Adaptation and Validation of the Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing: DIGEST-FEES

xlomafota13 shared this article with you from Inoreader Adaptation and Validation of the Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing: DIGEST-FEES Via swallowing exercises J Speech Lang Hear Res. 2021 May 25:1-9. doi: 10.1044/2021_JSLHR-21-00014. Online ahead of print. ABSTRACT Purpose While flexible endoscopic evaluation of swallowing (FEES) is a common clinical procedure used in the head and neck cancer (HNC) population, extant outcome measures for FEES such as bolus-level penetration-aspiration and residue scores are not well suited as global patient-level endpoint measures of dysphagia severity in cooperative group trials or clinical outcomes res earch. The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) was initially developed and validated for use during videofluoroscopic evaluations as a way to grade safety, efficiency, and overall pharyngeal swallowing impairment. The purpose of this study was to adapt and validate DIGEST for use with FEES. Method A modified Delphi exercise was conducted for content validation, expert consensus, adaptation, and operationalization of DIGEST-FEES. Three blinded, expert raters then evaluated 100 de-identified post-HNC treatment FEES examinations. Intra- and interrater reliability were tested with quadratic weighted kappa. Criterion validity against the MD Anderson Dysphagia Inventory, Functional Oral Intake Scale, Secretion Severity Scale, and Yale Residue Rating Scale was assessed with Spearman correlation coefficients. Results Interrater reliability was almost perfect for overall DIGEST-FEES grade (κw = 0.83) and safety grade (κw = 0.86) and substantial for e fficiency grade (κw = 0.74). Intrarater reliability was excellent for all raters (0.9-0.91). Overall DIGEST-FEES grade correlated with MD Anderson Dysphagia Inventory (r = -.43, p < .0001), Functional Oral Intake Scale (r = -.43, p < .0001), Secretion Severity Scale (r = .47, p < .0001), Yale Vallecular Residue (r = .73, p < .0001), and Yale Pyriform Sinus Residue (r = .65, p < .0001). Conclusion DIGEST-FEES is a valid and reliable scale to describe the severity of pharyngeal dysphagia in patients with HNC. Supplemental Material https://doi.org/10.23641/asha.14642787. PMID:34033498 | DOI:10.1044/2021_JSLHR-21-00014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patient‐to‐robot registration: the fate of robot‐assisted stereotaxy

xlomafota13 shared this article with you from Inoreader Patient‐to‐robot registration: the fate of robot‐assisted stereotaxy Via The International Journal of Medical Robotics and Computer Assisted Surgery ABSTRACT Background Robot-assisted stereotaxy (RAS) promises higher stereotactic accuracy (SA) and time efficiency (TE) than frame-based stereotaxy. However, both aspects are attributed to the problem of patient-to-robot registration. Objective To examine different registration techniques regarding their SA and TE. Methods This study enrolled 57 patients undergoing RAS with bone fiducial (BFR) or laser surface registration (LSR). SA was measured by the entry point error (EPE). Additionally, predictors of SA (registration error [RegE], distance-to-registration plane [DTC]) and TE (imaging, skin-to-skin) were assessed. Results The mean SA was 1.0±0.8mm. BFR increased SA by reducing RegE and DTC. In LSR, EPE depended on DTC (face and forehead) with highest accuracy for DTC≤100mm. CT-based LSR exerted a higher SA than MR-based LSR. In BFR, TE was confined by the additional imaging. Conclusion Every registration technique counteracts one of the promises of RAS. New solutions are needed to increase the acceptance of RAS in neurosurgery. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Robotized Handheld Smart Tool for Orthopedic Surgery

