Δευτέρα 22 Νοεμβρίου 2021

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader

pae.gif

Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna

Thyroid Research and Practice 2021 18(1):14-18

Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant.
View on the web

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader

pae.gif

Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna

Thyroid Research and Practice 2021 18(1):14-18

Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant.
View on the web

Acute suppurative thyroiditis: An unusual complication

xlomafota13 shared this article with you from Inoreader

pae.gif

Dipratim Das, Partha Chakraborty, Madhurima Ganguly, Pankaj Kumar Halder

Thyroid Research and Practice 2021 18(1):37-39

Acute thyroiditis is rare and usually subsides with medical therapy. An abscess arising due to it is even rarer. Sometimes, surgical drainage is required to control ongoing infection and sepsis. We report a case of a 4-year-old girl who had acute suppurative thyroiditis. The swelling was not resolving after 9 days of administering intravenous antibiotics and eventually compressing the esophagus and trachea which was relieved leading to a speedy recovery on emergency surgical drainage.
View on the web

The never-ending battle between proximal row carpectomy and four corner arthrodesis: A systematic review and meta-analysis for the final verdict

xlomafota13 shared this article with you from Inoreader

J Plast Reconstr Aesthet Surg. 2021 Oct 23:S1748-6815(21)00516-7. doi: 10.1016/j.bjps.2021.09.076. Online ahead of print.

ABSTRACT

While scaphoid excision combined with Four Corner Arthrodesis (FCA) or Proximal Row Carpectomy (PRC) is a commonly-used salvage procedures to treat type two and type three Scapholunate Advanced Collapse (SLAC) and Scaphoid Nonunion Advanced Collapse (SNAC)-induced degenerative arthritis, controversy remains over which treatment intervention provides superior outcomes. We searched for articles comparing a range of motion, grip strength, complications requiring reoperation, conversion to wrist arthrodesis, pain, and disability of shoulder and arm scores between FCA and PRC-treated patients. The risk of bias was assessed using the National Institutes of Health (NIH) quality assessment tool. We performed a meta-analysis using Random-Effects Models. Fifteen articles (10 retrospective, 2 cross-sectional, 1 prospe ctive, and 2 randomized trials) were included. There was no significant difference between PRC and FCA in any of the different outcome measures. The risk of bias was found consistently high across all studies. Despite the lack of high-quality evidence, based on existing literature, we recommend PRC as the preferred choice of treatment because of the simplicity of the surgical procedure, lack of hardware-related complications, and comparable long-term outcomes. Level of evidence: III - Therapeutic.

PMID:34802951 | DOI:10.1016/j.bjps.2021.09.076

View on the web

Oral squamous cell carcinoma outcome in adolescent/young adult: Systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader

Abstract

To perform a systematic review focusing on the prognosis of oral cavity squamous cell carcinoma (OSCC) in young patients (≤40 years old) compared to older (>40 years old). Four databases were used in our search strategy. First, all titles were systematically organized using the Covidence platform online. In the second phase, 118 full texts of potentially eligible studies were analyzed by reviewers independently and in pairs. Twelve studies were considered eligible for data extraction. The relapse was higher in the young than in controls (pooled relative risk (RR) = 1.31; 95% CI [1.10–1.56]). The 5-year disease-free survival (DFS) was worse in young group (pooled hazard ratio (HR) = 0.73; 95% CI [0.63–0.85]) but the 5-year overall survival (OS) estimate was similar between the groups (pooled HR = 0.84; 95% CI [0.70–1.00]). While the 5-year OS was similar between groups, the number of relapses and 5-year DFS were worse in patients with OS CC ≤40 years old.

View on the web

Assessment of swallow function pre and post‐endoscopic CO2 laser medial arytenoidectomy: a case series

xlomafota13 shared this article with you from Inoreader

Abstract

Endoscopic CO2 laser medial arytenoidectomy is performed for glottic stenosis however post-operative aspiration remains a risk Pre-operative and post-operative objective and subjective assessments of swallow function were evaluated There was no statistically significant difference when comparing pre- and post-operative penetration-aspiration scores or subjective swallow function If baseline swallow is impaired, this should not preclude the patient from arytenoidectomy; baseline FEES is essential to aid surgical planning and inform patient consent 'Staged arytenoidectomy' should be performed as a swallow-preserving procedure

