Impact of resection margin status and revision transoral laser microsurgery in early glottic cancer: analysis of organ preservation and local disease control on a cohort of 153 patients.

xlomafota13 shared this article with you from Inoreader Impact of resection margin status and revision transoral laser microsurgery in early glottic cancer: analysis of organ preservation and local disease control on a cohort of 153 patients. Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Related Articles Impact of resection margin status and revision transoral laser microsurgery in early glottic cancer: analysis of organ preservation and local disease control on a cohort of 153 patients. Braz J Otorhinolaryngol. 2020 Oct 17;: Authors: Saraniti C, Montana F, Chianetta E, Greco G, Verro B Abstract INTRODUCTION: Transoral laser microsurgery represents the treatment of choice for early glottic cancer. Its use and effectiveness are mainly related to laryngeal exposure and deep extension of tumor. Histopathologic assessment of surgical margin presents a main issue about transoral laser microsurgery and complete oncological excision. OBJECTIVE: The aim was to analyze the impact of revision surgery on organ preservation and local disease control in patients with early glottic cancer treated by transoral laser microsurgery. METHODS: We carried out a retrospective study on a cohort of 153 patients with early glottic cancer (Tis, T1, T2) treated by transoral laser microsurgery. Resection margins were classified as follows: "free" if macroscopic margin-tumor distance was at least 2mm, as "close" if it was less than 2mm and "positive" if the margin was involved by carcinoma. Patients were divided into two groups: patients with free resection margins (Group A) and patients with positive, close or not-evaluable resection margins (Group B). Group A (36) underwent periodic followup. Group B (117) underwent a second look laser CO2 2 months after surgery. Fifteen patients of Group A with suspected persistence of carcinoma during followup underwent a second laser resection after a time interval of 4-8 months after first surgery. Overall survival, disease-free survival, disease-specific survival, ultimate local control with laser alone and organ preservation rates were estimated. RESULTS: Five-year overall survival rate and 5-year disease-specific survival were 100% in both groups. The five-year laryngeal preservation rate was 100% in Group A and 95.2% in Group B. Five-year disease-free survival was 92.15% and 5-year ultimate local control with laser alone in 92.15% of patients. CONCLUSION: This study has demonstrated that revision Transoral Laser Microsurgery is able to confirm the oncological radicality in most cases, even in the case of positive, close or non-evaluable margins. Considering our results, according to our experience, the second look with CO2 laser is a therapeutic strategy to consider, even in the case of close or non-evaluable as well as positive margins. PMID: 33272837 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of the Connecticut olfactory test (CCCRC) adapted to Brazil.

xlomafota13 shared this article with you from Inoreader Validation of the Connecticut olfactory test (CCCRC) adapted to Brazil. Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Related Articles Validation of the Connecticut olfactory test (CCCRC) adapted to Brazil. Braz J Otorhinolaryngol. 2020 Nov 06;: Authors: Fenólio GHM, Anselmo-Lima WT, Tomazini GC, Compagnoni IM, Amaral MSAD, Fantucci MZ, Peixoto PPL, Guimarães AF, Guimarães RES, Sakano E, Valera FCP, Tamashiro E Abstract INTRODUCTION: Olfactory changes are quite common in the population, causing a significant impact on the quality of life. Documentation of the olfactory function is essential for the diagnosis, treatment and follow-up of patients with inflammatory diseases of the upper airways, neurodegenerative diseases or viral infections. Among the different existing smell tests, the CCCRC is an inexpensive test, easy to apply, but it has not yet been evaluated on a large scale in the Brazilian population. OBJECTIVE: To validate the CCCRC smell test, after adaptation for the Brazilian population, evaluating the performance of healthy volunteers and the stability of the test in retests. METHODS: In this study, we carried out a cultural adaptation of the CCCRC test to Brazil. To validate and determine the normality scores, we applied the test to 334 healthy volunteers, aged >18 years of age. The retest was also carried out in up to four weeks on 34 additional volunteers to assess validity of the results. RESULTS: When evaluating the participants' performance, normosmia and mild hyposmia values were obtained in more than 95% of them. Women (58.4%) showed better accuracy than men (41.6%): p<0.02, and individuals over 60 years of age showed worse performance (median: 6; 75th percentile: 6.5; 25th percentile). The test and retest of the 34 volunteers demonstrated that there was agreement (ICC, intraclass correlation coefficient) considered good in the left nostril (ICC=0.65) and excellent in the right nostril (ICC=0.77) in the combined score. CONCLUSION: The CCCRC test adapted to Brazil showed normal values, similar to the originally-described test and validations in other countries, with a high reproducibility rate. Considering the highly favorable cost-benefit ratio, the adapted CCCRC is a very useful tool for measuring olfactory function in the Brazilian population. PMID: 33272838 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality of life in tongue cancer treated patients before and after speech therapy: a randomized clinical trial.

