Insurance type is associated with appropriate use of surgical and adjuvant care for differentiated thyroid carcinoma

xlomafota13 shared this article with you from Inoreader Insurance type is associated with appropriate use of surgical and adjuvant care for differentiated thyroid carcinoma Via radioactive iodine Surgery. 2021 Sep 30:S0039-6060(21)00794-7. doi: 10.1016/j.surg.2021.07.038. Online ahead of print. ABSTRACT BACKGROUND: We aimed to characterize the association between differentiated thyroid cancer (DTC) patient insurance status and appropriateness of therapy (AOT) regarding extent of thyroidectomy and radioactive iodine (RAI) treatment. METHODS: The National Cancer Database was queried for DTC patients diagnosed between 2010 and 2016. Adjusted odds ratios (AOR) for AOT, as defined by the American Thyroid Association guidelines, and hazard ratios (HR) for overall survival (OS) were calculated. A difference-in-differences (DD) analysis examined the association of Medicaid expansion with outcomes for low-income patients aged <65. RESULTS: A total of 224,500 patients were included. Medicaid and uninsured patients were at increased risk of undergoing inappropriate therapy, including inappropriate lobectomy (Medicaid 1.36, 95% confidence interval [CI]: 1.21-1.54; uninsured 1.30, 95% CI: 1.05-1.60), and under-treatment with RAI (Medicaid 1.20, 95% CI: 1.14-1.26; uninsured 1.44, 95% CI: 1.33-1.55). Inappropriate lobectomy (HR 2.0, 95% CI: 1.7-2.3, P < .001) and under-treatment with RAI (HR 2.3, 95% CI: 2.2-2.5, P < .001) were independently associated with decreased survival, while appropriate surgical resection (HR 0.3, 95% CI: 0.3-0.3, P < .001) was associated with improved odds of survival; the model controlled for all relevant clinico-pat hologic variables. No difference in AOT was observed in Medicaid expansion versus non-expansion states with respect to surgery or adjuvant RAI therapy. CONCLUSION: Medicaid and uninsured patients are at significantly increased odds of receiving inappropriate treatment for DTC; both groups are at a survival disadvantage compared with Medicare and those privately insured. PMID:34600741 | DOI:10.1016/j.surg.2021.07.038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Days alive and out of hospital following transoral robotic surgery: Cohort study of 262 patients with head and neck cancer

xlomafota13 shared this article with you from Inoreader Days alive and out of hospital following transoral robotic surgery: Cohort study of 262 patients with head and neck cancer Via Head & Neck Abstract Background Days alive and out of hospital (DAOH) is a validated outcome in clinical trials, since it reflects procedure-associated morbidity and mortality. Transoral robotic surgery (TORS) has become a widely adopted procedure with increasing demand for knowledge and data on morbidity. Methods Retrospective single-center assessment of a prospective TORS database comprising patients treated for malignancy between 2013 and 2018 using DAOH to describe procedure- and disease-related morbidity the first 12-postoperative months. Results For 262 patients, median DAOH365 was 357 days (IQR 351–360). Indications for TORS were (i) primary curative resection (61%), (ii) salvage resection (15%), and (iii) diagnostic work-up of cancer of unknown primary in the head and neck (24%). Median DAOH365 was 359 days (IQR 351–361 days), 348 days (IQR 233–355), and 357 days (351–361), respectively. Pneumonia had the highest impact in DAOH365 reduction. Conclusion Total median DAOH365 after TORS was 357 days. The main cause leading to DAOH365 reduction was pneumonia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Massive Cervical Lymphadenopathy Post-COVID-19 Vaccination

