Insurance type is associated with appropriate use of surgical and adjuvant care for differentiated thyroid carcinoma

xlomafota13 shared this article with you from Inoreader Insurance type is associated with appropriate use of surgical and adjuvant care for differentiated thyroid carcinoma Via radioactive iodine Surgery. 2021 Sep 30:S0039-6060(21)00794-7. doi: 10.1016/j.surg.2021.07.038. Online ahead of print. ABSTRACT BACKGROUND: We aimed to characterize the association between differentiated thyroid cancer (DTC) patient insurance status and appropriateness of therapy (AOT) regarding extent of thyroidectomy and radioactive iodine (RAI) treatment. METHODS: The National Cancer Database was queried for DTC patients diagnosed between 2010 and 2016. Adjusted odds ratios (AOR) for AOT, as defined by the American Thyroid Association guidelines, and hazard ratios (HR) for overall survival (OS) were calculated. A difference-in-differences (DD) analysis examined the association of Medicaid expansion with outcomes for low-income patients aged <65. RESULTS: A total of 224,500 patients were included. Medicaid and uninsured patients were at increased risk of undergoing inappropriate therapy, including inappropriate lobectomy (Medicaid 1.36, 95% confidence interval [CI]: 1.21-1.54; uninsured 1.30, 95% CI: 1.05-1.60), and under-treatment with RAI (Medicaid 1.20, 95% CI: 1.14-1.26; uninsured 1.44, 95% CI: 1.33-1.55). Inappropriate lobectomy (HR 2.0, 95% CI: 1.7-2.3, P < .001) and under-treatment with RAI (HR 2.3, 95% CI: 2.2-2.5, P < .001) were independently associated with decreased survival, while appropriate surgical resection (HR 0.3, 95% CI: 0.3-0.3, P < .001) was associated with improved odds of survival; the model controlled for all relevant clinico-pat hologic variables. No difference in AOT was observed in Medicaid expansion versus non-expansion states with respect to surgery or adjuvant RAI therapy. CONCLUSION: Medicaid and uninsured patients are at significantly increased odds of receiving inappropriate treatment for DTC; both groups are at a survival disadvantage compared with Medicare and those privately insured. PMID:34600741 | DOI:10.1016/j.surg.2021.07.038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Days alive and out of hospital following transoral robotic surgery: Cohort study of 262 patients with head and neck cancer

xlomafota13 shared this article with you from Inoreader Days alive and out of hospital following transoral robotic surgery: Cohort study of 262 patients with head and neck cancer Via Head & Neck Abstract Background Days alive and out of hospital (DAOH) is a validated outcome in clinical trials, since it reflects procedure-associated morbidity and mortality. Transoral robotic surgery (TORS) has become a widely adopted procedure with increasing demand for knowledge and data on morbidity. Methods Retrospective single-center assessment of a prospective TORS database comprising patients treated for malignancy between 2013 and 2018 using DAOH to describe procedure- and disease-related morbidity the first 12-postoperative months. Results For 262 patients, median DAOH365 was 357 days (IQR 351–360). Indications for TORS were (i) primary curative resection (61%), (ii) salvage resection (15%), and (iii) diagnostic work-up of cancer of unknown primary in the head and neck (24%). Median DAOH365 was 359 days (IQR 351–361 days), 348 days (IQR 233–355), and 357 days (351–361), respectively. Pneumonia had the highest impact in DAOH365 reduction. Conclusion Total median DAOH365 after TORS was 357 days. The main cause leading to DAOH365 reduction was pneumonia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of genistein on cisplatin induced ototoxicity and oxidative stress

