Head and Neck Cancer Posttreatment Surveillance Questions

xlomafota13 shared this article with you from Inoreader Head and Neck Cancer Posttreatment Surveillance Questions Via JAMA Otolaryngology–Head & Neck Surgery Online First The role of close follow-up of patients with head and neck cancer after completion of therapy is unquestionably important, but questionably vague. While National Comprehensive Cancer Network guidelines on the timing of surveillance are published, the lack of high-level evidence on the effectiveness of these protocols and the changing landscape of HPV-associated cancers on survivorship have expectedly raised the collective eyebrow on their suitability in the current era. As more patients with head and neck cancer benefit from a quantity-of-li fe perspective from more advanced radiation delivery systems, chemoimmunotherapy breakthroughs, and improved surgical techniques, the impending impact this has on resources needed in surveillance, such as costs associated with specialty examinations and anatomic imaging studies, as well as the psychosocial and financial impact on the patients themselves, is becoming more prevalent. In the Original Investigation by Chen et al, the authors seek to identify physician and patient-related barriers to deintensifying surveillance practices and provide suggestions on facilitating change. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictive Value of a Genomic Classifier in Indeterminate Thyroid Nodules Based on Nodule Size

xlomafota13 shared this article with you from Inoreader Predictive Value of a Genomic Classifier in Indeterminate Thyroid Nodules Based on Nodule Size Via JAMA Otolaryngology–Head & Neck Surgery Online First This case series examines the accuracy of a genomic classifier in diagnosis and treatment of patients with indeterminate thyroid nodules. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Local Anesthetic Infusion for Improving Pain From Head and Neck Cancer Surgery—Reply

xlomafota13 shared this article with you from Inoreader Local Anesthetic Infusion for Improving Pain From Head and Neck Cancer Surgery—Reply Via JAMA Otolaryngology–Head & Neck Surgery Online First In Reply We thank Drs Rahman and Mendelsohn for their interest in our recent study. The performance of a neck dissection has been shown to be associated with great and potentially long-lasting pain and is therefore also listed in the German S3 guideline for acute postoperative pain as a surgical procedure with expected high pain levels. Multimodal pain therapy strategies used in various surgical disciplines incorporate the continuous application of local anesthesia in surgical wound cavities. Therefore, this mechanism seems to be reasonable also in the wound cavity after neck dissection. Furthermore, anesthesia of the superficial branches of the cervical plexus also represents an effective technique of anesthesia of the entire lateral neck as it is also performed during local anesthetic procedures on the cervical vessels. Brown has reported that the anterior rami of the second to fourth cervical nerves may also interconnect with peripheral branches of the trigeminal, facial, glossopharyngeal, and hypoglossal nerves. Thus, effective pain relief by a locally applied anesthetic also seems reasonable and effective in the context of neck dissection involving the cervical plexus and, in our opinion, may achieve more than pure anesthesia of the skin of the neck only. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinician Attitudes and Beliefs About Deintensifying Head and Neck Cancer Surveillance

xlomafota13 shared this article with you from Inoreader Clinician Attitudes and Beliefs About Deintensifying Head and Neck Cancer Surveillance Via JAMA Otolaryngology–Head & Neck Surgery Online First This qualitative study surveys otolaryngologists and radiation oncologists regarding their opinions on deintensification of surveillance in patients with diagnosed head and neck cancer. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic cauterisation and injection of Voicegel for treatment of congenital pyriform fossa sinus tracts

xlomafota13 shared this article with you from Inoreader Endoscopic cauterisation and injection of Voicegel for treatment of congenital pyriform fossa sinus tracts Via Laryngologie Acta Otorhinolaryngol Ital. 2021 Oct;41(5):432-435. doi: 10.14639/0392-100X-N1433. ABSTRACT OBJECTIVE: To demonstrate our experience in treating pyriform fossa sinus tracts (PFST) using a novel technique of endoscopic cauterisation of the pyriform fossa sinus opening combined with injection of sodium carboxymethylcellulose gel (VoiceGel) lateral to the tract to encourage tight closure. METHODS: Over a 48-month period, we used this technique on 11 patients who were diagnosed with PFST at BC Children's Hospital, a tertiary paediatric centre in Vancouver, BC, Canada. RESULTS: The 11 patients included 8 males and 3 females, and mean age at presentation was 69 months (range 22-108 months). Mean time from beginning of symptoms till diagnosis was 15 months (range 12-22 months). Ten PFST were on the left side of the neck and one on the right. Nine patients presented with recurrent neck infections and two had suppurative thyroiditis. All p atients had endoscopic cauterisation of their PFST opening combined with injection of carboxymethylcellulose lateral to the sinus tract to cause tract collapse. Mean follow up was 15.8 months (range 8-24). All patients are asymptomatic without recurrence at the last follow-up visit. No post-operative complications were reported. CONCLUSIONS: Endoscopic management of paediatric PFST combined with the injection of sodium carboxymethylcellulose gel lateral to the sinus tract appears to be a safe and effective treatment option for PFST. PMID:34734578 | DOI:10.14639/0392-100X-N1433 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The 5‐HT1A receptor agonist, 8‐OH‐DPAT, Attenuates Long‐Lasting Pain in Imiquimod‐Induced Psoriasis in Mice.

