Low‐ and high‐dose radioiodine ablation for low‐/intermediate‐risk differentiated thyroid cancer

xlomafota13 shared this article with you from Inoreader Low‐ and high‐dose radioiodine ablation for low‐/intermediate‐risk differentiated thyroid cancer in China: A large randomized clinical trial Via Head & Neck Abstract Background To determine whether 1.1 GBq radioiodine therapy is as effective as 3.7 GBq for ablation in Chinese patients with differentiated thyroid cancer (DTC). Methods In this single‐center randomized study, we compared the successful radioiodine ablation rates of 1.1 GBq and 3.7 GBq for patients with DTC. Results At 6–8 months after radioiodine ablation, there were 95 (39%) patients in the 1.1 GBq group and 79 (32%) patients in the 3.7 GBq group with thyroid hormone withdrawal (THW), and ablation success rates were 84% versus 80%, respectively; and 149 (61%) patients in the 1.1 GBq group and 169 (68%) patients in the 3.7 GBq group without THW, and ablation success rates were 89% versus 90%, respectively. In total, the ablation was successful in 412 (87%) of the 474 patients, and it was similar between the two groups. Conclusions Low‐dose radioiodine ablation was as effective as high dose in Chinese DTC patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Redefining risk of contralateral cervical nodal disease in early stage oropharyngeal cancer in the human papillomavirus era

xlomafota13 shared this article with you from Inoreader Redefining risk of contralateral cervical nodal disease in early stage oropharyngeal cancer in the human papillomavirus era Via Head & Neck Abstract Background The optimal extent of surgery and/or radiation to the contralateral lymph node region is unknown in early‐stage human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (OPSCC). Methods To investigate the pathologic incidence of and risk factors for contralateral nodal disease (CND) in cT1‐T2 HPV‐related OPSCC treated with transoral robotic surgery (TORS) and bilateral neck dissection (BND), the records of 120 patients were reviewed. Results Eleven patients displayed pathologic contralateral nodal disease (pCND), including 7.1% of tonsil and 10.9% of base of tongue (BOT) cases. Medial hemistructure involvement and cN2 disease were significantly associated with pCND. Zero cN0 patients had pCND, and on multivariate analysis only cN classification remained significantly associated with pCND. Four percent of BOT patients and 2% of tonsil patients with a well‐lateralized primary and cN0/N1 neck demonstrated pCND. Conclusions HPV‐related OPSCC that are cN0‐N1 have exceedingly low rates of pCND. Well‐lateralized HPV‐related BOT primaries with limited clinical nodal disease may be candidates for ipsilateral only treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Respiratory‐swallow coordination and swallowing impairment in head and neck cancer

xlomafota13 shared this article with you from Inoreader Respiratory‐swallow coordination and swallowing impairment in head and neck cancer Via Head & Neck Abstract Background The aim of the study was to determine the link between frequency of optimal respiratory‐swallow coordination, swallowing impairment, and airway invasion in head and neck cancer (HNC) patients. Method A cross‐sectional study of a heterogeneous group of HNC patients (49), precancer (N = 30) or postcancer treatment (N = 29), participated in a single Modified Barium Swallow Study (MBSS) with synchronized respiratory data. Results Spearman correlation coefficients revealed significant negative correlations between optimal respiratory‐swallow phase pattern and objective measures of swallowing impairment: penetration‐aspiration scale max, pharyngeal total, and oral total scores with Spearman correlation coefficients of −0.53 (z .001), −0.50 (P < .001), and −0.43 (P = .002), respectively. Optimal respiratory‐swallow pattern was significantly decreased (P = .03) in patients after cancer treatment compared with another patient group before cancer treatment. Conclusion These findings indicate that as the percentage of optimal respiratory‐swallow phase patterns increase, swallowing impairment decreases in the HNC patient population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A new landmark for lingual artery identification during transoral surgery: Anatomic‐radiologic study

