Quantification of the Impact of Intraoperative Ultrasound in Transoral Robotic Tongue Base Reduction

xlomafota13 shared this article with you from Inoreader Quantification of the Impact of Intraoperative Ultrasound in Transoral Robotic Tongue Base Reduction Via The Laryngoscope Objectives/Hypothesis Transoral robotic surgery (TORS) in the base of the tongue (BOT) reduction has been shown to decrease the apnea-hypopnea index (AHI) and improve daytime sleepiness in obstructive sleep apnea (OSA) patients. Intraoperative ultrasound (IOU) can be employed to guide the surgery and prevent massive bleeding. Study Design Cohort study with historical control. Methods A cohort study to compare the outcomes between OSA patients who received TORS with and without IOU assistance. Results From 2016 to 2019, this study enrolled 80 OSA patients who underwent TORS in BOT: 57 in the IOU(+) and 23 in IOU(−) groups. The TORS with IOU presented with shorter operative time, less blood loss, and greater excised BOT volume. The IOU(+) group had greater improvement in the AHI and subjective questionnaire evaluation. The excised volume of BOT was significantly associated with the change in AHI. Conclusion The IOU could improve outcomes in BOT reduction surgery without raising the risk of surgical complications. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Noninvasive Respiratory Support as an Alternative to Tracheostomy in Severe Laryngomalacia

xlomafota13 shared this article with you from Inoreader Noninvasive Respiratory Support as an Alternative to Tracheostomy in Severe Laryngomalacia Via The Laryngoscope Objectives/Hypothesis To analyze the role of noninvasive respiratory support (NRS) as an alternative to tracheostomy in the management of severe laryngomalacia. Study Design We conducted a monocentric retrospective study in a tertiary pediatric care center. Methods All children under the age of 3 years with severe laryngomalacia, treated between January 2014 and December 2019, were included. Patient demographics, medical history, nutrition, surgery, NRS, and outcome were reviewed. Predictors for NRS were analyzed. Results One hundred and eighty-eight patients were included. Mean age was 4 ± 5 months and mean weight was 4,925 ± 1,933 g. An endoscopic bilateral supraglottoplasty was performed in 183 (97%) patients and successful in 159 (87%). NRS was initiated in 29 (15%) patients at a mean age of 3 ± 2 months (1–11 months): 15 (52%) patients were treated with NRS after surgical failure, 9 (31%) were treated with NRS initiated prior to surgery because of abnormal overnight gas exchange, and 5 (17%) were treated exclusively with NRS due to comorbidities contraindicating an endoscopic procedure. NRS was successfully performed in all patients with a mean duration of 6 ± 11 months. No patient required a tracheostomy. Univariate analysis identified the following predictors of NRS: neonatal respiratory distress (P = .003), neurological comorbidity (P < .001), associated laryngeal abnormality (P < .001), cardiac surgery (P&n bsp;= .039), surgical endoscopic revision (P = .007), and nutritional support (P < .001). Conclusion NRS is a safe procedure, which may avoid a tracheostomy in severe laryngomalacia, in particular, in case of endoscopic surgery failure, respiratory failure before surgery, and/or severe co-morbidity. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Outcomes of Diffuse Sclerosing Variant Papillary Thyroid Carcinoma in Pediatric Patients

xlomafota13 shared this article with you from Inoreader Clinical Outcomes of Diffuse Sclerosing Variant Papillary Thyroid Carcinoma in Pediatric Patients Via The Laryngoscope Objectives/Hypothesis The diffuse sclerosing variant of papillary thyroid carcinoma (DSV) may be more aggressive than conventional well-differentiated non-DSV related papillary thyroid carcinomas (N-PTC). Study Design Retrospective chart review. Methods Retrospective review of clinical outcomes for patients 21 years of age or younger who underwent initial surgery for PTC at a single institution from January 1, 2005 to April 1, 2020. Genomic analysis was performed using targeted next-generation sequencing. Data were analyzed using Fischer's exact test and Kaplan–Meier curve log-rank test. Results Our cohort consisted of 72 patients, nine with DSV and 63 with N-PTC. Age at diagnosis was comparable (15.4 vs. 16.2 years, respectively, P = .46). DSV were more likely to be in the high-risk American Thyroid Academy pediatric risk group (100% vs. 41.3%, P = .004), to present with regional cervical lymph node metastases (100% vs. 60.3%, P = .036), and to present with distant metastases (67% vs. 22%, P = .005). No mortality seen in either group over 27.5 (interquartile range 14.8, 46.00) months average follow-up. Throughout the follow-up period, DSV were more likely to experience progression than N-PTC (hazard ratio = 5.7 [95% confidence interval 1.7–20.0; P = .0056]). In a subset of 19 patients with aggressive disease who had molecular testing as part of clinical care we detected RET fusions in nearly all DSV compared to a minority of N-PTC (83% vs. 15.4%, P =  ;.0095). Conclusions Pediatric patients with DSV have more advanced disease at diagnosis and are more likely to experience progression of disease compared to patients with N-PTC. The prevalence of RET fusions in our cohort recapitulates the frequency of this alteration described in prior studies. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of Determinants of Postoperative Satisfaction After Rhinoplasty

