofluoroscopy swallow study (VFSS) and clinician-and patient-reported outcomes. RESULTS: Ten participants were recruited over a 6-month period, all of whom had oropharyngeal dysphagia confirmed on VFSS. At the conclusion of the 10-week intervention period, DIGEST (Dynamic Imaging Grade of Swallowing Toxicity) scores improved significantly for both safety and efficiency components. Four of seven participants who had a percutaneous endoscopic gastrostomy tube at baseline were no longer reliant on it for their nutrition, hydration or medication at the completion of the therapeutic period. While four participants continued to aspirate on thin fluids, none developed aspiration pneumonia. CONCLUSION: Oropharyngeal dysphagia as a consequence of HNC treatment is ch allenging to rehabilitate; however, in selected patients, it is responsive to intensive and individualized rehabilitation programs. PMID:34791759 | DOI:10.1111/ans.17365 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Altered brain network functional connectivity patterns in patients with vestibular migraine diagnosed according to the diagnostic criteria of the Bárány Society and the International Headache Society

xlomafota13 shared this article with you from Inoreader Altered brain network functional connectivity patterns in patients with vestibular migraine diagnosed according to the diagnostic criteria of the Bárány Society and the International Headache Society Via cortical auditory J Neurol. 2021 Nov 18. doi: 10.1007/s00415-021-10868-0. Online ahead of print. ABSTRACT BACKGROUND: Vestibular migraine (VM) is considered one of the most common causes of episodic central vestibular disorders, the mechanism of VM is currently still unclear. The development of functional nuclear magnetic resonance (fMRI) in recent years offers the possibility to explore the altered functional connectivity patterns in patients with VM in depth. The study aimed to investigate altered patterns of brain network functional connectivity in patients with VM diagnosed based on the diagnostic criteria of the Bárány Society and the International Headache Society, and hope to provide a scientific theoretical basis for understanding whether VM is a no-structural central vestibular disease, i.e., functional central vestibular disease with altered brain function. METHODS: Seventeen patients with VM who received treatment in our hospital from Decemb er 2018 to December 2020 were enrolled. Eight patients with migraine and 17 health controls (HCs) were also included. Clinical data of all patients were collected. Blood pressure, blood routine tests and electrocardiography were conducted to exclude other diseases associated with chronic dizziness. Videonystagmography, the vestibular caloric test, the video head impulse test and vestibular-evoked myogenic potentials were measured to exclude peripheral vestibular lesions. MRI was utilized to exclude focal lesions and other neurological diseases. All subjects underwent fMRI. The independent component analysis was performed to explore changes in intra- and inter-network functional connectivity in patients with VM. RESULTS: Among 17 patients with VM, there were 7 males and 10 females with an average age of 39.47 ± 9.78 years old. All patients had a history of migraine. Twelve (70.6%) patients had recurrent spontaneous vertigo, 2 (11.7%) patients had visually induced vertigo, and 3 (17.6%) patients had head motion-induced vertigo. All 17 patients with VM reported worsening of dizziness vertigo during visual stimulation. The migraine-like symptoms were photophobia or phonophobia (n = 15, 88.2%), migraine-like headache (n = 8, 47.1%), visual aura during VM onset (n = 7, 41.2%). 5 (29.4%) patients with VM had hyperactive response during the caloric test, and 12 (70.6%) patients had caloric test intolerance. Eleven (64.7%) patients had a history of motion sickness. Totally 13 independent components were identified. Patients with VM showed decreased functional connectivity in the bilateral medial cingulate gyrus and paracingulate gyrus within sensorimotor network (SMN) compared with HCs. They also showed weakened functional connectivity between auditory network (AN) and anterior default mode network (aDMN) compared with HCs, and enhanced functional connectivity between AN and the salience network (SN) compared with patients with migraine. CONCLUSION: Patien ts with vestibular migraine showed obvious altered functional connectivity in the bilateral medial cingulate gyrus and paracingulate gyrus within the SMN. The median cingulate and paracingulate gyri may be impaired, the disinhibition of sensorimotor network and vestibular cortical network may result in a hypersensitivity state (photophobia/phonophobia). Altered functional connectivity between AN and DMN, SN may lead to increased sensitivity to vestibular sensory processing. PMID:34792633 | DOI:10.1007/s00415-021-10868-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immediate and Short-term Effects of Straw Phonation in Air or Water on Vocal Fold Vibration and Supraglottic Activity of Adult Patients with Voice Disorders Visualized with Strobovideolaryngoscopy: A Pilot Study

xlomafota13 shared this article with you from Inoreader Immediate and Short-term Effects of Straw Phonation in Air or Water on Vocal Fold Vibration and Supraglottic Activity of Adult Patients with Voice Disorders Visualized with Strobovideolaryngoscopy: A Pilot Study Via Journal of Voice Purpose The first purpose of this study was to investigate and compare the short-term effects after a semi-occluded vocal tract (SOVT) therapy session consisting of straw phonation (SP) in air or water on vocal fold vibration and supraglottic activity of adult patients with voice disorders, visualized with strobovideolaryngoscopy (SVL). The second purpose of this study was to investigate and compare immediate changes in the patients' vocal fold vibration and supraglottic activity during SP in air or water, visualized with SVL. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complete Facial Paralysis Caused by Stabbing With a Car Key at the Stylomastoid Foramen

xlomafota13 shared this article with you from Inoreader Complete Facial Paralysis Caused by Stabbing With a Car Key at the Stylomastoid Foramen Via ear nose throat Ear Nose Throat J. 2021 Nov 18:1455613211056548. doi: 10.1177/01455613211056548. Online ahead of print. ABSTRACT Non-iatrogenic traumatic facial paralysis is most common in intratemporal facial nerve injury caused by temporal bone fracture, followed by intraparotid facial nerve branch injury. Facial paralysis caused by injury to the extratemporal trunk of the facial nerve is extremely rare. We present a case of a 60-year-old man suffering from immediate complete left periphe ral facial paralysis due to blunt transection of extratemporal trunk of facial nerve by stabbing with a car key. There was a facial nerve defect about 1 cm in length. The great auricular nerve was grafted to repair the facial nerve. Over 12 months, his facial nerve function improved to a House-Brackmann III/VI. PMID:34792423 | DOI:10.1177/01455613211056548 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.