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Τετάρτη 10 Φεβρουαρίου 2021

Xerostomia and hyposalivation in patients with obstructive sleep apnea

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Abstract

Objective

(a) To report the xerostomia prevalence and severity in patients with obstructive sleep apnea (OSA). (b) To assess the saliva pH in patients with OSA.

Design

Simultaneous cohort observational clinical study.

Setting

In Sleep Medicine Centre at Lomonosov Moscow State University from March to June 2019.

Participants

The study was conducted on 30 patients with OSA aged from 35 to 65 years.

Main Outcomes Measures:

The diagnosis of sleep apnea was made after standard polysomnography using the Domino program. The severity of OSA was indicated using the Apnea‐Hypopnea Index. Xerostomia was evaluated using Fox's test. Hyposalivation was evaluated by measurement of salivary flow rate. Determination of the saliva pH was carried out with a pH meter. Statistical analysis was performed by one‐way ANOVA and Tukey‐Kramer multi‐comparison test.

Results

Twenty‐two out of 30 (73.3%) patients were diagnosed with "dry mouth". Hyposalivation was observed in 6 out of 30 (20%). Dry mouth on awakening was observed in 60.0%, 72.7% and 88.9% of patients with mild, moderate and severe OSA, respectively. The average salivary flow rate was 0.28ml/min, 0.24ml/ min and 0.14ml/ min, respectively. The average pH value in patients with mild, moderate and severe apnea was 6.40±0.017, 6.15±0.27 and 5.87±0.24, respectively.

Conclusions

In patient with mild and moderate OSA the saliva amount and rate are similar (P>0.05). With the increase of OSA severity both these parameters change (P<0.001). The acidity of the saliva was correlated with the level of OSA and it statistically increased with the increment of the OSA severity (P<0.05‐P<0.001).

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Determination of variables for a more accurate diagnostic approach in suspected acute invasive fungal rhinosinusitis: A non‐concurrent cohort study

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Abstract

Objective

To describe a group of patients with suspected acute invasive fungal rhinosinusitis (AIFRS) diagnosis, and identify factors associated with a greater risk of presenting this disease.

Design

Non‐concurrent cohort study.

Setting

A single center non‐concurrent follow‐up of patients with suspected AIFRS between August 2015 and July 2018.

Participants

50 inpatients referred due to suspected AIFRS at Hospital Clínico Universidad Católica based on the association of a predisposing factor (neutropenia/immunodeficiency/poorly controlled diabetes) with fever of unknown origin.

Main outcome measure

The primary outcome was AIFRS diagnosis, defined as a concordant tissue biopsy.

Results

AIFRS was confirmed in 18% (9/50) of the evaluated patients. AIFRS was significantly associated with a positive galactomannan (p=0.04), and a paranasal sinus MRI with lack of contrast enhancement (LoCE) (p=0.04) orbit compromise (p=0.03) or global extrasinusal extension (p=0.04). LoCE and extrasinusal extension in the paranasal sinus/brain MRI were risk factors for AIFRS (OR 16; CI 1.2–210.6 and OR 12.75; CI 1.3–128.8 respectively). Conversely, a nasal endoscopy showing healthy mucosa was identified as a protective factor for AIFRS (OR 0.06; CI 0.007–0.57).

Conclusions

In patients with suspected AIFRS we identified laboratory and radiologic variables associated with the disease, which may help for a more accurate diagnostic algorithm and approach in this population.

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Radioactive iodine therapy may not improve disease‐specific survival in follicular variant papillary thyroid cancer without distant metastasis: A propensity score‐matched analysis

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Abstract

Background

Whether radioactive iodine (RAI) therapy is effective in improving disease‐specific survival (DSS) in patients with follicular variant papillary thyroid cancer (FVPTC) without distant metastasis remains unclear.

Methods

Patients with FVPTC were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The Kaplan–Meier method and the Cox proportional hazards regression model were used to evaluate DSS. Propensity score‐matched analysis was performed to reduce the influence of confounding bias.

Results

RAI did not improve DSS, even in patients with aggressive features such as T4 classification (p = 0.658), extrathyroidal extension (p = 0.083), lateral lymph node metastasis (p = 0.544), and ≥5 metastatic lymph nodes (p = 0.599).

Conclusion

RAI did not affect DSS in patients with FVPTC without distant metastases in this SEER database study. Multicenter, prospective studies including recurrence and molecular information should be conducted to comprehensively evaluate the effects of RAI on FVPTC.

