Oral mucositis. Is it present in the immunotherapy of the immune checkpoint pd1/pd-l1 against oral cancer? A systematic review

xlomafota13 shared this article with you from Inoreader Oral mucositis. Is it present in the immunotherapy of the immune checkpoint pd1/pd-l1 against oral cancer? A systematic review Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2021 Mar 27:24353. doi: 10.4317/medoral.24353. Online ahead of print. ABSTRACT BACKGROUND: Oral mucositis (OM) is a painful lesion that takes place in the mucosa of the oral cavity, usually its etiology is associated with drug therapies in cancer patients. It is presented as well-defined ulcers whose painful symptomatology sometimes implies the suspension of oncological treatment or parenteral feeding, being therefore an important adverse effect, marking the evolution of these types of therapies against cancer. The present work aim is to know the prevalence of oral mucositis in oral cancer immunotherapy compared to its prevalence in standard therapy. MATERIAL AND METHODS: A protocol was developed for a systematic review following PRISMA® guidelines and a focused question (PICO) was constructed. A comprehensive literature search was conducted on electronic databases including PubMed, the SCOPUS data base, the Cochrane library and the Web of Science (WOS). RESULTS: Six clinical trials were included that met the different inclusion criteria. In these articles, a discrepancy between the prevalence of OM in patients treated with chemotherapy and patients treated with immunotherapy related to the immune checkpoint PD-1/PD-L1 (Nivolumab and Pembrolizumab) was observed. CONCLUSIONS: The prevalence of oral mucositis is lower in new immunotherapy with monoclonal antibodies against oral cancer than drugs used so far (chemotherapy drugs [methotrexate, cisplatin] as well as cetuximab). However, more studies should be carried out to confirm these data. PMID:33772569 | DOI:10.4317/medoral.24353 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cranial fat dissemination following fat grafting for lumbar dural tear: First case report in the literature

xlomafota13 shared this article with you from Inoreader Cranial fat dissemination following fat grafting for lumbar dural tear: First case report in the literature Via leak of cerebrospinal fluid Int J Surg Case Rep. 2021 Mar 22;81:105809. doi: 10.1016/j.ijscr.2021.105809. Online ahead of print. ABSTRACT INTRODUCTION AND IMPORTANCE: Dural tear and cerebrospinal fluid (CSF) leak is among the most common complications in lumbar spine surgery. Although primary dural suturing is the preferred method for repair, this is not always achievable specially with ventrolateral tears. Autologous fat grafting is one of the oldest and effective methods for dural repair which can also be used along with other methods of repair. This case report highlights a unique post spinal surgery complication with comment on how to avoid it. To our knowledge, this has not been previously reported in the literature. CASE PRESENTATION: The authors report a sixty-seven-year-old male with lumbar pseudomeningocele and cranial fat dissemination following fat grafting for non suturable lumbar dural tear. This was demonstrated on magnetic resonance imaging (MRI) af ter her presented with low-pressure headache. CLINICAL DISCUSSION: Intraoperative dural tear is one of the most common complications in spinal surgery. Methods for optimal dural repair including fat grafting have been described but the choice still heavily dependent on the surgeon's preference and experience. Fat graft can migrate leading to potential undesirable further complications like hydrocephalus and aseptic meningitis. CONCLUSION: Cranial fat dissemination following fat grafting for lumbar dural tear should be recognized as a post-operative complication in lumbar spine surgery. It should be considered in case of hydrocephalus or aseptic meningitis post dural fat grafting. Surgeons should utilize adjunct methods to minimize its incidence. PMID:33773369 | DOI:10.1016/j.ijscr.2021.105809 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lacrimal Sac Anterior Border-Maxillary Line Distance: Effect on Endoscopic Dacryocystorhinostomy (EDCR) Surgery Results and NLDO-SS Questionnaire

xlomafota13 shared this article with you from Inoreader Lacrimal Sac Anterior Border-Maxillary Line Distance: Effect on Endoscopic Dacryocystorhinostomy (EDCR) Surgery Results and NLDO-SS Questionnaire Via Otolaryngology Indian Abstract This study aimed to investigate the effect of the maxillary line (ML)-lacrimal sac anterior border (LSA) distance on the results of endoscopic dacryocystorhinostomy (EDCR) operation. The study was designed retrospectively. The distance between LSA and ML was measured from preoperative paranasal sinus computed tomography (PNSCT) images. Nasolacrimal duct obstruction symptom score (NLDO-SS) was calculated before and after surgery. The endoscopically proven of the transition of the 2% fluorescein drop instilled into the eye to the nasal passage accepted as a surgical success. 47 patients included in the study and eight of them underwent bilateral EDCR. The average age of the patients was 50.3 ± 14.8. The LSA-ML distance was 4.2 ± 1.0 mm in all patients. The duration of surgery was found as 38.1 ± 6.1 min for each side. The preoperative NLDO-SS mean was 54.9 ± 11.7 and 22.2 ± 12.1 postoperatively (p = 0.000, CI = 28 .9–36.2). Six patients (11%) required revision surgery. A statistically significant high positive correlation was found between duration of surgery and LSA-ML distance (p = 0.000, r = 0.840). There was a significant negative correlation between the duration of surgery and postoperative NLDO-SS (p = 0.041, r = −0.276). The LSA-ML distance calculated in this study was found to be significantly associated with the decrease in the duration of surgery and the NLDO-SS score obtained after surgery. However, more valid results can be obtained if similar studies are carried out in larger samples containing a sufficient number of revision cases. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Community-acquired Haemophilus influenzae meningitis in adults

