Exercise-based dysphagia rehabilitation for adults with oesophageal cancer: a systematic review

xlomafota13 shared this article with you from Inoreader Exercise-based dysphagia rehabilitation for adults with oesophageal cancer: a systematic review Via swallowing exercises BMC Cancer. 2022 Jan 10;22(1):53. doi: 10.1186/s12885-021-09155-y. ABSTRACT BACKGROUND: Dysphagia is prevalent in oesophageal cancer with significant clinical and psychosocial complications. The purpose of this study was i) to examine the impact of exercise-based dysphagia rehabilitation on clinical and quality of life outcomes in this population and ii) to identify key rehabilitation components that may inform future research in this area. METHODS: Randomised control trials (RCT), non-RCTs, cohort studies and case series were included. 10 databases (CINAHL Complete, MEDLINE, EMBASE, Web of Science, CENTRAL, and ProQuest Dissertations and Theses, OpenGrey, PROSPERO, RIAN and SpeechBITE), 3 clinical trial registries, and relevant conference abstracts were searched in November 2020. Two independent authors assessed articles for eligibility before completing data extraction, quality assessment using ROBINS-I and Downs and Black Checklist, followed by descriptive data analysis. The primary outcomes included oral intake, respiratory status and quality of life. All comparable outcomes were combined and discussed throughout the manuscript as primary and secondary outcomes. RESULTS: Three single centre non-randomised control studies involving 311 participants were included. A meta-analysis could not be completed due to study heterogeneity. SLT-led post-operative dysphagia intervention led to significantly earlier start to oral intake and reduced length of post-operative hospital stay. No studies found a reduction in aspiration pneumonia rates, and no studies included patient reported or quality of life outcomes. Of the reported secondary outcomes, swallow prehabilitation resulted in significantly improved swallow efficiency following oesophageal surgery compared to the control group, and rehabilitation following surgery resulted in significantly reduced vallecular and pyriform sinus residue. The three studies were found to have 'serious' to 'critical' risk of bias. CONCLUSIONS: This systematic review highlights a low-volume of low-quality evidence to support exercise-based dysphagia rehabilitation in adults undergoing surgery for oesophageal cancer. As dysphagia is a common symptom impacting quality of life throughout survivorship, findings will guide future research to determine if swallowing rehabilitation should be included in enhanced recovery after surgery (ERAS) programmes. This review is limited by the inclusion of non- randomised control trials and the reliance on Japanese interpretation which may have resulted in bias. The reviewed studies were all of weak design with limited data reported. PMID:35012495 | DOI:10.1186/s12885-021-09155-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study

xlomafota13 shared this article with you from Inoreader Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study Via Journal of Thyroid Research Introduction. Thyroid cancer is the third most common cancer that occurs in children and adolescents. Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Although the mortality rate of thyroid malignancy in children is usually low, the disease recurrence is higher in children with more severe clinical presentation than in adults. This study aimed to determine the demographic and clinicopathological characteristics and outcome of pediatric and adolescent patients with thyroid malignancy in Indonesia. Methods. The retrospective study included all patients diagnosed with thyroid carcinoma aged View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frequency-specific prediction model of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss

xlomafota13 shared this article with you from Inoreader Frequency-specific prediction model of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss 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. 2022 Jan 11. doi: 10.1007/s00405-021-07246-x. Online ahead of print. ABSTRACT PURPOSE: The hearing outcome of idiopathic sudden sensorineural hearing loss (ISSNHL) is hard to predict. We herein constructed a multiple regression model for hearing outcomes in each frequency separately in an attempt to achieve practical prediction in ISSNHL. METHODS: We enrolled 235 consecutive in-patients with ISSNHL who were treated in our department from 2015 to 2020 (average hearing level at 250-4000 Hz ≥ 40 dB; time from onset to treatment ≤ 14 days; 126 males/109 females; age range 17-87 years (average 61.0 years)). All patients received systemic prednisolone administration combined with intratympanic dexamethasone injection. The pure-tone hearing threshold of 125-8000 Hz was measured at every octave before (HLpre) and after (HLpost) treatment. A multiple regression model was constructed for HLpost (dependent variable) using five explanatory variables (age, days from onset to treatment, presence of vertigo, HLpre, and hearing level of the contralateral ear). RESULTS: The multiple correlation coefficient increased as the frequency increased. Strong correlations were seen in high frequencies, with multiple correlation coefficients of 0.784/0.830 for 4000/8000 Hz. The width of the 70% prediction interval was narrower for 4000/8000 Hz (± 18.2/16.3 dB) than for low to mid-frequencies. Among the five explanatory variables, HLpre showed the largest partial correlation coefficient for any frequency. The partial correlation coefficient for HLpre increased as the frequency increased, which may partially explain the high multiple correlation coefficients for high frequencies. CONCLUSION: The present model would be of practical use for predicting hearing outcomes in high frequencies in patients with ISSNHL. PMID:35015092 | DOI:10.1007/s00405-021-07246-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevention and treatment of CSF leaks in congenital complex spinal lipomas

xlomafota13 shared this article with you from Inoreader Prevention and treatment of CSF leaks in congenital complex spinal lipomas Via leak of cerebrospinal fluid Acta Neurochir (Wien). 2022 Jan 11. doi: 10.1007/s00701-021-05095-5. Online ahead of print. ABSTRACT BACKGROUND: Congenital complex spinal lipomas (CSL) are challenging lesions to treat. Cerebrospinal fluid (CSF) leaks are feared complications due to the risk of infection, and subsequent scarring that may promote retethering. Much has been written in the literature on the surgical technique of CSL resection with less emphasis placed on the prevention and management of CSF leak. METHOD: The authors describe the nuances in the prevention and management of CSF leaks in the context of CSL, including the operative approach, resection, closure and recommended postoperative care. CONCLUSION: CSF leaks are complications that can be minimized with deliberate steps and meticulous surgical technique. PMID:35015155 | DOI:10.1007/s00701-021-05095-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The fascial structure of the breast: New findings on the anatomy of the inframammary fold

xlomafota13 shared this article with you from Inoreader The fascial structure of the breast: New findings on the anatomy of the inframammary fold Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Dec 7:S1748-6815(21)00647-1. doi: 10.1016/j.bjps.2021.11.109. Online ahead of print. ABSTRACT The inframammary fold defines the shape and structure of the breast, especially in women. As the inframammary fold is placed between the fifth and sixth ribs, the ligaments or fascia are thought to attach from these ribs. However, the previous literature on what structures constitute the inframammary fold does not provide sufficient knowledge for reconstructing the natural form of the fold. This study aimed to clarify the structure that involves the inframammary fold. Ten sides of five formalin-fixed, adult Asian cadaveric breasts were studied. Upon dissection of the breast, including the ribs, the fat lobules were removed while preserving the septal structures under the microscope. The fascial structures were observed grossly and radiographically. A multilayered fascial structure was noted from the dermis n ear the inframammary fold, anchored to the deep fascia of the pectoralis major muscle mainly at the height of the fourth rib and partially of the fifth rib, from the outside of the nipple to the linea axillaris media, where the fold could be clearly observed. Additionally, the fat lobules around the inframammary fold were subdivided by thin septa closer to the dermis, and they fused posteriorly and upward to form this fascial structure. The inframammary fold was not formed by an adhesion directly under the sixth rib, but by the skin "hanging" from the height of the fourth and fifth ribs due to the multilayered fascial structure that repeatedly fused and dissociated and the changes in the size of the fat lobules. This new anatomical finding may help in inframammary fold reconstruction. PMID:34998682 | DOI:10.1016/j.bjps.2021.11.109 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cerebrospinal fluid leak repair: utility of intrathecal fluorescein for correct topographic identification of the skull base defects

