Αρχειοθήκη ιστολογίου

Τετάρτη 23 Φεβρουαρίου 2022

Value of six comorbidity scales for predicting survival of patients with primary surgery for oral squamous cell carcinoma

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Abstract

Background

Comorbidities influence treatment outcome of oral squamous cell carcinoma (OSCC). This study compared the predictive performance of six comorbidity scales for overall survival after surgery for OSCC.

Methods

We retrospectively analyzed OSCC patients, surgically treated at an academic center in Belgium between January 01, 2000 and January 01, 2020. Validity of the scales was evaluated using the area under the curve (AUC) of receiver operating characteristic curves.

Results

Three hundred and twenty three patients were included. Elixhauser Comorbidity Index (AUC = 0.74, 95% CI: 0.55–0.92; AUC = 0.73, 95% CI: 0.55–0.80), modified Elixhauser Comorbidity Index (AUC = 0.72, 95% CI: 0.54–0.91; AUC = 0.69, 95% CI: 0.51–0.77), and Combined Comorbidity Index (AUC = 0.76, 95% CI: 0.58–0.84; AUC = 0.76, 95% CI: 0.59–0.84) were meaningful predictors for 2 and 5-year survival, respectively.

Conclusion

Selected comorbidity scales were capable of predicting overall survival for OSCC patients 2 and 5 years after primary surgery.

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Long-term follow-up of patients managed conservatively for acute traumatic CSF rhinorrhoea

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World Neurosurg. 2022 Feb 19:S1878-8750(22)00211-X. doi: 10.1016/j.wneu.2022.02.065. Online ahead of print.

ABSTRACT

OBJECTIVE: Conservative management of acute traumatic cerebrospinal fluid rhinorrhoea (TCR) results in cessation of the leak in most patients. The objective of this study was to estimate the incidence of recurrent cerebrospinal fluid (CSF) rhinorrhoea and meningitis in these patients on long-term follow-up and to determine the risk factors associated with them.

METHODS: Data on 50 patients with acute TCR who were successfully treated with conservative management between 2013 and 2015 and had long term follow-up was retrieved from our head injury database. Patient variables were analysed to determine the risk factors associated with recurrence of CSF rhinorrhoea and meningitis.

RESULTS: All patients in our series developed CSF rhinorrhoea within 48 hours of trauma. The mean duration of follow-up was 6.3 ± 1.3 years. CSF rhinorrhoea recurred in 16 (32%) patients, 15 (93.8%) of whom developed it within 3 years of trauma. Meningitis occurred in 5 (10%) patients and one of them died. Sphenoid sinus fractures and features of raised intracranial pressure on computerised tomography (CT) of the brain at admission were significantly associated with the development of meningitis. There were no risk factors identified for the recurrence of CSF rhinorrhoea.

CONCLUSIONS: Patients with acute TCR in whom rhinorrhoea subsides with conservative therapy, have the highest risk for recurrence of leak or meningitis within three years of the trauma. Therefore, we recommend that these patients be counselled about the need for periodic follow up for several years.

PMID:35192972 | DOI:10.1016/j.wneu.2022.02.065

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Necrotising Otitis Externa Antibiotic therapy complications: A retrospective cohort analysis

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Abstract

NOE is a rare but life-threatening condition. Treatment is long-term intravenous antibiotics. However, there is no evidence on the complications of antibiotic treatment in this complex cohort of patients In our study, patients on average are treated with two different antibiotic regimes 63% of these changes in regimen are due to direct adverse effects from treatment including drug intolerance and lack of significant clinical response leading to deterioration and morbid complications Patients requiring multiple antibiotic regimes have a statistically longer duration of treatment. These adverse effects appear to occur more frequently in patients with additional comorbidities. This novel data provides information clinicians can use when initiating treatment for NOE and counsel patients appropriately

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Similarities and differences of estrogen in the regulation of temporomandibular joint osteoarthritis and knee osteoarthritis

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Histol Histopathol. 2022 Feb 23:18442. doi: 10.14670/HH-18-442. Online ahead of print.

ABSTRACT

BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) and knee osteoarthritis (knee OA) are two kinds of common osteoarthritis (OA) that are characterized by chronic degeneration of soft and hard tissues around joints. Their gender and age differences suggest that there are similarities and differences between the pathogenic mechanisms of TMJOA and knee OA.

OBJECTIVE: To review recent studies on the effect of estrogen on TMJOA and knee OA, and summarize their possible pathogenesis and molecular mechanisms.

SOURCES: Articles up to present reporting the relationship of estrogen and TMJOA or knee OA are included. An extensive electronic search was conducted of databases including PubMed, Web of science core collection.

CONCLUSION: According to epidemiological investigations, TMJOA primarily happens to females of puberty a nd childbearing age, while knee OA mainly affects postmenopausal women. Epidemiological investigation and experimental research suggest that estrogen may have a different effect on TMJ and on knee. Though estrogen regulates TMJOA and knee OA via estrogen-related receptors (ERR), their pathogenesis and pathway of estrogen regulation are different. To find out the accurate regulation of estrogen on TMJOA and knee OA, specific pathways and molecular mechanisms still need further exploration.

PMID:35194774 | DOI:10.14670/HH-18-442

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Measured and self-reported olfactory function

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Eur Arch Otorhinolaryngol. 2022 Feb 23. doi: 10.1007/s00405-022-07298-7. Online ahead of print.

ABSTRACT

PURPOSE: The lack of epidemiological data on the proportion of olfactory dysfunction (OD) using comprehensive olfactory assessment in healthy adults in Scandinavia motivated to the present study which aimed to explore the proportion of OD in voluntary healthy Norwegian adults, assessed by Sniffin' Sticks, and its correlation to self-reported olfactory function. Furthermore, sociodemographic and clinical factors associated with olfactory function were analysed.

METHODS: The sample included 405 Norwegian participants, aged 18-78 years, 273 women and 132 men, who underwent olfactory testing with extensive Sniffin' Sticks test, allergy testing, clinical examination with nasal endoscopy and completed a self-administered questionnaire, including self-evaluation of olfactory function on a 100 mm Visual Analogue Scale.

RESULTS: We found that 37% had OD, of which 1.2% had anosmia assessed with extensive Sniffin' Sticks test. The proportion of hyposmia and anosmia increased with age. Men and participants with low education had poorer olfactory function scores. Allergy, smoking status, general health and endoscopic findings were not associated with measured olfactory function. We found no correlation between self-reported and measured olfactory function.

CONCLUSIONS: This study has identified that a large proportion of our sample of voluntary healthy Norwegian adults have OD, considerably more common in older adults and somewhat more common in men and individuals with low education. The lack of correlation between self-reported and measured olfactory function highlights the importance of using validated tests for a reliable olfactory evaluation.

PMID:35195760 | DOI:10.1007/s00405-022-07298-7

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