xlomafota13 shared this article with you from Inoreader Community-acquired Haemophilus influenzae meningitis in adults Via leak of cerebrospinal fluid J Infect. 2021 Mar 24:S0163-4453(21)00134-1. doi: 10.1016/j.jinf.2021.03.016. Online ahead of print. ABSTRACT BACKGROUND: Haemophilus influenzae is an uncommon cause of meningitis in adults. METHODS: We analyzed episodes of community-acquired H. influenzae meningitis in adults included in a prospective nationwide cohort study in the Netherlands. RESULTS: From 2006 to July 2018, 82 of 2272 (4%) bacterial meningitis episodes were caused by H. influenzae (mean annual incidence 0.5 patients per 1,000,000). Median age was 61 years (IQR 46-68), and 48 episodes (59%) occurred in woman. Predisposing factors were otitis and/or sinusitis in 33 of 76 patients (49%), immunocompromising conditions in 19 of 75 patients (25%) and cerebrospinal fluid leak in 13 of 79 patients (17%). Serotyping showed 63 of 80 isolates (79%) were non-typeable (NTHi). Three patients (4%) died and 14 patients (17%) had an unfavorable outcome (Glasgow Outcome Scale s core < 5 at discharge). Pneumonia (odds ratio [OR] 5.8, 95% confidence interval [95%CI] 1.1-30.8), presence of immunocompromising conditions (OR 6.0, 95%CI 1.5-24.4), and seizures on admission (OR 10.7, 95%CI 1.6-72.8) were associated with an unfavorable outcome, while NTHi was associated with a favorable outcome (OR 5.6, 95%CI 1.6-19.5). CONCLUSION: H. influenzae is an uncommon cause of adult bacterial meningitis patients mainly causing disease in those with predisposing factors, such as CSF leakage, ENT infections, and immunocompromised state. In adult patients the majority of H. influenzae meningitis is caused by non-typeable strains. PMID:33774020 | DOI:10.1016/j.jinf.2021.03.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term follow-up of olfactory and gustatory dysfunction in COVID-19: 6 months case-control study of health workers

xlomafota13 shared this article with you from Inoreader Long-term follow-up of olfactory and gustatory dysfunction in COVID-19: 6 months case-control study of health workers 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 Mar 28. doi: 10.1007/s00405-021-06764-y. Online ahead of print. ABSTRACT PURPOSE: The study aimed to determine the incidence and long-term evolution of COVID-related olfactory (OD) and gustatory (GD) dysfunction, the recovery timeline, and the association with other symptoms. The secondary objective was to identify the predictive clinical factors for the evolution of these symptoms. METHODS: A prospective case-control study was conducted from March 15 to October 15, 2020, in health workers with COVID-19 related symptoms in a tertiary care hospital. 320 patients were included after 6 months of follow-up: 195 in the case group and 125 in the control group. Olfactory dysfunction (OD), dysosmia, and gustatory dysfunction (GD) onset and recovery rate after 6 months follow-up are analyzed in both groups. RESULTS: There were 125 (64.1%) in case group patients with OD and 118 (60.5%) with GD. Total o r partial recovery OD and GD was found in 89%, mainly in the first 2 months. In the control group, there were 14 (11.2%) patients with OD and 33 (26.4%) patients with GD, with 100% of total/partial recovery. CONCLUSION: In both groups, OD and GD showed high-resolution rates during the first two months after the onset of symptoms. Nevertheless, 11% of the case group patients did not show any recovery, and the partial resolution was present in 30% of our patients, at the 6 months follow-up. We found a high correlation between OD and GD, both in the appearance of symptoms and in their recovery. Nasal obstruction and dyspnea have been identified as risk factors for the persistence of symptoms. PMID:33774737 | DOI:10.1007/s00405-021-06764-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lumboperitoneal shunts for the treatment of idiopathic normal pressure hydrocephalus

