Ninety‐day mortality following transoral robotic surgery or radiation at Commission on Cancer‐accredited facilities

alexandrossfakianakis shared this article with you from Inoreader Ninety‐day mortality following transoral robotic surgery or radiation at Commission on Cancer‐accredited facilities via Head & Neck Abstract Background Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown. Methods NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson–Deyo score 0–1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities. Results 3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all p < 0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality. Conclusions There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment. View on Web

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the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM‐Pt)

alexandrossfakianakis shared this article with you from Inoreader The Portuguese version of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM‐Pt): translation, cultural adaptation, and multicenter validation study in professional orchestra musicians via Pain Practice Abstract Objectives We aim to assess the validity and reliability of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) and to add to its cross-cultural adaptation process by translating, culturally adapting and validating the MPIIQM into European Portuguese language in the population of Portuguese musicians. Methods A Portuguese version of the MPIIQM (MPIIQM-Pt) was created through a process of forward and back translation, pilot testing and cultural adaptation by expert panel evaluation. The psychometric evaluation was performed in a validation sample of 134 musicians, at baseline and after seven days. Results The high degree of internal consistency and the substantial test-retest reliability coefficients were demonstrated for each subscale (α = 0,896 and ICC = 0,997 for "pain intensity", and α = 0,879 and ICC = 0,999 for "pain interference", respectively). Exploratory factor analysis indicated two-factor structure (pain intensity and interference) that explained 75,5% of the variance. Both convergent and divergent validity are well demonstrated, confirming more than 90% of the previously defined hypotheses regarding correlations with other measures. Discussion MPIIQM-Pt is the first validated questionnaire to evaluate pain among Portuguese musicians. It showed excellent psychometric properties, both in terms of internal consistency, test-retest reliability, factor analysis, and construct validity. Therefore, it is a valid and reliable tool suitable for both research and clinical practice purposes. MPIIQM-Pt will allow the development of more robust studies on pain among musicians and the improved assessment and monitoring of pain in this population, filling an important gap in this field of Pain Medicine. View on Web

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Therapieadhärenz drei Monate nach Einleitung einer nichtinvasiven CPAP-Therapie bei 1078 Patienten mit obstruktiver Schlafapnoe (OSA)

alexandrossfakianakis shared this article with you from Inoreader Therapieadhärenz drei Monate nach Einleitung einer nichtinvasiven CPAP-Therapie bei 1078 Patienten mit obstruktiver Schlafapnoe (OSA) via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1949-3026 Einleitung Die nächtliche kontinuierliche positive Überdruckatmung (CPAP) gilt als therapeutischer Goldstandard einer obstruktiven Schlafapnoe (OSA). Die CPAP-Therapie stellt zumeist eine Dauertherapie mit geringen Nebenwirkungen dar. Trotzdem ist die Therapietreue unbefriedigend. In dieser Arbeit wurden die Therapietreue betrachtet und typische Probleme katalogisiert. Methode 1078 OSA-Patienten wurden nach diagnostischer Polygrafie (PG) oder Polysomnografie (PSG) auf eine CPAP-Therapie eingestellt. Die Therapietreue wurde nach 3 Monaten nachverfolgt. Folgende Therapieadhärenz-Gruppen wurden festgelegt: 1. gute CPAP-Einstellung und Nutzung, 2. CPAP-Abbruch nach anfänglicher Nutzung, 3. mangelnde CPAP-Nutzung wegen Nebenwirkungen, 4. Abbruch aufgrund fehlender Motivation/geringem Leidensdruck, 5. Masken-Unverträglichkeit, 6. CPAP-Versagen aufgrund fehlenden Therapieeffekts, 7. Umstellung auf anderes Beatmungsverfahren, 8. keine Kontrolle erfolgt. Ergebnisse Von 1078 CPAP-Patienten erschienen 830 Patienten (77 %) zur Therapiekontrolle. Hiervon waren 450 Patienten (54,2%) in Gruppe 1, 216 Patienten (26%) in Gruppe 2, 71 Patienten (8,5%) in Gruppe 3, 35 Patienten (4,2%) in Gruppe 4, 14 Patienten (1,7%) in Gruppe 5, 3 Patienten (0,4 %) in Gruppe 6 und 41 Patienten (4,9%) in Gruppe 7. Ein geringer obstruktiver Ereignisindex, niedriger CPAP-Druck und tendenziell auch ein geringer Epworth-Sleepiness-Score waren Prädiktoren für CPAP-Versagen. Für die Therapietreue konnten keine signifikanten Prädiktoren dargestellt werden. Diskussion Eine effektive Therapienutzung von 54% nach 3 Monaten ist ein suboptimales Ergebnis. Prädiktoren für CPAP-Versagen waren Parameter, die vor Therapie auf geringen Leidensdruck der Patienten deuteten. Trotz großer Patientenkohorte konnten keine signifikanten CPAP-Adhärenz-Prädiktoren durch anthropometrische oder PSG-Daten dargestellt werden. Vielmehr könnten Erfahrungen in den ersten Therapietagen ausschlaggebend sein. CPAP-Geräte bieten Komforteinstellungen, die kenntnisgerecht auf den Patienten individualisiert werden müssen. Eine große Auswahl an unterschiedlichen Maskenformen erfordert Erfahrung und Training bei der patientenorientierten Maskenanpassung. Eine 3-monatige Wiedervorstellung erscheint zu lang, um Therapieprobleme zeitnah mit dem Patienten zu besprechen. Telemedizinische Möglichkeiten oder kurzfristige telefonische Beratungsoptionen sollten in Betracht gezogen werden. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on Web

