MRI as a road‐map for surgical intervention of acute invasive fungal sinusitis

xlomafota13 shared this article with you from Inoreader MRI as a road‐map for surgical intervention of acute invasive fungal sinusitis in Covid‐19 era Via Clinical Otolaryngology Abstract Objectives Acute invasive fungal sinusitis AIFS has high mortality rate, and its incidence has increased without explanation in Covid-19 era. Proper diagnosis and effective surgical debridement have a crucial role in decreasing this high mortality rate. MRI could detect early ischemic changes with localization of extrasinus devitalized fungal inflamed tissue to guide surgical intervention. Study design Prospective study Setting ORL-HNS department -Zagazig University. Methods T1 with gadolinium and T2 fat suppression sequences were investigated and correlated with surgical findings in cases recently recovered from Covid-19 "seroconversion". Loss of contrast enhancement LOCE/black sign in T1+G was hypothesized to reflect necrotic areas while hyperintense signal/white sign in T2 fat suppression was hypothesized to correlate with severely inflamed devitalized tissue in periantral region These radiological findings were correlated with intraoperative findings to identify positive predictive finding. Results 40 patients were included in this study, of which 38 had LOCE/ black sign in T1+G 95%. True ischemic turbinate was detected only in 35 cases (positive predictable value PPV= 92.1%). Hyperintense signal/ white sign in T2 fat suppression was detected in orbit, pterygopalatine-infratemporal fossa, sphenoid process, zygoma, external skin, and these findings were correlated with intraoperative findings (PPV ranging from 72.7% to 100%). Conclusion MRI has a crucial role in localization of devitalized tissue, and subsequently guides surgical intervention. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Enhanced removal of radioactive iodine anions from wastewater using modified bentonite: Experimental and theoretical study

xlomafota13 shared this article with you from Inoreader Enhanced removal of radioactive iodine anions from wastewater using modified bentonite: Experimental and theoretical study Via radioactive iodine Chemosphere. 2021 Dec 22:133401. doi: 10.1016/j.chemosphere.2021.133401. Online ahead of print. ABSTRACT Efficient and cost-effective removal of radioactive iodine anions from contaminated water has become a crucial task and a great challenge for waste treatment and environmental remediation. Herein, we present hexadecylpyridinium chloride monohydrate modified bentonite (HDPy-bent) for the efficient and selective removal of iodine anions (I- and IO3-) from contaminated water. Batch experiments showed that HDPy-bent could remove more than 95% of I- and IO3- within 10 min, and had maximum I- and IO3- adsorption capacities of 80.0 and 50.2 mg/g, respectively. Competitive experiments indicated that HDPy-bent exhibited excellent I- and IO3- selectivity in the excessive presence of common concomitant anions including PO43-, SO42-, HCO3-, NO3-, Cl- (maximum mole ratio of anions vs iodine anions was ∼50,000). An anion exchange mechanism was proposed for the selective adsorption of iodine anions. Optimal adsorption structure of HDPy+/I- (IO3-) at atomic level and driving forces of the I- (IO3-) adsorption were calculated by density functional theory (DFT) simulati ons. Moreover, the good durability and reusability of the HDPy-bent has been demonstrated with 5 adsorption-desorption cycles. Dynamic column experiment also demonstrated that HDPy-bent exhibited excellent removal and fractional recovery capabilities towards I- and IO3- from simulated groundwater and environmental water samples. In conclusion, this work presents a promising adsorbent material for the decontamination of radioactive iodine anions from wastewater on a large scale. PMID:34953880 | DOI:10.1016/j.chemosphere.2021.133401 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incidence of Head and Neck Cancers before and after 9/11 in New York City and New York State