xlomafota13 shared this article with you from Inoreader Lumboperitoneal shunts for the treatment of idiopathic normal pressure hydrocephalus Via leak of cerebrospinal fluid J Clin Neurosci. 2021 Apr;86:1-5. doi: 10.1016/j.jocn.2020.12.031. Epub 2021 Jan 25. ABSTRACT The standard of care for idiopathic normal pressure hydrocephalus (iNPH) is placement of a ventriculoperitoneal (VP) shunt. However, VP shunts require intracranial intervention and are associated with notable postoperative complications, with some groups reporting complication rates for VP shunts ranging from 17 to 33%, along with failure rates up to 17.7%. Lumboperitoneal (LP) shunts are an alternative for cerebrospinal fluid diversion that do not require intracranial surgery, thus providing utility in patients where intracranial surgery is not possible or preferred. Here we retrospectively reviewed our 25 patients with LP horizontal-vertical (LP-HV) shunts placement for initial treatment for iNPH from 2014 to 2019. All patients had preoperative gait dysfunction, 16 (64%) had urinary incontinence, and 21 (84%) exhibited cognitive insufficiency. Two weeks post-shunt placement, 23/25 (92%) patients demonstrated improvement in gait, 11/16 (68%) had improvement in incontinence, and 14/21 (66%) had improvement cognitive insufficiency. At six months or greater follow up 13/20 (65%) had improvement in gait, 7/15 (47%) showed improvement in incontinence, and 11/15 (73%) demonstrated improvement in cognitive function. Six patients (24%) required at least one revision of the LP shunt. Shunt malfunctions resulted from CSF leak in one patient, shunt catheter migration in two patients, peritoneal catheter pain in one patient, and clinical symptoms for overdrainage in two patients. Thus, we demonstrate that LP-HV shunt placement is safe and efficacious alternative to VP shunting for iNPH, resulting in notable symptomatic improvement and low risk of overdrainage, and may be considered for patients where cranial approaches should be avoided. PMID:33775310 | DOI:10.1016/j.jocn.2020.12.031 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pain management in cancer patients in a Tunisian hospital

xlomafota13 shared this article with you from Inoreader Pain management in cancer patients in a Tunisian hospital Via Association française pour l'étude du cancer Bull Cancer. 2021 Mar 25:S0007-4551(21)00079-5. doi: 10.1016/j.bulcan.2020.12.013. Online ahead of print. ABSTRACT Pain is a common symptom in cancer patients. It is subjective and difficult to communicate. It continues to be outsourced and often overlooked despite the existence of multiple recommendations. The objective of this study is to describe pain management in cancer patients in a Tunisian hospital. This is a prospective study, conducted over one month at the maternity centre of Monastir by an intern in pharmacy using a questionnaire. Of 128 patients assessed, 50 were algic. Twenty-six percent of algic patients were not treated. The neuropathic component of pain was present in 30 % of cases but under treatment. Relief opioids were prescribed in 43 % of cases to relieve pain. Paracetamol was prescribed in 26 % of cases. Ten percent of patients use paracetamol self-medication. Sixteen percent of patients have tried non-pharmacolo gical means, of which 62 % consume plants. To optimise the management of pain at our centre, the available analgesic sheets have been developed, validated by the medical staff and disseminated in the departments of carcinology and oncohematology. Therapeutic education sessions were also scheduled to warn patients about the risks of self-medication and misuse of medicinal plants. Pain management is complex. It requires respect for international recommendations, but especially for the efforts made by all stakeholders. PMID:33775385 | DOI:10.1016/j.bulcan.2020.12.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pioneering Iodine-125-Labeled Nanoscale Covalent Organic Frameworks for Brachytherapy

xlomafota13 shared this article with you from Inoreader Pioneering Iodine-125-Labeled Nanoscale Covalent Organic Frameworks for Brachytherapy Via radioactive iodine Bioconjug Chem. 2021 Mar 28. doi: 10.1021/acs.bioconjchem.1c00040. Online ahead of print. ABSTRACT Brachytherapy has been clinically used for the treatment of malignant solid tumors. However, the classic therapeutic radioactive 125I seed must be surgically implanted directly into tumors. To avoid the surgery and prevent irrational radioactive distribution, radioiodine-loaded nanomaterials are ever-developing for brachytherapy. Hence, it is still a notable challenge to ob tain an advanced material that simultaneously incorporates features of high radiolabeling rate, short labeling time, good radiolabeling stability, and long tumor retention time. Covalent organic frameworks (COFs), which are crystalline polymers with ordered pores, are widely applied in guest delivery of drugs based on their high porosity and modifiable skeleton. Herein, we developed a functionalized nanoscale PEG-COF-Ag material, which could rapidly capture radioiodine reaching a 94% radiolabeling yield in 30 s. In addition, more than 95% 125I was maintained after 24 h in PBS (phosphate-buffered saline) as well as in serum and over 90% for nearly 1 week. PEG-COF-Ag-125I (125I-COF) demonstrated excellent cancer cell killing performance in vitro, and further experiments in vivo revealed a long tumor retention time and effective tumor treatment during the radiotherapy. The results indicate that radioiodine-labeled PEG-COF-Ag could be potentially applied in brachytherapy with a promising therapeutic effect. PMID:33775095 | DOI:10.1021/acs.bioconjchem.1c00040 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emerging and distinct video head impulse test responses in elderly with vestibular symptoms

