Multi‐Institutional Analysis of Outcomes in Supraglottic Jet Ventilation with a Team‐Based Approach

xlomafota13 shared this article with you from Inoreader Multi‐Institutional Analysis of Outcomes in Supraglottic Jet Ventilation with a Team‐Based Approach Via The Laryngoscope Objectives/Hypothesis To evaluate the safety and complications of endoscopic airway surgery using supraglottic jet ventilation with a team‐based approach. Study Design Retrospective cohort study. Methods Subjects at two academic institutions diagnosed with laryngotracheal stenosis who underwent endoscopic airway surgery with jet ventilation between January 2008 and December 2018 were identified. Patient characteristics (age, gender, race, follow‐up duration) and comorbidities were extracted from the electronic health record. Records were reviewed for treatment approach, intraoperative data, and complications (intraoperative, acute postoperative, and delayed postoperative). Results Eight hundred and ninety‐four patient encounters from 371 patients were identified. Intraoperative complications (unplanned tracheotomy, profound or severe hypoxic events, barotrauma, laryngospasm) occurred in fewer than 1% of patient encounters. Acute postoperative complications (postoperative recovery unit [PACU] rapid response, PACU intubation, return to the emergency department [ED] within 24 hours of surgery) were rare, occurring in fewer than 3% of patient encounters. Delayed postoperative complications (return to the ED or admission for respiratory complaints within 30 days of surgery) occurred in fewer than 1% of patient encounters. Diabetes mellitus, active smoking, and history of previous tracheotomy were independently associated with intraoperative, acute, and delayed complications. Conclusions Employing a team‐based approach, jet ventilation during endoscopic airway surgery demonstrates a low rate of complications and provides for safe and successful surgery. Level of Evidence Level 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patient journey through cases of depression from claims database using machine learning algorithms

xlomafota13 shared this article with you from Inoreader Patient journey through cases of depression from claims database using machine learning algorithms Via Rhinitis by Yoshitake Kitanishi, Masakazu Fujiwara, Bruce Binkowitz Health insurance and acute hospital-based claims have recently become available as real-world data after marketing in Japan and, thus, classification and prediction using the machine learning approach can be applied to them. However, the methodology used for the analysis of real-world data has been hitherto under debate and research on visualizing the patient journey is still inconclusive. So far, to classify diseases based on medical histories and patient demographic background and to predict the patient prognosis for each disease, the correlation structure of real-world data has been estimated by machine learning. Therefore, we applied association analysis to real-world data to consider a combination of disease events as the patient journey for depression diagnoses. However, association analysis makes it difficult to interpret multiple outcome measures simultaneously and comprehensively. To address this issue, we applied the Topological Data Analysis (TDA) Mapper to sequentially in terpret multiple indices, thus obtaining a visual classification of the diseases commonly associated with depression. Under this approach, the visual and continuous classification of related diseases may contribute to precision medicine research and can help pharmaceutical companies provide appropriate personalized medical care. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safety of Early Mobilization in Patients With Intraoperative Cerebrospinal Fluid Leak in Minimally Invasive Spine Surgery: A Case Series.

xlomafota13 shared this article with you from Inoreader Safety of Early Mobilization in Patients With Intraoperative Cerebrospinal Fluid Leak in Minimally Invasive Spine Surgery: A Case Series. Via leak of cerebrospinal fluid Related Articles Safety of Early Mobilization in Patients With Intraoperative Cerebrospinal Fluid Leak in Minimally Invasive Spine Surgery: A Case Series. Oper Neurosurg (Hagerstown). 2021 Feb 20;: Authors: Aljoghaiman M, Ellenbogen Y, Takroni R, Yang K, Farrokhyar F, Reddy K Abstract BACKGROUND: Cerebrospinal fluid (CSF) leak is a common complication in spine surgery. Repairing durotomy is more difficult in the setting of minimally invasive spine surgery (MISS). Efficacy of postoperative bed rest in case of dural tear in MISS is not clear. OBJECTIVE: To assess the safety and efficacy of our protocol of dura closure without changing access, early mobilization, and discharge in cases of intraoperative CSF leak in MISS. METHODS: A retrospective review from 2006 to 2018 of patients who underwent MISS for degenerative and neoplastic diseases with documented accidental or intentional durotomy was conducted. The primary outcome of interest was readmission rate for repair of persistent CSF leak. Secondary outcomes captured included development of pseudomeningocele, positional headache, and subdural hematoma. RESULTS: A total of 80 patients were identified out of 527 patients. Of these, intentional durotomy was performed in 28 patients and unintentional durotomy occurred in 52 patients. Mean follow-up period was 80.6 mo. Most of the patients were discharged on postoperative day 0 (within 4 h of surgery) without activity restrictions. A total of 2 (2.5%) patients required readmission and dural repair for continuous CSF leak and 3 patients (3.75%) developed pseudomeningocele. No lumbar drain insertion, meningitis, or subdural hematoma was reported. CONCLUSION: Early mobilization and discharge in cases of intraoperative CSF leak in MISS appear to be safe and not associated with higher rate of complications than that of reported literature. PMID: 33609122 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of staging on survival outcomes: a nationwide real-world cohort study of metastatic uveal melanoma

