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.

Longitudinal assessment of anti-SARS-CoV-2 immune responses for six months based on the clinical severity of COVID-19

alkiviadis.1961 shared this article with you from Inoreader Longitudinal assessment of anti-SARS-CoV-2 immune responses for six months based on the clinical severity of COVID-19 Via Journal of Infectious Diseases - Advance Access Abstract There is insufficient data on the longevity of immunity acquired following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We aimed to evaluate the duration of SARS-CoV-2-specific humoral and cellular immunity according to the clinical severity of coronavirus disease 2019 (COVID-19). The study population comprised asymptomatic (n=14), symptomatic/non-pneumonic (n=42), and pneumonic (n=41) patients. The anti-SARS-CoV-2 IgG and neutralizing antibody (NAb) titers lasted until six mont hs after diagnosis, with positivity rates of 66.7% and 86.9%, respectively. Older age, prolonged viral shedding and accompanying pneumonia were more frequently found in patients with sustained humoral immunity. SARS-CoV-2 specific T-cell response was strongly observed in pneumonic patients and prominent in individuals with sustained humoral immunity. In conclusion, most (> 85%) patients carries NAb until six months after diagnosis of SARS-CoV-2 infection, providing insights for establishing vaccination strategies against COVID-19. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sex differences in the evolution of neutralizing antibodies to SARS-CoV-2

alkiviadis.1961 shared this article with you from Inoreader Sex differences in the evolution of neutralizing antibodies to SARS-CoV-2 Via Journal of Infectious Diseases - Advance Access Abstract We measured Anti-Spike (S), Nucleoprotein (N) and neutralizing antibodies (NAbs) in sera from 308 RT-qPCR + healthcare workers with mild disease, collected at two time-points up to 6 months after symptom onset. At Month 1 (M1), anti-S and N antibody levels were higher in males > 50 years or with a body mass index (BMI) > 25. At M3-6, anti-S and anti-N antibodies were detected in 99% and 59% of individuals, respectively. Anti-S antibodies and NAbs declined faster in males than in females, independently of age and BMI, suggesting an association of sex with evolution of the humoral response. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Shedding of culturable virus, seroconversion, and 6-month follow-up antibody responses in the first 14 confirmed cases of COVID-19 in the United States

alkiviadis.1961 shared this article with you from Inoreader Shedding of culturable virus, seroconversion, and 6-month follow-up antibody responses in the first 14 confirmed cases of COVID-19 in the United States Via Journal of Infectious Diseases - Advance Access Abstract We aimed to characterize presence of culturable virus in clinical specimens during acute illness, and antibody kinetics up to six months post-onset, among 14 early US COVID-19 patients. We isolated viable SARS-CoV-2 from rRT-PCR-positive respiratory specimens collected during days 0-8 post-onset, but not after. All 13 patients with two or more serum specimens developed anti-spike antibodies; 12 developed detectable neutralizing antibodies. We did not isolate virus after detection of neutralizing antibodie s. Eight participants provided serum at six months post-onset; all retained detectable anti-spike IgG, and half had detectable neutralizing antibodies. Two participants reported not feeling fully recovered at six months. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.