xlomafota13 shared this article with you from Inoreader Cerebrospinal fluid leak repair: utility of intrathecal fluorescein for correct topographic identification of the skull base defects Via leak of cerebrospinal fluid World Neurosurg. 2022 Jan 6:S1878-8750(22)00007-9. doi: 10.1016/j.wneu.2022.01.004. Online ahead of print. ABSTRACT BACKGROUND: In the management of cerebrospinal fluid (CSF) leak the identification of the exact discharge spot is paramount. This can represent a challenge for the radiologist and the surgeon. In the present study, we analyzed a series of patients affected by endonasal CSF leak who underwent endoscopic surgical reconstruction aided by the use of intrathecal fluorescein (ITF). The purpose of this work is to assess the efficacy of intraoperative ITF in addition to computed tomography (CT) scan and magnetic resonance imaging (MRI) for correct topographic localization of the CSF leak. METHODS: Eighty-three patients were enrolled in the study. The main outcome was the concordance between the supposed radiological defect site and the actual one seen intraoperatively. The recurrence free survival (RFS) was evaluated as secondary outcome. RESULTS: ITF better defined the defect site allowing a change in the treatment in 21 cases (25.3%), in which a non-concordance was observed between the suspected radiological site and the actual surgical one. Good agreement was found between the specific topographic localization (k=0.737, p<0.0001), whereas fair agreement was observed considering the side of the defect (k=0.362, p=0.0009) and correct identification of multiple sites (k=0.044, p=0.666). The 10-year 96% estimate of RFS confirmed the correct repair of the fistula site in most of the cases. CONCLUSIONS: Our data demonstrate the utility and safety of intraoperative ITF for management of patients affected by endonasal CSF leak. ITF improved the topographical diagnosis of the leak site, ensuring the best target reconstruction and very low recurrence rate. PMID:34999266 | DOI:10.1016/j.wneu.2022.01.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstruction of Subtotal Defect of the Lower Lip: Combined Use of Karapandzic and Nasolabial Flap

xlomafota13 shared this article with you from Inoreader Reconstruction of Subtotal Defect of the Lower Lip: Combined Use of Karapandzic and Nasolabial Flap Via Otolaryngology Indian Abstract Subtotal reconstruction of the lower lip after excision of the tumor is always a challenge for surgeons. It is because of the difficulty in  regaining the function of the lip, including the oral competency and restoring the aesthetic subunit. A 46-year-old patient presented with an ulceroproliferative growth involving 70% of the lower lip, including the right commissure. After the confirmation to be a malignancy, patient underwent excision of the tumour and reconstruction of the lower lip using the left Karapandzic flap and right nasolabial flap. The patient was on regular follow-up in the postoperative period to assess the surgical outcomes. The combined use of Karapandzic flap and the nasolabial flap can be reliably used for subtotal reconstruction of the lower lip in advanced oral cavity malignancy, involving one of the commissures. Later can ensure good postoperative results in terms of aesthetic and functional lip reconstruction without any significant intraoperative or postoperative complications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epidemiology, Clinical Features and Management of Rhino Orbital Mucormycosis in Post COVID 19 Patients

xlomafota13 shared this article with you from Inoreader Epidemiology, Clinical Features and Management of Rhino Orbital Mucormycosis in Post COVID 19 Patients Via Otolaryngology Indian Abstract COVID 19 infections may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is a fungal infection primarily affecting immunocompromised individuals. We have observed sudden rise of mucormycosis cases in post COVID 19 patients. Here we have reported 100 cases of mucormycosis associated with COVID 19. To study epidemiology and clinical features of rhino orbital mucormycosis in post COVID 19 patients. To evaluate efficacy of medical as well as surgical treatment in such patients. This was an observational mixed (retrospective + prospective) study with a duration of 2 months. After noting demographic data, necessary radiological investigation was advised and representative tissue was sent for KOH and histopathological examination. Medical and surgical treatment was planned accordingly. Most patients (55%) presented with complaint of headache and facial pain. Hard palate involvement was observed in 45% patients. Unilateral pr esentation (68%) was more common. Only 25% patients who presented early had normal vision. We reported 22 patients with complete loss of vision. Eye movements were restricted in 58% patients. Diabetes mellitus is most common predisposing factor (65%). 9 patients required orbital exentration. Only 18% patients required Amphotericin for more than 14 days. Immune dysregulation caused by COVID 19 infection in addition to widespread use of steroids and broad-spectrum antibiotics may lead to the development mucormycosis. Diabetes Mellitus type II is another important risk factor and the presence of both have additional effect in causing mucormycosis. Headache and facial pain should be considered highly suspicious of mucormycosis. Early diagnosis with efficient treatment can improve prognosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Brain Herniation Secondary to Cerebrospinal Fluid Leak Following Elective Lumbar Spine Surgery

