Impact of the development of immune related adverse events in metastatic melanoma treated with PD -1 inhibitors

xlomafota13 shared this article with you from Inoreader Impact of the development of immune related adverse events in metastatic melanoma treated with PD -1 inhibitors Via Melanoma Research - Current Issue Some clinical trials have described improved outcomes in patients who develop immune-related adverse events (irAEs) while receiving immune checkpoint inhibitors for advanced melanoma. It is unknown if this effect would be seen in a real-world population. This is a single-center retrospective analysis of all patients receiving single-agent PD-1 inhibitor for unresectable stage III or stage IV melanoma between 2012 and 2018. The majority of patients had cutaneous melanoma and were elderly (put in median and range). Totally 33.3% were BRAF mutated and 66.7% had PD-1 inhibitor as first-line treatment for metastat ic disease. Also, 22% of patients had brain metastases at presentation. Of the 87 patients included in this analysis, 48 (55%) developed at least one irAE. Dermatologic toxicities were the most common irAE. The median time to develop any irAE was 12 weeks. Only one patient died of immune-related toxicity. Overall survival in the population of patients that had an irAE was significantly greater than those that did not have any toxicity (21.1 vs. 7.5 months; P  View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory Neuroblastoma: A Novel Site of Presentation

xlomafota13 shared this article with you from Inoreader Olfactory Neuroblastoma: A Novel Site of Presentation Via Otolaryngology Indian Abstract Olfactory neuroblastoma (ONB) or esthesioneuroblastoma is a rare malignant intranasal tumor, commonly originated from upper part of nasal cavity. Majority of cases presented with nasal obstruction or epistaxis. ONB is rarely reported in ectopic locations. Here we present the first-ever documented case of an olfactory neuroblastoma situated anterior to body of maxilla, presented as left sided facial swelling. This case report is aimed at achieving the consideration of this rare tumour as a differential diagnosis in the lesions of the anatomical region surrounding the commonly known site of origin i.e. the sinonasal cavity. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patient Reported Outcomes of Scalp and Forehead Reconstruction for Defects Following Oncological Resections (North-East Indian Tertiary Cancer Centre Study)

xlomafota13 shared this article with you from Inoreader Patient Reported Outcomes of Scalp and Forehead Reconstruction for Defects Following Oncological Resections (North-East Indian Tertiary Cancer Centre Study) Via Otolaryngology Indian Abstract Background Approximately 1–2% of all scalp tumours are malignant, but they comprise up to 13% of all malignant cutaneous neoplasms. The current study presents our experience of reconstruction of scalp and forehead for malignant tumours treated at our centre. Methods This is a single institutional observational study conducted at a tertiary cancer centre in North East India. Post-operative outcomes related to quality of life of patients were measured with help of FACE-Q scales. Face-Q –Satisfaction with outcome and FACE-Q- appearance related psychosocial distress scores were analysed. Histograms were used for descriptive statistics. Data were checked for normality using Kolmogorov–Smirnova and Shapiro–Wilk test. For non-normal data Wilcoxon test was used. A p value less than 0.05 was considered as statistically significant at 5% level of significance. Results Mean age of patients was 57.6 ± 14.2 years. The mean defect size was 89.036 ± 81.77 cm2. The mean satisfaction with outcome scores and distress scores at 3-months was 54.9 ± 8.6 and 34.8 ± 8.5 respectively with a statistically significant p value of 0.001.Mean satisfaction scores and psychological distress scores were better at the end of three months when compared to at the time of discharge with a statistical significant p value of < 0.0001. Conclusion Scalp and forehead reconstructions for defects following oncological resections are technically challenging and if chosen carefully with meticulous planning, both local and free tissue transfers give satisfactory outcome in long term follow up. There are lots of reconstruction options for scalp and forehead defects and knowledge of the basic bio-geometry of the each flap is must. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterior and Central Skull Base Fibrous Dysplasia: A 12 Years’ Experience

