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Κυριακή 27 Μαρτίου 2022

New ENT Abstracts


Thyroid tumor ratio: Improving the assessment of the impact of size in pediatric thyroid cancer
3d
by
Connie Paik, Beth Osterbauer, Grace Sahyouni, Soyun Park, Gabriel Gomez, Daniel Kwon, Juliana Austin
via
Head & Neck
Abstract
Background
The impact of thyroid nodule size is less useful in children who have smaller thyroid volumes than in adults. We investigate using a novel thyroid tumor ratio measurement in children with thyroid cancer.

Methods
Patient and pathologic characteristics were investigated via Student's t-test in a univariate analysis for any correlation with the log-transformed tumor ratio, followed by a multivariate linear regression.

Results
Of 75 patients with malignancy and tumor ratio information, mean ratio decreased with increasing age (p = 0.04). Out of several clinical factors, patients with lymph node metastases and those treated with postoperative radioactive iodine had significantly higher mean tumor ratios on multivariate analysis (p = 0.04 for both factors).

Conclusions
Our study is the first to describe thyroid tumor volume in pediatric thyroid cancer and shows that increased tumor ratio was associated with indicators of more advanced disease such as lymph node metastases and use of radioactive iodine.

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Efficacy and safety of preoperative embolization in carotid body tumor treatment: A propensity score matching retrospective cohort study
3d
by
Zhaoyu Wu, Peng Qiu, Hongji Pu, Kaichuang Ye, Guang Liu, Weimin Li, Xiaobing Liu, Minyi Yin, Mier Jiang, Jinbao Qin, Xinwu Lu, Zhen Zhao
via
Head & Neck
Abstract
Background
To assess the efficacy and safety of preoperative embolization (PE) in patients with carotid body tumor (CBTs).

Methods
In a single-center retrospective cohort study, 127 patients underwent surgical resection of CBTs from January 2003 to December 2019. One-to-one propensity score matching was conducted between patients with or without PE.

Results
Thirty-two (25.2%) patients received PE. After propensity score matching, no statistically significant differences were found in the baseline characteristics of 28 patients in each group. Compared with NPE group, operative time and estimated blood loss (EBL) were significantly reduced in the PE group. The incidence of stroke, perioperative complications, intraoperative blood transfusion, vascular reconstruction, hospital stay, tumor recurrence, and all-cause mortality were not different between the PE and NPE group.

Conclusions
Preoperative embolization was efficient and safe with a reduction of intraoperative blood loss and operative time during CBT resection.

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Post‐acute health care needs of people with head and neck cancer: Mapping health care services, experiences, and the impact of rurality
3d
by
Jasmine Foley, Clare L. Burns, Elizabeth C. Ward, Rebecca L. Nund, Laurelie R. Wishart, Lizbeth M. Kenny, Maurice Stevens
via
Head & Neck
Abstract
Background
People with head and neck cancer (HNC) have complex health care needs; however, limited evidence exists regarding the nature or patterns of service access and use. This study explored the post-discharge health care needs and experiences of individuals with HNC from metropolitan and rural areas.

Methods
Health care appointments and services accessed by people with HNC were collated for 6-month post-treatment. Data analysis of the whole cohort examined patterns of access while journey mapping integrated participants' experiences of recovery.

Results
The 6-month service access journey was mapped for 11 people. Rural participants attended a significantly greater number of appointments (p = 0.012), higher canceled/missed appointments (p = 0.013), and saw more professionals (p = 0.007). Rural participants reported higher stress and burden due to service access barriers and unmet needs.

Conclusions
Multiple challenges and inequities exist for rural people with HNC. Findings inform opportunities to enhance the post-treatment recovery of people with HNC in rural areas.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
Telephone consultation 11855 int 1193,

Effects and influencing factors of vestibular rehabilitation in 171 cases

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):263-269. doi: 10.3760/cma.j.cn115330-20210601-00321.

