Sinonasal adenocarcinoma: A population‐based analysis of demographic and socioeconomic disparities

xlomafota13 shared this article with you from Inoreader Sinonasal adenocarcinoma: A population‐based analysis of demographic and socioeconomic disparities Via Head & Neck Abstract Background Sinonasal adenocarcinoma (SNAC) is a rare tumor. The impact of health disparities on survival, stage at presentation, and utilization of surgery is not well understood in patients with SNAC. Methods The Surveillance, Epidemiology, and End Results database was queried for cases of SNAC from 1973 to 2015. Cases were analyzed to assess for disparities in presentation, treatment, and survival. Results SNAC was identified in 630 patients. In a multivariate model of overall survival, an age increase of 10 years (Hazard Ratio (HR) = 1.37, p < 0.001), male sex (HR = 1.26, p = 0.045), and more recent decade of diagnosis (HR = 0.74, p < 0.001) were significantly related to time-to-death. There is a higher rate of SNAC-related death in counties with more rural populations (p = 0.027). Conclusion Future interventions targeting rural and less well-educated populations may improve care with the goal of increasing the span of healthy life and reducing survival disparities related to SNAC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Expression of cathepsins B and D by cancer stem cells in head and neck metastatic malignant melanoma

xlomafota13 shared this article with you from Inoreader Expression of cathepsins B and D by cancer stem cells in head and neck metastatic malignant melanoma Via Melanoma Research - Published Ahead-of-Print We have previously demonstrated cancer stem cell (CSC) subpopulations in head and neck metastatic malignant melanoma (HNmMM), and the expression of components of the renin–angiotensin system (RAS) by these CSCs. Cathepsins B, D and G are involved in carcinogenesis and constitute bypass loops of the RAS . This study investigated the expression and localization of cathepsins B, D and G, in relation to these CSCs. Immunohistochemical staining demonstrated expression of cathepsins B, D and G in HNmMM sections from all 20 patients. Western blotting confirmed the presence of cathepsins B and D proteins in all six HNmMM tissue samples and four HNmMM-derived primary cell lines. RT-qPCR showed transcript expression of cathepsins B, D and G in all six HNmMM tissue samples, and cathepsins B and D but not cathepsin G in all four HNmMM-derived primary cell lines. Enzymatic activity assays demonstrated cathepsins B and D were active in all six HNmMM tissue samples. Immunofluorescence staining performed on two of the HNmMM tissue samples demonstrated expression of cathepsins B and D by the CSCs, and cathepsin G by cells within the peritumoral. Our novel findings suggest the possibility of targeting these CSCs by modulation of paracrine RAS signaling. Received 14 January 2021 Accepted 2 May 2021 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Correspondence to Swee T. Tan, MBBS, FRACS, PhD, Gillies McIndoe Research Institute, PO Box 7184, Newtown, Wellington 6242, New Zealand, Tel: +64 (0) 4 2820366; e-mail: swee.tan@gmri.org.nz Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasal Mucociliary Clearance in Prolonged Tracheostomy Patients: A Prospective Case–Control Study

xlomafota13 shared this article with you from Inoreader Nasal Mucociliary Clearance in Prolonged Tracheostomy Patients: A Prospective Case–Control Study Via Otolaryngology Indian Abstract Prolonged tracheostomy bypasses the upper airways leading to absence or reduction of nasal airflow. This altered nasal physiology not only impairs olfaction but also may cause mucociliary dysfunction and consequent nasal crusting and rhinosinusitis.To objectively evaluate the extent of nasal mucociliary impairment in patients with prolonged duration of tracheostomy.This is a prospective case–control study done in a tertiary care center wherein the nasal mucocilary function was assessed by saccharin test in patients who were tracheostomized for a period of more than 4 weeks and the saccharin transit time (time taken to appreciate the sweet taste after endoscopic insertion of saccharin pellet on anterior end of inferior turbinate) was compared by the same test in age and sex matched healthy individuals. The saccharin transit time in the two groups was statistically analyzed using student t-test. Mean saccharin transit time in 30 patients with prolonged trach eostomy was 934.97 s with a standard deviation of 75.95 s whereas in 30 controls, the meantime was 447.4 s with a standard deviation of 63.22 s, which was statistically significant (p < 0.001). Conclusion Prolonged duration of tracheostomy leads to impaired nasal mucociliary clearance, which in turn could cause chronic rhinosinusitis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Adjuvant Medical Therapies on Surgical Outcomes in Idiopathic Subglottic Stenosis