xlomafota13 shared this article with you from Inoreader Quality of life in tongue cancer treated patients before and after speech therapy: a randomized clinical trial. Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Related Articles Quality of life in tongue cancer treated patients before and after speech therapy: a randomized clinical trial. Braz J Otorhinolaryngol. 2020 Nov 09;: Authors: Balbinot J, Real CS, Melo CC, Dornelles S, Costa SSD Abstract INTRODUCTION: Tongue cancer is one of the most common subtypes of head and neck cancer. The aggressive effects of treatment cause aesthetic, psychosocial and functional deficits, especially dysphagia, which affects patient quality of life. Rehabilitation, which is essential for functional maximum recovery, helps patients deal with new and altered structures and has a positive impact on quality of life. OBJECTIVE: To verify the impact of speech therapy on swallowing quality of life in tongue cancer patients after treatment. METHODS: This parallel randomized clinical trial was conducted at a public hospital in Porto Alegre, RS, Brazil. Before and after the intervention, a quality of life questionnaire (the Deglutition Handicap Index) was employed, dysphagia severity was assessed with fiberoptic endoscopic evaluation of swallowing, and the Functional Oral Intake Scale carried out. The experimental group underwent four-week sessions of speech therapy over one month, while the control group received the institution's usual follow-up. RESULTS: Thirty individuals treated for tongue cancer were divided into a study and a control group. Deglutition Handicap Index scores decreased significantly (approximately 40 points) (p < 0.001) after the intervention in the study group. There was a significant correlation between improved quality of life, reduced dysphagia severity and increased in Functional Oral Intake Scale scores (p < 0.001). CONCLUSION: After speech therapy, quality of life scores related to deglutition and dysphagia severity improved in patients treated for tongue cancer. PMID: 33272839 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Low Serum 25OHD Levels with Abnormal Bone Microarchitecture in Well-Differentiated Thyroid Cancer.

xlomafota13 shared this article with you from Inoreader Association of Low Serum 25OHD Levels with Abnormal Bone Microarchitecture in Well-Differentiated Thyroid Cancer. Via radioactive iodine Related Articles Association of Low Serum 25OHD Levels with Abnormal Bone Microarchitecture in Well-Differentiated Thyroid Cancer. Med Sci (Basel). 2020 Dec 01;8(4): Authors: Hawkins Carranza F, Guadalix Iglesias S, De Mingo Dominguez ML, Allo Miguel G, Arroba CM, Alvares BL, Martínez Diaz-Guerra G Abstract The association of low levels of 25 hydroxyvitamin D (25OHD) with papillary thyroid cancer (PTC) is being studied, as to whether it is a risk factor or as a coincidental one. This study aimed to evaluate serum levels of deficiency, insufficiency, and sufficiency of 25OHD in PTC and its relationship with the trabecular bone score (TBS) and bone mineral density (BMD). This study includes 134 postmenopausal women with PTC, followed for 10 years. BMD was measured with DXA Hologic QDR 4500, and TBS with Med-Imaps iNsight2.0 Software. Mean serum 25OHD was 23.09 ± 7.9 ng/mL and deficiency, insufficiency, and sufficiency levels were 15.64 ± 2.9, 25.27 ± 2.7, and 34.7 ng/mL, respectively. Parathyroid hormone (PTH) and bone alkaline phosphatase (BAP) were higher in deficiency (57.65 ± 22.6 ng/mL; 29.5 ± 14 U/L) and in insufficiency (45.88 ± 19.8 ng/mL; 23.47 ± 8.8 U/L) compared with sufficiency of 25OHD (47.13 ± 16 and 22.14± 9.7 ng/mL) (p = 0.062 and p = 0.0440, respectively) . TBS was lower in patients with 25OHD < 20 ng/mL (1.24 ± 0.13) compared with between 20-29 (1.27 ± 0.13, p < 0.05) and 30 ng/mL (1.31 ± 0.11, p < 0.01). We found low TBS in patients with PTC and long-term follow-up associated with low serum 25OHD levels, not associated with cancer stage, or accumulative iodine radioactive dose. Low 25OHD associated with deleterious bone quality in patients with PTC should be restored for the prevention of fractures. PMID: 33271814 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patients' and surgeons' experiences after failed breast reconstruction: A qualitative study.

