Factors predictive of 90‐day mortality after surgical resection for oral cavity cancer: Development of a recursive partitioning analysis for risk stratification

xlomafota13 shared this article with you from Inoreader Factors predictive of 90‐day mortality after surgical resection for oral cavity cancer: Development of a recursive partitioning analysis for risk stratification Via Head & Neck Abstract Background Factors that influence postoperative mortality (POM) have been identified, but a predictive model to guide clinicians treating oral cavity cancer (OCC) has not been well established. Methods Patients with OCC undergoing upfront surgical resection were included. Primary outcome was 90-day POM (90dPOM). Results 33 845 were identified using the National Cancer Database. Rate of 90dPOM was 3.2%. Predictors of higher 90dPOM include older age, higher comorbidity scores, nonprivate insurance, lower income, treatment in an academic facility, higher T- and N-classification, radical excision, and presence of positive margins. On RPA, two high-risk (90dPOM > 10%) patient subsets were identified: patients ≥80 years of age with T3-4 disease and patients <80 years, with any comorbidity and T3-4, N2-3 disease. Conclusions We identified a subset of patients in this cohort who are at high risk for 90dPOM. These patients may warrant additional perioperative and postoperative monitoring in addition to better preoperative assessment and screening. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Topical Cannabis‐Based Medicines – A Novel Adjuvant Treatment for Venous Leg Ulcers: An Open‐Label Trial

xlomafota13 shared this article with you from Inoreader Topical Cannabis‐Based Medicines – A Novel Adjuvant Treatment for Venous Leg Ulcers: An Open‐Label Trial Via Experimental Dermatology Abstract Venous Leg Ulcers are highly prevalent lower limb integumentary wounds that remain challenging to heal despite the use of evidence-based compression therapies. A multitude of adjuvant treatments have been studied but none have demonstrated enough efficacy to gain adoption into treatment guidelines. Global attention on cannabis-based therapies is increasing and has been driven by quantum scientific advancements in the understanding of the endocannabinoid signalling system. Topical Cannabis-Based Medicines represent a novel treatment paradigm for venous leg ulcers in terms of promoting wound closure. Fourteen complex patients with sixteen recalcitrant leg ulcers were treated with Topical Cannabis-Based Medicines in conjunction with compression bandaging, every second day, to both wound bed and peri-wound tissues. The cohort had a mean age of 75.8 years and was medically complex as reflected by a mean M3 multimorbidity index score of 2.94 and a mean Palliative Performance Scale score of 67.1%. Complete wound closure, defined being fully epithelialized, was achieved among 11 patients (79%) and 13 wounds (81%) within a median of 34 days. All three remaining patients demonstrated progressive healing trends but were lost to follow-up. The treatments were well tolerated, and no significant adverse reactions were experienced. The rapid wound closure of previously non-healing venous leg ulcers among elderly and highly complex patients suggests that Topical Cannabis-Based Medicines may become effective adjuvants in conjunction with compression therapy. This may also indicate that they may have an even broader role within integumentary and wound management. Therefore, this treatment paradigm warrants being subjected to controlled trials. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spectral features of cortical auditory evoked potentials inform hearing threshold and intensity percepts in acoustic and electric hearing

xlomafota13 shared this article with you from Inoreader Spectral features of cortical auditory evoked potentials inform hearing threshold and intensity percepts in acoustic and electric hearing Via cortical auditory J Neural Eng. 2021 May 19. doi: 10.1088/1741-2552/ac02db. Online ahead of print. ABSTRACT Stimulus-elicited changes in electroencephalography (EEG) recordings can be represented using Fourier magnitude and phase features (Makeig et al., 2004). The present study aimed to quantify how much information about hearing responses are contained in the magnitude, quantified by event-related spectral perturbations (ERSP); and the phase, quantified by inter-trial coherence (ITC). By testing if one feature contained more information and whether this information was mutually exclusive to the features, we aimed to relate specific EEG magnitude and phase features to hearing perception. Relating hearing perception to a measure such as EEG which does not require behavioral feedback from the listener is important in both neuroscience research and clinical audiology. EEG responses were recorded from twenty adults who were presented with acoustic stimuli, and tw enty adult cochlear implant users with electrical stimuli. Both groups were presented with short, 50 ms stimuli at varying intensity levels relative to their hearing thresholds. Extracted ERSP and ITC features were inputs for a linear discriminant analysis classifier (Wong et al., 2016). The classifier then predicted whether the EEG signal contained information about the sound stimuli based on the input features. Classifier decoding accuracy was quantified with the mutual information (MI) measure (Cottaris et al., 2009; Hawellek et al., 2016), and compared across the two feature sets, and to when both feature sets were combined. We found that classifiers using either ITC or ERSP feature sets were both able to decode hearing perception, but ITC-feature classifiers were able to decode responses to a lower but still audible stimulation intensity, making ITC more useful than ERSP for hearing threshold estimation. We also found that combining the information from both feature sets did no t improve decoding significantly, implying that ERSP brain dynamics has a limited contribution to the EEG response, possibly due to the stimuli used in this study. PMID:34010826 | DOI:10.1088/1741-2552/ac02db View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Korean Society of Thyroid Radiology Guidelines for the Management of Pediatric Thyroid Nodules: Suitability and Risk Factors