xlomafota13 shared this article with you from Inoreader Impact of staging on survival outcomes: a nationwide real-world cohort study of metastatic uveal melanoma Via Melanoma Research - Published Ahead-of-Print No data exist regarding whether any first-line treatment for metastatic uveal melanoma provides overall survival (OS) benefit, if staged and compared to best supportive care (BSC). We analyzed OS in a nationwide, consecutive cohort diagnosed with metastatic uveal melanoma between January 1999 and December 2016 . The Helsinki University Hospital Working Formulation was used to assign patients to stage IVa, IVb and IVc, corresponding to predicted median OS ≥12, View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study.

xlomafota13 shared this article with you from Inoreader Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study. Via pubmed: "med oral patol oral... Related Articles Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study. Med Oral Patol Oral Cir Bucal. 2021 Feb 20;: Authors: González-Serrano J, López-Pintor RM, Cecilia-Murga R, Torres J, Hernández G, López-Quiles J Abstract BACKGROUND: Propolis has anti-inflammatory, analgesic and healing properties. The purpose of this study was to determine whether a gel containing 2% of propolis extract, 0.2% of ascorbic acid and 0.2% of tocopherol acetate is effective in preventing surgical complications related to impacted lower third molar extractions. MATERIAL AND METHODS: A randomized, double-blind, split-mouth study was performed. Fifteen patients were recruited who needed bilateral impacted lower third molar extractions with a similar surgical difficulty. A test or placebo gel was administered randomly inside post-extraction sockets. Each patient was instructed to apply the gel 3 times/day in the surgical wound for a week. After a month, the contralateral third molar was extracted, and the opposite gel applied. The following parameters were diagnosed/evaluated and then recorded: alveolar osteitis following Blum's criteria, swelling and trismus at day one, two, three and seven post-intervention, wound healing at day 7 post-intervention, and postoperative pain using a visual analog scale, as well as, the number of analgesic pill intake. RESULTS: A total of twenty-six surgical procedures were performed in 13 patients (mean age 20.67±2 years). Alveolar osteitis was reported in 3 patients from the placebo group (23.1%) and none in the test group (0%) (p=0.25). No statistically significant differences were reported in swelling, trismus, wound healing or analgesic pill consumption between two groups. But statistically lower postoperative pain during the 7 days after surgical extractions was found according to visual analog scale in test group compared to the placebo group (p=0.007). No side effects were reported. CONCLUSIONS: The application of this gel may be effective in preventing alveolitis and thus reducing postoperative pain after impacted third molar extractions. More randomized clinical trials with larger sample are needed to confirm these results. PMID: 33609021 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of saliva as a complementary technique to the diagnosis of COVID-19: a systematic review.

