Assessment of the Use of Humidified Nasal Cannulas for Oxygen Therapy in Patients with Epistaxis

xlomafota13 shared this article with you from Inoreader Assessment of the Use of Humidified Nasal Cannulas for Oxygen Therapy in Patients with Epistaxis Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: In China, nasal cannula oxygen therapy is typically humidified. However, it is difficult to decide whether to suspend nasal cannula oxygen inhalation after the nosebleed has temporarily stopped. Therefore, we conducted a preliminary investigation on whether the use of humidified nasal cannulas in our hospital increases the incidence of epistaxis. Methods: We conducted a survey of 176,058 inpatients in our hospital and other city branches of our hospit al over the past 3 years and obtained information concerning their use of humidified nasal cannulas for oxygen inhalation, nonhumidified nasal cannulas, anticoagulant and antiplatelet drugs, and oxygen inhalation flow rates. This information was compared with the data collected at consultation for epistaxis during these 3 years. Results: No significant difference was found between inpatients with humidified nasal cannulas and those without nasal cannula oxygen therapy in the incidence of consultations due to epistaxis (χ2 = 1.007, p #x3e; 0.05). The same trend was observed among hospitalized patients using anticoagulant and antiplatelet drugs (χ2 = 2.082, p #x3e; 0.05). Among the patients with an inhaled oxygen flow rate ≥5 L/min, the incidence of ear-nose-throat (ENT) consultations due to epistaxis was 0. No statistically significant difference was found between inpatients with a humidified oxygen inhalation flow rate #x3c;5 L/m in and those without nasal cannula oxygen therapy in the incidence of ENT consultations due to epistaxis (χ2 = 0.838, p #x3e; 0.05). A statistically significant difference was observed in the incidence of ENT consultations due to epistaxis between the low-flow nonhumidified nasal cannula and nonnasal cannula oxygen inhalation groups (χ2 = 18.428, p #x3c; 0.001). The same trend was observed between the 2 groups of low-flow humidified and low-flow nonhumidified nasal cannula oxygen inhalation (χ2 = 26.194, p #x3c; 0.001). Discussion/Conclusion: Neither high-flow humidified nasal cannula oxygen inhalation nor low-flow humidified nasal cannula oxygen inhalation will increase the incidence of recurrent or serious epistaxis complications; the same trend was observed for patients who use anticoagulant and antiplatelet drugs. Humidification during low-flow nasal cannula oxygen inhalation can prevent severe and repeated e pistaxis to a certain extent. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome

xlomafota13 shared this article with you from Inoreader Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome Via leak of cerebrospinal fluid Cureus. 2021 Jun 18;13(6):e15733. doi: 10.7759/cureus.15733. eCollection 2021 Jun. ABSTRACT Introduction Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of largely benign intraspinal neoplasms. These are amenable to gross total excision and usually carry a good functional outcome. Methods In this study, we reviewed the surgical outcomes of 35 patients who underwent excision of intradural extramedullary tumors. Patient demographics, severity and duration of symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were collected. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel and Nurick grading. The back pain was assessed with help of the Denis pain scale (DPS). Results The histopathological outcomes of the study were as follows: six patients of neurofibroma, 12 cases of s chwannoma, nine cases of meningiomas, three cases of ependymoma, one case of dorsal neurenteric cyst, two cases of epidermoid cyst, one case of cauda equina paraganglioma, and one case of filum terminale dermoid cyst. Paresthesia/numbness were the commonest symptoms (88.6%), weakness of limbs in (80%), sphincter dysfunction in 15 patients (42.9%), and paraplegia was seen in three patients (8.57%). The complications encountered were - one case each of cerebrospinal fluid (CSF) leak, surgical site infection, and pseudomeningocele. The percentage of spinal canal occupied ranged from 71-94%. The mean percentage of the spinal canal occupied by the tumor was 81.8%. In our series, 77.14% of patients (p<0.0001) had good functional outcomes as per improvement in Frankel score. The DPS and Nurick score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significant functional improvement was noted at the one-week, one-month, and on e-year follow-up, with a p-value of <0.0001. Conclusions The IDEM tumors are usually benign and are readily detected by contrast-enhanced MRI scans. These have excellent surgical outcomes with some exceptions. Greater canal occupancy and a longer duration of symptoms are usually seen to correspond with suboptimal functional outcomes. PMID:34285844 | PMC:PMC8286542 | DOI:10.7759/cureus.15733 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Facial Paresis and Pulsatile Middle Ear Mass

xlomafota13 shared this article with you from Inoreader Facial Paresis and Pulsatile Middle Ear Mass Via ear nose throat Ear Nose Throat J. 2021 Jul 21:1455613211031510. doi: 10.1177/01455613211031510. Online ahead of print. ABSTRACT Head and neck paragangliomas are uncommon pathologies that present with common symptoms such as pulsatile tinnitus and aural pressure. This article highlights an unusual presentation of a patient with facial paresis who was found to have a jugular paraganglioma. Emphasis is placed on how the otologic examination showed a pulsatile middle ear mass that led to the d iagnosis. This case illustrates the importance of maintaining a healthy degree of clinical suspicion when encountering common complaints. PMID:34284609 | DOI:10.1177/01455613211031510 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle Ear Adenomatous Neuroendocrine Tumor: A Rare Entity

xlomafota13 shared this article with you from Inoreader Middle Ear Adenomatous Neuroendocrine Tumor: A Rare Entity Via ear nose throat Ear Nose Throat J. 2021 Jul 21:1455613211029785. doi: 10.1177/01455613211029785. Online ahead of print. ABSTRACT Middle ear adenomatous neuroendocrine tumors (MEANT) are rare, mainly benign neoplasms and account for less than 2% of the middle and inner ear neoplasms. There are no specific radiological or clinical findings; therefore, the diagnosis is often difficult. Biopsy prior to surgery is often proposed. The definite treatment is the complete surgical resection. We pres ent an uncommon clinical report of a MEANT, which was treated successfully with surgical excision. PMID:34284607 | DOI:10.1177/01455613211029785 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Lidcombe Program for Early Stuttering in Non-English-Speaking Countries: A Systematic Review

xlomafota13 shared this article with you from Inoreader The Lidcombe Program for Early Stuttering in Non-English-Speaking Countries: A Systematic Review Via Folia Phoniatrica et Logopaedica Background: The Lidcombe Program is a stuttering treatment approach for children between the ages of 3 and 6 years. Most papers about the Lidcombe Program, however, are based on studies conducted in native English-speaking countries. The aim of this paper is to systematically review the delivery and implementation of the Lidcombe Program in non-native English-speaking countries. Summary: A resource search was conducted between October and November 2019. Scopus, Pu bMed, ASHA, Cochrane Library, ERIC, Google Scholar, and SpeechBITE databases and reference lists of relevant papers were searched for the identification process. Joanna Briggs Institute tools were used for the appraisal of the studies. The search yielded 8 studies conducted in non-native English-speaking countries. The Lidcombe Program is efficacious in non-native English-speaking countries when delivered to both preschool and young school age children who stutter. It is reported to be delivered with minor changes and challenges. The number of weekly clinic visits and the total time needed to reach zero or near-zero stuttering levels with the Lidcombe Program can be up to 3 times greater in non-native English-speaking countries than in native English-speaking countries, mostly due to the increased time needed to introduce the parental verbal contingencies. Key Messages: Speech and language therapists practicing in non-native English-speaking countries are encouraged to use the Lidcombe Program for both preschool and young school age children who stutter, although this can take more time than that reported in native English-speaking countries. Further investigation to explore the therapy process with children and parents in non-native English-speaking countries is needed. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

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.