xlomafota13 shared this article with you from Inoreader Impact of Adjuvant Medical Therapies on Surgical Outcomes in Idiopathic Subglottic Stenosis Via The Laryngoscope Objectives/Hypothesis Adjuvant medications including proton pump inhibitors (PPI), antibiotics (trimethoprim/sulfamethoxazole [TMP-SMX]), and inhaled corticosteroids (ICS) may be prescribed for patients with idiopathic subglottic stenosis (iSGS). We describe medication use with endoscopic dilation (ED) or endoscopic resection with medical treatment (ERMT) and evaluate impact on outcomes. Study Design International, prospective, 3-year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS. Methods Post hoc secondary analysis of prospectively collected North American Airway Collaborative data on outcomes linked with adjuvant medication utilization. Primary outcome was time to recurrent operation, evaluated using Kaplan–Meier curves and Cox regression analysis. Secondary outcomes of change in peak expiratory flow (PEF) and clinical chronic obstructive pulmonary disease questionnaire (CCQ) score over 12 months were compared. Results Sixty-one of 129 patients undergoing ED received PPI (47%), and 10/143 patients undergoing ED received ICS (7%). TMP-SMX was used by 87/115 patients (76%) undergoing EMRT. PPI use in the ED group did not affect time to recurrence (hazard ratio [HR] = 1.00, 95% confidence interval [CI]: 0.53–1.88; P = .99) or 12-month change in PEF (L/min) (median [interquartile range], 12.0 [10.7–12.2] vs. 8.7 [−5.1 to 24.9]; P = .59), but was associated with 12-month change in CCQ (−0.05 [−0.97 to 0.75] vs. −0.50 [−1.60 to 0.20]; P = .04). ICS did not affect outcome measures. TMP-SMX use in ERMT did not affect time to recurrence (HR = 0.842, 95% CI: 0.2345–3.023; P = .79), PEF at 12 months (75 [68–89] vs. 81 [68–89]; P = .92), or 12-month change in CCQ (0.20 [−1.05 to 0.47] vs. −0.30 [−1.00 to 0.10]; P = .45). Conclusion There is no standard practice for prescribing adjuvant medications. These data do not support that adjuvant medications prolong time to recurrence or increase PEF. Patients with iSGS and gastroesophageal reflux disease may experience some symptom benefit with PPI. Level of evidence Level 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictors of Respiratory Dysfunction at Diagnosis of Robin Sequence

xlomafota13 shared this article with you from Inoreader Predictors of Respiratory Dysfunction at Diagnosis of Robin Sequence Via The Laryngoscope Objectives/Hypothesis Robin sequence (RS) consists of associated micrognathia, glossoptosis, and respiratory dysfunction, with or without cleft palate. Studies on how different patient characteristics impact the severity of respiratory dysfunction are scarce and contradictory; this study investigates how different features affect respiratory obstruction severity at diagnosis of RS in controlled analysis. Study Design Retrospective cohort study that enrolled 71 RS patients under 90 days old who received care in our institution from 2009 to 2020. Methods The primary outcome, respiratory dysfunction, was categorized into four severity groups and analyzed using a multinomial logistic regression model that considered age, sex, mandible length, cleft palate, syndromic diagnosis, other airway anomalies, and degree of glossoptosis. Results Mandible length, syndromic diagnosis, and Yellon grade 3 glossoptosis were related to poorer respiratory outcomes (need for respiratory support). In univariate analysis, for each additional 1 mm of mandible length at diagnosis, a mean reduction of 28% in the risk of needing respiratory support was observed (OR = 0.72; 0.58–0.89); syndromic diagnosis and grade 3 glossoptosis also raised the risk (OR = 6.50; 1.59–26.51 and OR = 12.75; 1.03–157.14, respectively). In multivariate analysis, only mandible length significantly maintained its effects (OR = 0.73; 0.56–0.96), a 27% reduction. Conclusions Mandible length was an independent predictor for more severe respiratory dysfunction in RS patients, with larger mandibles showing protective effects. Syndromic diagnosis and Yellon grade 3 glossoptosis are also likely to be associated with poorer respiratory outcomes, although this was not demonstrated in multivariate analysis. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reliability of the ‘M-Line’ in the Prediction of the Facial Nerve Position in Patients with Parotid Neoplasms

