A case of acute liver injury induced by methimazole

xlomafota13 shared this article with you from Inoreader A case of acute liver injury induced by methimazole Via Thyroid Res Pract Karthika Niveditha, Arun S Menon, Harish Kumar, Malini Eapen, Rajesh Gopalakrishna Thyroid Research and Practice 2021 18(1):34-36 Antithyroid drugs, methimazole, and propylthiouracil have been reported to cause hepatotoxicity. We report the case of a patient with methimazole induced liver injury who presented within a few weeks of commencement of the drug. She presented with a cholestatic picture and responded well to discontinuation of the drug and administration of steroids. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader Long-term hypocalcemia prediction post thyroidectomy Via Thyroid Res Pract Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna Thyroid Research and Practice 2021 18(1):14-18 Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term hypocalcemia prediction post thyroidectomy

xlomafota13 shared this article with you from Inoreader Long-term hypocalcemia prediction post thyroidectomy Via Thyroid Res Pract Deepak Janardhan, Sandeep Suresh, PG Balagopal, Nebu Abraham George, KM Jagathnath Krishna Thyroid Research and Practice 2021 18(1):14-18 Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary hypothyroidism on follow-up in a cohort of Indian patients with subacute thyroiditis

xlomafota13 shared this article with you from Inoreader Primary hypothyroidism on follow-up in a cohort of Indian patients with subacute thyroiditis Via Thyroid Res Pract Pramila Kalra, KM Prasanna Kumar Thyroid Research and Practice 2021 18(1):1-5 Objectives: Subacute thyroiditis (SAT) is a temporary dysfunction of the thyroid gland and is commonly due to its viral infection. Permanent hypothyroidism after recovery from SAT has been reported in various studies. Methodology: This was a prospective study conducted in two tertiary care centers in South India to follow-up these cases for the development of permanent primary hypothyroidism at 1-year follow-up after recovery from SAT. Results: The total number of cases followed up was 146, including 103 females (70.5%) and 43 males (29.5%). Females' mean age was 33.03 ± 11.7 years, and males' mean age was 40.17 ± 11.84 years. Seven patients reported the second attack of thyroiditis. The mean thyroid-stimulating hormone (TSH) recorded at baseline was 0.042 ± 0.056 µIU/ml. Permanent hypothyroidism was seen in 19.86% of the cases at a 1-year follow-up and was found to be higher in patients with lower TSH at baseline. The females and males were affected at a younger age as compared to other studies. The incidence of permanent hypothyroidism was found to be higher as compared to some but lesser compared to a few others. The iodine supplementation could also be one of the postulates for this higher incidence of hypothyroidism. The severity of thyrotoxicosis was a significant determinant of the future development of hypothyroidism. Conclusions: The patients with SAT need to be followed up for the development of permanent hypothyroidism. The prevalence of hypothyroidism at 1 year was 19.86% after an attack of thyroiditis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The role of vein grafts in reconstructive head and neck microsurgery

xlomafota13 shared this article with you from Inoreader The role of vein grafts in reconstructive head and neck microsurgery Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 26:S1808-8694(21)00175-0. doi: 10.1016/j.bjorl.2021.09.004. Online ahead of print. ABSTRACT OBJECTIVE: Free tissue transfer is widely used for head and neck reconstruction. In certain circumstances, vein grafting is required to elongate free flap pedicles to connect them to appropriate recipient vessels. Because of controversy regarding the use of interposition vein grafts in free tissue reconstruction, this paper reports vein graft indications, techniques, safety, and outcomes for head and neck microvascular surgery. METHODS: Twenty-six patients (23 men and 3 women) who underwent interposition vein grafting concurrent with free tissue transfer were included in this study. The most common reason for head and neck reconstruction with vein graft was tumor recurrence, followed by flap salvage. The interposition vein grafts were applied in two manners as temporary arteriovenous (A-V) loop and conduit to extend the length of the free flap for venous drainage. RESULTS: The most common reconstructions were anterolateral thigh flaps (15 cases), followed by vastus lateralis myocutaneous (3 cases) and radial forearm (2 cases) flaps. The common recipient vessels were superior thyroid artery, superficial temporal artery and external jugular vein. The free flap loss rate was 7.7% with vein grafts and 4.9 without vein grafts (p = 0.380). The free flap complication rate was 50.0% and 16.8% in patients with and without vein grafts, respectively (p < 0.001). Radiation therapy, chemotherapy, prior neck dissection, and prior free flap transfer were more common in the vein graft group (all p < 0.001). The hospital stay was significantly longer for the vein graft group than for the non-vein graft group (29.5 vs. 19.0 days; p = 0.001). CONCLUSION: Overall free flap survival rates of 92.3% and 95.1% in the vein and non-vein graft groups, respectively - indicating the reliability of the vein grafts in challenging head and neck reconstructions, particularly in salvage cases and patients with multiple reconstructions. LEVEL OF EVIDENCE: Level 3. PMID:34802968 | DOI:10.1016/j.bjorl.2021.09.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The never-ending battle between proximal row carpectomy and four corner arthrodesis: A systematic review and meta-analysis for the final verdict

