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Πέμπτη 8 Δεκεμβρίου 2022

Endonasal Lacrimal Transposition to Expand Pre‐Lacrimal Medial Maxillectomy Approach

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Endonasal Lacrimal Transposition to Expand Pre-Lacrimal Medial Maxillectomy Approach

EPLA lacrimal transposition facilitates management of maxillary sinus/pterygopalatine fossa lesions and overcomes limitations such as the Simmen type I recess or IPMS pedicled on the medial wall, without increasing peri-operative morbidity. Laryngoscope, 2022


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Asymptomatic Patients and Rising Incidence of Thyroid Cancer

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To the Editor The overdiagnosis of thyroid cancer has been a global public health problem. We read the recent study by Sajisevi et al in which the authors retrospectively analyzed data from 1328 patients who underwent thyroid-directed surgery and suggested limiting overtreatment of asymptomatic thyroid cancer. Herein, we raise several concerns.
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Tonsillectomy vs Modified Uvulopalatopharyngoplasty for Hypertrophy and Obstructive Sleep Apnea

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This randomized clinical trial examines whether modified uvulopalatopharyngoplasty is more effective than tonsillectomy alone for treating adults with tonsillar hypertrophy and moderate to severe obstructive sleep apnea.
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American Thyroid Association Guidelines and Management of Papillary Thyroid Carcinoma

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This cohort study determines how the 2009 and 2015 Americ an Thyroid Association guidelines may have corresponded with trends in the management of patients with low-risk papillary thyroid carcinoma.
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Berichtetes und gemessenes Riech- und Schmeckvermögen in einer Long-COVID-Kohorte

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Laryngorhinootologie
DOI: 10.1055/a-1970-6510

Einleitung Störungen des Riech- und Schmecksinns werden häufig zahlenmäßig übereinstimmend als Long-COVID-Symptom beklagt. Anhand von Befunden einer Spezialsprechstunde (HNO-LCS) soll geklärt werden, wie groß tatsächlich der Anteil pathologischer olfaktorischer bzw. gustatorischer Diagnosen in dieser Kohorte ist. Methodik 48 erwachsene Patienten, die die HNO-LCS aus eigenem Leidensdruck aufsuchten, wurden nach ihrer Anamnese befragt, sie schätzten ihr Riech- (SER) und Schmeckvermögen (SES) mit Schulnoten ein und absolvierten als Riechtest den erweiterten Sniffin'Sticks-Test und als Schmecktest den 3-Tropfen-Test. Aus dem SDI-Riechscore und dem totalen Schmeckscore (SScore-total) wurden anhand von Normwerten Diagnosen erstellt. Zwischen den gemessenen Scores und der Selbsteinschätzung und zwischen SER und SES wurden Korrelationen berechnet. Ergebnisse Tatsächliche pathologische chemosensorische Diagnosen bestanden bei 90% der Patienten. Pathologische olfaktorische Diagnosen waren doppelt so häufig wie gustatorische. Bei 10% der Kohorte war keine pathologische Diagnose verifizierbar. Bei 6 Patienten wurde ein Anosmie-Ageusie-Syndrom diagnostiziert. SER korrelierte stark mit SDI. SES korrelierte moderat mit SScore-total. SER korrelierte stark mit SES. Schlussfolgerungen Bei der Interpretation berichteter chemosensorischer Symptome besteht die Gefahr einer Konfusion von Riechen und Schmecken durch die Betroffenen. Deshalb ist die Überprüfung der chemischen Sinne mit validierten Tests in Long-COVID-Ambulanzen wichtig.
[...]

Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Τετάρτη 7 Δεκεμβρίου 2022

Main Causal Agents of Occupational Asthma

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Abstract
Objectives
The definition of work-related Asthma (WRA) has changed in recent years and new etiologies and agents have been identified. The aim of this study is to describe the main causal agents of WRA in France in the period 2001–2018 in the main work sectors.
Methods
Data were collected from the French national network of occupational health surveillance and prevention [Réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P)], Data between 2001 and 2018 with at least a probable or certain association with one occupational agent, were included.
Results
Work sectors with more cases OF WRA included personal service activities (10.6%), food industry (10.2%) and healthcare activities (7.6%). WRA cases were most frequently related to flour (10%), quaternary ammoniums compounds (5.3%), isocyanates (5.1%) and cleaning products (4.8%).
Conclusion
Occupational exposure to specific ag ents capable of causing WRA is still present, and four agents represent more than 25% of the cases. Actions to prevent respiratory exposure are still relevant.
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Τρίτη 6 Δεκεμβρίου 2022

Switching certolizumab pegol from a prefilled syringe or autoinjection pen to an AVA® e‐Device in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis patients

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Six months multicentre pilot open label single-arm study to evaluate patient experience, acceptability and satisfaction of switching certolizumab pegol from a prefilled syringe or autoinjection pen to an AVA® e-Device in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis patients

AVA® is a new electromechanical injection device for self-injecting certolizumab pegol (CZP). Thirty four patients were included (28 women) RA 11, PsA 10 and axial axSpA 13. Patients reported >90% adherence assessed with AVA® injection log and the full dose of CZP was injected on all patients with AVA® device. No safety findings related to AVA® CZP administration were identified. AVA® device is an advantageous delivery option for CZP. This study provides further evidence to support that AVA® device is a valid method for switching CZP from syringe or pen with highly preference in patients with RA, PsA and axSpa.


Abstract

What Is Known and Objective

The study aimed to assess acceptability and patient experience of Certolizumab (CZP) self-injection with AVA® and clarify patient device preference after switching CZP from the syringe or auto-injection pen to AVA® in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients.

Method

A multicentre open-label, cross-sectional and prospective study among four Spanish hospitals was performed. Adult RA, PsA, axSpA patients treated for at least 6 months with the CZP syringe or pen were recruited. At the first visit, patients completed Pre-AVA® questionnaire. Patients were instructed on proper administration of CZP by AVA®. After 2 and 6 months of CZP self-injections using the AVA®, patient experience, adherence, preference and safety of each administration was assessed using post-AVA® questionnaire.

Results and Discussion

Thirty four patients were included (28 women). All patients self-administered CZP AVA® the full dose of CZP was injected. Patients reported >90% adherence to CZP AVA® assessed with the injection log. Pain at the injection site was reduced after switching to AVA®. Twenty nine patients preferred CZP AVA® and five patients preferred the CZP pen. No safety-related findings related to AVA® CZP administration were identified.

What Is New and Conclusion

The AVA® is an advantageous delivery option for CZP in patients with RA, PsA, axSpA.

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Trotabresib, an oral potent bromodomain and extraterminal inhibitor, in patients with high-grade gliomas: a phase I, “windowofopportunity” study

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Abstract
Background
The bromodomain and extraterminal protein (BET) inhibitor trotabresib has demonstrated antitumor activity in patients with advanced solid tumors, including high-grade gliomas. CC-90010-GBM-001 (NCT04047303) is a phase I study investigating the pharmacokinetics, pharmacodynamics, and CNS penetration of trotabresib in patients with recurrent high-grade gliomas scheduled for salvage resection.
Methods
Patients received trotabresib 30 mg/day on days 1–4 before surgery, followed by maintenance trotabresib 45 mg/day 4 days on/24 days off after surgery. Primary endpoints were plasma pharmacokinetics and trotabresib concentrations in resected tissue. Secondary and exploratory endpoints included safety, pharmacodynamics, and antitumor activity.
Results
Twenty patients received preoperative trotabresib and underwent resection with no delays or cancellations of surgery; 16 patients received maintenance trot abresib after recovery from surgery. Trotabresib plasma pharmacokinetics were consistent with previous data. Mean trotabresib brain tumor tissue:plasma ratio was 0.84 (estimated unbound partition coefficient [KPUU] 0.37), and modulation of pharmacodynamic markers was observed in blood and brain tumor tissue. Trotabresib was well tolerated; the most frequent grade 3/4 treatment-related adverse event during maintenance treatment was thrombocytopenia (5/16 patients). Sixmonth progression-free survival was 12%. Two patients remain on treatment with stable disease at cycles 25 and 30.
Conclusions
Trotabresib penetrates the blood–brain-tumor barrier in patients with recurrent high-grade glioma and demonstrates target engagement in resected tumor tissue. Plasma pharmacokinetics, blood pharmacodynamics, and safety were comparable with previous results for trotabresib in patients with advanced solid tumors. Investigation of adjuvant trotabresib + temozolomide and concom itant trotabresib + temozolomide + radiotherapy in patients with newly diagnosed glioblastoma is ongoing (NCT04324840).
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Δευτέρα 5 Δεκεμβρίου 2022

