Rates of bone reabsorption and union in mandibular reconstruction using the osteocutaneous radial forearm free flap

xlomafota13 shared this article with you from Inoreader Rates of bone reabsorption and union in mandibular reconstruction using the osteocutaneous radial forearm free flap Via Head & Neck Abstract Background Historical concerns over bone resorption and malunion of the osteocutaneous radial forearm free flap (OCRFFF) limited its widespread adoption for head and neck reconstruction, despite lack of outcomes data evaluating this notion. Methods A retrospective cohort study was performed including patients 18 years or older who underwent reconstruction of the mandible using an OCRFFF. Linear modeling and logistic regression were used to evaluate the change in bone volume and union over time. Results One hundred and twenty-one patients were included in the study. A mixed effects linear model incorporating age, sex, treatment type, and number of bone segments did not demonstrate a significant loss of bone volume over time. A logistic regression model identified lack of adjuvant treatment and time to be significantly associated with complete union. Conclusion This study supports that the OCRFFF is a stable form of osseus reconstruction for defects of the head and neck. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Properties of relative timing and phonetic complexity in adults with dysarthria secondary to amyotrophic lateral sclerosis

xlomafota13 shared this article with you from Inoreader Properties of relative timing and phonetic complexity in adults with dysarthria secondary to amyotrophic lateral sclerosis Via Folia Phoniatrica et Logopaedica Introduction: This study examined the relative timing in individuals with dysarthria secondary to amyotrophic lateral sclerosis (ALS). The aim was to examine whether relative timing was influenced by severity of dysarthria and phonetic complexity of the speech being produced. Methods: Twenty-one adults with dysarthria secondary to ALS, who presented with a range of dysarthria severity, participated in the study. A group of non-impaired, age-matched adults served as controls. All participants produced a single phrase, across which four measures of relative timing were calculated, and the phonetic composition (complexity) of each measure was considered. Both participant groups completed the Sentence Intelligibility Test, which provided measures of speech intelligibility and speaking rate. Results: Relative timing did not significantly differ between speaker groups across the four measures, regardless of phonetic complexity. Neither Sentence Intelligibility Test score nor speaking rate were significantly correlated with relative timing. Discussion: Relative timing of phrase-level speech appears to remain intact regardless of the phonetic complexity of speech among individuals with dysarthria secondary to ALS. The potential of an internal phonological system organizing speech gestures is discussed to explain why the consistency in relative timing occurs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis

xlomafota13 shared this article with you from Inoreader Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis Via The Laryngoscope Objectives/Hypothesis Evaluation of the clinical outcomes after 6 months of treatment with a novel adjustable implant, the APrevent® Vocal-Implant-System (VOIS), in conjunction with medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis. Study Design Prospective case series study at single tertiary referral center. Methods Preoperative and 1 week, 7 weeks, and 6 months postoperative glottal efficiency (maximum phonation time [MPT]), voice quality (including GRBAS-scores and acoustic parameters) and self-perceived voice-related handicap (voice handicap index [VHI-30]) were measured and analyzed, whereas type of vocal fold closure was evaluated and determined by flexible videolaryngoscopy based on Södersten and Lindestad classification (Wilcoxon signed-rank test). Results Thirteen patients underwent MT with VOIS under local anesthesia. Six months after surgery, the VHI-30 and MPT had improved from a preoperative mean of 75.0 ± 22.9 and 2.7 ± 2.1 s to a postoperative mean of 20.6 ± 19.7 and 6.3 ± 4.0 s, respectively. The mean GRBAS score improved from preoperative scores of Gpreop = 2.7, Rpreop = 2.6, Bpreop = 2.6, Apreop = 2.2, and Spreop = 2.0 to Gpostop = 0.3, Rpostop = 0.3, Bpostop = 0.2, Apostop = 0.2, and Spostop = 0.3 at 6 months postoperatively. Improved glottal closure was achieved in all patients (n = 13). Five patients received postoperative adjustment for the optimization of voice quality and glottal closure. No intra- or postoperative complications were observed. Significant improvements in acoustic parameters, i ncluding percentage jitter, percentage shimmer, and signal-to-noise ratio, were also observed after MT. All results were statistically significant (P < .05, Cohen's d > .8). Conclusions APrevent® VOIS-Implantation is a safe procedure with good voice outcomes. Postoperative adjustments can be performed smoothly to optimize voice quality and glottal closure. Level of Evidence III Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dupilumab in CRSwNP: Responder Analysis Using Clinically Meaningful Efficacy Outcome Thresholds