xlomafota13 shared this article with you from Inoreader A Robotized Handheld Smart Tool for Orthopedic Surgery Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Handheld surgical robots offer functionalities, such as active guidance, tremor suppression and force reflection, for surgeons to enhance their skill in manipulating surgical tools during medical intervention. In orthopedic surgery, the robot additionally has to offer sufficient rigidity and power for bone machining. The size and weight of the mechanical design, together with the control behavior associated with involuntary hand motion, navigation and reflected force to the human, all influence the overall performance of an orthopedic handheld robot. The paper proposes a miniature and compact design for an embedded robot, which is a similar weight as a handpiece. Then, a shared controller is proposed to address the coupling among involuntary and voluntary hand motions, robot navigation, tool feedback forces and force artifacts from actuation. The handheld robot is able to stabilize the drill positioning by removing involuntary tremors as well as reduce force artifacts from motor a ctuation in experiments involving pedicle tunneling on a porcine spine. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Detection of viral gene expression in risk‐stratified biopsies reveals no active HPV in cutaneous squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Detection of viral gene expression in risk‐stratified biopsies reveals no active HPV in cutaneous squamous cell carcinoma Via Experimental Dermatology Abstract Background Human papillomavirus (HPV) infection is known to promote the development of mucosal squamous cell carcinoma (mSCC), including pathologically high-grade lesions, but its role in cutaneous squamous cell carcinoma (cuSCC) remains unclear, particularly in lesions that are considered high risk. Objective We aimed to determine whether enhanced HPV transcriptional activity can be detected in high-risk cuSCC samples compared with low-grade SCC samples or normal skin. Methods We performed RNA sequencing of cuSCC across 23 risk-stratified skin lesions. A subset of samples was tested for the presence of HPV DNA. High-quality, non-human reads from each sample group were used for viral analysis using Microbiome Coverage Profiler. Results None of the samples analysed had detectable expression of HPV RNA, while 64% of samples tested positive for HPV DNA. All samples were found to have expression of human endogenous retrovirus, and multiple samples showed expression of other viruses. Conclusions Viral and prophage gene expression can be monitored in cuSCC or normal skin biopsies, yet no sample in our study showed evidence of active HPV gene expression despite evidence of HPV genome presence. This suggests HPV transcription does not play a role in differentiating high-risk cuSCCs from low-risk cuSCCs or normal skin. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence and prognosis of otorhinolaryngological symptoms in patients with COVID-19: a systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Prevalence and prognosis of otorhinolaryngological symptoms in patients with COVID-19: a systematic review and meta-analysis Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 25. doi: 10.1007/s00405-021-06900-8. Online ahead of print. ABSTRACT OBJECTIVE: A systematic review and meta-analysis were performed to evaluate the prevalence and prognosis of otorhinolaryngological symptoms in patients with the diagnosed coronavirus disease 2019 (COVID-19). METHODS: A systematic search of PubMed, Embase, Web of Science, and Google Scholar databases was performed up to August 19, 2020.We included studies that reported infections with COVID-19 and symptoms of otolaryngology. The retrieved data from the respective studies were evaluated and summarized. The study's immediate result was to assess the combined prevalence of otorhinolaryngological symptoms in patients with COVID-19. However, the secondary result was to determine the exacerbation of COVID-19 infection in patients with otorhinolaryngological symptoms. RESULTS: Fifty-four studies with 16,478 patients were include d. Olfactory dysfunction, sneezing and sputum production were the 3 most prevalent otorhinolaryngological symptoms in patients with COVID-19. The pooled prevalence amongst the prevalent symptoms was 47% (95% CI 29-65; range 0-98; I2 = 99.58%), 27% (95% CI 11-48; range 12-40; I2 = 93.34%), and 22% (95% CI 16-30; range 2-56; I2 = 97.60%), respectively. The proportion of severely ill patients with sputum production and shortness of breath was significantly higher among patients with COVID-19 infections (OR 1.66 [95% CI 1.08-2.54]; P = 0.02, I2 = 51% and 3.29 [95% CI 1.57-6.90]; P = 0.002, I2 = 49%, respectively). Subgroup analysis showed no statistically significant differences between the incidence of otolaryngology symptoms in severely ill patients and non-severely ill patients (OR 1.43 [95% CI 1.12-1.82]; P = 0.07 I2 = 53.1%). In contrast, the incidence of shortness of breath in severely ill patients was significantly increased (3.29 [1.57-6.90]; P = 0.002, I2 = 49%). CONCLUSION: Our research shows that otorhinolaryngology symptoms in patients with COVID-19 are not uncommon, which should attract otorhinolaryngologists' attention. PMID:34032909 | DOI:10.1007/s00405-021-06900-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effectiveness and safety of growth factors in the treatment of tympanic membrane perforations: a systematic review and meta-analysis of randomized controlled trials

