Multi-level factors associated with more intensive use of radioactive iodine for low-risk thyroid cancer

xlomafota13 shared this article with you from Inoreader Multi-level factors associated with more intensive use of radioactive iodine for low-risk thyroid cancer Via radioactive iodine J Clin Endocrinol Metab. 2021 Mar 4:dgab139. doi: 10.1210/clinem/dgab139. Online ahead of print. ABSTRACT CONTEXT: The use of radioactive iodine (RAI) for low-risk thyroid cancer is common, and variation in its use exists, despite the lack of benefit for low-risk disease and potential harms and costs. OBJECTIVE: To simultaneously assess patient- and physician-level factors associated with patient-reported receipt of RAI for low-risk thyroid cancer. DESIGN, SETTING, PART ICIPANTS: This population-based survey study of patients with newly-diagnosed differentiated thyroid cancer identified via the Surveillance Epidemiology and End Results (SEER) registries of Georgia and Los Angeles County included 989 patients with low-risk thyroid cancer, linked to 345 of their treating general surgeons, otolaryngologists and endocrinologists. MAIN OUTCOMES: Patient-reported receipt of RAI for low-risk thyroid cancer. RESULTS: Among this sample, 48% of patients reported receiving RAI, and 23% of their physicians reported they would use RAI for low-risk thyroid cancer. Patients were more likely to report receiving RAI if they were treated by a physician who reported they would use RAI for low-risk thyroid cancer compared to those whose physician reported they would not use RAI (Adjusted OR: 1.84, 95%CI: 1.29-2.61). The odds of patients reporting they received RAI was 55% lower among patients whose physicians reported they saw a higher volume of patients w ith thyroid cancer (40+ vs. 0-20) (Adjusted OR: 0.45, 0.30-0.67). CONCLUSIONS: Physician perspectives and attitudes about using RAI, as well as patient volume, influence RAI use for low-risk thyroid cancer. Efforts to reduce overuse of RAI in low-risk thyroid cancer should include interventions targeted towards physicians, in addition to patients. PMID:33687063 | DOI:10.1210/clinem/dgab139 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic use of fine‐needle aspiration cytology and core‐needle biopsy in head and neck sarcomas

xlomafota13 shared this article with you from Inoreader Diagnostic use of fine‐needle aspiration cytology and core‐needle biopsy in head and neck sarcomas Via Head & Neck Abstract The diagnostic role of fine‐needle aspiration cytology (FNAC) and core‐needle biopsy (CNB) has not been comprehensively assessed in head and neck sarcomas. A systematic review of published cases (1990–2020) was conducted. Diagnostic performance of both FNAC/CNB to determine tumor dignity and histopathological diagnosis was calculated. One hundred and sixty‐eight cases were included for which FNAC (n = 156), CNB (n = 8), or both (n = 4) were used. Predominant histologies were skeletal muscle, chondrogenic and vascular sarcomas. FNAC correctly assessed dignity in 76.3% and histology in 45% of cases. Dignity was significantly better for vascular tumors, metastatic and recurrent specimens, and worse for chondrogenic sarcomas. CNB showed a 92% accuracy to identify dignity and 83% for histopathology. FNAC and CNB are useful methods for the diagnosis of head and neck sarcomas, particularly well‐suited in the context of recurrent or metastatic disease. The role of CNB remains largely unexplored for this indication. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intensity‐modulated radiation therapy for nasal cavity and paranasal sinus tumors: Experience from a single institute

xlomafota13 shared this article with you from Inoreader Intensity‐modulated radiation therapy for nasal cavity and paranasal sinus tumors: Experience from a single institute Via Head & Neck Abstract Background To assess the efficacy of intensity‐modulated radiation therapy (IMRT) for tumors of the nasal cavity and paranasal sinus (PNS) region. Materials and Methods Two hundred fourteen patients with tumors of the nasal cavity and PNS region treated with curative intent IMRT between 2007 and 2019 were included in this retrospective analysis. Results Fifty‐one (24.1%) received definitive RT/CTRT and 163 (75.9%) received adjuvant RT. Most common histology was squamous cell carcinoma (26.1%) followed by adenoid cystic carcinoma (21.5%). The median follow‐up was 43.5 months. The 5‐year local control (LC), event‐free survival (EFS), and overall survival (OS) for the entire cohort was 66.9%, 59%, and 73.9%, respectively. On univariate analysis treatment with nonsurgical modality, T classification and undifferentiated/poorly differentiated histology were associated with inferior 5‐year LC, EFS, and OS. Four patients had late Grade 3/Grade 4 ocular toxicity. Conclusions IMRT should be the standard of care for tumors of PNS region across all histologies and treatment setting. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Swallowing and communication outcomes following primary transoral robotic surgery