xlomafota13 shared this article with you from Inoreader Message: Abstract Background: The guideline for managing pediatric thyroid nodules has not been established. We investigated the appropriateness of the Korean Society of Thyroid Radiology (KSThR) guidelines and the need to consider risk factors for managing pediatric thyroid nodules. Methods: From August 2007 to February 2020, a database of thyroid nodules in patients younger than 19 years who underwent fine-needle aspiration (FNA) was analyzed. Two radiologists retrospectively reviewed ultrasound images to characterize the nodules according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) criteria. Thyroid nodules were divided into benign and malignant nodules. Clinical risk factors were identified, including familial thyroid cancer, history of radiation therapy, and underlying thyroiditis. According to the K-TIRADS categories and the presence of risk factors, malignancy rates were calculated. We compared the diagnostic performance of the original KSThR guidelines and newly suggested criteria for FNA derived by simulation tests with variable size cutoffs in the total study population, a group with risk factors, and a group without risk factors. Results: A total of 107 patients (mean age, 13.9 years; range, 4–18 years; 83 females; 50 patients with risk factors) with 133 nodules (71 benign and 62 malignant) were included. The malignancy rate of thyroid nodules was higher in the group with risk factors (64.0%) than in the group without risk factors (43.9%; p = 0.037). Compared with the KSThR guideline (≥1.0 cm for K-TIRADS 4 and 5), the accuracy was higher (62.4% vs. 56.4%) and the unnecessary biopsy rate was lower (44.0% vs. 47.4%) when the new criteria (≥0.6 cm for K-TIRADS 4 and ≥0.5 cm for K-TIRADS 5) were used in the total study population. In particular, in the group with risk factors, the newly suggested size criteria had a much higher accuracy (73.1% vs. 59.7%) and lower unnecessary biopsy rate (30.4% vs. 35.5%) than the KSThR guideline. Conclusions: For the management of thyroid nodules in children, it is necessary to consider risk factors and adjust the criteria values for FNA. FNA should be considered in children with risk factors for thyroid cancer even if thyroid nodules are small. Korean Society of Thyroid Radiology Guidelines for the Management of Pediatric Thyroid Nodules: Suitability and Risk Factors Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Headaches Associated with Face Mask Use During COVID-19 Pandemic-Are We Seeing a Headache Epidemic?

xlomafota13 shared this article with you from Inoreader Headaches Associated with Face Mask Use During COVID-19 Pandemic-Are We Seeing a Headache Epidemic? Via Otolaryngology Indian Abstract COVID-19 has disrupted daily life and has affected the whole community. The healthcare workers have been at high risk caring for the suspected and confirmed COVID-19 patients across the globe. COVID-19 challenges have forced everyone to adopt a different lifestyle and there has been stress on hand hygiene, social distancing, and regular usage of PPE kits. Continuous use of face masks and respirators has resulted in a variety of symptoms of which headache forms a major part by all healthcare professionals as well as the patients. So the question is are we seeing a silent headache epidemic? In the letter, we have discussed the various types of headaches secondary to regular use of face masks and respirators, the extent to which it has affected the whole community, the growing threat of a silent epidemic, and measures to combat the same. We believe the measures described will help to curb the burden of headaches in the whole community. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acoustic Characteristics of Short Vowels

xlomafota13 shared this article with you from Inoreader Acoustic Characteristics of Short Vowels by Normal Nepali Young Adults Via Otolaryngology Indian Abstract Introduction Speech production is the most unique task performed by a human. The speech signals consist of strings of vowels and consonants. Vowels are differentiated based on acoustic characteristics. Methodology A total of 50 Nepali students, 25 males and 25 females of the age range 18 to 25 years with no history of voice disorders, flu, neurological disorders, speech, language impairment, and respiratory dysfunction were included in the study. Sustained phonation of five short vowels /a/, /i/, /o/, /u/ and /e/ were used in order to measure the acoustic variables. PRAAT software was used to extract the acoustic parameter of voice; mean pitch, Jitter, RAP, PPQ 5, Shimmer, and APQ 11. Result Mean and SD was calculated using SPSS. Mann–Whitney test revealed there was a highly significant difference in all the parameters taken for the study among males and females. However, the females had greater F0, jitter, RAP, PPQ5, shimmer, APQ11 than the males. Conclusion Before implementing these norms in clinical set up we must consider that these values are developed for the adults whose L1 is Nepali language and the software used for the establishment of norms was Praat. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Visual Influences on Auditory Behavioral, Neural, and Perceptual Processes: A Review

