Varicella post-exposure management for pediatric oncology patients

xlomafota13 shared this article with you from Inoreader Varicella post-exposure management for pediatric oncology patients Via Association française pour l'étude du cancer Bull Cancer. 2022 Jan 26:S0007-4551(22)00004-2. doi: 10.1016/j.bulcan.2021.11.016. Online ahead of print. ABSTRACT INTRODUCTION: The objective was to evaluate health care providers' (HCP) adherence to and efficacy of varicella post-exposure prophylaxis (PEP) recommendations. It was an observational, prospective, multicenter study set in Ile-de-France, France. METHODS: All children under 18 with a cancer diagnosis, currently or within 3months of receiving cancer treatment, regardless of varicella zoster virus (VZV) serostatus or previous personal history of varicella, were eligible. Study participants with significant exposure were reviewed prospectively for PEP indications. Main outcome measures were the percentage of exposure situations for which HCP were guideline-compliant, the proportion of available VZV serostatuses and the incidence of breakthrough varicella after different PEP approaches. RESULTS: A total of 51 patie nts from 15 centers were enrolled after 52 exposure episodes. Median age at exposure was 5 years (range, 1-15). Exposure within the household led to 38% of episodes. Prophylactic treatment consisted in specific anti-VZV immunoglobulins (V-ZIG) (n=19) or in oral aciclovir (n=15). No prophylactic treatment was given for 18 patients (in compliance, n=16). In compliance with guidelines, 17 patients received V-ZIG, 11 did not develop varicella (65%, [95% CI, 39-90%]); 15 received aciclovir, 13 did not develop varicella (87%, [95% CI, 67-100%]). Breakthrough varicella occurred in 11 patients, with simple clinical course in all cases; in 8/47 (17%) episodes when PEP was guideline-compliant versus 3/5 (60%) when not. DISCUSSION: Recommendations have been respected and are efficient. PEP needs to be standardized and a study carried out to define the optimal approach. Anti-VZV immunization of seronegative family members should be encouraged. PMID:35093244 | DOI:10.1016/j.bulcan.2021.11.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Computed tomography-assessed variations of the carotid sinus

xlomafota13 shared this article with you from Inoreader Computed tomography-assessed variations of the carotid sinus Via radiol anat Surg Radiol Anat. 2022 Jan 30. doi: 10.1007/s00276-021-02871-x. Online ahead of print. ABSTRACT PURPOSE AND BACKGROUND: Previous studies have identified variations regarding the morphology and location of the carotid sinus, a phenomenon still not commonly approached or studied on computed tomography angiography (CTA). Detailed characterization of the carotid sinus was performed on CTAs, determining its position, diameter and length. METHODS: The study group included 43 patients with disease-free carotid trunks subjected to cervical CTA. We measured the terminal caliber of the common carotid artery (CCA), as well as the calibers of the internal (ICA) and external carotid arteries (ECA) at their origin. The diameters were correlated with the location and the shape of the carotid sinus. We also measured the length of the sinus dilatation (carotid bulb), in regard to its location on the terminal branches of the common carotid artery. RESULTS: Mean diameters of the studied arteries were 7.39 ± 1.04 mm for the CCA, 6.71 ± 1.49 mm for the ICA and, respectively, 4.27 ± 0.75 mm for the ECA. The classical position of the carotid sinus was seen in 80% of cases, the rest being considered anatomical variants. The length of the carotid bulb on the ICA was 9.99 ± 2.22 mm, showing variability between genders. CONCLUSIONS: The carotid sinus does not always extend to the ICA, presenting different distribution patterns that might be relevant in sinu s pathology from a clinical point of view, respectively from a surgical point of view during invasive or minimally invasive interventions on the carotid axis. PMID:35094129 | DOI:10.1007/s00276-021-02871-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New drug approvals: Ripretinib for advanced gastrointestinal stromal tumors (GIST) in fourth or later-line therapy

xlomafota13 shared this article with you from Inoreader New drug approvals: Ripretinib for advanced gastrointestinal stromal tumors (GIST) in fourth or later-line therapy Via Association française pour l'étude du cancer Bull Cancer. 2022 Jan 27:S0007-4551(22)00017-0. doi: 10.1016/j.bulcan.2022.01.002. Online ahead of print. NO ABSTRACT PMID:35094842 | DOI:10.1016/j.bulcan.2022.01.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid Disease in Pregnancy: A Touch of Clarity

xlomafota13 shared this article with you from Inoreader Thyroid Disease in Pregnancy: A Touch of Clarity Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Tissue Engineered Construct for Laryngeal Regeneration: A Proof‐of‐Concept Device Design Study