xlomafota13 shared this article with you from Inoreader Evaluation of saliva as a complementary technique to the diagnosis of COVID-19: a systematic review. Via pubmed: "med oral patol oral... Related Articles Evaluation of saliva as a complementary technique to the diagnosis of COVID-19: a systematic review. Med Oral Patol Oral Cir Bucal. 2021 Feb 20;: Authors: Sagredo-Olivares K, Morales-Gómez C, Aitken-Saavedra J Abstract BACKGROUND: Infectious disease coronavirus 2019 (COVID-19) is caused by the SARS-CoV-2 virus, and it mainly affects the upper respiratory tract. The gold standard for its diagnosis is real-time reverse transcription polymerase chain reaction (RT-qPCR) performed on a nasopharyngeal swab. In contrast, testing saliva has significant advantages as a diagnostic method. MATERIAL AND METHODS: We searched for articles evaluating saliva as a diagnostic method for COVID-19 on the PUBMED/MEDLINE, WEB OF SCIENCE, COCHRANE, and SCIELO platforms. We initially found 233 articles and 20 were selected for inclusion following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol: 18 cross-sectional studies and 2 case reports, including 8 from America, 8 from Asia, and 4 from Europe. The studies evaluated the presence of viral RNA, IgG, IgM, and IgA in samples of unstimulated saliva from adults with confirmed or suspected COVID-19. The vast majority of the studies performed RT-qPCR on the saliva samples and compared the results with the gold standard (a nasopharyngeal swab of the same patient). RESULTS: Saliva samples analyzed by RT-qPCR, reverse transcription isothermal amplification (RT-LAMP), spectroscopy, and enzyme-linked immunosorbent assay (ELISA) offer high sensitivity to detect SARS-CoV-2 in the early stages of the disease and among asymptomatic patients as compared to nasopharyngeal swab RT-qPCR. In addition, the self-collection of saliva offers the possibility of receiving telemedicine instructions to carry out the test, reducing the risk of contagion. CONCLUSIONS: The diagnosis of COVID-19 through saliva is sensitive, non-invasive, and is of low risk for the healthcare professionals. However, further studies are recommended to validate its clinical use. PMID: 33609022 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic value of the immunohistochemical expression of vascular endothelial growth factors in malignant salivary gland neoplasms: a systematic review and meta-analysis.

xlomafota13 shared this article with you from Inoreader Prognostic value of the immunohistochemical expression of vascular endothelial growth factors in malignant salivary gland neoplasms: a systematic review and meta-analysis. Via pubmed: "med oral patol oral... Related Articles Prognostic value of the immunohistochemical expression of vascular endothelial growth factors in malignant salivary gland neoplasms: a systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2021 Feb 20;: Authors: Dos Santos E, Ramos JC, Normando AG, Leme AF Abstract BACKGROUND:  The immunohistochemical expression of vascular endothelial growth factor is a prognostic marker in several cancer types. In salivary gland tumors, the association between vascular endothelial growth factor and prognosis remains unclear. The purpose of this study was to perform a systematic review and meta-analysis to assess whether the immunohistochemical expression of vascular endothelial growth factor in patients with salivary gland neoplasms presents prognostic value. MATERIAL AND METHODS: Immunohistochemical studies assessing the predictive value of vascular endothelial growth factor in salivary gland neoplasms were systematically reviewed using PubMed, Scopus, Embase, Cochrane Library, and Web of Science databases. It was assessed any survival rates. The fixed-effect model with an adjusted hazard ratio (HR) and 95% confidence intervals (95% CI) as effect measures were performed in the meta-analysis. The Quality in Prognosis Studies (QUIPS) tool was used to assess the quality of the included studies, and the evidence quality was assessed by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) system. RESULTS: The immunohistochemical overexpression of vascular endothelial growth factor in patients with salivary gland neoplasms was associated with shortened survival (HR=5.37, 95% CI: 2.67-10.83, P = 0.00001). In addition, the presence of vascular endothelial growth factor was tightly associated with tumor size, lymph node metastasis, clinical stage, perineural invasion, vascular invasion, poor local control of the disease, and recurrence. CONCLUSIONS: The immunohistochemical overexpression of vascular endothelial growth factor in patients with salivary gland neoplasms has prognostic value and was associated with decreased survival time. However, more primary well-designed studies are necessary to increase the level of evidence. PMID: 33609023 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of the laser at low intensity on primary burning oral syndrome: a systematic review.