xlomafota13 shared this article with you from Inoreader The 5‐HT1A receptor agonist, 8‐OH‐DPAT, Attenuates Long‐Lasting Pain in Imiquimod‐Induced Psoriasis in Mice. Via Experimental Dermatology ABSTRACT Psoriasis pain is a common symptom underestimated and rarely evaluated in psoriasis clinical trials. This work aimed to investigate if the development of secondary chronic allodynia and hyperalgesia in the imiquimod (IMQ)-induced psoriasis mice model could be modulated by anti-inflammatory agents and compound 48/80 (C48/80) and to determine whether the activation of 5-HT1A receptor modulates these nociceptive behaviors. C57BL/6 male mice were treated with 5% IMQ for 7 days. The paw withdrawal responses to von Frey filaments (10 and 250 mN) were used to assess the allodynia and hyperalgesia. Nociceptive behaviors were also evaluated using ketorolac 15 mg/kg s.c; adalimumab 10 mg/kg s.c., and C48/80 10 mg/kg i.p. Then, the serum serotonin and the impact of 8-OH-DPAT (1 mg/kg s.c), a 5-HT1A receptor agonist, on long-lasting pain were examined. Mice receiving IMQ showed enhanced nociception, which decreased with all tested compounds. The serum serotonin in the IM Q-group showed a significant decrease (947.042 ng/ml) regarding the control group (1143.68 ng/ml). The pre-treatment with 8-OH-DPAT alleviated pain-related behaviors. These results suggest that the long-lasting pain resulting from psoriasis inflammation is also associated with the serotonergic system. The 5-HT1A receptor should be further explored as a potential therapeutic target for psoriasis pain modulation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pathogenesis of solar urticaria: classic perspectives and emerging concepts

xlomafota13 shared this article with you from Inoreader Pathogenesis of solar urticaria: classic perspectives and emerging concepts Via Experimental Dermatology Abstract Solar urticaria is a rare, immunologically-mediated photodermatosis in which activation of cutaneous mast cells is triggered by specific wavelengths of solar electromagnetic radiation. This manifests clinically as the rapid development of cutaneous itch, erythema and wheal formation after several minutes of sun exposure. Disease mechanisms in solar urticaria remain incompletely elucidated and there have been few recent investigations of its pathobiology. Historic passive transfer experiments performed during the twentieth century provide support for a "photoallergy" model of disease pathogenesis, wherein molecular alteration of a putative chromophore by solar electromagnetic radiation produces mast cell activation via an IgE-dependent mechanism. However, this model does not account for several observations made during passive transfer experiments, nor does it explain a range of subsequent clinical and photobiological observations made in solar urticaria patients. Furthermore, increased understanding of the molecular dynamics underpinning cutaneous mast cell responses highlights the need to reformulate our understanding of solar urticaria pathogenesis in the context of this contemporary scientific landscape. In this review, we discuss the current understanding of solar urticaria pathogenesis and, by incorporating recent scientific and clinical observations, develop new hypotheses to drive future investigation into this intriguing disorder. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Do epidermal keratinocytes have sensory and information processing systems?

xlomafota13 shared this article with you from Inoreader Do epidermal keratinocytes have sensory and information processing systems? Via Experimental Dermatology Abstract It was long considered that the role of epidermal keratinocytes is solely to construct a water-impermeable protective membrane, the stratum corneum, at the uppermost layer of the skin. However, in the last two decades, it has been found that keratinocytes contain multiple sensory systems that detect environmental changes, including mechanical stimuli, sound, visible radiation, electric fields, magnetic fields, temperature and chemical stimuli, and also a variety of receptor molecules associated with olfactory or taste sensation. Moreover, neurotransmitters and their receptors that play crucial roles in the brain are functionally expressed in keratinocytes. Recent studies have demonstrated that excitation of keratinocytes can induce sensory perception in the brain. Here, we review the sensory and information processing capabilities of keratinocytes. We discuss the possibility that epidermal keratinocytes might represent the earliest stage in the development of the brain during the evolution of vertebrates. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Engineering Functional Skin Constructs: A Quantitative Comparison of Three‐Dimensional Bioprinting with Traditional Methods