xlomafota13 shared this article with you from Inoreader A Tissue Engineered Construct for Laryngeal Regeneration: A Proof‐of‐Concept Device Design Study Via The Laryngoscope Objectives/Hypothesis Develop a patient-specific tissue engineered construct for laryngeal reconstruction following a partial laryngectomy. Study Design Bench and animal research. Methods A construct made from a porous polyethylene scaffold shaped in a canine-specific configuration and seeded with autologous canine adipose-derived stem cells in fibrin glue was implanted in a canine following a partial laryngectomy. After 1 year, the construct was first evaluated in vivo with high-speed imaging and acoustic–aerodynamic measures. It was then explanted and evaluated histologically. Results The canine study at 1 year revealed the construct provided voicing (barking) with acoustic and aerodynamic measures within normal ranges. The canine was able to eat and breathe normally without long-term support. The construct was integrated with epithelialization of all areas except the medial portion of the vocal fold structure. No anti-infective agents were needed after the standard perioperative medications were completed. Conclusion This study provided a successful first step toward developing a patient-specific composite construct for patients undergoing partial laryngectomies. Level of Evidence Not Applicable Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Place of Linacs in extracranial stereotactic radiotherapy: Are they now equivalent to Cyberknife®?

xlomafota13 shared this article with you from Inoreader Place of Linacs in extracranial stereotactic radiotherapy: Are they now equivalent to Cyberknife®? Via Association française pour l'étude du cancer Bull Cancer. 2022 Jan 25:S0007-4551(22)00003-0. doi: 10.1016/j.bulcan.2021.10.008. Online ahead of print. ABSTRACT Extracranial stereotactic radiotherapy has developed recently, since the years 1990-2000. Devices specifically dedicated to this type of treatment were then developed and shared the favors of radiation oncologists: Tomotherapy® and especially Cyberknife®, which offered the advantage of "tracking" with the possibility of real time motion correction, allowing an increase in the precision of targeting volumes. Recently, the latest generations of linear accelerators (Linac) have been developed, integrating much higher dose rates, an improved ballistic precision with a very short treatment duration time and the possibility of real time motion management (with notably the possibility of adaptive radiotherapy in real time with the development of "MLC tracking"). So are Linacs able to perform equivalent (not inferior) extracrani al stereotactic radiotherapy treatments to those with Cyberknife®, the historical gold standard in this field? This article presents a comparison of these two treatment devices, by successively considering dose distributions in the irradiated volume, distant received doses from this volume (including the "integral dose"), problems linked to the duration of the sessions and those linked to motion management. PMID:35090720 | DOI:10.1016/j.bulcan.2021.10.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bereavement Practices Among Head and Neck Cancer Surgeons

xlomafota13 shared this article with you from Inoreader Bereavement Practices Among Head and Neck Cancer Surgeons Via The Laryngoscope Objectives Head and neck cancer surgeons frequently interact with dying patients with advanced disease and their families, but little is known about their bereavement practices after a patient's death. The aim of this study is to elucidate the frequency of common bereavement practices, cited barriers to bereavement, and predictive physician factors that lead to an increase in bereavement practices among head and neck cancer surgeons. Methods A 20-item survey was sent to 827 active surgeons of the American Head and Neck Society. Approval was obtained and the survey was distributed through the American Head and Neck Society. Demographics, frequency of common bereavement practices, empathy, and barriers were assessed. Multiple linear regression was performed to determine physician factors associated with more frequent bereavement follow-up. Results There were 156 respondents (18.9% response rate). Overall, surgeons were more likely to usually/always call (48.5%) or send a letter (42.4%) compared with other practices such as attending funerals (0%), offering family meetings (18.6%), or referring family members to counseling (7.7%). Many barriers were cited as being at least somewhat important: being unaware about a patient's death (67.3%) was the most cited, whereas 51.3% cited a lack of mentorship/training in this area. Scoring higher on empathy questions (P ≤ .001) was associated with more frequent surgeon bereavement follow-up with the family of deceased patients. Conclusion There is substantial practice variation among surgeons suggesting a lack of consensus on their roles in bereavement follow-up. Having higher empathy was predictive of higher engagement. Level of Evidence NA Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic accuracy of conventional oral examination for detecting oral cavity cancer and potentially malignant disorders in patients with clinically evident oral lesions: Systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Diagnostic accuracy of conventional oral examination for detecting oral cavity cancer and potentially malignant disorders in patients with clinically evident oral lesions: Systematic review and meta‐analysis Via Head & Neck Abstract This systematic review evaluates the diagnostic accuracy of conventional oral examination (COE) versus incisional or excisional biopsy for the diagnosis of malignant and/or dysplastic lesions in patients with clinically evident lesions. Searches were conducted across five electronic databases from inception to January 2020. Meta-analyses were undertaken, where appropriate. Among 18 included studies, 14 studies were included in the meta-analysis, giving summary estimates for COE of 71% sensitivity and 85% specificity for the diagnosis of dysplastic and/or malignant lesions. The pooled diagnostic accuracy of identifying malignant-only lesions was reported in seven studies, giving a pooled estimate of 88% sensitivity and 81% specificity. Diagnostic accuracy of different types of dental/medical professionals in identifying dysplastic or malignant lesions gave varying estimates of sensitivity and specificity across three studies. Further research is needed to improve the diagnostic acc uracy of COE for early detection of dysplastic and malignant oral lesions. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Birth of the Beta-knife Thyroidectomy: The Radiance of Saul Hertz