xlomafota13 shared this article with you from Inoreader Incidence of Head and Neck Cancers before and after 9/11 in New York City and New York State Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: The incidence of cancers in New York State (NYS) before and after 9/11 including lung, colorectal, and renal cancers has been previously described. To date, the incidence of head and neck cancers (HNCs) before and after 9/11 has not been described. Methods: Cancers involving the oral cavity and oropharynx; the nose, nasal cavity, nasopharynx, and middle ear; larynx; and thyroid were identified using the New York State Cancer Registry (NYSCR). Age-adjusted incidence and rates per 100,000 residents from 1987 to 2015 were analyzed using joinpoint regression. Trends in incidence using annual percent changes are presented. Results: The overall rate of HNC increased slightly by 0.7% (p #x3c; 0.001) from 1987 to 2003 in NYS. From 2003 to 2008, the rate increased by 5.73% (p #x3c; 0.001), and from 2008 to 2015, the rate increased by 1.68% (p #x3c; 0.001). The rate of thyroid cancer increased by 6.79% (p #x3c; 0.001) from 1987 to 2003, by 9.99% (p #x3c; 0.001) from 2003 to 2009, and by 2.41% (p = 0.001) from 2009 to 2015. The rate of thyroid cancer was higher in women at all time points. In a subset analysis of HNCs excluding thyroid cancer, the rate decreased by 2.02% (p #x3c; 0.001) from 1991 to 2001, followed by a nonsignificant increase of 0.1% (p = 0.515) from 2001 to 2015. The rate of oropharyngeal (OP) cancer significantly increased from 1999 to 2015 (2.65%; p #x3c; 0.001). The rate of oral cavity cancer significantly decreased from 1987 to 2003 (1.97%; p #x3c; 0.001), with no significant change after 2003. The rate of laryngeal cancer decreased significantly by 2.43% (p #x3c; 0.001) from 1987 to 2015, as did the rate of nasal cavity/nasopharyngeal cancer (0.33%; p = 0.03). Conclusions: In NYS, OP cancer and thyroid cancer rates increased significantly during the study period. The rate of thyroid cancer wa s higher in women. The rate of combined HNC increased significantly after 9/11 compared to before 9/11; however, in a subset analysis of all HNC patients excluding thyroid cancer, the rate decreased significantly prior to 9/11 and then nonsignificantly increased afterward. This suggests that the increase in thyroid cancer accounts for the increase in combined HNC in NYS. The impact of 9/11 on rates of HNC requires further research. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic histologique et moléculaire des cancers de l'ovaire - recommandations pour la pratique clinique Saint-Paul 2021: Histological and molecular diagnosis of ovarian

xlomafota13 shared this article with you from Inoreader Diagnostic histologique et moléculaire des cancers de l'ovaire - recommandations pour la pratique clinique Saint-Paul 2021: Histological and molecular diagnosis of ovarian Via Association française pour l'étude du cancer Bull Cancer. 2021 Dec;108(9S1):S33-S38. doi: 10.1016/S0007-4551(21)00585-3. ABSTRACT Oncogenetic testing is now part of standard management in high grade ovarian cancer, including at least mutational status of BRCA1/BRCA2 genes. If necessary, tumor genetic testing is followed by constitutional testing to either confirm the constitutional origin of variants identified in BRCA1/2 genes or detect variants in other predisposition genes. The whole process including prescription of tumoral testing, retrieval of analysis report and communication of results must be formalized, as well as information on possible consequences of the results for the patient and her family. Tumor material must meet criteria of size and cellularity to allow high-quality analysis. These samples are processed during the preanalytical phase with two major steps : time of cold ischemia and fixation. Only pathogenic (Class V) and likely pathogenic (Class IV) variants sh own in tumor tissue are mentioned in the report. Currently, only BRCA1 and BRCA2 genes are routinely studied but, in the future, analysis will be extended to other genes involved in homologous recombination repair. In patients without BRCA mutation, other biomarkers reflecting sensitivity to PARP inhibitors, such as HRD scores (homologous recombination deficiency) that appeared recently, will have to be implemented in routine practice in order to better select patients for these treatments and choose optimal therapy. PMID:34955160 | DOI:10.1016/S0007-4551(21)00585-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mise à jour 2021 des recommandations pour la pratique clinique de Nice/Saint-Paul-de-Vence dans le cancer de l’ovaire épithélial de haut grade: Updated 2021 recommendations for the clinical practice of Nice/Saint-Paul-de-Vence in epithelial high grade ovarian cancer

