Differentiated Thyroid Cancer Presenting With Solitary Bony Metastases to the Frontal Bone of the Skull

xlomafota13 shared this article with you from Inoreader Differentiated Thyroid Cancer Presenting With Solitary Bony Metastases to the Frontal Bone of the Skull Via radioactive iodine Cureus. 2021 Oct 13;13(10):e18735. doi: 10.7759/cureus.18735. eCollection 2021 Oct. ABSTRACT A 75-year-old lady was referred to the oral and maxillofacial surgery (OMFS) team with a painless swelling in the midline of her forehead. Investigations diagnosed it as a solitary metastasis of thyroid cancer. Follicular thyroid cancers are known to metastasise to bone; however, bony metastasis to the frontal bone of the skull is very rare. This case highlights how the effective use of a m ultidisciplinary team can lead to better patient outcomes. The patient went on to have a total thyroidectomy and received both radioactive iodine therapy and radiotherapy to the bony metastasis. PMID:34790486 | PMC:PMC8586824 | DOI:10.7759/cureus.18735 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Targeting the mTOR Pathway in Hurthle Cell Carcinoma Results in Potent Anti-Tumor Activity

xlomafota13 shared this article with you from Inoreader Targeting the mTOR Pathway in Hurthle Cell Carcinoma Results in Potent Anti-Tumor Activity Via radioactive iodine Mol Cancer Ther. 2021 Nov 17:molcanther.0224.2021. doi: 10.1158/1535-7163.MCT-21-0224. Online ahead of print. ABSTRACT Hurthle cell carcinomas (HCC) are refractory to radioactive iodine and unresponsive to chemotherapeutic agents, with a fatality rate that is the highest among all types of thyroid cancer after anaplastic thyroid cancer. Our previous study on the genomic landscape of HCCs identified a high incidence of disruptions of mTOR pathway effectors. Here, we report a detaile d analysis of mTOR signaling in cell line and patient-derived xenograft (PDX) mouse models of HCCs. We show that mTOR signaling is upregulated and that targeting mTOR signaling using mTOR inhibitors suppresses tumor growth in primary tumors and distant metastasis. Mechanistically, ablation of mTOR signaling impaired the expression of p-S6 and cyclin A2, resulting in the decrease of S phase and blocking of cancer cell proliferation. Strikingly, mTOR inhibitor treatment significantly reduced lung metastatic lesions, with the decreased expression of Snail in xenograft tumors. Our data demonstrates that mTOR pathway blockade represents a novel treatment strategy for HCC. PMID:34789562 | DOI:10.1158/1535-7163.MCT-21-0224 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of ENT emergency patients during the COVID-19 pandemic in Germany

xlomafota13 shared this article with you from Inoreader Analysis of ENT emergency patients during the COVID-19 pandemic in Germany Via hno HNO. 2021 Nov 17. doi: 10.1007/s00106-021-01121-1. Online ahead of print. ABSTRACT BACKGROUND: This retrospective observational study was undertaken to assess the ENT emergency workload during the COVID-19 pandemic caused by the severe acute respiratory coronavirus‑2 (SARS-CoV-2). MATERIALS AND METHODS: All 3230 patients who were treated as an emergency from 23.01.2020 to 06.08.2020 in the Department of Otolaryngology at the SLK-Kliniken Heilbronn were included in thi s study. Demographic data, diagnostics, diagnosis, and treatment (in-/outpatient) were retrospectively retrieved. Not only did the physicians on call triage the emergency department (ED) ENT patients, but the patients also self-assessed their urgency of treatment. RESULTS: The number of patients consulting our ED decreased significantly during the pandemic, by 42.2%. However, the top diagnoses remained almost constant, with epistaxis being the most frequent diagnosis before, during, and after COVID-19. Facial trauma remained the second most frequent consultation reason. The hospitalization rate decreased from 21.9% before COVID-19 to 16.2% during the pandemic. Surgical therapy was necessary in 17.6% of patients before COVID-19 and this increased to 23.5% during COVID-19. The self-referral rate increased from 61 to 66% during the pandemic. More men than women consulted the ED during COVID-19. Regarding the triage assessment by the physician on call and the patient's self-assess ment, a significant discrepancy was noted before, during, and after COVID-19. CONCLUSION: The reasons for reduction in ENT ED visits are multifactorial. The clinical consequences of decreased hospitalizations remain uncertain. However, health authorities need to advocate the safety of the hospital environment to limit potential damage. PMID:34791514 | DOI:10.1007/s00106-021-01121-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intensive dysphagia rehabilitation program for patients with head and neck cancer