xlomafota13 shared this article with you from Inoreader Brain Herniation Secondary to Cerebrospinal Fluid Leak Following Elective Lumbar Spine Surgery Via leak of cerebrospinal fluid Cureus. 2021 Dec 8;13(12):e20266. doi: 10.7759/cureus.20266. eCollection 2021 Dec. ABSTRACT Lumbar spine surgery can be complicated by perioperative cerebrospinal fluid (CSF) leak. However, development of brain herniation secondary to CSF leak following lumbar spine surgery has not been previously reported in the current literature. This case report describes a 48-year-old woman who, after a revision lumbar decompression and fusion, experienced CSF leak followed by development of brain herniation, which resulted in patient demise. The postoperative period was complicated by patient nonadherence to conservative management of CSF leak. PMID:35004068 | PMC:PMC8735843 | DOI:10.7759/cureus.20266 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What's in a Name? A Cost-Effectiveness Analysis of the Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features' Nomenclature Revision

xlomafota13 shared this article with you from Inoreader What's in a Name? A Cost-Effectiveness Analysis of the Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features' Nomenclature Revision Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Interventions Within the Scope of Occupational Therapy to Address Preventable Adverse Events in Inpatient and Home Health Postacute Care Settings: A Systematic Review

xlomafota13 shared this article with you from Inoreader Interventions Within the Scope of Occupational Therapy to Address Preventable Adverse Events in Inpatient and Home Health Postacute Care Settings: A Systematic Review Via swallowing exercises Am J Occup Ther. 2022 Jan 1;76(1):7601180060. doi: 10.5014/ajot.2022.047589. ABSTRACT IMPORTANCE: Practitioners need to be familiar with, and involved in, managing quality-related adverse events in postacute care. OBJECTIVE: To determine interventions within the scope of occupational therapy that address preventable adverse events in adult postacute inpatient and home health settings. DATA SOURCES: Articles published from January 1995 through 2019 identified through sea rches of MEDLINE, PsycINFO, CINAHL, OTseeker, and Cochrane databases. Study Selection and Data Collection: Articles were collected, evaluated, and analyzed by two independent reviewers. They were assessed and synthesized with a goal of informing clinical practice. FINDINGS: Twenty-four articles were included in the review. Of the 10 Centers for Medicare & Medicaid Services preventable adverse events, 6 were addressed: diabetes management (n = 2), dysphagia (n = 5), infection control (n = 1), pressure ulcers (n = 6), falls (n = 5), and discharge management (n = 5). There was strong strength of evidence that exercise programs should, when appropriate, be implemented in both inpatient and home health settings to decrease the risk of falls. There was moderate strength of evidence that practitioners could consider implementing a facility wide evidence-based pressure ulcer program; providing multidisciplinary rehabilitation and swallow strengthening exercises for dysphagia; impl ementing a multidisciplinary, multicomponent falls program; and using a manualized depression intervention in home health to decrease hospital readmission. CONCLUSIONS AND RELEVANCE: The review highlights the importance of preventable adverse events and of occupational therapy practitioners acknowledging and managing these events to enhance health outcomes and to control health care costs. What This Article Adds: Many interventions typically performed by occupational therapy practitioners address preventable adverse events. The review highlights the importance of practitioners being aware of this category of impairment or injury. PMID:34990510 | DOI:10.5014/ajot.2022.047589 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.