Mohs micrographic surgery for cutaneous malignancy of the hand & upper limb - Raising awareness of its applications and advantages

xlomafota13 shared this article with you from Inoreader Mohs micrographic surgery for cutaneous malignancy of the hand & upper limb - Raising awareness of its applications and advantages Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 7:S1748-6815(21)00467-8. doi: 10.1016/j.bjps.2021.09.030. Online ahead of print. ABSTRACT Mohs Micrographic Surgery (MMS) is primarily recognised for use in facial tumours, however it should also be considered to aid excision of tumours of the hand, where preservation of tissue and maintenance of function are key factors. Mohs surgery can serve to facilitate decision making both by the patient and surgeon. This can be particularly helpful when proposing more extensive surgery, or prior to complex reconstruction where confirmation of tumour clearance is paramount. We use case examples with medical images to illustrate the advantages of MMS over conventional excision. The establishment of an MMS hand service, delivered by a surgeon with specialist upper limb resection and reconstructive expertise, has allowed our unit to provide optimal treatment, governance, and outcomes for this group of patients . PMID:34686456 | DOI:10.1016/j.bjps.2021.09.030 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between Thyroid Function and Heart Rate Monitored by Wearable Devices in Patients with Hypothyroidism

xlomafota13 shared this article with you from Inoreader Association between Thyroid Function and Heart Rate Monitored by Wearable Devices in Patients with Hypothyroidism Via radioactive iodine Endocrinol Metab (Seoul). 2021 Oct 21. doi: 10.3803/EnM.2021.1216. Online ahead of print. ABSTRACT BACKGROUND: Heart rate (HR) monitored by a wearable device (WD) has demonstrated its clinical feasibility for thyrotoxicosis subjects. However, the association of HR monitored by wearables with hypothyroidism has not been examined. We assessed the association between serum thyroid hormone concentration and three WD-HR parameters in hypothyroid subjects. METHODS: Forty-four subje cts scheduled for radioactive iodine therapy (RAI Tx) after thyroid cancer surgery were included. Thirty subjects were prepared for RAI Tx by thyroid hormone withdrawal (hypothyroidism group) and 14 subjects by recombinant human thyrotropin (control group). Three WD-HR parameters were calculated from the HR data collected during rest, during sleep, and from 2:00 AM to 6:00 AM, respectively. We analyzed the changes in conventionally measured resting HR (On-site rHR) and WDHR parameters relative to thyroid hormone levels. RESULTS: Serum free thyroxine (T4) levels, On-site rHR, and WD-HR parameters were lower in the hypothyroid group than in the control group at the time of RAI Tx. WD-HR parameters also reflected minute changes in free T4 levels. A decrease in On-site rHR and WD-HR parameters by one standard deviation (On-site rHR, approximately 12 bpm; WD-HR parameters, approximately 8 bpm) was associated with a 0.2 ng/dL decrease in free T4 levels (P<0.01) and a 2-fold incre ase of the odds ratio of hypothyroidism (P<0.01). WD-HR parameters displayed a better goodness-of-fit measure (lower quasi-information criterion value) than On-site rHR in predicting the hypothyroidism. CONCLUSION: This study identified WD-HR parameters as informative and easy-to-measure biomarkers to predict hypothyroidism. PMID:34674500 | DOI:10.3803/EnM.2021.1216 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Whole-Body Radioiodine Effective Half-Life in Patients with Differentiated Thyroid Cancer Via radioactive iodine Diagnostics (Basel). 2021 Sep 22;11(10):1740. doi: 10.3390/diagnostics11101740. ABSTRACT Background: Radioactive 131I (RAI) therapy is used in patients with differentiated thyroid cancer (DTC) after total thyroidectomy for remnant ablation, adjuvant treatment or treatment of persistent disease. 