xlomafota13 shared this article with you from Inoreader Mise à jour 2021 des recommandations pour la pratique clinique de Nice/Saint-Paul-de-Vence dans le cancer de l'ovaire épithélial de haut grade: Updated 2021 recommendations for the clinical practice of Nice/Saint-Paul-de-Vence in epithelial high grade ovarian cancer Via Association française pour l'étude du cancer Bull Cancer. 2021 Dec;108(9S1):S1-S4. doi: 10.1016/S0007-4551(21)00581-6. ABSTRACT Since the previous 2013 and 2016 recommendations for clinical practice (RPC) Nice/Saint-Paul-de-Vence for gynecological cancers, the management of ovarian cancer has become more complex with the evolution of the quality criteria recommended for surgery and the integration of molecular biology for the decision of medical treatments, especially for high grade epithelial ovarian cancers. Surgical indications have become more precise both in the first line and in the context of relapse. Treatments with PARP inhibitors is a major advance in medical management with significant efficacy in maintenance after response to platinum-based chemotherapy. The benefit already known in the case of late relapse has also been demonstrated in first-line treatment with progression-free survival never observed in this pathology with patients with very long responses, especial ly in the case of BRCA gene abnormalities (somatic or constitutional). In 2021, medical and surgical strategies in front line including PARP inhibitors associated or not with bevacizumab as a maintenance complement after platinum chemotherapy are guided by both response to platinum agents and molecular profiling including BRCA (somatic or constitutional) genetic status and homologous recombination pathway (HRD) abnormalities, that should be early tested. On behalf of the GINECO national oncologist group, we have updated the guidelines for high grade ovarian epithelial cancer (excepted rare tumors) in order to allow rapid dissemination of the latest advances to the medical community and improve daily practice. PMID:34955157 | DOI:10.1016/S0007-4551(21)00581-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prise en charge chirurgicale du cancer épithélial de l'ovaire - première ligne et première rechute: Surgical management of epithelial ovarian cancer - first line and first relapse

xlomafota13 shared this article with you from Inoreader Prise en charge chirurgicale du cancer épithélial de l'ovaire - première ligne et première rechute: Surgical management of epithelial ovarian cancer - first line and first relapse Via Association française pour l'étude du cancer Bull Cancer. 2021 Dec;108(9S1):S13-S21. doi: 10.1016/S0007-4551(21)00583-X. ABSTRACT Based on recently published data, these recommendations present some evolutions in the surgical management of high grade epithelial ovarian cancers. In apparently early stages (FIGO I and II), surgical staging must be undertaken to confirm the absence of both peritoneal lesions and lymph node involvement (that might change stage and management). Neoadjuvant chemotherapy is not indicated, surgical exploration should be performed upfront, by laparotomy, to reduce the risk of rupture of the primary tumor. In advanced stages, the first step is to evaluate the feasibility of primary surgery with complete tumor cytoreduction. If it appears unfeasible, 3 or 4 cycles of neoadjuvant chemotherapy are administered before interval surgey. Whether it is implemented in the primary or interval setting, surgery must be performed by experimented teams, in an approved f acility, having developed a rehabilitation program. Lymph node dissection is not mandatory if no adenopathies have been identified by imaging and by peroperative palpation. At first relapse, the surgical decision must be made by a multidisciplinary team, using scores predictive of complete cytoreduction (AGO or iMODEL criteria). Similarly as in first line, the objective is to achieve resection without any residual disease. Surveillance after first-line treatment must be adapted, according to the probability of another complete cytoreduction in case of late relapse, especially in patients who benefited from primary complete surgery and maintained good performance status. PMID:34955158 | DOI:10.1016/S0007-4551(21)00583-X View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The immunologic balance: three cases of rituximab-associated melanoma

xlomafota13 shared this article with you from Inoreader The immunologic balance: three cases of rituximab-associated melanoma Via Melanoma Research - Current Issue Currently, there is no known clinical evidence that rituximab increases the rate of subsequent primary malignancies; however, some studies have raised the question of increased melanoma risk following rituximab treatment for non-Hodgkin lymphoma. We report three interesting cases of suspected rituximab-induced melanoma. We hypothesize that this association is secondary to rituximab-driven shifts in the immunologic balance. Based on these cases, it is possible that the number of post-rituximab melanoma cases is underreported. Further mechanistic research into individual cases and population-level studies are required to better define association and risk; however, given the increasing prevalence of oncologic and nononcologic rituximab use, awareness across all fields is essential. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical features, molecular characteristics and surgical management of primary penile mucosal melanoma based on the European Association of Urology Penile Cancer Guidelines