xlomafota13 shared this article with you from Inoreader Anterior and Central Skull Base Fibrous Dysplasia: A 12 Years' Experience Via Otolaryngology Indian Abstract Fibrous dysplasia, specially of anterior and central skull base region, is a rare disorder. This article discusses about our experience in this pathology. A tertiary care institute based retrospective type study was conducted over a period of 12 years. Demographics, radiology, intraoperative details, pathology and follow up were taken into consideration and the data was analysed. Sixteen patients with complaints of proptosis, diplopia, nasal obstruction and/or facial deformity, underwent endoscopic sinus surgery. Subtotal resection was done in 5 patients. Ethmoid bone involvement was seen in 12 patients. Post operatively, diplopia persisted in one patient and one patient had epistaxis. All patients were followed up for 2–10 years with no other complications reported. Anterior and central skull base involvement is rare in fibrous dysplasia. However, it can be removed effectively by endoscopic approach. Overall safety of patient has more concern rather than complete removal of disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Partial Middle Turbinectomy Versus Medialization Suturing of Middle Turbinate in the Management of Sinonasal Polyposis: A Comparative Study

xlomafota13 shared this article with you from Inoreader Partial Middle Turbinectomy Versus Medialization Suturing of Middle Turbinate in the Management of Sinonasal Polyposis: A Comparative Study Via Otolaryngology Indian Abstract The main goals of endoscopic sinus surgery (ESS) is, to enlarge the sinus ostia. Most common cause of failure of ESS is lateralization of the middle turbinate causing recurrent blockade of osteomeatal complex (OMC) and recurrence of disease. Many techniques have been described for preventing lateralization of the middle turbinate. We compared the postoperative outcomes following endoscopic sinus surgery (ESS) for sinonasal polyposis (SNP) with medialization suturing of middle turbinate and partial middle turbinectomy. 60 patients who underwent ESS for SNP were divided into three groups, Group A (Medialization suturing of the middle turbinate with septum), Group B (partial middle turbinectomy) and Group C (control-no middle turbinate intervention). Preoperative Lund Kennedy scoring, Lund McKay scoring, SNOT 22 scoring was done. Post-operatively, Lund Kennedy scoring was done at 1st, 4th, 12th week and SNOT 22 scoring was done at 4th, 12th week. Statistical analysi s and comparison of data between the groups was done. Both the techniques, helped to improve OMC patency, mucosal healing, and to minimize adhesions. Medialization of the middle turbinate helped in improvement of SNOT 22 and Lund Kennedy scores in the postoperative period as compared to the non-interventional group. However, between the two middle turbinate interventional groups there was no statistically significant difference. Achieving middle meatal patency by middle turbinate interventions improves the postoperative outcomes. However, long-term follow-up studies are recommended for evaluation of efficacy of these techniques and to look for recurrence of disease in SNP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Studying nerve transfers: Searching for a consensus in nerve axons count

xlomafota13 shared this article with you from Inoreader Studying nerve transfers: Searching for a consensus in nerve axons count Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 5:S1748-6815(21)00154-6. doi: 10.1016/j.bjps.2021.03.064. Online ahead of print. ABSTRACT Axonal count is the base for efficient nerve transfer; despite its capital importance, few studies have been published on human material, most research approaches being performed on experimental animal models of nerve injury. Thus, standard analysis methods are still lacking. Quantitative data obtained have to be reproducible and comparable with published data by other research groups. To share results with the scientific community, the standardization of quantitative analysis is a fundamental step. For this purpose, the experiences of the Italian, Austrian, German, Greek, and Iberian-Latin American groups have been compared with each other and with the existing literature to reach a consensus in the fiber count and draw up a protocol that can make future studies from different centers comparable. The search for a standardization of the methodology was aimed to reduce all the factors that are associated with an increase in the variability of the results. All the preferential methods to be used have been suggested. On the other hand, alternative methods and different methods have been identified to achieve the same goal, which in our experience are completely comparable; therefore, they can be used indifferently by the different centers according to their experience and availability. PMID:33962889 | DOI:10.1016/j.bjps.2021.03.064 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A review of the impact of hearing interventions on social isolation and loneliness in older people with hearing loss

