A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

xlomafota13 shared this article with you from Inoreader A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients Via The Laryngoscope Objectives To assess the incidence, risk factors, and complications of blood transfusions (BTs) in elective thyroidectomy patients. Methods A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program. Adult patients who underwent elective thyroidectomy from 2005 to 2019 were divided into two cohorts based on whether they received BT or not. Multivariable binary logistic regression models were used to identify risk factors of BT and its impact on postoperative complications. Results Of 180,483 patients, 0.13% received BT. Risk factors for BT included underweight body mass index (BMI) (adjusted odds ratio [OR] 3.179, 95% confidence interval [CI] 1.444–6.996), bleeding disorders (OR 2.121, 95% CI 1.149–3.913), anemia (OR 4.730, 95% CI 3.472–6.445), preoperative transfusion (OR 7.230, 95% CI 1.454–35.946), American Society of Anesthesiology physical statuses 3–5 (OR 3.103, 95% CI 2.143–4.492), operative time >150 min (OR 4.390, 95% CI 1.996–9.654), and inpatient thyroidectomy (OR 5.791, 95% CI 3.816–8.787). In addition, transfusion was independently associated with any postoperative complication, non-infectious, cardiac, pulmonary, renal, vascular, or infectious complications, surgical site infection, sepsis, septic shock, wound disruption, pneumonia, unplanned reoperation, prolonged length of stay, and mortality. Conclusion Recognition of risk factors of BT is imperative to identify at-risk patients and reduce transfusions by controlling modifiable risk factors such as anemia, operative time, and BMI. In cases where transfusions are still indicated, surgeons should optimize care to prevent or adequately manage transfusion-associated complications. Level of evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Full coverage path planning algorithm for MRgFUS therapy

xlomafota13 shared this article with you from Inoreader Full coverage path planning algorithm for MRgFUS therapy Via The International Journal of Medical Robotics and Computer Assisted Surgery ABSTRACT Background High-quality methods for Magnetic Resonance guided Focused Ultrasound (MRgFUS) therapy planning are needed for safe and efficient clinical practices. Herein, an algorithm for full coverage path planning based on preoperative MR images is presented. Methods The software functionalities of an MRgFUS robotic system were enhanced by implementing the developed algorithm. The algorithm's performance in accurate path planning following a Zig-Zag pathway was assessed on MR images. The planned sonication paths were performed on acrylic films using the robotic system carrying a 2.75 MHz single element transducer. Results Ablation patterns were successfully planned on MR images and produced on acrylic films by overlapping lesions with excellent match between the planned and experimental lesion shapes. Conclusions The advanced software was proven efficient in planning and executing full ablation of any segmented target. The reliability of the algorithm could be enhanced through the development of a fully automated segmentation procedure. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modified Olfactory Training Is An Effective Treatment Method For Covid‐19 Induced Parosmia

xlomafota13 shared this article with you from Inoreader Modified Olfactory Training Is An Effective Treatment Method For Covid‐19 Induced Parosmia Via The Laryngoscope ABSTRACT Objectives Covid-19 infection often causes olfactory dysfunction and parosmia may occur in some patients with olfactory dysfunction. In this study, we retrospectively investigated the effectiveness of modified olfactory training (MOT) for the treatment of Covid-19-induced parosmia. Methods This study presents results of MOT performed with 12 odors for 36 weeks in patients with olfactory dysfunction following Covid-19 infection. A total of 75 participants were included in the study (mean age 33 years, range 16–60 years). The patients were separated into two groups: 1) Treatment group consisted of parosmia patients who received MOT with three sets of four different odors sequentially. 2) Control group consisted of parosmia patients who did not perform any olfactory training. Both groups were matched for age and sex distribution of participants. Results When the treatment group and the control group were compared, a significant improvement was observed in both groups at the third, sixth, and ninth month, however the improvement in the treatment group was found to be better than in the control group (p<0.001). Extending the treatment from six to nine months in the treatment group was found to be effective in mitigating parosmia complaints and improving discrimination scores (p<0.001). Conclusion This study has shown that modified olfactory training is effective in the treatment of parosmia following Covid-19 infection. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Central nervous system disorders on lorlatinib: How to detect and manage in practice?