xlomafota13 shared this article with you from Inoreader Dupilumab in CRSwNP: Responder Analysis Using Clinically Meaningful Efficacy Outcome Thresholds Via The Laryngoscope Objectives/Hypothesis Dupilumab, a fully human monoclonal antibody that blocks the shared interleukin (IL)-4/IL-13 receptor component, significantly improved outcomes for patients with chronic rhinosinusitis with nasal polyps (CRSwNP) in the SINUS-24 and SINUS-52 studies. This post hoc analysis evaluated dupilumab's effect on patient-reported symptoms and objective outcome measures using thresholds of clinically meaningful within-patient change from baseline. Methods Patients with CRSwNP receiving subcutaneous dupilumab or placebo every 2 weeks in SINUS-24/SINUS-52 were analyzed. Patients recorded severity of nasal congestion (NC), loss of smell (LoS), and anterior/posterior rhinorrhea (each within range 0–3) daily. Total Symptom Score (TSS) was calculated as a composite severity score (0–9) for these symptoms. Objective measures included University of Pennsylvania Smell Identification Test (UPSIT; 0–40), nasal polyps score (NPS; 0–8), and Lund–Mackay computed tomography score (LMK-CT; 0–24). Thresholds of within-patient change in scores from baseline at weeks 24 and 52 considered clinically meaningful were ≥1.0 (NC, LoS), ≥3.0 (TSS), ≥8.0 (UPSIT), ≥1.0 (NPS), and ≥5.0 (LMK-CT). Results A total of 724 and 303 patients were included in the week 24 and 52 analyses, respectively. Responder rates were significantly higher with dupilumab versus placebo at week 24 for NC (64% vs. 24%), LoS (63% vs. 14%), TSS (62% vs. 15%), UPSIT (54% vs. 6%), NPS (63% vs. 14%), and LMK-CT (59% vs. 3%); all P < .0001. Results were consistent at week 52. Conclusion Significantly greater proportions of dupilumab-treated patients with CRSwNP compared with placebo demonstrated clinically meaningful improvements in patient-reported sinonasal symptoms and objective outcomes. Level of Evidence 2 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical diagnostic utility of ultrasound-guided fine needle aspiration biopsy in parotid masses

xlomafota13 shared this article with you from Inoreader Clinical diagnostic utility of ultrasound-guided fine needle aspiration biopsy in parotid masses Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211058922. doi: 10.1177/01455613211058922. Online ahead of print. ABSTRACT BACKGROUND: Fine needle aspiration (FNA) is a common diagnostic tool used in the initial evaluation of parotid masses. In the literature, variable diagnostic accuracy of FNA is reported. Therefore, when considering clinical management of these patients, the utility of FNA is unclear. The aim of this study was to determine the capability of ultrasound-guided FNA to differentiate between benign and malignant neoplasms. Further, the way in which FNA results affect clinical decision-making was assessed. METHODS: Retrospective data were collected for all patients who underwent parotidectomy at a large Canadian tertiary care center between 2011 and 2016. Patient demographics, preoperative imaging reports, preoperative FNA results, and final pathological diagnosis were analyzed. RESULTS: Of the 199 patients who underwent parotidectomy, 184 had preoperative ultrasound-guided FNA. There were a total of 13 non-diagnostic FNAs. In diagnosing malignancy, FNA had a sensitivity and specificity of 71.4% and 98.7%, respectively. The positive predictive value (PPV) was 83.3%. The negative predictive value was 97.5%. Of the non-diagnostic FNAs, 2 out of 13 (15.4%) were deemed malignant neoplasms on final pathology. CONCLUSION: FNA is a useful adjunct in the work-up of parotid masses, but it should be used with caution. Due to limited sensiti vity, it should not be relied upon as the sole determinant of a surgeon's management plan. PMID:34818946 | DOI:10.1177/01455613211058922 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delta neutrophil index levels can be a good indicator to predict patients with chronic rhinosinusitis who need surgery