ABSTRACT

Objective: To explore the effect of vestibular rehabilitation and to identify factors that can affect rehabilitation outcomes. Methods: From December 2018 to October 2020, patients who underwent vestibular rehabilitation in the Eye, Ear, Nose and Throat Hospital of Fudan University were prospectively followed up. A battery of vestibular function examinations and psychological status evaluations were applied before and after rehabilitation initiation. The main outcomes were vertigo/dizziness and unsteadiness, measured by visual analogue scale (VAS); Secondary outcomes were daily activities and participation, assessed by vestibular activities and participation measure (VAP). Paired t-test was used to compare the effects before and after rehabilitation. Binary logistic regressions were applied to anal yze the influencing factors of rehabilitation outcomes. Results: A total sample of 171 patients was followed up regularly with a median time of 11 months. Of the 171 patients evaluated, 72 were males and 99 were females; age ranged from 10 to 89 years old with a median age of 55 years old. At 6-month follow-up, the difference of VAS score of vertigo/dizziness and unsteadiness pre-post rehabilitation was 1.79±1.80 and 1.56±1.76, respectively; The difference of activity and participation domain of VAP score was 2.51±13 and 1.27±3.75, respectively. All differences pre-post rehabilitation exhibited statistically significant with P values<0.01. Regression analysis demonstrated that the length of symptom onset was a significant predictor of poor balance recovery (OR=6.52; 95%CI:2.10, 20.27). Visual dependence (OR=5.44; 95%CI: 1.38, 21.47) and suspectable anxiety (OR=6.45; 95%CI: 1.49, 28.30) were identified as risk factors for poor recovery of vertigo/dizziness. Conclusions: Vestibular rehabilitation effectively reduces dizziness, promotes balance, and improves the function of daily activities. Time from the onset, visual dependence and suspectable anxiety are the main factors hindering a desirable rehabilitation outcome.

PMID:35325936 | DOI:10.3760/cma.j.cn115330-20210601-00321

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Analysis of whole-mouth taste function test results in 584 healthy adults

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):289-294. doi: 10.3760/cma.j.cn115330-20210409-00190.

ABSTRACT

Objective: To assess the taste function of healthy Chinese adults with the reliable whole-mouth taste test, and to analyze the correlation of taste function with age and gender. Methods: The clinical data of 584 participants reporting the normal sense of smell and taste from March 2019 to January 2020 in the Physical Examination Center of Beijing Anzhen Hospital were analyzed in the study, including 297 males and 287 females, aging (46.9±16.6) years. The subjects were divided into youth group (19-35 years old), middle aged group (36-50 years old), middle-elderly aged group (51-65 years old) and elderly group (66-80 years old). The taste test involved 5 tastants (sour, sweet, salty, umami and bitter) and 7 concentrations. The perception and recognition scores of five tastes were obtained through th e whole-mouth taste test. SPSS 22.0 software was used for statistical analysis. Results: The intra-class correlation coefficients of the whole-mouth taste test were 0.751 to 0.828, which showed high test-retest reliability. The total score of perception and recognition of five tastes showed the significant negative correlation with age (r value was -0.49 and -0.44, respectively, both P<0.001). Compared with the other two groups, taste function of middle-elderly aged and elderly group decreased significantly (all P<0.001). There was no significant difference in total perception scores and total recognition scores between youth and middle aged group (all P>0.05). The perception scores and recognition scores of sour, salty, umami, bitter and total scores in females were higher than those in males (all P<0.05), but there was no significant difference in perception scores and recognition scores for sweet between them (P value w as 0.584 and 0.223, respectively). Conclusions: The taste function is significantly negatively correlated with age. Except the sweet, females are more sensitive to the sour, salty, umami and bitter tastes than males.

PMID:35325940 | DOI:10.3760/cma.j.cn115330-20210409-00190

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Correlation analysis of smell and taste loss with COVID-19 outbreak trend based on big data of internet

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):282-288. doi: 10.3760/cma.j.cn115330-20210808-00536.

