| New research into approach/avoidance conflict P Vijayalakshmi Archives of Mental Health 2018 19(2):51-51 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| "PUT A SIGN HERE and PUT A SIGN THERE!" (obtaining informed consent is not so easy in this changed litigious world) Rama Reddy Karri Archives of Mental Health 2018 19(2):52-53 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| APPSYCON Kakinada - "Extending with interventions" P Srinivasa Teja Archives of Mental Health 2018 19(2):54-56 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| The mystery of the missing dream in psychiatry (DS Raju Memorial Oration at IPS-AP State Conference Kakinada) M S. V. K. Raju Archives of Mental Health 2018 19(2):57-63 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| The role of human touch in psychiatry (Manasa Oration IPS-AP State conference Kakinada) M Vijaya Gopal Archives of Mental Health 2018 19(2):64-69 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| A review of functional gastrointestinal disorders: A primer for mental health professionals Suhas Chandran, SN Prakrithi, Supriya Mathur, M Kishor, T S. Sathyanarayana Rao Archives of Mental Health 2018 19(2):70-81 Functional gastrointestinal disorders (FGIDs) are chronic, recurrent, frequently debilitating disorders with no identifiable underlying pathology. They occur due to a complex interplay between biological, psychological, and social factors and are some of the most common conditions encountered in general clinical practice as well as the specialist gastroenterological clinic. The top-down regulation of visceral sensations plays an important role in the pathophysiology of the disease, i.e., the central processing of emotions and stressors altering the sensory and motor components of the gut, which increases hypersensitivity and therefore symptom severity. In addition, the core personality traits of the individual play their part in the way symptoms are perceived, further providing proof for the long-prevailing belief that the gut and emotions are linked, the so-called “gut feeling.” The current diagnostic criteria for FGIDs are entirely based on subjective symptoms, challenging in itself due to the varied presentations, and further complicated by the current unavailability of objective laboratory tests which could confirm its presence in the symptomatic individual. The various treatment modalities include psychotherapies ranging from cognitive behavioral therapy to mindfulness, along with appropriate pharmacotherapy to treat physical and psychiatric comorbidities. Addressing all these underlying causes, in addition to weighing in the genetic makeup of the individual, is necessary for delineating accurate prognosis, reducing attending health-care costs, and improving overall outcome of the individual. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Therapeutic intervention for children through play: An overview Basavaraj Shrinivasa, Madina Bukhari, G Ragesh, Ameer Hamza Archives of Mental Health 2018 19(2):82-89 Play is children's innate mode of self-expression and a method through which they explore the world. It has important implication for overall (physical, psychological, and psychosocial) development of any children. Play therapy capitalizes on such therapeutic powers or changing mechanisms within play and considers its strategic use through trained professionals to promote specific therapeutic outcomes within therapeutic contexts. This review article aims to provide a brief description on the use of play as therapeutic agent for change, different processes expressed in play, therapeutic powers within the play, and major approaches to play therapy. An attempt has also been made to list out some of the research studies from the available literature to prove the efficacy of play therapy in different conditions. The article concludes with highlighting the current issues and challenges faced by play therapy practice as a therapeutic medium to be used with children and way forward has been suggested. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Impact of psychosocial paradigms on gender equality Abdul Raffie Naik, Tejaswini Padikkal Archives of Mental Health 2018 19(2):90-94 Gender is the social, behavioral, and cultural attributes, expectations, and norms associated with being a woman or a man. The aim of gender equality is the empowerment of women, thus enabling them to manage their lives. Gender equality is a fundamental issue. The lives of people are heavily influenced by the societal stereotyping of gender. While there are differences in the biological makeup of men and women, the gender roles that are played are determined both socially and culturally. Despite major changes in the attitudes of people over the years, the issue of gender is still very much alive in society today. Gender inequalities impact women over their lifetime, their health, educational attainment, and economic conditions. Gender equality will be achieved only when women and men enjoy the same opportunities, rights, and obligations in all spheres of life. The paper is a study on the existing literature on gender and equality to understand the existing social and psychological paradigms that act as a barrier to equality among the different genders. The present study aims at understanding an overall picture of the psychosocial paradigms that infringe on gender equality. Journal articles and texts on gender inequality were identified and reviewed. psychological, sociological, and psychosocial perspectives of gender inequality are presented in the paper. Gender inequality in health, education, and work is present to date. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mental health issues in Kashmir valley: An overview Rizwan Hassan Bhat, Shah Mohd Khan Archives of Mental Health 2018 19(2):95-96 Most mental health researchers believe that there is a variety of contributing factors to the onset of mental health issues. Studies have found that there are physical, social, environmental, and psychological causes. This paper highlights some of the mental health issues that are prevailing in Kashmir. The research so far conducted in the valley has pointed social, environmental, and psychological issues prevailing in general in the Kashmir Valley. The prevailing disturbances in the valley from the past two decades of turmoil in Kashmir were cited by most researchers as the main reasons for mental health problems. Apart from this, the changing political parties, ethics to divide, and rule resulting economic dynamics of inhabitants are also responsible for this menace. Depression, posttraumatic stress disorder, obsessive-compulsive disorder, stress, and anxiety are diagnosed in general to cause mental trauma, and illness. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Impact of traumatic brain injury on cognitive functions Padilla-Zambrano Huber Said, Amrita Ghosh, Ranabir Pal, Nataraja Poli, Luis Rafael Moscote-Salazar, Amit Agrawal Archives of Mental Health 2018 19(2):97-101 In this systematic review, we summarize the current understanding and controversies on cognitive sequelae after traumatic brain injury (TBI) to understand the cognitive deficits such as memory, attention, executive functions, and unawareness of their deficits in TBI patients. This review presents the cognitive sequel of patients with moderate-to-severe TBI by a comprehensive focused conglomeration of research publications by searching various resources. A search strategy with specific inclusion criteria was performed in PubMed, Cochrane, Web of Science, and the WHO Global Health Library. This review noted that TBI is related with increase of various neurological and non-neurological disorders including problems with attention, inability to concentrate, speech and language dysfunctions, learning and memory impairment, impaired reasoning, impaired planning and problem-solving. This review found that patients' cognitive deficits are common in victims of moderate to severe TBI often as the long-lasting sequalae. The present review suggests that there is a need for further research to develop unique rehabilitation methods that will help to enhance brain plasticity and process of recovery after TBI.
