An improved predictive model for postoperative pulmonary complications after free flap reconstructions in the head and neck

xlomafota13 shared this article with you from Inoreader An improved predictive model for postoperative pulmonary complications after free flap reconstructions in the head and neck Via Head & Neck Abstract Background Commonly used predictive models for postoperative pulmonary complications (PPCs) do not perform when applied to head and neck cases. A head and neck‐specific risk prediction tool is needed. Methods Data on 794 free flap head and neck surgery cases at a single center were abstracted from the electronic medical record. Each case was reviewed for the development of PPCs. A predictive model was developed and was then compared to existing predictive models for PPCs. Results The least absolute shrinkage and selection operator procedure identified age, alcohol use, history of congestive heart failure, preoperative packed cell volume, preoperative oxygen saturation, and preoperative metabolic equivalents as predictors of PPCs in the head and neck population. The model demonstrated an area under the receiving operating characteristic curve of 0.75 (0.69–0.80) with moderately good calibration. Comparisons to the performance of existing models demonstrate superior performance. Conclusions The model for the development of PPCs developed in this article displays superior performance to existing models. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A dynamic prognostic nomogram to predict the benefit from surgical treatment modality for patients with laryngeal squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader A dynamic prognostic nomogram to predict the benefit from surgical treatment modality for patients with laryngeal squamous cell carcinoma Via Head & Neck Abstract Background Although nonsurgical treatment strategy is increasingly adopted in patients with locoregionally advanced laryngeal squamous cell carcinoma (LSCC), survival disparities were reported between surgical treatment modality and organ preservation protocols, highlighting the great importance for accurate patients' selection. Method This secondary analysis used data from the Surveillance, Epidemiology, and End Results database between 2010 and 2015 with follow‐up data up to 2018. We developed and validated a dynamic prognostic nomogram for overall survival (OS) in 4237 patients with LSCC and subgroup of 2087 patients with locoregionally advanced laryngeal squamous cell carcinoma (LALSCC). Based on the total risk score derived from the dynamic nomogram, two well‐matched risk groups (i.e., low‐ and high‐risk) were created via X‐tile software and 1‐to‐1 propensity score matching (PSM); surgical treatment modality was compared with nonsurgical one in each risk group. Results A more accurate and convenient dynamic prognostic nomogram based on age, marital status, T category, N category, M category, tumor size, and tumor differentiation was developed and validated, of which the predictive performance was superior to that of TNM staging system. For high‐risk LALSCC selected by the dynamic nomogram, after 1‐to‐1 PSM, significantly improved OS was observed in patients with receiving surgical treatment compared to those receipt of nonsurgical management (restricted mean survival time at 36‐month: 26.6 vs 22.7, p < 0.001; restricted mean survival time at 60‐month: 36.7 vs 31.0, p = 0.003). Conclusion We establish and validate a more accurate and convenient dynamic prognostic nomogram for patients with LSCC, which may predict the benefit from surgical treatment modality for patients with high‐risk LALSCC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trunkoplasty after massive weight loss - a case series with a one-stage body contouring procedure for the NHS patient

xlomafota13 shared this article with you from Inoreader Trunkoplasty after massive weight loss - a case series with a one-stage body contouring procedure for the NHS patient Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Mar 10:S1748-6815(21)00087-5. doi: 10.1016/j.bjps.2021.02.008. Online ahead of print. ABSTRACT Body contouring post massive weight loss (MWL) is a considerable task and is often a functional rather than esthetic operation. Clinicians are often encouraged to solve multiple issues in a single setting that can be difficult in the MWL patient. A simple abdominoplasty often does not provide a satisfactory outcome in such patients and may result in disharmony of the esthetic unit of the trunk. Trunkoplasty is a technique that combines a fleur-de-lis abdominoplasty and reverse abdominoplasty. This is a one-stage operation to address the extra skin of the whole trunk esthetic unit. The average operation time was 4 h with a 3-surgeon team. No blood transfusions were required. There were 3 out of 15 patients with wound-related problems and no incidence of postoperative hematomas. There were no returns to theat ers. Seromas formed were not symptomatic and no interventions were required. The average inpatient stay was 6.9 days and a return to work after 4 weeks. It can improve abdominal contour, define the waist, and improve mons ptosis in one stage without any change in position. This procedure has some specific advantages (accommodates preexisting abdominal scars), but also has shortcomings as compared to "standard" circumferential body contouring. PMID:33785269 | DOI:10.1016/j.bjps.2021.02.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative morphological changes over time of vascularized scapular bone used for mandibular reconstruction: A retrospective cohort study

