Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study

xlomafota13 shared this article with you from Inoreader Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study Via Journal of Thyroid Research Introduction. Thyroid cancer is the third most common cancer that occurs in children and adolescents. Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Although the mortality rate of thyroid malignancy in children is usually low, the disease recurrence is higher in children with more severe clinical presentation than in adults. This study aimed to determine the demographic and clinicopathological characteristics and outcome of pediatric and adolescent patients with thyroid malignancy in Indonesia. Methods. The retrospective study included all patients diagnosed with thyroid carcinoma aged View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frontal Sinus Fractures

xlomafota13 shared this article with you from Inoreader Frontal Sinus Fractures Via leak of cerebrospinal fluid 2021 Dec 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. ABSTRACT Skull fractures are common injuries observed in the setting of both blunt and penetrating trauma. The frontal sinuses are located within the frontal bone, superior and medial to the orbits. The frontal sinuses begin developing around 5 to 6 years of age and become fully developed between the ages of 12 and 20. Sensation is provided by both the supraorbital and supratrochlear nerves, which are branches of the ophthalmic division of the trigeminal nerve (CN V1). The blood supply to the frontal sinuses comes from the supraorbital and supratrochlear arteries. The frontal sinuses consist of bony anterior and posterior tables (walls) and they drain inferiorly, medially, and posteriorly via the frontal recess into either the middle meatus or ethmoid infundibulum, depending on the attachment of the uncinate process of the ethmoid bone. If the un cinate process attaches to the lamina papyracea, the frontal sinus drains into the middle meatus via the semilunar hiatus. If the uncinate process attaches to the skull base or the middle turbinate, the frontal sinus drains into the ethmoid infundibulum before emptying into the middle meatus. The anterior border of the frontal recess is the posterior wall of the agger nasi air cell, while the posterior wall is formed by the ethmoid bulla. The medial wall of the frontal recess is the middle turbinate, and the lateral wall is the orbit. While the volume of the frontal sinus is extremely variable, the average size is approximately 10 mL; the sinus itself may be entirely absent in 0.8-7.4% of patients, unilaterally, and may be bilaterally absent in up to 5% of patients. Frontal cranial bones have a greater thickness than the more lateral temporal bones (6.15 cm in males, 7.13 cm in females compared to 4.33 cm and 4.41 cm, respectively). As a result, these fractures require a more forceful mechanism of injury than other facial bone fractures, occur less frequently than other forms of skull trauma, and often present with concurrent injuries. These other injuries include naso-orbito-ethmoid fractures, orbital injuries, cerebrospinal fluid (CSF) leak, intracranial hemorrhage, and cervical spine fractures, among others. The potential for other potentially devastating injuries to occur along with frontal sinus fractures makes a thorough evaluation of these patients imperative. Additionally, appropriate classification and indications for surgical repair of frontal sinus fractures remain controversial, resulting in a variety of management strategies. PMID:32491451 | Bookshelf:NBK557519 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frequency-specific prediction model of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss

xlomafota13 shared this article with you from Inoreader Frequency-specific prediction model of hearing outcomes in patients with idiopathic sudden sensorineural hearing loss Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Jan 11. doi: 10.1007/s00405-021-07246-x. Online ahead of print. ABSTRACT PURPOSE: The hearing outcome of idiopathic sudden sensorineural hearing loss (ISSNHL) is hard to predict. We herein constructed a multiple regression model for hearing outcomes in each frequency separately in an attempt to achieve practical prediction in ISSNHL. METHODS: We enrolled 235 consecutive in-patients with ISSNHL who were treated in our department from 2015 to 2020 (average hearing level at 250-4000 Hz ≥ 40 dB; time from onset to treatment ≤ 14 days; 126 males/109 females; age range 17-87 years (average 61.0 years)). All patients received systemic prednisolone administration combined with intratympanic dexamethasone injection. The pure-tone hearing threshold of 125-8000 Hz was measured at every octave before (HLpre) and after (HLpost) treatment. A multiple regression model was constructed for HLpost (dependent variable) using five explanatory variables (age, days from onset to treatment, presence of vertigo, HLpre, and hearing level of the contralateral ear). RESULTS: The multiple correlation coefficient increased as the frequency increased. Strong correlations were seen in high frequencies, with multiple correlation coefficients of 0.784/0.830 for 4000/8000 Hz. The width of the 70% prediction interval was narrower for 4000/8000 Hz (± 18.2/16.3 dB) than for low to mid-frequencies. Among the five explanatory variables, HLpre showed the largest partial correlation coefficient for any frequency. The partial correlation coefficient for HLpre increased as the frequency increased, which may partially explain the high multiple correlation coefficients for high frequencies. CONCLUSION: The present model would be of practical use for predicting hearing outcomes in high frequencies in patients with ISSNHL. PMID:35015092 | DOI:10.1007/s00405-021-07246-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cerebral Spinal Fluid Leak Disorders