xlomafota13 shared this article with you from Inoreader Delta neutrophil index levels can be a good indicator to predict patients with chronic rhinosinusitis who need surgery Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211058491. doi: 10.1177/01455613211058491. Online ahead of print. ABSTRACT OBJECTIVES: Predicting the need for surgical treatment among patients with chronic rhinosinusitis (CRS) is challenging. The delta neutrophil index (DNI) has been proposed as a useful laboratory marker of immature granulocytes, which indicates infection or severe inflammation in several diseases. This study evaluated DNI as an early predictor of the need for surger y in patients with CRS. METHODS: A total of 117 patients diagnosed with CRS were enrolled in this retrospective and observational study. Medical records, including symptoms data, WBC count, ESR level, LUC count, Lund-Mackay scores, and DNI, were reviewed. The receiver operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for predicting surgery. RESULTS: Among 117 patients, 49 patients (41.9%) needed surgical intervention. The areas under the WBC, ESR, LUC, and DNI ROC curves were .571, .600, .592, and .782, respectively. The optimal cut-off value of DNI to predict surgery was .9%. The prognostic precision of DNI showed that the sensitivity was 59.2% and the specificity was 98.5%. In the analysis of risk factors, DNI levels were significantly associated with surgical intervention (odds ratio, 2.22; 95% confidence interval, 1.48-3.34; P < .01). CONCLUSIONS: The level of DNI, which reflects the severity of the disease, may be a useful predictor for determining the need for surgical intervention in patients with CRS. This is the first literature to verify the role of DNI in upper airway disease. PMID:34818928 | DOI:10.1177/01455613211058491 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Squamous cell papilloma-like presentation of multiple neurovascular hamartomas of the oral cavity

xlomafota13 shared this article with you from Inoreader Squamous cell papilloma-like presentation of multiple neurovascular hamartomas of the oral cavity Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211061623. doi: 10.1177/01455613211061623. Online ahead of print. ABSTRACT Significance Statement: Neurovascular hamartomas (NVH) is an uncommon tumor-like developmental anomaly. We hereby report the case of a 28-year-old woman presenting with multiple millimetric excrescences in the oral cavity that were clinically interpreted as squamous cell papilloma and histologically consistent with NVHs. Neurovascular hamartomas is rare in the oral cavity. To the best of our knowledge, multiple NVHs have never been reported at this site. PMID:34818931 | DOI:10.1177/01455613211061623 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High Annexin A10 expression is correlated with poor prognosis in pancreatic ductal adenocarcinoma