xlomafota13 shared this article with you from Inoreader Massive Cervical Lymphadenopathy Post-COVID-19 Vaccination Via ear nose throat Ear Nose Throat J. 2021 Oct 2:1455613211048984. doi: 10.1177/01455613211048984. Online ahead of print. ABSTRACT The coronavirus disease 2019 (COVID-19) is a global pandemic caused by severe acute respiratory syndrome coronavirus 2. Rapid spread with rampant growth of cases and deaths brought forth an urgent need for novel therapies including vaccinations. The mRNA vaccines for COVID-19 disease have been implemented at an unprecedented scale in an effort to combat the unrelen ting pandemic. Such a massive scale vaccination program is bound to coincide with adverse events related to treatment. We present a case of massive cervical lymphadenopathy in a 58-year-old male patient post-Moderna COVID-19 vaccination. Additional investigations did not identify malignancy and he was diagnosed with vaccine-related lymphadenopathy. Patient significantly improved with corticosteroid treatment within 2 days of admission. Lymphadenopathy is reported as the second most common local reaction to the Moderna vaccine. Promoting knowledge of this side effect, particularly in the setting widespread vaccination efforts, would allow for better management of cases, especially in relation to oncologic patients. PMID:34601889 | DOI:10.1177/01455613211048984 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Solitary neurofibroma in the external auditory canal

xlomafota13 shared this article with you from Inoreader Solitary neurofibroma in the external auditory canal Via ear nose throat Ear Nose Throat J. 2021 Oct 2:1455613211048978. doi: 10.1177/01455613211048978. Online ahead of print. ABSTRACT Significance Statement: Neurofibromas, derived from perineural cells, are usually benign in the nervous system. Although neurofibromas are common in the head and neck, they rarely affect the external auditory canal (EAC), and few cases have been reported. We describe a case of a solitary EAC neurofibroma with otoscopy, radiological imaging, a surgical approa ch, and an uneventful outcome. PMID:34601890 | DOI:10.1177/01455613211048978 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resolvin D2 suppresses NLRP3 inflammasome by promoting autophagy in macrophages

xlomafota13 shared this article with you from Inoreader Resolvin D2 suppresses NLRP3 inflammasome by promoting autophagy in macrophages Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1222. doi: 10.3892/etm.2021.10656. Epub 2021 Aug 26. ABSTRACT Inflammasome, a multiprotein complex that regulates interleukin (IL)-1β secretion and pyroptosis, participates in numerous inflammatory diseases, including sepsis, atherosclerosis and type-2 diabetes. Investigating the inflammasome regulation is therefore crucial to understand the inflammasome activation and develop treatment for the related diseases. In addition, it remains unknown how the inflammasome is naturally suppressed during the inflammatory process. The present study aimed to investigate the role of resolvin D2 (RvD2), an innate suppressor of inflammation produced from essential ω3-polyunsaturated fatty acids, in the activation of the inflammasome via in vitro and in vivo experiments. The effects of RvD2 on the cytokine production of inflammasome-related peritonitis were determined, and the NLRP3 inflammasome activation was investigated in the presence of RvD2. Moreover, the potential mechanisms underlying RvD2 in NLRP3 inflammasome regulation through autophagy and proteasome were investigated. The results of the present study demonstrated that RvD2 suppressed inflammasome-mediated peritonitis in vivo and regulated the NLR family pyrin domain containing 3 (NLRP3) inflammasome, but not in absent in melanoma 2 (AIM2), NLR family CARD domain containing 4 (NLRC4) inflammasomes. Mechanistically, RvD2 was found to promote the degradation of NLRP3 through autophagy, and the inhibition of autophagy could reverse the RvD2-mediated suppression of NLRP3 inflammasome in vitro and partially reverse the inflammasome-mediated peritonitis in vivo. In summary, the present study reported the negative regulation of NLRP3 inflammasome activation by RvD2. The findings from this study may extend the knowledge of the innate regulation of inflammasome and highlight a possible target for inflammasome-r elated diseases. PMID:34603519 | PMC:PMC8453332 | DOI:10.3892/etm.2021.10656 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Antibodies against thyroid-stimulating hormone receptor cause maternal-neonatal transmission of Graves' Disease