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Τρίτη 1 Ιανουαρίου 2019
Mental Health
Does cartilage tympanoplasty impair hearing in patients with normal preoperative hearing? A comparison of different techniques
Abstract
Objectives
To evaluate and compare functional outcomes of tympanoplasty procedures with temporalis fascia and four different types of cartilage grafts in chronic otitis media (COM) cases with normal preoperative hearing levels.
Methods
Records of patients who underwent type 1 tympanoplasty for non-complicated COM in a tertiary medical center between January 2010 and January 2017 were reviewed. Patients with central or marginal and dry perforations of the tympanic membrane, normal middle ear mucosa, intact ossicular chain and patients with a preoperative pure tone average (PTA) level of 25 dB or less and a word recognition score (WRS) of 88% or greater were included in the study. Graft success rates, preoperative and postoperative functional outcomes, and anatomical results were analyzed.
Results
One hundred and forty-four patients who met the inclusion criteria were evaluated in the study. PTA and Air-bone gap (ABG) levels decreased significantly both in TF and CG groups after the surgery (p = 0.001). Similarly, WRS scores increased significantly in both groups (p = 0.001). There was not a significant difference in terms of PTA increase, WRS increase, and ABG closure levels between cartilage and TF groups. Increase in PTA, closure in ABG, and increase in WRS levels were compared among TF, WsCCG, MCG, PCG, and CPIG groups. The increase in PTA levels was also found to be significantly superior in the TF group (p = 0,023). However, the multivariate analysis showed no significant difference for increase in WRS, closure in ABG and increase in PTA levels according to graft type (p = 0.285; p = 0.461; p = 0.106, respectively) and gender (p = 0.487; p = 0.811; p = 0.756, respectively).
Conclusion
In COM cases with normal preoperative hearing, both TF and cartilage lead to superb functional and anatomical outcomes. There was not a significant difference in terms of PTA increase, WRS increase and ABG closure levels between cartilage and TF groups. The graft success rate of cartilage was found to be superior to TF, but there was not a statistically significant difference. Different types of cartilage grafts can be used in cases with normal preoperative hearing without the concern of hearing impairment.
http://bit.ly/2BTtFnr
Heat shock protein 70 is induced by pepsin via MAPK signaling in human nasal epithelial cells
Abstract
Background
Recent studies have shown that laryngopharyngeal reflux is associated with chronic rhinosinusitis. Pepsin may be a key factor involved in the injury of nasal mucosal epithelial cells, but the pathogenesis remains unclear. We are to investigate whether a mitogen-activated protein kinase (MAPK) pathway regulates heat shock protein 70 (HSP70) expression in primary cultures of human nasal epithelial cells (HNEpCs) in response to pepsin stimulation.
Methods
HSP70 protein expression levels in HNEpCs were estimated by Western blot analysis after treatment with pepsin. MAPK pathway activity levels were also evaluated to elucidate the mechanism underlying the effects of pepsin on HSP70 in HNEpCs. Inhibitors of signaling pathways were used to determine the contribution of MAPKs in HSP70 response after pepsin stimulation. Cellular apoptosis and cell viability in HNEpCs after treatment with pepsin were measured.
Results
The expression of HSP70 increased after stimulation with pepsin and decreased after the removal of pepsin. Pepsin induced activation of p38, extracellular signal-regulated kinase 1/2, and c-Jun N-terminal kinase (JNK) 1/2. Inhibition of JNK1/2 reduced HSP70 expression in HNEpCs. The apoptosis in HNEpCs at 12 h after treatment with pepsin at pH 7.0 increased significantly when compared with the control and pH 7.0 groups. Cell viability decreased following exposure to pepsin at pH 7.0.
Conclusion
Pepsin, even under neutral pH 7.0, increases the expression of HSP70 in HNEpCs by activating the JNK/MAPK signaling pathway. Increased HSP70 may be the protective mechanism when pepsin presents in the other parts of the body.
http://bit.ly/2F0dAzy
Expression of C-type lectin receptor mRNA in otitis media with effusion and chronic otitis media with and without cholesteatoma
C-type lectin receptors (CLRs) are a family of pattern recognition receptors (PRPs). The expression of CLRs has been analyzed in other diseases but has not yet been compared in patients with otitis media with effusion (OME), chronic otitis media (COM) and COM with cholesteatoma (Chole OM). This study therefore evaluated the levels of expression of mRNAs encoding Dectin-1, MR1, MR2, DC-SIGN, Syk, Card-9, Bcl-10, Malt-1, Src, DEC-205, Tim-3, Trem-1, and DAP-12 in patients with OME, COM, and Chole OM.
http://bit.ly/2R3vuc5
Optimizing the cumulative cisplatin dose during radiotherapy in nasopharyngeal carcinoma: Dose-effect analysis for a large cohort
Publication date: February 2019
Source: Oral Oncology, Volume 89
Author(s): Liang Peng, Cheng Xu, Yu-Pei Chen, Rui Guo, Yan-Ping Mao, Ying Sun, Jun Ma, Ling-Long Tang
Abstract
Objectives
Definitive concurrent chemoradiotherapy (CCRT) is the standard treatment for locoregionally advanced nasopharyngeal carcinoma (NPC). The cumulative cisplatin dose (CCD) during radiotherapy is an important prognostic factor; however, the optimal CCD is undetermined.
Materials and methods
In this retrospective analysis, patients with locoregionally advanced NPC treated with single-agent cisplatin-based CCRT or RT alone from 2009 through 2015 were identified. CCD was entered into a multivariate Cox regression model as a continuous variable using natural cubic splines to allow for a nonlinear relationship between CCD and outcomes. The primary endpoint was overall survival, and the secondary endpoints were locoregional relapse‐free survival and distant metastasis‐free survival.
Results
A total of 2 924 patients were included in our study, with a median CCD of 160 mg/m2 (range, 0–300 mg/m2). As the CCD increased, the risk of death remained steady until 180 mg/m2, then decreased sharply until 250 mg/m2, and then increased until 300 mg/m2. The optimal CCD of 230–270 mg/m2 was associated with the lowest risk of death and disease relapse. However, the CCD had less prognostic value for disease control, especially for distant control among high-risk patients (N2–3 or T4).