xlomafota13 shared this article with you from Inoreader Efficacy of the laser at low intensity on primary burning oral syndrome: a systematic review. Via pubmed: "med oral patol oral... Related Articles Efficacy of the laser at low intensity on primary burning oral syndrome: a systematic review. Med Oral Patol Oral Cir Bucal. 2021 Feb 20;: Authors: Matos AL, Silva PU, Paranhos LR, Santana IT, Matos FR Abstract BACKGROUND: Primary burning mouth syndrome (BMS) is a chronic clinical condition of idiopathic mainly characterized by pain and a burning sensation in the oral cavity. The application of laser at low intensity therapy is a treatment option. This systematic review evaluated the efficacy of laser therapy in treating symptoms of burning mouth syndrome. MATERIAL AND METHODS: The study was formulated according to the PRISMA and Cochrane guidelines. Seven databases were used as primary sources of research. Only randomized controlled clinical trials were included. The efficacy of the therapy was estimated comparing the values of the visual and numerical scales of pain before and after laser treatment, through qualitative analysis. RESULTS: The search resulted in 348 records and only eight filled the eligibility criteria and were included. All studies evaluated pain and / or a burning sensation considering a time interval of two to ten weeks. The total sample consisted of 314 patients submitted to treatment: 123 from the control group, who participated with laser off or with the tip blocked, and 191 from the intervention group, treated with low-level laser therapy. The female gender stood out and the average age of the participants was 60.89 years. The main symptoms reported were pain and a burning sensation in the oral mucosa and tongue. The parameters adopted by the authors for laser treatment were diverse and the variables were not fully described in the published studies. Visual analog and numerical scales were used to assess symptoms and only three studies showed statistical significance. CONCLUSIONS: It is suggested that laser therapy may be an effective alternative in the treatment of BMS. New randomized clinical trials should consider well-established protocols to better understand the efficacy of laser therapy without confounding the effects. PMID: 33609024 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Capsaicin intake and oral carcinogenesis: A systematic review.

xlomafota13 shared this article with you from Inoreader Capsaicin intake and oral carcinogenesis: A systematic review. Via pubmed: "med oral patol oral... Related Articles Capsaicin intake and oral carcinogenesis: A systematic review. Med Oral Patol Oral Cir Bucal. 2021 Feb 20;: Authors: Mosqueda-Solís A, Lafuente-Ibáñez de Mendoza I, Aguirre-Urizar JM, Mosqueda-Taylor A Abstract BACKGROUND: Chili is the most heavily and frequently consumed spice, either as a flavouring or colouring agent, and it is also a major source of pro-vitamin A, vitamin E and C. The main capsinoidcapsaicinoid found in chili peppers is capsaicin. It has been demonstrated that capsaicin acts as a cancer-suppressing agent through its antioxidant and anti-inflammatory effects, by blocking several signal transduction pathways. Oral squamous cell carcinoma is one of the most prevalent cancer worldwide. It is noteworthy that in countries where populations of diverse ethnic groups co-exist, differences have been observed in terms of incidence of oral cancer. The variances in their diet could explain, at least in part, these differences. The objective of this systematic review is to explore if there is evidence of a possible relationship between capsaicin intake and the incidence of oral squamous cell carcinoma, and discuss such association. MATERIAL AND METHODS: A bibliographical search was made in PubMed, Scopus and Web of Science databases, and finally 7 experimental studies were included; OHAT risk of bias tool was used to assess their quality. RESULTS: allAll the studies confirm that capsaicin is a chemopreventive agent that prevents the development of oral cancer, through inhibition of malignant cell proliferation and increase of apoptosis. CONCLUSIONS: More human studies are needed in order to clarify the real link between consumption of chili (capsaicin) and the prevalence of oral cancer. PMID: 33609025 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic transcanal management of tympanosclerosis.