131I retention data, which are used to indicate the time at which a 131I treated DTC patient can be released from the hospital, may bring some insight s regarding clinical factors that prolong the length of hospitalization. The aim of this study was to investigate the 131I whole-body retention in DTC patients during 131I therapy. Methods: We monitored 166 DTC patients to follow the 131I whole-body retention during 131I therapy with a radioactivity detector fixed on the ceiling of each protected room. A linear regression fit permitted us to estimate the whole-body 131I effective half-life in each patient, and a relationship was sought between patients' clinical characteristics and whole-body effective 131I half-life. Results: The effective 131I half-life ranged from 4.08 to 56.4 h. At multivariable analysis, longer effective 131I half-life was related to older age and extensive extra-thyroid disease. Conclusions: 131I effective half-life during 131I treatment in DTC patients is highly variable amon g patients and is significantly longer in older and in patients with RAI uptake in large thyroid remnants or in extrathyroidal disease that significantly prolongs the whole-body retention of 131I. PMID:34679438 | PMC:PMC8535104 | DOI:10.3390/diagnostics11101740 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic Lymphocytic Thyroiditis and Aggressiveness of Pediatric Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Chronic Lymphocytic Thyroiditis and Aggressiveness of Pediatric Differentiated Thyroid Cancer Via radioactive iodine Laryngoscope. 2021 Oct 23. doi: 10.1002/lary.29908. Online ahead of print. ABSTRACT OBJECTIVES/HYPOTHESIS: Hashimoto's Thyroiditis (HT) is a common cause of hypothyroidism. Among adults with differentiated thyroid cancer (DTC), HT appears to be associated with less severe disease burden. In the absence of information regarding HT and disease burden among children with DTC, we assessed the relationship between pediatric DTC severity and HT. STUDY DESIGN: Retrospective cohort.< /p> METHODS: Charts from 90 pediatric patients who underwent surgical removal of DTC from 2002 to 2017 at tertiary-care children's hospital were reviewed. Demographic, clinical, surgical, pathology, and outcome details were compared between patients with and without HT. Consistency among diagnostic modalities of HT was also evaluated. RESULTS: Median age at presentation was 16.0 years (range 4.2-18.9 years). Twenty-two patients were male (24%). Forty-five patients (50%) had HT based on presence of thyroid autoantibodies and/or surgical pathology findings and 45 patients did not have HT. Patients with HT had increased odds of microcalcifications (odds ratio [OR]: 3.01, P = .031) and decreased odds of palpable nodules (OR: 0.212, P = .024) and T2 lesions (vs. T1) (OR: 0.261, P = .015) compared with non-HT. No significant differences in demographics and the incidence of multifocality, extrathyroidal extension, lymphovascular invasion, lymph node or pulmonary metastases, disease recurrence, or radioactive iodine treatment were found between the two groups. Thyroglobulin/thyroid peroxidase autoantibodies and surgical pathology indicative of HT were concordant in 82.4% (κ = 0.635, P < .001). CONCLUSION: HT was present in 50% of children with DTC. Patients with DTC and HT presented with smaller tumors compared to non-HT patients. No significant differences in other markers of disease aggressiveness were found between the two groups. LEVEL OF EVIDENCE: 3 Laryngoscope, 2021. PMID:34687456 | DOI:10.1002/lary.29908 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reusable surgical drapes in Plastic surgery: What is the sticking point?

xlomafota13 shared this article with you from Inoreader Reusable surgical drapes in Plastic surgery: What is the sticking point? Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 7:S1748-6815(21)00468-X. doi: 10.1016/j.bjps.2021.09.027. Online ahead of print. NO ABSTRACT PMID:34688592 | DOI:10.1016/j.bjps.2021.09.027 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparative study of porous polyethylene versus absorbable polydextro- and polylevolactic-lactide plate in reconstruction of isolated medial orbital wall fracture