ABSTRACT

Objective: To analyze the correlation between loss of smell/taste and the number of real confirmed cases of coronavirus disease 2019 (COVID-19) worldwide based on Google Trends data, and to explore the guiding role of smell/taste loss for the COVID-19 prevention and control. Methods: "Loss of smell" and "loss of taste" related keywords were searched in the Google Trends platform, the data were obtained from Jan. 1 2019 to Jul. 11 2021. The daily and newly confirmed COVID-19 case number were collected from World Health Organization (WHO) since Dec. 30 2019. All data were statistically analyzed by SPSS 23.0 software. The correlation was finally tested by Spearman correlation analysis. Results: A total of data from 80 weeks were collected. The retrospective analysis was performed on the new tre nd of COVID-19 confirmed cases in a total of 186 292 441 cases worldwide. Since the epidemic of COVID-19 was recorded on the WHO website, the relative searches related to loss of smell/taste in the Google Trends platform had been increasing globally. The global relative search volumes of "loss of smell" and "loss of taste" on Google Trends was 10.23±2.58 and 16.33±2.47 before the record of epidemic while 80.25±39.81 and 80.45±40.04 after (t value was 8.67, 14.43, respectively, both P<0.001). In the United States and India, the relative searches for "loss of smell" and "loss of taste" after the record of epidemic were also much higher than before (all P<0.001). The correlation coefficients between the trend of weekly new COVID-19 cases and the Google Trends of "loss of smell" in the global, United States, and India was 0.53, 0.76, and 0.82 respectively (all P<0.001), the correlation coefficients with Google Trends of "loss of taste" was 0.54, 0.78, and 0.82 respectively (all P<0.001). The lowest and highest point of loss of smell/taste search curves of Google Trends in different periods appeared 7 to 14 days earlier than that of the weekly newly COVID-19 confirmed cases curves, respectively. Conclusions: There is a significant positive correlation between the number of newly confirmed cases of COVID-19 worldwide and the amount of keywords, such as "loss of smell" and "loss of taste", retrieved in Google Trends. The trend of big data based on Google Trends might predict the outbreak trend of COVID-19 in advance.

PMID:35325939 | DOI:10.3760/cma.j.cn115330-20210808-00536

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Treatment, Outcome, and Relapse of Spontaneous and Nonspontaneous Cerebrospinal Fluid Leak

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Brain Sci. 2022 Mar 2;12(3):340. doi: 10.3390/brainsci12030340.

ABSTRACT

Cerebrospinal fluid (CSF) leak can be spontaneous or nonspontaneous. The management options include conservative treatments, blood patch, and surgical repairs. We compared clinical symptoms, image findings, management options, hospitalization, and relapse rates among different causes of CSF leaks. Eighty-one patients were recruited: 20 with spontaneous and 61 with nonspontaneous CSF leaks. Nonspontaneous causes included lumbar puncture, surgery, and trauma. Surgery sites comprised sphenoid, spine, skull base, and calvaria. Spontaneous CSF leak came from the sphenoid or spine. Age, gender, body mass index, initial symptoms, hospitalization, treatment courses, and recurrence rates showed no difference between the groups. The spontaneous group had higher CSF accumulations on their MRIs. MRI pachymeninge enhancement showed the highest sensitivity (78.6%) for intracranial hyp otension. Meningitis occurred in 1/3 of sphenoid, skull base, and calvarian surgeries. Earlier reoperation was correlated with shorter hospitalization (r = 0.651), but the recurrence rates were similar. Longer intervals between surgery and CSF leak encouraged reoperation. Among the spontaneous spine and lumbar puncture-related CSF leaks, 57.1% of them responded to 4 days of conservative treatment. Among the trauma-related CSF leaks, 90.9% of them required surgical repair. The demographic data and symptoms were similar in various groups of CSF leak. The symptom onset durations and treatment strategies were different. However, the recurrence rates were similar.

PMID:35326296 | DOI:10.3390/brainsci12030340

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Potential effects of lowering the threshold of statistical significance in the field of chronic rhinosinusitis - A meta-research on published randomized controlled trials over last decade

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Braz J Otorhinolaryngol. 2021 Dec 4:S1808-8694(21)00196-8. doi: 10.1016/j.bjorl.2021.11.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of change in p-value threshold from 0.05 to 0.005, on published Randomized Controlled Trials (RCTs) over the last ten years in the field of chronic rhinosinusitis.

