Initial Experience with Proton Beam Therapy for Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Initial Experience with Proton Beam Therapy for Differentiated Thyroid Cancer Via radioactive iodine Int J Part Ther. 2021 Jun 25;8(1):311-318. doi: 10.14338/IJPT-D-20-00053. eCollection 2021 Summer. ABSTRACT PURPOSE: External beam radiotherapy is used in a subset of high-risk patients with differentiated thyroid cancer (DTC). Recurrent, radioactive iodine (RAI)-refractory DTC carries a poor prognosis. We report our initial experience of intensity-modulated proton therapy (IMPT) for recurrent, RAI-refractory DTC. PATIENTS AND METHODS: Fourteen patients with recurrent, RAI-re fractory DTC were consecutively treated with IMPT from November 2016 to March 2020 at our multisite institution. Patient, tumor, and treatment characteristics were recorded. Overall survival and local-regional recurrence-free survival were recorded and estimated using the Kaplan-Meier method. Acute and late treatment-related toxicities were recorded based on the Common Terminology Criteria for Adverse Events version 5.0. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Head and Neck Module at baseline and after IMPT. Eleven patients were included in the final analysis. RESULTS: Median follow-up was 8 months (range, 3-40) for all patients. Median age at treatment with IMPT was 64 years (range, 40-77), and the majority were men (64%). Recurrent histologies included papillary (55%), Hurthle cell (36%), and poorly differentiated (9%) carcinoma; 1 patient had tall cell variant. Concurrent chemotherapy was not administered for any pat ient in this cohort. At 8 months, all patients were alive without local-regional failure. Acute grade 3 toxicities were limited to 1 patient with dysphagia, requiring feeding tube placement. Two patients experienced late grade 3 esophageal stenosis requiring dilation. There were no grade 4 or 5 toxicities. There were no differences in pretreatment versus posttreatment patient-reported outcomes in terms of dysphagia or hoarseness. CONCLUSION: In our early experience, IMPT provided promising local-regional control for recurrent, RAI-refractory DTC. Further study is warranted to evaluate the long-term efficacy and safety of IMPT in this patient population. PMID:34285957 | PMC:PMC8270099 | DOI:10.14338/IJPT-D-20-00053 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultrasound-guided implantation of radioactive (125)I seed in radioiodine refractory differentiated thyroid carcinoma

xlomafota13 shared this article with you from Inoreader Ultrasound-guided implantation of radioactive (125)I seed in radioiodine refractory differentiated thyroid carcinoma Via radioactive iodine BMC Cancer. 2021 Jul 20;21(1):834. doi: 10.1186/s12885-021-08500-5. ABSTRACT BACKGROUND: Treatment for radioiodine refractory differentiated thyroid carcinoma (RR-DTC) is challenging. The purpose of this study was to assess the efficacy and safety of ultrasound-guided implantation of radioactive 125I-seed in radioiodine refractory differentiated thyroid carcinoma. METHODS: Thirty-six cervical metastatic lymph nodes (CMLNs) diagnosed with RR-DTC from 18 patients wer e enrolled in this retrospective study. US and contrast-enhanced ultrasound (CEUS) examinations were performed before implantation. Follow-up comprised US, CEUS, thyroglobulin (Tg) level and routine hematology at 1-3, 6, 9 and 12 months and every 6 months thereafter. The volumes of the nodules were compared before implantation and at each follow-up point. The volume reduction rate (VRR) of nodules was also recorded. RESULTS: The median volume of the nodules was 523 mm3 (148, 2010mm3) initially, which decreased significantly to 53mm3 (0, 286mm3) (P < 0.01) at the follow-up point of 24 months with a median VRR as 95% (86,100%). During the follow-up period (the range was 24-50 months), 25 (69%) nodules had VRR greater than 90%, of which 12 (33%) nodules had VVR ≈ 100% with unclear structures and only 125I seed images were visible in the US. At the last follow-up visit, the serum Tg level decreased from 57.0 (8.6, 114.8) ng/ml to 4.9 (0.7, 50.3) ng/ml, (P < 0.01). CONCLUSION: US-guided 125I seed implantation is safety and efficacy in treating RR- DTC. It could be an effective supplement for the comprehensive treatment of thyroid cancer. PMID:34284748 | DOI:10.1186/s12885-021-08500-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Marios Loukas, R. Shane Tubbs Peter Abrahams, Stephen Carmichael, Thomas Gest: Gray's Anatomy review 3rd edition : Academic Press, Elsevier Inc, 2022, ISBN: 978-0-323-63,916-3, 544 pp

xlomafota13 shared this article with you from Inoreader Marios Loukas, R. Shane Tubbs Peter Abrahams, Stephen Carmichael, Thomas Gest: Gray's Anatomy review 3rd edition : Academic Press, Elsevier Inc, 2022, ISBN: 978-0-323-63,916-3, 544 pp Via radiol anat Surg Radiol Anat. 2021 Jul 20. doi: 10.1007/s00276-021-02798-3. Online ahead of print. NO ABSTRACT PMID:34286372 | DOI:10.1007/s00276-021-02798-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Paramassetric Subcutaneous Dirofilariasis: A Rare Entity

