Intermediate-risk thyroid carcinoma: indicators of a poor prognosis

xlomafota13 shared this article with you from Inoreader Intermediate-risk thyroid carcinoma: indicators of a poor prognosis Via radioactive iodine Arch Endocrinol Metab. 2021 May 18;64(6):764-771. doi: 10.20945/2359-3997000000290. ABSTRACT OBJECTIVE: The intermediate-risk (IR) category includes tumors with different degrees of aggression. We aimed to identify the risk factors associated with unfavorable response to initial treatment and compare the effect of low/high radioactive iodine (RAI) therapy. METHODS: A total of 614 IR patients were selected from a database, during 1972-2015. All patients underwent total thyroid ectomy and RAI therapy and were reclassified after 12-18 months into the favorable (complete/indeterminate) response group and the unfavorable (biochemical/incomplete structural) response group. A total of 92 patients were assessed for late response (mean: 9.19 ± 5.73 years). Age, gender, tumor size, histology, multifocality, vascular invasion, extrathyroidal extension, presence and number of lymph node metastasis, and stimulated thyroglobulin at ablation (sTg) were evaluated. RESULTS: Mean age at diagnosis was 41.47 ± 15.81 years, and 83.6% of the patients were female. Within 12-18 months after initial therapy, unfavorable response was detected in 41.2% of the patients and was associated, in multivariate analysis, with lymph node metastasis (p = 0.041; odds ratio [OR] = 1.9), presence of more than five metastatic lymph nodes (p = 0,017; OR = 2.6), and sTg > 10 ng/mL (p = 0.005; OR = 10.0). For patients with a longer follow-up, sTg >10 ng/mL was associated with unfavor able response (p = 0.002; OR = 6.8). A higher RAI dose was not related to better prognosis at the end of the follow-up. CONCLUSION: A sTg level of >10 ng/mL and lymph node metastasis were associated with an unfavorable response 12-18 months after initial treatment. A RAI dose below 150 mCi was proven sufficient to treat IR patients. PMID:34033287 | DOI:10.20945/2359-3997000000290 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oral changes in cocaine abusers: an integrative review

xlomafota13 shared this article with you from Inoreader Oral changes in cocaine abusers: an integrative review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 May 14:S1808-8694(21)00083-5. doi: 10.1016/j.bjorl.2021.04.011. Online ahead of print. ABSTRACT INTRODUCTION: Cocaine is one of the most often used psychoactive drugs worldwide, being extracted from the leaves of Erytroxylus coca plant. Its abusive use can trigger several consequences for the human body, including the oral cavity. OBJECTIVE: To identify the oral disorders that are most commonly found in individuals who abuse cocaine, in addition to the main diagnostic and treatment methods. METHODS: An integrative review was carried out on the databases: LILACS, BBO, LIS, MEDLINE, SciELO, Science Direct and PubMed. The following keywords were used: "Cocaína", "Boca", "Palato" and "Odontologia", together with their synonyms and variations in English, obtained from DeCS and MeSH. The inclusion criteria were original articles, articles in Portuguese, English and Spanish, studies involving individ uals, without restriction related to the year of publication. Animal studies, literature reviews, book chapters, theses and dissertations were excluded. RESULTS: In total, 1373 records were identified. Of these, 22 articles were selected to comprise the review. Several oral alterations caused by cocaine abuse were found, primarily perforation of the palate, predisposition to periodontal diseases, temporomandibular disorders, bruxism, damage to oral tissues, dental caries, destructive lesions of the facial midline, xerostomia and ageusia. Among the diagnostic methods used by the professionals, anamnesis, intraoral examinations and head and neck computed tomography were the most frequently mentioned. As for treatment, in patients with palatal perforation, the reconstruction of the affected area or the use of prosthetic obturators is carried out. CONCLUSION: The management of these patients is not an easy task, as many of the users do not even seek professional help. The he alth professionals must be able to recognize these manifestations and alterations to establish timely and accurate diagnosis and treatment planning. PMID:34034978 | DOI:10.1016/j.bjorl.2021.04.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical implications of intraoperative eABRs to the Evo®-CI electrode array recipients

