Magnesium alginate versus proton pump inhibitors for the treatment of laryngopharyngeal reflux: a non-inferiority randomized controlled trial

xlomafota13 shared this article with you from Inoreader Magnesium alginate versus proton pump inhibitors for the treatment of laryngopharyngeal reflux: a non-inferiority randomized controlled trial 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. 2022 Jan 15. doi: 10.1007/s00405-021-07219-0. Online ahead of print. ABSTRACT PURPOSE: Proton pump inhibitors (PPIs) are commonly prescribed for laryngopharyngeal reflux (LPR), but their efficacy remains debated. Alginates is an option for the treatment of LPR with few adverse effects. The study aimed to investigate the non-inferiority of an alginate suspension (Gastrotuss®) compared to PPIs (Omeprazole) in reducing LPR symptoms and signs. METHODS: A non-inferiority randomized controlled trial was conducted. Fifty patients with laryngopharyngeal symptoms (Reflux Symptom Index -RSI- ≥ 13) and signs (Reflux Finding Score -RFS- ≥ 7) were randomized in two treatment groups: (A) Gastrotuss® (20 ml, three daily doses) and, (B) Omeprazole (20 mg, once daily). The RSI and the RFS were assessed at baseline and after 2 months of treatment. RESULTS: Groups had similar RSI and RFS scores at baseline. From pre- to 2-month posttreatment, the mean RSI significantly decreased (p = 0.001) in alginate and PPI group (p = 0.003). The difference between groups in the RSI change was not significant (95%CI: - 4.2-6.7, p = 0.639). The mean RFS significantly decreased in alginate (p = 0.006) and PPI groups (p = 0.006). The difference between groups in the mean change RFS was not significant (95%CI: - 0.8; 1.4, p = 0.608). CONCLUSION: After 2 months of treatment, LPR symptoms and signs are significantly reduced irrespective of the treatment. Alginate was non-inferior to PPIs and may represent an alternative treatment to PPIs for the treatment of LPR. PMID:35032204 | DOI:10.1007/s00405-021-07219-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterior Cervical Discectomy and Fusion Using Zero-P System for Treatment of Cervical Spondylosis: A Meta-Analysis

xlomafota13 shared this article with you from Inoreader Anterior Cervical Discectomy and Fusion Using Zero-P System for Treatment of Cervical Spondylosis: A Meta-Analysis Via Traditional dysphagia therapy Pain Res Manag. 2021 Dec 16;2021:3960553. doi: 10.1155/2021/3960553. eCollection 2021. ABSTRACT OBJECTIVE: The current study aimed to explore the efficacy of Zero profile intervertebral fusion system (Zero-P) and traditional anterior plate cage system (PC) in the treatment of cervical spondylotic myelopathy (CSM). Further, the present study evaluated effects of the treatments on medical security, height of intervertebral disc, adjacent-level ossification development (ALOD), and adjacent segmentation disease (ASD) through a systematic retrospective analysis. METHODS: Studies on Zero-P system and traditional anterior plate cage system for ACDF in the treatment of CSM were searched in PubMed, Web of Science, Ovid, Embase, and Cochrane Library databases. Two independent researchers screened articles, extracted data, and evaluated the quality of the articles based on the inclusion and exclusion criteria of the current study. RevMan5.3 softwa re was used for meta-analysis following the guidelines of Cochrane collaboration network. Cervical curvature, interbody fusion rate, preoperative and postoperative disc height index (DHI), fusion cage sinking rate, postoperative dysphagia, ASD, ALOD, and loosening of screw were compared between the two groups. RESULTS: A total of 17 literatures were included in the present study, including 6 randomized controlled trials and 11 observational studies. The studies comprised a total of 1204 patients with CSM, including 605 patients in the Zero-P system group (Zero-P group) and 599 patients in the traditional animal plate cage group (PC group). Results of this meta-analysis showed that postoperative dysphagia [OR = 0.40, CI (0.28, 95% 0.58), P < 0.00001], ALOD [OR = 0.09, CI (0.02, 95% 0.39), P = 0.001], ASD [OR = 0.42, CI (0.20, 95% 0.86), P = 0.02], and screw loosening [OR = 0.20, CI (0.08, 95% 0.52), P = 0.0009] of the Zero-P group were significant ly lower compared with the PC group. On the other hand, preoperative cervical curvature [WMD = -0.23, CI (-1.38, 95% 0.92), P = 0.69], postoperative cervical curvature [WMD = -0.38, CI (-1.77, 95% 1.01), P = 0.59], cage sinking rate [OR = 1.41, CI [0.52, 95% 3.82], P = 0.50], intervertebral fusion rate [OR = 0.76, CI (0.27, 95% 2.48), P = 0.38], preoperative DHI [WMD = -0.04, CI (-0.14, 95% 0.22), P = 0.65], and postoperative DHI [WMD = 0.06, CI (-0.22, 95% 0.34), P = 0.675] were not significantly different between the two groups. CONCLUSION: It was evident that the Zero-P system used in ACDF is superior compared with the traditional anterior plate cage system in postoperative dysphagia, avoiding ALOD, ASD, and screw loosening. PMID:34956433 | PMC:PMC8702348 | DOI:10.1155/2021/3960553 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Interpretable Machine Learning–Based Prediction of Intraoperative Cerebrospinal Fluid Leakage in Endoscopic Transsphenoidal Pituitary Surgery: A Pilot Study