xlomafota13 shared this article with you from Inoreader The effectiveness and safety of growth factors in the treatment of tympanic membrane perforations: a systematic review and meta-analysis of randomized controlled trials Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 25. doi: 10.1007/s00405-021-06891-6. Online ahead of print. ABSTRACT PURPOSE: To determine the clinical efficacy and safety of growth factors in the treatment of tympanic membrane (TM) perforations from randomized controlled trials (RCTs). METHODS: Databases, including PubMed, EMBASE, Cochrane library, Ebsco, Ovid, Scopus, and Web of Science, were searched for articles in any language about studies on the treatment of TM perforations with growth factors. Inclusion criteria were: (1) randomized controlled trials (RCTs); (2) only patients with TM perforations included; and (3) any kinds of growth factors or related products were used as an intervention. Exclusion criteria were: (1) study was not reported as a full paper, only as an abstract; (2) review studies and case reports; and (3) an inability to extract valid data. Outcomes of interest included perforation closure rate, closure time, hearin g improvement, and complications. RESULTS: Nineteen RCTs with a total of 1335 participants were included. Growth factors effectively increased the rate of perforation closure [risk ratio (RR): 1.21 95% confidence interval (1.12, 1.30), p < 0.01] and shortened closure time [mean difference (MD): - 16.71 (- 22.74, - 10.15), p < 0.01]. There was no significant difference in hearing improvement [MD: 0.10 (- 0.50, 0.70), p = 0.74] or complications [RR: 1.49 (0.96, 2.32), p = 0.07] between the growth factor intervention group and the control group. CONCLUSION: Growth factors are effective and safe in the treatment of TM perforations. However, better designed clinical trials should be carried out in the future to obtain more robust findings about the effectiveness of growth factors in the treatment of TM perforations. PMID:34032907 | DOI:10.1007/s00405-021-06891-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between obstructive sleep apnea and thyroid cancer incidence: a national health insurance data study

xlomafota13 shared this article with you from Inoreader Association between obstructive sleep apnea and thyroid cancer incidence: a national health insurance data study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 25. doi: 10.1007/s00405-021-06896-1. Online ahead of print. ABSTRACT PURPOSE: Little is known about the incidence of thyroid cancer in patients with obstructive sleep apnea (OSA). This study aimed to evaluate whether OSA is associated with the incidence of thyroid cancer based on the Korea National Health Insurance Service (KNHIS) database. METHODS: This study was designed as a retrospective cohort data analysis of the KNHIS dataset. A total of 198,574 patients who were over 20 years of age and had been newly diagnosed with OSA between 2007 and 2014 were enrolled. A control group of 992,870 individuals was selected based on propensity score matching by age and sex. The mean follow-up duration was 4.5 ± 2.3 years. The primary endpoint was the incidence of newly diagnosed thyroid cancer. RESULTS: The hazard ratio (HR) for thyroid cancer incidence among OSA patients compared to the control was 1.72 (95% confidence interval [CI] 1.60-1.84) based on Model 1 (not adjusted by any covariate) and 1.64 (95% CI 1.53-1.76) based on Model 2 (adjusted by income level, diabetes, hypertension, and dyslipidemia). Thyroid cancer incidence was significantly higher in male patients (HR = 1.93, 95% CI 1.74-2.12) than female ones (HR = 1.39, 95% CI 1.26-1.54). When compared by age, the HR of thyroid cancer was higher in middle-aged (40 ≤ age < 65 years) patients (HR = 1.68, 95% CI 1.55-1.83) than in young (20 ≤ age < 40 years, HR = 1.53, 95% CI 1.32-1.77) or old (65 ≤ age, HR = 1.28, 95% CI 0.94-1.74) patients. CONCLUSION: OSA may increase the risk of developing thyroid cancer, especially in middle-aged men. PMID:34032908 | DOI:10.1007/s00405-021-06896-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acupuncture is associated with a positive effect on odour discrimination in patients with postinfectious smell loss-a controlled prospective study