xlomafota13 shared this article with you from Inoreader Visual Influences on Auditory Behavioral, Neural, and Perceptual Processes: A Review Via Journal of the Association for Research in Otolaryngology Abstract In a naturalistic environment, auditory cues are often accompanied by information from other senses, which can be redundant with or complementary to the auditory information. Although the multisensory interactions derived from this combination of information and that shape auditory function are seen across all sensory modalities, our greatest body of knowledge to date centers on how vision influences audition. In this review, we attempt to capture the state of our understanding at this point in time regarding this topic. Following a general introduction, the review is divided into 5 sections. In the first section, we review the psychophysical evidence in humans regarding vision's influence in audition, making the distinction between vision's ability to enhance versus alter auditory performance and perception. Three examples are then described that serve to highlight vision's ability to modulate auditory processes: spatial ventriloquism, cross-modal dynamic capture, and the McGurk effect. The final part of this section discusses models that have been built based on available psychophysical data and that seek to provide greater mechanistic insights into how vision can impact audition. The second section reviews the extant neuroimaging and far-field imaging work on this topic, with a strong emphasis on the roles of feedforward and feedback processes, on imaging insights into the causal nature of audiovisual interactions, and on the limitations of current imaging-based approaches. These limitations point to a greater need for machine-learning-based decoding approaches toward understanding how auditory representations are shaped by vision. The third section reviews the wealth of neuroanatomical and neurophysiological data from animal models that highlights audiovisual interactions at the neuronal and circuit level in both subcortical and cortical structures. It also speaks to the functional significance of audiov isual interactions for two critically important facets of auditory perception—scene analysis and communication. The fourth section presents current evidence for alterations in audiovisual processes in three clinical conditions: autism, schizophrenia, and sensorineural hearing loss. These changes in audiovisual interactions are postulated to have cascading effects on higher-order domains of dysfunction in these conditions. The final section highlights ongoing work seeking to leverage our knowledge of audiovisual interactions to develop better remediation approaches to these sensory-based disorders, founded in concepts of perceptual plasticity in which vision has been shown to have the capacity to facilitate auditory learning. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prepectoral immediate breast reconstruction with polyurethane foam-coated implants: Feasibility and early results in risk-reducing and therapeutic mastectomies

xlomafota13 shared this article with you from Inoreader Prepectoral immediate breast reconstruction with polyurethane foam-coated implants: Feasibility and early results in risk-reducing and therapeutic mastectomies Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 20:S1748-6815(21)00181-9. doi: 10.1016/j.bjps.2021.03.077. Online ahead of print. ABSTRACT BACKGROUND: There is a renewed interest for prepectoral reconstruction. We aimed to describe the feasibility and the early complications associated with immediate one-stage direct-to-implant (DTI) reconstruction using prepectoral anatomical polyurethane (PU) foam-coated implants alone, for women with breast cancer or mutation carriers undergoing risk-reducing surgery. METHODS: We performed a single-center, retrospective review of 50 patients (mean age of 49 years), who underwent skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) and immediate prepectoral PU implant-based reconstruction. All procedures were performed by the same senior operator, from July 2018 to March 2020. RESULTS: A total of 64 mastectomies (25 SSMs and 39 NSMs) with one-stage prepectoral PU foam-coated implant r econstruction were performed. Out of 50 patients, 6 required surgical revision within 30 days, because of hematoma (2), wound dehiscence (2) infection (1), and full thickness nipple-areolar complex (NAC) necrosis (1). Four patients developed a cutaneous rash with spontaneous resolution. Statistical analysis showed a significant influence of hypothyroidism and previous radiotherapy on the risk of complications. The association with prior radiotherapy (pRT) was not significant using binary logistic regression. When excluding oncological reasons and patient's wish for NAC excision, our decision to perform an NSM was influenced by breast cup size, preoperative measurements, and breast weight. CONCLUSIONS: Early experience with immediate prepectoral DTI reconstruction with PU-covered implants alone suggests that it is a reliable procedure. Prior breast irradiation does not increase postoperative complication rates in our series. NAC preservation was decided according to preoperativ e lower breast measurements. PMID:34011475 | DOI:10.1016/j.bjps.2021.03.077 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oncoplastic reconstruction of central lumpectomy defects using the medial pillar island flap