xlomafota13 shared this article with you from Inoreader Interpretable Machine Learning–Based Prediction of Intraoperative Cerebrospinal Fluid Leakage in Endoscopic Transsphenoidal Pituitary Surgery: A Pilot Study Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1740621 Purpose Transsphenoidal surgery (TSS) for pituitary adenomas can be complicated by the occurrence of intraoperative cerebrospinal fluid (CSF) leakage (IOL). IOL significantly affects the course of surgery predisposing to the development of postoperative CSF leakage, a major source of morbidity and mortality in the postoperative period. The authors trained and internally validated the Random Forest (RF) prediction model to preoperatively identify patients at high risk for IOL. A locally interpretable model-agnostic explanations (LIME) algorithm is employed to elucidate the main drivers behind each machine learning (ML) model prediction. Methods The data of 210 patients who underwent TSS were collected; first, risk factors for IOL were identified via conventional statistical methods (multivariable logistic regression). Then, the authors trained, optimized, and audited a RF prediction model. Results IOL reported in 45 patients (21.5%). The recursive feature selection algorithm identified the following variables as the most significant determinants of IOL: Knosp's grade, sellar Hardy's grade, suprasellar Hardy's grade, tumor diameter (on X, Y, and Z axes), intercarotid distance, and secreting status (nonfunctioning and growth hormone [GH] secreting). Leveraging the predictive values of these variables, the RF prediction model achieved an area under the curve (AUC) of 0.83 (95% confidence interval [CI]: 0.78; 0.86), significantly outperforming the multivariable logistic regression model (AUC = 0.63). Conclusion A RF model that reliably identifies patients at risk for IOL was successfully trained and internally validated. ML-based prediction models can predict events that were previously judged nearly unpredictable; their deployment in clinical practice may result in improved patient care and reduced postoperative morbidity and healthcare costs. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss

xlomafota13 shared this article with you from Inoreader Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This systematic review and meta-analysis evaluates recent evidence on the effect of hyperbaric oxygen therapy on hearing outcomes in patients with sudden sensorineural hearing loss to determine if this treatment should be part of a combination regimen. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tumor Site and the Prognosis and Immunogenomics of HPV-Related Cancers

xlomafota13 shared this article with you from Inoreader Tumor Site and the Prognosis and Immunogenomics of HPV-Related Cancers Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cohort study categorizes tumors of the head and neck and the cervix by human papillomavirus (HPV) positivity status and compares their immunogenomic landscapes and associations with survival. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Performance on Dichotic Auditory Tests With Risk for Incident Dementia and Alzheimer Dementia

xlomafota13 shared this article with you from Inoreader Association of Performance on Dichotic Auditory Tests With Risk for Incident Dementia and Alzheimer Dementia Via JAMA Otolaryngology–Head & Neck Surgery Current Issue This cohort study examines associations between signal sen sitivity, central auditory processing, and dementia and Alzheimer dementia risk. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss

xlomafota13 shared this article with you from Inoreader Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss Via JAMA Otolaryngology–Head & Neck Surgery Current Issue The treatment of idiopathic sudden sensorineural hearing loss (SSNHL) continues to be a substantial clinical challenge, in part because of the heterogeneity of the patient population and in part because of the difficulty of studying a disorder with no known causes and no defined, proven, or widely accepted course of clinical intervention. We read with interest the systematic review and meta-analysis by Joshua and colleagues on hyperbaric oxygen therapy (HBOT) for patients with SSNHL. Rhee and colleagues published a review of the same topic i n 2019; however, their conclusions were criticized for significant heterogeneity of the pooled studies, which introduced potentially unsurmountable bias. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.