xlomafota13 shared this article with you from Inoreader Central nervous system disorders on lorlatinib: How to detect and manage in practice? Via Association française pour l'étude du cancer Bull Cancer. 2022 Mar 4:S0007-4551(22)00069-8. doi: 10.1016/j.bulcan.2022.01.011. Online ahead of print. ABSTRACT The therapeutic arsenal for advanced ALK positive non-small cell lung cancer has been enriched by specific treatments targeting this molecular abnormality, with five molecules available, including lorlatinib, approved since July 2020. This treatment can have side effects common to other tyrosine kinase inhibitors, as well as other less common disorders affecting the central nervous system such as impaired cognitive function, speech or mood. The prevalence of neuro-psychiatric effects under treatment with lorlatinib reported in studies is nearly 40 % with a mild to moderate intensity in most cases. Given the potential impact on patients' quality of life and even on compliance with treatment, it is essential to include their detection during consultations. The main problem is still to have simple screening tools adapted to cl inical practice. A multidisciplinary expert panel (pulmonologist, medical oncologist, psychiatrist, neurologist, pharmacist, nurse) therefore met to propose, based on data from the literature and their clinical experience, elements of management in order to detect these cognitive disorders at an early stage and optimize treatment tolerance. The subjects discussed concern screening and assessment tools, the management of side effects, and their prevention. The use of the practical elements proposed by the group could help optimize the identification and management of central nervous system disorders occurring on lorlatinib. PMID:35256158 | DOI:10.1016/j.bulcan.2022.01.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pituitary Gland Surgical Emergencies: The Role of Endoscopic Intervention

xlomafota13 shared this article with you from Inoreader Pituitary Gland Surgical Emergencies: The Role of Endoscopic Intervention Via leak of cerebrospinal fluid Otolaryngol Clin North Am. 2022 Mar 4:S0030-6665(21)00252-8. doi: 10.1016/j.otc.2021.12.016. Online ahead of print. ABSTRACT True pituitary surgical emergencies are rare. These events can occur throughout the perioperative period and are broadly categorized by the timing of occurrence. Acute indications for emergent pituitary surgery include pituitary apoplexy, vision loss, and severe Cushing presentation. Emergencies may also occur intraoperatively, secondary to bleeding. Postoperative emergencies include epistaxis, pneumocephalus, and intracranial bleeding. Cerebrospinal fluid (CSF) leak occurs in about 37.4% of transsphenoidal sellar surgery, yet postoperative CSF leaks are less frequent at approximately 2.6%. As they occur often during pituitary surgery, CSF leaks alone are generally not considered a true surgical emergency unless associated with symptomatic tension pneumocephalus. PMID:35256166 | DOI:10.1016/j.otc.2021.12.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

'Cement bridge over troubled incus' technique in subjects with oval window atresia and anomalous incus: A preliminary report

xlomafota13 shared this article with you from Inoreader "Cement bridge over troubled incus" technique in subjects with oval window atresia and anomalous incus: A preliminary report Via pubmed: "clin exp otorhinola... Clin Exp Otorhinolaryngol. 2022 Mar 4. doi: 10.21053/ceo.2021.01823. Online ahead of print. NO ABSTRACT PMID:35255662 | DOI:10.21053/ceo.2021.01823 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Hearing Rehabilitation Therapy Program in Hearing Aids Users: A Prospective Randomized Controlled Study

xlomafota13 shared this article with you from Inoreader Effect of Hearing Rehabilitation Therapy Program in Hearing Aids Users: A Prospective Randomized Controlled Study Via pubmed: "clin exp otorhinola... Clin Exp Otorhinolaryngol. 2022 Mar 4. doi: 10.21053/ceo.2021.00948. Online ahead of print. ABSTRACT BACKGROUND: Despite sufficient hearing gains, many patients with hearing loss have difficulty using hearing aids due to poor word recognition ability. This study was performed to introduce our hearing rehabilitation therapy (HRT) program for hearing aid users and to evaluate its effect on hearing improvement. STUDY DESIGN: Prospective randomized case-control study. SUBJECTS AND METHODS: Thirty-seven participants with moderate to moderate-severe sensorineural hearing loss who had used bilateral hearing aids for more than three months with sufficient functional hearing gain were enrolled in this study. Nineteen participants were randomly assigned to the control group (CG) and 18 patients were assigned to participate in our HRT program once a week for eight consecutive weeks (hearing rehabilitation therapy group, HRTG). Their h earing results and questionnaire scores regarding hearing handicap and hearing aid outcomes were prospectively collected and compared between the two groups. RESULTS: After completing eight weeks of the HRT program, the HRTG showed significantly higher delta score of consonant-only and consonant-vowel sound perception compared to the CG (p<0.05). In addition, the HRTG had a significant improvement in hearing ability as measured by two questionnaires (p<0.05), while no differences were observed in the CG. However, word and sentence recognition test results did not show significant differences between the two groups. CONCLUSION: Even after short-term HRT, patients had subjectively better hearing outcomes and improved phoneme perception ability; this provides scientific evidence regarding a possible positive role for HRT programs in hearing aid users. Further validation in a larger population with a long-term follow-up study is needed. PMID:35255665 | DOI:10.21053/ceo.2021.00948 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relationships between maximum tongue pressure and second formant transition in speakers with different types of dysarthria

