Phonation Resistance Training Exercises (PhoRTE) With and Without Expiratory Muscle Strength Training (EMST) For Patients With Presbyphonia: A Noninferiority Randomized Clinical Trial

xlomafota13 shared this article with you from Inoreader Phonation Resistance Training Exercises (PhoRTE) With and Without Expiratory Muscle Strength Training (EMST) For Patients With Presbyphonia: A Noninferiority Randomized Clinical Trial Via swallowing exercises J Voice. 2021 Mar 16:S0892-1997(21)00077-1. doi: 10.1016/j.jvoice.2021.02.015. Online ahead of print. ABSTRACT OBJECTIVES: Presbyphonia negatively impacts quality of life in patients with age-related voice changes. A proof-of-concept study showed promise for high vocal intensity exercise to treat presbyphonia, which became the basis for a novel intervention for age-related voice changes known as Phonation Resistance Training Exercises (PhoRTE). Expiratory Muscle Strength Training ( EMST) has also been proposed as an additional intervention to target and strengthen the aging respiratory system; however, EMST has undergone limited evaluation as an adjunct treatment for elderly patients undergoing voice therapy for presbyphonia. This study determined if the addition of EMST to PhoRTE voice therapy (PhoRTE + EMST) is at least as effective at voice improvement as PhoRTE alone. STUDY DESIGN: Prospective, randomized, controlled, single-blinded, non-inferiority. MATERIALS AND METHODS: Participants aged 55 years or older with a diagnosis of vocal fold atrophy were randomized to complete PhoRTE therapy or PhoRTE + EMST. The primary outcome was change in Voice Handicap Index-10 (VHI-10). Secondary outcomes included the Aging Voice Index, maximum expiratory pressure, and acoustic and aerodynamic measures of voice. Repeated measures linear mixed models were constructed to analyze outcomes at a significance level of α = 0.10. RESULTS: Twenty-six participa nts were recruited for the study, and 24 participants were randomized to either treatment arm. Sixteen participants completed the entire study. Both treatment arms showed statistically significant and clinically meaningful improvements in VHI-10 (PhoRTE mean [M] = -8.20, P < 0.001; PhoRTE + EMST M = -9.58, P < 0.001), and PhoRTE + EMST was noninferior to PhoRTE alone (P = 0.069). Both groups experienced a statistically significant pre-post treatment decrease (improvement) in AVI scores (PhoRTE M = -18.40, P = 0.004; PhoRTE + EMST M = -16.28, P = 0.005). PhoRTE+EMST had statistically significantly greater changes in maximum expiratory pressure compared to PhoRTE alone (PhoRTE M = 8.24 cm H2O, PhoRTE + EMST M = 32.63 cm H2O; P= 0.015). Some secondary acoustic and aerodynamic outcomes displayed trends toward improvement. CONCLUSION: This study demonstrates that voice therapy targeting high vocal intensity exercise (eg, PhoRTE) and EMST can play a role in improving voice outcomes for patients with presbyphonia. PMID:33741235 | DOI:10.1016/j.jvoice.2021.02.015 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

We must respect the anti-SARS-CoV-2 vaccine schedule without delay in cancer patients under treatment

xlomafota13 shared this article with you from Inoreader We must respect the anti-SARS-CoV-2 vaccine schedule without delay in cancer patients under treatment Via Association française pour l'étude du cancer Bull Cancer. 2021 Mar 5:S0007-4551(21)00073-4. doi: 10.1016/j.bulcan.2021.02.003. Online ahead of print. NO ABSTRACT PMID:33741139 | DOI:10.1016/j.bulcan.2021.02.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tumor-host interface in oral squamous cell carcinoma: Impact on nodal metastasis and prognosis

xlomafota13 shared this article with you from Inoreader Tumor-host interface in oral squamous cell carcinoma: Impact on nodal metastasis and prognosis 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. 2021 Mar 20. doi: 10.1007/s00405-021-06756-y. Online ahead of print. ABSTRACT PURPOSE: To evaluate tumor-host interface in oral squamous cell carcinoma (OSCC) by the Brandwein-Gensler histological risk score (BG risk score); to assess its association with clinicopathological features and impact on survival outcomes in a contemporary cohort staged as per AJCC 8th edition pTNM classification. METHODS: This retrospective cohort study at a tertiary care centre included 178 cases of OSCC treated by primary surgical resection from 2013 to 2016. Pathological lymph node status, disease-free survival (DFS), overall survival (OS) were assessed. RESULTS: BG risk score assessment categorized 25 (14%) cases as low-risk, 93 (52%) as intermediate-risk, and 60 (34%) as high-risk. BG risk score category progression from low to intermediate to high risk was associated with an incremental risk of worsening pN status , DFS, and OS. BG risk score categories significantly demarcated 2-year DFS (96% in low-risk, 51.6% in intermediate-risk, 15% in high-risk; p < 0.001) and OS (96% in low-risk, 66.7% in intermediate-risk, 31.3% in high-risk; p < 0.001). On stratified analysis, BG risk score could further demarcate prognosis in early (I/II) and late (III/IV) stage subgroups (p < 0.001). Multivariate analysis indicated the prognostic impact of BG risk score categories to be additional to, and of equal magnitude to, impact of pTNM stage. CONCLUSIONS: BG risk score is a powerful prognostic tool in OSCC additional to pTNM staging. It can enable risk stratification and inform decisions regarding post-surgical adjuvant treatment. It is undertaken with routine histopathological evaluation, with no increased expense or turnaround time. A case is made for its inclusion in OSCC reporting guidelines. PMID:33743065 | DOI:10.1007/s00405-021-06756-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence and pubo-umbilical index of pyramidalis muscle in a select Kenyan population

