Frequency of Follow-up of Oral Cavity and Oropharynx Patients and Appropriate Use of Imaging and Other Surveillance Methodology

Abstract

Purpose of Review

The treatment paradigm for oral cavity and oropharyngeal cancer is shifting. As our treatment strategies change, it calls into question whether surveillance strategies warrant change as well. Therefore, the goal of this paper is to critically review the literature with respect to the current pattern and timing of surveillance and the use of post-treatment imaging in patients with oral cavity and oropharyngeal carcinoma.

Recent Findings

Recent studies suggest that routine surveillance does not improve overall survival, but it does improve locoregional control. Imaging does play an important role in post-operative surveillance.

Summary

Survival following treatment for head and neck cancer is improving. While routine surveillance may not improve overall survival, it still has benefit for patients, particularly in detecting and managing anxiety and post-operative complications.

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The Value of Urgent and Emergent Care in Otolaryngology

Abstract

Purpose of Review

The aim of this report is to review the literature regarding the value of care provided for urgent and emergent otolaryngologic conditions and to investigate alternative models of health care delivery.

Recent Findings

Ear, nose, and throat problems comprise a large portion of chief complaints in emergency departments (EDs). Otolaryngologic conditions are predominantly low acuity and may be handled on an outpatient basis, leading to a potential mismatch between the needs of the patient and the level of resources expended. Alternative models have been investigated both in otolaryngology and in other medical specialties, but the implications for quality of care and cost are uncertain.

Summary

Urgent and emergent care for ear, nose, and throat conditions is not well studied and is ripe for new models of health care delivery, which may include specialty-specific EDs, clinics, and urgent care centers. Economic analysis of the models will be essential to provide evidence of value and is currently lacking.

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Fluid management concepts for severe neurological illness: an overview

Purpose of review The acute care of a patient with severe neurological injury is organized around one relatively straightforward goal: avoid brain ischemia. A coherent strategy for fluid management in these patients has been particularly elusive, and a well considered fluid management strategy is essential for patients with critical neurological illness. Recent findings In this review, several gaps in our collective knowledge are summarized, including a rigorous definition of volume status that can be practically measured; an understanding of how electrolyte derangements interact with therapy; a measurable endpoint against which we can titrate our patients' fluid balance; and agreement on the composition of fluid we should give in various clinical contexts. Summary As the possibility grows closer that we can monitor the physiological parameters with direct relevance for neurological outcomes and the various complications associated with neurocritical illness, we may finally move away from static therapy recommendations, and toward individualized, precise therapy. Although we believe therapy should ultimately be individualized rather than standardized, it is clear that the monitoring tools and analytical methods used ought to be standardized to facilitate appropriately powered, prospective clinical outcome trials. Correspondence to Boris D. Heifets, MD, PhD, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 300 Pasteur Drive Rm H3580, Stanford, CA 94305, USA. Tel: +1 650 497 8057; fax: +1 650 725 8544; e-mail: bheifets@stanford.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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In Response

No abstract available

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Special Cardiac Arrest Situations in the Perioperative Period

No abstract available

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Experience of Airway Management Training Program for Low- and Middle-Income Countries

No abstract available

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New biologics in the treatment of urticaria

Purpose of review Symptomatic management of chronic spontaneous urticaria (CSU) basically depends on second-generation H1 antihistamines and omalizumab. Omalizumab is a game changer in the management, but still there is a need for new targets and new biologics targeting new pathways in the treatment which will provide long-lasting remission, which will be given orally and which will be cheaper. This review will focus on new biologics that are underway of production or are already under use for different disorders but could be beneficial for the treatment of Chronic urticaria. Recent findings In this review, the treatment targets are classified according to the cells which are involved in the pathogenesis of CSU. Those are mast cells/basophils, B cells, T cells and eosinophils. The treatments that are under clinical trials for CSU are anti-IgE treatments such as ligelizumab, molecules targeting intracellular signaling pathways such as spleen tyrosine kinase inhibitors, surface inhibitory molecules such as siglec-8, anti-IL-1s such as canakinumab, Bruton kinase (BTK) inhibitors such as GDC-0853 and anti-IL-5s such as benralizumab and mepolizumab. Summary The ongoing clinical trials on new targets of treatment hold new hopes not only for a better care of the disease but also a better understanding of the pathomechanisms lying underneath. Correspondence to Emek Kocatürk, Department of Dermatology, Okmeydanı Training and Research Hospital, Darulaceze Caddesi, Sisli, Istanbul, Turkey. Tel: +90 2123146300; e-mail: emekozgur@yahoo.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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