Care and Management of Voice Change for Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline

xlomafota13 shared this article with you from Inoreader Care and Management of Voice Change for Thyroid Surgery: Korean Society of Laryngology, Phoniatrics and Logopedics Clinical Practice Guideline Via pubmed: "clin exp otorhinola... Clin Exp Otorhinolaryngol. 2021 Jun 1. doi: 10.21053/ceo.2021.00633. Online ahead of print. ABSTRACT Voice change is a common complaint after thyroid surgery and has significant impacts on quality of life. The Korean Society of Laryngology, Phoniatrics, and Logopedics set up a task force team to establish guideline recommendations on education, care, and management related to thyroid surgery. The guideline recommendations include preoperative voice education, management of anticipated voice change during surgery, and comprehensive voice care after thyroid surgery, including in-depth information and up-to-date knowledge based on validated literature. The committee constructed 14 key questions (KQ) in three categories: preoperative (KQ1-2), intraoperative (KQ 3-8), and postoperative (KQ 9-14) management and developed 18 evidence-based recommendations. The Delphi survey reached an agreement on each recommendation. Detailed evidence profil es are presented for each recommendation. The level of evidence for each recommendation is classified into high, moderate, and low-quality. The recommendation's strengths are adjusted to consider the level of evidence resulting in the recommendation and are divided into strong and weak. The guidelines are primarily targeted toward physicians who treat thyroid surgery patients and speech-language pathologists participating in patient care. These guidelines will also help primary care physicians, nurses, healthcare policymakers, and patients improve their understanding of voice changes and voice care after thyroid surgery. PMID:34098629 | DOI:10.21053/ceo.2021.00633 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparative assessment of three posterior fossa decompression techniques and evaluation of the evidence supporting the efficacy of syrinx shunting and filum terminale sectioning in Chiari malformation type I. A systematic review and network meta-analysis

xlomafota13 shared this article with you from Inoreader Comparative assessment of three posterior fossa decompression techniques and evaluation of the evidence supporting the efficacy of syrinx shunting and filum terminale sectioning in Chiari malformation type I. A systematic review and network meta-analysis Via leak of cerebrospinal fluid World Neurosurg. 2021 Jun 4:S1878-8750(21)00819-6. doi: 10.1016/j.wneu.2021.05.124. Online ahead of print. ABSTRACT BACKGROUND: This study aimed to compare the effectiveness of posterior fossa decompression (PFD), posterior fossa decompression with duraplasty (PFDD), and posterior fossa decompression with resection of tonsils (PFDRT) in Chiari malformation type I (CMI). Furthermore, we aimed to evaluate the evidence supporting the efficacy of filum terminale sectioning (FTS), syringo-subarachnoid shunting (SSS), and syringo-peritoneal shunting (SPS) in CMI. METHODS: PubMed, Cochrane, and Embase databases were screened for English-language studies published from inception until 11 of August 2020. A total of 3593 studies were identified through the searching process. Finally, 15 cohort studies were included in the systematic review and network meta-analysis. RESULTS: No studies concerning FTS, SSS, and SPS were found eligible. There fore only PFD, PFDD, and PFDRT were compared. PFDD showed significantly higher incidence of complications (RR, 3.79; 95% CI, 2.54-5.64) cerebrospinal fluid (CSF) leak (RR, 9.74; 95% CI, 2.33-40.78) and neurologic deficit (RR, 8.76; 95% CI, 2.08-36.90) than PFD. Both PFDD and PFDRT achieved higher syringomyelia improvement (RR, 1.23; 95% CI, 1.09-1.39), (RR, 1.32; 95% CI, 1.15-1.51) and greater clinical improvement (RR, 1.24; 95% CI, 1.10-1.39), (RR, 1.24; 95% CI, 1.08-1.44) than PFD. We have not found any differences between PFDD and PFDRT. CONCLUSIONS: PFDD and PFDRT are superior to PFD, especially in patients with syringomyelia-Chiari complex, due to greater syringomyelia reduction and better clinical improvement. However, PFDD and PFDRT can be considered equally efficient. There is no evidence pleading in favor of the SFT, SSS, and SPS over any posterior fossa decompression technique. PMID:34098134 | DOI:10.1016/j.wneu.2021.05.124 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Comparative Study of Cold Dissection Tonsillectomy and Harmonic Scalpel Tonsillectomy Under Microscope- Our Experience