xlomafota13 shared this article with you from Inoreader The never-ending battle between proximal row carpectomy and four corner arthrodesis: A systematic review and meta-analysis for the final verdict Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 23:S1748-6815(21)00516-7. doi: 10.1016/j.bjps.2021.09.076. Online ahead of print. ABSTRACT While scaphoid excision combined with Four Corner Arthrodesis (FCA) or Proximal Row Carpectomy (PRC) is a commonly-used salvage procedures to treat type two and type three Scapholunate Advanced Collapse (SLAC) and Scaphoid Nonunion Advanced Collapse (SNAC)-induced degenerative arthritis, controversy remains over which treatment intervention provides superior outcomes. We searched for articles comparing a range of motion, grip strength, complications requiring reoperation, conversion to wrist arthrodesis, pain, and disability of shoulder and arm scores between FCA and PRC-treated patients. The risk of bias was assessed using the National Institutes of Health (NIH) quality assessment tool. We performed a meta-analysis using Random-Effects Models. Fifteen articles (10 retrospective, 2 cross-sectional, 1 prospe ctive, and 2 randomized trials) were included. There was no significant difference between PRC and FCA in any of the different outcome measures. The risk of bias was found consistently high across all studies. Despite the lack of high-quality evidence, based on existing literature, we recommend PRC as the preferred choice of treatment because of the simplicity of the surgical procedure, lack of hardware-related complications, and comparable long-term outcomes. Level of evidence: III - Therapeutic. PMID:34802951 | DOI:10.1016/j.bjps.2021.09.076 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Do patients with chronic rhinosinusitis exhibit elevated rates of Covid‐19 infection?

xlomafota13 shared this article with you from Inoreader Do patients with chronic rhinosinusitis exhibit elevated rates of Covid‐19 infection? Via The Laryngoscope Abstract Patients with chronic rhinosinusitis (CRS) may have concerns regarding their potential for an increased likelihood of contracting Covid-19, given baseline inflammatory disease and utilization of topical or oral immunosuppressive therapies for disease treatment. In the present study, we utilize matched cohort sampling of over 12,000 CRS patients and 12,000 controls seen between June of 2020 and January of 2021, examining rates of Covid-19 testing and positivity during that time period. We found no difference in Covid-19 contraction between CRS patients and matched non-CRS patients, despite an almost two-fold significant increase in testing among those with CRS. This suggests that CRS patients are likely not inherently more vulnerable to Covid-19 infection at a rate above that of the general population. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of swallow function pre and post‐endoscopic CO2 laser medial arytenoidectomy: a case series

xlomafota13 shared this article with you from Inoreader Assessment of swallow function pre and post‐endoscopic CO2 laser medial arytenoidectomy: a case series Via Clinical Otolaryngology Abstract Endoscopic CO2 laser medial arytenoidectomy is performed for glottic stenosis however post-operative aspiration remains a risk Pre-operative and post-operative objective and subjective assessments of swallow function were evaluated There was no statistically significant difference when comparing pre- and post-operative penetration-aspiration scores or subjective swallow function If baseline swallow is impaired, this should not preclude the patient from arytenoidectomy; baseline FEES is essential to aid surgical planning and inform patient consent 'Staged arytenoidectomy' should be performed as a swallow-preserving procedure View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Honesty and Transparency, Indispensable to the Clinical Mission—Part III

