Socioeconomic Status and Survival in Nasopharyngeal Carcinoma: A Population‐Based Study

xlomafota13 shared this article with you from Inoreader Socioeconomic Status and Survival in Nasopharyngeal Carcinoma: A Population‐Based Study Via The Laryngoscope Objectives/Hypothesis To evaluate survival for nasopharyngeal carcinoma in relation to socioeconomic status. Study Design Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) Census Tract-level Socioeconomic Status Database (2000–2016). Methods Patients with nasopharyngeal carcinoma diagnosed between 2000 and 2016 were identified. Data were stratified based on socioeconomic status, divided into three groups: group 1 being the poorest and group 3 the wealthiest. Univariate analysis as well as multivariate Cox regression analysis adjusted for individual variables was performed. Results A total of 5,527 patients were included in the study, with 33% in group 1, 34% in group 2, and 33% in group 3. There was a significant difference between groups in regard to age at diagnosis, race, histologic subtype, overall stage, tumor stage, nodal stage, and whether or not they received radiation. Patients in group 1, the poorest socioeconomic status, were more likely to be young (P = .003), black (P < .0001), present with higher overall stage (P = .009), tumor stage (P = .01), and nodal stage (P = .02), and less likely to receive radiation (P = .005). In multivariate analysis, there was a significant difference in survival between the groups, with group 1 patients less likely to survive compared to group 3 (hazard ratio = 1.28; 95% CI 1.07–1.57). Conclusions Patients in the poorest socioeconomic status presented with more advanced nasopharyngeal cancer and were less likely to receive radiation when compared with individuals of higher socioeconomic status. The poorest socioeconomic status groups were less likely to survive from their disease when controlling for other variables. Level of Evidence NA Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sclerotherapy Versus Cautery/Laser Treatment for Epistaxis in Hereditary Hemorrhagic Telangiectasia

xlomafota13 shared this article with you from Inoreader Sclerotherapy Versus Cautery/Laser Treatment for Epistaxis in Hereditary Hemorrhagic Telangiectasia Via The Laryngoscope Objectives/Hypothesis Surgical interventions for epistaxis management in hereditary hemorrhagic telangiectasia (HHT) demonstrate short-term success and require repeated procedures for disease control. Although electrocautery and/or laser photocoagulation (C ± L) are most frequently performed, sodium tetradecyl sclerotherapy (STS) is emerging as a promising newer treatment. We hypothesized that in a 24-month time period, STS would require fewer treatments than C ± L to maintain epistaxis severity within the mild range. Study Design Retrospective study. Methods We retrospectively assessed 67 patients with HHT with moderate and severe epistaxis that were treated periodically with C ± L (34 patients) versus STS (33 patients). The primary outcome was the number of procedures needed to maintain the epistaxis severity score (ESS) as mild. Secondary outcomes assessed for differences in postoperative complications, hemoglobin levels, iron stores, hematologic support, and quality-of-life (QoL) scores. Results To maintain ESS in the mild range, 1.6 STS procedures (range, 1–4) were performed versus 3.6 C ± L procedures (range, 1–8) (P = .003). Significant postoperative differences included reduction in nasal crusting (3% vs. 32%, P = .001), foul odor (3% vs. 35%, P < .001), and septal perforation (3% vs. 29%, P = .006) after STS. There were no significant differences between the two treatments in hemoglobin levels, iron stores, hematologic support, or QoL scores. Conclusion STS is able to attain satisfactory epistaxis control with significantly fewer procedures and lower postoperative complications than C ± L. STS should be considered as the initial surgical intervention for epistaxis in patients with HHT. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Characteristics, Classification, and Management of Adult Nasopharyngolaryngeal Hemangioma