xlomafota13 shared this article with you from Inoreader Antibodies against thyroid-stimulating hormone receptor cause maternal-neonatal transmission of Graves' Disease Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1253. doi: 10.3892/etm.2021.10688. Epub 2021 Sep 3. ABSTRACT The present study aimed to investigate whether the thyroid-stimulating hormone receptor (TSHR) autoantibodies (Ab) from mothers with Graves' disease (GD) could cause neonatal thyroid disease and the underlying mechanisms of this. An adenovirus expressing the TSHR A-subunit and a control adenovirus expressing β-galactosidase was constructed by Beijing Sino Geno Max Co., Ltd. The sequences were subsequently verified and amplified via PCR. A GD model was established in female BALB/c mice (n=90) by three intramuscular injections of a TSHR-expressing adenovirus (Ad-TSHR). Mice injected with Ad-β-galactosidase served as a sham immunization group. The immunized females were paired with unimmunized males to generate offspring. The serum levels of TSHR-Ab and thyroxine (T4) of mothers and neonates were measured after delivery. Breast milk was collected f rom the stomachs of neonatal mice to determine the TSHR-Ab levels. The positive rate of serum TSHR-Ab (>0.3 IU/l) in the TSHR group was 99% (89/90) and 0% in the sham group. The mother mice in the TSHR group had elevated serum T4 levels and the thyroid pathological features of Graves' hyperthyroidism.GD mice gave birth to smaller newborns with thyroid pathological changes and higher serum levels of TSHR-Ab and T4, compared to the offspring in the sham group. The TSHR-Ab levels in breast milk from the GD mice declined with time. Mice immunized with Ad-TSHR exhibited the clinicopathological features of human GD and give birth to neonates with thyroid disease at birth. PMID:34603521 | PMC:PMC8453324 | DOI:10.3892/etm.2021.10688 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

MicroRNA-34a directly targets high-mobility group box 1 and inhibits the cancer cell proliferation, migration and invasion in cutaneous squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader MicroRNA-34a directly targets high-mobility group box 1 and inhibits the cancer cell proliferation, migration and invasion in cutaneous squamous cell carcinoma Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1257. doi: 10.3892/etm.2021.10692. Epub 2021 Sep 3. ABSTRACT [This retracts the article DOI: 10.3892/etm.2017.5245.]. PMID:34603525 | PMC:PMC8453323 | DOI:10.3892/etm.2021.10692 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The added value of three-dimensional ultrasonography in uterine pathology

xlomafota13 shared this article with you from Inoreader The added value of three-dimensional ultrasonography in uterine pathology Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1261. doi: 10.3892/etm.2021.10696. Epub 2021 Sep 6. ABSTRACT The rapid development achieved over the last decades in volume rendering of ultrasound data, known as three-dimensional (3D) ultrasound technique, leads to new opportunities for refining the diagnosis in many gynaecologic conditions. The aim of the present study was to evaluate the advantages of 3D ultrasound over two-dimensional (2D) ultrasound in uterine pathology and to establish the optimal time point during the menstrual cycle to perform 3D ultrasound examination in order to achieve the maximum of useful information. A cross-sectional study on 200 patients who underwent gynaecologic 2D and 3D ultrasound examinations was performed. The addition of 3D examination to 2D ultrasound in uterine pathology provided the most useful information concerning: Congenital uterine anomalies, intrauterine devices (IUDs), adenomyosis, and submucous myomas. The findings showed that the 3D ultrasound scan is a useful tool in gynaecology, especially in cases with congenital uterine anomalies, myoma, and IUD. Although initially it was used for research purposes only, recent findings suggest its usefulness in routine ultrasound scan and the possibility of witnessing its introduction as a recommended examination procedure in the foreseeable future. Further research should be conducted in order to establish the sensitivity of 3D ultrasound in the detection of minor endometrial conditions, by correlating the imaging findings with the hysteroscopic results. PMID:34603529 | PMC:PMC8453339 | DOI:10.3892/etm.2021.10696 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Construction of a new cervical anatomically adaptive titanium mesh cage based on measurements of cervical geometry: A morphological and cadaveric study