xlomafota13 shared this article with you from Inoreader Acupuncture is associated with a positive effect on odour discrimination in patients with postinfectious smell loss-a controlled prospective study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 25. doi: 10.1007/s00405-021-06872-9. Online ahead of print. ABSTRACT INTRODUCTION: Smell disorders are common in the general population and occur e.g., after infections, trauma or idiopathically Treatment strategies for smell loss range from surgery, medication to olfactory training, depending on the pathology, but they are limited This study examined the effect of acupuncture on olfactory function. METHODS: Sixty patients with smell loss following infections of the upper respiratory tract were included in this investigation Half of the study group were randomly assigned to verum acupuncture and the other half to sham acupuncture Olfaction was measured by means of the "Sniffin' Sticks" test battery (odour threshold, discrimination and identification). RESULTS: Compared to sham acupuncture, verum was associated with an improvement of smell function as measured by the TDI score (p = 0.039) The improvement was largely determined by improvement in odour discrimination, and was significantly better in patients with a shorter duration of the disorder. CONCLUSION: The present results suggest that acupuncture is an effective supplementary treatment option for patients with olfactory loss. PMID:34032906 | DOI:10.1007/s00405-021-06872-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The anatomical variant of high soleus muscle may predispose to tendinopathy: a preliminary MR study

xlomafota13 shared this article with you from Inoreader The anatomical variant of high soleus muscle may predispose to tendinopathy: a preliminary MR study Via radiol anat Surg Radiol Anat. 2021 May 25. doi: 10.1007/s00276-021-02768-9. Online ahead of print. ABSTRACT PURPOSE: This study aimed to examine the anatomic variations at the level of the distal soleus musculotendinous junction and the possible association between the length of the free tendon and the development of symptomatic Achilles tendinopathy. METHODS: We retrospectively assessed 72 ankle MRI studies with findings of Achilles tendinopathy (study group, 26 females/46 males, mean age 52.6 ± 10.5 years, 30 right/42 left) and 72 ankle MRI studies with normal Achilles tendon (control group, 32 females/40 males, mean age 35.7 ± 13.7 years, 42 right/30 left side). We measured the distance from the lowest outline of the soleus myotendinous junction to the proximal outline of the Achilles tendon insertion (length of the free tendon, diameter a) and to the distal outline of the insertion (distance B). We also measured the maximum thickness of the free tendon (diameter c) and the distance between the levels of maximum thickness to the proximal outline of the Achilles tendon insertion (distance D). All measurements were assessed twice. Statistical analysis was performed using independent t test. RESULTS: Distances A and B were significantly larger in tendinopathic tendons (59.7 and 83.4 mm, respectively) than normal Achilles tendons (38.5 and 60.8 mm, respectively) (p = 0.001). Mean distance C was larger in tendinopathic than normal tendons (11.2 versus 4.9 mm). Distances C and D were significantly larger in males than females. There was no significant difference in the measurements between sides. CONCLUSION: There is wide anatomical variation in the length of the free Achilles tendon. Tendinopathy may be associated with the thicker free part of the Achilles tendon. The anatomical variant of the high soleus musculotendinous junction resulting in a longer free Achilles tendon may be a predisposing factor to the development of tendinopathy. PMID:34032901 | DOI:10.1007/s00276-021-02768-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intermediate-risk thyroid carcinoma: indicators of a poor prognosis