xlomafota13 shared this article with you from Inoreader A new landmark for lingual artery identification during transoral surgery: Anatomic‐radiologic study Via Head & Neck Abstract Background A landmark for the identification of the lingual artery (LA) through a transoral perspective can provide surgeons with an easy method to prevent and manage intraoperative bleeding during transoral approach to the base of tongue (BOT). Methods Thirteen tongue and five head and neck specimens were dissected to identify and assess the reliability of the lingual point (LP) as a new landmark for the LA at BOT. The pathway of 42 LAs was radiologically evaluated; axial depth and vertical offset were measured for each LA. Results Dissection study: a description of LP is provided; the LA was easily identified in all specimens (36/36 sides) using LP as a landmark. Radiologic study: the mean depth of the LA was 4.2 mm, the mean vertical offset was 1.3 mm. Conclusions LP is a simple and reliable landmark for identification of the LA, potentially helping surgeons to prevent and manage intraoperative bleeding. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG).

xlomafota13 shared this article with you from Inoreader UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG). Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG). J Plast Reconstr Aesthet Surg. 2021 Jan;74(1):13-29 Authors: Turton P, El-Sharkawi D, Lyburn I, Sharma B, Mahalingam P, Turner SD, MacNeill F, Johnson L, Hamilton S, Burton C, Mercer N Abstract Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK) negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies a nd although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimize the need for systemic treatments, reduce morbidity and the risk of poor outcomes. These guidelines provide an evidence-based and systematic framework for the assessment and treatment of patients with suspected or proven BIA-ALCL and are aimed at all clinicians involved in the care of people with breast implants. PMID: 33483089 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review.

xlomafota13 shared this article with you from Inoreader The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles The ban of the ipsilateral limb as a skin graft donor site after melanoma excision: A critical review. J Plast Reconstr Aesthet Surg. 2021 Jan 08;: Authors: Hage JJ, van Akkooi ACJ Abstract Split-thickness skin grafts are often applied in the management of primary cutaneous melanoma. It is routine surgical practice to use the contralateral limb because of the alleged risk of donor site metastases that may occur when the ipsilateral limb is used. The rationale and clinical evidence for this routine were assessed in light of current understanding of pathways of metastasis of melanoma. We found the preference for the contralateral limb to go back to Paget's ideas on melanoma spread from 1889, and the clinical observation of five cases of split-thickness skin graft donor site metastases in a series of 226 tumours, published in 1962. We traced ten additional reported cases of melanoma metastases occurring in the skin graft donor site. Contralateral donor sites were involved in seven of these cases. In light of current knowledge, the occurrence and the location of any split skin donor site metastasis are to be considered as mere indicators of an aggressive course of s ystemic disease. Any location of a split skin donor site, whether ipsilateral or contralateral in relation to the primary tumour, may become the location of metastases but chances that such metastases occur are extremely rare. Because of the lack of evidence in favour of the use of the contralateral limb and because of sound considerations in favour of using the ipsilateral limb, we conclude that there is no objective argument to sustain the dogmatic ban of the ipsilateral limb as a donor site for a split-thickness skin graft in melanoma surgery. PMID: 33483262 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy.

xlomafota13 shared this article with you from Inoreader Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy. Via radioactive iodine Related Articles Predictors of thyroglobulin in the lymph nodes recurrence of papillary thyroid carcinoma undergoing total thyroidectomy. BMC Surg. 2021 Jan 22;21(1):53 Authors: Xing Z, Qiu Y, Li Z, Zhang L, Fei Y, Zhu J, Su A Abstract BACKGROUND: To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC). METHODS: This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines. RESULTS: Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392-55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649-267.384; P = 0.019). CONCLUSION: Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively. PMID: 33482804 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study.