xlomafota13 shared this article with you from Inoreader Oncoplastic reconstruction of central lumpectomy defects using the medial pillar island flap Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 18:S1748-6815(21)00206-0. doi: 10.1016/j.bjps.2021.03.102. Online ahead of print. ABSTRACT PURPOSE: This report presents the medial pillar island flap technique of oncoplastic breast reconstruction of central defects that involve the nipple-areola complex. METHODS: The procedure was performed in patients who presented with inferior pole redundancy using a vertical mammaplasty pattern. The flap was designed utilizing the territory of the lower pole as an island flap pedicled by the internal mammary artery perforators surrounded by the soft tissue of the medial pillar. RESULTS: Eight patients underwent the procedure with a mean age of 57.6 years. Median breast cup size was D (range: from C to DDD). The mean body mass index was 37.3 kg/m2 (range: from 32.1 to 41.5). The size of the defect ranged from 64 to 150 cm3 (mean, 97.2). Concomitant opposite breast vertical r eduction was performed in 6 cases. Flap survival was uneventful. Nipple reconstruction was performed 6 months after radiation treatment in 4 patients. No major complications were encountered. Two patients developed minor wound breakdown after nipple reconstruction. CONCLUSIONS: The medial pillar island flap is presented as a safe and reliable option for the reconstruction of central partial mastectomy defects in patients with macromastia or breast ptosis. Internal mammary system provides predictable and robust flap viability while complete separation from the inframammary fold allows for unrestricted mobility. The procedure is designed with vertical scar mammaplasty, which results in a smooth contour to the lower pole. The flap allows for nipple reconstruction using well-vascularized skin paddle. The technique is offered as an alternative oncoplasty option for neoareolar reconstruction. PMID:34011471 | DOI:10.1016/j.bjps.2021.03.102 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Performance of infrared thermography and thermal stress test in perforator mapping and flap monitoring: A meta-analysis of diagnostic accuracy

xlomafota13 shared this article with you from Inoreader Performance of infrared thermography and thermal stress test in perforator mapping and flap monitoring: A meta-analysis of diagnostic accuracy Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 18:S1748-6815(21)00192-3. doi: 10.1016/j.bjps.2021.03.088. Online ahead of print. ABSTRACT BACKGROUND: Accurate mapping of perforators prior to flap reconstruction and early detection of poor flap perfusion reduces the risk of flap failure. Infrared thermography (IRT) has recently regained popularity within reconstructive surgery to aid flap design, reduce operative time and assess flap viability based on surface temperature changes. The aim of this review is to quantify the diagnostic ability of IRT in perforator mapping preoperatively and monitor flap perfusion perioperatively. METHODS: We conducted a systematic review of literature and included all studies that evaluated the use of IRT for perforator mapping and flap perfusion monitoring. We used a mixed-effects logistic regression bivariate model to estimate the summary sensitivity and specificity and constructed hierarchical summary re ceiver operative characteristic (HSROC) curves. OUTCOME: We identified 18 studies and observed IRT to have sensitivities of 99.6% and 89.6% with specificities of 99.9% and 96.0% for perforator mapping and flap monitoring, respectively. Moreover, IRT recognises patterns of perfusion within interperforator zones through visualisation of angiosomal rewarming and may improve flap outcomes. PMID:34011474 | DOI:10.1016/j.bjps.2021.03.088 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Presence of estrogen and progesterone receptors in proliferating and involuting infantile hemangiomas

xlomafota13 shared this article with you from Inoreader Presence of estrogen and progesterone receptors in proliferating and involuting infantile hemangiomas Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 20:S1748-6815(21)00204-7. doi: 10.1016/j.bjps.2021.03.100. Online ahead of print. ABSTRACT BACKGROUND: Studies in the literature have demonstrated the presence of sex hormone receptors in infantile hemangiomas (IHs), but further investigation is needed to determine the role of these receptors in their proliferation and involution. To date, there are no studies in the literature that aimed to quantitatively examine the expression of sex hormone receptors throughout the different phases of hemangioma development. OBJECTIVE: The objective of our study was to quantitatively evaluate the expression of estrogen (ER) and progesterone (PR) receptors in the proliferative and involuting phases of IHs through the use of real-time polymerase chain reaction (RT-PCR). METHODS: Twenty IHs (10 proliferating and 10 involuting) were harvested and prepared for molecular investigation. ER receptor alpha (ERα) and beta (ERβ) and the PR expression were examined by RT-PCR and western blot. RESULTS: RT-PCR analysis demonstrated that mRNA expression of ERα, ERβ, and PR was significantly lower in proliferating versus involuting IH. Western blot analysis revealed increased protein expression of ERα in involuting hemangiomas as compared to proliferating ones. CONCLUSIONS: Our study demonstrates the variable expression of ER and PR receptors in proliferating and involuting hemangiomas. Further studies are needed to determine the exact role of these hormone receptors in the growth and involution of IHs. PMID:34011473 | DOI:10.1016/j.bjps.2021.03.100 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.