xlomafota13 shared this article with you from Inoreader Analysis of Determinants of Postoperative Satisfaction After Rhinoplasty Via The Laryngoscope Objectives/Hypothesis To analyze different variables that influence postrhinoplasty quality of life outcomes to ascertain the determinants of postoperative satisfaction. Study Design Prospective, observational study. Methods This was a prospective, observational study where patients were divided into two groups based on the postoperative Rhinoplasty Outcome Evaluation (ROE) score: high satisfaction group, when postoperative ROE scores were >50, and low satisfaction group, when postoperative ROE scores were ≤50. Patients' general characteristics, Portuguese version of the Nasal Obstruction Symptom Evaluation (NOSE-p) score, the Body Dysmorphic Disorder Examination, nasal angles, and measures from the esthetic facial analysis of postoperative photographs were compared between the groups. Results Seventy-eight patients were included: 19 in the low satisfaction group and 58 in the high satisfaction group. The median reduction in the NOSE-p score was −45 (interquartile range [IIQ] −20 to −60) (P < .001) in the high satisfaction group and −10 (IIQ −10 to −30) in the low satisfaction group (P = .053). The high satisfaction group had a significantly higher reduction in NOSE-p scores. There was no significant difference between the groups in terms of the analyzed facial parameters, although a significant difference was found when comparing them with the ones established in the literature as a pattern. Previous rhinoplasty, preoperative crooked nose, and higher NOSE-p scores were significantly associated with lower ROE scores (P < .05) in the robust Poisson regression model. Conclusion Functional results play an important role in satisfaction after rhinoplasty. Neoclassical canons were not fulfilled even in a group of patients with a high postoperative satisfaction evaluation. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Role of PI3’‐Lipid Signaling in Melanoma Initiation, Progression and Maintenance

xlomafota13 shared this article with you from Inoreader The Role of PI3'‐Lipid Signaling in Melanoma Initiation, Progression and Maintenance Via Experimental Dermatology ABSTRACT Phosphatidylinositol-3'-kinases (PI3Ks) are a family of lipid kinases that phosphorylate the 3' hydroxyl (OH) of the inositol ring of phosphatidylinositides (PI). Through their downstream effectors, PI3K generated lipids (PI3K-lipids hereafter) such as PI(3,4,5)P3 and PI(3,4)P2 regulate myriad biochemical and biological processes in both normal and cancer cells including: responses to growth hormones and cytokines; the cell division cycle; cell death; cellular growth; angiogenesis; membrane dynamics; and autophagy and many aspects of cellular metabolism. Engagement of receptor tyrosine kinase by their cognate ligands leads to activation of members of the Class I family of PI3'-kinases (PI3Kα, β, δ & γ) leading to accumulation of PI3K-lipids. Importantly, PI3K-lipid accumulation is antagonized by the hydrolytic action of a number of PI3K-lipid phosphatases, most notably the melanoma suppressor PTEN (lipid phosphatase and tensin homologue). Downstream of PI3K--lipid production, the protein kinases AKT1-3 are believed to be key effectors of PI3'-kinase signaling in cells. Indeed, in preclinical models, activation of the PI3K→AKT signaling axis cooperates with alterations such as expression of the BRAFV600E oncoprotein kinase to promote melanoma progression and metastasis. In this review, we describe the different classes of PI3K-lipid effectors, and how they may promote melanomagenesis, influence the tumor microenvironment, melanoma maintenance, and progression to metastatic disease. We also provide an update on both FDA-approved or experimental inhibitors of the PI3K→AKT pathway that are currently being evaluated for the treatment of melanoma either in preclinical models or in clinical trials. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Erythrokeratodermia variabilis et progressiva due to a novel mutation in GJB4