xlomafota13 shared this article with you from Inoreader Patients' and surgeons' experiences after failed breast reconstruction: A qualitative study. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles Patients' and surgeons' experiences after failed breast reconstruction: A qualitative study. J Plast Reconstr Aesthet Surg. 2020 Nov 08;: Authors: Kouwenberg CAE, van Hoogdalem LE, Mureau MAM, Ismail S, Gopie JP, Tibben A, Kranenburg LW Abstract BACKGROUND: The goal of postmastectomy breast reconstruction (BR) is to improve the quality of life of patients. However, complications following autologous BR (A-BR) and implant-based BR (I-BR) occur frequently and may even lead to BR-failure, which can be a distressing event for both patients and surgeons. The current study, therefore, examines the experiences of both patients and surgeons after a BR-failure. METHODS: Patients with a failed BR from a large multicenter cohort study and participating plastic surgeons were invited to participate in semi-structured interviews focusing on their experiences. The interviews were analyzed according to the principles of grounded theory. RESULTS: Fourteen patients with a failed I-BR, four patients with a failed A-BR, and four plastic surgeons were participated. Three main categories emerged from the data: personal experiences with BR-failure, the motives for a redo of a failed BR, and patient-surgeon communication. Patients would like to be treated with more attention to their personal feelings and lives, instead of being approached from a purely medical-technical perspective. Surgeons may experience feelings of guilt leading to the strong urge to fix the failed BR, whereas patients may be less inclined to undergo additional operations. Patients want to know what the choice for a particular type of BR would mean to their personal lives. The impact of I-BR-failure may be underestimated and requires the same degree of intensive aftercare and attention. CONCLUSIONS: Implementing the recommendations of this study in clinical practice may facilitate improvements in how both patients and surgeons cope with a BR-failure. PMID: 33272843 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Comprehensive Analysis of Age and Gender Effects in European Portuguese Oral Vowels

xlomafota13 shared this article with you from Inoreader A Comprehensive Analysis of Age and Gender Effects in European Portuguese Oral Vowels Via Journal of Voice The knowledge about the age effects in speech acoustics is still disperse and incomplete. This study extends the analyses of the effects of age and gender on acoustics of European Portuguese (EP) oral vowels, in order to complement initial studies with limited sets of acoustic parameters, and to further investigate unclear or inconsistent results. A database of EP vowels produced by a group of 113 adults, aged between 35 and 97, was used. Duration, fundamental frequency (f0), formant frequencies (F1 to F3), and a selection of vowel space metrics (F1 and F2 range ratios, vowel articulation index [VAI] and formant centralization ratio [FCR]) were analyzed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Madhura mycosis of foot

xlomafota13 shared this article with you from Inoreader Madhura mycosis of foot Via Neuroradiology Cases   Sagittal T2w Sagittal T1w Sagittal STIR MRI study of ankle/foot with x-ray correlation shows: A lobulated abnormal soft tissue measuring approximately 70 mm in length and 40 mm in depth on dorsal aspect of foot encasing extensor tendons with hypo intense signal on T2-weighted images, "dot in a circle" sign on MRI.  Soft tissue density on x-ray without dystrophic calcification on x-ray. Lytic destruction of adjacent anterior corner of tibia on MRI and x-ray. Associated tibio talar joint effusion. Multifocal ovoid l ytic lesion with sclerotic rim on x-ray involving distal end of tibia with fluid signal on MRI. Marginal lytic destruction of distal end of fibula. Circumferential punched-out marginal erosion of neck of talus which is markedly thinned out with an associated marrow oedema on STIR. Multifocal marrow oedema involving tarsal bones, tenosynovitis of extensor as well as plantar tendons. Multiple ulcers, nodules and discharging sinuses on skin of dorsal aspect of foot when examined clinically. Imaging diagnosis: Madhura mycosis of foot with osteomyelitis of tibia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID 19 Cerebritis