xlomafota13 shared this article with you from Inoreader A comparative study of porous polyethylene versus absorbable polydextro- and polylevolactic-lactide plate in reconstruction of isolated medial orbital wall fracture Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 17:S1748-6815(21)00410-1. doi: 10.1016/j.bjps.2021.08.023. Online ahead of print. ABSTRACT BACKGROUND: Several materials for medial orbital wall reconstruction have been mentioned in the literature. Our main purpose was to investigate postoperative enophthalmos and diplopia after medial orbital wall reconstruction with polydextro- and polylevolactic (poly-L/DL) acid (P[L/DL]LA) mesh plates and porous polyethylene plates. METHODS: Using a retrospective study design, we enrolled a cohort of isolated medial blowout fracture patients treated during a 58-month interval. The predictor variable was medial orbital wall reconstruction materials (P(L/DL)LA mesh plate and porous polyethylene plate. The main outcome variables included the occurrence of postoperative enophthalmos and diplopia at 1 week, 1, 3, 6, and 12 months post-surgery . Appropriate descriptive, uni- and bivariate statistics were computed, and P < 0.05 was considered significant. RESULTS: Three hundred-two isolated medial blowout fracture patients were included (24.5% females, 67% treated with P(L/DL)LA mesh plate). Exophthalmos measured highest in both groups 1 week after surgery and decreased steadily for 6 months postoperatively. Statistically significant differences were observed between both groups at 1 week, 1 month, and 3 months after surgery, with a higher incidence of exophthalmos observed in the P(L/DL)LA mesh plate group (P < 0.001). No significant differences were observed at 6 and 12 months after surgery. CONCLUSION: The occurrence of enophthalmos after medial blowout fracture reconstruction with P(L/DL)LA mesh plate is comparable with the use of porous polyethylene plate. Both P(L/DL)LA mesh and porous polyethylene plates are, th erefore, reliable implants for medial orbital wall reconstruction. PMID:34690092 | DOI:10.1016/j.bjps.2021.08.023 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Opioid prescriptions in bone metastatic cancer patients: A cross sectional nationwide pharmacoepidemiological study

xlomafota13 shared this article with you from Inoreader Opioid prescriptions in bone metastatic cancer patients: A cross sectional nationwide pharmacoepidemiological study Via Association française pour l'étude du cancer Bull Cancer. 2021 Oct 20:S0007-4551(21)00375-1. doi: 10.1016/j.bulcan.2021.08.006. Online ahead of print. ABSTRACT Oncological situations represent the majority of palliative situations. Labeling the palliative stage often comes too late in oncology. Pain comes first among discomfort symptoms with the greatest impact on quality of life. We wondered whether the evolutionary stage of the cancer was linked with the prescriptions of opioid analgesics. We observed the prescriptions of strong opioids in patients suffering from metastatic bone cancer 3 months before and after identifying the situation as palliative. This is a cross-sectional observational study performed between January 1, 2012 and December 31, 2016 using data from the French (nationwide claims database). We included 38,399 patients with cancer with at least one metastatic bone location in a palliative situation. Seventeen percent (n=6544) of patients had a prescription of op ioid analgesics after palliative care labeling, 19.8 % (n=7606) had a prescription before, 31.1 % (n=11 949) had a prescription before and after and 32.0 % had no prescription of opioid analgesics. An increase in the dosage of opioid analgesics is observed between before and after labeling the stage of the disease as palliative with an average dosage ranging from 99.6 to 142.3mg per day. This study shows that labeling a situation as palliative affects prescriptions of strong opioid analgesics. An early identification of the situation as palliative is essential to provide appropriate care. PMID:34688483 | DOI:10.101 6/j.bulcan.2021.08.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of cancer pain