Perceived legitimacy can moderate the effect of proscriptive vs. prescriptive injunctions on intentions to comply with UK government COVID‐19 guidelines and reactance

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Abstract

Proscriptive injunctions (i.e., telling people what they should not do) have been found in research to elicit greater perceptions of a threat to freedom, and greater reactance (anger, irritation and annoyance), than prescriptive injunctions (i.e., telling people what they should do), across several health and social behaviours. The current research investigated the effects of Injunction Type (proscriptive vs. prescriptive) and perceived legitimacy of the injunction, on intentions to comply with UK government behavioural guidelines during the COVID-19 pandemic, and on reactance. In two online experimental studies (Study 1: N = 142; Study 2: N = 307), UK participants were presented with information about UK government COVID-19 guidelines that included either a proscriptive injunction or prescriptive injunction and reported their perceptions of the legitimacy of the injunction, their intentions to comply with government guidelines, a nd their reactance. In both Study 1 and Study 2, the effect of Injunction Type on intentions to comply and reactance was moderated by perceived legitimacy. In both studies, when perceived legitimacy was low, participants exposed to the proscriptive injunction indicated lower intentions to comply with UK government COVID 19 guidelines than did participants exposed to the prescriptive injunction, The findings imply that using a prescriptive injunction frame can elicit greater intentions to comply than using a proscriptive injunction frame when people perceive the injunction to be unreasonable. The results are discussed in relation to the role of legitimacy in determining the effectiveness of different types of injunctions on compliance with rules and guidelines.

This article is protected by copyright. All rights reserved.

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International variations in carcinoma and melanoma incidence in children and adolescents

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In order to compare the subtype distribution of carcinoma and melanoma in children and adolescents between Japan and other countries, we extracted information on cancer incidence in children and adolescents from the third volume of the International Incidence of Childhood Cancer series (IICC-3) (1). The IICC-3 reports the number or incidence rates of cancers diagnosed in childhood and adolescence, from cancer registries (regional or national) worldwide. We analysed carcinoma and melanoma incidence in four countries in Asia (Japan, China, the Republic of Korea and Thailand), two countries in Africa (Egypt and Uganda), four countries in the Americas (North: The United States of America and Canada, Latin and Caribbean: Brazil and Colombia), three countries in Europe (the United Kingdom [UK], France and Germany) and two countries in Oceania (Australia and New Z ealand). Information from the Republic of Korea, USA, UK, Australia and New Zealand was obtained at the national level, and that from the other countries was extracted from one or multiple regional cancer registries. The years of incidence included in the analyses varied from country to country, ranging from 1990 to 2014, with the shortest being 12 years (Egypt: 1999–2010, UK: 2000–2011) and the longest being 24 years (Japan and China: both 1990–2013). In this study, we compared the incidence and proportional distribution of carcinoma and melanoma subtypes in children (0–14 years old) and adolescents (15–19 years old) between these countries.
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