xlomafota13 shared this article with you from Inoreader Prevalence and pubo-umbilical index of pyramidalis muscle in a select Kenyan population Via radiol anat Surg Radiol Anat. 2021 Mar 20. doi: 10.1007/s00276-021-02733-6. Online ahead of print. ABSTRACT PURPOSE: Pyramidalis is a lower anterior abdominal wall muscle that is considered vestigial and shows variations in prevalence and size. It's been utilized as an anatomical landmark and harvested for use in various surgical procedures. Despite knowledge of its clinical importance, data on the prevalence of pyramidalis remain absent from the Kenyan population with few studies globa lly reporting on its pubo-umbilical index. We therefore aimed to determine the prevalence and relative lengths (pubo-umbilical index) of pyramidalis muscle in a sample Kenyan population. MATERIALS AND METHODS: Fifty-two cadavers (41 males, 11 females) from the Department of Human Anatomy, University of Nairobi were used. Prevalence and length of the muscle (l) were established, and the distance between pubic symphysis and umbilicus (L) measured and used to calculate pubo-umbilical index (l/L ×100%). Independent and paired T tests were done, using SPSS® version 22. A p value of ≤ 0.05 was considered statistically significant at a 95% confidence interval. RESULTS: Pyramidalis was present in 84% (44) of cadavers; 83% (43) bilaterally, 2% (1) unilaterally, and 85.4% (35) in males, 81.8% (9) in females. Mean length in males and females was 71.8 ± 35 mm and 63.5 ± 37.5 mm, respectively. Mean pubo-umbilical index was 38% ± 18 (39 % ± 18 males, 35% ± 19 females). No sta tistically significant difference was found. CONCLUSION: Pyramidalis is a highly prevalent muscle in the Kenyan population and, hence, could be exploited for its clinical and surgical utilities. The muscle terminates largely within the 2nd quarter (25-50%) of the infra-umbilical linea alba measured from pubic symphysis. Its pubo-umbilical index would be useful to surgeons making midline infra-umbilical incisions and performing procedures involving the muscle. PMID:33743034 | DOI:10.1007/s00276-021-02733-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Propranolol versus nadolol for treatment of pediatric subglottic hemangioma,,,,,Nadolol is a non-selective β-adrenergic antagonist that lacks intrinsic sympathomimetic activity and membrane-stabilizing properties. Nadolol is two to four times more potent than propranolol. The drug reduces IOP when administered topically in a concentration of 0.3–2%160 or orally in a dose of 20–40 mg. Nadolol - an overview | ScienceDirect Topicswww.sciencedirect.com › topics › neuroscience › nadolol

xlomafota13 shared this article with you from Inoreader Message: Nadolol is a non-selective β-adrenergic antagonist that lacks intrinsic sympathomimetic activity and membrane-stabilizing properties. Nadolol is two to four times more potent than propranolol. The drug reduces IOP when administered topically in a concentration of 0.3–2%160 or orally in a dose of 20–40 mg. Nadolol - an overview | ScienceDirect Topicswww.sciencedirect.com › topics › neuroscience › nadolol Propranolol versus nadolol for treatment of pediatric subglottic hemangioma Via International Journal of Pediatric Otorhinolaryngology Publication date: Available online 21 March 2021 Source: International Journal of Pediatric Otorhinolaryngology Author(s): Weining Yang, Nikolaus E. Wolter, Sharon L. Cushing, Elena Pope, Jennifer K. Wolter, Evan J. Propst View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Propranolol versus nadolol for treatment of pediatric subglottic hemangioma

xlomafota13 shared this article with you from Inoreader Propranolol versus nadolol for treatment of pediatric subglottic hemangioma Via International Journal of Pediatric Otorhinolaryngology Publication date: Available online 21 March 2021 Source: International Journal of Pediatric Otorhinolaryngology Author(s): Weining Yang, Nikolaus E. Wolter, Sharon L. Cushing, Elena Pope, Jennifer K. Wolter, Evan J. Propst View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Immunotherapy for head and neck cancer: from recurrent/metastatic disease to (neo)adjuvant treatment in surgically resectable tumors

xlomafota13 shared this article with you from Inoreader Immunotherapy for head and neck cancer: from recurrent/metastatic disease to (neo)adjuvant treatment in surgically resectable tumors Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review We aim to summarize the current evidence on the role of immune checkpoint inhibitors in the (neo)adjuvant treatment of squamous cell carcinoma of the head and neck (HNSCC), with a particular focus on surgically treated patients. Recent findings Pembrolizumab +/– chemotherapy improves the outcome in patients with previously untreated recurrent/metastatic HNSCC. Nivolumab is superior to chemotherapy after platinum failure. The addition of avelumab to chemoradiation failed to improve the outcome in patients with locally advanced HNSCC. Neoadjuvant presurgical programmed cell death 1 receptor (PD-1) blockade is safe and associated with encouraging overall response rate. KEYNOTE-689 randomizes patients with resectable stage III/IVA HNSCC to surgery and adjuvant standard of care +/– neoadjuvant and adjuvant pembrolizumab. ADHERE assigns surgically treated HNSCC at high risk of recurrence to chemoradiotherapy (CRT) and either durvalumab or placebo. MK-3475–689 evaluates the role of pembrolizumab in patients with resectable HNSCC. NIVOPOSTOP evaluates the addition of nivolumab to CRT in patients with surgically treated pStage III/IV HNSCC or pT3N1/pT4N1 oropharyngeal cancer with at least 20 packs/year at high risk of relaps e. Summary Multiple trials are currently evaluating the role of immunotherapy in HNSCC amenable to surgery. Neoadjuvant presurgical PD-1 blockade is feasible and safe and is associated with an encouraging overall response rate. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.