Use of Polysomnography and CPAP in Children Who Received Adenotonsillectomy, US 2004 to 2018

xlomafota13 shared this article with you from Inoreader Use of Polysomnography and CPAP in Children Who Received Adenotonsillectomy, US 2004 to 2018 Via The Laryngoscope Objectives 1) To determine the prevalence polysomnogram (PSG) and continuous positive airway pressure (CPAP) therapy use in children who received adenotonsillectomy (AT) for sleep symptoms. 2) To identify health care disparities in these regards. Study Design Retrospective database analysis. Methods This study used data from Optum (Health Services Innovation Company) to identify 92,490 children who received AT for sleep symptoms between 2004 and 2018. Prevalence of preoperative PSG and postoperative PSG and CPAP were described. Clinical and demographic characteristics were compared between children who had preoperative PSG and those who did not. Characteristics of children with trisomy 21 (T21) were compared to assess PSG and CPAP use in a high-risk cohort. Predictive modeling was used to identify patient characteristics associated with postoperative PSG and CPAP use. Results Preoperative PSG was obtained in 5.5% of children overall and 33.2% of children with T21. Male sex, obesity, other medical comorbidities, non-White race/ethnicity, and higher parent education were associated with preoperative PSG. Fewer than 3% of children received postoperative PSGs and approximately 3% went on to receive CPAP therapy postoperatively. Multiple logistic regression showed that age at surgery, male sex, obesity, other medical comorbidities, non-White race/ethnicity, and higher parent education were associated with postoperative PSG and CPAP use. Conclusions and Relevance This study described the prevalence pre-AT PSG use and post-AT PSG and CPAP use for persistent symptoms and identified sleep health care disparities in these regards. These results show that increased, equitable access to PSG is needed in children, particularly in the workup and treatment persistent symptoms after AT. Level of Evidence 4 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Omaveloxolone attenuates squamous cell carcinoma growth and disease severity in an Epidermolysis Bullosa mouse model

xlomafota13 shared this article with you from Inoreader Omaveloxolone attenuates squamous cell carcinoma growth and disease severity in an Epidermolysis Bullosa mouse model Via Experimental Dermatology Abstract Patients with Epidermolysis Bullosa (EB) are susceptible to development of squamous cell carcinomas (SCC) at sites of chronic inflammation and fibrosis. While triterpenoids such as RTA 408 (Omaveloxolone) have been shown to reduce inflammation and inhibit tumor growth in various cancer models, the utility of this class of drugs in the treatment of SCC has not been investigated. Given the dual anti-inflammatory and anti-neoplastic properties of triterpenoids, we hypothesized RTA 408 would be an effective treatment for SCCs that arise in the chronic inflammatory setting in EB. We tested the effects of topical RTA 408 on a mouse model of non-Herlitz, junctional EB. RTA 408 significantly reduced phenotypic severity in the affected ears of Lamc2jeb mice. In cultures, RTA 408 reduced cell viability in EB-associated SCC cell lines and normal human epidermal keratinocytes. When administered in vivo, RTA 408 inhibited SCC tumor growth in mice without cutaneous or systemic tox icity. These results suggest that RTA 408 can be a promising new therapy to reduce inflammation and inhibit SCC growth in patients with EB. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of radiotherapy combined with immune checkpoint inhibitors in patients with melanoma: a systemic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Efficacy of radiotherapy combined with immune checkpoint inhibitors in patients with melanoma: a systemic review and meta-analysis Via Melanoma Research - Current Issue The purpose of this study is to review the efficacy of radiotherapy combined with immune checkpoint inhibitors (ICIs) in the treatment of melanoma and systematically evaluate the efficacy and safety of this combined treatment compared with ICIs alone. We searched a number of online databases up to 1 July 2021. Comprehensive Meta-Analysis 2.0 and RevMan 5.0 were used for summary analysis. The overall survival (OS), progression-free survival (PFS), overall response rate (ORR) and treatment adverse effects (AEs) were calculated. In total, 624 patients were included from 12 studies, including nine published studies and the r esults of three clinical trials. Radiotherapy combined with ICIs had a higher ORR compared with ICIs alone (35.00 vs. 20.39%). In terms of survival effect, radiotherapy combined with ICIs had no obvious advantage in OS. There was no statistically significant difference between 6-month and 12-month OS (P = 0.13; P = 0.69). There was no significant difference in PFS at 6 months (P = 0.08), but there was a significant difference in PFS at 12 months (P = 0.005). For patients with melanoma, radiotherapy combined with ICIs can improve the effective rate of treatment. Although there is no obvious OS advantage, it can improve PFS without serious adverse effects. Most of the studies included in this article are retrospective analyses, and there are few randomized controlled studies at present. Therefore, more prospective studies are still needed to explore the efficacy of radiotherapy combined with immunotherapy in melanoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chemosaturation with percutaneous hepatic perfusion of melphalan for metastatic uveal melanoma