xlomafota13 shared this article with you from Inoreader Reliability of the 'M-Line' in the Prediction of the Facial Nerve Position in Patients with Parotid Neoplasms Via Otolaryngology Indian Abstract Preoperative radiological assessment of parotid tumours represents a crucial step in the planning of a parotidectomy in order to avoid post-operative facial nerve paralysis. The purpose of this study is to determine the reliability of the novel 'M-line' in predicting the facial nerve position and compare it to various radiological methods in the same context. 66 patients whom had underwent parotidectomy for parotid tumours from January 2012 to February 2021 were analyzed. Parotid tumour location were identified using the retromandibular vein, facial nerve line, Conn's arc, Utrecht line and the 'M'-line were compared to the intraoperative location of parotid tumours.The 'M'-line is a novel hypothetical line (drawn between the lateral surface of the mandible to the lateral border of the mastoid process) used to identify the location of the facial nerve radiologically. The 'M-Line' and other methods of radiological assessments were associated with statistical significance in predicting if the parotid tumours were superficial or deep to the facial nerve (p-value < 0.05).The 'M-line' had demonstrated a sensitivity of 73.6% and 92.3% specificity.It had also yielded the highest accuracy (77.3%) in the prediction of the parotid tumour location in relation to the facial nerve. While the radiological lines represented by the Retromandibular vein,facial nerve line,Utrecht line and Conn's arc were statistically significant in predicting the location of the parotid tumour in relation to the facial nerve, the M-line was the most accurate and sensitive predictor in our study.The M-Line is a potentially useful tool to predict the location of the facial nerve in relation to a parotid tumour. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of Intelligibility in Children with Velopharyngeal Insufficiency: The Relationship between Intelligibility in Context Scale and Experimental Measures

xlomafota13 shared this article with you from Inoreader Assessment of Intelligibility in Children with Velopharyngeal Insufficiency: The Relationship between Intelligibility in Context Scale and Experimental Measures Via Folia Phoniatrica et Logopaedica Purpose: The purpose of this study was to investigate the clinical application of the Intelligibility in Context Scale (ICS) instrument in children with velopharyngeal insufficiency (VPI). This study investigated the relationship between clinical speech outcomes and parental reports of speech intelligibility across various communicative partners. Methods: The ICS was completed by the parents of 20 English-speaking children aged 4–12 years diagnosed with VPI. The parents were asked to rate their children's speech intelligibility across communication partners using a 5-point scale. Clinical metrics obtained using standard clinical transcription on the Picture-Cued SNAP-R Test were: (1) percentage of consonants correct (PCC), (2) percentage of vowels correct (PVC), and (3) percentage of phonemes correct (PPC). Nasalance from nasometer data was included as an indirect measure of nasality. Intelligibility scores obtained from naive listener's transcriptions and speech-language pathologists' (SLP) ratings were compared with the ICS results. Result: Greater PCC, PPC, PVC, and transcription-based intelligibility values were significantly associated with higher ICS values, respectively (r[20] = 0.84, 0.82, 0.51, and 0.70, respectively; p #x3c; 0.05 in all cases). There was a negative and significant correlation between ICS mean scores and SLP ratings of intelligibility (r = –0.74; p #x3c; 0.001). The re was no significant correlation between ICS values and nasalance scores (r[20] = –0.28; p = 0.22). Conclusion: The high correlations obtained between the ICS with PCC and PPC measures indicate that articulation accuracy has had a great impact on parents' decision-making regarding intelligibility in this population. Significant agreement among ICS scores with naive listener transcriptions and clinical ratings supports use of the ICS in practice. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.