xlomafota13 shared this article with you from Inoreader Clinical Characteristics, Classification, and Management of Adult Nasopharyngolaryngeal Hemangioma Via The Laryngoscope Objectives/Hypothesis To analyze the clinical features, classification, and treatment of adult nasopharyngolaryngeal hemangioma (ANPLH). Study Design Retrospective study. Methods From February 2009 to May 2020, 101 patients with ANPLH were reviewed and analyzed. Results Symptoms of ANPLH were frequently displayed as abnormal pharyngeal sensation and functional defection. According to lesion location, ANPLH was divided into five categories including nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, and mixed types. The mixed type constitutes the highest portion, and the nasopharyngeal type is the least in our cohort. Most lesions could resect through natural cavity under endoscopy. Patients with mixed lesions had a higher rate of postoperative recurrence and planned multiple surgeries. Acceptable but not severe intraoperative and postoperative complications occurred in our patient cohort. Conclusions Patients with ANPLH are always symptomatic and even functional defective, which can be classified into five categories based on lesion location. For these patients, endoscopic surgery through natural cavity is recommended to remove lesions with fewer complications and favorable clinical outcomes. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vocal Acoustics and Aerodynamics During Scripted Reading Compared to Spontaneous Speech

xlomafota13 shared this article with you from Inoreader Vocal Acoustics and Aerodynamics During Scripted Reading Compared to Spontaneous Speech Via Journal of Voice Examination of vocal acoustics and phonatory aerodynamics during connected speech provide a more ecologically valid approach to voice assessment than single phoneme measures. The purpose of the current investigation was to determine if differences exist in vocal acoustics and aerodynamics between reading and spontaneous speech tasks in patients with common voice disorders. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Investigating resistin like beta (RETNLB) as a tumor promoter for oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Investigating resistin like beta (RETNLB) as a tumor promoter for oral squamous cell carcinoma Via Head & Face Medicine Oral cavity cancer ranks the sixth most common malignancy worldwide, of which oral squamous cell carcinoma is the predominant type. This study aimed to investigate the function and the underlying mechanism of ... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation of tumour and treatment characteristics to dose received by cochlea in volumetric arc therapy

xlomafota13 shared this article with you from Inoreader Correlation of tumour and treatment characteristics to dose received by cochlea in volumetric arc therapy 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 Jun 23. doi: 10.1007/s00405-021-06950-y. Online ahead of print. ABSTRACT PURPOSE: This is a radiation field simulation study using CT images designed to see the cochlear dosimetry and its correlation with tumour and treatment characteristics during radiotherapy for head and neck cancers (HNC) for identifying the factors associated with a higher dose delivered to the cochlea. METHODS: From 2018 to 2020, 80 patients with HNC underwent volumetric arc therapy (VMAT) to a dose of 66-70 Gy at 2 Gy per fraction with bilateral cochlea contoured for VMAT optimization as an organ at risk. Minimum, mean and maximum planned radiation dose to the cochlea based on tumour and treatment characteristics and dose-volume histogram variables of VMAT plans were analysed. RESULTS: Mean (standard deviation, SD) cochlear volume was 0.14 (0.06) cm3 with maximum and mean planned doses of 10.3 (SD = 11.6) Gy and 8.5 (SD = 9.8) Gy, respectively. We found a statistically significant correlation between mean dose received by bilateral cochlea (P-0.000, rright-0.84, rleft-0.78, rmidline-0.92). Tumours of the paranasal sinuses, and the parotids and more advanced T stages were associated with a higher mean dose to cochlea but was not significant statistically. The dose received by the 95% target nodal volume (D95%) showed a significant correlation with the cochlear mean dose (P-0.000, rright-0.85, rleft-0.77, rmidline-0.93) CONCLUSION: With VMAT we have achieved a better sparing of cochlea. The mean dose to the cochlea of one side significantly differed from the other side in patients with lateralized cancers. D95% of nodal volume also showed a significant correlation with the cochlear mean dose. PMID:34160665 | DOI:10.1007/s00405-021-06950-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Deep neck infections with and without mediastinal involvement: treatment and outcome in 218 patients

