A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients

xlomafota13 shared this article with you from Inoreader A Comprehensive Assessment of Blood Transfusions in Elective Thyroidectomy Based on 180,483 Patients Via The Laryngoscope Objectives To assess the incidence, risk factors, and complications of blood transfusions (BTs) in elective thyroidectomy patients. Methods A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program. Adult patients who underwent elective thyroidectomy from 2005 to 2019 were divided into two cohorts based on whether they received BT or not. Multivariable binary logistic regression models were used to identify risk factors of BT and its impact on postoperative complications. Results Of 180,483 patients, 0.13% received BT. Risk factors for BT included underweight body mass index (BMI) (adjusted odds ratio [OR] 3.179, 95% confidence interval [CI] 1.444–6.996), bleeding disorders (OR 2.121, 95% CI 1.149–3.913), anemia (OR 4.730, 95% CI 3.472–6.445), preoperative transfusion (OR 7.230, 95% CI 1.454–35.946), American Society of Anesthesiology physical statuses 3–5 (OR 3.103, 95% CI 2.143–4.492), operative time >150 min (OR 4.390, 95% CI 1.996–9.654), and inpatient thyroidectomy (OR 5.791, 95% CI 3.816–8.787). In addition, transfusion was independently associated with any postoperative complication, non-infectious, cardiac, pulmonary, renal, vascular, or infectious complications, surgical site infection, sepsis, septic shock, wound disruption, pneumonia, unplanned reoperation, prolonged length of stay, and mortality. Conclusion Recognition of risk factors of BT is imperative to identify at-risk patients and reduce transfusions by controlling modifiable risk factors such as anemia, operative time, and BMI. In cases where transfusions are still indicated, surgeons should optimize care to prevent or adequately manage transfusion-associated complications. Level of evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Study on the Effect of 850 nm Low-Level Diode Laser versus Electrical Stimulation in Facial Nerve Regeneration for Patients with Bell’s Palsy

xlomafota13 shared this article with you from Inoreader A Study on the Effect of 850 nm Low-Level Diode Laser versus Electrical Stimulation in Facial Nerve Regeneration for Patients with Bell's Palsy Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Bell's palsy is acute facial paralysis with unclear etiology that results in weakness of facial muscles or paralysis on one side of the face. Methods: This prospective, randomized, single-blind, controlled study was conducted on 45 patients with Bell's palsy who were randomly divided into three equal groups. Two groups received either low-level laser therapy (LLLT) or electrical stimulation (E.S.) both in conjunction to medications, massage, and facial exercise treatment. The third group (control) was treated with medication, massage, and facial exercise. Results: The primary outcome was the improvement of nerve conduction velocity of facial nerve while the secondary outcome was the change of Sunnybrook facial grading system (SBGS). The outcome measures were evaluated pre- and posttreatment. There was statistically significant difference between the three groups in favor of the LLLT group regarding the nerve action pot ential amplitude and latency, in addition to signs of nerve regeneration and improved SBGS. Conclusion: This short-term investigation revealed that LLLT proved to be more efficient than E.S. in facial nerve regeneration for patients with Bell's palsy. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cognitive Impairment and Mild to Moderate Dysphagia in Elderly Patients: A Retrospective Controlled Study

xlomafota13 shared this article with you from Inoreader Cognitive Impairment and Mild to Moderate Dysphagia in Elderly Patients: A Retrospective Controlled Study Via ear nose throat Ear Nose Throat J. 2022 Mar 7:1455613211054631. doi: 10.1177/01455613211054631. Online ahead of print. ABSTRACT Background: To investigate whether cognitive impairment in elderly patients could correlate with the severity of swallowing disorders detectable through the endoscopic fiber optic evaluation. Methods: Elderly patients (≥65 years) performing a swallowing evaluation were included and divided according to the Dysphagia outcome and severity scale (DOSS) . Neurological evaluation and Mini-Mental test examination (MMET) were administered to detect cognitive impairment. Results: Significantly worse swallowing function was reported in the cognitive impairment group than the control one (40% vs 19%; P = .001). A different significant distribution of swallowing performance was detected according to the patient's MMET score (P < .001; P < .001; P = .01). At the ANOVA test among dependent variables assessed, only age>65 and MMET<10 were significantly correlated with swallowing function (F = 3.862, P = .028; F = 17.49, P = .000). Conclusions: The elderly patient has an increased risk for unrecognized swallowing disorders, with a prevalence of mild to moderate forms. Assessment of cognitive performance could facilitate the identification of swallowing disorders by providing a higher level of suspicion for silent aspiration in subjects with poor MMET scores. PMID:35255725 | DOI:10.1177/01455613211054631 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative Care from the Rhinologic and Neurological Perspectives