xlomafota13 shared this article with you from Inoreader Treatment of cancer pain in Mali: Experience of the mother-child medical oncology service of the CHU in Bamako Via Association française pour l'étude du cancer Bull Cancer. 2021 Oct 20:S0007-4551(21)00376-3. doi: 10.1016/j.bulcan.2021.08.007. Online ahead of print. ABSTRACT Two hundred patients were refereed for advanced cancer to the oncology department of Luxembourg Hospital in Bamako. All these patients reported intense pain (88 %) which was only treated before admission by OMS level 1 analgesics. It clearly shows that cancer pain is undertreated in Malian peripheral sanitary structures. After evaluation of the pain by analog visual and verbal scales patients, the appropriate analgesic drugs such as morphine (OMS level 3) were given. A control of the pain was obtained in all the patients (100 %) with a dramatic improvement in quality of life. This study emphasizes the need for a pain control program at the Malian state level with a basic education of care givers, hospital-centric networks and access to morphine and opioids at the different levels involved in cancer management. PMID:< a href="https://pubmed.ncbi.nlm.nih.gov/34688484/?utm_source=Inoreader&utm_medium=rss&utm_content=1pWbXSyt-bgOwyfswAxLlZpSXeeWbmCyNlsY-SXJggVtkrlgb7&ff=20211026004807&v=2.15.0" target="_blank" rel="noopener" class="underlink bluelink">34688484 | DOI:10.1016/j.bulcan.2021.08.007 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Study on the feature of cortical auditory evoked potential under different auditory tasks in cochlear implant children

xlomafota13 shared this article with you from Inoreader Study on the feature of cortical auditory evoked potential under different auditory tasks in cochlear implant children Via cortical auditory Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Sep 7;56(9):943-950. doi: 10.3760/cma.j.cn115330-20201109-00857. ABSTRACT Objective: To investigate the variation regularity and influencing factors of cortical auditory evoked potential (CAEP) evoked by pure tone, syllable and tone stimuli in cochlear implant (CI) children. Methods: Cortical auditory evoked potential (CAEP) responses were collected from 46 CI children in the sound field. Pure tones with frequencies of 1 kHz and 2 kHz were used as the standard and the deviant respectively in the pure tone stimulation condition. The Chinese Mandarin tokens/ba/-/pa/and/ba1/-/ba4/pairs were used as the stimuli respectively in the syllable and tone stimulation condition. The latency, amplitude and presence rate of P1 and mismatch negative(MMN) were obtained and the correlation between the difficulty of auditory task, the age of hearing month, the duration of severe-profound hearing loss, the wearing history of hearing aid before CI, the hearing threshold of the better ear before CI and the latency and amplitude of P1 and MMN were analyzed. All statistical analyses and figures were conducted using SPSS 25.0. Results: The P1 presence rate of pure tone, syllable and tone group was 100% (17/17), 100% (13/13) and 75.0% (12/16), respectively, with significant difference (χ²=8.214, P=0.016). There was significant difference between pure tone group and tone group (χ²=4.836, P=0.028), but no significant difference between pure tone group and syllable group, syllable group and tone group. The MMN presence rate of pure tone, syllable and tone group was 94.1% (16/17), 84.6% (11/13) and 62.5% (10/16), respectively, but no significant difference among the three groups with different auditory tasks(χ²=0.066, P=0.066). No significant difference was observed among the three groups of different auditory tasks in the latenc y and amplitude of P1 and MMN. Multiple linear regression analysis showed that the latency of P1 was positively correlated with the difficulty of auditory task and the hearing threshold of the better ear before CI, and negatively correlated with hearing age and the history of hearing aid before CI. The latency of MMN was positively correlated with the difficulty of auditory task, and negatively correlated with hearing age. Conclusions: The P1 presence rate of pure tone auditory task is significantly higher than that of tone auditory task. The difficulty of auditory task, hearing age, the history of hearing aid before CI, and the hearing threshold of the better ear before CI has significant effects on the P1 latency. The difficulty of auditory task and hearing age has significant effects on the MMN latency. PMID:34666442 | DOI:10.3760/cma.j.cn115330-20201109-00857 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Development and assessment of a MOOC about delirium in geriatric oncology

