Personalized radioiodine therapy for thyroid cancer patients with known disease

xlomafota13 shared this article with you from Inoreader Personalized radioiodine therapy for thyroid cancer patients with known disease Via radioactive iodine Fac Rev. 2021 Apr 7;10:36. doi: 10.12703/r/10-36. eCollection 2021. ABSTRACT Radioactive iodine (RAI) 131I is a targeted therapy for patients with RAI-avid follicular cell-derived thyroid cancer. However, the responsiveness to 131I therapy varies among thyroid cancer patients mainly owing to differential RAI uptake and RAI radiosensitivity among patients' lesions. A personalized approach to maximize 131I therapeutic efficacy is proposed based on rec ent scientific advances and future opportunities. PMID:33977289 | PMC:PMC8103907 | DOI:10.12703/r/10-36 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does Prematurity Play a Role in Newborn Microtia-Anotia?

xlomafota13 shared this article with you from Inoreader Does Prematurity Play a Role in Newborn Microtia-Anotia? Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 12:34894211015735. doi: 10.1177/00034894211015735. Online ahead of print. ABSTRACT OBJECTIVE: Microtia-anotia (MA) describes a range of external ear anomalies which is commonly associated with various syndromes and malformations of the head and neck. Previous studies have suggested a strong association between MA and male sex, maternal diabetes, and Hispanic race/ethnicity. This study seeks to evaluate the associations between MA and preter m newborns in the United States. METHODS: Population-based inpatient registry analysis was conducted. Kids' Inpatient Database (2016) was used to identify weighted in-hospital births with diagnosis of prematurity or MA. Demographic information was obtained, and odds ratios (ORs) were used to determine associations between prematurity and MA. RESULTS: Among patients included in our dataset, 8.655% (326 285) were preterm and 0.016% (523) had MA. 0.003% (109) of patients were preterm and had MA. Preterm infants had 2.19 times the odds (95% C.I. = 1.78-2.69) of having MA when compared to the full-term population. The binary logistic regression model accounting for possible confounding variables produced an aOR of 1.48 (95% C.I. = 1.17-1.87) for the association between prematurity and MA. CONCLUSION: Infants who are born preterm are more likely to have MA than full term infants. The current results will allow for improved risk stratification, maternal counseling, and in terventions in the case of prematurity. PMID:33978496 | DOI:10.1177/00034894211015735 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement

xlomafota13 shared this article with you from Inoreader Impact of Patient Socioeconomic Disparities on Time to Tympanostomy Tube Placement Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 12:34894211015741. doi: 10.1177/00034894211015741. Online ahead of print. ABSTRACT OBJECTIVES: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). METHODS: A retrospect ive cohort study was performed at a tertiary children's hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. RESULTS: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance (P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8 , 95% CI: 1.2-2.5, P = .003). CONCLUSIONS: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. LEVEL OF EVIDENCE: 4. PMID:33978498 | DOI:10.1177/00034894211015741 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Impact of Medical Comorbidities on Patient Satisfaction in Chronic Rhinosinusitis

xlomafota13 shared this article with you from Inoreader The Impact of Medical Comorbidities on Patient Satisfaction in Chronic Rhinosinusitis Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 12:34894211015736. doi: 10.1177/00034894211015736. Online ahead of print. ABSTRACT BACKGROUND: Patient satisfaction has a significant bearing on medical therapy compliance and patient outcomes. The purpose of this study was to (1) describe patient satisfaction, as characterized by the Patient Satisfaction Questionnaire-18 (PSQ-18), in the care of patients with chronic rhinosinusitis (CRS) and (2) analyze the impact of comorbidities on satis faction using the functional comorbidity index (FCI). METHODS: Patient demographics, disease severity measures, and PSQ-18 scores for patients with CRS presenting to a tertiary rhinology clinic between November 2019 and April 2020 were collected and analyzed. FCI was calculated retrospectively using the electronic medical record; individual comorbidities were tabulated. Spearman's correlations followed by multivariate regression was used to assess the relationship between medical comorbidities and PSQ-18. RESULTS: Sixty-nine patients met criteria for analysis. There were no significant differences in age, gender, and Sinonasal Outcomes Test-22 scores between CRS patients with (CRSwNP) and without (CRSsNP) nasal polyps. There was no significant difference in the mean FCI for patients with CRSwNP versus CRSsNP (5.1 and 4.3, respectively) (P = .843). Similarly, there was no significant difference in the mean sum PSQ-18 score (78/100 in both) between these cohorts (P = .148). The mean sum PSQ-18 score was not significantly associated with anxiety (P = .728), depression (P = .624), or FCI (P = .282), but was significantly associated with hearing impairment (P < .001). CONCLUSION: Patient satisfaction in the care of CRS is generally high with a diagnosis of comorbid hearing impairment demonstrating a negative association with satisfaction in this cohort. PMID:33978506 | DOI:10.1177/00034894211015736 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Virtual Resident Mentorship Groups for Fourth Year Medical Students Applying into Otolaryngology-Head and Neck Surgery