xlomafota13 shared this article with you from Inoreader Postoperative morphological changes over time of vascularized scapular bone used for mandibular reconstruction: A retrospective cohort study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Mar 10:S1748-6815(21)00085-1. doi: 10.1016/j.bjps.2021.02.009. Online ahead of print. ABSTRACT BACKGROUND: Currently, sequential morphological changes of vascularized scapular bone for mandibular reconstruction have remained unreported. METHODS: We retrospectively analyzed 18 patients with defects on the lateral segment of the mandible who underwent postoperative computed tomography (CT) scanning at 1, 6, 12, and 24 months postoperatively. Using the cross-sectional coronal CT images during each assessment, we measured the height and thickness of the grafted scapular bone at points 10 and 30 mm away from the mesial segment and evaluated their differences over time. Then, the relationship between the morphological changes of the grafted scapular bone and the distance from the mesial bone segment, the number of occlusal supports on the contralateral side of the mandible, and the correlation of sex and age were evaluated. RESULTS: The height of the grafted scapular bone decreased by approximately 11% and its thickness increased by 14% within 24 months postoperatively. The bone thickness increase was greater at point 30 mm from the mesial bone segment. Patients with two occlusal contacts (premolar and molar) on the contralateral side had a significantly higher rate of bone thickness increase. Furthermore, the graft morphology was not associated with age or sex. CONCLUSION: A vascularized scapular bone thickens over time, which depends on the distance from the mesial bone segment and the occlusal contact regions on the contralateral side of the mandible. PMID:33785268 | DOI:10.1016/j.bjps.2021.02.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sarcoidosis Causing Complete Nasal Obstruction

xlomafota13 shared this article with you from Inoreader Sarcoidosis Causing Complete Nasal Obstruction Via ear nose throat Ear Nose Throat J. 2021 Mar 31:1455613211003837. doi: 10.1177/01455613211003837. Online ahead of print. ABSTRACT Our case demonstrates the rare presentation of sinonasal sarcoidosis causing severe nasal obstruction. While the patient had a remote history of pulmonary sarcoidosis, she was in remission and had no prior history of sinonasal involvement. Sarcoidosis should be considered in a patient with nasal obstruction especially when there is a history of systemic sarcoid dis ease. PMID:33784855 | DOI:10.1177/01455613211003837 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Clinical Report of Intramuscular Hemangioma of the Middle Scalene Muscle

xlomafota13 shared this article with you from Inoreader A Rare Clinical Report of Intramuscular Hemangioma of the Middle Scalene Muscle Via ear nose throat Ear Nose Throat J. 2021 Mar 31:1455613211003834. doi: 10.1177/01455613211003834. Online ahead of print. ABSTRACT Intramuscular hemangioma (IMH) is an uncommon benign vascular lesion, which develops in skeletal muscles and it accounts for <1% of all hemangiomas. The accurate diagnosis is often difficult because the clinical and radiological findings are not specific. The gold standard treatment of IMH is surgical resection. We present a rare clinical report of IMH of the m iddle scalene muscle that was treated successfully with preoparative embolization and surgical excision. PMID:33784878 | DOI:10.1177/01455613211003834 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delayed Tracheal Perforation Following Total Thyroidectomy