xlomafota13 shared this article with you from Inoreader A Comparative Study of Cold Dissection Tonsillectomy and Harmonic Scalpel Tonsillectomy Under Microscope- Our Experience Via Otolaryngology Indian Abstract Tonsillectomy is one of the most common proceduresin routine otolaryngology.Given that the pediatric demographic is usually in question, ENT surgeons are resorting to newer modalities that minimize the dreaded complication of intra-operative and post-operative hemorrhage and have shorter operative time. The present study was conducted on patients admitted in ward in the Department of Otorhinolaryngology at SMS Medical College and Hospital, JaipurFrom July 2019 to June 2020 on a sample size of 40 patient diagnosed as adeno-tonsillar hypertrophy of grade 3–4. Each patient underwent tonsillectomy by cold dissection method on one side and by ultrasonic scalpel on other. The present study was conducted on patients admitted in ward in the Department of Otorhinolaryngology at SMS Medical College and Hospital, JaipurFrom July 2019 to June 2020 on a sample size of 40 patient diagnosed as adeno-tonsillar hypertrophy of grade 3–4. Each patient underwent tonsillectomy by cold dissection method on one side and by ultrasonic scalpel on other. In our study Mean operation time, mean blood loss, Analogue score for post-operative pain at 24hrs and 7th postoperative day respectively and Healing of wound on 14th post-operative day were significantly lower in cases of tonsillectomy with harmonic scalpel than cold dissection method tonsillectomy. The novel technique of tonsillectomy harmonic scalpel is proven to be better with regard to lesser operative time, blood loss and lesser post-operative morbidity. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mechanisms of regulating NIS transport to the cell membrane and redifferentiation therapy in thyroid cancer

xlomafota13 shared this article with you from Inoreader Mechanisms of regulating NIS transport to the cell membrane and redifferentiation therapy in thyroid cancer Via radioactive iodine Clin Transl Oncol. 2021 Jun 8. doi: 10.1007/s12094-021-02655-0. Online ahead of print. ABSTRACT Iodine is an essential constituent of thyroid hormone. Active iodide accumulation in the thyroid is mediated by the sodium iodide symporter (NIS), comprising the first step in thyroid hormone biosynthesis, which relies on the functional expression of NIS on the cell membrane. The retention of NIS expressed in differentiated thyroid cancer (DTC) cells allows further treatment with post-op erative radioactive iodine (RAI) therapy. However, compared with normal thyroid tissue, differentiated thyroid tumors usually show a decrease in the active iodide conveyance and NIS is generally retained within the cells, indicating that posttranslational protein transfer to the plasma membrane is abnormal. In recent years, through in vitro studies and studies of patients with DTC, various methods have been tested to increase the transport rate of NIS to the cell membrane and increase the absorption of iodine. An in-depth understanding of the mechanism of NIS transport to the plasma membrane could lead to improvements in RAI therapy. Therefore, in this review, we discuss the current knowledge concerning the post-translational mechanisms that regulate NIS transport to the cell membrane and the current status of redifferentiation therapy for patients with RAI-refractory (RAIR)-DTC. PMID:34100218 | DOI:10.1007/s12094-021-02655-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trends in treatments for prostate cancer in the United States, 2010-2015

xlomafota13 shared this article with you from Inoreader Trends in treatments for prostate cancer in the United States, 2010-2015 Via American Journal of Cancer Research Am J Cancer Res. 2021 May 20;11(5):2351-2368. eCollection 2021. ABSTRACT Although annual mortality trends for prostate cancer were stabilized in recent years, understanding the exact treatment changes is necessary for optimal management. Utilization of not-otherwise specified (NOS) treatments for prostate cancer was unclear. Thus, this study aimed to analyze trends in treatment for prostate cancer in the U.S. from 2010 to 2015 and examine whether the treatment for the prostate cancer in the U.S. is compliant with clinical practice guidelines. Using joinpoint regression models, we examined trends in the rate and proportion of age-standardized utilization (ASUR and ASUP) of treatments for prostate cancer diagnosed during 2010-2015 in the U.S. based on the data from the Surveillance, Epidemiology, and End Results (SEER, 2018 data-release, with linkage to active surveillance/watchful waiting [AS/WW]) cancer registry program. Among 316,690 men with prostate cancer diagnosed during 2010-2015, ASUR and ASUP for radical prostatectomy, radiotherapy, AS/WW and NOS treatment were 32.7, 34.4, 10.0 and 40.1 per 100,000, and 27.9%, 29.3%, 8.5% and 34.2%, respectively. Trends in the overall ASUR for prostate cancer treatments differed by cancer risk group, patients' age, race/ethnicity, Gleason score, insurance status, and the average education level, average poverty-level and foreign-born person percentage of the patient's residence-county, but not by rural-urban continuum or region. ASUP of radical prostatectomy decreased from 9.8% in 2010 to 4.8% in 2015 (annual percent change [APC] = -12.0%, 95% CI, -15.9 to -7.9%), and the decrease was observed in all different risk groups. ASUP of AS/WW increased from 16.4% in 2010 to 30.2% in 2013 (APC = 22.7%, 95% CI, 4.6 to 44.0%) and then remained stable through 2013 to 2015 (APC = 1.9%, 95% CI, -24.1 to 36.9%). The increasing tendency of AS/WW only occurred in the low-risk and interm ediate-risk groups. The ASUP of NOS treatment has increased from 32.3% in 2010 to 36.8% in 2015 (P<0.01). In conclusion, ASUR and ASUP for prostate cancer treatments, including NOS treatment, had changed during 2010-2015. Their trends appeared to differ by cancer risk-group, age, race/ethnicity, Gleason score and socioeconomic factors. Future studies are warranted to understand the impacts of upward trends in ASUP of NOS treatments and AS/WW on patient survival and prostate cancer mortality. PMID:34094691 | PMC:PMC8167696 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mitochondrial structural alterations in ovarian cancer patient-derived xenografts resistant to cisplatin