xlomafota13 shared this article with you from Inoreader Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study. Via radioactive iodine Related Articles Impact of Dyslipidemia on the Risk of Second Cancer in Thyroid Cancer Patients: A Korean National Cohort Study. Ann Surg Oncol. 2021 Jan 22;: Authors: Ho J, Kim E, Han M, Jung I, Lee J, Jo YS Abstract BACKGROUND: Studies have shown that radioactive iodine therapy (RAIT) affects the development of second cancer in thyroid cancer patients. The impact of other factors, such as dyslipidemia are not clear. METHODS: A retrospective analysis of thyroid cancer patients with a 1,251,913 person-year follow-up was conducted using data from the Health Insurance Review and Assessment database in South Korea from January 2008 to December 2018. We investigated factors related to second cancer development using a nested case-control analysis to avoid length bias. RESULTS: The overall risk of developing second cancer was higher in thyroid cancer patients than in the general population [standardized incidence ratio, 3.34; 95% confidence interval (CI) 3.30-3.39]. Second cancer incidence was higher in patients who received RAIT than in those who did not [odds ratio (OR) 1.130; 95% CI 1.094-1.169]. Moreover, the risk of second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.265; 95% CI 1.223-1.309). After adjustment for RAIT, the incidence of a second cancer was higher in patients with dyslipidemia than in those without dyslipidemia (OR 1.262; 95% CI 1.221-1.306). CONCLUSIONS: The risk of second cancer development in patients with thyroid cancer appears to be high. Dyslipidemia may be associated with an increased risk of several types of second cancers. PMID: 33483844 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging.

xlomafota13 shared this article with you from Inoreader Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging. Via leak of cerebrospinal fluid Related Articles Spontaneous spinal cerebrospinal fluid-venous fistulas in patients with orthostatic headaches and normal conventional brain and spine imaging. Headache. 2021 Jan 23;: Authors: Schievink WI, Maya M, Prasad RS, Wadhwa VS, Cruz RB, Moser FG, Nuno M Abstract OBJECTIVE: To determine the occurrence of cerebrospinal fluid (CSF)-venous fistulas, a type of spinal CSF leak that cannot be detected with routine computerized tomography myelography, among patients with orthostatic headaches but normal brain and spine magnetic resonance imaging. BACKGROUND: Spontaneous spinal CSF leaks cause orthostatic headaches but their detection may require sophisticated spinal imaging techniques. METHODS: A prospective cohort study of patients with orthostatic headaches and normal brain and conventional spine imaging who underwent digital subtraction myelography (DSM) to look for CSF-venous fistulas, between May 2018 and May 2020, at a quaternary referral center for spontaneous intracranial hypotension. RESULTS: The mean age of the 60 consecutive patients (46 women and 14 men) was 46 years (range, 13-83 years), who had been suffering from orthostatic headaches between 1 and 180 months (mean, 43 months). DSM demonstrated a spinal CSF-venous fistula in 6 (10.0%; 95% confidence interval [CI]: 3.8-20.5%) of the 60 patients. The mean age of these five women and one man was 50 years (range, 41-59 years). Spinal CSF-venous fistulas were identified in 6 (19.4%; 95% CI: 7.5-37.5%) of 31 patients with spinal meningeal diverticula but in none (0%; 95% CI: 0-11.9%) of the 29 patients without spinal meningeal diverticula (p = 0.024). All CSF-venous fistulas were located in the thoracic spine. All patients underwent uneventful surgical ligation of the fistula. Complete and sustained resolution of symptoms was obtained in five patients, while in one patient, partial recurrence of symptoms was noted 3 months postoperatively. CONCLUSION: Concerns about a spinal CSF leak should not be dismissed in patients suffering from orthostatic headaches when conventional imaging turns out to be normal, even though the yield of identifying a CSF-venous fistula is low. PMID: 33484155 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lateral semicircular canal-BPPV: Prospective randomized study on the efficacy of four repositioning maneuvers