xlomafota13 shared this article with you from Inoreader Postoperative Care from the Rhinologic and Neurological Perspectives Via leak of cerebrospinal fluid Otolaryngol Clin North Am. 2022 Mar 4:S0030-6665(21)00248-6. doi: 10.1016/j.otc.2021.12.012. Online ahead of print. ABSTRACT Postoperative care of patients undergoing endoscopic transsphenoidal pituitary surgery requires a multidisciplinary team approach, capitalizing on the complementary knowledge and skills of surgical and medical disciplines, including neurosurgery, otolaryngology, endocrinology, ophthalmology, and radiology. In the early postoperative period, endocrinologic problems and cerebrospinal fluid leak are the major drivers of morbidity and need for readmission or revision surgery. With a team-based approach, most complications can be mitigated with a low risk of serious complications and excellent quality of life. Patients often require long-term postoperative follow-up for surveillance and management of neurologic, endocrinologic, and sinonasal concerns. PMID:35256174 | DOI:10.1016/j.otc.2021.12.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Hearing Rehabilitation Therapy Program in Hearing Aids Users: A Prospective Randomized Controlled Study

xlomafota13 shared this article with you from Inoreader Effect of Hearing Rehabilitation Therapy Program in Hearing Aids Users: A Prospective Randomized Controlled Study Via pubmed: "clin exp otorhinola... Clin Exp Otorhinolaryngol. 2022 Mar 4. doi: 10.21053/ceo.2021.00948. Online ahead of print. ABSTRACT BACKGROUND: Despite sufficient hearing gains, many patients with hearing loss have difficulty using hearing aids due to poor word recognition ability. This study was performed to introduce our hearing rehabilitation therapy (HRT) program for hearing aid users and to evaluate its effect on hearing improvement. STUDY DESIGN: Prospective randomized case-control study. SUBJECTS AND METHODS: Thirty-seven participants with moderate to moderate-severe sensorineural hearing loss who had used bilateral hearing aids for more than three months with sufficient functional hearing gain were enrolled in this study. Nineteen participants were randomly assigned to the control group (CG) and 18 patients were assigned to participate in our HRT program once a week for eight consecutive weeks (hearing rehabilitation therapy group, HRTG). Their h earing results and questionnaire scores regarding hearing handicap and hearing aid outcomes were prospectively collected and compared between the two groups. RESULTS: After completing eight weeks of the HRT program, the HRTG showed significantly higher delta score of consonant-only and consonant-vowel sound perception compared to the CG (p<0.05). In addition, the HRTG had a significant improvement in hearing ability as measured by two questionnaires (p<0.05), while no differences were observed in the CG. However, word and sentence recognition test results did not show significant differences between the two groups. CONCLUSION: Even after short-term HRT, patients had subjectively better hearing outcomes and improved phoneme perception ability; this provides scientific evidence regarding a possible positive role for HRT programs in hearing aid users. Further validation in a larger population with a long-term follow-up study is needed. PMID:35255665 | DOI:10.21053/ceo.2021.00948 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Normative measurements of the superior oblique and inferior oblique muscles by magnetic resonance imaging

xlomafota13 shared this article with you from Inoreader Normative measurements of the superior oblique and inferior oblique muscles by magnetic resonance imaging Via radiol anat Surg Radiol Anat. 2022 Mar 8. doi: 10.1007/s00276-022-02915-w. Online ahead of print. ABSTRACT PURPOSE: Normative oblique muscle data may help to diagnose pathological enlargement of the oblique muscles. We aim to describe the normative values of the superior and inferior oblique muscles in an Australian cohort on T1-weighted MRI and fat suppressed contrast enhanced T1-weighted MRI. METHODS: A retrospective review of patients who underwent 3 T orbital MRI. The healthy orbits were used to conduct measurements in patients with a unilateral orbital lesion. The maximum diameters of the superior and inferior oblique muscles were measured on coronal planes. The diameter was measured perpendicular to the long axis of the muscles. RESULTS: The normal measurements (mean ± SD) on fat suppressed contrast enhanced T1-weighted MRI: superior oblique, 3.0 ± 0.5 mm and inferior oblique, 2.7 ± 0.5 mm. On T1-weighted MRI: superior oblique, 2.8 ± 0.5 mm and inferior oblique, 2.5 ± 0.4 mm. In patients who had both sequences performed, the superior and inferior oblique diameters were significantly higher on the fat suppressed contrast-enhanced T1-weighted MRI than the T1-weighted MRI sequence (p < 0.01). CONCLUSION: Oblique muscle enlargement may be seen in a range of orbital diseases. These data may help in diagnosing oblique muscle enlargement. In addition, variations in the measured muscle diameters can be seen according to the scan sequence th at is used. PMID:35258651 | DOI:10.1007/s00276-022-02915-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.