Myxedema Psychosis after Levothyroxine Withdrawal in Radioactive Iodine Treatment of Differentiated Thyroid Cancer: A Case Report

xlomafota13 shared this article with you from Inoreader Myxedema Psychosis after Levothyroxine Withdrawal in Radioactive Iodine Treatment of Differentiated Thyroid Cancer: A Case Report Via radioactive iodine Case Rep Oncol. 2021 Nov 8;14(3):1596-1600. doi: 10.1159/000520128. eCollection 2021 Sep-Dec. ABSTRACT Neuropsychiatric symptoms, especially acute psychosis (often referred to as myxedema madness or psychosis), are rare but possible clinical presentations of patients with hypothyroidism. A 42-year-old woman with papillary thyroid carcinoma and recent total thyroidectomy had developed flat affect, paranoid delusion, and visual and auditory hallucination during inpatient admission fo r elective radioactive iodine treatment. On admission, her history and physical exam did not reveal symptoms and signs of significant hypothyroidism. Other medical causes of acute psychosis were excluded, and the patient was immediately treated with thyroid hormone replacement therapy. Subsequently, her thyroid function normalized, and her psychotic symptoms gradually improved. Although there is a lack of classic signs and symptoms of hypothyroidism, myxedema madness should be recognized as one of the potentially treatable causes of acute psychosis. PMID:34950002 | PMC:PMC8647114 | DOI:10.1159/000520128 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incidence of Spinal CSF Leakage on CT Myelography in Patients with Nontraumatic Intracranial Subdural Hematoma

xlomafota13 shared this article with you from Inoreader Incidence of Spinal CSF Leakage on CT Myelography in Patients with Nontraumatic Intracranial Subdural Hematoma Via leak of cerebrospinal fluid Diagnostics (Basel). 2021 Dec 6;11(12):2278. doi: 10.3390/diagnostics11122278. ABSTRACT The aim of the present study was to demonstrate the incidence of spinal cerebrospinal fluid (CSF) leaks in patients with nontraumatic intracranial subdural hematoma (SDH) and determine clinical parameters favoring such leaks. This retrospective study was approved by the institutional review board. Patients diagnosed with nontraumatic intracranial SDH who underwent computed tomography (CT) myelography between January 2012 and March 2018 were selected. 60 patients (male: female, 39:21; age range, 20-82 years) were enrolled and divided into CSF leak-positive and CSF leak-negative groups according to CT myelography data. Clinical findings were statistically compared between the two groups. Spinal CSF leak was observed in 80% (48/60) of patients, and it was significantly associated with an age of <69 years (p = 0.006). However, patients aged ≥69 yea rs also had a tendency to exhibit spontaneous intracranial hypotension (SIH)-induced nontraumatic intracranial SDH (60.87%; 14/23). Therefore, CT myelography is recommended to be performed for the evaluation of possible SIH in patients with nontraumatic intracranial SDH, particularly those aged <69 years. Patients aged ≥69 years are also good candidates for CT myelography because SIH tends to occur even in this age group. PMID:34943515 | DOI:10.3390/diagnostics11122278 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes of Endolymphatic Sac Surgery for Meniere’s Disease with and without Comorbid Migraine

xlomafota13 shared this article with you from Inoreader Outcomes of Endolymphatic Sac Surgery for Meniere's Disease with and without Comorbid Migraine Via International Journal of Otolaryngology Purpose. To explore outcomes of endolymphatic sac surgery for patients with Meniere's disease with and without the comorbid condition of migraine. Materials and Methods. A retrospective chart review of adult patients undergoing endolymphatic sac surgery at a single tertiary care center from 1987 to 2019 was performed. All adult patients who failed medical therapy and underwent primary endolymphatic sac surgery were included. The main outcome measures were vertigo control and functional level scale (FLS) score. Patient characteristics, comorbidities, and audiometric outcomes were tracked as well. Results. Patients with Meniere's disease and migraine had a stronger association with psychiatric comorbidities (64.29% vs. 25.80%, ), shorter duration of vertigo episodes (143 vs. 393 min, ), and younger age (36.6 vs. 50.8 yr, ) at the time of endolymphatic sac surgery. Postoperative pure tone averages and word recognition scores were nearly identical to preoperative baselines. Class A vertigo control (47.92%) was most common, followed by class B vertigo control (31.25%). The FLS score improved from 4.2 to 2.8 (). Both patients with and without migraine had classes A-B vertigo control (66.67% vs. 80.95%) without any statistically significant difference (). Of the patients who required secondary treatment (10.42%), none had migraine. Conclusions. Endolymphatic sac surgery is an effective surgical intervention for Meniere's disease with and without migraine. Patients with comorbid migraine tend to be younger and present with psychiatric comorbidities. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Regulation of nuclear medicine services: Perception of the problems and challenges in Colombia for the approach to cancer