xlomafota13 shared this article with you from Inoreader Intensive dysphagia rehabilitation program for patients with head and neck cancer Via swallowing exercises ANZ J Surg. 2021 Nov 18. doi: 10.1111/ans.17365. Online ahead of print. ABSTRACT BACKGROUND: In response to the pathophysiology and expected trajectory of dysphagia that arises following treatment for head and neck cancer (HNC), an intensive and progressive approach to dysphagia is warranted. This pilot study evaluates the recovery of swallowing function following the implementation of an exercise-based approach to dysphagia rehabilitation. METHODS: Consecutive recruitment wa s carried out prospectively at a quaternary referral centre. Participants were aged 18 years and older and had completed treatment for HNC. Dysphagia was assessed pre and post a 10-week rehabilitation program using videofluoroscopy swallow study (VFSS) and clinician-and patient-reported outcomes. RESULTS: Ten participants were recruited over a 6-month period, all of whom had oropharyngeal dysphagia confirmed on VFSS. At the conclusion of the 10-week intervention period, DIGEST (Dynamic Imaging Grade of Swallowing Toxicity) scores improved significantly for both safety and efficiency components. Four of seven participants who had a percutaneous endoscopic gastrostomy tube at baseline were no longer reliant on it for their nutrition, hydration or medication at the completion of the therapeutic period. While four participants continued to aspirate on thin fluids, none developed aspiration pneumonia. CONCLUSION: Oropharyngeal dysphagia as a consequence of HNC treatment is ch allenging to rehabilitate; however, in selected patients, it is responsive to intensive and individualized rehabilitation programs. PMID:34791759 | DOI:10.1111/ans.17365 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Altered brain network functional connectivity patterns in patients with vestibular migraine diagnosed according to the diagnostic criteria of the Bárány Society and the International Headache Society