xlomafota13 shared this article with you from Inoreader Clinical features, molecular characteristics and surgical management of primary penile mucosal melanoma based on the European Association of Urology Penile Cancer Guidelines Via Melanoma Research - Current Issue Penile mucosal melanoma is an aggressive and rare genital malignancy. The aim of the present study was to review the management and outcomes of a homogenous cohort of patients with histologically confirmed penile mucosal melanoma, at a single specialist centre. A retrospective review of an institutional database identified patients with penile mucosal melanoma over a 10-year period. Patient demographics, histopathological characteristics, type of primary surgery, recurrence, presence of metastatic disease and molecular markers were evaluated. The management of the patients was initially based on the European Associati on of Urology (EAU) penile cancer guidelines which are primarily for squamous cell carcinoma with inputs from a melanoma multidisciplinary team. Twelve patients with penile mucosal melanoma were analysed. Median [interquartile range (IQR)] age was 69.5 (67.25−81) years. The overall median follow-up (IQR) was 69.5 (20−114) months, while median follow-up for cancer-specific survival (CSS) was 11.5 (8−37) months. Location of the primary tumour was glans penis (n = 7), urethra (n = 2) and inner prepuce (n = 3). The CSS at 1, 2 and 5 years after primary surgery was 33%, 16.7% and 0%, respectively. The recurrence-free survival at 1, 3 and 5 months after the primary surgery was 90%, 67% and 56%, respectively. All patients with metastatic disease or with inguinal lymph node invasion at presentation, died within 25 months of the primary diagnosis. Management based on the modified EAU penile cancer guidelines still led to poor outcomes. We present a management diagram based on our experience. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Leptomeningeal dissemination as a first sign of progression in metastatic melanoma: a diagnostic lesson

xlomafota13 shared this article with you from Inoreader Leptomeningeal dissemination as a first sign of progression in metastatic melanoma: a diagnostic lesson Via Melanoma Research - Current Issue One of the most serious complications of advanced melanoma is the diffusion of cancer cells to the central nervous system. The diagnosis of leptomeningeal metastasis (LMM) is notoriously challenging and requires a combination of consistent MRI and cerebrospinal fluid (CSF) cytology. In ambiguous cases, mutations like BRAF V600E in CSF-cell-free (cf)DNA may help to clarify diagnosis of LMM. Here we present the case of a young woman who developed isolated LMM after the diagnosis of a node-positive primary melanoma with normal LDH. The CSF was negative for tumour cells by cytology but positive for cfDNA BRAF V600E mutatio n, thus allowing us to diagnose LMM. To our knowledge, this is the first case where CSF sampling for the detection of BRAF mutation was used to identify leptomeningeal disease in the presence of negative MRI and without involvement of any other distant sites. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Breathy Dysphonia, Not Just a Pain in the Neck

xlomafota13 shared this article with you from Inoreader Breathy Dysphonia, Not Just a Pain in the Neck Via ear nose throat Ear Nose Throat J. 2021 Dec 27:1455613211069919. doi: 10.1177/01455613211069919. Online ahead of print. ABSTRACT We describe a rare occurrence of unilateral vocal fold paralysis associated with a cervical osteophyte abutting the course of the recurrent laryngeal nerve. Trans-nasal laryngoscopy is vital in diagnosing vocal fold paralysis, but often does not provide insight into etiology. This case highlights the importance of radiographic imaging in newly diagnosed vocal fold paralysis, and underscores the principle that a diagnosis is not idiopathic until all sources have been ruled out. PMID:34958270 | DOI:10.1177/01455613211069919 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Intramolecular Ionic Interaction Linking Defective Sodium/Iodide Symporter Transport to the Plasma Membrane and Dyshormonogenic Congenital Hypothyroidism

xlomafota13 shared this article with you from Inoreader An Intramolecular Ionic Interaction Linking Defective Sodium/Iodide Symporter Transport to the Plasma Membrane and Dyshormonogenic Congenital Hypothyroidism Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.