Conclusions
A CCD dose of 230–270 mg/m2 (240 mg/m2 is recommended) is optimal for patients with locoregionally advanced NPC, especially for those at low risk (T1–3 and N0–1). For high-risk patients (N2–3 or T4), additional chemotherapy should be administered before or after CCRT.
http://bit.ly/2RjDHbt
Letter to the Editor about the Article: “Performance of different imaging techniques in the diagnosis of head and neck cancer mandibular invasion: A systematic review and meta-analysis”
Publication date: Available online 1 January 2019
Source: Oral Oncology
Author(s): Rama Jayaraj, Chellan Kumarasamy
http://bit.ly/2GQKOUN
Factors associated with masticatory performance and swallowing threshold according to dental formula development
Publication date: Available online 31 December 2018
Source: Archives of Oral Biology
Author(s): Tomohiro Takeshima, Yuko Fujita, Kenshi Maki
Abstract
Objective
The aims of the present study were to the determine changes in, and factors related to, masticatory performance and swallowing threshold according to dental formula development.
Methods
A total of 120 subjects, ranging in age from 4 to 19, and 21 to 29 years, were included in the present study. Grip strength and maximum occlusal force were measured in all subjects. Masticatory performance and swallowing threshold (including the number of chewing cycles and chewing time), were determined according to the concentration of dissolved glucose obtained from gummy jellies. The 12-item General Health Questionnaire (GHQ-12) was used to assess mental health status in participants 21 to 29 years of age.
Results
In the primary dentition, masticatory performance and glucose concentration before swallowing were the lowest in all dentition groups. Masticatory performance was the highest in subjects 21 to 29 years of age. In children with mixed and permanent dentition, glucose concentration levels before swallowing were similar to those in individuals aged 21 to 29 years. Multiple regression analysis revealed that maximum occlusal force was significantly and positively correlated with glucose concentration before swallowing in children, and the GHQ-12 score was significantly and negatively correlated with glucose concentration before swallowing in young adults.
Conclusions
Changes in swallowing threshold did not coincide with masticatory performance according to dental formula stage. Maximum occlusal force was the variable most strongly associated with swallowing threshold in children, while in young adults, better mental health status was closely associated with a higher swallowing threshold.
http://bit.ly/2SADKwY
Prestin autoantibodies screening in idiopathic sudden sensorineural hearing loss
Publication date: Available online 31 December 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): H. Tovi, H. Ovadia, R. Eliashar, M.A. de Jong, M. Gross
Abstract
Objectives
To define the clinical association of serum prestin autoantibodies and their impact on prognosis, as specific serum diagnostic markers in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).
Design
Sera from 63 patients with ISSNHL were screened prospectively for the presence of prestin autoantibodies by an enzyme-linked immunosorbent assay (Elisa) test. Serum was assayed for anti-prestin IgG antibodies using recombinant human prestin (SLC26 A5). Demographic, clinical, and audiometric variables were analyzed.
Results
Two patients (3.17%) had demonstrable anti-prestin antibodies in serum (exact 95% CI: −1.16% to 7.5%). No statistically significant association was found between prestin autoantibodies and demographic or audiologic parameters.
Conclusions
This preliminary and novel study does not support the presence of an active humoral immune reaction against prestin in ISSNHL.
http://bit.ly/2AlUBw3
Hypertrophic recurring lichen planus of the external auditory canal
Publication date: Available online 31 December 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): A. Košec, M. Kostić, J. Ajduk, M. Ries
Abstract
Introduction
We report a case of unilateral progressive primary hypertrophic lichen planus of the external auditory canal requiring several surgical interventions to deal with constant pruritus, otorrhoea, stenosis and conductive hearing loss.
Case summary
A 58-year-old woman was initially treated with meatoplasty for suspected chronic obliterating otitis externa. She remained symptom-free for 5 years, before the disease recurred, affecting other body surfaces as well. Otorrhoea, conductive hearing loss and pruritus worsened, and a canal wall down tympanomastoidectomy was performed, removing the skin of the external auditory canal and the tympanic membrane completely. Lichen planus was confirmed histopathologically.
Discussion
Very few surgical results have been published on stenosis of the external auditory canal caused by lichen planus. Complete medial external auditory canal skin elevation and removal with postoperative split-skin grafting is advised for initial treatment. We discuss treatment options and surgical outcome after initial surgical failure.
http://bit.ly/2SqCBrn
Symptomatic head and neck lipomas
Publication date: Available online 31 December 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): Y. Najaf, C. Cartier, V. Favier, R. Garrel
Abstract
Introduction
Lipomas are very common benign lumps that could be encountered in any part of the body but with limited proportion being present in the head and neck region.
Case summary
In this article, three different cases of symptomatic cervical lipomas were illustrated, with their different diagnostic as well as therapeutic approaches and will be discussed in light of medical literature.
Discussion
These cervical tumors tend to grow slowly giving variable signs that include dysphagia, dyspnea, dysphonia due to the mass effect of surrounding structures or can be present as simple as a cosmetic concern. Clinicians must bear in mind the malignant transformation of lipomas, which can be challenging to diagnose. With this article, authors will try to highlight the importance of maintaining a good communication between surgeons, pathologists and radiologists as an essential part of the medical management.
http://bit.ly/2AoKSVM
Evaluation of choroidal thickness measurements in patients with marked nasal septal deviation
Publication date: Available online 31 December 2018
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Selin Üstün Bezgin, Taliye Çakabay, Sadık Etka Bayramoğlu, Nihat Sayın, Murat Koçyiğit
Abstract
Introduction
Chronic upper airway obstruction due to marked nasal septal deviation may cause chronic hypoxia. It may change the balance of the sympathetic-parasympathetic system and may affect blood flow in choroid.
Objective
To assess choroidal thickness measurements of patients with marked nasal septal deviation.
Methods
The patients who had nasal obstruction symptoms diagnosed with marked nasal septal deviation by anterior rhinoscopy and nasal endoscopy and scheduled for septoplasty were included in the study. The control group consisted of age, sex and body mass index-matched healthy individuals. The choroidal measurements at the central fovea and 1000 μm away from the fovea in the nasal and temporal regions were performed using enhanced depth imaging optical coherence tomography.
Results
In the patient group, 52eyes of 26 patients with a mean age of 26.34 ± 8.14 years were examined. In the control group, 52 eyes of 28 healthy individuals with a mean age of 26.69 ± 7.84 years were examined. There was no statistically significant difference in terms of choroidal thickness measurements between the groups (p > 0.05).