xlomafota13 shared this article with you from Inoreader Altered brain network functional connectivity patterns in patients with vestibular migraine diagnosed according to the diagnostic criteria of the Bárány Society and the International Headache Society Via cortical auditory J Neurol. 2021 Nov 18. doi: 10.1007/s00415-021-10868-0. Online ahead of print. ABSTRACT BACKGROUND: Vestibular migraine (VM) is considered one of the most common causes of episodic central vestibular disorders, the mechanism of VM is currently still unclear. The development of functional nuclear magnetic resonance (fMRI) in recent years offers the possibility to explore the altered functional connectivity patterns in patients with VM in depth. The study aimed to investigate altered patterns of brain network functional connectivity in patients with VM diagnosed based on the diagnostic criteria of the Bárány Society and the International Headache Society, and hope to provide a scientific theoretical basis for understanding whether VM is a no-structural central vestibular disease, i.e., functional central vestibular disease with altered brain function. METHODS: Seventeen patients with VM who received treatment in our hospital from Decemb er 2018 to December 2020 were enrolled. Eight patients with migraine and 17 health controls (HCs) were also included. Clinical data of all patients were collected. Blood pressure, blood routine tests and electrocardiography were conducted to exclude other diseases associated with chronic dizziness. Videonystagmography, the vestibular caloric test, the video head impulse test and vestibular-evoked myogenic potentials were measured to exclude peripheral vestibular lesions. MRI was utilized to exclude focal lesions and other neurological diseases. All subjects underwent fMRI. The independent component analysis was performed to explore changes in intra- and inter-network functional connectivity in patients with VM. RESULTS: Among 17 patients with VM, there were 7 males and 10 females with an average age of 39.47 ± 9.78 years old. All patients had a history of migraine. Twelve (70.6%) patients had recurrent spontaneous vertigo, 2 (11.7%) patients had visually induced vertigo, and 3 (17.6%) patients had head motion-induced vertigo. All 17 patients with VM reported worsening of dizziness vertigo during visual stimulation. The migraine-like symptoms were photophobia or phonophobia (n = 15, 88.2%), migraine-like headache (n = 8, 47.1%), visual aura during VM onset (n = 7, 41.2%). 5 (29.4%) patients with VM had hyperactive response during the caloric test, and 12 (70.6%) patients had caloric test intolerance. Eleven (64.7%) patients had a history of motion sickness. Totally 13 independent components were identified. Patients with VM showed decreased functional connectivity in the bilateral medial cingulate gyrus and paracingulate gyrus within sensorimotor network (SMN) compared with HCs. They also showed weakened functional connectivity between auditory network (AN) and anterior default mode network (aDMN) compared with HCs, and enhanced functional connectivity between AN and the salience network (SN) compared with patients with migraine. CONCLUSION: Patien ts with vestibular migraine showed obvious altered functional connectivity in the bilateral medial cingulate gyrus and paracingulate gyrus within the SMN. The median cingulate and paracingulate gyri may be impaired, the disinhibition of sensorimotor network and vestibular cortical network may result in a hypersensitivity state (photophobia/phonophobia). Altered functional connectivity between AN and DMN, SN may lead to increased sensitivity to vestibular sensory processing. PMID:34792633 | DOI:10.1007/s00415-021-10868-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immediate and Short-term Effects of Straw Phonation in Air or Water on Vocal Fold Vibration and Supraglottic Activity of Adult Patients with Voice Disorders Visualized with Strobovideolaryngoscopy: A Pilot Study

xlomafota13 shared this article with you from Inoreader Immediate and Short-term Effects of Straw Phonation in Air or Water on Vocal Fold Vibration and Supraglottic Activity of Adult Patients with Voice Disorders Visualized with Strobovideolaryngoscopy: A Pilot Study Via Journal of Voice Purpose The first purpose of this study was to investigate and compare the short-term effects after a semi-occluded vocal tract (SOVT) therapy session consisting of straw phonation (SP) in air or water on vocal fold vibration and supraglottic activity of adult patients with voice disorders, visualized with strobovideolaryngoscopy (SVL). The second purpose of this study was to investigate and compare immediate changes in the patients' vocal fold vibration and supraglottic activity during SP in air or water, visualized with SVL. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complete Facial Paralysis Caused by Stabbing With a Car Key at the Stylomastoid Foramen

xlomafota13 shared this article with you from Inoreader Complete Facial Paralysis Caused by Stabbing With a Car Key at the Stylomastoid Foramen Via ear nose throat Ear Nose Throat J. 2021 Nov 18:1455613211056548. doi: 10.1177/01455613211056548. Online ahead of print. ABSTRACT Non-iatrogenic traumatic facial paralysis is most common in intratemporal facial nerve injury caused by temporal bone fracture, followed by intraparotid facial nerve branch injury. Facial paralysis caused by injury to the extratemporal trunk of the facial nerve is extremely rare. We present a case of a 60-year-old man suffering from immediate complete left periphe ral facial paralysis due to blunt transection of extratemporal trunk of facial nerve by stabbing with a car key. There was a facial nerve defect about 1 cm in length. The great auricular nerve was grafted to repair the facial nerve. Over 12 months, his facial nerve function improved to a House-Brackmann III/VI. PMID:34792423 | DOI:10.1177/01455613211056548 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survival and swallowing function outcome impact factors analysis of surgery-oriented comprehensive treatment for hypopharyngeal cancer in a series of 122 patients

