Comparison Between Different Approaches Applied in Pediatric Adenoidectomy: A Network Meta-Analysis

xlomafota13 shared this article with you from Inoreader Comparison Between Different Approaches Applied in Pediatric Adenoidectomy: A Network Meta-Analysis Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Feb 28:34894221081612. doi: 10.1177/00034894221081612. Online ahead of print. ABSTRACT OBJECTIVE: Adenoidectomy is a surgical procedure most frequently performed by otolaryngologists. However, there are no universally accepted guidelines for the choice of the surgical approach in specific circumstances. Therefore, a network meta-analysis (NMA) is needed to summarize existing studies and provide more evidence-based medical guidelines. METH ODS: A systematic search of the literature was conducted in the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE databases from inception to 31 July 2021. A network meta-analysis of operating time, intraoperative blood loss, postoperative pain score, and incidence of postoperative residual tissue was performed. RESULTS: A total of 20 studies with 2329 patients were included. Four common surgical approaches, including powered vacuum shaver adenoidectomy (PVSA), plasma field ablation adenoidectomy (PFAA), curettage adenoidectomy (CUA), and suction diathermy adenoidectomy (SDA), were compared for operative time, intraoperative blood loss, postoperative pain score, and incidence of postoperative residual tissue. There were no significant differences between the surgical techniques for the 3 endpoints, operative time, intraoperative blood loss, and incidence of postoperative residual tissue. The data showed lower postoperative pain scores for PFAA than for CUA (MD = -3.45, 95% CI [-6.01, -0.95]). There were no significant differences in other surgical approaches for postoperative pain scores. CONCLUSION: There were no significant differences between PVSA, PFAA, CUA, and SDA for operative time, intraoperative blood loss, and incidence of postoperative residual tissue. PFAA had advantages over CUA for postoperative pain scores. PMID:35227080 | DOI:10.1177/00034894221081612 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical variations of the branches from left colic artery and middle colic artery at splenic flexure

xlomafota13 shared this article with you from Inoreader Anatomical variations of the branches from left colic artery and middle colic artery at splenic flexure Via radiol anat Surg Radiol Anat. 2022 Mar 1. doi: 10.1007/s00276-022-02898-8. Online ahead of print. ABSTRACT BACKGROUND: Variations of the vasculature at splenic flexure by left colic artery (LCA) and middle colic artery (MCA) remain ambiguous. OBJECTIVES: This study aim to investigate the anatomical variations of the branches from LCA and MCA at splenic flexure area. METHODS: Using ultra-thin CT images (0.5-mm thickness), we traced LCA and MCA till their merging site with par acolic marginal arteries through maximum intensity projection (MIP) reconstruction and computed tomography angiography (3D-CTA). RESULTS: A total of 229 cases were retrospectively enrolled. LCA ascending branch approached upwards till the distal third of the transverse colon in 37.6%, reached the splenic flexure in 37.6%, and reached the lower descending colon in 23.1%, and absent in 1.7% of the cases. Areas supplied by MCA left branch and aMCA were 33.2%, 44.5% and 22.3% in the proximal, middle and distal third of transverse colon of the cases, respectively. The accessory MCA separately originated from the superior mesenteric artery was found in 17.9% of the cases. Mutual correlation was found that, when the LCA ascending branch supplied the distal transverse colon, MCA left branch tended to feed the proximal transverse colon; when the LCA ascending branch supplied the lower part of descending colon, MCA left branch was more likely to feed the distal third of transverse colon . CONCLUSIONS: Vasculature at splenic flexure by LCA and MCA varied at specific pattern. This study could add more anatomical details for vessel management in surgeries for left-sided colon cancer. PMID:35230505 | DOI:10.1007/s00276-022-02898-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Graves' disease in children and adolescents in Iceland

