Head and Neck Medicine by Alexandros G.Sfakianakis

We retrieved the sample for this case‐control study from the Taiwan "Longitudinal Health Insurance Database 2005". All 557 patients aged 40 years or older with a diagnosis of sialolithiasis were cases and 1671 matched controls (without sialolithiasis) were selected.

Subjects and Methods

We used the chi‐square test to explore differences between cases and controls on socio‐demographic characteristics. Furthermore, conditional logistic regressions were used to examine the association of sialolithiasis with previously diagnosed osteoporosis.

Results

Of 2228 sampled patients, 171 (7.68%) had ever been previously diagnosed with osteoporosis; 58 (10.41%) among cases and 113 (6.76%) among controls (p=0.005). Conditional logistic regression analysis found that the odds ratio (OR) of prior osteoporosis for cases was 1.79 (95% confidence interval [CI]: 1.24‐2.59, p=0.002) relative to controls after adjusting for urbanization, and the selected medical co‐morbidities. Furthermore, we found that among patients aged ≥65 years, the adjusted OR of prior osteoporosis for cases was 1.89 (95% CI=1.02‐3.51).No significant relationship was observed among patients aged <65 years old.

Conclusion

This study demonstrates an association between sialolithiasis and osteoporosis. Although the finding warrants further investigation, the results call for more awareness of the possible concurrence of osteoporosis among physicians and patients with salivary gland stones.

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Use of psychologic strategies to reduce pain and anxiety related to dermatology procedures

Abstract

The fear of painful procedures is at an increased incidence within the pediatric population. This can be an extremely challenging obstacle in dermatology where injections, blood draws, and cryotherapy are often required during the care of patients. Psychologic techniques based on cognitive behavioral therapy (CBT) can be implemented leading up to and while performing these procedures to help reduce patient anxiety.

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Lessons from times of shortage: interchangeability of venom preparations and dosing protocols

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Κυριακή 10 Φεβρουαρίου 2019

False negative rate of fine‐needle aspiration in thyroid nodules: impact of nodule size and ultrasound pattern

Abstract

Background

To retrospectively evaluate the false negative rate of ultrasound‐guided fine needle aspiration (FNA) according to the nodule size and ultrasound pattern.

Methods

We included 432 consecutive thyroid nodules from 384 patients who underwent ultrasound‐guided FNA with benign results (≥1 cm). The false negative rate in the nodules was assessed according to the nodule size and ultrasound pattern based on the Korean‐Thyroid Imaging Reporting and Data System (K‐TIRADS).

Results

The overall false negative rate was 3.2%. There was a trend toward an increasing false negative rate as the K‐TIRADS score increased (P < .001). In low or high suspicion nodules (K‐TIRADS 3 and 5), there was no significant difference in false negative rate according to the nodule size; however, among the intermediate suspicion nodules (K‐TIRADS 4), the false negative rate was higher in large nodules (≥3 cm, P = .039).

Conclusion

The impact of nodule size on the false negative rate differed according to the ultrasound pattern.

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Botulinum toxin A for pain reduction in pediatric patients with Parry‐Romberg syndrome

Abstract

Parry‐Romberg syndrome (PRS) is characterized by hemiatrophy of facial structures, including skin, subcutaneous fat, muscle, bone, and cartilage. Complications associated with PRS include headaches, seizures, and chronic facial pain. Protocol for the treatment of chronic facial pain is not clear; reports on the use of botulinum toxin A injections for pain reduction in adults but not in the pediatric/adolescent population are available. Here, we discuss two pediatric PRS cases in which treatment with botulinum toxin A injections reduced or eliminated facial pain.

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