xlomafota13 shared this article with you from Inoreader Survival and swallowing function outcome impact factors analysis of surgery-oriented comprehensive treatment for hypopharyngeal cancer in a series of 122 patients Via ear nose throat Ear Nose Throat J. 2021 Nov 18:1455613211058108. doi: 10.1177/01455613211058108. Online ahead of print. ABSTRACT OBJECTIVE: Under current standards of treating highly aggressive hypopharyngeal cancer (HPC), oncological control and functional outcome are still unsatisfactory worldwide. This study explored the surgery-oriented comprehensive treatment approach based on 15 years of practice. METHODS: A retrospective cohort of HPC patients treated by the senior author at Ch inese PLA General Hospital between Nov 2005 and Aug 2012 and Capital Medical University Beijing Friendship Hospital between May 2014 and Nov 2019 was studied. Oncological control, swallowing function, and quality of life (QoL) were assessed. RESULTS: In total, 122 patients were included in this study, with 11 (9.0%) cases in the early stage and 111 (91.0%) cases in the advanced stage. Five-year overall survival (OS) and disease-free survival (DFS) were 40.0% and 36.1%, respectively. The swallowing outcome was satisfactory in 90 (73.8%) patients. Tracheostomy-free survival was achieved in 55 (45.1%) patients. Multivariate cox regression analysis showed that the size of the surgical defect, local-regional recurrence, and distant metastasis were independent impact factors for OS and DFS (P < .05). Multivariate analysis showed that the logistic regression coefficients (standard error) of pharyngo-cutaneous fistula and local-regional recurrence on swallowing function were 1.274 (.532) and 1.283 (.496), respectively (P < .05). In addition, the logistic regression coefficients (standard error) of the clinical stage, local-regional recurrence, decannulation, and feeding tube on QoL were -7.803 (3.593), -7.699 (3.151), 13.853 (3.494), and -20.243 (3.696), respectively (P < .05). CONCLUSIONS: Surgery-oriented comprehensive treatment can give rise to good swallowing function without jeopardizing oncological control. The size of the surgical defect, local-regional recurrence, and distant metastasis were independent factors impacting OS and DFS. Pharyngo-cutaneous fistula and local-regional recurrence were independent factors impacting swallowing function. Clinical stage, local-regional recurrence, decannulation, and feeding tube were independent factors impacting QoL. PMID:34792398 | DOI:10.1177/01455613211058108 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of swallowing rehabilitation using traditional therapy, kinesiology taping and neuromuscular electrical stimulation on dysphagia in post-stroke patients: A randomized clinical trial