xlomafota13 shared this article with you from Inoreader Graves' disease in children and adolescents in Iceland Via radioactive iodine Laeknabladid. 2022 Mar;108(3):123-129. doi: 10.17992/lbl.2022.03.680. ABSTRACT INTRODUCTION: Graves' disease is an autoimmune disease in which autoantibodies cause an increase in the production of thyroid hormones, and is the most common cause of thyrotoxicosis in children. Symptoms in children are often more obscure than in adults. The aim of the study is to assess the incidence of Graves' disease in children and adolescents in Iceland over the span of two decades (2001-2021), and furthermore to investigate if the incidence rate has increased, as well as to describe treatment options and disease recurrence. MATERIAL/METHODS: This retrospective descriptive study included all children diagnosed with Graves' disease in the years 2001-2021 in Iceland. Information was obtained from the Directorate of Health's drug database and from ICD-10 diagnoses at Landspítali - The National University Hospital. RESULTS: In total, 57 children and adolescents were diagnosed with Graves', the overall incidence rate was 3.5/100,000 person-years. Gender ratio was 1:2.7 (male : female) and the mean age at diagnosis was 13.6 for boys and 13.9 years for girls. Of those 12 individuals currently receiving drug therapy (21.8%), four patients have had disease relapse. Thirteen patients reached an euthyroid state with medication (23.7%), 25 received treatment with radioactive iodine (45.5%) and 5 underwent surgery (9.1%). Boys were more likely to relapse. Disease recurrence w as 31.8%. CONCLUSION: The incidence of Graves' disease did not increase during the study period. The disease was more common in girls, although the gender ratio was lower than expected. Antithyroid drugs were the first choice in treatment and radioactive iodine was the most common permanent treatment option. Disease recurrence was common. A possible relationship between the duration of the original drug therapy and disease recurrence should be investigated. PMID:35230257 | DOI:10.17992/lbl.2022.03.680 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcome measurement in adult flexor tendon injury: A systematic review

xlomafota13 shared this article with you from Inoreader Outcome measurement in adult flexor tendon injury: A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 20:S1748-6815(21)00423-X. doi: 10.1016/j.bjps.2021.08.033. Online ahead of print. ABSTRACT BACKGROUND: Defining the optimal, evidence-based management of flexor tendon injury remains challenging. Lack of consensus on which measures to use to assess the outcome of interventions is a key issue, especially with regard to patient-reported outcome measures (PROMs). This systematic review defines the landscape of outcome measurement in studies on interventions for flexor tendon injuries to guide future research. METHODS: A PRISMA-compliant systematic review was conducted using bespoke search strategies applied to MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL and AMED. A protocol was developed and registered prospectively (CRD42020186780). We identified all studies describing adult patients undergoing interventions for acute hand flexor tendon injuries. RESULTS: Of the 4844 studies, 114 studies met the final inclusion criteria for evaluating the outcomes of 8127 participants with 9071 injured digits. Studies included 24 randomised controlled trials, 19 cohort studies and 61 case series. Nine different PROMs were used in 24 studies (22%): three site-specific PROMs, one generic quality-of-life measure and four visual analogue scales. Clinician-reported outcome measures were used in 103 studies (96%), such as the range of motion reported in 102 studies (94%). Adverse outcomes were reported in 96 studies (89%), with the most frequently reported adverse outcomes being tendon rupture and infection. Re-operation was reported in 21 studies (19%). The most frequently reported health economic outcome measure was the length of work absence, reported in ten studies (9%). CONCLUSIONS: There is variability in the use of outcome measures used to study interventions for flexor tendon injuries. An independent systematic review of the psychometric properties of the identified outcome measures and a specific multi-stakeholder consensus process may support optimal choice and standardisation for future studies. PMID:35219612 | DOI:10.1016/j.bjps.2021.08.033 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Facial nerve perineural spread from cutaneous squamous cell carcinoma of the head and neck: A single institution analysis of epidemiology, treatment, survival outcomes, and prognostic factors