xlomafota13 shared this article with you from Inoreader Development and assessment of a MOOC about delirium in geriatric oncology Via Association française pour l'étude du cancer Bull Cancer. 2021 Oct 21:S0007-4551(21)00383-0. doi: 10.1016/j.bulcan.2021.05.014. Online ahead of print. ABSTRACT INTRODUCTION: Among the themes to be addressed by a Massive Open Online Course (MOOC) on geriatric oncology, one of the priorities was delirium, due to its frequency, complications and difficulties encountered by healthcare professionals in diagnosing and managing delirium. Our study aims to evaluate professional practices in the area of education, regarding the evaluation of the content of a MOOC module about delirium syndrome in geriatric oncology. METHODS: We created a multidisciplinary group to define the scientific content, the pedagogical objectives, the scriptwriting and the development of a training module. The quality of instructional design was then evaluated according to eleven MOOC design principles to promote learning. Participants were studied. RESULTS: Seven of the eleven criteria for evaluating pedagogical quality were documented. Among the 1020 participants, 455 (44.6%) completed the final test concerning delirium: 417 (40.8%) passed the final test; 406 documented their profession and the region of France where they worked: 146 (32%) nurses (confirming the participation of the targeted audience), 103 (22.6%) doctors/pharmacists (illustrating the multi-professional interest of the thematic), with a wide distribution of the participants over the national territory. DISCUSSION: The multidisciplinary team's investment in developing these teaching materials strengthened the group's cohesion and valuated its professional skills. All teaching resources developed for access via the internet must be accompanied by an evaluation of the quality of the scientific content, objectives and teaching methods, before being able to appreciate its use in the field and assess its real impact on the participants' learning and practice. PMID:34689979 | DOI:10.1016/j.bulcan.2021.05.014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Computational Modeling of Information Propagation during the Sleep-Waking Cycle

xlomafota13 shared this article with you from Inoreader Computational Modeling of Information Propagation during the Sleep-Waking Cycle Via cortical auditory Biology (Basel). 2021 Sep 22;10(10):945. doi: 10.3390/biology10100945. ABSTRACT Non-threatening familiar sounds can go unnoticed during sleep despite the fact that they enter our brain by exciting the auditory nerves. Extracellular cortical recordings in the primary auditory cortex of rodents show that an increase in firing rate in response to pure tones during deep phases of sleep is comparable to those evoked during wakefulness. This result challenges the hypothesis that during sleep cortical responses are weakened through thalamic gating. An alternative explanation comes from the observation that the spatiotemporal spread of the evoked activity by transcranial magnetic stimulation in humans is reduced during non-rapid eye movement (NREM) sleep as compared to the wider propagation to other cortical regions during wakefulness. Thus, cortical responses during NREM sleep remain local and the stimulus only reaches nearby neuronal populations. W e aim at understanding how this behavior emerges in the brain as it spontaneously shifts between NREM sleep and wakefulness. To do so, we have used a computational neural-mass model to reproduce the dynamics of the sensory auditory cortex and corresponding local field potentials in these two brain states. Following the synaptic homeostasis hypothesis, an increase in a single parameter, namely the excitatory conductance g¯AMPA, allows us to place the model from NREM sleep into wakefulness. In agreement with the experimental results, the endogenous dynamics during NREM sleep produces a comparable, even higher, response to excitatory inputs to the ones during wakefulness. We have extended the model to two bidirectionally connected cortical columns and have quantified the propagation of an excitatory input as a function of their coupling. We have found that the general increase in all conductances of the cortical excitatory synapses that drive the system from NREM sleep to wakefulness does not boost the effective connectivity between cortical columns. Instead, it is the inter-/intra-conductance ratio of cortical excitatory synapses that should raise to facilitate information propagation across the brain. PMID:34681044 | PMC:PMC8533346 | DOI:10.3390/biology10100945 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.