xlomafota13 shared this article with you from Inoreader Deep neck infections with and without mediastinal involvement: treatment and outcome in 218 patients 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 Jun 23. doi: 10.1007/s00405-021-06945-9. Online ahead of print. ABSTRACT PURPOSE: Infections of the deep neck, although becoming scarcer due to the widespread use of antibiotics, still represent a dangerous and possibly deadly disease, especially when descending into the mediastinum. Due to the different specialities involved in the treatment and the heterogenous presentation of the disease, therapeutic standard is still controversial. This study analyzes treatment and outcome in these patients based on a large retrospective review and proposes a therapeutic algorithm. METHODS: The cases of 218 adult patients treated with deep neck abscesses over a 10-year period at a tertiary university hospital were analyzed retrospectively. Clinical, radiological, microbiological and laboratory findings were compared between patients with and without mediastinal involvement. RESULTS: Forty-five patients (2 0.64%) presented with abscess formation descending into the mediastinum. Those patients had significantly (all items p < 0.0001) higher rates of surgical interventions (4.27 vs. 1.11) and tracheotomies (82% vs. 3.4%), higher markers of inflammation (CRP 26.09 vs. 10.41 mg/dl), required more CT-scans (3.58 vs. 0.85), longer hospitalization (39.78 vs 9.79 days) and more frequently needed a change in antibiotic therapy (44.44% vs. 6.40%). Multi-resistant pathogens were found in 6.67% vs. 1.16%. Overall mortality rate was low with 1.83%. CONCLUSION: Despite of the high percentage of mediastinal involvement in the present patient collective, the proposed therapeutic algorithm resulted in a low mortality rate. Frequent CT-scans, regular planned surgical revisions with local drainage and lavage, as well as an early tracheotomy seem to be most beneficial regarding the outcome. PMID:34160666 | DOI:10.1007/s00405-021-06945-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Can fractal dimension analysis be used in quantitating collagen structure?

xlomafota13 shared this article with you from Inoreader Can fractal dimension analysis be used in quantitating collagen structure? Via Experimental Dermatology Abstract It is well known that collagen tissue, especially the collagen structure, plays an important role in wound healing. However, most research on collagen has been qualitative and morphological, based on sections, and cannot be used for real-time monitoring and clinical prediction. There are no standardized methods of quantitative analysis based on the whole skin sample in three dimensions (3-D). In order to explore a 3-D quantitative analysis, we developed a method that was derived from that of material science and physics, combined with our previous technique, X-ray scattering (SAXS). We hypothesized that the dermis might be analyzed by fractal dimensions. To test this hypothesis, we performed the analysis in different pathological conditions, such as scar tissue, different time points after wounding, skin in different degrees of burns, and skin in diabetes. The results showed that fractal dimension analysis could detect differences in different locations of the scar tissue, in diff erent time points after wounding, and in a different extent of the severity of skin in diabetes. The research demonstrated that fractal dimension analysis can describe the 3-D structure of the collagen tissue of the skin, which will be beneficial for studying wound healing and finding new clinical treatments. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Graves disease and metastatic hormonal-active Hürthle cell thyroid cancer: A case report

xlomafota13 shared this article with you from Inoreader Graves disease and metastatic hormonal-active Hürthle cell thyroid cancer: A case report Via radioactive iodine Medicine (Baltimore). 2021 Jun 25;100(25):e26384. doi: 10.1097/MD.0000000000026384. ABSTRACT RATIONALE: A hormone-active metastatic Hürthle cell thyroid carcinoma (HCTC) and Graves disease (GD) present a therapeutic challenge and is rarely reported. PATIENT CONCERNS: We present a 64-year-old male patient, who had dyspnea and left hip pain lasting 4 months. He had clinical signs of hyperthyroidism and a tumor measuring 9 cm in diameter of the left thyroid lobe, metastatic nec k lymph node and metastases in the lungs, mediastinum, and bones. DIAGNOSIS: Laboratory findings confirmed hyperthyroidism and GD. Fine-needle aspiration biopsy and cytological investigation revealed metastases of HCTC in the skull and in the 8th right rib. A CT examination showed a thyroid tumor, metastatic neck lymph node, metastases in the lungs, mediastinum and in the 8th right rib measuring 20 × 5.6 × 4.5 cm, in the left acetabulum measuring 9 × 9 × 3 cm and parietooccipitally in the skull measuring 5 × 4 × 2 cm. Histology after total thyroidectomy and resection of the 8th right rib confirmed metastatic HCTC. INTERVENTIONS: The region of the left hip had been irradiated with concomitant doxorubicin 20 mg once weekly. When hyperthyroidism was controlled with thiamazole, a total thyroidectomy was performed. Persistent T3 hyperthyroidism, most likely caused by TSH-R-stimulated T3 production in large metastasis in the 8th right rib, was eliminated by rib resection . Thereafter, the patient was treated with 3 radioactive iodine-131 (RAI) therapies (cumulative dose of 515 mCi). Unfortunately, the tumor rapidly progressed after treatment with RAI and progressed 10 months after therapy with sorafenib. OUTCOMES: Despite treatment, the disease rapidly progressed and patient died due to distant metastases. He survived for 28 months from diagnosis. LESSONS: Simultaneous hormone-active HCTC and GD is extremely rare and prognosis is dismal. Concomitant external beam radiotherapy and doxorubicin chemotherapy, followed by RAI therapy, prevented the growth of a large metastasis in the left hip in our patient. However, a large metastasis in the 8th right rib presented an unresolved problem. Treatment with rib resection and RAI did not prevent tumor recurrence. External beam radiotherapy and sorafenib treatment failed to prevent tumor growth. PMID:34160415 | DOI:10.1097/MD.0000000000026384 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A rare tumor manifestation in the head and neck region