xlomafota13 shared this article with you from Inoreader Chemosaturation with percutaneous hepatic perfusion of melphalan for metastatic uveal melanoma Via Melanoma Research - Current Issue Uveal melanoma, the most common primary ocular malignancy in adults, carries a poor prognosis: 50% of patients develop the metastatic disease with a 10–25% 1-year survival and no established standard of care treatment. Prior studies of melphalan percutaneous hepatic perfusion (M-PHP) have shown promise in metastatic uveal melanoma (mUM) patients with liver predominant disease but are limited by small sample sizes. We contribute our findings on the safety and efficacy of the procedure in the largest sample population to date. A retrospective analysis of outcome and safety data for all mUM patients receiving M-PHP was perfor med. Tumour response and treatment toxicity were evaluated using RECIST 1.1 and Common Terminology Criteria for Adverse Events v5.03, respectively. 250 M-PHP procedures were performed in 81 patients (median of three per patient). The analysis demonstrated a hepatic disease control rate of 88.9% (72/81), a hepatic response rate of 66.7% (54/81), and an overall response rate of 60.5% (49/81). After a median follow-up of 12.9 months, median overall progression-free (PFS) and median overall survival (OS) were 8.4 and 14.9 months, respectively. There were no fatal treatment-related adverse events (TRAE). Forty-three grade 3 (29) or 4 (14) TRAE occurred in 23 (27.7%) patients with a significant reduction in such events between procedures performed in 2016–2020 vs. 2012–2016 (0.17 vs. 0.90 per patient, P View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Real-world frequency of BRAF testing and utilization of therapies in patients with advanced melanoma

xlomafota13 shared this article with you from Inoreader Real-world frequency of BRAF testing and utilization of therapies in patients with advanced melanoma Via Melanoma Research - Current Issue Both BRAF/MEK targeted agents and immunotherapy are approved for the treatment of advanced melanoma. BRAF testing is recommended at the time of advanced melanoma diagnosis. In addition, little is known regarding the treatment trends for patients with BRAF mutated tumors. This investigation aims to assess the real-world prevalence of molecular testing and treatment trends for patients with BRAF mutated tumors. Using a de-identified database, patients of age ≥18 years with advanced melanoma from 2013 to 2018 were examined. Molecular testing performed within 3 months of advanced diagnosis was considered to have the test pe rformed at the time of diagnosis. Test prevalence was calculated and compared in groups stratified by the patient, tumor and treatment factors. In total 4459 patients were included; 1936 (43.4%) stage III, 1191 (26.7%) stage IV and 1332 (29.9%) recurrent. Totally 50.4% of patients received systemic treatment; 76.4% stage IV, 71% recurrent patients and 26.7% stage III patients. However, 73.5% received first-line immunotherapy. In total 73.8% of patients had molecular testing, and 50.5% had tested at the time of advanced diagnosis. Of those tested 42% had a BRAF mutated tumor. In total 48% of these patients received first-line immunotherapy whereas 43% received a BRAF inhibitor, with increasing immunotherapy use seen over time. The majority of patients with advanced melanoma undergo molecular testing at the time of advanced diagnosis. Immunotherapy is the most commonly prescribed treatment regardless of BRAF mutational status. These results provide real-world data on the frequency of molecular testing and treatment trends for patients with advanced melanoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proof-of-concept of a new FFP2 mask adapted to Otolaryngological practice in pandemic: a prospective study