xlomafota13 shared this article with you from Inoreader Mitochondrial structural alterations in ovarian cancer patient-derived xenografts resistant to cisplatin Via American Journal of Cancer Research Am J Cancer Res. 2021 May 15;11(5):2303-2311. eCollection 2021. ABSTRACT Mitochondria have attracted attention in cancer research as organelles associated with tumor development and response to therapy. We recently reported acquisition of resistance to cisplatin (DDP) associated with a metabolic rewiring in ovarian cancer patient-derived xenografts (PDXs) models. DDP-resistant PDXs models were obtained mimicking the clinical setting, treating mice bearing sensitive-DDP tumors with multiple cycles of DDP until the development of resistance. To further characterize the metabolic rewiring, the present study focused on tumor mitochondria. We analysed by transmission electron microscopy the mitochondria structure in two models of DDP-resistant and the corresponding DDP-sensitive PDXs and evaluated tumor mDNA content, the expression of genes and proteins involved in mitochondria functionality, and mitochondria fitness-related processes, such as autophagy. We observed a decrease in the number of mitochondria paralleled by an increased volume in DDP-resistant versus DDP-sensitive PDXs. DDP-resistant PDXs presented a higher percentage of damaged mitochondria, in particular of type 2 (concave-shape), and type 3 (cristolysis) damage. We found no difference in the mDNA content, and the expression of genes involved in mitochondrial biogenesis was similar between the sensitive and resistant PDXs. An upregulation of some genes involved in mitochondrial fitness in DDP-R versus DDP-S PDXs was observed. At protein level, no difference in the expression of proteins involved in mitochondrial function and biogenesis, and in autophagy/mitophagy was found. We here reported that the acquisition of DDP resistance is associated with morphological alterations in mitochondria, even if we couldn't find any dysregulation in the studied genes/proteins that could explain the observed differences. PMID:34094686 | PMC:PMC8167697 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Regional lymph nodes distribution pattern in central area of right-sided colon cancer: in-vivo detection and the update on the clinical exploration

xlomafota13 shared this article with you from Inoreader Regional lymph nodes distribution pattern in central area of right-sided colon cancer: in-vivo detection and the update on the clinical exploration Via American Journal of Cancer Research Am J Cancer Res. 2021 May 15;11(5):2095-2105. eCollection 2021. ABSTRACT Distribution of regional lymph nodes (LNs) is decisive for the lymphadenectomy boundary in radical resection of right-sided colon cancer (RCC). Currently, the data of LNs in central area remains ambiguous and scarce. Herein we aim to provide a more detailed anatomical research on LNs surrounding the superior mesenteric vessels for RCC and investigated the metastasis rate. In this study, Carbon Nanoparticles (CNs) and Indocyanine Green (ICG) were used for regional LNs mapping by preoperative colonoscopic tattooing (PCT) and we laparoscopically observed the stained LNs distribution pattern. Lastly, 143 RCC patients who received a "superior mesenteric artery (SMA)-oriented" hemicolectomy were included to calculate the probability of LNs metastasis in our target area. 27 patients diagnosed as RCC (mean age 58.04 years, 17 male) were included. 14 patients underwent CNs injection and 13 patients consented to the ICG, while 4 cases suffered from imaging failure. The unequal number of the regional LNs located between SMV and SMA was detected in 22 cases (81.48%), posterior to SMV area in 6 cases (22.22%), and anterior to SMA in 16 cases (59.26%), respectively. The presence of LNs posterior to SMV was associated with the crossing pattern of ileocolic artery (χ2 = 4.24, P = 0.039). The probability of LNs metastasis in the above areas (target areas) was 2.10% (3/143). In conclusion, right-hemi colon-draining lymphatic vessels anteriorly/posteriorly traversed the SMV and arrived at the surface of SMA near the middle colonic artery (MCA) level, which highlights the potential need of removing mesenteric tissue in our target area on lymphatic resection. PMID:34094671 | PMC:PMC8167669 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.