METHODS: A search of the PubMed database from 1st January 2011 to 31st December 2020 was conducted to include all RCTs that used p-value to determine the effects of an intervention. Data extracted included p-values, type of intervention, publishing journal with indexing, registration, funding, and multi- or single center status. The proportion of primary endpoints having p < 0.005 was determined first, followed by those with p > 0.005 but <0.05. Logistic regression analysis was used to determine if any trial characteristic was associated with reporting of significant p-values.

RESULTS: In total, 16 8 primary endpoints were identified from 123 RCTs. On analysis, 80 had a p-value <0.05, i.e., statistically significant on conventional parameter. Out of these, 53.75% had a p-value <0.005, which would retain significance under the proposed threshold, and the remaining 46.25% to be reclassified as "suggestive". None of the trial characteristics were contributing to reporting of conventional or proposed p-values on logistic regression analysis.

CONCLUSION: Lowering the p-value threshold would render 46.25% of a decade of published RCTs results (in the field of CRS) to be reclassified as merely "suggestive" and not significant. Trial characteristics were not found contributing to reporting of p-value <0.005 or even <0.05.

LEVEL OF EVIDENCE: II.

PMID:35331655 | DOI:10.1016/j.bjorl.2021.11.004

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The Auditory Processing Domains Questionnaire (APDQ): Brazilian-Portuguese version

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Braz J Otorhinolaryngol. 2022 Jan 4:S1808-8694(21)00213-5. doi: 10.1016/j.bjorl.2021.12.001. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to determine the fidelity, reliability, and internal validity of the APDQ when translated from English to Brazilian-Portuguese language.

METHODS: The first phase included the APDQ translation into Brazilian-Portuguese including forward translation, translation assessment and back-translation in a group of 10 students. The second phase involved establishing the internal consistency and reliability of the APDQ Brazilian-Portuguese version. Data was collected from 66 students without any risk factor for auditory processing disorder. Subjects were divided into a younger group (7-10 yrs) and an older group (11-17 yrs).

RESULTS: All items showed appropriate quality in terms of translation. In determining internal consistency, Cronbach's alpha in subscales of auditory proce ssing, attention and language was found to be 0.93, 0.85 and 0.74, respectively. Intraclass Correlation Coefficient for total score was 0.95, ensuring a strong test-retest reliability.

CONCLUSION: The Brazilian-Portuguese version of the APDQ has favorable translation quality, internal validity and reliability. It is now ready for continued study as a differential screening tool for 7- to 17-year-old Brazilian children with listening difficulties who are at risk for auditory processing disorder, attention deficits and language learning challenges.

PMID:35331656 | DOI:10.1016/j.bjorl. 2021.12.001

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Giving Children with Deafness a Cape: Amplifying Diverse Portrayals of Hearing Loss in Media

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Ear Nose Throat J. 2022 Mar 24:1455613221087941. doi: 10.1177/01455613221087941. Online ahead of print.

NO ABSTRACT

PMID:35331032 | DOI:10.1177/01455613221087941

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Preclinical study of Shen Qi Li Xin formula in improving the development of chronic heart failure

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Histol Histopathol. 2022 Mar 25:18454. doi: 10.14670/HH-18-454. Online ahead of print.