xlomafota13 shared this article with you from Inoreader Proof-of-concept of a new FFP2 mask adapted to Otolaryngological practice in pandemic: a prospective study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Mar 14. doi: 10.1007/s00405-022-07319-5. Online ahead of print. ABSTRACT OBJECTIVE: The objective of this study was to appreciate the tolerance and convenience of a new FFP2 mask allowed the realization of nasal examination in period of pandemic. METHODS: Fifty-one patients were prospectively recruited from two European hospitals to test the FFP2 mask prototype. The following outcomes were evaluated in patients after the clinical examination: fear about coronavirus disease 2019 (COVID-19) infection; easiness of mask placement; tolerability; reassurance; and overall satisfaction about the use of this kind of mask in a pandemic context. Seven otolaryngologists evaluated the mask acceptance and usefulness in patients through a standardized physician-reported outcome questionnaire. RESULTS: Fifty patients completed the evaluation. There were 25 males and 25 females. The mean age of patients was 4 1 years. Ninety percent of patients considered that the use of the mask reduced the risk to be infected during the examination. Seventy percent of patients reported high or very high satisfaction and should recommend mask to other patients in pandemic period. The realization of nasal examination was easier with optic compared with flexible trans-nasal examination (p = 0.001), which significantly impacted the satisfaction level of physician (p = 0.001). The physician difficulty to perform the examination significantly impacted the satisfactory of patient (p = 0.033). CONCLUSION: The new bioserenity FFP2 mask allows the realization of the trans-nasal endoscopic examination during a pandemic. The use of this mask requires little training period of physician. The use of this mask prototype is well received by patients who reported better perception of self-protection against the virus. PMID:35286440 | DOI:10.1007/s00405-022-07319-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The computed tomographic evaluation of bony bridge of C1 as bleeding risk factor at the screw placement

xlomafota13 shared this article with you from Inoreader The computed tomographic evaluation of bony bridge of C1 as bleeding risk factor at the screw placement Via radiol anat Surg Radiol Anat. 2022 Mar 14. doi: 10.1007/s00276-022-02919-6. Online ahead of print. ABSTRACT PURPOSE: To investigate the prevalence and morphological characteristics of ponticulus posticus (PP) and ponticulus lateralis (PL) using computed tomography (CT) images on a large study sample of the Anatolian population. The presence of the PP and PL bridges can limit gap available for placement procedure through the bony elements of C1. Routine screw techniques are contraindicat ed because of high risk of fatal bleeding of vertebral artery (VA). METHODS: The CT images of 1000 subjects (500 males, 500 females) were examined for the morphological characteristics and presence of PP and PL. The anteroposterior diameter, superoposterior (transverse) diameter, surface area, and central thickness of the bony bridge of the PP, PL, and transverse foramina (TF). RESULTS: The prevalence of PP was 14.8%, and bilateral complete PP was the most common PP type at 6.8%. The prevalence of PL was 4.1% and left-side complete PL was the most common PL type at 1.2%. The prevalence of both PP and PL was more common in males and bilateral complete PP were more predominant in males (p = 0.004, p = 0.038, and p = 0.010, respectively). The surface area of PP and PL were determined to be smaller than the surface area of the ipsilateral TF (p < 0.001 and p = 0.042, respectively). CONCLUSION: PP is not an uncommon anatomic anomaly and PL is even less frequently enc ountered. The prevalence of PP and PL was more common in males and bilateral complete PP was more predominant in males. Detailed information about the prevalence and morphometry of the PP and PL obtained in the present study could guide the clinicians dealing with neurosurgery, physical medicine and rehabilitation, and radiology in their practice. PMID:35286403 | DOI:10.1007/s00276-022-02919-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnosis and correction of the obstructive sleep apnea syndrome in children with tonsillar ring pathological conditions