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Olfactory Dysfunction Among Asymptomatic Patients with SARS CoV2 Infection: A Case–Control Study

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Abstract

Olfactory dysfunction (hyposmia, anosmia) is a well-recognized symptom in patients with coronavirus disease-19 (COVID-19). Studies of olfactory dysfunction in asymptomatic patients have not been reported. We conducted a study looking for the presence of olfactory dysfunction with an objective assessment tool in asymptomatic Covid 19 and compared it with patients with mild COVID-19 and age-matched controls. We recruited 57 male patients each of Mild COVID-19, asymptomatic Covid 19, and healthy controls for the study. All participants underwent evaluation of smell threshold by Butanol Threshold test (BTT) and ability to distinguish common odors by Smell identification test. The scores of each test were recorded on a numerical scale. The participants in all three arms were matched for age, history of smoking, and pre-existing medical conditions. The mean scores of the Butanol Threshold test in Mild COVID-19, asymptomatic Covid 19 and controls were 2.95 ± 2.25 ( 0–7.5), 3.42 ± 2.23 (0–7.5), and 4.82 ± 1.86 (0–8), respectively. A one-way ANOVA showed a significant difference between groups (df 2, MS 53.78, F 11.94, p < 0.005). Intergroup differences using the student T-test showed significantly low BTT scores in Mild COVID-19 (p < 0.005) and asymptomatic (p < 0.005) as compared to control. BTT scores could not distinguish between asymptomatic patients and control. The smell threshold was impaired in asymptomatic Covid 19 and Mild COVID-19. Butanol Threshold Test score could not differentiate between asymptomatic Covid 19 and controls.

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Early detecting cervical necrotizing fasciitis from deep neck infections: a study of 550 patients.

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Early detecting cervical necrotizing fasciitis from deep neck infections: a study of 550 patients.

Eur Arch Otorhinolaryngol. 2021 Feb 09;:

Authors: Sideris G, Sapountzi M, Malamas V, Papadimitriou N, Maragkoudakis P, Delides A

Abstract
PURPOSE: The aim of this retrospective review study is to evaluate Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score as an indicative parameter in early detecting cervical necrotizing fasciitis (CNF) from deep neck infections (DNI).
METHODS: We reviewed 12 cases of CNF and 538 cases of non-necrotizing deep neck infection hospitalized in our hospital over the last decade. Cervical necrotizing fasciitis was histologically confirmed.
RESULTS: Using an LRINEC score of 6 as a cutoff sensitivity was calculated at 100% (95% CI 99.9-100) and specificity 72.5% (95% CI 72.4-72.6). Negative predicted value (NPV) was 100% and positive predicted value (PPV) was 7.5%. C-reactive protein (CRP), white blood count (WBC), and glucose (Glu) levels have a higher correlation. Haemoglobin (Hb), sodium (Na), and creatinine (Cr) do not seem to have a big impact in our study.
CONCLUSION: LRINEC score proves to be a useful "rule-out" tool that works on the safe side with high sensitivity and poor specificity. WBC, CRP, and Glu seem to be the most significant variables of the LRINEC score. Hb, Na, and Cr make the score safer. Decision for surgery must be based on medical history, clinical symptoms and signs, imaging findings, and laboratory tests and not according to the LRINEC score itself.

PMID: 33559743 [PubMed - as supplied by publisher]

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Unilateral absence of pulmonary artery associated with lung cancer: analysis of operation strategy based on digital preoperative planning and surgical simulation with three-dimensional visualization.

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Unilateral absence of pulmonary artery associated with lung cancer: analysis of operation strategy based on digital preoperative planning and surgical simulation with three-dimensional visualization.

Surg Radiol Anat. 2021 Feb 09;:

Authors: Liu Y, Zhang S

Abstract
Unilateral absence of a pulmonary artery (UAPA) is a rare congenital anomaly. The occurrence of lung cancer in association with UAPA is even rarer, and clinical experience is very limited. This report aims to describe a case of unilateral absence of the right pulmonary artery that was associated with primary carcinoma of the contralateral lung. Both ipsilateral and contralateral lung cancer operations in patients with UAPA are extremely rare, with limited clinical experience. This article provides insights into the operative tolerability and outcomes after lung surgery in patients with UAPA, with an analysis of the operation strategy based on digital preoperative planning and surgical simulation with three-dimensional (3D) visualization, which may enable lung cancer surgery to be performed safely.

PMID: 33559715 [PubMed - as supplied by publisher]

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The posterior horn of the medial and lateral meniscus both reduce the effective posterior tibial slope: a radiographic MRI study.

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The posterior horn of the medial and lateral meniscus both reduce the effective posterior tibial slope: a radiographic MRI study.

Surg Radiol Anat. 2021 Feb 09;:

Authors: Hohmann E, Tetsworth K, Glatt V, Ngcelwane M, Keough N

Abstract
PURPOSE: The purpose of this study was to quantify the posterior horn meniscal slope and determine its contribution to the reduction in posterior tibial slope.
METHODS: Patients aged between 16 and 60 years and had intact menisci with no evidence of previous injury or surgery were included. Patients with radiological evidence of osteoarthritis Grade II-IV, any acute or chronic meniscus injuries, fractures, and ligamentous injuries were excluded. The posterior bony slope (PTS) and the meniscus slope (MS) of the posterior horns were measured at 25, 50, and 75% from the medial and lateral borders of the tibial plateau.
RESULTS: 325 MR images (mean age 37.1 ± 10.9 years) were included. There were 194 males and 131 females, with 162 left and 163 right knees. The PTS in the medial compartment ranged from (-) 2.8° to 3.7° and from (-) 1.3° to 1.9° in the lateral compartment (p = 0.0001). The MS in the medial compartment ranged from 27.4° to 28.2°, and from 27.8° to 28.7° in the lateral compartment (p > 0.05). The differences between the medial and lateral knee compartment were statistically significant. At the 25% interval the p level was 0.037, at 50% p = 0.00001, and at 75% p = 0.0001. There were no significant between gender differences.
CONCLUSIONS: The results of this study demonstrated a significant reduction in posterior tibial bone slope by the posterior horns of both the medial and lateral meniscus, from a mean of (-) 1° to 2° to a more horizontal anterior slope. The posterior bone slope was larger in the medial compartment by 1°, resulting in a smaller slope reduction in the lateral compartment.

PMID: 33559716 [PubMed - as supplied by publisher]

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Automatic Classification of Healthy Subjects and Patients With Essential Vocal Tremor Using Probabilistic Source-Filter Model Based Noise Robust Pitch Estimation

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Via Voice

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Publication date: Available online 10 February 2021

Source: Journal of Voice

Author(s): Achuth Rao MV, B.K. Yamini, J. Ketan, A. Preetie Shetty, Pramod Kumar Pal, N. Shivashankar, Prasanta Kumar Ghosh

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Radioactive iodine therapy may not improve disease-specific survival in follicular variant papillary thyroid cancer without distant metastasis: A propensity score-matched analysis.

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Radioactive iodine therapy may not improve disease-specific survival in follicular variant papillary thyroid cancer without distant metastasis: A propensity score-matched analysis.

Head Neck. 2021 Feb 09;:

Authors: Wang X, Zheng X, Zhu J, Li Z, Wei T

Abstract
BACKGROUND: Whether radioactive iodine (RAI) therapy is effective in improving disease-specific survival (DSS) in patients with follicular variant papillary thyroid cancer (FVPTC) without distant metastasis remains unclear.
METHODS: Patients with FVPTC were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The Kaplan-Meier method and the Cox proportional hazards regression model were used to evaluate DSS. Propensity score-matched analysis was performed to reduce the influence of confounding bias.
RESULTS: RAI did not improve DSS, even in patients with aggressive features such as T4 classification (p = 0.658), extrathyroidal extension (p = 0.083), lateral lymph node metastasis (p = 0.544), and ≥5 metastatic lymph nodes (p = 0.599).
CONCLUSION: RAI did not affect DSS in patients with FVPTC without distant metastases in this SEER database study. Multicenter, prospective studies including recurrence and molecular information should be conducted to comprehensively evaluate the effects of RAI on FVPTC.

PMID: 33559196 [PubMed - as supplied by publisher]

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Results of a survey on elderly head and neck cancer patients on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO).

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Results of a survey on elderly head and neck cancer patients on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO).

Acta Otorhinolaryngol Ital. 2020 Dec;40(6):405-409

Authors: Belgioia L, De Felice F, Bacigalupo A, Alterio D, Argenone A, D'Angelo E, Desideri I, Franco PF, Merlotti A, Musio D, Orlandi E, Ursino S, Paiar F

Abstract
Objective: Over the years, evidence-based data and technical improvements have consolidated the central role of radiation therapy (RT) in head and neck cancer (HNC) treatment, even in the elderly. This survey aimed to describe the management of the elderly HNC patients among Italian Radiation Oncology Departments (RODs) and provide possible suggestions for improvement.
Methods: An online survey based on 43 questions was sent to RODs via email. For each RODs, a radiation oncologist with expertise in HNC was invited to answer questions addressing his/her demographic data, ROD multidisciplinary unit (MU) organisation and ROD management policy in elderly HNC patients.
Results: In total, 68 RODs answered, representing centres located in 16 Italian regions. MU was considered the core of HNC patient management in almost all the entire country. However, in many RODs, there was minimal access to a routinely comprehensive geriatric assessment at diagnosis. Most treatments were reported by respondents as curative (89% on average) and the preferred treatment technique was intensity modulated radiation therapy (IMRT). A considerable variation between RODs was found for RT target volumes. There was a relation between the specialist's years of experience and type of concomitant systemic therapy prescribed.
Conclusions: Substantial differences in elderly HNC management have been found, especially concerning patient clinical evaluation and target volume delineation. This survey shows the necessity to design a prospective national trial to provide a uniform treatment strategy and define an effective patient-centred approach.

PMID: 33558767 [PubMed - in process]

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Micronucleus, nucleoplasmic bridge and nuclear bud frequencies in patients with laryngeal carcinoma.

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Micronucleus, nucleoplasmic bridge and nuclear bud frequencies in patients with laryngeal carcinoma.

Acta Otorhinolaryngol Ital. 2020 Dec;40(6):410-414

Authors: Yazici I, Caglar O, Guclu O, Cobanoglu H, Coskun M, Coskun M, Kilic A, Dereköy FS

PMID: 33558768 [PubMed - in process]

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