xlomafota13 shared this article with you from Inoreader Erythrokeratodermia variabilis et progressiva due to a novel mutation in GJB4 Via Experimental Dermatology Abstract Erythrokeratodermia variabilis et progressiva (EKVP) is a rare genodermatosis of clinical and genetic heterogeneity, characterized by the manifestations of localized or disseminated persistent hyperkeratotic plagues and stationary to migratory transient erythematous patches. The majority of EKVP cases display an autosomal dominant mode of inheritance with incomplete penetrance, although recessive transmission has also been described. Mutations associated with EKVP have been primarily detected in connexin (Cx) genes. We herein reported a Chinese sporadic case of late-onset EKVP with a novel heterozygous missense mutation c.109G>A (p.V37M) in GJB4 (Cx30.3) gene, which resulted in a significant reduction of GJB4 expression in the epidermis of the patient. In accordance, while wild-type GJB4 localized at the cell membrane of HeLa cells forming intercellular junctions and intracellular puncta, V37M mutant variant was diffusely expressed within HeLa cells at a considerably lower leve l. Our findings reveal an essential role of GJB4 in the pathogenesis of EKVP and provides insights into the therapeutic potential of the disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What about using sniffin' sticks 12 items test to screen post-COVID-19 olfactory disorders?

xlomafota13 shared this article with you from Inoreader What about using sniffin' sticks 12 items test to screen post-COVID-19 olfactory disorders? 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 Oct 30. doi: 10.1007/s00405-021-07148-y. Online ahead of print. ABSTRACT BACKGROUND: Post-COVID-19 Olfactory impairment has a negative impact on quality of life. The Sniffin Sticks test 12 items (SST-12) can be used in quick olfactory disorders screening. Its evaluation in a post-covid-19 situation was the main objective of this work. METHODS: All patient impaired with a post-COVID olfactory loss were included while consulting to the ENT department. The clinical examination included an olfaction recovery self-assessment (VAS), a nasofibroscopy, a quality of life (QoL) assessment, the complete Sniffin' Sticks Test (SST), and the SST-12. RESULTS: Among the 54 patients included, 92% (n = 50) were correctly screened as olfactory impaired by SST-12. We report excellent correlations between SST-12 and SST (rho (52) = 0.98, p < 0.001), QoL(rho(52) = 0.33 p = 0.016), or VAS ( rho(52) = 0.49, p < 0.001) assessments. CONCLUSIONS: SST-12 is a quick and reliable tool to screen large-scale population of post-COVID-19 olfactory impaired patients and could be used in a general daily clinical practice. PMID:34716806 | DOI:10.1007/s00405-021-07148-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of first‐line palliative chemotherapy for post‐treatment metastasis after gemcitabine plus cisplatin induction chemotherapy: Gemcitabine plus cisplatin and non‐gemcitabine plus cisplatin chemotherapy

xlomafota13 shared this article with you from Inoreader Management of first‐line palliative chemotherapy for post‐treatment metastasis after gemcitabine plus cisplatin induction chemotherapy: Gemcitabine plus cisplatin and non‐gemcitabine plus cisplatin chemotherapy Via Head & Neck Abstract Background To evaluate whether patients with post-treatment metastasis are suitable for GP first-line palliative chemotherapy (PCT) after undergoing GP IC. Methods Seven hundred and forty-six patients with post-treatment metastasis after undergoing GP IC were eligible. Survival outcomes were compared. Results Significant differences in survival rates were observed between patients treated with GP and non-GP chemotherapy (2-year progression-free survival [PFS]: 0.7% vs. 9.7%). We investigated survival outcomes of patients treated with GP PCT within 2 years after undergoing GP IC, treated with GP PCT 2 years after undergoing GP IC, and those of non-GP PCT patients (2-year PFS: 0.0%, 2.3%, 9.7%). However, there was no difference in the 2-year PFS between the patients that received GP PCT 2 years after undergoing GP IC and the non-GP PCT treated patients. Conclusions GP is not recommended for patients that have received GP IC within 2 years. Two years after undergoing GP IC, GP can be considered. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Decreased CFTR/PPARγ and increased transglutaminase 2 in nasal polyps

xlomafota13 shared this article with you from Inoreader Decreased CFTR/PPARγ and increased transglutaminase 2 in nasal polyps Via Auris Nasus Larynx Publication date: Available online 30 October 2021 Source: Auris Nasus Larynx Author(s): Thi Nga Nguyen, Hideaki Suzuki, Yasuhiro Yoshida, Jun-ichi Ohkubo, Tetsuro Wakasugi, Takuro Kitamura View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pembrolizumab-induced Remission After Failure of Axicabtagene Ciloleucel: Case Report and Literature Review