xlomafota13 shared this article with you from Inoreader Construction of a new cervical anatomically adaptive titanium mesh cage based on measurements of cervical geometry: A morphological and cadaveric study Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1256. doi: 10.3892/etm.2021.10691. Epub 2021 Sep 3. ABSTRACT Mismatch between the titanium mesh cage and cervical geometries is an important factor that induces subsidence in anterior cervical corpectomy and fusion (ACCF). The aim of the present study was to construct a new quadrate anatomically adaptive titanium mesh cage (AA-TMC) that matches well with the cervical geometries and segmental alignment in one- and two-level ACCF. Computed tomography (CT) scans of 54 individuals were used to measure the cervical endplate geometries. X-rays of 74 young individuals were used to measure the intervertebral body angle (IBA) and intervertebral body height (IBH) of the surgical segments. The AA-TMC was designed based on these measured parameters. A total of 18 cervical cadaveric specimens underwent successive one- and two-level ACCF using the AA-TMC. Postoperatively, the specimens underwent CT scanning to assess the degree of matching of the TMC-endplate interface (TEI), IBA and IBH. A TEI interval <0.5 mm was considered well matching. In the sagittal plane, 93.8% of the inferior endplates were arched, whereas 94.8% of the superior endplates were flat. In the coronal plane, 82.9% of the inferior endplates and 93.8% of the superior endplates were flat. A total of 91.7 and 94.4% of the TEIs were well matched in one- and two-level ACCF, respectively. The postoperative IBA and IBH values were consistent with the values of young individuals. The AA-TMC achieved good matching with cervical geometries and segmental alignment in one- and two-level ACCF, and is proposed for use in ACCF to increase the contact at the TEI and achieve sufficient lordosis restoration. PMID:34603524 | PMC:PMC8453342 | DOI:10.3892/etm.2021.10691 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Biological therapies targeting the type 2 inflammatory pathway in severe asthma (Review)

xlomafota13 shared this article with you from Inoreader Biological therapies targeting the type 2 inflammatory pathway in severe asthma (Review) Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1263. doi: 10.3892/etm.2021.10698. Epub 2021 Sep 6. ABSTRACT Asthma is a variable chronic respiratory disease characterized by airway inflammation and hyperresponsiveness, bronchoconstriction, and mucus hypersecretion. While most patients with asthma achieve good control of the disease, 5-10% experience severe symptoms and recurrent exacerbation despite the maximal offered therapy with inhaled corticosteroids and long acting bronchodilators. In previous years, novel biological therapies have become available, and various asthma phenotypes that are characterized by specific biomarkers have been identified. Currently approved biological agents target inflammatory molecules of the type 2 inflammatory pathway, and are effective at decreasing the frequency of asthma attacks, controlling symptoms and decreasing use of systemic steroids. The present study reviewed the effectiveness and safety profile of the curren tly approved biological drugs and provided an overview of the assessment of patients with severe asthma who are potentially suitable for biological therapy, in order to help clinicians to select the most appropriate biological agent. PMID:34603531 | PMC:PMC8453334 | DOI:10.3892/etm.2021.10698 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Kikuchi-Fujimoto Disease Associated With Mycoplasma Pneumoniae Infection

xlomafota13 shared this article with you from Inoreader Kikuchi-Fujimoto Disease Associated With Mycoplasma Pneumoniae Infection Via ear nose throat Ear Nose Throat J. 2021 Oct 2:1455613211044225. doi: 10.1177/01455613211044225. Online ahead of print. ABSTRACT Kikuchi-Fujimoto disease (KFD) is a self-limited disease that is more common in young Asian women. Typical presentations included fever and cervical lymphadenopathy. The etiology of KFD is unknown, and diagnosis is based mainly on lymph node biopsy. KFD has been reported to be associated with Mycoplasma pneumoniae infection. However, the role of antibiotic t reatment is unclear. We reported 2 cases of KFD associated with Mycoplasma pneumoniae infection and were successfully treated with a macrolide. PMID:34605286 | DOI:10.1177/01455613211044225 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.