Conclusion
Our results suggest that marked nasal septal deviation may not lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening.
Resumo
Introdução
A obstrução crônica das vias aéreas superiores devido a acentuado desvio do septo nasal pode causar hipóxia crônica. Pode alterar o equilíbrio do sistema simpático-parassimpático e afetar o fluxo sanguíneo na coroide.
Objetivo
Avaliar as medidas da espessura da coroide em pacientes com acentuado desvio de septo nasal.
Método
Foram incluídos no estudo pacientes que apresentavam sintomas de obstrução nasal, com diagnóstico de acentuado desvio de septo realizado por rinoscopia anterior e endoscopia nasal, e com septoplastia programada. O grupo controle consistiu de indivíduos saudáveis pareados por idade, sexo e índice de massa corporal. As medidas da coroide na fóvea central e a 1000 μm da fóvea nas regiões nasal e temporal foram realizadas utilizando-se tomografia de coerência óptica com imagem de profundidade melhorada.
Resultados
No grupo de pacientes, 52 olhos de 26 pacientes com média de idade de 26,34 ± 8,14 anos foram examinados. No grupo controle, 52 olhos de 28 indivíduos saudáveis com média de idade de 26,69 ± 7,84 anos foram examinados. Não houve diferença estatisticamente significante em termos de medidas da espessura da coroide entre os grupos (p > 0,05).
Conclusão
Nossos resultados sugerem que desvios do septo nasal acentuados podem não levar à hipóxia significativa e ativação simpática, resultando na deterioração do fluxo sanguíneo coroidal e consequente espessamento da coroide.
http://bit.ly/2AoHnyO
Salvage total laryngectomy: is a flap necessary?
Publication date: Available online 31 December 2018
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Ricardo Gonzalez Orús Álvarez Morujo, Paula Martinez Pascual, Manuel Tucciarone, Mario Fernández Fernández, Rosalia Souviron Encabo, Tomás Martinez Guirado
Abstract
Introduction
Pharyngocutaneous fistula is the most significant complication after salvage total laryngectomy in patients who have received previous treatment with radiotherapy with or without chemotherapy.
Objective
Our purpose is to review the fistula rate in radiated patients undergoing salvage total laryngectomy, to determine if the use of pectoralis major flap interposition reduces the incidence and duration of fistula, and to examine other risk factors.
Methods
We made a retrospective review of patients undergoing salvage total laryngectomy for exclusively larynx cancer after failure of primary curative radiotherapy between 2000 and 2017. General data from patients, risk factors and other complications were analyzed.
Results
We identified 27 patients whose mean age was 66.4 years, mainly male (92.5%). The primary closure group without pectoralis major flap included 14 patients, and the group with PMP closure included 13 patients. Pharyngocutaneous fistula was present in 15 patients (55.5%). Global pharyngocutaneous fistula rate was higher in the group of patients without pectoralis major flap compared with those where the flap was interposed (78.6% vs. 30.8%, p = 0.047). Also the pharyngocutaneous fistulas which need to be surgical repaired (64.3% vs. 7.7%, p = 0.03) and large pharyngostomes (64.3% vs. 0%, p = 0.0004) were present in a higher rate in the group closed primary without pectoralis major flap. We did not find other risk factors with statistical significance. Oral diet initiation (84 days vs. 21.5 days, p = 0.039) and the duration of hospitalization (98.3 days vs. 27.2 days, p = 0.0041) were much lower in patients with a preventive pectoralis major flap. Two patients died as a consequence of complications of large pharyngostomes.
Conclusions
Prophylactic pectoralis major flap repair reduced the incidence, severity and duration of fistula and should be considered during salvage total laryngectomy.
Resumo
Introdução
A fístula faringocutânea é a complicação mais significativa após laringectomia total de resgate em pacientes que receberam tratamento prévio com radioterapia com ou sem quimioterapia.
Objetivo
Nosso objetivo é revisar a taxa de fístula em pacientes irradiados submetidos a laringectomia total de resgate, para determinar se o uso de interposição de retalho do peitoral maior reduz a incidência e duração da fístula e examinar outros fatores de risco.
Método
Fizemos uma revisão retrospectiva de pacientes submetidos à laringectomia total de resgate para câncer exclusivamente laríngeo após falha da radioterapia curativa primária entre 2000 e 2017. Dados gerais dos pacientes, fatores de risco e outras complicações foram analisados.
Resultados
Foram identificados 27 pacientes com média de idade de 66,4 anos, principalmente do sexo masculino (92,5%). O grupo de fechamento primário sem retalho de peitoral maior incluiu 14 pacientes, e o grupo de fechamento com retalho de peitoral maior incluiu 13 pacientes. Fístula faringocutânea esteve presente em 15 pacientes (55,5%). A taxa global de fístula faringocutânea foi maior no grupo de pacientes sem retalho de peitoral maior em comparação com aqueles que receberam o retalho (78,6% vs. 30,8%, p = 0,047). Além disso, as fístulas faringocutâneas que precisaram ser reparadas através de cirurgia (64,3% vs. 7,7%, p = 0,03) e grandes faringostomias (64,3% vs. 0%, p = 0,0004) apresentaram uma taxa mais alta no grupo fechado primariamente sem retalho do peitoral maior. Não encontramos outros fatores de risco com significância estatística. O início da dieta oral (84 dias vs. 21,5 dias, p = 0,039) e a duração da internação (98,3 dias vs. 27,2 dias, p = 0,0041) foram muito menores nos pacientes com uso preventivo do retalho do peitoral maior. Dois pacientes morreram em consequência de complicações de grandes faringostomias.
Conclusões
O uso profilático do retalho do peitoral maior reduziu a incidência, a gravidade e a duração da fístula e deve ser considerado durante a laringectomia total de resgate.
http://bit.ly/2SuTaCR
Identification of risk factors for residual cholesteatoma in children and adults: a retrospective study on 110 cases of revision surgery
Publication date: Available online 31 December 2018
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Veronika Volgger, Göran Lindeskog, Eike Krause, Florian Schrötzlmair
Abstract
Introduction
Residual disease after cholesteatoma removal is still a challenge for the otorhinolaryngologist. Scheduled "second-look" surgery and, more recently, radiological screenings are used to identify residual cholesteatoma as early as possible. However, these procedures are cost-intensive and are accompanied by discomfort and risks for the patient.
