A Novel 3-Step Tuning Fork Hearing Test; Preliminary Report on Its Clinical Utility

xlomafota13 shared this article with you from Inoreader A Novel 3-Step Tuning Fork Hearing Test; Preliminary Report on Its Clinical Utility Via Otolaryngology Indian Abstract It is pertinent to have a Tuning Fork Hearing Test that stand-alone can detect severities (Mild, Moderate, Severe and Profound) and the types of hearing losses (Conductive, Sensorineural, and Mixed). A novel 3-Step Tuning Fork Hearing Test (3-STFHT) was attempted for the first time that could detect both the types and the severities of hearing losses. The study was aimed to describe the method of the 3-STFHT and evaluate its clinical utility and reliability. Research Design: Hospital-based observational study of a diagnostic tool. Settings: Otorhinolaryngology Department of a tertiary care medical college hospital. Subjects: 108 adult patients (216 ears) who required hearing evaluation. Main Outcome measures: Sensitivity and specificity of novel 3-STFHT were assessed by comparing its results with the reports of pure tone audiometry in detecting the type and severity of hearing loss. The new 3-STFHT was found very effective (100% sensitivity and specificity) in de tecting conductive and profound sensorineural hearing losses. The sensitivity in detecting sensorineural hearing loss was found 97%-100%. The sensitivity was observed relatively low (92%) at detecting mixed hearing loss. The overall sensitivity and specificity of the 3-STFHT in detecting the types of hearing losses was found 97% and 86% respectively. The novel 3-STFHT, which is simple and convenient, was found very effective in detecting the types and severity of hearing losses. The 3-STFHT can be an important tool in otorhinolaryngology practice and in primary care setting for detecting and screening the types and severities of hearing losses. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cost of Total Intravenous Anesthesia Versus Inhalation Anesthesia in Obstructive Sleep Apnea Surgery

xlomafota13 shared this article with you from Inoreader Cost of Total Intravenous Anesthesia Versus Inhalation Anesthesia in Obstructive Sleep Apnea Surgery Via The Laryngoscope ABSTRACT Objectives To compare cost and time spent in surgical and postoperative courses in patients with obstructive sleep apnea (OSA) undergoing surgery with either total intravenous anesthesia (TIVA) or inhalational anesthesia. Study Design Retrospective chart review. Methods Retrospective review on patients undergoing surgery for OSA under general anesthesia from January 2019 to October 2020. Cost per service was acquired for the day of surgery. Results A total of 230 patients were included: 95 received TIVA; 135 received inhalation anesthesia. Total cost was significantly higher in the TIVA nasal surgery group by $286 (P = .035). TIVA produced significantly higher pharmacy and operating room costs across all surgeries and OSA severities. These increased costs were offset by significantly lower supply costs in upper airway stimulator (UAS, −$419.50; P = .007) and uvulopalatopharyngoplasty (UPPP, −$115.16; P = .015) patients receiving TIVA. In the TIVA cohort, there was a trend toward lower recovery room costs after UAS (−$111.09; P = .063) and nasal surgery (−$64.45; P = .096) and anesthesia costs after nasal surgery (−$36.67; P = .054). Total recovery time was reduced by 18 minutes (P = .004) for nasal surgery, 25 minutes (P = .043) for UAS, and 27 minutes (P  ;= .147) for UPPP patients receiving TIVA. Conclusion When used in an outpatient setting for patients with OSA, TIVA adds to pharmacy and operating room costs, but this is usually offset by lower supply, anesthesia, and recovery room costs. We found decreased recovery times in the TIVA cohort. TIVA has proven benefits in patient outcomes and can be cost-effective in OSA surgery. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Limited contribution of indocyanine green (ICG) angiography for the detection of parathyroid glands and their vascularization during total thyroidectomy: A STROBE observational study

xlomafota13 shared this article with you from Inoreader Limited contribution of indocyanine green (ICG) angiography for the detection of parathyroid glands and their vascularization during total thyroidectomy: A STROBE observational study Via European Annals of Otorhinolaryngology, Head and Neck Diseases Publication date: Available online 2 March 2022 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): J. Quéré, G. Potard, R. Le Pennec, R. Marianowski, J.-C. Leclere View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary Pyomyositis of Levator Scapulae

xlomafota13 shared this article with you from Inoreader Primary Pyomyositis of Levator Scapulae Via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a young woman who presented with a suspected deep neck space infection who was subsequently found to have an intramuscular abscess in the left levator scapulae muscle. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tumor mutational burden and somatic mutation status to predict disease recurrence in advanced melanoma