xlomafota13 shared this article with you from Inoreader Virtual Resident Mentorship Groups for Fourth Year Medical Students Applying into Otolaryngology-Head and Neck Surgery Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 12:34894211015740. doi: 10.1177/00034894211015740. Online ahead of print. ABSTRACT OBJECTIVE: To create a longitudinal near-peer mentorship program for medical students applying to otolaryngology. METHODS: A program for longitudinal near-peer mentorship was designed based on a needs analysis of senior medical students. Program objectives were to (1) provide didactic education on common otolaryngology consults, (2) facilitate resident- student networking, and (3) enable applicants to meet other students. Senior otolaryngology residents were matched with medical students from across the United States applying to otolaryngology for a series of online small group meetings. Sessions included resident-designed didactics covering high-yield clinical scenarios and a mentorship component focused on transition to residency topics. Program evaluation included anonymized pre- and post-tests for each didactic session and an anonymous post-program participant survey. RESULTS: There were 40 student participants from across the United States, with an average attendance of 73% of sessions per participant. Performance on didactic testing improved for 2 of the 3 sessions. Participants stated they would be very likely to recommend each session to another student in the future (4.96/5.00, obs = 155). Participants stated the most valuable part of the program was interacting with residents (82% of responses), transition to reside ncy advice (28%), and learning about otolaryngology consults (28%). Suggestions for improvement included expanding content, increasing the number of sessions, and involving additional faculty and residents. CONCLUSION: A longitudinal virtual experience can be valuable for near-peer mentorship for medical students applying to otolaryngology. PMID:33978510 | DOI:10.1177/00034894211015740 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of phoneme recognition skills in pediatric auditory brainstem implant users

xlomafota13 shared this article with you from Inoreader Evaluation of phoneme recognition skills in pediatric auditory brainstem implant users 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 11. doi: 10.1007/s00405-021-06840-3. Online ahead of print. ABSTRACT OBJECTIVES: This study aims to evaluate the relationship between phoneme recognition skills and language development skills in pediatric auditory brainstem implant (ABI) users. It further intends to identify the delays and problems that may occur in the phoneme recognition skills of children with ABI and shed light on rehabilitation programs. METHODS: Our study included 20 children using ABI and another 20 using cochlear implants (CI). They were aged between 6 and 8 years 11 months. The participants exhibited homogenous demographic and audiological characteristics. The Turkish version of the Test of Language Development-Primary: Fourth Edition (TOLDP:4) was used to evaluate the language development skills, and the Turkish version of the Phoneme Recognition Test (PRT) was applied to assess the phoneme recognition skills. RESULTS: There was a statistically significant difference (p < 0.05) in the PRT values as well as in the language development skills between the children with ABI and those with CI. It was observed that the values of the children with CI were significantly higher than those of children with ABI. CONCLUSION: Although children with ABI were not able to match the skills of their peers with CI, their language development and communication skills improved. It is believed that this study will contribute to the literature by demonstrating that the use of ABI improves phoneme recognition skills in children who are not eligible for CI or who do not adequately benefit from CI. PMID:33977366 | DOI:10.1007/s00405-021-06840-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of vocal fatigue and vocal tract discomfort between teachers of normal pupils and teachers of mentally disabled pupils

xlomafota13 shared this article with you from Inoreader Comparison of vocal fatigue and vocal tract discomfort between teachers of normal pupils and teachers of mentally disabled pupils 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 12. doi: 10.1007/s00405-021-06863-w. Online ahead of print. ABSTRACT PURPOSE: This study aims to study the comparison of vocal fatigue and vocal tract discomfort between teachers of normal pupils and teachers of mentally disabled pupils. STUDY DESIGN: Cross-sectional study METHODS: Participants were 179 teachers (50 male, 129 female) and 30 non-teachers (14 male, 16 female) who participated in the current study. The teachers work in elementary schools. Furthermore, 87 of the teachers work for mentally disabled pupils at special elementary schools. Non-teachers were Ahvaz Jundishapur University of Medical Sciences employees who consider as the control group. They completed the Persian VFI and VTDp questionnaires three times, at the beginning, middle, and end of their office hours for 1 workday. RESULTS: The current study's findings indicate that the Persian VFI and VTD scores of non-teache rs were significantly lower than teachers' scores. Furthermore, teachers of mentally disabled pupils demonstrated higher values from teachers of normal pupils based on the Persian VFI and VTDp scores CONCLUSION: The study results showed that teachers experienced more vocal fatigue and vocal tract discomfort than non-teachers. Furthermore, teachers of mentally disabled pupils indicated more vocal fatigue, the larynx's physical discomfort, and vocal tract discomfort, but this difference was practically small. PMID:33978817 | DOI:10.1007/s00405-021-06863-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role and mechanism of PKM2 in the development of LPS-induced acute kidney injury