xlomafota13 shared this article with you from Inoreader Facial nerve perineural spread from cutaneous squamous cell carcinoma of the head and neck: A single institution analysis of epidemiology, treatment, survival outcomes, and prognostic factors Via Head & Neck Abstract Background This study aimed to examine patients with facial nerve (VII) perineural spread (PNS) from cutaneous squamous cell carcinoma of the head and neck. Methods Retrospective analysis of patients managed by an Australian tertiary center between 2000 and 2019. Results Seventy three patients were included. Most presented with recurrent disease (89.0%) and simultaneous trigeminal nerve (V) involvement (67.1%). Of the 55 patients (75.3%) who received curative intent treatment, 48 received surgery plus/minus post-operative radiotherapy. In these patients, 5-year disease-free survival, disease-specific survival, and overall survival was 50.7%, 68.7%, and 58.1%, respectively. Pathological nodal disease, involved margins, increasing VII zonal extent, and concurrent zone 2 V PNS significantly worsened outcomes. Conclusion High rates of recurrent disease reflects the importance of adequate treatment of the primary. Surgery and post-operative radiotherapy remains the mainstay treatment. Outcomes are improved in early-stage disease and with clear surgical margins, reinforcing the need for prompt diagnosis and intervention. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19 and change to home nursing care: Prospective study on 100 patients followed in CLCC

xlomafota13 shared this article with you from Inoreader COVID-19 and change to home nursing care: Prospective study on 100 patients followed in CLCC Via Association française pour l'étude du cancer Bull Cancer. 2022 Feb 14:S0007-4551(22)00071-6. doi: 10.1016/j.bulcan.2022.01.013. Online ahead of print. ABSTRACT BACKGROUND: During the COVID-19 epidemic, the lockdown measures were associated with professional guidelines to care for patients. We noticed that the home nursing care of some patients monitored in supportive care wards were interrupted. The aim of this study is to determine the impact of lockdown on the home nursing care of patients monitored in supportive care wards. MATERIALS AND METHODS: This observational, descriptive, monocentric, and prospective study was conducted in the supportive care wards from the 04.20 to the 05.15.2020 among 100 patients. They were asked about their home nursing care and their frequency before and after lockdown. Our study received a favorable ruling from the ethics committee of the Hôpitaux universitaires de Strasbourg. RESULTS: About two thirds of patients had experienced a ch ange with their home nursing care. A complete interruption was observed for 40% of them and a reduction of frequency for 10% of them. Some populations were more deeply affected: patients with a performance status 3-4, women, patients living alone or patients with motor disability. The interruption of a task usually performed by a professional was observed for 49% of patients, with the task becoming incumbent on the patient or family caregivers. CONCLUSION: Our study shows a strong impact of the lockdown on the home nursing care of our patients in spite of the professional guidelines encouraging continuity of care. Our study underlines the great importance of protecting the access to care of the most vulnerable patients. PMID:35219501 | DOI:10.1016/j.bulcan.2022.01.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transoral robotic surgery for the identification of unknown primary head and neck squamous cell carcinomas: Its effect on the wait and the weight

xlomafota13 shared this article with you from Inoreader Transoral robotic surgery for the identification of unknown primary head and neck squamous cell carcinomas: Its effect on the wait and the weight Via Head & Neck Abstract Background Neck carcinoma of unknown primary (CUP) is a frequent scenario. Transoral robotic mucosectomies (TORM) of pharynx have increased rate of primary identification, but come with cost of treatment delay. Methods We reviewed patients who underwent CUP protocol from 2014 to 2020. Patients with cervical nodes carcinoma and failure to localize a primary source were classified as CUP. We determined primary identification rate and postoperative complications. Results We included 65 patients underwent TORM. Surgical approach consisted of lingual and/or palatine tonsillectomies. The primary detection rate was 49.2%. Average weight reduction was 2.5 ± 4.3 kg. The average number of days from consultation to definitive treatment was 52.2 ± 18.3. Conclusion A systematic approach to patients with CUP showed a promising primary identification rate compared to panendoscopy alone. TORM carries a small risk of complications. The benefits of primary identification must be weighed with the morbidity and delay to definitive treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.