xlomafota13 shared this article with you from Inoreader Tumor mutational burden and somatic mutation status to predict disease recurrence in advanced melanoma Via Melanoma Research - Published Ahead-of-Print Tumor mutational burden (TMB) has recently been identified as a biomarker of response to immune checkpoint inhibitors in many cancers, including melanoma. Co-assessment of TMB with inflammatory markers and genetic mutations may better predict disease outcomes. The goal of this study was to evaluate the potential for TMB and somatic mutations in combination to predict the recurrence of disease in advanced melanoma. A retrospective review of 85 patients with stage III or IV melanoma whose tumors were analyzed by next-generation sequencing was conducted. Fisher's exact test was used to assess differences in TMB category by somatic mutation status as well as recurrence locations. Kaplan–Meier estimates and Cox-proportional regression model were used for survival analyses. The most frequently detected mutations were TERT (32.9%), CDKN2A (28.2%), KMT2 (25.9%), BRAF V600E (24.7%), and NRAS (24.7%). Patients with TMB-L + BRAFWT status were more likely to have a recurrence [hazard ratio (HR), 3.43; confidence interval (CI), 1.29–9.15; P = 0.01] compared to TMB-H + BRAF WT. Patients with TMB-L + NRASmut were more likely to have a recurrence (HR, 5.29; 95% CI, 1.44–19.45; P = 0.01) compared to TMB-H + NRAS WT. TMB-L tumors were associated with local (P = 0.029) and in-transit (P = 0.004) recurrences. Analysis of TMB alone may be insufficient in understanding the relationship between melanoma's molecular profile and the body's immune system. Classification into BRAFmut, NRASmut, and tumor mutational load groups may aid in identifying patients who are more likely to have disease recurrence in advanced melanoma. Received 9 December 2021 Accepted 13 January 2022 Correspondence to Meghan J. Hotz, BS, Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA, Tel: +1 610 675 6602; fax: +1 215 728 2773; e-mail: mjohannahotz@gmail.com Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How Many Nodes to Take? Lymph Node Ratio Below 1/3 Reduces Papillary Thyroid Cancer Nodal Recurrence

xlomafota13 shared this article with you from Inoreader How Many Nodes to Take? Lymph Node Ratio Below 1/3 Reduces Papillary Thyroid Cancer Nodal Recurrence Via The Laryngoscope Introduction Papillary thyroid carcinoma (PTC) accounts for the majority of thyroid malignancies; risk of PTC recurrence over a 30-year period is approximately 30%, of which 70% occur as nodal metastases. Patients with nodal disease who are treated with therapeutic dissection are at higher risk for recurrence, but optimal nodal yield has not been defined. We aim to determine variables predictive of nodal recurrence of PTC within the first 5 years of surgery, with a focus on lymph node ratio (LNR), to inform clinical decision-making. Methods Retrospective chart review identified 41 patients with nodal recurrence of PTC and 284 without nodal recurrence following thyroid surgery from 2000 to 2015. Cohorts were compared with regards to clinical history, surgical findings, and tumor characteristics. Results The fraction of the patients who underwent therapeutic central or lateral lymph node dissection was significantly higher in the nodal recurrence cohort. Maximum tumor size, presence of extrathyroidal extension, largest lymph node focus, LNR, postoperative thyroglobulin level, and administration of postoperative radioactive iodine were significantly increased in the PTC nodal recurrence group. LNR greater than 0.3 held the highest level of significance as a binary cutoff and captured the larger proportion of patients in the nodal recurrence cohort (68.3%). Conclusion This study demonstrates characteristics to help assess risk of nodal recurrence of PTC and suggests LNR of lower than 0.3 is optimal to reduce risk of recurrence. The next steps include cohort studies to validate findings and weight variable analysis to optimize the extent of surgical therapeutic dissection. Level of Evidence 4 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survival of adult patients with solid cancer