xlomafota13 shared this article with you from Inoreader Paramassetric Subcutaneous Dirofilariasis: A Rare Entity Via Otolaryngology Indian Abstract Dirofilariasis is an uncommon zoonotic parasitic infection affecting humans due to the bite of a mosquito vector. It is an endemic caused by Dirofilaria which is characterized in humans as nodules in lungs, subcutaneous tissue, peritoneal cavity, eyes. We present a case of Dirofilariasis with subcutaneous presentation in paramassetric region. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vestibular Hypersensitivity in Patients with Chronic Noise Exposure

xlomafota13 shared this article with you from Inoreader Vestibular Hypersensitivity in Patients with Chronic Noise Exposure Via Otolaryngology Indian Abstract It has been demonstrated that high-intensity noise exposure adversely affects the human balance function. The Tullio phenomenon (TP) refers to sound-induced imbalance which is resulted from hypersensitivity of vestibular end organs to normal acoustic stimuli. Although different etiologies have been attributed to TP, evidence on the role of excessive noise exposure in the development of this symptom is limited. The present study aims to assess the vestibular functions in patients manifesting TP symptom who were exposed to long-term excessive noise levels. This was an analytic cross-sectional study conducted on 17 males diagnosed with TP with a history of chronic noise-induced hearing loss (TP group) and 17 healthy individuals. All subjects in both groups underwent complete otological, videonystagmography (VNG), and cervical vestibular myogenic potential (cVEMP) assessments. The most common complaint in TP subjects was vertigo and imbalance. During the VNG assessme nt, we found abnormal positional nystagmus and caloric irrigation (vestibular hyperfunction) results in 4 (23.53%) and 9 (52.94%) patients, respectively. Seven (41.17%) patients indicated cVEMP thresholds which were abnormally lower than the normal values ( ≤ 70 dB HL). However, when both VNG and cVEMP results were considered together, the abnormal rate reached 70.58% (12 of 17 cases). Our findings showed that both the semicircular canal as well as otolith stuctures could be affected in TP patients with a history of chronic noise exposure. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endotracheal Intubation with Laryngeal Mirror in Simulated Difficult Direct Laryngoscopy: Comparison of Gum Elastic Bougie Versus Styleted Endotracheal Tube

xlomafota13 shared this article with you from Inoreader Endotracheal Intubation with Laryngeal Mirror in Simulated Difficult Direct Laryngoscopy: Comparison of Gum Elastic Bougie Versus Styleted Endotracheal Tube Via Otolaryngology Indian Abstract Laryngeal mirror (LM) is an inexpensive, portable, readily available device which can help visualize the vocal cords in difficult airway (DA) situations. We evaluated its use in improving glottic view prior to placing the airway adjuncts in simulated difficult airway.Eighty patients scheduled to undergo elective surgery under general anaesthesia with endotracheal intubation were allocated- Bougie group (Group B) and Stylet group (Group S). Direct laryngoscopy was performed and CL grade III simulated. The glottic view was obtained using laryngeal mirror and Gum Elastic Bougie (GEB)/ Styleted Endotracheal Tube (ETT) inserted under mirror view. Time taken to obtain glottic view in LM and time for successful intubation were noted.Significant improvement in glottic view with LM was observed, with the view improving to Grade I in 76.25% and grade II in 23.75% of patients. Both groups were comparable with respect to number of attempts and success rate (p =  0.55).The success rate was 90% in group B and 95% in group S. Time taken for intubation was less in Group S (52.44 ± 14.23 s vs. 62.805 ± 20.74 s) [p = 0.01]. Hence, overall stylet proved to be a better adjunct with mirror guided intubation.We recommend stylet assisted rather than GEB assisted ET intubation under LM guidance in emergency scenarios. Also, further controlled trials are recommended to know the exact location of the mirror in relation to bulb of the laryngoscope as well as different angles at which it is placed to improve the view and stabilize the assembly. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Future Solutions for Voice Rehabilitation in Laryngectomees: A Review of Technologies Based on Electrophysiological Signals

xlomafota13 shared this article with you from Inoreader Future Solutions for Voice Rehabilitation in Laryngectomees: A Review of Technologies Based on Electrophysiological Signals Via Otolaryngology Indian Abstract Loss of voice is a serious concern for a laryngectomee which should be addressed prior to planning the procedure. Voice rehabilitation options must be educated before the surgery. Even though many devices have been in use, each device has got its limitations. We are searching for probable future technologies for voice rehabilitation in laryngectomees and to familiarise with the ENT fraternity. We performed a bibliographic search using title/abstract searches and Medical Subject Headings (MeSHs) where appropriate, of the Medline, CINAHL, EMBASE, Web of Science and Google scholars for publications from January 1985 to January 2020. The obtained results with scope for the development of a device for speech rehabilitation were included in the review. A total of 1036 articles were identified and screened. After careful scrutining 40 articles have been included in this study. Silent speech interface is one of the topics which is extensively being studied. It is based o n various electrophysiological biosignals like non-audible murmur, electromyography, ultrasound characteristics of vocal folds and optical imaging of lips and tongue, electro articulography and electroencephalography. Electromyographic signals have been studied in laryngectomised patients. Silent speech interface may be the answer for the future of voice rehabilitation in laryngectomees. However, all these technologies are in their primitive stages and are potential in conforming into a speech device. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.