xlomafota13 shared this article with you from Inoreader COVID 19 Cerebritis Via Neuroradiology Cases Clinically: A known case of COVID 19 positive admitted for fever and breathlessness. After five days of hospital admission developed sinusitis, headache and started worsening repidly. Subjected for MRI due to sudden onset loss of consciousness and neurological examination revealed new onset ophthalmoplegia.  MRI shows bilateral geographic shaped patchy T2 hyperintensities involving frontal lobes with diffusion restriction at the floor of anterior cranial fossa. Mild lepto meningeal enhancement on post contrast.  An associated marked bilateral paranasal sinusitis. Possibility of COVID 19 Cerebritis, Neuro inv asiveness by transnasal route suggested and can be attributed to known Neurotropism of the virus.  Neurotropism of Covid 19 Neuronal pathway is one of important way of spread of neuropathic viruses like Cov to enter central nervous system. These viruses can migrate with the help of sensory as well as motor nerve endings and have ability of retrograde as well as antegrade spread along the olfactory nervous system due to the unique anatomical organisation of olfactory nerves and olfactory bulb in the nasal cavity and fore brain. As a result, Cov after paranasal sinus infection can enter brain through olfactory tract in early stages of infection rapidly, within seven days of infection as in our case. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstruction of upper limb soft-tissue defects after sarcoma resection with free flaps: A systematic review.

xlomafota13 shared this article with you from Inoreader Reconstruction of upper limb soft-tissue defects after sarcoma resection with free flaps: A systematic review. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles Reconstruction of upper limb soft-tissue defects after sarcoma resection with free flaps: A systematic review. J Plast Reconstr Aesthet Surg. 2020 Nov 08;: Authors: Lucattelli E, Lusetti IL, Cipriani F, Innocenti A, De Santis G, Innocenti M Abstract BACKGROUND AND OBJECTIVES: Upper limb preservation after soft tissue sarcoma (STS) surgical excision is now the accepted gold standard and it often requires reconstruction with free flaps. The purpose of this review is to summarize current literature on upper limb reconstruction with free flaps after STS resection. METHODS: A systematic review was performed in July 2019 in PubMed and MedLine Ovid databases according to the PRISMA guidelines. RESULTS: A total of 17 studies were included in the final analysis, with 132 patients. The most common diagnosis was Malignant Fibrous Histiocytoma. The most frequent timing of flap coverage was immediate. The success rate was almost always 100%. The length of follow-up was reported in 11 studies with a range of 2-187 months. The most commonly reported patient-centered outcome was the MSTS Score. Based on the evidence of the literature collected, we divided the upper limb into four parts (shoulder, elbow and arm, forearm and wrist, and hand) and described the most common and functional free flaps used for reconstruction after STS resection. CONCLUSIONS: Free flaps in the treatment of STS of the upper extremity have a good overall outcome, with a low postoperative complication rate. A wide array of free flaps is available for reconstruction, and the choice of flap is based on defect size, types of tissue required, postoperative functional goal, and surgeon preference. A greater degree of standardization is needed in the reporting of patient-centered outcomes to facilitate future comparative studies. PMID: 33277214 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term functional outcomes of vascularized fibular and iliac flap for mandibular reconstruction: A systematic review and meta-analysis.

xlomafota13 shared this article with you from Inoreader Long-term functional outcomes of vascularized fibular and iliac flap for mandibular reconstruction: A systematic review and meta-analysis. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles Long-term functional outcomes of vascularized fibular and iliac flap for mandibular reconstruction: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg. 2020 Nov 08;: Authors: Ma H, Van Dessel J, Shujaat S, Bila M, Gu Y, Sun Y, Politis C, Jacobs R Abstract INTRODUCTION: To date, there is a lack of evidence related to the long-term evaluation of recipient-site functional outcomes following mandibular reconstruction with vascularized bone grafts. Therefore, the aim of this systematic review and meta-analysis was to evaluate the long-term recipient-site functional outcomes in oral oncology patients who require mandibular reconstruction with either vascularized fibular flap (VFF) or vascularized iliac flap (VIF). METHODS: An extensive electronic search was conducted in PubMed, Web of Science, Cochrane, and Embase databases for identifying articles published until April 2020. All papers were dual screened for eligibility in accordance with the Preferred Reporting of Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines. The risk of bias was assessed using the MINORS tool. A meta-analysis of functional outcome parameters was performed to estimate single incidence rates. RESULTS: A total of 257 patients with a mean follow-up period of 38.6 ± 19.5 months were included in this meta-analysis, where 174 patients underwent VFF reconstruction and 83 patients involved reconstruction with VIF. The functional outcomes in patients reconstructed with VIF showed improved scoring for mastication, deglutition, diet, and speech. Speech showed highest score among all functional parameters, whereas, mastication was the most poorly recovered parameter in relation to reconstruction with both flaps. No significant difference in functional outcomes was observed between both flaps. CONCLUSION: Current evidence seems to indicate that VIF offers improved long-term recipient-site functional outcomes. Yet, considering a high level of data heterogeneity in published studies, future long-term standardized comparative studies should be conducted. PMID: 33277215 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.