xlomafota13 shared this article with you from Inoreader The role and mechanism of PKM2 in the development of LPS-induced acute kidney injury Via Cellular and Molecular Biology Histol Histopathol. 2021 May 12:18343. doi: 10.14670/HH-18-343. Online ahead of print. ABSTRACT A previous study suggested that pyruvate kinase M2 (PKM2) plays a vital role of metabolic reprogramming in the regulation of the innate inflammatory response, while PKM2 is a sensitive biomarker for nephrotoxicity. In this study, we investigated the role and mechanism of PKM2 in development of LPS-induced acute kidney injury. The AKI model of mice was established using LPS. The serum levels of blood urea nitrogen (Bun), creatinine (Cr), and Cystatin C (CysC) were identified using the enzyme-linked immunosorbent assay (ELISA). Hematoxylin and Eosin staining (H&E) was employed to assess pathological changes in kidney tissues of LPS-induced AKI model. Immunohistochemical staining and Western blot analysis were carried out to determine the expression of apoptosis-related factors at protein levels. We found that Bun, CysC, and Cr were signifi cantly increased in the LPS group compared with the control group. The histopathological assay showed model swollen tubular epithelial cells and the presence of vacuolar degeneration in the LPS-induced AKI. In addition, expression levels of PKM2 significantly increased in the LPS group compared with the control group at both protein and mRNA levels (P<0.01). The inhibition of PKM2 by shikonin notably suppressed the expression of HIF-1α and apoptosis-related factors such as BNIP3, Bax, and Caspase-3, while the inhibition of PKM2 by shikonin significantly improved the histopathological symptoms of LPS-induced AKI. This study demonstrated the potential role of PKM2 in LPS-induced AKI and identified PKM2 as a promising therapeutic target in the treatment of AKI. PMID:33978226 | DOI:10.14670/HH-18-343 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Isolated Dysphagia in a Patient with Medial Medullary Infarction - Effects of Evidence-Based Dysphagia Therapy: A Case Report

xlomafota13 shared this article with you from Inoreader Isolated Dysphagia in a Patient with Medial Medullary Infarction - Effects of Evidence-Based Dysphagia Therapy: A Case Report Via swallowing exercises Case Rep Neurol. 2021 Mar 19;13(1):190-199. doi: 10.1159/000513676. eCollection 2021 Jan-Apr. ABSTRACT Medial medullary infarction (MMI) is a vascular occlusion in the medulla oblongata leading to certain constellations of neurological symptoms and seriously affecting the patient. Effective evidence-based treatment of severe dysphagia as sole symptom of MMI has not yet been reported. This case study aims to report successful effects of evidence-based therapy based on findings of dy sphagia symptoms and pathophysiology of swallowing by flexible endoscopic evaluation of swallowing (FEES) in severe isolated dysphagia after MMI. FEES was performed to evaluate swallowing pathophysiology and dysphagia symptoms in a 57-year-old male with severe dysphagia after MMI. On the basis of FEES findings, simple and high-frequent evidence-based exercises for improvement of swallowing were implemented: thermal stimulation of faucial arches, Jaw Opening Exercise, and Jaw Opening Against Resistance. After 7 weeks of high-frequent evidence-based therapy and regular FEES evaluation the patient was set on full oral diet with no evidence of aspiration risk. In a first case report of isolated dysphagia in MMI our case illustrates that high-frequent evidence-based dysphagia therapy in combination with FEES as the method to evaluate and monitor swallowing pathophysiology can lead to successful and quick rehabilitation of severely affected dysphagic patients. PMID:33976655 | PMC:PMC8077515 | DOI:10.1159/000513676 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Accurate Operative Time Prediction in Thyroid Surgery: A Rural Tertiary Care Facility Experience

xlomafota13 shared this article with you from Inoreader Accurate Operative Time Prediction in Thyroid Surgery: A Rural Tertiary Care Facility Experience Via ear nose throat Ear Nose Throat J. 2021 May 12:1455613211016702. doi: 10.1177/01455613211016702. Online ahead of print. ABSTRACT OBJECTIVE: To determine whether surgeons can estimate thyroid operative time more accurately than a system-generated average time estimate. METHODS: Four otolaryngologists at a single institution with extensive endocrine surgery experience were asked to predict their operative times for all eligible thyroid surgeries. These estimates were compared to system- generated operative time predications based on averaging the surgeon's previous 10 cases with the same Current Procedural Terminology code. The surgeon-generated estimations and system-generated estimations were then compared to each other and the actual operative time. RESULTS: A final sample of 73 cases was used for all analyses. Average age was 51 years old and the majority of patients were female. Surgeon-generated operative time estimates were significantly more accurate than system-generated estimates based on time averaging (P < .001). These findings were consistent across each surgeon individually and within each procedure type (hemithyroidectomy and total thyroidectomy). These findings had a power of over 99% based on mean differences. CONCLUSION: As the financial center of modern hospitals, an efficient operating room is integral to economic success. Improving the precision of operative time estimation reduces costly unplanned staff overtime, canceled cases, and underutilization. Our research at a rural tertiary care center shows that experienced thyroid surgeons can substantially reduce the error of estimating thyroid operative times by considering individual patient characteristics. Although no objective variables have so far been identified to correlate with thyroid operative time, surgeon-generated operative time estimation is significantly more accurate than a generic system approach of averaging previous operative times. PMID:33978503 | DOI:10.1177/01455613211016702 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.