xlomafota13 shared this article with you from Inoreader Clinical implications of intraoperative eABRs to the Evo®-CI electrode array recipients Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 May 14:S1808-8694(21)00084-7. doi: 10.1016/j.bjorl.2021.04.012. Online ahead of print. ABSTRACT INTRODUCTION: Electrically evoked auditory brainstem responses provide reliable clinical information to assist professionals in the auditory rehabilitation of cochlear implant users. OBJECTIVE: This study aimed to investigate intraoperative evoked auditory brainstem response recordings in Evo®-cochlear implant electrode array recipients and its correlation with their behavioral levels and auditory performance. METHODS: This is a retrospectivey study. Intraoperative evoked auditory brainstem responses were recorded in adult Evo®-cochlear implant electrode array recipients. Wave V latencies, amplitudes and interpeak III-V intervals were recorded in three different electrode locations and compared to the sentence recognition scores obtained from subjects after six months of device use. Evoked auditory brainstem responses thresholds were also recorded and compared to the behaviorally determined levels of the subjects in the sound processor activation. RESULTS: Evoked auditory brainstem responses thresholds were significantly correlated with both, behavioral T- and C-levels and they were recorded at audible electrical stimulation levels in all subjects. There was a significant correlation between interpeak III-V interval recorded in the apical electrode and sentence recognition scores of the subjects. CONCLUSIONS: Intraoperative evoked auditory brainstem responses can be used to establish audible levels for fitting the sound processor in Evo®-cochlear implant recipients and it could help professionals to plan further actions aiming to improve their auditory performance. PMID:34034979 | DOI:10.1016/j.bjorl.2021.04.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary intraoral epithelioid hemangioendothelioma of the tongue: a case report and review of literature

xlomafota13 shared this article with you from Inoreader Primary intraoral epithelioid hemangioendothelioma of the tongue: a case report and review of literature Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 May 13:S1808-8694(21)00082-3. doi: 10.1016/j.bjorl.2021.04.010. Online ahead of print. NO ABSTRACT PMID:34034980 | DOI:10.1016/j.bjorl.2021.04.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Pediatric Lateral Submental Mass: A Rare Presentation of Dermoid Cyst

xlomafota13 shared this article with you from Inoreader A Pediatric Lateral Submental Mass: A Rare Presentation of Dermoid Cyst Via ear nose throat Ear Nose Throat J. 2021 May 25:1455613211019787. doi: 10.1177/01455613211019787. Online ahead of print. ABSTRACT Dermoid cysts are benign cutaneous neoplasms that contain germ cells from the ectoderm and mesoderm. Approximately 70% are diagnosed during childhood before the age of 5. Although they can present throughout the body, the prevalence is 7% for those arising from the head and neck. These lesions present primarily as midline masses and are classified as sublingual, su bmental, or overlapping depending on their relationship with the muscles of the floor of mouth. A 10-year-old female presented with a 2-week history of right submental swelling. She denied pain, dysphagia, odynophagia, or respiratory distress. Physical examination showed nontender fullness of the submental region without erythema or induration and no palpable cervical lymphadenopathy. Ultrasound showed an oval-shaped cystic mass measuring 4.8 × 4.0 × 2.6 cm. After a course of clindamycin, a computed tomography was obtained which showed a right 4.5 × 4.0 × 2.6 cm fluid filled lesion, within the right lateral floor of mouth. Intraoral resection was performed and the mass was freed from the geniohyoid and mylohyoid. Histopathology was consistent with a dermoid cyst. Submental masses have a broad differential, but rarely are they dermoid cysts if they arise lateral to the midline. With appropriate diagnosis and total surgical excision, patients and their families can be reassured in similar cases. PMID:34034545 | DOI:10.1177/01455613211019787 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID‐19 Cross infection rate after surgical procedures. Incidence and outcome