Objective
To identify anamnestic, clinical, and surgery-related risk factors for residual cholesteatoma.
Methods
The charts of 108 patients, including children as well as adults, having undergone a second-look or revision surgery after initial cholesteatoma removal at a tertiary referral hospital, were analyzed retrospectively.
Results
Gender, age, mastoid pneumatization, prior ventilation tube insertion, congenital cholesteatoma, erosion of ossicles, atticotomy, resection of chorda tympani, different reconstruction materials, and postoperative otorrhea did not emerge as statistically significant risk factors for residual disease. However, prior adenoid removal, cholesteatoma growth to the sinus tympani and to the antrum and mastoid, canal-wall-up 2 ways approach, and postoperative retraction and perforation were associated with a statistically higher rate of residual disease. A Type A tympanogram as well as canal-wall-down plus reconstruction 2 ways approach for extended epitympanic and for extended epitympanic and mesotympanic cholesteatomas were associated with statistically lower rates of residual disease. A score including the postoperative retraction or perforation of the tympanic membrane, the quality of the postoperative tympanogram and the intraoperative extension of the cholesteatoma to the sinus tympani and/or the antrum was elaborated and proved to be suitable for predicting residual cholesteatoma with acceptable sensitivity and high specificity.
Conclusion
Cholesteatoma extension to the sinus tympani, antrum and mastoid makes a residual disease more likely. The canal-wall-down plus reconstruction 2 ways approach seems safe with similar rates of residual cholesteatoma and without the known disadvantages of canal-wall-down surgery. The described score can be useful for identifying patients who need a postoperative radiological control and a second-look surgery.
Resumo
Introdução
A doença residual após a remoção do colesteatoma ainda é um desafio para o otorrinolaringologista. A cirurgia revisional programada e, mais recentemente, exames radiológicos, são utilizados para identificar o colesteatoma residual o mais precocemente possível. Entretanto, esses procedimentos são dispendiosos e acompanhados de desconforto e riscos para o paciente.
Objetivo
Identificar fatores de risco anamnésicos, clínicos e relacionados à cirurgia para o colesteatoma residual.
Método
Foram analisados retrospectivamente os prontuários de 108 pacientes, incluindo crianças e adultos, que passaram por revisão cirúrgica após a remoção inicial do colesteatoma em um hospital terciário de referência.
Resultados
O sexo, idade, pneumatização da mastoide, inserção anterior de tubo de ventilação, colesteatoma congênito, erosão dos ossículos, aticotomia, ressecção da corda do tímpano, diferentes materiais de reconstrução e otorreia pós-operatória não se mostraram fatores de risco estatisticamente significantes para a ocorrência de doença residual. Entretanto, remoção prévia da adenoide, crescimento do colesteatoma para o interior do seio timpânico e para o antro e a mastoide, abordagem de duas vias com canal wall-up e retração e perfuração pós-operatórias foram associados a uma taxa estatisticamente maior de doença residual. Um timpanograma tipo A, assim como a reconstrução de duas vias com a abordagem canal wall-down para colesteatomas com extensão para o recesso epitimpânico e/ou extensão epitimpânica e mesotimpânica, foram associados com taxas estatisticamente menores da doença residual. Um escore, incluindo a retração ou perfuração pós-operatória da membrana timpânica, a qualidade do timpanograma pós-operatório e a extensão intraoperatória do colesteatoma para o seio timpânico e/ou antro, foi elaborado e se mostrou adequado para predizer colesteatoma residual com sensibilidade aceitável e alta especificidade.
Conclusão
A extensão do colesteatoma para o seio timpânico, antro e mastoide torna a doença residual mais provável. A abordagem do tipo canal wall-down mais a reconstrução de 2 vias parece segura, com taxas semelhantes de colesteatoma residual e sem as desvantagens conhecidas da cirurgia do tipo canal wall-down. O escore descrito pode ser útil para identificar pacientes que necessitam de controle radiológico pós-operatório e cirurgia revisional.
http://bit.ly/2ArCCEH
What do otolaryngologists want to learn? An educational targeted needs assessment study
Publication date: Available online 31 December 2018
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Mustafa Daloğlu, Mustafa Kemal Alimoğlu
Abstract
Introduction
Targeted needs assessment which includes identifying the needs of learners is a key step of program development. However, this step is commonly underestimated in postgraduate medical education programs, including otolaryngology residency training. Determining the needs of otolaryngologists may help educators to design more purposeful continuing medical education training programs. Furthermore, needs of specialists may provide a clearer insight about effectiveness of the residency programs in that specialty.
Objective
To determine training needs of otolaryngology specialists and to identify deficiencies in otolaryngology residency training programs.
Methods
Seventy-eight otolaryngology specialists, who completed all data gathering forms properly, were included in this descriptive, cross-sectional study. Demographic data of the participants were collected. Training needs of the participants were determined in seven basic areas of otolaryngology via two-round Delphi method. The basic areas were otology–neurotology, rhinology, laryngology, head and neck surgery, pediatric otolaryngology, sleep disorders and facial plastic surgery. Additionally, we asked an open-ended question to investigate the reasons why the participants perceived themselves incompetent and undereducated, or why they needed further training in some of the basic otolaryngology areas.
Results
Facial plastic surgery, otology-neurotology and head and neck surgery were the most cited training areas in the needs assessment. Training needs differed according to experience and place of work. Financial expectations, deficiencies in residency training, regression in knowledge and skills, and special interest were effective determinants on decisions of the participants while determining their training needs.
Conclusion
Otolaryngologists need further training in some areas of their field due to different reasons. Determining these areas and reasons will help in designing more effective continuous medical education activities and residency training programs in otolaryngology.
Resumo
Introdução
A avaliação de necessidades específicas, que inclui a identificação das necessidades dos alunos, é um passo fundamental no desenvolvimento de programas educacionais. No entanto, esta etapa costuma ser subestimada em programas de pós-graduação em educação médica, inclusive na residência em otorrinolaringologia. Determinar as necessidades dos otorrinolaringologistas pode ajudar os educadores a projetar programas mais direcionados de treinamento em educação médica continuada. Além disso, a análise das necessidades dos especialistas pode oferecer uma visão clara sobre a eficácia dos programas de residência nessa especialidade.