xlomafota13 shared this article with you from Inoreader Delayed Tracheal Perforation Following Total Thyroidectomy Via The Laryngoscope Abstract Delayed tracheal rupture following total thyroidectomy (TT) is rare and represents a potential airway emergency. A 34‐year‐old female with Felty Syndrome underwent TT for Hashimoto's thyroiditis. On post‐operative day 10, she presented with subcutaneous emphysema and an anterolateral tracheal perforation on CT scan. Urgent operative exploration revealed transmural tracheal necrosis and a 5 mm perforation. This was oversewn with non‐absorbable suture and a strap muscle flap rotated over the defect to promote healing. Repeat direct laryngoscopy at 72 hours revealed healing tissue. Tracheal necrosis and perforation following TT constitutes a potential airway emergency and should be promptly explored and repaired. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Podoplanin is required for tumor cell invasion in cutaneous squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Podoplanin is required for tumor cell invasion in cutaneous squamous cell carcinoma Via Experimental Dermatology Abstract The invasiveness of late stage cutaneous squamous cell carcinoma (cSCC) is associated with poor patients' prognosis and linked to strong upregulation of the glycoprotein Podoplanin (PDPN) in cancer cells. However, the function of PDPN in these processes in cSCC carcinogenesis has not been characterized in detail yet. Employing a CRISPR/Cas9‐based loss‐of‐function approach on murine cSCC cells, we show that the loss of Pdpn results in decreased migration and invasion in vitro. Complementing these in vitro studies, labeled murine control and Pdpn knockout cells were injected orthotopically into the dermis of nude mice to recapitulate the formation of human cSCC displaying a well‐differentiated morphology with a PDPN‐positive reaction in fibroblasts in the tumor stroma. Smaller tumors were observed upon Pdpn loss, which is associated with reduced tumor cell infiltration into the stroma. Utilizing Pdpn mutants in functional experim ents in vitro we provide evidence that both the intra‐ and extracellular domains are essential for cancer cell invasion. These findings underline the critical role of PDPN in cSCC progression and highlight potential therapeutic strategies targeting PDPN‐dependent cancer cell invasion especially in late‐stage cSCC patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Molecular epidemiology of non‐syndromic autosomal recessive congenital ichthyosis in a Middle Eastern population