xlomafota13 shared this article with you from Inoreader Cerebral Spinal Fluid Leak Disorders Via leak of cerebrospinal fluid 2021 Nov 15. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. ABSTRACT The cerebrospinal fluid (CSF) acts as a nourishing and protective layer surrounding the central nervous system. This protective cushion circulates within the ventricular system and the subarachnoid space around the brain and the spinal cord, which helps to provide the buoyancy to counteract various shear and stress encountered during the movement of the skull and vertebral column. In various disorders that present with CSF leak, the loss of this protective nutrient-rich layer can injure the function of the brain and the spinal cord. Such conditions might be associated with fractures in the skull base, congenital bony defects, or might be associated with raised intracranial pressure (ICP). It also predisposes the brain and spinal cord to the external environment increasing the risk of meningitis, ventriculitis, and arachnoiditis. The traditional concept of CSF formation, distribution, and absorption was previously based on the bulk flow model. However, this model seems inadequate to explain the pathophysiological mechanisms of various CSF flow-related disorders based on recent literature. The currently accepted CSF flow system comprises pulsatile CSF flow, lymphatic system, capillary exchange, and the traditional ventricular-cisternal system. According to the current understanding, the production of CSF is from multiple sources, primarily from the choroid plexus of the lateral and fourth ventricles. Apart from this, interstitial space, ependyma, and dural sleeves of the spinal nerve roots also contribute to the total CSF turnover. Similarly, CSF is absorbed in multiple sites, with dural venous sinuses being the major drainage site via arachnoid granulations followed by choroid plexus and glymphatic system. PMID:35015396 | Bookshelf:NBK576371 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevention and treatment of CSF leaks in congenital complex spinal lipomas

xlomafota13 shared this article with you from Inoreader Prevention and treatment of CSF leaks in congenital complex spinal lipomas Via leak of cerebrospinal fluid Acta Neurochir (Wien). 2022 Jan 11. doi: 10.1007/s00701-021-05095-5. Online ahead of print. ABSTRACT BACKGROUND: Congenital complex spinal lipomas (CSL) are challenging lesions to treat. Cerebrospinal fluid (CSF) leaks are feared complications due to the risk of infection, and subsequent scarring that may promote retethering. Much has been written in the literature on the surgical technique of CSL resection with less emphasis placed on the prevention and management of CSF leak. METHOD: The authors describe the nuances in the prevention and management of CSF leaks in the context of CSL, including the operative approach, resection, closure and recommended postoperative care. CONCLUSION: CSF leaks are complications that can be minimized with deliberate steps and meticulous surgical technique. PMID:35015155 | DOI:10.1007/s00701-021-05095-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New drug approval: Pembrolizumab in association with chemotherapy as first line treatment for advanced/metastatic oesophageal carcinomas or HERnegative gastroesophageal adenocarcinoma, expressing PD-L1 with a CPS≥10

xlomafota13 shared this article with you from Inoreader New drug approval: Pembrolizumab in association with chemotherapy as first line treatment for advanced/metastatic oesophageal carcinomas or HERnegative gastroesophageal adenocarcinoma, expressing PD-L1 with a CPS≥10 Via Association française pour l'étude du cancer Bull Cancer. 2022 Jan 5:S0007-4551(21)00575-0. doi: 10.1016/j.bulcan.2021.09.021. Online ahead of print. NO ABSTRACT PMID:34998526 | DOI:10.1016/j.bulcan.2021.09.021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cerebrospinal fluid leak repair: utility of intrathecal fluorescein for correct topographic identification of the skull base defects

xlomafota13 shared this article with you from Inoreader Cerebrospinal fluid leak repair: utility of intrathecal fluorescein for correct topographic identification of the skull base defects Via leak of cerebrospinal fluid World Neurosurg. 2022 Jan 6:S1878-8750(22)00007-9. doi: 10.1016/j.wneu.2022.01.004. Online ahead of print. ABSTRACT BACKGROUND: In the management of cerebrospinal fluid (CSF) leak the identification of the exact discharge spot is paramount. This can represent a challenge for the radiologist and the surgeon. In the present study, we analyzed a series of patients affected by endonasal CSF leak who underwent endoscopic surgical reconstruction aided by the use of intrathecal fluorescein (ITF). The purpose of this work is to assess the efficacy of intraoperative ITF in addition to computed tomography (CT) scan and magnetic resonance imaging (MRI) for correct topographic localization of the CSF leak. METHODS: Eighty-three patients were enrolled in the study. The main outcome was the concordance between the supposed radiological defect site and the actual one seen intraoperatively. The recurrence free survival (RFS) was evaluated as secondary outcome. RESULTS: ITF better defined the defect site allowing a change in the treatment in 21 cases (25.3%), in which a non-concordance was observed between the suspected radiological site and the actual surgical one. Good agreement was found between the specific topographic localization (k=0.737, p<0.0001), whereas fair agreement was observed considering the side of the defect (k=0.362, p=0.0009) and correct identification of multiple sites (k=0.044, p=0.666). The 10-year 96% estimate of RFS confirmed the correct repair of the fistula site in most of the cases. CONCLUSIONS: Our data demonstrate the utility and safety of intraoperative ITF for management of patients affected by endonasal CSF leak. ITF improved the topographical diagnosis of the leak site, ensuring the best target reconstruction and very low recurrence rate. PMID:34999266 | DOI:10.1016/j.wneu.2022.01.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.