xlomafota13 shared this article with you from Inoreader Effect of swallowing rehabilitation using traditional therapy, kinesiology taping and neuromuscular electrical stimulation on dysphagia in post-stroke patients: A randomized clinical trial Via Traditional dysphagia therapy Clin Neurol Neurosurg. 2021 Nov 6;211:107020. doi: 10.1016/j.clineuro.2021.107020. Online ahead of print. ABSTRACT OBJECTIVE: We aimed to evaluate the functional recovery of stroke patients with orophyaryngeal dysphagia after treatment with traditional swallowing therapy (TST), neuromuscular electrical stimulation (NMES), and kinesiology taping (KT), by using clinical swallowing assessments and objective fiberoptic endoscopic evaluation of swallowing (FEES). METHODS: A total of 37 patients were randomized in three groups: those who received TST and NMES as Group 1 (n:12), those who received both TST and KT as Group 2 (n:13), and those who received TST, NMES, and KT together as Group 3 (n:12). Patients were evaluated before treatment, after treatment, and three months after treatment onset with bedside water-swallow test, Eating Assessment Tool (EAT-10), Functional Oral Intake Scale (FOIS), penetration-aspiration scale (PAS), and Nationa l Institute of Health-Swallow Safety Scale (NIH-SSS). FOIS, PAS, and NIS-SSS were completed according to results of fiberoptic endoscopic evaluation of swallowing (FEES). RESULTS: A statistically significant decrease was observed in bedside water-swallow test, EAT-10, PAS, and NIH-SSS scores in all treatment groups 5 weeks and 3 months after treatment onset compared to pre-treatment scores (p < 0.05). There was a statistically significant increase in FOIS scores 5 weeks and 3 months after treatment compared to pretreatment scores in all treatment groups (p < 0.05). When the pre-treatment, 3-week, and 5-month swallow scale scores of all groups were compared, there was no significant different difference in terms of bedside water-swallow test, EAT-10, FOIS, PAS, or NIH-SSS scores (p > 0.05). CONCLUSION: According to the results of our study, KT is a new option in the treatment of stroke-related dysphagia, is an effective treatment approach and its efficacy is main tained throughout long-term follow-up. PMID:34781221 | DOI:10.1016/j.clineuro.2021.107020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of the value of ultrasound and enhanced magnetic resonance imaging in judging cervical lymph node metastasis in patients with oral cancer

xlomafota13 shared this article with you from Inoreader Comparison of the value of ultrasound and enhanced magnetic resonance imaging in judging cervical lymph node metastasis in patients with oral cancer Via Association française pour l'étude du cancer Bull Cancer. 2021 Nov 12:S0007-4551(21)00423-9. doi: 10.1016/j.bulcan.2021.09.010. Online ahead of print. ABSTRACT BACKGROUND: Oral cancer is the twelfth largest malignant tumor in the world. Oral cancer is prone to lymph node metastasis in the early stages of the disease, and lymph node metastasis will directly affect the treatment and survival rate. Therefore, whether the lymph node metastasis can be accurately evaluated is of great significance to the treatment and prognosis of patients. OBJECTIVE: The diagnostic efficacy of three methods of preoperative ultrasound, enhanced magnetic resonance (enhanced MR), and ultrasound combined with enhanced MR on cervical lymph node metastasis of oral cancer were compared. MATERIALS AND METHODS: A retrospective analysis of 399 cases of oral cancer completed by head and neck surgery at Cancer Center of Sun Yat-sen University, China. In all cases, the maxillofacial and neck enhanced M R and cervical lymph node ultrasound examinations were performed before surgery, and imaging diagnosis was made for cervical lymph node metastasis and compared with pathology. All judgment results were statistically processed using the chi-square test. RESULTS: Compared with the above three methods, the diagnostic efficiency of ultrasound alone is better, and the diagnostic efficiency of enhanced MR combined ultrasound is not significantly better than that of ultrasound alone. There are differences in the diagnostic efficacy of the three inspection methods in different clinical sub-periods, all of which are better for the diagnosis of stage I. For patients with stage I, II, and III, there were no differences between the three examination methods. However, for stage IV patients,the diagnostic efficiency of ultrasound alone is better. For patients with stage N0, there was no difference in diagnostic efficacy between the three methods. For the assessment of lymph nodes in the I-I II region, there are differences between the three methods of examination: the diagnostic efficiency of ultrasound alone is better, and enhanced MR combined ultrasound is not significantly better than ultrasound alone. For the evaluation of lymph nodes in the IV-VII region, there was no difference in diagnostic efficacy between the three methods. CONCLUSION: According to the clinical characteristics and prognosis of patients with oral cancer, although enhanced MR can better evaluate the tumor, ultrasound may be considered as the preferred imaging method for cervical lymph node metastasis. SIGNIFICANCE: Accurate assessment and proper and timely treatment of lymph node metastasis can help improve the survival rate of patients. PMID:34782121 | DOI:10.1016/j.bulcan.2021.09.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.