Objetivo
Determinar as necessidades de treinamento de especialistas em otorrinolaringologia e identificar deficiências nos programas de residência em otorrinolaringologia.
Método
Este estudo descritivo e transversal incluiu 78 especialistas em otorrinolaringologia que preencheram todos os formulários de coleta de dados adequadamente. Os dados demográficos dos participantes foram coletados. As necessidades de treinamento dos participantes foram determinadas em sete áreas básicas da otorrinolaringologia usando o método Delphi em duas rodadas. As áreas básicas foram otologia/neurotologia, rinologia, laringologia, cirurgia de cabeça e pescoço, otorrinolaringologia pediátrica, distúrbios do sono e cirurgia plástica facial. Além disso, uma pergunta aberta foi usada para investigar os motivos pelos quais os participantes consideravam ter pouco conhecimento ou ser incapazes de atuar nessa área, ou por que precisavam de mais treinamento em algumas dessas áreas básicas.
Resultados
Na avaliação das necessidades, cirurgia plástica facial, otologia-neurotologia e cirurgia de cabeça e pescoço foram as áreas de treinamento mais relatadas. As necessidades de treinamento variaram de acordo com a experiência e o local de trabalho. Expectativas financeiras, deficiências no treinamento durante a residência, regressão do conhecimento e habilidades, além de interesse especial foram determinantes efetivos nas decisões dos participantes ao identificar suas necessidades de treinamento.
Conclusão
Por diferentes motivos, os otorrinolaringologistas precisam de mais treinamento em algumas áreas. A determinação dessas áreas e motivos ajudará a planejar atividades de educação médica continuada e programas de treinamento em residência em otorrinolaringologia mais eficazes.
http://bit.ly/2SwXiSA
هفت باور نادرست درباره سرقت علمی - نیتیو پیپر
مانند سایر موضوعات، بدفهمیها و باورهای نادرست زیادی درباره سرقت علمی وجود دارد. با نادیده گرفتن قانون حق تألیف که بهروشنی مجازاتهای سرقت علمی را تبیین کرده است، بسیاری از پژوهشگران خود را بهطور جدی دچار دردسر میکنند. علیرغم آگاهی از نادرست بودن باورهای زیر، بسیاری از افراد آنها را توجیهی برای سرقتهای علمی میدانند. سرقت علمی از جمله پدیدههایی است که مردم دوست ندارند در کلاس درس یا محل کار دربارهاش صحبت کنند. در اینجا، هفت باور نادرست درباره سرقت علمی مرور میشوند، پس با نیتیو پیپر همراه باشید.
هفت باور نادرست درباره سرقت علمی
۱- تنها محتوایی که مالکیت خصوصی دارد را نمیتوان سرقت کرد
سرقت علمی و کپیرایت در این زمینه وجه اشتراک دارند. برخی فکر میکنند اگر اثری تحت مالکیت عمومی بوده یا مدت زمان مشخصی از انتشارش گذشته باشد، نیازی نیست به نام صاحب اثر اشاره کنند. هرچند در این حالت حق تألیف را نقض نکردهاید، با این حال، حتی اگر نویسنده اثر سالها پیش فوت کرده باشد یا اثر تحت مالکیت عمومی باشد، باز هم باید به نام وی اشاره کنید؛ در غیر این صورت، مرتکب سرقت علمی شدهاید.
۲- تنها باید نقل قولهای مستقیم را ارجاعدهی کرد
بسیاری از دانشجویان تنبل که از ارجاع دادن بیزارند همیشه در اینجا قربانی میشوند. آنها فکر میکنند تنها باید نقل قول مستقیم را ارجاعدهی کنند. بنابراین، با پارافریز کردن کل اثر از نقل قول مستقیم فرار میکنند. اما واقعیت این است که کلمات ابزارهای انتقال دادن، قرض گرفتن و اشتراکگذاری ایدهها و افکارند. ارجاع دادن کمک میکند سایر افراد محل دقیق منبع شما را پیدا کنند. بنابراین، حتی اگر کار را پارافریز کنید و به منبعتان ارجاع ندهید، مرتکب سرقت علمی شدهاید.
۳- سرقت علمی تصادفی اهمیتی ندارد
حتی پس از پارافریز کردن، شباهتهایی که با متن اصلی وجود دارد قابل ردگیریاند. حتی اگر برای پارافریز کردن تلاش زیادی انجام دهید، باز هم سرقت علمی صورت گرفته است. برخی اوقات، مشابهت یابهای آنلاین مواردی از شباهت را ردیابی میکنند که باعث شگفتی شما میشود. ممکن است به علت ثبت نکردن منابع پژوهشی از ابتدای نوشتن مقاله، آنها را گم کرده باشید. اینجا جایی است که ادعای بیگناهی میکنید. ممکن است از سرقت علمی اجتناب کرده باشید، اما واقعیت این است مرتکب خلاف شدهاید و ممکن است جریمهای سنگین در انتظارتان باشد. سرقت علمی تصادفی یا غیرتصادفی مهم نیست؛ مقاله همچنان سرقتی است.
۴- اینترنت یعنی دانش مشترک
بسیاری از دانشجویان گمان میکنند که چون اینترنت رایگان و دسترسی به آن برای همه آزاد است جزئی از دانش عمومی به حساب میآید و نیازی نیست اطلاعات استخراج شده از آن را ارجاعدهی کنند. دانش مشترک تعریف خاص خود را دارد. دانش مشترک یعنی اطلاعات و حقایقی که برای همه آشناست و در تمام کتابهای مرجع در دسترس عموم است و بهراحتی میتوان آن را بازیابی کرد. بنابراین، باید تمام منابع اطلاعاتی اینترنتی را ارجاعدهی کرد.
۵- سرقت علمی از خود مهم نیست
بسیاری از دانشجویان عادت کردهاند که مقاله خود را بازنویسی و در ژورنالهای متعدد سابمیت کنند. این کار نوعی سرقت علمی آکادمیک است. بسیاری از افراد این ادعا را که چیزی از دیگران سرقت نشده است قبول ندارند. کپیبرداری از کارهای خودتان و بازنویسی کردنشان ممکن است دردسرساز شود. بیشتر نویسندگان از فرصت سوء استفاده میکنند و از کارهایشان مجدداً استفاده میکنند. به همین دلیل، بسیاری از نشریات قانونهایی دارند که مانع از استفاده مجدد از آثار پیشین میشوند، مگر آنکه به روشنی به آنها ارجاعدهی شده باشد.
