Nutritional problems of patients with COVID‐19 receiving dietetic treatment in primary care

alexandrossfakianakis shared this article with you from Inoreader Nutritional problems of patients with COVID‐19 receiving dietetic treatment in primary care via Journal of Human Nutrition and Dietetics Abstract Background The nutritional problems of patients who are hospitalised for COVID-19 are becoming increasingly clear. However, a large group of patients have never been hospitalised and also seem to experience persistent nutritional problems. The present study describes the nutritional status, risk of sarcopenia and nutrition-related complaints of patients recovering from COVID-19 receiving dietetic treatment in primary care. Methods In this retrospective observational study, data were collected during dietetic treatment by a primary care dietitian between April and December 2020. Both patients who had and had not been admitted to the hospital were included at their first visit to a primary care dietitian. Data on nutritional status, risk of sarcopenia and nutrition-related complaints were collected longitudinally. Results Data from 246 patients with COVID-19 were collected. Mean age was 57 ± 16 years and 61% of the patient population was female. At first consultation, two thirds of patients were classified as overweight or obese (BMI >25 kg/m2). The majority had experienced unintentional weight loss due to COVID-19. Additionally, 55% of hospitalised and 34% of non-hospitalised patients had a high risk of sarcopenia. Most commonly reported nutrition-related complaints were: decreased appetite, shortness of breath, changed or loss of taste, and feeling of being full. Nutrition-related complaints decreased after the first consultation, but remained present over time. Conclusions In conclusion, weight changes, risk of sarcopenia and nutrition-related complaints were prevalent in patients with COVID-19, treated by a primary care dietitian. Nutrition-related complaints improved over time, but remained prevalent until several months after infection. This article is protected by copyright. All rights reserved. View on Web

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Prognostic Utility of Tumor Stage versus American Thyroid Association Risk Class in Thyroid Cancer

alexandrossfakianakis shared this article with you from Inoreader Prognostic Utility of Tumor Stage versus American Thyroid Association Risk Class in Thyroid Cancer via The Laryngoscope The prognostic strengths of American Joint Committee on Cancer (AJCC) staging and American Thyroid Association (ATA) risk classification in well-differentiated thyroid cancer were evaluated. AJCC staging served as a more prognostic model for patient survival compared to ATA risk classification. The greater predictive strength of AJCC staging became less pronounced when multiple additional demographic and clinical factors were considered. Objective To evaluate the prognostic strengths of American Joint Committee on Cancer (AJCC) staging and American Thyroid Association (ATA) risk classification in well-differentiated thyroid cancer (DTC), and their implications in guiding medical decision-making and epidemiological study designs. Methods The 2004–2017 National Cancer Database was queried for DTC patients. Cox proportional hazards (CPH) and Kaplan–Meier analyses modeled patient mortality and overall survival, respectively. Each CPH model was evaluated by its concordance index, measure of explained randomness (MER), Akaike information criterion (AIC), and area under receiver operating characteristic curve (AUC). Results Overall, 134,226 patients were analyzed, with an average age of 48.1 ± 15.1 years (76.9% female). Univariate CPH models using AJCC staging demonstrated higher concordance indices, MERs, and AUCs than those using ATA risk classification (all p < 0.001). Multivariable CPH models using AJCC staging demonstrated higher concordance indices (p = 0.049), MERs (p = 0.046), and AUCs (p = 0.002) than those using ATA risk classification. The AICs of multivariable AJCC staging and ATA risk models were 7.564 × 104 and 7.603 × 104, respectively. AJCC stage I tumors were associated with greater overall survival than those classified as ATA low risk, whereas AJCC stages II-III and stage IV tumors demonstrated worse survival than ATA intermediate- and high-risk tumors, respectively (all p < 0.001). Conclusion AJCC staging may be a more predictive system for patient survival than ATA risk. The prognostic utility of these two systems converges when additional demographic and clinical factors are considered. AJCC staging was found to classify patients across a wider range of survival patterns than the ATA risk stratification system. Level of Evidence 4 Laryngoscope, 2022 View on Web

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Changes in Cough Airflow and Acoustics After Injection Laryngoplasty

alexandrossfakianakis shared this article with you from Inoreader Changes in Cough Airflow and Acoustics After Injection Laryngoplasty via The Laryngoscope We explored the following hypotheses in a cohort of patients undergoing injection laryngoplasty: (1) glottic insufficiency affects voluntary cough airflow dynamics and restoring glottic competence may improve parameters of cough strength, (2) cough strength can be inferred from cough acoustic signal, and (3) glottic competence changes cough sounds and correlates with spectrogram morphology. Our study thus indicates that injection laryngoplasty may help avert aspiration in patients with glottic insufficiency by improving cough effectiveness and that improved cough airflow measures may be tracked with cough sounds. Objective/Hypothesis We explored the following hypotheses in a cohort of patients undergoing injection laryngoplasty: (1) glottic insufficiency affects voluntary cough airflow dynamics and restoring glottic competence may improve parameters of cough strength, (2) cough strength can be inferred from cough acoustic signal, and (3) glottic competence changes cough sounds and correlates with spectrogram morphology. Study Type/Design Prospective interventional study. Methods Subjects with glottic insufficiency secondary to unilateral vocal fold paresis, paralysis, or atrophy, and scheduled for injection laryngoplasty completed an instrumental assessment of voluntary cough airflow using a pneumotachometer and a protocolized voluntary cough sound recording. A Wilcoxon signed-rank test was used to compare the differences between pre- and post-injection laryngoplasty in airflow and acoustic measures. A Spearman rank-order correlation was used to evaluate the association between airflow and acoustic cough measures. Results Twenty-five patients (13F:12M, mean age 68.8) completed voluntary cough airflow measurements and 22 completed cough sound recordings. Following injection laryngoplasty, patients had a statistically significant decreased peak expiratory flow rise time (PEFRT) (mean change: −0.03 s, SD: 0.06, p = 0.04) and increased cough volume acceleration (mean change: 13.1 L/s2, SD: 33.9, p = 0.03), suggesting improved cough effectiveness. Correlation of cough acoustic measures with airflow measures showed a weak relationship between PEFRT and acoustic energy (coefficient: −0.31, p = 0.04) and peak power density (coefficient: −0.35, p = 0.02). Conclusions Our study thus indicates that injection laryngoplasty may help avert aspiration in patients with glottic insufficiency by improving cough effectiveness and that improved cough airflow measures may be tracked with cough sounds. Level of Evidence 3 Laryngoscope, 2022 View on Web

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VEGF and VEGFR family members are expressed by neoplastic cells of NF1-associated tumors and may play an oncogenic role in malignant peripheral nerve sheath tumor growth through an autocrine loop

alexandrossfakianakis shared this article with you from Inoreader VEGF and VEGFR family members are expressed by neoplastic cells of NF1-associated tumors and may play an oncogenic role in malignant peripheral nerve sheath tumor growth through an autocrine loop via Annals of Diagnostic Pathology Publication date: Available online 23 June 2022 Source: Annals of Diagnostic Pathology Author(s): Benjamin Bonsang, Laurent Maksimovic, Pascale Maille, Nadine Martin, Ingrid Laurendeau, Eric Pasmant, Ivan Bièche, Justin Deschamps, Pierre Wolkenstein, Nicolas Ortonne View on Web

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