xlomafota13 shared this article with you from Inoreader The effect of genistein on cisplatin induced ototoxicity and oxidative stress Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Jul 30:S1808-8694(21)00133-6. doi: 10.1016/j.bjorl.2021.07.001. Online ahead of print. ABSTRACT OBJECTIVE: Cisplatin is an antineoplastic agent used in adults and children for the treatment of various malignant diseases. It can cause irreversible ototoxicity. Genistein is a phytoestrogen. Genistein functions as an antioxidant and cell cycle inhibitor by inhibiting the DNA topoisomerase and tyrosine protein kinase enzymes. The protective effect of genistein in preventing cisplatin-induced ototoxicity and levels of the oxidative stress was investigated. METHODS: 32 Sprague Dawley rats were used in 4 groups (control, cisplatin, cisplatin + genistein, genistein). Otoacoustic emission measurements of the distortion product were performed on the 1st, 2nd and 5th days of the test protocol. Serum malondialdehyde, superoxide dismutase, catalase, glutathione peroxidase, total antioxidant status, total oxidant status and oxidative stress index measurements were made. RESULTS: The hearing of the cisplatin + genistein group was found to be better than that of the cisplatin group. While the malondialdehyde, total oxidant status and oxidative stress index parameters decreased significantly in the cisplatin + genistein group compared to the cisplatin group, superoxide dismutase increased significantly (p < 0.05). CONCLUSION: Genistein showed positive effects against ototoxicity with its antioxidant effect. LEVEL OF EVIDENCE: Level 3. PMID:34602350 | DOI:10.1016/j.bjorl.2021.07.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Auditory, Visual, and Cross-Modal Mismatch Negativities in the Rat Auditory and Visual Cortices

xlomafota13 shared this article with you from Inoreader Auditory, Visual, and Cross-Modal Mismatch Negativities in the Rat Auditory and Visual Cortices Via cortical auditory Front Hum Neurosci. 2021 Sep 17;15:721476. doi: 10.3389/fnhum.2021.721476. eCollection 2021. ABSTRACT When the brain tries to acquire an elaborate model of the world, multisensory integration should contribute to building predictions based on the various pieces of information, and deviance detection should repeatedly update these predictions by detecting "errors" from the actual sensory inputs. Accumulating evidence such as a hierarchical organization of the deviance-detection system indicates that the deviance-detection system can be interpreted in the predictive coding framework. Herein, we targeted mismatch negativity (MMN) as a type of prediction-error signal and investigated the relationship between multisensory integration and MMN. In particular, we studied whether and how cross-modal information processing affected MMN in rodents. We designed a new surface microelectrode array and simultaneously recorded visual and auditory evoked pote ntials from the visual and auditory cortices of rats under anesthesia. Then, we mapped MMNs for five types of deviant stimuli: single-modal deviants in (i) the visual oddball and (ii) auditory oddball paradigms, eliciting single-modal MMN; (iii) congruent audio-visual deviants, (iv) incongruent visual deviants, and (v) incongruent auditory deviants in the audio-visual oddball paradigm, eliciting cross-modal MMN. First, we demonstrated that visual MMN exhibited deviance detection properties and that the first-generation focus of visual MMN was localized in the visual cortex, as previously reported in human studies. Second, a comparison of MMN amplitudes revealed a non-linear relationship between single-modal and cross-modal MMNs. Moreover, congruent audio-visual MMN exhibited characteristics of both visual and auditory MMNs-its latency was similar to that of auditory MMN, whereas local blockage of N-methyl-D-aspartic acid receptors in the visual cortex diminished it as well as visual MMN. These results indicate that cross-modal information processing affects MMN without involving strong top-down effects, such as those of prior knowledge and attention. The present study is the first electrophysiological evidence of cross-modal MMN in animal models, and future studies on the neural mechanisms combining multisensory integration and deviance detection are expected to provide electrophysiological evidence to confirm the links between MMN and predictive coding theory. PMID:34602996 | PMC:PMC8484534 | DOI:10.3389/fnhum.2021.721476 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Massive Cervical Lymphadenopathy Post-COVID-19 Vaccination