xlomafota13 shared this article with you from Inoreader Survival of adult patients with solid cancer in Reunion Island, 1998-2014 Via Association française pour l'étude du cancer Bull Cancer. 2022 Feb 26:S0007-4551(22)00068-6. doi: 10.1016/j.bulcan.2022.01.010. Online ahead of print. ABSTRACT INTRODUCTION: Population-based cancer survival is a major indicator of effectiveness of cancer management. This study is the first population-based study to estimate the net survival (NS) of adult cancer patients in Reunion Island, a French overseas department with distinctive epidemiological, cultural, and sociodemographic characteristics. METHODS: All adult incident cases (n=23,055) of invasive solid tumors diagnosed between 1998 and 2014 and registered in the Reunion Island Cancer Registry were included in the study. The Pohar-Perme estimator was used to estimate 1-, 3-, 5-, and 10-year NS. RESULTS: 5-year NS ranged from 7% (liver in women) to 97% (thyroid cancer in women) for cancers diagnosed between 2006 and 2014. For the most common cancers, the age-standardized 5-year NS of women was 81% for breast canc er, 58% for colorectal cancer and 62% for cervical cancer. For men, the age-standardized 5-year NS was 85% for prostate cancer, 12% for lung cancer, and 52% for colorectal cancer. Age-standardized 5-year NS increased slightly with the period of diagnosis (from 1998-2005 to 2006-2014) for prostate, breast, head and neck, lung, colorectal (women), and stomach (men) cancers, remained stable for colorectal (men) cancer, and decreased slightly for cervical and stomach (women) cancers. DISCUSSION: Overall, NS was lower in Reunion Island than in mainland France. While the epidemiological, cultural, and sociodemographic characteristics of the Reunionese population likely explain some of the observed differences compared to mainland France, site-specific studies are needed to explore the different determinants of survival in Reunion Island. PMID:35232576 | DOI:10.1016/j.bulcan.2022.01.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid and Parathyroid Conditions: Hyperthyroidism

xlomafota13 shared this article with you from Inoreader Thyroid and Parathyroid Conditions: Hyperthyroidism Via radioactive iodine FP Essent. 2022 Mar;514:11-17. ABSTRACT Hyperthyroidism is an excess in thyroid hormone production caused by such conditions as Graves disease, toxic multinodular goiter, and toxic adenoma. Overt hyperthyroidism is defined as a low or undetectable thyrotropin (TSH) level with elevated triiodothyronine (T3) or thyroxine (T4) values, whereas subclinical hyperthyroidism is defined as low or undetectable TSH with normal T3 and T4 levels. Symp toms of hyperthyroidism include nervousness, heat intolerance, weight loss, and fatigue. The long-term consequences of unmanaged or poorly managed hyperthyroidism include increased risk of all-cause mortality, cardiovascular events, atrial fibrillation, sexual dysfunction, and osteoporosis. Overt and subclinical hyperthyroidism can be managed effectively with antithyroid drugs (eg, propylthiouracil, methimazole) or with definitive therapies (eg, radioactive iodine ablation, thyroidectomy). Subclinical hyperthyroidism is not always treated, although close monitoring is needed to prevent disease complications or progression to overt hyperthyroidism. Treatment for subclinical hyperthyroidism is recommended for patients 65 years or older with TSH levels lower than 0.10 mIU/L. Treatment also is recommended for symptomatic patients or those with cardiac or osteoporotic risk factors. Thyroid storm is a life-threatening complication of unmanaged or inadequately managed hyperthyroidism that warrants urgent treatment in a hospital setting. PMID:35235281 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Asiatic acid improves high-fat-diet-induced osteoporosis in mice via regulating SIRT1/FOXO1 signaling and inhibiting oxidative stress

xlomafota13 shared this article with you from Inoreader Asiatic acid improves high-fat-diet-induced osteoporosis in mice via regulating SIRT1/FOXO1 signaling and inhibiting oxidative stress Via Cellular and Molecular Biology Histol Histopathol. 2022 Mar 1:18446. doi: 10.14670/HH-18-446. Online ahead of print. ABSTRACT Asiatic acid can attenuate osteoporosis through suppressing adipogenic differentiation and osteoclastic differentiation. Oxidative stress enhances osteoclastic differentiation but represses osteogenic differentiation to promote osteoporosis. However, the role and mechanism of asiatic acid in osteoporosis have not been reported. Firstly, mice were fed with high-fat-diet (HFD) with or without asiatic acid for 16 weeks. Data from an automatic biochemical analyzer showed that HFD induced down-regulation of high-density lipoprotein (HDL) and an increase of serum levels of triglyceride (TG), total cholesterol (TC) and low-density lipoprotein (LDL). However, asiatic acid administration attenuated the decrease of HDL and increase of serum TG, TC and LDL in osteoporotic mice. Secondly, HFD induced high levels of malondialdehyde (MDA) and reactive oxyg en species (ROS), low levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in osteoporotic mice. However, the levels of MDA, ROS, SOD and GSH-Px in osteoporotic mice were reversed by asiatic acid administration. (this section is unclear and requires revision) Asiatic acid administration reduced expression of c-telopeptide of type 1 collagen (CTX-1), enhanced alkaline phosphatase (ALP) and procollagen type 1 N-terminal propeptide (P1NP) in HFD-induced osteoporotic mice. (this section is unclear and requires revision) Thirdly, asiatic acid promoted calcium deposition in bone marrow cells and osteogenic differentiation in osteoporotic mice, but decreased ALP in bone marrow cells. Lastly, asiatic acid enhanced SIRT1 and nuclear FOXO1 (Nu-FOXO1) expression, while it reduced Acetyl FOXO1 (Ac-FOXO1) in osteoporotic mice. In conclusion, asiatic acid might inhibit oxidative stress and promote osteogenic differentiation through activating SIRT1/FOXO1 to attenuate HFD-induc ed osteoporosis in mice. PMID:35229281 | DOI:10.14670/HH-18-446 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison Between Different Approaches Applied in Pediatric Adenoidectomy: A Network Meta-Analysis