xlomafota13 shared this article with you from Inoreader Honesty and Transparency, Indispensable to the Clinical Mission—Part III Via Otolaryngologic Clinics of North America The hidden epidemic of burnout exacts a staggering toll on professionals and patients, reflected in increased risk of medical errors, complications, and staff turnover. For surgeons, nurses, and other team members working at the sharp end of care, adverse events can amplify work exhaustion, interpersonal disengagement, and risk of moral adversity. Visionary leaders are not content to mitigate burnout and moral injury; they elevate the human experience throughout health care by modeling wellness, fostering moral courage, promoting safety of professionals, and restoring joy in work. Part 3, Health Professional Wellness and Resilience, introduces the final pillar for advancing the clinical mission. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The log odds of positive neck lymph nodes is a superior lymph node predictor for overall survival in head and neck cancer: a population-based analysis in Germany

xlomafota13 shared this article with you from Inoreader The log odds of positive neck lymph nodes is a superior lymph node predictor for overall survival in head and neck cancer: a population-based analysis in Germany 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 Nov 22. doi: 10.1007/s00405-021-07176-8. Online ahead of print. ABSTRACT BACKGROUND: This population-based study investigated the influence of different lymph node (LN) classifications on overall survival (OS) in head and neck cancer (HNC). METHODS: 401 patients (median age: 57 years; 47% stage IV) of the Thuringian cancer registries with diagnosis of a primary HNC receiving a neck dissection (ND) in 2009 and 2010 were included. OS was assessed in relation to total number of LN removed, number of positive LN, LN ratio, and log odds of positive LN (LODDS). RESULTS: Mean number of LODDS was 0-0.96 ± 0.57. When limiting the multivariate analysis to TNM stage, only the UICC staging (stage IV: HR 9.218; 95% CI 2.721-31.224; p < 0.001) and LODDS > - 1.0 (HR 2.120; 95% CI 1.129-3.982; p = 0.019) were independently associated with lower OS. CONCLUSION: LODDS was an independent and superi or predictor for OS in HNC in a population-based setting with representative real-life data. PMID:34807283 | DOI:10.1007/s00405-021-07176-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A multicentre retrospective cohort study on COVID-19-related physical interventions and adult hospital admissions for ENT infections

xlomafota13 shared this article with you from Inoreader A multicentre retrospective cohort study on COVID-19-related physical interventions and adult hospital admissions for ENT infections 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 Nov 22. doi: 10.1007/s00405-021-07180-y. Online ahead of print. ABSTRACT PURPOSE: To report changes in adult hospital admission rates for acute ENT infections following the introduction of COVID-19-related physical interventions such as hand washing, use of face masks and social distancing of 2-m in the United Kingdom. METHODS: Retrospective cohort study comparing adult admissions with acute tonsillitis, peritonsillar abscess, epiglottitis, glandular fever, peri-orbital cellulitis, acute otitis media, acute mastoiditis, retropharyngeal abscess and parapharyngeal abscess in the 1-year period after the introduction of COVID-related physical interventions (2020-2021) with a 1-year period before this (2019-2020) in three UK secondary care ENT departments. RESULTS: In total, there were significantly fewer admissions for ENT infections (n = 1073, 57.56%, p < 0.001; RR 2.36, 95% CI [2.17, 2.56]) in the 2020-2021 period than in the 2019-2020 period. There were significant reductions in admissions for tonsillitis (64.4%; p < 0.001), peritonsillar abscess (60.68%; p < 0.001), epiglottitis (66.67%; p < 0.001), glandular fever (38.79%; p = 0.001), acute otitis media (26.85%; p = 0.01) and retropharyngeal and/or parapharyngeal abscesses (45.45%; p = 0.04). CONCLUSION: Our study demonstrates a sizeable reduction in adult admissions for ENT infections since the introduction of COVID-19-related physical interventions. There is evidence to support the use of physical interventions in the prevention of viral transmission of respiratory disease. Preventing ENT infections requiring admission through simple physical interventions could be of great benefit to the quality of life of patients and economical benefit to healthcare systems. PMID:34807284 | DOI:10.1007/s00405-021-07180-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.