ABSTRACT

Chronic heart failure (CHF) is a common clinical heart disease. In recent years, traditional Chinese medicines have shown good outcomes in CHF treatment. We aimed to explore the therapeutic effect of Shen Qi Li Xin formula (SQLXF) in CHF. CHF rats were treated with SQLXF at the doses of 8.48, 16.96, and 33.92 g/kg/d once a day for 4 weeks by intragastric administration. The hemodynamic and cardiac function parameters of the rats were monitored by conduction echocardiography. In our results, SQLXF treatment at the doses of 16.96 and 33.92 g/kg/d significantly improved the haemodynamics and cardiac function of CHF rats by enhancing the levels of LVSP, +dp/dtmax, -dp/dtmax, LVEF and LVFS and reducing the levels of LVEDP, LVEDD and LVESD. SQLXF treatment at 16.96 and 33.92 g/kg/d also attenuated the damage of myocardial tissues in CHF rats. In a ddition, compared with normal rats, the number of pericytes was reduced in myocardial tissues of CHF rats. SQLXF treatment at the doses of 16.96 and 33.92 g/kg/d obviously increased the number of pericytes and proliferation of endothelial cells and promoted angiogenesis in myocardial tissues of CHF rats. In vitro, SQLXF impaired low-oxygen-induced inhibition of cell viability and promotion of apoptosis in primary pericytes. Importantly, SQLXF enhanced the adhesion ability of pericytes to endothelial cells. In conclusion, SQLXF improved myocardial injury in CHF rats by enhancing the interaction between pericytes and endothelial cells, suggesting that SQLXF may be a potential drug for CHF treatment.

PMID:35333374 | DOI:10.14670/HH-18-454

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Columellar strut grafts versus septal extension grafts during rhinoplasty for airway function, patient satisfaction and tip support

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J Plast Reconstr Aesthet Surg. 2022 Feb 24:S1748-6815(22)00095-X. doi: 10.1016/j.bjps.2022.02.017. Online ahead of print.

ABSTRACT

IMPORTANCE: Different techniques exist to provide tip support in rhinoplasty. There is little evidence to provide a consensus on the most effective choice.

OBJECTIVE: Evaluating columellar strut graft (CSG) and septal extension grafts (SEG) for their influence on airway function, patient satisfaction and tip support.

DESIGN, SETTINGS AND PARTICIPANTS: A retrospective cohort study was undertaken on 165 adult patients who underwent open rhinoplasty with either a CSG or SEG, from February 2012 to August 2019 in a single tertiary facial-plastic practice in Sydney, Australia. Operations were for both cosmetic and functional indications, and both primary and revision cases were assessed. Airway testing and patient-reported outcomes (PROMs) were performed preoperatively and at least 6 months following the procedure. Photographic tip analysis was taken from approximately 4 and 12-month postoperative photographs.

MAIN OUTCOMES AND MEASURES: Nasal peak inspiratory flow (NPIF) and total nasal airway resistance (NAR) were the primary airway functional outcomes. The primary PROMs analysed were a visual analogue scale (VAS) for nasal obstruction and 13-point Likert scale for global cosmesis, the Nose Outcome Symptom Evaluation (NOSE), and the nasal obstruction score. Tip support was determined by the nasolabial angle (NLA) and Simon's ratio as assessed by Rhinobase developed by Apaydin et al. on lateral Frankfort plane photographs. Data normalised as an improvement over preoperative baseline, accounting for individual variability.

RESULTS: A total of 165 patients was assessed (35.2 ± 12.9 yrs, 72% female), 100 (61%) of which received SEG. There were similar nasal airway assessments between CSG and SEG groups, with ΔNPIF (20.0 ± 42.1 L/min v 19.9 ± 44.9 L/min, p = 0.983) and Δ "obstructed" NAR (-1.13 ± 1.90 v -1.02 ± 4.33 Pa/cm3/s, p = 0.849). Amongst PROMs, a greater cosmetic outcome was seen in the SEG group (7.20 ± 2.97 v 5.69 ± 3.45, p < 0.01) with all other assessments similar between CSG and SEG techniques. Photographic analysis of tip projection showed reduced NLA distortion in the SEG.

CONCLUSION AND RELEVANCE: While greater patient-perceived cosmesis was seen in patients with a SEG, there were similar airflow and patient-reported nasal function between groups. Photographic analysis of tip projection showed SEG patients additionally benefited from less NLA distortion and greater tip maintenance.

PMID:35337759 | DOI:10.1016/j.bjps.2022.02.017

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H2O2 Concentration in Exhaled Breath Condensate Increases After Phonotrauma: A Promise of Noninvasive Monitoring?

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The present study was designed to observe the concentration of hydrogen peroxide (H2O2) in exhaled breath condensate (EBC) after induced phonotrauma.
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