+بیشتر بخوانید: سرقت علمی از خود یا self-plagiarism چیست و چرا باید از آن اجتناب کرد؟
۶- هم میتوانم از ارجاعدهی درونمتنی استفاده کنم و هم از کتابشناسی
بسیاری از دانشجویان فکر میکنند میتوانند یکی از این دو شیوه را به کار ببرند. واقعیت این است که ژورنالها هم ارجاع درونمتنی و هم کتابشناسی را الزامی میدانند. ارجاعات درونمتنی نشان میدهند که محتوای قرض گرفته شده کجا آغاز میشود و کجا پایان مییابد. کتابشناسی به مخاطب نشان میدهد که چگونه میتوانند به منابع استفاده شده دسترسی پیدا کنند.
۷- سرقت علمی تنها در کشورهای غیرانگلیسیزبان رایج است
موانع زبانی تا حدی در این مسئله نقش داشته است. این باور تا حدی درست است. پژوهشگرانی که کارهایشان را به انگلیسی آماده میکنند با مسائل متعددی مواجه میشوند که آنها را در معرض سرقت علمی قرار میدهد. ممکن است به دلیل کمبود اعتماد به نفس مرتکب این عمل شوند. با این حال، واقعیت این است که سرقت علمی مسئلهای جهانی است، و هم در کشورهای انگلیسی زبان اتفاق میافتد و هم در کشورهای غیرانگلیسی زبان.
سرقت علمی مجازات دارد. مهم نیست در کجا اتفاق افتاده است. بنابراین، پیشنهاد میشود از استادان دانشگاه کمک گرفته شود. مطمئن شوید که باورهای درست و نادرست درباره سرقت علمی و مجازاتهای آن را مطابق با قانون حق تالیف درک کردهاید. ویراستاران باید پژوهشگران را توجیه کنند که سرقت علمی چه تاثیر نامطلوبی بر صاحبان اصلی آثار دارد.
Tra2β silencing suppresses cell proliferation in laryngeal squamous cell carcinoma via inhibiting PI3K/AKT signaling
Objectives/Hypothesis
Transformer‐2 protein homolog beta (Tra2β) generally plays an important role in various human cancers, but its role and the underlying mechanisms in laryngeal squamous cell carcinoma (LSCC) remained unknown. So this study aimed to assess the clinical significance and regulatory mechanisms of Tra2β in LSCC.
Study Design
Laboratory analysis.
Methods
Expression of Tra2β was compared in human LSCC tissue samples and paired adjacent normal tissue samples. The in vitro effects of Tra2β expression in Hep‐2 cells on their proliferation, invasion, and migration were assessed by CCK‐8 assays, Matrigel invasion, and transwell migration assays. In addition, the effects of downregulation of Tra2β on the activation of PI3K/AKT signaling pathway were measured using Western blot analysis. The effect of Tra2β on the growth of tumors was detected in the Hep‐2–injected xenograft models in vivo.
Results
Reverse‐transcription quantitative polymerase chain reaction analysis and immunochemistry analysis indicated that the increased expression of Tra2β in LSCC was significantly associated with poor differentiation, lymph node metastasis, and advanced clinical stage. In vitro knockdown of Tra2β caused a significant decrease in the proliferation, invasion, and migration of Hep‐2 cells. Tra2β silencing decreased the expression of Bcl‐2 but increased Bax and Caspase‐3 both in mRNA and protein levels. Furthermore, knockdown of Tra2β eliminated the suppressive effects of activation of PI3K/AKT signaling. In vivo knockdown of Tra2β significantly inhibited the tumor growth of Hep‐2–injected xenograft mice.
Conclusions
The results of the present study demonstrated that knockdown of Tra2β inhibits the proliferation and invasion of LSCC cells, at least partly via inhibiting PI3K/AKT signaling.
Level of Evidence
NA Laryngoscope, 2018
http://bit.ly/2F1juR9
Respiratory Epithelial Adenomatoid Hamartoma (REAH) in the Olfactory Cleft: Often Masked by Bilateral Nasal Polyps
Abstract
Respiratory epithelial adenomatoid hamartoma (REAH) is a distinct non-neoplastic entity originating from anterior olfactory cleft in the nasal cavity, often going unnoticed. Clinically, REAH presents as unilateral or bilateral nasal polyps. Our aim is to expand the understanding of bilateral REAH associated with nasal polyposis with respect to clinical, radiological and histopathological features for better clinical outcomes. Our analysis includes patients presenting as bilateral nasal polyps, whose CT-PNS showed opacity in olfactory clefts. During endoscopic sinus surgery, the lesions in the olfactory cleft (medial-to-middle turbinate) were identified and the specimens from olfactory cleft and ethmoid sinus cavity were subjected separately to histopathological analysis. Six patients (average age 50 years, 83% male) of bilateral REAH with nasal obstruction of > 3 years were analysed. On nasal endoscopy, the polypoid masses in the olfactory cleft and in the ethmoids did not show any gross differences. However, polypoidal masses from the olfactory cleft bled more during biopsy and excision. Histopathological study of these masses revealed the closely arranged round to oval glands (with few dilated glands) lined by ciliated columnar epithelium in mildly edematous stroma, confirming the presence of REAH. REAH is an often overlooked lesion in the nasal cavity, arising from olfactory cleft. The presence of nasal polyposis obscures this lesion, resulting in under diagnosis. The prompt identification with high index of suspicion by the otorhinolaryngologists helps in accurate histopathological diagnosis thereby improving clinical outcomes.
http://bit.ly/2SwQlRu
A Sizeable Solitary Pedunculated Peripheral Osteoma of the Hard Palate: A Case Report
Abstract
Osteomas are benign, slow growing, usually sessile osteogenic tumors of unknown etiology. They arise from proliferation of either cancellous or compact bone. They can be central, peripheral or extra-skeletal based on their origin from endosteum, periosteum or extra-skeletal soft tissue respectively. They are commonly found in the skull and facial bones, the most common site in the maxillofacial region being paranasal sinuses. Among the jaw bones the most common site is the mandible. The hard palate is a rare site for such osteomas with a very few cases reported in literature. We report a case of large pedunculated peripheral osteoma of the hard palate in a 38 year old male. The tumor was excised with no recurrence after 3 years followup.
http://bit.ly/2ArRvXx
Treatment outcomes with whole‐field versus split‐field intensity‐modulated radiotherapy for patients with nasopharyngeal carcinoma
Abstract
Background
The purpose of this study was to present our comparison of the clinical outcome of patients with nasopharyngeal carcinoma (NPC) treated with whole‐field intensity‐modulated radiotherapy (whole‐field‐IMRT) or split‐field‐IMRT.