xlomafota13 shared this article with you from Inoreader A rare tumor manifestation in the head and neck region Via hno HNO. 2021 Jun 23. doi: 10.1007/s00106-021-01071-8. Online ahead of print. NO ABSTRACT PMID:34160625 | DOI:10.1007/s00106-021-01071-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perfusion analysis in parotid gland tumors using contrast-enhanced ultrasound (CEUS)

xlomafota13 shared this article with you from Inoreader Perfusion analysis in parotid gland tumors using contrast-enhanced ultrasound (CEUS) Via hno HNO. 2021 Jun 23. doi: 10.1007/s00106-021-01077-2. Online ahead of print. ABSTRACT OBJECTIVE: The diagnosis of parotid gland tumors is challenging due to their rarity and heterogenity. Neither conventional ultrasound nor magnetic resonance imaging (MRI) nor computed tomography (CT) allow a reliable pretherapeutic diagnosis. In addition to conventional ultrasound, contrast-enhanced ultrasound (CEUS) enables a more detailed assessment of perfusion in parotid gland tumors, ther eby improving evaluation of this tumor entity. Extensive studies with analysis of perfusion characteristics in different regions of interest (ROI) in parotid gland tumors are currently lacking. This study analysed and compared perfusion parameters in different intratumoral areas of malignant and benign parotid gland tumors using CEUS. MATERIALS AND METHODS: A total of 100 patients with tumors in the parotid gland were examined using B‑mode sonography, colour Doppler sonography and CEUS. The parameters magnitude, echogenicity, demarcation, vascularisation and in particular perfusion characteristics were measured and analysed. Analysis of quantitative CEUS parameters was performed using a specific method for perfusion analysis with certain ROI, which were allocated in a standardized manner in the entire parotid gland tumors. The perfusion parameters were compared between intratumoral ROI in the tumors and between particular tumor entities. Qualitative CEUS analysis with an est imation of perfusion patterns was additionally performed. RESULTS: Histologically benign tumors were found in 92 cases, and malignant tumors in eight cases. CEUS analysis of perfusion patterns revealed a centripetal perfusion pattern in malignant tumors significantly more frequently than in benign tumors. In the perfusion analysis of quantitative CEUS parameters, all tumors showed higher perfusion intensities in the peripheral ROI. In benign tumors, more differences in perfusion intensity between the intratumoral ROIs were detected compared to malignant tumors. CONCLUSION: The perfusion parameters (centripetal perfusion pattern; area under the curve) evaluated in this study have the potential to improve pretherapeutic diagnostics of parotid gland tumors in terms of differentiation of tumor entity. Further studies with larger patient cohorts are required for subsequent investigation and validation of the diagnostic accuracy of particular parameters to detect perfusion pat terns potentially specific to particular tumor entities. PMID:34160626 | DOI:10.1007/s00106-021-01077-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.