xlomafota13 shared this article with you from Inoreader Comparison Between Different Approaches Applied in Pediatric Adenoidectomy: A Network Meta-Analysis Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 28:34894221081612. doi: 10.1177/00034894221081612. Online ahead of print. ABSTRACT OBJECTIVE: Adenoidectomy is a surgical procedure most frequently performed by otolaryngologists. However, there are no universally accepted guidelines for the choice of the surgical approach in specific circumstances. Therefore, a network meta-analysis (NMA) is needed to summarize existing studies and provide more evidence-based medical guidelines. METH ODS: A systematic search of the literature was conducted in the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE databases from inception to 31 July 2021. A network meta-analysis of operating time, intraoperative blood loss, postoperative pain score, and incidence of postoperative residual tissue was performed. RESULTS: A total of 20 studies with 2329 patients were included. Four common surgical approaches, including powered vacuum shaver adenoidectomy (PVSA), plasma field ablation adenoidectomy (PFAA), curettage adenoidectomy (CUA), and suction diathermy adenoidectomy (SDA), were compared for operative time, intraoperative blood loss, postoperative pain score, and incidence of postoperative residual tissue. There were no significant differences between the surgical techniques for the 3 endpoints, operative time, intraoperative blood loss, and incidence of postoperative residual tissue. The data showed lower postoperative pain scores for PFAA than for CUA (MD = -3.45, 95% CI [-6.01, -0.95]). There were no significant differences in other surgical approaches for postoperative pain scores. CONCLUSION: There were no significant differences between PVSA, PFAA, CUA, and SDA for operative time, intraoperative blood loss, and incidence of postoperative residual tissue. PFAA had advantages over CUA for postoperative pain scores. PMID:35227080 | DOI:10.1177/00034894221081612 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Graves' disease in children and adolescents in Iceland

xlomafota13 shared this article with you from Inoreader Graves' disease in children and adolescents in Iceland Via radioactive iodine Laeknabladid. 2022 Mar;108(3):123-129. doi: 10.17992/lbl.2022.03.680. ABSTRACT INTRODUCTION: Graves' disease is an autoimmune disease in which autoantibodies cause an increase in the production of thyroid hormones, and is the most common cause of thyrotoxicosis in children. Symptoms in children are often more obscure than in adults. The aim of the study is to assess the incidence of Graves' disease in children and adolescents in Iceland over the span of two decades (2001-2021), and furthermore to investigate if the incidence rate has increased, as well as to describe treatment options and disease recurrence. MATERIAL/METHODS: This retrospective descriptive study included all children diagnosed with Graves' disease in the years 2001-2021 in Iceland. Information was obtained from the Directorate of Health's drug database and from ICD-10 diagnoses at Landspítali - The National University Hospital. RESULTS: In total, 57 children and adolescents were diagnosed with Graves', the overall incidence rate was 3.5/100,000 person-years. Gender ratio was 1:2.7 (male : female) and the mean age at diagnosis was 13.6 for boys and 13.9 years for girls. Of those 12 individuals currently receiving drug therapy (21.8%), four patients have had disease relapse. Thirteen patients reached an euthyroid state with medication (23.7%), 25 received treatment with radioactive iodine (45.5%) and 5 underwent surgery (9.1%). Boys were more likely to relapse. Disease recurrence w as 31.8%. CONCLUSION: The incidence of Graves' disease did not increase during the study period. The disease was more common in girls, although the gender ratio was lower than expected. Antithyroid drugs were the first choice in treatment and radioactive iodine was the most common permanent treatment option. Disease recurrence was common. A possible relationship between the duration of the original drug therapy and disease recurrence should be investigated. PMID:35230257 | DOI:10.17992/lbl.2022.03.680 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.