xlomafota13 shared this article with you from Inoreader Molecular epidemiology of non‐syndromic autosomal recessive congenital ichthyosis in a Middle Eastern population Via Experimental Dermatology Abstract Autosomal recessive congenital ichthyosis (ARCI) is a rare and heterogeneous skin cornification disorder presenting with generalized scaling and varying degrees of erythema. Clinical manifestations range from lamellar ichthyosis (LI), congenital ichthyosiform erythroderma (CIE) through the most severe form of ARCI, Harlequin ichthyosis (HI). We used homozygosity mapping, whole exome and direct sequencing to delineate the relative distribution of pathogenic variants as well as identify genotype‐phenotype correlations in a cohort of 62 Middle Eastern families with ARCI of various ethnic backgrounds. Pathogenic variants were identified in most ARCI‐associated genes including TGM1 (21%), CYP4F22 (18%), ALOX12B (14%), ABCA12 (10%), ALOXE3 (6%), NIPAL4 (5%), PNPLA1 (3%), LIPN (2%) and SDR9C7 (2%). In 19% of cases, no mutation was identified. Our cohort revealed a higher prevalence of CYP4F22 and ABCA12 path ogenic variants and a lower prevalence of TGM1 and NIPAL4 variants, as compared to data obtained in other regions of the world. Most variants (89%) in ALOX12B were associated with CIE and were the most common cause of ARCI among patients of Muslim origin (26%). Palmoplantar keratoderma associated with fissures was exclusively a result of pathogenic variants in TGM1. To our knowledge, this is the largest cohort study of ARCI in the Middle Eastern population reported to date. Our data demonstrate the importance of population‐tailored mutation screening strategies and shed light upon specific genotype‐phenotype correlations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic and clinicopathological significance of GPRC5A in various cancers: A systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Prognostic and clinicopathological significance of GPRC5A in various cancers: A systematic review and meta-analysis Via Head and neck cancers by Lu Dai, Xiao Jin, Zheng Liu Background GPRC5A is associated with various cancer initiation and progression. Controversial findings have been reported about GPRC5A prognostic characteristics, and no meta-analysis has been conducted to assess the relationship between GPRC5A and cancer prognosis. Therefore, the objective of this meta-analysis is to evaluate the overall prognostic effectiveness of GPRC5A. Methods We first conducted a systematic search in the PubMed, Embase, Web of Science, CNKI, Cochrane, and WangFang databases. The hazard ratio (HR) and odds ratios (OR) with 95% CI were then pooled to assess the associations between GPRC5A expression and overall survival (OS), disease-free survival (DFS), event-free survival (EFS), and clinicopathological characteristics. Chi-squared test and I2 statistics were completed to evaluate the heterogeneity in our study. A random‐effects model was used when significant heterogeneity existed (I2>50% and p Results In total, 15 st udies with 624 patients met inclusion criteria of this study. Our results showed that higher expression of GPRC5A is associated with worse OS (HR:1.69 95%CI: 1.20–2.38 I2 = 75.6% p = 0.000), as well as worse EFS (HR:1.45 95%CI: 1.02–1.95 I2 = 0.0% p = 0.354). Subgroup analysis indicated that tumor type might be the source of high heterogeneity. Additionally, cancer patients with enhanced GPRC5A expression were more likely to lymph node metastasis (OR:1.95, 95%CI 1.33–2.86, I2 = 43.9%, p = 0.129) and advanced tumor stage (OR: 1.83, 95%CI 1.15–2.92, I2 = 61.3%, p = 0.035), but not associated with age, sex, differentiation, and distant metastasis. Conclusion GPRC5A can be a promising candidate for predicting medical outcomes and used for accurate diagnosis, prognosis prediction for patients with cancer; however, the predictive value of GPRC5A varies significantly according to cancer type. Further stu dies for this mechanism will be necessary to reveal novel insights into application of GPRC5A in cancers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two-phase survey on the frequency of use and safety of MRI for hearing implant recipients

xlomafota13 shared this article with you from Inoreader Two-phase survey on the frequency of use and safety of MRI for hearing implant recipients 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 Mar 31. doi: 10.1007/s00405-020-06525-3. Online ahead of print. ABSTRACT PURPOSE: Magnetic resonance imaging (MRI) is often used to visualize and diagnose soft tissues. Hearing implant (HI) recipients are likely to require at least one MRI scan during their lifetime. However, the MRI scanner can interact with the implant magnet, resulting in complications for the HI recipient. This survey, which was conducted in two phases, aimed to evaluate the safety and performance of MRI scans for individuals with a HI manufactured by MED-EL (MED-EL GmbH, Innsbruck, Austria). METHODS: A survey was developed and distributed in two phases to HEARRING clinics to obtain information about the use of MRI for recipients of MED-EL devices. Phase 1 focused on how often MRI is used in diagnostic imaging of the head region of the cochlear implant (CI) recipients. Phase 2 collected safety information about MRI scans perfor med on HI recipients. RESULTS: 106 of the 126 MRI scans reported in this survey were performed at a field strength of 1.5 T, on HI recipients who wore the SYNCHRONY CI or SYNCHRONY ABI. The head and spine were the most frequently imaged regions. 123 of the 126 scans were performed without any complications; two HI recipients experienced discomfort/pain. One recipient required reimplantation after an MRI was performed using a scanner that had not been approved for that implant. There was only one case that required surgical removal of the implant to reduce the imaging artefact. CONCLUSION: Individuals with either a SYNCHRONY CI or SYNCHRONY ABI from MED-EL can safely undergo a 1.5 T MRI when it is performed according to the manufacturer's safety policies and procedures. PMID:33788034 | DOI:10.1007/s00405-020-06525-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.