xlomafota13 shared this article with you from Inoreader Emerging and distinct video head impulse test responses in elderly with vestibular symptoms Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 20:S1808-8694(21)00056-2. doi: 10.1016/j.bjorl.2021.02.011. Online ahead of print. ABSTRACT INTRODUCTION: Dizziness has been reported to be the most common symptom in elderly population. Video head impulse test, VHIT, allows clinicians to assess the vestibular function in elderly individuals, during their initial stages of vestibular symptoms. Inferences from VHIT responses were traditionally low vestibulo-ocular reflex gain or a normal vestibulo-ocular reflex gain. However, the possibility of a third and new variant of the vestibulo-ocular reflex gain has not been clinically explored yet. OBJECTIVES: To determine and report distinct patterns of vestibulo-ocular reflex gain using VHIT in elderly individuals with vestibular symptoms. METHODS: Retrospective cross-sectional study was done on a group of elderly patients who were above 70 years of age. These individuals were subjected to VHIT du ring their symptomatic phase. A vestibulo-ocular reflex gain value between 0.80-01.20 (Horizontal plane) was considered normal. The gain above and below this cutoff range was considered abnormal. RESULTS: 39 elderly patients (15 males and 24 females) whose mean age range was 74.71 years were evaluated for the VHIT response. Vestibulo-ocular reflex gain obtained was categorized into three distinct patterns: (i) normal vestibulo-ocular reflex gain, (ii) reduced vestibulo- ocular reflex gain and (iii) increased vestibulo-ocular reflex gain. The mean vestibulo- ocular reflex gain for both left and right horizontal canals varied significantly between the three groups (p < 0.05). No significant effect of age and vestibulo-ocular reflex gain was noted, though vestibulo-ocular reflex gain was higher in 80 years and above age (p > 0.05). CONCLUSION: Elderly individuals with dizziness may show varying responses with vestibulo-ocular reflex gain during the symptomatic period. The third type of hyperactive vestibule-ocular reflex responses that emerged from the current study were potential indicators of fluid dynamic changes in the inner ear. These responses need to be explored further as it relates to new clinical markers for both peripheral and central vestibular disorders. PMID:33775614 | DOI:10.1016/j.bjorl.2021.02.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary epidural lumbar Ewing sarcoma presenting as cauda equina syndrome in an adult patient who underwent surgical decompression: A case report

xlomafota13 shared this article with you from Inoreader Primary epidural lumbar Ewing sarcoma presenting as cauda equina syndrome in an adult patient who underwent surgical decompression: A case report Via Sociedad Luso-Española de Neurocirugía Neurocirugia (Astur). 2021 Mar 25:S1130-1473(21)00029-4. doi: 10.1016/j.neucir.2021.01.005. Online ahead of print. ABSTRACT Ewing sarcoma (ES) is a rare primary neoplasm in the lumbar adult spine and may mimic a benign tumor. In this case, after a patient's three-month history of lower back pain and rapidly progressing leg numbness and weakness, magnetic resonance imaging (MRI) showed a mass in the third lumbar vertebra. At a two-month follow-up, imaging showed a fracture, compression and lesion enlargement. Decompression and fixation confirmed ES, and the patient began combined radiotherapy and chemotherapy. Two months postoperatively, residual ES was suspected on MRI. The patient underwent a second surgery, and histopathology confirmed necrosis. A six-month follow-up after the first surgery showed no tumor recurrence. This case supports the inclusion of ES in the differential diagnosis of pathologic spinal fracture. Early decompression and spinal fixation are critical for preserving neurologic and spinal functions in ES complicated by a compression fracture. Combined adjuvant radiotherapy and chemotherapy remain the standard therapeutic strategy. PMID:33775555 | DOI:10.1016/j.neucir.2021.01.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of platelet-rich fibrin (PRF) on wound healing, adhesion, and hemostasis after endoscopic sinus surgery in patients with nasal polyposis

xlomafota13 shared this article with you from Inoreader The effect of platelet-rich fibrin (PRF) on wound healing, adhesion, and hemostasis after endoscopic sinus surgery in patients with nasal polyposis Via American Journal of Otolaryngology Publication date: Available online 29 March 2021 Source: American Journal of Otolaryngology Author(s): Hüseyin Sari, Semih Karaketir, Tolgar Lutfi Kumral, Muhammed Fatih Akgun, Berk Gurpınar, Deniz Hanci, Guler Berkiten, Yavuz Uyar View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.