xlomafota13 shared this article with you from Inoreader High Annexin A10 expression is correlated with poor prognosis in pancreatic ductal adenocarcinoma Via Cellular and Molecular Biology Histol Histopathol. 2021 Nov 25:18397. doi: 10.14670/HH-18-397. Online ahead of print. ABSTRACT Pancreatic ductal adenocarcinoma (PDAC) is the third-leading cause of cancer-related death. Owing to its poor prognosis, new molecular biomarkers for PDAC are needed. Annexin A10 (ANXA10) is a calcium-/phospholipid-binding protein belonging to the annexin family of proteins. ANXA10 is not only associated with gastric phenotypes, but also acts an independent prognostic factor in several cancers. However, the role of ANXA10 in PDAC remains unknown. Therefore, we examined the relationship between ANXA10 and the prognosis of PDAC. We analyzed the expression of ANXA10 using data from public databases, and performed immunohistochemistry analysis for 81 PDAC cases. We then investigated the relationship between ANXA10 expression and clinicopathological features. ANXA10 was detected in 47 of 81 PDAC cases (58%). High expression of ANXA10 was signific antly related to poor overall survival (OS; p=0.011). Univariate analysis of OS revealed three prognostic parameters: tumor grade (p=0.046), perineural invasion (p=0.017), and ANXA10 expression (p=0.012). Multivariate analysis indicated that ANXA10 expression (p<0.01) alone was a prognostic factor in PDAC cases. Our findings suggest that ANXA10 expression is an independent prognostic factor in PDAC cases and shows promise as a new biomarker in PDAC. PMID:34821375 | DOI:10.14670/HH-18-397 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis Via radioactive iodine Eur J Nucl Med Mol Imaging. 2021 Nov 25. doi: 10.1007/s00259-021-05625-4. Online ahead of print. ABSTRACT PURPOSE: Although it has been proven that radioactive iodine (RAI) treatment is an effective and well-tolerated procedure in patients with differentiated thyroid cancer (DTC), there is still some concern regarding the risk of developing a second primary malignancy after RAI administration. We performed a systematic review and meta-analysis to investigate the risk of primary bre ast cancer in patients with DTC undergoing RAI therapy. METHODS: A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. RESULTS: The final analysis included 14 studies accounting for a total of 200,247 patients with DTC (98,368 treated with RAI and 101,879 not treated with RAI). The relative risk of primary breast cancer in patients with DTC treated with RAI to those not treated with RAI among studies ranged from 0.45 to 2.55, the pooled relative risk was 0.83 (95% confidence interval, 0.70-0.99), and the heterogeneity was 71.5%. CONCLUSION: The present meta-analysis indicates that patients with DTC treated with RAI do not have a higher risk of primary breast cancer compared to those not treated with RAI. These findings suggest that RAI therapy does not increase the risk of breast cancer. PMID:34820683 | DOI:10.1007/s00259-021-05625-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The impact of trans-arterial embolization on the result of chemoradiotherapy in oral cavity cancer

xlomafota13 shared this article with you from Inoreader The impact of trans-arterial embolization on the result of chemoradiotherapy in oral cavity cancer Via ear nose throat Ear Nose Throat J. 2021 Nov 25:1455613211054181. doi: 10.1177/01455613211054181. Online ahead of print. ABSTRACT Objectives: Evaluation of the hemostatic effect of trans-arterial embolization on patients with advanced oral cavity cancer who had bleeding complications while undergoing definitive concurrent chemoradiotherapy (CCRT). Additionally, assess the effect of trans-arterial embolization on treatment response following concurrent chemoradiotherapy, as well as ove rall survival (OS) and progression-free survival (PFS) in the group of patients following the intervention.Method: From September 2018-June 2021, a retrospective descriptive study was conducted on 16 patients with inoperable, locally advanced oral cavity cancer who received definitive concurrent chemoradiotherapy, experienced acute bleeding complications, and received selective intravascular intervention with various embolization materials at Vietnam National Cancer Hospital.Results: After selective embolization, 16/16 patients ceased bleeding; 1 patient re-bled for the second time after 3 weeks. The average duration of chemoradiotherapy interruption due to intervention was 6.7 days. After CCRT, 15/16 (93.75%) patients achieved a response, with 9/16 (56.25%) patients achieving a complete response. The median OS was 14 months (range, 3-26 months), and the median PFS was 10 months (range, 3-20 months). There were no significant complications, particularly neurological si de effects.ConclusionsTumor bleeding is a common and serious complication of CCRT treatment in patients with locally advanced oral cavity cancer. Embolization is a safe and effective method of controlling acute bleeding that has no adverse effect on the outcome of definitive concurrent chemoradiotherapy. PMID:34821166 | DOI:10.1177/01455613211054181 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Machine learning-based voice assessment for the detection of positive and recovered COVID-19 patients

xlomafota13 shared this article with you from Inoreader Machine learning-based voice assessment for the detection of positive and recovered COVID-19 patients Via Journal of Voice Many virological tests have been implemented during the COVID-19 pandemic for diagnostic purposes, but they appear unsuitable for screening purposes. Furthermore, current screening strategies are not accurate enough to effectively curb the spread of the disease. Therefore, the present study was conducted within a controlled clinical environment to determine eventual detectable variations in the voice of COVID-19 patients, recovered and healthy subjects, and also to determine whether machine learning-based voice assessment (MLVA) can accurately discriminate between them, thus potentially serving as a more effective mass-screening tool. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.