xlomafota13 shared this article with you from Inoreader Massive Cervical Lymphadenopathy Post-COVID-19 Vaccination Via ear nose throat Ear Nose Throat J. 2021 Oct 2:1455613211048984. doi: 10.1177/01455613211048984. Online ahead of print. ABSTRACT The coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus 2. Rapid spread with rampant growth of cases and deaths brought forth an urgent need for novel therapies including vaccinations. The mRNA vaccines for COVID-19 disease have been implemented at an unprecedented scale in an effort to combat the unrelen ting pandemic. Such a massive scale vaccination program is bound to coincide with adverse events related to treatment. We present a case of massive cervical lymphadenopathy in a 58-year-old male patient post-Moderna COVID-19 vaccination. Additional investigations did not identify malignancy and he was diagnosed with vaccine-related lymphadenopathy. Patient significantly improved with corticosteroid treatment within 2 days of admission. Lymphadenopathy is reported as the second most common local reaction to the Moderna vaccine. Promoting knowledge of this side effect, particularly in the setting widespread vaccination efforts, would allow for better management of cases, especially in relation to oncologic patients. PMID:34601889 | DOI:10.1177/01455613211048984 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Solitary neurofibroma in the external auditory canal

xlomafota13 shared this article with you from Inoreader Solitary neurofibroma in the external auditory canal Via ear nose throat Ear Nose Throat J. 2021 Oct 2:1455613211048978. doi: 10.1177/01455613211048978. Online ahead of print. ABSTRACT Significance Statement: Neurofibromas, derived from perineural cells, are usually benign in the nervous system. Although neurofibromas are common in the head and neck, they rarely affect the external auditory canal (EAC), and few cases have been reported. We describe a case of a solitary EAC neurofibroma with otoscopy, radiological imaging, a surgical approa ch, and an uneventful outcome. PMID:34601890 | DOI:10.1177/01455613211048978 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of the safety and effectiveness of a sealant hemostatic patch for preventing cerebrospinal fluid leaks in cranial surgery

xlomafota13 shared this article with you from Inoreader Evaluation of the safety and effectiveness of a sealant hemostatic patch for preventing cerebrospinal fluid leaks in cranial surgery Via leak of cerebrospinal fluid Expert Rev Med Devices. 2021 Oct 4. doi: 10.1080/17434440.2021.1988850. Online ahead of print. ABSTRACT Background: Cerebrospinal fluid (CSF) leak remains a significant source of morbidity after neurosurgical procedures. The objective is to evaluate the effectiveness and safety of a polyethylene glycol-coated collagen patch (PCC) in different neurosurgical procedures.Methods: A retrospective, single-center cohort study in patients who underwent a cranial neurosurgical procedure. After collecting multiple data variables, patients were divided into two groups depending on the use of PCC as sealant on dural closure following procedures.Results: Data from 230 patients were collected (PCC, 128; control group, 102). Incidence of CSF leakage was significantly lower in the PCC group (p<.001). Complications that were significantly lower in PCC than the control group included surgical infection (p=.022), and hydrocephalus (p=.017), as well as reduce d rates of reintervention (p<.001) and shorter hospital stays (p=.028). Factors associated with a higher incidence of CSF leakage included posterior fossa procedures, reinterventions and the need for CSF drainage placement. PCC reduced the risk of suffering CSF leakage in more than 75% (p=.002) once adjusted for age, surgical approach, type of cranial opening, reintervention, CSF drainage, dural substitute and dural defect coverage.Conclusions: Our findings confirm PCC as an effective means of preventing CSF leakage following cranial neurosurgery with fewer associated complications. PMID:34601992 | DOI:10.1080/ 17434440.2021.1988850 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Current diagnosis and treatment of rhinosinusal aspergilloma (Review)