xlomafota13 shared this article with you from Inoreader Intermediate-risk thyroid carcinoma: indicators of a poor prognosis Via radioactive iodine Arch Endocrinol Metab. 2021 May 18;64(6):764-771. doi: 10.20945/2359-3997000000290. ABSTRACT OBJECTIVE: The intermediate-risk (IR) category includes tumors with different degrees of aggression. We aimed to identify the risk factors associated with unfavorable response to initial treatment and compare the effect of low/high radioactive iodine (RAI) therapy. METHODS: A total of 614 IR patients were selected from a database, during 1972-2015. All patients underwent total thyroid ectomy and RAI therapy and were reclassified after 12-18 months into the favorable (complete/indeterminate) response group and the unfavorable (biochemical/incomplete structural) response group. A total of 92 patients were assessed for late response (mean: 9.19 ± 5.73 years). Age, gender, tumor size, histology, multifocality, vascular invasion, extrathyroidal extension, presence and number of lymph node metastasis, and stimulated thyroglobulin at ablation (sTg) were evaluated. RESULTS: Mean age at diagnosis was 41.47 ± 15.81 years, and 83.6% of the patients were female. Within 12-18 months after initial therapy, unfavorable response was detected in 41.2% of the patients and was associated, in multivariate analysis, with lymph node metastasis (p = 0.041; odds ratio [OR] = 1.9), presence of more than five metastatic lymph nodes (p = 0,017; OR = 2.6), and sTg > 10 ng/mL (p = 0.005; OR = 10.0). For patients with a longer follow-up, sTg >10 ng/mL was associated with unfavor able response (p = 0.002; OR = 6.8). A higher RAI dose was not related to better prognosis at the end of the follow-up. CONCLUSION: A sTg level of >10 ng/mL and lymph node metastasis were associated with an unfavorable response 12-18 months after initial treatment. A RAI dose below 150 mCi was proven sufficient to treat IR patients. PMID:34033287 | DOI:10.20945/2359-3997000000290 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oral changes in cocaine abusers: an integrative review

xlomafota13 shared this article with you from Inoreader Oral changes in cocaine abusers: an integrative review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 May 14:S1808-8694(21)00083-5. doi: 10.1016/j.bjorl.2021.04.011. Online ahead of print. ABSTRACT INTRODUCTION: Cocaine is one of the most often used psychoactive drugs worldwide, being extracted from the leaves of Erytroxylus coca plant. Its abusive use can trigger several consequences for the human body, including the oral cavity. OBJECTIVE: To identify the oral disorders that are most commonly found in individuals who abuse cocaine, in addition to the main diagnostic and treatment methods. METHODS: An integrative review was carried out on the databases: LILACS, BBO, LIS, MEDLINE, SciELO, Science Direct and PubMed. The following keywords were used: "Cocaína", "Boca", "Palato" and "Odontologia", together with their synonyms and variations in English, obtained from DeCS and MeSH. The inclusion criteria were original articles, articles in Portuguese, English and Spanish, studies involving individ uals, without restriction related to the year of publication. Animal studies, literature reviews, book chapters, theses and dissertations were excluded. RESULTS: In total, 1373 records were identified. Of these, 22 articles were selected to comprise the review. Several oral alterations caused by cocaine abuse were found, primarily perforation of the palate, predisposition to periodontal diseases, temporomandibular disorders, bruxism, damage to oral tissues, dental caries, destructive lesions of the facial midline, xerostomia and ageusia. Among the diagnostic methods used by the professionals, anamnesis, intraoral examinations and head and neck computed tomography were the most frequently mentioned. As for treatment, in patients with palatal perforation, the reconstruction of the affected area or the use of prosthetic obturators is carried out. CONCLUSION: The management of these patients is not an easy task, as many of the users do not even seek professional help. The he alth professionals must be able to recognize these manifestations and alterations to establish timely and accurate diagnosis and treatment planning. PMID:34034978 | DOI:10.1016/j.bjorl.2021.04.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.