xlomafota13 shared this article with you from Inoreader COVID‐19 Cross infection rate after surgical procedures. Incidence and outcome Via The Laryngoscope Abstract Introduction Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) is transmitted by droplet as well as airborne infection. Surgical patients are vulnerable to the infection during their hospital admission. Some surgical procedures are classified as aerosol generating (AGP). Methods Retrospective observational study in a tertiary healthcare centre of four specialities associate with known AGP's during the four months of the first wave of UK COVID-19 epidermic to identify post-surgical cross infection with SARSCoV-2 within 14 days of a procedure. Results There were 3410 procedures reported during this period. The overall cross infection rate from tested patients was 1.3% (4 patients), i.e., 0.11% of all operations over 4 months. Ear, nose, and throat carried slightly higher rate of infection (0.4%) than gastroenterology (0.08%). The mortality rate was 0.3% (one gastroenterology patient from 304 positive cases) compared to 0% if surgery performed after recovery from SARSCoV-2 and 37.5% when surgery was conducted during the incubation period of the disease. Routine preoperative rapid screening tests and self-isolation is crucial to avoid the risk of cross infection. Patients with underlying malignancy or receiving chemotherapy were more prone to pulmonary complications and mortality. Conclusion The risk of SARS-COV-2 cross infection after surgical procedure is very low. Preoperative screening and self-isolation together with personal protective measures should be in place to minimize the cross infection. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Percutaneous and open tracheostomy in patients with COVID‐19: The Weill Cornell experience in New York City

xlomafota13 shared this article with you from Inoreader Percutaneous and open tracheostomy in patients with COVID‐19: The Weill Cornell experience in New York City Via The Laryngoscope Abstract Objective Report long-term tracheostomy outcomes in patients with COVID-19. Methods Prospectively collected data were extracted for adults with COVID-19 undergoing percutaneous or open tracheostomy between April 4 and June 2, 2020 at a major medical center in New York City. The primary endpoint was weaning from mechanical ventilation. Secondary outcomes included sedation weaning, decannulation, and discharge. Results 101 patients underwent tracheostomy, including 48 percutaneous (48%) and 53 open (52%), after a median intubation time of 24 days (IQR 20, 31). The most common complication was minor bleeding (n = 18, 18%). The all-cause mortality rate was 15% and no deaths were attributable to the tracheostomy. Eighty-three patients (82%) were weaned off mechanical ventilation, 88 patients (87%) were weaned off sedation, and 72 patients (71%) were decannulated. Censored median times from tracheostomy to sedation and ventilator weaning were 8 (95% CI 6–11) and 18 (95% CI 14–22) days, respectively (uncensored: 7 and 15 days). Median time from tracheostomy to decannulation was 36 (95% CI 32–47) days (uncensored: 32 days). Of those decannulated, 82% were decannulated during their index admission. There were no differences in outcomes or complication rates between percutaneous and open tracheostomy. Likelihood of discharge from the ICU was inversely related to intubation time, th ough the clinical relevance of this was small (HR 0.97, 95% CI 0.943–0.998; p = 0.037). Conclusion Tracheostomy by either percutaneous or open technique facilitated sedation and ventilator weaning in patients with COVID-19 after prolonged intubation. Additional study on the optimal timing of tracheostomy in patients with COVID-19 is warranted. Level of Evidence 3 This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal Sarcoidosis and Swallowing: What Do We Know About Dysphagia Assessment and Management in this Population?