xlomafota13 shared this article with you from Inoreader Current diagnosis and treatment of rhinosinusal aspergilloma (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1264. doi: 10.3892/etm.2021.10699. Epub 2021 Sep 6. ABSTRACT There are numerous types of sinusitis caused by fungal strains, some of which already colonize the nasal cavity. Mild forms present fungus balls growing inside a preexisting sinus cavity. The invasive type ranges from chronic manifestations to acute aggravated episodes. The latter scenario is encountered in cases with reduced immune responses, such as patients with diabetes, individuals receiving any form of transplant, AIDS cases and chemotherapy patients. Without the control of immunosuppression, the infection is aggravated and extends to the orbit and inside the skull base, regardless of the prompt surgical and medical treatment. This is the most common pathogenic fungus on the nasal sinuses level. It can occasionally enter the sinus cavity during dental procedures. The pathogenesis is enhanced by anaerobic conditions in poorly ventilated sinus cavities. Rhinosinusal aspergilloma has a slow, insidious evolution over months and even years. Our experience revealed the presence of both a dental problem and previous self-administered antibiotic regimens in almost every case. The initial symptoms are common with sinusitis of dental origin, but aspergilloma should be considered when a patient with a competent immune system does not respond to standard antibiotic treatment. The final diagnosis of rhinosinusal aspergilloma is conducted on a pathology sample with silver staining. The bacteriology exam of the sinus secretion rarely reveals a fungus infection; however, as revealed in our clinical experience, there may be coinfection with other multidrug-resistant bacteria. Surgical treatment must establish a wide exposure of the sinus cavity and correct drainage regardless of the external, combined or endoscopic approach. Early diagnosis and emergency surgical debridement along with administering systemic antifungal compounds in som e cases represent the key to the successful treatment of invasive aspergilloma. PMID:34603532 | PMC:PMC8453335 | DOI:10.3892/etm.2021.10699 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mangiferin inhibits hypoxia/reoxygenation-induced alveolar epithelial cell injury via the SIRT1/AMPK signaling pathway

xlomafota13 shared this article with you from Inoreader Mangiferin inhibits hypoxia/reoxygenation-induced alveolar epithelial cell injury via the SIRT1/AMPK signaling pathway Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1220. doi: 10.3892/etm.2021.10654. Epub 2021 Aug 26. ABSTRACT Lung ischemia-reperfusion injury (LIRI) is one of the complications that can occur after lung transplantation and may lead to morbidity and mortality. Mangiferin (MAF) is a naturally occurring glucosyl xanthone that has been documented to possess anti-inflammatory, immunomodulatory and potent antioxidant effects. The purpose of the present study was to investigate the effect of MAF on LIRI using a hypoxia-reoxygenation (H/R) cell model. In the present study, the viability of lung alveolar epithelial cells (A549) and H/R-A549 were detected by MTT assay. ELISA was used to evaluate the expression levels of IL-6 and IL-1β. TUNEL assay and western blotting were used to evaluate the apoptosis. In addition, H/R-A549 cells were treated with sirtinol, which is known inhibitor of sirtuin 1 (SIRT1) activity, to determine the effects of MAF on proteins asso ciated with the SIRT1/5'AMP-activate protein kinase (AMPK) signaling pathway using western blotting. The results showed that 20 µM MAF exerted a protective effect on A549 cells against H/R mediating no clear cytotoxic effects. In terms of inflammation, MAF reduced IL-6, IL-1β, cyclooxygenase-2 and inducible nitric oxide synthase expression, which was accompanied by activation of the SIRT1/AMPK signaling pathway. In addition, compared with those in the group treated with sirtinol, expression of SIRT1, Bcl-2 and AMPK activity were elevated in MAF-treated H/R-A549 cells, whereas the expression of Bax, cleaved caspase-3 and cleaved caspase-9 was suppressed. TUNEL analysis of H/R-A549 cells treated with MAF in combination with sirtinol revealed that treatment with sirtinol blocked the SIRT1/AMPK signaling pathway and increased the apoptosis rate compared with the MAF group. Taken together, results of the present study revealed that MAF could inhibit lung H/R cell injury through the SIR T1/AMPK signaling pathway. PMID:34603517 | PMC:PMC8453333 | DOI:10.3892/etm.2021.10654 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resolvin D2 suppresses NLRP3 inflammasome by promoting autophagy in macrophages