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Comparison of Transnasal Esophagoscopy and Sedated Esophagogastroduodenoscopy in the Assessment of Laryngopharyngeal Reflux

alexandrossfakianakis shared this article with you from Inoreader Comparison of Transnasal Esophagoscopy and Sedated Esophagogastroduodenoscopy in the Assessment of Laryngopharyngeal Reflux via Clinical Otolaryngology Abstract Objective Transnasal esophagoscopy (TNE) in the awake patient and esophagogastroduodenoscopy (EGD) in sedation are both used in the assessment of laryngopharyngeal reflux (LPR). The objective of this study was to compare these two endoscopic methods in contributing to the diagnosis of LPR. Methods This study included 54 patients presenting with signs and symptoms suspicious for LPR, which were examined both by TNE and EGD. The contribution of each method to the diagnosis of LPR was evaluated separately and then compared with each other. Results In detecting LPR, TNE showed a significant higher sensitivity (94% vs. 60%) and accuracy (93% vs. 59%) than EGD, but their specificity was equal (50% each). The most common pathologic findings in both methods were a hiatal hernia (70% vs 48%) and gaping cardia (69% vs 24%), followed by peptic esophagitis (41% vs 24%). Conclusion The value of EGD is limited in the workup of LPR, as sedation tends to mask the subtle findings in this kind of reflux disease. View on Web

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Brachial Plexus Magnetic Resonance Neurography: Technical Challenges and Solutions

alexandrossfakianakis shared this article with you from Inoreader Brachial Plexus Magnetic Resonance Neurography: Technical Challenges and Solutions via Investigative Radiology - Current Issue Magnetic resonance neurography of the brachial plexus (BP) is challenging owing to its complex anatomy and technical obstacles around this anatomic region. Magnetic resonance techniques to improve image quality center around increasing nerve-to-background contrast ratio and mitigating imaging artifacts. General considerations include unilateral imaging of the BP at 3.0 T, appropriate selection and placement of surface coils, and optimization of pulse sequences. Technical considerations to improve nerve conspicuity include fat, vascular, and respiratory artifact suppression techniques; metal ar tifact reduction techniques; and 3-dimensional sequences. Specific optimization of these techniques for BP magnetic resonance neurography greatly improves image quality and diagnostic confidence to help guide nonoperative and operative management. View on Web

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Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID‐19 in Beijing, China

alexandrossfakianakis shared this article with you from Inoreader Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID‐19 in Beijing, China via Journal of Medical Virology Abstract Background A series of nonpharmaceutical interventions (NPIs) was launched in Beijing, China, on January 24, 2020, to control coronavirus disease 2019. Methods To reveal the roles of NPIs on respiratory syncytial virus (RSV), respiratory specimens collected from children with acute respiratory tract infection during Jul 2017 and Dec 2021 in Beijing were screened by CEMP assay. Specimens positive for RSV were subjected to PCR and genotyped by G gene sequencing and phylogenetic analysis using iqtree v1.6.12. The paraFix mutations were analyzed with the R package sitePath. Clinical data were compared using SPSS 22.0 software. Results Before NPIs launched, each RSV endemic season started from Oct/Nov to Feb/Mar of the next year in Beijing. After that, the RSV positive rate abruptly dropped from 31.93% in Jan to 4.39% in Feb 2020; then, a dormant state with RSV positive rates ≤1% from Mar to Sep, a nearly dormant state in Oct (2.85%) and Nov (2.98%) and a delayed endemic season in 2020, and abnormal RSV positive rates remaining at approximately 10% in summer until Sep 2021 were detected. Finally, an endemic RSV season returned from Oct 2021. There was a game between subtypes A and B, and RSV-A replaced RSV-B in July 2021 to become the dominant subtype. Six RSV-A and 8 RSV-B paraFix (parallel and fixed) mutations were identified on G. The percentage of severe pneumonia patients decreased to 40.51% after NPIs launched. Conclusions NPIs launched in Beijing seriously interfered with the endemic season of RSV. This article is protected by copyright. All rights reserved. View on Web

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Tuberculosis and the Risk of Ischemic Heart Disease: A Nationwide Cohort Study

alexandrossfakianakis shared this article with you from Inoreader Tuberculosis and the Risk of Ischemic Heart Disease: A Nationwide Cohort Study via Clinical Infectious Diseases Advance Access Abstract Background Little is known about the risk of ischemic heart disease (IHD) in tuberculosis (TB) survivors. Methods We performed a population-based retrospective cohort study using the Korean National Health Insurance Service database. TB survivors (n = 60,602) and their 1:1 age- and sex-matched controls (n = 60,602) were enrolled. Eligible participants were followed up from 1 year after their TB diagnosis to the date of an IHD event, date of deat h, or the end of the study period (December 31, 2018), whichever came first. The risk of IHD was estimated using a Cox proportional hazards regression, and stratified analyses were performed for related factors. Among IHD events, we additionally analyzed for myocardial infarction (MI). Results During a median of 3.9 years of follow-up, 2.7% of TB survivors (1,633/60,602) and 2.0% of the matched controls (1,228/60,602) developed IHD, and 0.6% of TB patients (341/60,602) and 0.4% of the matched controls (223/60,602) developed MI. The overall risk of developing IHD and MI was higher in TB patients (adjusted hazard [aHR] 1.21, 95% CI 1.12–1.32 for IHD and aHR 1.48, 95% CI 1.23–1.78 for MI) than in the matched controls. Stratified analyses showed that TB survivors have an increased risk of IHD and MI regardless of income, place of residence, smoking status, alcohol consumption, physical activity, body mass index, and Charlson comorbidity index. Conclusions TB surviv ors have a higher risk of IHD than matched controls. Strategies are needed to reduce the burden of IHD in TB survivors. View on Web

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