xlomafota13 shared this article with you from Inoreader Engineering Functional Skin Constructs: A Quantitative Comparison of Three‐Dimensional Bioprinting with Traditional Methods Via Experimental Dermatology Abstract Tissue engineering has been successful in reproducing human skin equivalents while incorporating new approaches such as three-dimensional (3D) bioprinting. The latter method offers a plethora of advantages including increased production scale, ability to incorporate multiple cell types, and printing on demand. However, the quality of printed skin equivalents compared to those developed manually has never been assessed. To leverage the benefits of this method, it is imperative that 3D printed skin should be structurally and functionally similar to real human skin. Here, we developed four bilayered human skin epidermal-dermal equivalents: non-printed dermis and epidermis (NN), printed dermis and epidermis (PP), printed epidermis and non-printed dermis (PN), and non-printed epidermis and printed dermis (NP). The effects of printing induced shear stress [0.025 kPa (epidermis); 0.049 kPa (dermis)] were characterized both at the cellular and at the tissue level. At cellular level, no st atistically significant differences in keratinocyte colony forming efficiency (CFE) (p=0.1641), was observed. In the case of fibroblasts, no significant differences in the cell alignment index (p<0.1717), and their ability to contract collagen gel (p=0.851) were detected. At the tissue levels, all the four skin equivalents were characterized using histological and immunohistochemical analysis with no significant differences found in either epidermal basal cell count, thickness of viable epidermis, and relative intensity of filaggrin and claudin-1. Our results demonstrated that 3D printing can achieve the same high-quality skin constructs as have been developed traditionally, thus opening new avenues for numerous high-throughput industrial and clinical applications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Suspension laryngoscopy-assisted percutaneous dilatational tracheostomy: a safe method in COVID-19

xlomafota13 shared this article with you from Inoreader Suspension laryngoscopy-assisted percutaneous dilatational tracheostomy: a safe method in COVID-19 Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):389-394. doi: 10.14639/0392-100X-N1435. ABSTRACT OBJECTIVE: COVID-19 respiratory insufficiency has augmented demand of tracheostomies in intubated patients. Herein, we analyse our experience with suspension laryngoscopy-assisted percutaneous dilatational tracheostomy (SL-PDT) to assess the safety for both healthcare personnel and patients. METHODS: We conducted a retrospective review of all patients who underwent SL-PDT in the Intensive Care Unit (ICU) between March 13 and April 17, 2020 (first peak of SARS-CoV-2 pandemic). RESULTS: We included 28 SL-PDTs conducted in the ICU by a single operator using standard personal protective equipment (PPE) for high-risk procedures. The average procedure time was 30 minutes. Intraoperative complications were few, mild and promptly resolved. No operators were infected after the procedure. CONCLUSIONS: SL-PDT is a safe and quick technique: it is preferable to open surgical procedures, where air-flow cessation cannot be achieved and droplet emission is high. The cost/benefit ratio is low. A disadvantage is the need for an ENT surgeon who is familiar with direct laryngoscopy, with the main difficulty being the exposure of the upper airways. Minimal air leakage and good control of occasional bleeding makes it a safe procedure for the patient and medical personnel alike. PMID:34734573 | DOI:10.14639/0392-100X-N1435 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19 manifestation in the oral cavity - a narrative literature review

xlomafota13 shared this article with you from Inoreader COVID-19 manifestation in the oral cavity - a narrative literature review Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):395-400. doi: 10.14639/0392-100X-N1584. NO ABSTRACT PMID:34734574 | DOI: 10.14639/0392-100X-N1584 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The importance of the patient's perspective in function-sparing parotid surgery for benign neoplasms: clinical reappraisal

xlomafota13 shared this article with you from Inoreader The importance of the patient's perspective in function-sparing parotid surgery for benign neoplasms: clinical reappraisal Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):410-418. doi: 10.14639/0392-100X-N1463. ABSTRACT OBJECTIVE: Function-sparing surgery is the cornerstone for the treatment of benign parotid neoplasms. We assessed the incidences and determinants of the main postoperative complications, reappraising their influence on the patient's quality of life (QoL). METHODS: Patients who underwent parotid surgery for benign neoplasms were reviewed (2016-2019). Parotidectomy Outcome Invento ry-8 (POI-8) and condition-specific questionnaires were used to investigate the patient's perspective. RESULTS: We enrolled 211 patients. Preservation of the posterior branch of the great auricular nerve (GAN) seemed to reduce early dysfunction (87% vs 96%, p = 0.053), but not the late one. Deep lobe dissection and resection of more than one parotid segment favoured first bite syndrome (FBS) and Frey's syndrome (FS), respectively (16% vs 3%, p = 0.003; 37% vs 15%, p = 0.003). Neither GAN impairment, FBS, nor FS influenced patient QoL. Facial weakness affected 19 patients (9%), being more likely after total parotidectomy (23% vs 7%, p = 0.034). According to POI-8, QoL was mainly jeopardised by fear of revision surgery, especially in females (p = 0.005) and those experiencing early complications (p = 0.004). CONCLUSIONS: Reappraisal of the patient's perspective after functional parotid surg ery is fundamental to tailor preoperative counselling. PMID:34734576 | DOI:10.14639/0392-100X-N1463 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.