xlomafota13 shared this article with you from Inoreader Endoscopic transcanal management of tympanosclerosis. 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 Related Articles Endoscopic transcanal management of tympanosclerosis. Eur Arch Otorhinolaryngol. 2021 Feb 20;: Authors: Özdek A Abstract OBJECTIVES: The objectives of this study are to describe our experiences in endoscopic transcanal management of tympanosclerosis, to explain our surgical approaches to reconstruct the sound conduction system and to analyze the hearing results obtained with our surgical approaches. STUDY DESIGN: A retrospective cohort study, using medical records of 28 cases that underwent endoscopic transcanal tympanoplasty surgery due to tympanosclerosis from January 2016 to January 2020. SETTINGS: Private otology clinic PATIENTS: Twenty-eight ears of 26 patients were enrolled into study. Patients were grouped according to Wielinga-Kerr classification and only type II, III and IV patients were included in the study. INTERVENTIONS: Exclusively transcanal endoscopic surgery was performed in all cases. Primary goal was to mobilize the affected ossicles by removing the offending TS and reconstruct the ossicular chain. Malleostapediopexy was preferred when attic by-pass procedures were needed. Glass ionemer bone cement was used to reconstruct the ossicular defects. OUTCOME MEASURES: Preoperative and postoperative pure tone average of air conduction and bone conduction and air-bone gap results were evaluated. Operation was considered successful if postoperative ABG < 20 dB was achieved. Complications and graft take rate were also evaluated. RESULTS: Single-staged surgery was performed in 23 of 28 cases (82.1%). Graft take rate was 93%. The mean preoperative ABG significantly decreased from 33.9 ± 5.19 to 12.55 ± 5.52 dB postoperatively for 23 cases who had single-staged surgeries (p < 0.001, Wilcoxon signed rank test) at the end of the mean follow-up period of 23 months. For this group, the mean preoperative AC-PTA significantly improved from 48.64 ± 9.30 to 22.93 ± 7.45 dB (p < 0.001, Wilcoxon signed rank test) postoperatively with a mean PTA improvement of 25.71 ± 6.02 dB. Success criterion was achieved in 22 of 23 cases (95.7%). There was no sensorineural hearing loss, facial nerve paralysis and postoperative vertigo after the surgical procedures. All patients had been discharged within the first 24 h. CONCLUSIONS: Surgical treatment of tympanosclerosis is still a controversial issue. Endoscopic surgery seems a safe technique for the management of tympanosclerosis. Single-stage surgery is possible in most of the cases with a satisfactory hearing result. We speculate that addition of endoscopic view may increase the single-stage surgery ratio. PMID: 33609176 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The MO-meatocanalplasty: long-term results in the narrow external auditory canal with recurrent otitis externa or the inability to wear a hearing aid.

xlomafota13 shared this article with you from Inoreader The MO-meatocanalplasty: long-term results in the narrow external auditory canal with recurrent otitis externa or the inability to wear a hearing aid. 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 Related Articles The MO-meatocanalplasty: long-term results in the narrow external auditory canal with recurrent otitis externa or the inability to wear a hearing aid. Eur Arch Otorhinolaryngol. 2021 Feb 20;: Authors: De Greve G, van Dinther J, Vanspauwen R, Youri M, Verstreken M, Zarowski A, Offeciers E Abstract OBJECTIVE: The MO-meatocanalplasty is the oblique modification of the M-meatoplasty. The MO-meatocanalplasty was designed to address the superior quadrants of the meatus and the bony canal without the need for a retro-auricular incision. This retrospective analysis was performed to evaluate the long-term results of the MO-meatocanalplasty in patients with a narrow external auditory canal (EAC) with recurrent otitis externa or in patients unable to wear a hearing aid. METHODS: Twenty-two ears in twenty consecutive patients who received a MO-meatocanalplasty for a narrow EAC with recurrent otitis externa or the inability to wear a hearing aid were analysed retrospectively. There were no patients included with any type of previous or planned second stage tympanoplasty procedures. A follow-up period of 3 years was analysed for postoperative recurrent narrowing, the self-cleaning capacity of the EAC, the recurrence of otitis externa, the inability to wear a hearing aid, change in hearing level and for all types of aesthetical complaints. RESULTS: The MO-meatocanalplasty procedure was effective in 82% (n = 18). Postoperative recurrent narrowing was detected in 9% (n = 2). Insufficient self-cleaning capacity of the EAC was 9.1% (n = 2). The ability to wear a hearing aid was restored in all patients with the need for a hearing aid. No aesthetical complaints were reported. CONCLUSION: The MO-meatocanalplasty is an effective, safe and aesthetical accepted procedure to address the narrow meatus and external auditory canal. With this procedure, there is no need for a retro-auricular incision in order to create a well aerated, dry and self-cleaning EAC in patients with a narrow EAC with recurrent otitis externa or in patient with the inability to wear a hearing aid. PMID: 33609177 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.