xlomafota13 shared this article with you from Inoreader A review of the impact of hearing interventions on social isolation and loneliness in older people with hearing loss 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. 2021 May 7. doi: 10.1007/s00405-021-06847-w. Online ahead of print. ABSTRACT PURPOSE: Hearing loss affects many older people and is associated with social isolation and loneliness. The impact of hearing interventions however has not been established. The objective of this review is to determine the impact of hearing interventions in older people with hearing loss on social isolation and loneliness. METHODS: A literature review using PubMed, EMBASE and CINAHL databases was performed. Search terms included older people, elderly, aging, ageing, hearing aid, hearing rehabilitation, social isolation, loneliness and social interaction. English-language studies with participants aged over 60 years diagnosed with hearing loss comparing outcomes pre- and post-hearing interventions were included. RESULTS: A total of 176 articles were identified of which seven met the inclusion criteria. Five studies examine d the impact of traditional hearing aids whilst two articles examined outcomes after cochlear implantation. Several outcome measures were used. Loneliness outcomes were reported in three studies and social isolation outcomes in four. All studies reported improved social isolation and loneliness scores following hearing intervention. CONCLUSIONS: Small sample sizes, a lack of high-quality evidence, heterogenicity between studies and the presence of confounding factors limits interpretation of the literature. At present, there is inadequate evidence to support the use of hearing interventions in the treatment of social isolation and loneliness in older people. Given the ageing population, the significance of this health burden cannot be underestimated, emphasising the need for further research. PMID:33963432 | DOI:10.1007/s00405-021-06847-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Asymptomatic swallowing disorders may be present in individuals with laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy

xlomafota13 shared this article with you from Inoreader Asymptomatic swallowing disorders may be present in individuals with laryngeal and hypopharyngeal cancer treated with chemo-radiotherapy 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. 2021 May 7. doi: 10.1007/s00405-021-06861-y. Online ahead of print. ABSTRACT PURPOSE: Patients with advanced laryngeal and hypopharyngeal cancer are often treated with chemo-radiotherapy to avoid total laryngectomy. Subclinical swallowing disorders could be present in these patients even though patients do not complain of any symptoms. We sought to evaluate the impact of chemoradiation on swallowing and quality of life. METHODS: We studied 21 patients undergoing chemo-radiotherapy for advanced laryngeal and hypopharyngeal cancer. All patients were tumor-free and none reported symptoms related to dysphagia during follow-up or showed altered routine screening tests (EAT-10) to detect it. Swallowing functions were assessed using volume-viscosity swallow test (V-VST) and fiberoptic endoscopic evaluation of swallowing (FEES). Quality of life was assessed with the EORT-H&N35, and SWAL-QOL scales. RE SULTS: Frequent alterations in swallowing efficacy (100%) and safety (85.5%) were detected with V-VST and FEES. Quality-of-life scales showed a reduction in their scores between 12 and 17%, mainly in the areas of symptoms. CONCLUSION: Swallowing disorders are common after chemo-radiotherapy, even in patients who do not clinically manifest these disorders, contributing to a decrease in patients' quality of life. FEES and V-VST are useful procedures to detect asymptomatic swallowing disorders. PMID:33963434 | DOI:10.1007/s00405-021-06861-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality of life in vestibular schwannoma: a comparison of three surgical techniques

xlomafota13 shared this article with you from Inoreader Quality of life in vestibular schwannoma: a comparison of three surgical techniques 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. 2021 May 8. doi: 10.1007/s00405-021-06855-w. Online ahead of print. ABSTRACT OBJECTIVE: Through years, interest in quality of life (QoL) among patients affected by vestibular schwannoma (VS) has increased. The expansion of the indications for endoscopic ear surgery allowed the development of the transcanal transpromontorial surgery (TTS) for VS removal. The objective of the present study was to assess QoL in a cohort of VS patients operated on by translabyrinthine (TL), retrosigmoid (RS) and TTS approach. METHODS: The study was conducted on 111 patients who underwent surgery for VS between January 2017 and January 2020 at two different institutions. Patients fulfilled three questionnaires during follow-up: Glasgow Benefit Inventory, Depression Anxiety Stress Scales-21 and Penn Acoustic Neuroma Quality-Of-Life. The association between sex, age, date of surgery, tumor size, post-operative facial nerve (FN ) function and QoL outcomes was assessed. RESULTS: An overall subjective impairment was demonstrated in all groups. Age, Koos staging and FN functions were associated to distinct QoL outcomes. CONCLUSIONS: QoL decreases in patients surgically treated for VS. The TTS may allow improved scores in many domains, confirming to be a subjectively well-tolerated technique. PMID:33963915 | DOI:10.1007/s00405-021-06855-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Self-reported smell and taste recovery in coronavirus disease 2019 patients: a one-year prospective study