xlomafota13 shared this article with you from Inoreader Message: https://link.springer.com/article/10.1007/s12070-019-01737-4#:~:text=BPPV%20originating%20from%20stimulation%20of,lateral%20canal%20instead%20of%20the Lateral Semicircular Canal BPPV…Are We Still Ignorant? Jaskaran Singh & Bhanu Bhardwaj Indian Journal of Otolaryngology and Head & Neck Surgery volume 72, pages175–183(2020)Cite this article 137 Accesses Metricsdetails Abstract Benign Paroxysmal Vertigo is one of the most common causes of vertigo. The most common semicircular canal involved in pathogenesis of BPPV is Posterior semicircular canal. However anterior and lateral semicircular canals can also sometimes be responsible for BPPV but their involvement in pathogenesis is still underrated. The incidence of lateral semicircular canal BPPV is in literature is around 10–12% while anterior canal is about 3%. The main objective of this study was to provide the database for incidence of lateral canal BPPV from a tertiary care hospital with the aim that more clinicians incorporate this entity into their differential diagnosis when their cases of posterior canal BPPV are refractory. This was an observational cross-sectional study of 300 patients of BPPV who were coming in ENT OPD as primum or as referral. All the patients underwent both the Dix–Hallpike maneuver as well as the supine roll test. The patients who were having upbeating torsional vertical nyst agmus on Dix–Hallpike were treated on lines of posterior canal BPPV whereas those with horizontal nystagmus on supine roll test were treated on lines of lateral canal BPPV. The data was tabulated and analysed for the incidence of lateral canal BPPV. Out of 300 patients; 188 were males and 122 were females. Most commonly affected age group by BPPV was 40–50 years. Out of 300 cases 260 cases (86.6%) had posterior BPPV and 37 cases (12.3%) had lateral canal BPPV. 3 cases (1%) also had anterior canal BPPV. 30/37 cases of lateral BPPV had geotropic nystagmus while 7 cases had apo-geotropic nystagmus. Posterior canal BPPv was treated by Epleys maneuver. Superior canal BPPV was treated by Yacovino maneuver. The cases of lateral canal BPPV were treated by either Vannucchi-asprella; Gufoni; Lempert maneuver or by the combination of two maneuvers. Lateral canal BPPV is an important diagnosis to consider in all cases of BPPV. Its true incidence is still under blanket as many clinicians are not using supine roll test routinely in their practice while diagnosing BPPV. Many refractory cases of BPPV can be cured if the involvement of other canals in its pathogenesis is kept in the mind so that correct diagnostic and repositioning maneuvers can be applied. 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Neurology 70:2067–2074 CAS Article Google Scholar 40. Nuti D, Mandalà M, Salerni L (2009) Lateral canal paroxysmal positional vertigo revisited. Ann NY Acad Sci 1164:316–323 Article Google Scholar 41. Tirelli G, Russolo M (2004) 360-Degree canalith repositioning procedure for the horizontal canal. Otolaryngol Head Neck Surg 131:740–746 Article Google Scholar 42. Chiou WY, Lee HL, Tsai SC, Yu TH, Lee XX (2005) A single therapy for all subtypes of horizontal canal positional vertigo. Laryngoscope 115:1432–1435 Article Google Scholar Download references Author information Affiliations Sri Guru Ram Das Institute of Health Sciences and Research, Amritsar, India Jaskaran Singh & Bhanu Bhardwaj Mohali, India Jaskaran Singh Amritsar, India Bhanu Bhardwaj Corresponding author Correspondence to Bhanu Bhardwaj. Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Ethical Approval Before starting the study Ethical Clearance was taken from the institutional ETHICAL Committee as per DECLARATION OF HELSINKI. Informed consent Informed consent was duly taken from all the patients. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Reprints and Permissions About this article Verify currency and authenticity via CrossMark Cite this article Singh, J., Bhardwaj, B. Lateral Semicircular Canal BPPV…Are We Still Ignorant?. Indian J Otolaryngol Head Neck Surg 72, 175–183 (2020). https://doi.org/10.1007/s12070-019-01737-4 Download citation Received 06 September 2019 Accepted 09 September 2019 Published 26 September 2019 Issue Date June 2020 DOI https://doi.org/10.1007/s12070-019-01737-4 Keywords Horizontal canal BPPV Lateral canal BPPV Geotropic nystagmus Apo-geotropic nystagmus Supine roll test Bow and bean test Vannucchi asprella maneuver Gufoni maneuver Lempert maneuver Lateral semicircular canal-BPPV: Prospective randomized study on the efficacy of four repositioning maneuvers Via Acta Otorrinolaringológica Española Publication date: Available online 23 January 2021 Source: Acta Otorrinolaringológica Española Author(s): Filipe Correia, Luís Castelhano, Pedro Cavilhas, Pedro Escada View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.