xlomafota13 shared this article with you from Inoreader Regulation of nuclear medicine services: Perception of the problems and challenges in Colombia for the approach to cancer Via radioactive iodine Biomedica. 2021 Dec 15;41(4):692-705. doi: 10.7705/biomedica.6123. ABSTRACT Introduction: Colombia has modified the nuclear medicine norms that impact the administration of radioactive iodine therapy in the treatment of thyroid cancer. Objective: To identify the areas of agreement regarding the issue, as well as the current and emergent requirements associated with the normative for the operation of nuclear medicine services that have an impact on the care of patients with thyroid cancer in Colombia. Materials and methods: We conducted a two-round Delphi study for each expert, clinical, and regulatory group. The first round explored views on the implications of the regulations that apply to nuclear medicine. The second round rated the statements from the first round by their relevance. Results: The issues regarding nuclear medicine services were related to the normative clarity and the lack of synergy and coherence among inspection, surveillance, and control bodies. The demands on the waste management system require a high economic investment that can influence the service offer and have an impact on the integral control of thyroid cancer. Unification of the auditors' criteria, delimitation of the acting agent functions, technical assistance to the services to comply with the normative, and the oversight of the inspection, surveillance, and control bodies by the regulatory entities are among the current and future needs. Conclusions: Our findings suggest th at nuclear medicine services are going through a time of multiple institutional, regulatory, and economic challenges that put at risk the development and maintenance of nuclear medicine in cancer care. PMID:34936254 | DOI:10.7705/biomedica.6123 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Machine learning can identify patients at risk of hyperparathyroidism without known calcium and intact parathyroid hormone

xlomafota13 shared this article with you from Inoreader Machine learning can identify patients at risk of hyperparathyroidism without known calcium and intact parathyroid hormone Via Head & Neck Abstract Background To prove the concept of diagnosing primary hyperparathyroidism (pHPT) without calcium and parathyroid hormone (PTH) values and identifying potential risk factors for pHPT. Methods Data were extracted from the clinical data warehouse (CDW) at the University of Arkansas for Medical Sciences (UAMS) Epic EHR (2014–2019). Results 1737 patients with over 185 000 rows of clinical data were provided in a relational structure and processed/flattened to facilitate modeling. Phenotype elements were identified for pHPT without advance knowledge of calcium and PTH levels. The area under the curve (AUC) for the prediction of pHPT using our model was 0.86 with sensitivity and specificity of 0.8953 and 0.6686, respectively, using a 0.45 probability threshold. Conclusion Primary hyperparathyroidism was predicted from a dataset excluding calcium and PTH data with 86% accuracy. This approach needs to be validated/refined on larger samples of data and plans are in place to do this with other regional/national datasets. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proof of Concept Study For Using UR10 Robot To Help Total Hip Replacement

xlomafota13 shared this article with you from Inoreader Proof of Concept Study For Using UR10 Robot To Help Total Hip Replacement Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background The demand for total hip replacement (THR) for treating osteoarthritis has grown substantially worldwide. The existing robotic systems used in THR are invasive and costly. This study aims to develop a less-invasive and low-cost robotic system to assist THR surgery. Methods A preliminary robotic reaming system was developed based on a UR10 robot equipped with a reamer to cut acetabulum. A novel approach was proposed to cut through a 5mm hole in femur such that the operation is less invasive to the patients. Results The average error of the cutting hemisphere by the robotic reaming system is 0.118 2 mm which is smaller than the average result reaming by hand (0.130 1 mm) Conclusion The robotic reaming can help make THR procedures less invasive and more accurate. Moreover, the system is expected to be significantly less expensive than the robotic systems available in the market at present. This article is protecte d by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Systematic Review of Robotic Surgery: From Supervised Paradigms To Fully Autonomous Robotic Approaches

xlomafota13 shared this article with you from Inoreader A Systematic Review of Robotic Surgery: From Supervised Paradigms To Fully Autonomous Robotic Approaches Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background From traditional open surgery to laparoscopic surgery and robot-assisted surgery (RAS), advances in robotics, machine learning, and imaging are pushing the surgical approach to-wards better clinical outcomes. Pre-clinical and clinical evidence suggests that automation may standardise techniques, increase efficiency, and reduce clinical complications. Methods A PRISMA-guided search was conducted across PubMed and OVID. Results Of the 89 screened articles, 51 met the inclusion criteria, with 10 included in the final review. Automatic data segmentation, trajectory planning, intra-operative registration, trajectory drilling, and soft tissue robotic surgery were discussed. Conclusion Although automated surgical systems remain conceptual, several research groups have developed supervised autonomous robotic surgical systems with increasing consideration for ethico-legal issues for automation. Automation paves the way for precision surgery and improved safety and opens new possibilities for deploying more robust artificial intelligence models, better imaging modalities and robotics to improve clinical outcomes. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.