xlomafota13 shared this article with you from Inoreader Self-reported smell and taste recovery in coronavirus disease 2019 patients: a one-year 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. 2021 May 7. doi: 10.1007/s00405-021-06839-w. Online ahead of print. ABSTRACT PURPOSE: The aim of the present study was to estimate the 1 year prevalence and recovery rate of self-reported chemosensory dysfunction in a series of subjects with previous mild-to-moderate symptomatic COVID-19. METHODS: Prospective study based on the SNOT-22, item "sense of smell or taste" and additional outcomes. RESULTS: 268/315 patients (85.1%) completing the survey at baseline also completed the follow-up interview. The 12 months prevalence of self-reported COVID-19 associated chemosensory dysfunction was 21.3% (95% CI 16.5-26.7%). Of the 187 patients who complained of COVID-19 associated chemosensory dysfunction at baseline, 130 (69.5%; 95% CI 62.4-76.0%) reported complete resolution of smell or taste impairment, 41 (21.9%) reported a decrease in the severity, and 16 (8.6%) reported the symptom was unchanged or wor se 1 year after onset. The risk of persistence was higher for patients reporting a baseline SNOT-22 score ≥ 4 (OR = 3.32; 95% CI 1.32-8.36) as well as for those requiring ≥ 22 days for a negative swab (OR = 2.18; 95% CI 1.12-4.27). CONCLUSION: A substantial proportion of patients with previous mild-to-moderate symptomatic COVID-19 characterized by new onset of chemosensory dysfunction still complained on altered sense of smell or taste 1 year after the onset. PMID:33963433 | DOI:10.1007/s00405-021-06839-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intradural extraarachnoid sutureless technique combined with laminoplasty for indirect repair of ventral dural defects in spontaneous intracranial hypotension: technical note and case series

xlomafota13 shared this article with you from Inoreader Intradural extraarachnoid sutureless technique combined with laminoplasty for indirect repair of ventral dural defects in spontaneous intracranial hypotension: technical note and case series Via leak of cerebrospinal fluid Acta Neurochir (Wien). 2021 May 8. doi: 10.1007/s00701-021-04868-2. Online ahead of print. ABSTRACT BACKGROUND: There is a significant variance in surgical treatment strategies of ventral cerebrospinal fluid (CSF) leaks causing spontaneous intracranial hypotension (SIH). Posterior approaches might represent a preferable alternative to the more invasive anterior and lateral routes, as long as the spinal cord is not exposed to harmful manipulation. The aim of this technical note is to report and illustrate a new surgical technique using an intradural extraarachnoid sutureless technique via laminoplasty for indirect repair of ventral CSF leaks causing intractable SIH symptoms. METHODS: The surgical technique is described in a step by step fashion. Between May 2018 and May 2020, five patients with ventral spinal CSF leaks were operated on, utilizing this technique. All dural defects were located at the level of the thoracic spine. A retrosp ective review on demographic and radiological findings, symptoms, outcome, and follow-up was performed. RESULTS: The intra- and postoperative course was uneventful in all patients with no surgery-related complications. Three patients recovered completely at discharge, while neurological symptoms significantly improved in two patients. A postoperative MRI of the spine was obtained for all patients, demonstrating regressive signs of CSF leak. CONCLUSION: Based on the presented case series, this intradural extraarachnoid sutureless technique combined with laminoplasty seems to be a safe and effective option for indirect repair of ventral dural defects in SIH. In our opinion, it represents a valid alternative to traditional more aggressive approaches. PMID:33963904 | DOI:10.1007/s00701-021-04868-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.