xlomafota13 shared this article with you from Inoreader Laryngeal Sarcoidosis and Swallowing: What Do We Know About Dysphagia Assessment and Management in this Population? Via swallowing exercises Dysphagia. 2021 May 26. doi: 10.1007/s00455-021-10305-4. Online ahead of print. ABSTRACT INTRODUCTION: Sarcoidosis is a chronic granulomatous disease of unknown aetiology and laryngeal involvement is seen in a small percentage of cases. Dysphagia is a common but under-reported symptom. Little is known about how dysphagia typically presents or is managed in the context of this fluctuating disease. We present our case series using an SLT-led model of assessment and management. METHODS: A literature search was conducted for any articles that reported both laryngeal sarcoidosis and dysphagia. We then analysed a case series of laryngeal sarcoidosis patients treated at Charing Cross Hospital. We report on multidimensional swallowing evaluation and rehabilitative interventions. RESULTS: Seventeen papers report both laryngeal sarcoidosis and dysphagia, with only one paper giving details on the nature of the dysphagia and the treatment provided. In our case series (n = 7), patients presented with FOIS Scores ranging from 5 to 7 pre-operatively (median = 6). Aspiration (median PAS Score = 6 and Range = 3-8) and pharyngeal residue were common. Sensory issues were also prevalent with most unaware of the extent of their difficulties. Management interventions included safe swallowing advice, compensatory strategies, exercises and close surveillance given their potential for repeated surgical interventions. CONCLUSION: Laryngeal sarcoidosis is a rare condi tion. Dysphagia is under-reported and our experience highlights the need for specialist dysphagia intervention. Further research is required to understand dysphagia management requirements in the context of this fluctuating disease process. PMID:34037851 | DOI:10.1007/s00455-021-10305-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Potential protective effect of hesperidin on hypoxia/reoxygenation-induced hepatocyte injury

xlomafota13 shared this article with you from Inoreader Potential protective effect of hesperidin on hypoxia/reoxygenation-induced hepatocyte injury Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jul;22(1):764. doi: 10.3892/etm.2021.10196. Epub 2021 May 13. ABSTRACT Hesperidin (HDN) has been reported to have hydrogen radical- and hydrogen peroxide-removal activities and to serve an antioxidant role in biological systems. However, whether HDN protects hepatocytes (HCs) against hypoxia/reoxygenation (H/R)-induced injury remains unknown. The present study aimed to explore the role of HDN in H/R-induced injury. HCs were isolated and cultured under H/R conditions with or without HDN treatment. HC damage was markedly induced under H/R, as indicated by cell viability, supernatant lactate dehydrogenase levels and alanine aminotransferase levels; however, HDN treatment significantly reversed HC injury. Oxidative stress markers (malondialdehyde, superoxide dismutase, glutathioneand reactive oxygen species) were increased markedly during H/R in HCs; however, this effect was significantly attenuated after exposure to HDN . Compared with those of the control group, the mRNA expression levels of IL-6 and TNF-α in HCs and the concentrations of IL-6 and TNF-α in the supernatants increased significantly following H/R, and HDN significantly ameliorated these effects. Western blotting demonstrated that microtubule-associated protein 1 light chain 3α (MAP1LC3A, also known as LC3) and Beclin-1 protein expression levels increased, while sequestosome 1 levels decreased during H/R following exposure to HDN. The number of GFP-LC3 puncta in HCs following exposure to HDN was increased compared with that observed in HCs without HDN exposure under the H/R conditions after bafilomycin A1 treatment. In summary, the present study demonstrated that HDN attenuated HC oxidative stress and inflammatory responses while enhancing autophagy during H/R. HDN may have a potential protective effect on HCs during H/R-induced injury. PMID:34035861 | PMC:PMC8135133 | DOI:10.3892/etm.2021.10196 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dynamics of serum α-fetoprotein in viral hepatitis C without hepatocellular carcinoma