Methods
We retrospectively studied 388 patients with M0 NPC. The median lower neck doses were 50 Gy in 1.35 Gy/fractions for the 240 whole‐field‐IMRT patients, and 50.4 Gy in 1.8 to 2.0 Gy/fractions for the 148 split‐field‐IMRT patients.
Results
The IMRT technique did not affect the overall survival (OS; P = .077) and locoregional control (P = .231) rates. However, the split‐field‐IMRT group had more locoregional recurrences at the whole neck (P = .005) but not at the nasopharynx (P = .968) or the lower neck (P = .485). The patients treated with split‐field‐IMRT (43.2%) had more grade III neck fibrosis than the patients who received whole‐field‐IMRT (18.3%; P < .001). Only 1 patient had temporal lobe necrosis in our study.
Conclusion
Our study shows that whole‐field‐IMRT using a lower dose/fraction for the lower neck results in at least comparable locoregional control and less fibrosis compared to conventional fraction with split‐field‐IMRT.
http://bit.ly/2Sx9rXY
AHNS Series – Do you know your guidelines?: Assessment and management of malnutrition in patients with head and neck cancer: A review of the NCCN Clinical Practice Guidelines In Oncology (NCCN Guidelines®)
Abstract
This article is a part of the "Do you know your guidelines" series by the Education Committee of the American Head and Neck Society. The aim is to summarize the core principles outlined by the NCCN Clinical Practice Guidelines In Oncology (NCCN Guidelines®) on management of malnutrition in patients with head and neck cancer. We outline the current recommendations from the National Comprehensive Cancer Network® (NCCN®) for the screening and management of malnutrition, including indications for nutritional supplementation and placement of a nasogastric or gastrostomy tube. We also include a brief review of the available literature on additional screening tools, alternative guidelines, as well as an update on the emerging data surrounding the use of immune‐enhancing nutrition.
http://bit.ly/2Aqpi3z
Respiratory Epithelial Adenomatoid Hamartoma (REAH) in the Olfactory Cleft: Often Masked by Bilateral Nasal Polyps
Abstract
Respiratory epithelial adenomatoid hamartoma (REAH) is a distinct non-neoplastic entity originating from anterior olfactory cleft in the nasal cavity, often going unnoticed. Clinically, REAH presents as unilateral or bilateral nasal polyps. Our aim is to expand the understanding of bilateral REAH associated with nasal polyposis with respect to clinical, radiological and histopathological features for better clinical outcomes. Our analysis includes patients presenting as bilateral nasal polyps, whose CT-PNS showed opacity in olfactory clefts. During endoscopic sinus surgery, the lesions in the olfactory cleft (medial-to-middle turbinate) were identified and the specimens from olfactory cleft and ethmoid sinus cavity were subjected separately to histopathological analysis. Six patients (average age 50 years, 83% male) of bilateral REAH with nasal obstruction of > 3 years were analysed. On nasal endoscopy, the polypoid masses in the olfactory cleft and in the ethmoids did not show any gross differences. However, polypoidal masses from the olfactory cleft bled more during biopsy and excision. Histopathological study of these masses revealed the closely arranged round to oval glands (with few dilated glands) lined by ciliated columnar epithelium in mildly edematous stroma, confirming the presence of REAH. REAH is an often overlooked lesion in the nasal cavity, arising from olfactory cleft. The presence of nasal polyposis obscures this lesion, resulting in under diagnosis. The prompt identification with high index of suspicion by the otorhinolaryngologists helps in accurate histopathological diagnosis thereby improving clinical outcomes.
http://bit.ly/2SwQlRu
A Sizeable Solitary Pedunculated Peripheral Osteoma of the Hard Palate: A Case Report
Abstract
Osteomas are benign, slow growing, usually sessile osteogenic tumors of unknown etiology. They arise from proliferation of either cancellous or compact bone. They can be central, peripheral or extra-skeletal based on their origin from endosteum, periosteum or extra-skeletal soft tissue respectively. They are commonly found in the skull and facial bones, the most common site in the maxillofacial region being paranasal sinuses. Among the jaw bones the most common site is the mandible. The hard palate is a rare site for such osteomas with a very few cases reported in literature. We report a case of large pedunculated peripheral osteoma of the hard palate in a 38 year old male. The tumor was excised with no recurrence after 3 years followup.
http://bit.ly/2ArRvXx
Prevalence Ratio of Otitis Media with Effusion in Laryngopharyngeal Reflux
Background. Otitis media with effusion (OME) in adults is less prevalent than in the pediatric population but still causes considerable morbidity. It has been suggested that laryngopharyngeal reflux (LPR) may have a role in the aetiology of adult OME. Reflux advances to the laryngopharynx and, subsequently, to other regions of the head and neck such as oral cavity, nasopharynx, nasal cavity, paranasal sinuses, and even middle ear with clinical manifestations being asthma, sinusitis, and otitis media. Objective. To determine the prevalence ratio of otitis media with effusion in laryngopharyngeal reflux. Methods. Observational analytic with cross sectional design. Result. 9 of 28 subjects experienced OME in LPR group, and 2 of 28 subjects in non-LPR group. Statistically there was significant difference between the two groups with p-value 0.02 and with 95% confidence interval range of 1.066-18.990. Conclusion. The prevalence ratio of otitis media with effusion in laryngopharyngeal reflux group is 4.5 times that in non-laryngopharyngeal reflux group.
http://bit.ly/2Aoluzu
Δευτέρα 31 Δεκεμβρίου 2018
Radioactive Iodine Therapy in Patients with Differentiated Thyroid Cancer: Study of External Dose Rate Attenuation Law and Individualized Patient Management
Thyroid, Ahead of Print.
http://bit.ly/2AmzSbG
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A Case of Diprosopus Tetraophthalmos: Ocular Findings and Surgical Treatment of Exposure KeratopathyDiprosopus is a rare variation of conjoined twinning. In this report, ophthalmic findings in an infant with diprosopus tetraophthalmos are p...