xlomafota13 shared this article with you from Inoreader Relationships between maximum tongue pressure and second formant transition in speakers with different types of dysarthria Via Speech therapy by Toshiaki Tamura, Yasuhiro Tanaka, Yoshihiro Watanabe, Katsuro Sato The effects of muscle weakness on speech are currently not fully known. We investigated the relationships between maximum tongue pressure and second formant transition in adults with different types of dysarthria. It focused on the slope in the second formant transition because it reflects the tongue velocity during articulation. Sixty-three Japanese speakers with dysarthria (median age, 68 years; interquartile range, 58–77 years; 44 men and 19 women) admitted to acute and convalescent hospitals were included. Thirty neurologically normal speakers aged 19–85 years (median age, 22 years; interquartile range, 21.0–23.8 years; 14 men and 16 women) were also included. The relationship between the maximum tongue pressure and speech function was evaluated using correlation analysis in the dysarthria group. Speech intelligibility, the oral diadochokinesis rate, and the second formant slope were based on the impaired speech index. More than half of the speakers had mild to moderate dys arthria. Speakers with dysarthria showed significantly lower maximum tongue pressure, speech intelligibility, oral diadochokinesis rate, and second formant slope than neurologically normal speakers. Only the second formant slope was significantly correlated with the maximum tongue pressure (r = 0.368, p = 0.003). The relationship between the second formant slope and maximum tongue pressure showed a similar correlation in the analysis of subgroups divided by sex. The oral diadochokinesis rate, which is related to the speed of articulation, is affected by voice on/off, mandibular opening/closing, and range of motion. In contrast, the second formant slope was less affected by these factors. These results suggest that the maximum isometric tongue strength is associated with tongue movement speed during articulation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Normative measurements of the superior oblique and inferior oblique muscles by magnetic resonance imaging

xlomafota13 shared this article with you from Inoreader Normative measurements of the superior oblique and inferior oblique muscles by magnetic resonance imaging Via radiol anat Surg Radiol Anat. 2022 Mar 8. doi: 10.1007/s00276-022-02915-w. Online ahead of print. ABSTRACT PURPOSE: Normative oblique muscle data may help to diagnose pathological enlargement of the oblique muscles. We aim to describe the normative values of the superior and inferior oblique muscles in an Australian cohort on T1-weighted MRI and fat suppressed contrast enhanced T1-weighted MRI. METHODS: A retrospective review of patients who underwent 3 T orbital MRI. The healthy orbits were used to conduct measurements in patients with a unilateral orbital lesion. The maximum diameters of the superior and inferior oblique muscles were measured on coronal planes. The diameter was measured perpendicular to the long axis of the muscles. RESULTS: The normal measurements (mean ± SD) on fat suppressed contrast enhanced T1-weighted MRI: superior oblique, 3.0 ± 0.5 mm and inferior oblique, 2.7 ± 0.5 mm. On T1-weighted MRI: superior oblique, 2.8 ± 0.5 mm and inferior oblique, 2.5 ± 0.4 mm. In patients who had both sequences performed, the superior and inferior oblique diameters were significantly higher on the fat suppressed contrast-enhanced T1-weighted MRI than the T1-weighted MRI sequence (p < 0.01). CONCLUSION: Oblique muscle enlargement may be seen in a range of orbital diseases. These data may help in diagnosing oblique muscle enlargement. In addition, variations in the measured muscle diameters can be seen according to the scan sequence th at is used. PMID:35258651 | DOI:10.1007/s00276-022-02915-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.