xlomafota13 shared this article with you from Inoreader Dynamics of serum α-fetoprotein in viral hepatitis C without hepatocellular carcinoma Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jul;22(1):749. doi: 10.3892/etm.2021.10181. Epub 2021 May 12. ABSTRACT Viral hepatitis C represents a significant liver pathology worldwide, with a detrimental impact on national health systems. The present study aimed to correlate the levels of serum α-fetoprotein (AFP) with prognostic tools such as Fibroscan®, the presence of mixed cryoglobulinemia, and various demographic and standard biochemical markers, in patients with chronic hepatitis C, unrelated to hepatocellular carcinoma (HCC). A clinical study was designed considering three study groups: Hepatitis C virus (HCV) group including 35 patients with chronic hepatitis C and detectible viral load; sustained viral response (SVR) group including 20 HCV patients without detectable virus load 12 weeks after therapy cessation; a control group represented by 37 healthy volunteers. It was observed that serum AFP was moderately increased in the HCV and SVR groups and was positively correlated with aspartate transaminase (AST), alkaline phosphatase (AP), and γ-glutamyl transferase (GGT). The incidence of mixed cryoglobulinemia was increased in the HCV group, and the degree of fibrosis assessed by Fibroscan® was increased in both the HCV and SVR groups. In conclusion, the data revealed that a moderate increase in AFP levels could be present in patients with HCV even in the absence of HCC, unrelated to viral load or therapy response and that there was a linear positive correlation between serum levels of AFP and the degree of hepatic cytolysis and cholestasis. Additionally, mixed cryoglobulinemia was present in HCV patients with patent viral load, decreasing in those with SVR after therapy cessation unrelated to any renal impairment, while the degree of fibrosis was increased in HCV-infected patients, with no reversibility 12 weeks after successful therapy. PMID:34035846 | PMC:PMC8135122 | DOI:10.3892/etm.2021.10181 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of withdrawing an atherogenic diet on the atherosclerotic plaque in rabbits

xlomafota13 shared this article with you from Inoreader Effects of withdrawing an atherogenic diet on the atherosclerotic plaque in rabbits Via Experimental and therapeutic medicine Exp Ther Med. 2021 Jul;22(1):751. doi: 10.3892/etm.2021.10183. Epub 2021 May 12. ABSTRACT Lifestyle interventions and pharmacotherapy are the most common of non-invasive treatments for atherosclerosis, but the individual effect of diet on plaques remains unclear. The current study aimed to investigate the effect of withdrawing the atherogenic diet on plaque in the aortas of rabbits. Experimental atheroma was induced in 33 rabbits using a 1% high cholesterol diet for 30 days (H-30 d) or 90 days (H-90 d, baseline group). After 90 days of the atherogenic diet, the remaining animals were divided into four groups: A total of 10 rabbits continued to consume the atherogenic diet for 50 days (H-90 d & H-50 d; n=5) or 140 days (H-90 d & H-140 d; n=5). Another 13 rabbits were switched to a chow diet for 50 days (H-90 d & C-50 d; n=7) or 140 days (H-90 d & C-140 d; n=6). A total of 10 age-matched rabbits in the control groups were fed a chow diet for 90 and 230 days, respectively. The en face or cross-sectional plaque areas were determined using oil red O staining and elastic van Gieson staining. Immunohistochemistry analyses were used to assess the macrophages or smooth muscle cell contents. When fed an atherogenic diet for 90 days, the rabbits' abdominal aortas exhibited severe atherosclerotic lesions (the median en face plaque area was 63.6%). After withdrawing the atherogenic diet, the plaque area did not shrink with feeding the chow diet compared with the baseline, but increased to 71.8 or 80.5% after 50 or 140 days, respectively. After removing cholesterol from the diet, the lipids content in the plaques increased during the first 50 days, and then decreased compared with the baseline group. Furthermore, withdrawing the atherogenic diet increased the total collagen content and the percentage of the smooth muscle cells, alleviated macrophage infiltration, decreased the vulnerable index and promoted the cross-linking of collagen. Feeding the rabbits an atherogenic diet followed by removal of cholesterol from the diet did not lead to the regression of established lesions but instead delayed the progression of the lesions and promoted the stabilization of the plaque. PMID:34035848 | PMC:PMC8135140 | DOI:10.3892/e tm.2021.10183 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.