View on the web

The Value of Diversity, Equity, and Inclusion in Otolaryngology

xlomafota13 shared this article with you from Inoreader
Diversity impacts performance of our teams, fosters innovation, and improves outcomes of our patients in otolaryngology head and neck surgery. In addition to the moral imperative, increasing the otolaryngology diversity workforce will decrease health care disparities while equity and justice can increase the culture humility to take care of an increasingly diverse patient population. To move toward justice, otolaryngology departments need to end biases in faculty hiring, development, research evaluations, and publication practices. The more intentional our efforts, the more benefit to our patients, providers, staff, learners, and society.
View on the web

“Business” Is not a Four-Letter Word

xlomafota13 shared this article with you from Inoreader
Remember back to when you decided you wanted to be a physician? You made the conscious decision to study instead of going out, to spend your weekends and evenings buried in books and memorization, maybe even foregoing that really interesting humanities course because you had to "ace" organic chemistry. You did this because you wanted to be a doctor to help people and make a difference in this world, and that's what you told your medical school interviewers. Me, too. Not one of us said, "I want to be a doctor and make sure I run my business profitably so that I can pay my staff and myself fairly and stay in business to continue to help more patients and provide for my family and retire comfortably." Likewise, our curricula in medical school were rich in basic and clinical sciences, and more recently in ethics and communication, but, all along training, information continues to be sparse regarding business basics, employment and insurance negotiations, the intricacies o f human resource management, billing, coding and getting paid, what to do in case you are sued, and how to plan for your and your family's financial future.
View on the web

The log odds of positive neck lymph nodes is a superior lymph node predictor for overall survival in head and neck cancer: a population-based analysis in Germany

xlomafota13 shared this article with you from Inoreader

Eur Arch Otorhinolaryngol. 2021 Nov 22. doi: 10.1007/s00405-021-07176-8. Online ahead of print.

ABSTRACT

BACKGROUND: This population-based study investigated the influence of different lymph node (LN) classifications on overall survival (OS) in head and neck cancer (HNC).

METHODS: 401 patients (median age: 57 years; 47% stage IV) of the Thuringian cancer registries with diagnosis of a primary HNC receiving a neck dissection (ND) in 2009 and 2010 were included. OS was assessed in relation to total number of LN removed, number of positive LN, LN ratio, and log odds of positive LN (LODDS).

RESULTS: Mean number of LODDS was 0-0.96 ± 0.57. When limiting the multivariate analysis to TNM stage, only the UICC staging (stage IV: HR 9.218; 95% CI 2.721-31.224; p < 0.001) and LODDS > - 1.0 (HR 2.120; 95% CI 1.129-3.982; p = 0.019) were independently associated with lower OS.

CONCLUSION: LODDS was an independent and superi or predictor for OS in HNC in a population-based setting with representative real-life data.

PMID:34807283 | DOI:10.1007/s00405-021-07176-8

View on the web

A multicentre retrospective cohort study on COVID-19-related physical interventions and adult hospital admissions for ENT infections

xlomafota13 shared this article with you from Inoreader

Eur Arch Otorhinolaryngol. 2021 Nov 22. doi: 10.1007/s00405-021-07180-y. Online ahead of print.

ABSTRACT

PURPOSE: To report changes in adult hospital admission rates for acute ENT infections following the introduction of COVID-19-related physical interventions such as hand washing, use of face masks and social distancing of 2-m in the United Kingdom.

METHODS: Retrospective cohort study comparing adult admissions with acute tonsillitis, peritonsillar abscess, epiglottitis, glandular fever, peri-orbital cellulitis, acute otitis media, acute mastoiditis, retropharyngeal abscess and parapharyngeal abscess in the 1-year period after the introduction of COVID-related physical interventions (2020-2021) with a 1-year period before this (2019-2020) in three UK secondary care ENT departments.

RESULTS: In total, there were significantly fewer admissions for ENT infections (n = 1073, 57.56%, p < 0.001; RR 2.36, 95% CI [2.17, 2.56]) in the 2020-2021 period than in the 2019-2020 period. There were significant reductions in admissions for tonsillitis (64.4%; p < 0.001), peritonsillar abscess (60.68%; p < 0.001), epiglottitis (66.67%; p < 0.001), glandular fever (38.79%; p = 0.001), acute otitis media (26.85%; p = 0.01) and retropharyngeal and/or parapharyngeal abscesses (45.45%; p = 0.04).

CONCLUSION: Our study demonstrates a sizeable reduction in adult admissions for ENT infections since the introduction of COVID-19-related physical interventions. There is evidence to support the use of physical interventions in the prevention of viral transmission of respiratory disease. Preventing ENT infections requiring admission through simple physical interventions could be of great benefit to the quality of life of patients and economical benefit to healthcare systems.

PMID:34807284 | DOI:10.1007/s00405-021-07180-y

View on the web

Δημοφιλείς αναρτήσεις