xlomafota13 shared this article with you from Inoreader Diagnosis and correction of the obstructive sleep apnea syndrome in children with tonsillar ring pathological conditions Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2022;87(1):4-8. doi: 10.17116/otorino2022870114. ABSTRACT To summarize the results of a study of the clinical and polygrapic features of sleep in children with pathologic conditions of the tonsillar ring and obstructive sleep apnea. Tonsillar hypertrophy is the most common cause of obstructive sleep apnea in children. Using the data of overnight polysomnographic study and/or nocturnal pulse oximetry, groups of patients were distinguished depending on the presence and severity of their sleep breathing disorders. The effectiveness of adenotomy, adenotonsillotomy and/or adenotonsillectomy in children is demonstrated, depending on the severity of obstructive sleep apnea syndrome. Evaluation of breathing in sleeping children by polygraphic methods is necessary for early detection of obstructive sleep apnea syndrome and monitoring the effectiveness of surgical treatment. PMID:35274885 | DOI:10.17116/otorino2022870114 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The issue of auditory neuropathy: from origins to the present

xlomafota13 shared this article with you from Inoreader The issue of auditory neuropathy: from origins to the present Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2022;87(1):60-69. doi: 10.17116/otorino20228701160. ABSTRACT The issue of auditory neuropathy spectrum disorders (ANSD) has been in a focus of specialists attention for a relatively short time, but during this time a huge amount of scientific and practical knowledge about this hearing disorder has been accumulated. ANSD is a specific auditory deficit caused by dysfunction of periphery part of the auditory system, which may affect the inner hair cells, the spiral ganglion neurons and the auditory nerve, as well as the area of synaptic contact between them, while the outer hair cells, as a rule, remain intact. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, electrophysiological data may not correlate with hearing level, the discrepancy between pure tone audiometry and speech discrim ination is observed. ANSD prevalence, epidemiology, contemporary views on its etiology, including detailed information on hereditary forms of the disorder and its risk factors are considered in the review. The data on the basic rungs of the ANSD pathogenesis, which underlie the development of various forms of the disorder and mainly determine the rehabilitation approach, are presented. The detailed clinical and audiological characteristics of ANSD are presented; contemporary approach to ANSD diagnosis and rehabilitation, including indications for surgical treatment, are considered. PMID:35274894 | DOI:10.17116/otori no20228701160 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Current views on the treatment and prevention of recurrent acute otitis media in children (review of clinical recommendations)

xlomafota13 shared this article with you from Inoreader Current views on the treatment and prevention of recurrent acute otitis media in children (review of clinical recommendations) Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2022;87(1):46-51. doi: 10.17116/otorino20228701146. ABSTRACT Recurrent acute otitis media (RAOM) represents at least 3 or more separate episodes of acute otitis media within 6 months or four or more episodes over a 12-month period. The incidence of recurrent otitis media varies from 5 to 30% and does not tend to decrease. Until now, the questions of conservative and surgical treatment of patients remain unsolved. One of the main methods of treatment is antimicrobial therapy. Recently, the treatment of recurrent otitis media is complicated by the increasing acquired resistance of bacteria to antimicrobial drugs. There is also no consensus on the need for and scope of surgical interventions for children with RAOM. The authors in their article cite existing modern approaches to the prevention and treatment of RAOM in children. PMID:35274892 | DOI:10.17116/otorino20228701146 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

On the tactics of management and treatment of patients with congenital cerebral hernias in their localization in the maxillofacial region

xlomafota13 shared this article with you from Inoreader On the tactics of management and treatment of patients with congenital cerebral hernias in their localization in the maxillofacial region Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2022;87(1):87-90. doi: 10.17116/otorino20228701187. ABSTRACT The analysis of the state of two patients with congenital cerebral hernias was carried out, which made it possible to establish differences in the effect of hernias on the state of the body. In the first case, the hernia is localized in the nasal cavity, and after its removal, the postoperative cerebrospinal fluid (CSF) leakage was stopped by a flap of the mucous membrane from the opposite side of the nasal septum. In the second case clinical analysis and computed tomography made it possible to state that the hernia was in the retromaxillary space and did not affect the patient's condition. Computed tomography shows signs of moderate blood pressure on the adjacent formations, and removal of the hernia and stopping the subsequent CSF leakage were impossible. The presented observations demonstrate an ambiguous approach to resolving the issue of surgical i ntervention in such cases. PMID:35274898 | DOI:10.17116/otorino20228701187 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.