xlomafota13 shared this article with you from Inoreader Pembrolizumab-induced Remission After Failure of Axicabtagene Ciloleucel: Case Report and Literature Review Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3401-3406. doi: 10.21873/invivo.12639. ABSTRACT BACKGROUND: Failure after CD19-directed chimeric antigen receptor (CAR) T-cell therapy for patients with large B-cell B non-Hodgkin lymphoma, especially when it happens early, is an emerging clinical problem. There are no specific recommendations and therefore treatment of these patients remains empiricaI. Immune checkpoint inhibitors are becoming a therapeutic option for these patients. CASE REPORT: We present a case of a primary mediastinal large B-cell lymphoma who experienced relapse 3.5 months after axicabtagene-ciloleucel therapy and received pembrolizumab. After four cycles of pembrolizumab, complete metabolic response was confirmed. Treatment was discontinued after the sixth cycle due to immune checkpoint inhibitor-related pneumonitis. The disease remains in remission 8 months after the last pembrolizumab dose. We propose mechanisms of action and optimal duration of pembrolizumab treatment in this setting. Finally, we review the existing literature on the sequential administration of CD19-directed CAR T-cell therapy and immune checkpoint inhibitors. CONCLUSION: Immune checkpoint inhibitors are a promising treatment option for patients after failure of CD19-directed CAR-T cell therapy. PMID:34697175 | DOI:10.21873/invivo.12639 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality of Life in Swiss Patients With Spongiform Venous Malformations

xlomafota13 shared this article with you from Inoreader Quality of Life in Swiss Patients With Spongiform Venous Malformations Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3527-3535. doi: 10.21873/invivo.12655. ABSTRACT BACKGROUND/AIM: Spongiform venous malformations (sVMs) get symptomatic in >90% of cases during a person's lifetime. Misdiagnosis is still common and treatment often incomplete, making this disease a lifelong issue for patients with a relevant impact on their quality of life. PATIENTS AND METHODS: Medical records and imaging studies of patients with VMs from April 2002 to January 2017 were reviewed for confirmation of diagnosis and classification of the VMs. Only sVMs were included. Subjective data were obtained from the survey related to indication, response, and complications. We analyzed the frequency of correct diagnosis and Quality of Life by an SF12-based questionnaire for sVM-related issues in Swiss patients. RESULTS: A total of 80 patients were included in the study. Forty-six (58%) patients were females. Patients were 11.6-77 years old wi th a median age of 28.1 years. The correct diagnosis according to the ISSVA-classification after having been seen at our Institution was 87%. Thirty-one (39%) patients responded to the survey. Sixteen (51%) were female. Twenty-eight (90%) patients felt that their sVM-related state of health improved within a year. Twelve (39%) patients reported that they could not work as good as normal because of slight to modest impairment by the sVM, while 19 (61%) patients were unimpaired. Mental impairment was found in 8 (26%) patients, while 23 (74%) patients felt no impairment. Eight (26%) patients reported that they were impaired within social contacts due to their sVM. Only 9 (29%) patients reported that venous malformation was diagnosed around birth. Twenty-three (74%) patients received a wrong diagnosis. Patients that were treated, reported close to complete relief of symptoms in 26% (8 patients) while also 26% (8 patients) reported no change of symptoms after therapy. CONCLUSION: S wiss sVM patients also suffer from misdiagnosis and late diagnosis. They are impacted in their daily life by their disease. PMID:34697191 | DOI:10.21873/invivo.12655 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Intravenous Use of Lidocaine in Postoperative Pain Management After Laparoscopic Colorectal Surgery: A Meta-analysis and Meta-regression of RCTs

xlomafota13 shared this article with you from Inoreader Efficacy of Intravenous Use of Lidocaine in Postoperative Pain Management After Laparoscopic Colorectal Surgery: A Meta-analysis and Meta-regression of RCTs Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3413-3421. doi: 10.21873/invivo.12641. ABSTRACT BACKGROUND/AIM: Current literature reports regarding the effect of lidocaine in laparoscopic colectomies are still inconclusive. The purpose of this study was to review the current literature and estimate the overall effect of intravenous lidocaine administration in postoperative recovery of patients submitted to laparoscopic colectomies. MATERIALS AND METHODS: This study was completed based on the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic screening using scholar databases was performed (Medline, Scopus, Web of Science, CENTRAL). RESULTS: In total, 8 studies and 407 patients were included in this meta-analysis. Introduction of intravenous lidocaine in the perioperative analgesia scheme did not improve hospitalization duration (p=0.23), morphine consumption (p=0.96), perioperative bowel function (first flatus p=0.40, first bowel opened p=0.13, first diet p=0.16), or the overall complication rates (p=0.42). Overall, high heterogeneity levels were identified. CONCLUSION: Current evidence indicates that lidocaine does not improve rehabilitation after laparoscopic colectomies. PMID:34697177 | DOI:10.21873/invivo.12641 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.