xlomafota13 shared this article with you from Inoreader Swallowing and communication outcomes following primary transoral robotic surgery Via Head & Neck Abstract Background Heterogeneity within studies examining transoral robotic surgery (TORS) for oropharyngeal cancer (OPC) has made it challenging to make clear conclusions on functional outcomes. Infrequent use of instrumental swallow examinations compounds uncertainty surrounding the proposed functional advantage to TORS. Methods A prospective cohort of 49 patients underwent speech and swallowing assessment 12 months following treatment for OPC. Patients were assessed using fibreoptic endoscopic evaluation of swallowing (FEES), clinician‐ and patient‐reported outcomes. Participants were matched according to tumor site, T category, and age. Speech and swallowing outcomes were compared for those receiving TORS versus chemoradiation. Results When adjuvant radiotherapy to the primary site could be avoided, TORS demonstrated an advantage for feeding tube duration, secretion severity, penetration/aspiration, M. D. Anderson Dysphagia Inventory (MDADI), and airway protection. Conclusion This explorative study suggests that a treatment philosophy of selecting patients for TORS where adjuvant therapy can be omitted or confined to the neck warrants further evaluation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Keratinocyte‐derived IL‐1β induces PPARG down‐regulation and PPARD up‐regulation in

xlomafota13 shared this article with you from Inoreader Keratinocyte‐derived IL‐1β induces PPARG down‐regulation and PPARD up‐regulation in Via Experimental Dermatology Abstract Peroxisome proliferator‐activated receptors (PPARs) are a family of nuclear hormone receptors. In skin, PPARs modulate inflammation, lipid synthesis, keratinocyte differentiation and proliferation and thus are important for skin barrier homeostasis. Accordingly, PPAR expression is altered in various skin conditions that entail epidermal barrier impairment i.e. atopic dermatitis (AD) and psoriasis. Using human epidermal equivalents (HEEs) we established models of acute epidermal barrier impairment devoid of immune cells. We assessed PPAR and cytokine expression after barrier perturbation and examined effects of keratinocyte‐derived cytokines on PPAR expression. We show that acetone or SDS treatment causes graded impairment of epidermal barrier function. Furthermore, we demonstrate that besides IL‐1β and TNFα, IL‐33 and TSLP are highly relevant markers for acute epidermal barrier impairment. Both SDS‐ and acetone‐mediated epidermal barrier impairment reduce PPARG expression levels, whereas only SDS enhances PPARD expression. In line with findings in IL‐1β and TNFα treated HEEs, abrogation of IL‐1 signaling restores PPARG expression and limits the increase of PPARD expression in SDS‐induced epidermal barrier impairment. Thus, following epidermal barrier perturbation, keratinocyte‐derived IL‐1β and partly TNFα modulate PPARG and PPARD expression. These results emphasize a role for PPARγ and PPARβ/δ in acute epidermal barrier impairment with possible implications for diseases such as AD and psoriasis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Head and neck cancer and non‐steroidal anti‐inflammatory drugs: Systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Head and neck cancer and non‐steroidal anti‐inflammatory drugs: Systematic review and meta‐analysis Via Head & Neck Abstract The objective was to assess the effects of non‐steroidal anti‐inflammatory drugs (NSAIDs) on head and neck cancer (HNC) outcomes. A systematic review was conducted following the PRISMA guidelines. The MEDLINE and the Cochrane Central Register databases were searched. Risk of bias was assessed by the Cochrane Collaboration's tool and by the Newcastle‐Ottawa Scale. Meta‐analyses were performed with the RevMan software. Seventeen articles met the inclusion criteria. Quality scores for observational studies ranged between 5 and 8 stars and the RCT was assessed as high risk of bias. NSAIDs use was associated with a 13% risk reduction of HNC (OR: 0.87 95% CI 0.77–0.99). NSAIDs use was associated with a 30% reduced cancer‐specific mortality and with a 40% decreased risk on disease‐recurrence. NSAIDs may have a modest protective effect on HNC risk and a positive impact on cancer‐specific survival and disease‐recurrence. The findings do not support a protective role of as pirin on HNC outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multi-Detector CT Instillation Dacryocystography and Its Role in the Diagnosis of Lacrimal Drainage System Blocks

xlomafota13 shared this article with you from Inoreader Multi-Detector CT Instillation Dacryocystography and Its Role in the Diagnosis of Lacrimal Drainage System Blocks Via Otolaryngology Indian Abstract To assess the use of Multi-detector computed tomography instillation dacryocystography (MDCT-DCG) and its role in the diagnosis of lacrimal drainage system (LDS) blocks. It is a prospective evaluation of Twenty-five cases presenting with symptoms with NLDO (nasolacrimal duct obstruction) assessed by MDCT-DCG. The study was conducted in LN medical college and JK hospital Bhopal (M.P) territory centre between January 2016 and January 2017. Various levels of LDS obstruction were detected, Lower canaliculus 12% common canaliculus in 20% patients, lacrimal sac in 12% junction between lacrimal sac and NLD in 40% and NLD obstruction in 16% patients. The most common CTDCG findings were dilated opacified lacrimal sac with no opacification of the nasolacrimal duct (NLD) in 40% patients. CTDCG is a non-invasive, quick, patient friendly, indispensable in the assessment of NLDO procedure that adds benefit in documentation and preoperative planning. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.