xlomafota13 shared this article with you from Inoreader Resolvin D2 suppresses NLRP3 inflammasome by promoting autophagy in macrophages Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1222. doi: 10.3892/etm.2021.10656. Epub 2021 Aug 26. ABSTRACT Inflammasome, a multiprotein complex that regulates interleukin (IL)-1β secretion and pyroptosis, participates in numerous inflammatory diseases, including sepsis, atherosclerosis and type-2 diabetes. Investigating the inflammasome regulation is therefore crucial to understand the inflammasome activation and develop treatment for the related diseases. In addition, it remains unknown how the inflammasome is naturally suppressed during the inflammatory process. The present study aimed to investigate the role of resolvin D2 (RvD2), an innate suppressor of inflammation produced from essential ω3-polyunsaturated fatty acids, in the activation of the inflammasome via in vitro and in vivo experiments. The effects of RvD2 on the cytokine production of inflammasome-related peritonitis were determined, and the NLRP3 inflammasome activation was investigated in the presence of RvD2. Moreover, the potential mechanisms underlying RvD2 in NLRP3 inflammasome regulation through autophagy and proteasome were investigated. The results of the present study demonstrated that RvD2 suppressed inflammasome-mediated peritonitis in vivo and regulated the NLR family pyrin domain containing 3 (NLRP3) inflammasome, but not in absent in melanoma 2 (AIM2), NLR family CARD domain containing 4 (NLRC4) inflammasomes. Mechanistically, RvD2 was found to promote the degradation of NLRP3 through autophagy, and the inhibition of autophagy could reverse the RvD2-mediated suppression of NLRP3 inflammasome in vitro and partially reverse the inflammasome-mediated peritonitis in vivo. In summary, the present study reported the negative regulation of NLRP3 inflammasome activation by RvD2. The findings from this study may extend the knowledge of the innate regulation of inflammasome and highlight a possible target for inflammasome-r elated diseases. PMID:34603519 | PMC:PMC8453332 | DOI:10.3892/etm.2021.10656 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resolvin D2 suppresses NLRP3 inflammasome by promoting autophagy in macrophages

xlomafota13 shared this article with you from Inoreader Resolvin D2 suppresses NLRP3 inflammasome by promoting autophagy in macrophages Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1222. doi: 10.3892/etm.2021.10656. Epub 2021 Aug 26. ABSTRACT Inflammasome, a multiprotein complex that regulates interleukin (IL)-1β secretion and pyroptosis, participates in numerous inflammatory diseases, including sepsis, atherosclerosis and type-2 diabetes. Investigating the inflammasome regulation is therefore crucial to understand the inflammasome activation and develop treatment for the related diseases. In addition, it remains unknown how the inflammasome is naturally suppressed during the inflammatory process. The present study aimed to investigate the role of resolvin D2 (RvD2), an innate suppressor of inflammation produced from essential ω3-polyunsaturated fatty acids, in the activation of the inflammasome via in vitro and in vivo experiments. The effects of RvD2 on the cytokine production of inflammasome-related peritonitis were determined, and the NLRP3 inflammasome activation was investigated in the presence of RvD2. Moreover, the potential mechanisms underlying RvD2 in NLRP3 inflammasome regulation through autophagy and proteasome were investigated. The results of the present study demonstrated that RvD2 suppressed inflammasome-mediated peritonitis in vivo and regulated the NLR family pyrin domain containing 3 (NLRP3) inflammasome, but not in absent in melanoma 2 (AIM2), NLR family CARD domain containing 4 (NLRC4) inflammasomes. Mechanistically, RvD2 was found to promote the degradation of NLRP3 through autophagy, and the inhibition of autophagy could reverse the RvD2-mediated suppression of NLRP3 inflammasome in vitro and partially reverse the inflammasome-mediated peritonitis in vivo. In summary, the present study reported the negative regulation of NLRP3 inflammasome activation by RvD2. The findings from this study may extend the knowledge of the innate regulation of inflammasome and highlight a possible target for inflammasome-r elated diseases. PMID:34603519 | PMC:PMC8453332 | DOI:10.3892/etm.2021.10656 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.