xlomafota13 shared this article with you from Inoreader Birth of the Beta-knife Thyroidectomy: The Radiance of Saul Hertz Via radioactive iodine Am Surg. 2022 Jan 26:31348211060463. doi: 10.1177/00031348211060463. Online ahead of print. ABSTRACT This is the story of how one man's life's work allowed for Iodine-131 (I-131) to become a therapy for hyperthyroidism and thyroid cancer. What is now a standard in our times arose from Saul Hertz's rather challenging and humble beginnings. Thyroid lobectomy and total thyroidectomy were therapeutic mainstays for thyroid disease until Hertz treated his first patient with radioactive i odine (RAI) ablation therapy at Massachusetts General Hospital (MGH) on March 31, 1941. His concepts for using beta particle emission from RAI to ablate thyroid tissue were revolutionary. Hertz's RAI therapy translated to research with thyroid cancer by the mid-1940s. The high-energy beta particles produced cytolethal effects on remnant thyroid tissue left behind by total thyroidectomy, thereby accomplishing completion thyroidectomy in some patients. Progressive surgeons from the Hertz era incorporated RAI into their practice. MGH surgery resident Francis Moore took sabbatical from clinical training to do translational research with RAI and other radioisotopes. Irving Ariel of New York became known as a nuclear surgeon in the wake of Hertz's work. George Crile Jr of Cleveland became an RAI advocate for the surgical community, implementing several paradigm-changing concepts in thyroid disease along the way. Hertz was a visionary who sparked this movement, predicting many of the molec ular dilemmas with RAI-tumor avidity that clinical researchers continue to navigate today. This timely history for surgical oncologists and endocrine surgeons traces the development of RAI therapy through the life of Saul Hertz, a biographical window influenced by social stigma, political controversy, and mainstream media. PMID:35081787 | DOI:10.1177/00031348211060463 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A structured ICA-based process for removing auditory evoked potentials

xlomafota13 shared this article with you from Inoreader A structured ICA-based process for removing auditory evoked potentials Via cortical auditory Sci Rep. 2022 Jan 26;12(1):1391. doi: 10.1038/s41598-022-05397-3. ABSTRACT Transcranial magnetic stimulation (TMS)-evoked potentials (TEPs), recorded using electroencephalography (EEG), reflect a combination of TMS-induced cortical activity and multi-sensory responses to TMS. The auditory evoked potential (AEP) is a high-amplitude sensory potential-evoked by the "click" sound produced by every TMS pulse-that can dominate the TEP and obscure observation of other neural components. The AEP is peripherally evoked and therefore should not be stimulation site specific. We address the problem of disentangling the peripherally evoked AEP of the TEP from components evoked by cortical stimulation and ask whether removal of AEP enables more accurate isolation of TEP. We hypothesized that isolation of the AEP using Independent Components Analysis (ICA) would reveal features that are stimulation site specific and unique individual features. In order to i mprove the effectiveness of ICA for removal of AEP from the TEP, and thus more clearly separate the transcranial-evoked and non-specific TMS-modulated potentials, we merged sham and active TMS datasets representing multiple stimulation conditions, removed the resulting AEP component, and evaluated performance across different sham protocols and clinical populations using reduction in Global and Local Mean Field Power (GMFP/LMFP) and cosine similarity analysis. We show that removing AEPs significantly reduced GMFP and LMFP in the post-stimulation TEP (14 to 400 ms), driven by time windows consistent with the N100 and P200 temporal characteristics of AEPs. Cosine similarity analysis supports that removing AEPs reduces TEP similarity between subjects and reduces TEP similarity between stimulation conditions. Similarity is reduced most in a mid-latency window consistent with the N100 time-course, but nevertheless remains high in this time window. Residual TEP in this window has a time-c ourse and topography unique from AEPs, which follow-up exploratory analyses suggest could be a modulation in the alpha band that is not stimulation site specific but is unique to individual subject. We show, using two datasets and two implementations of sham, evidence in cortical topography, TEP time-course, GMFP/LMFP and cosine similarity analyses that this procedure is effective and conservative in removing the AEP from TEP, and may thus better isolate TMS-evoked activity. We show TEP remaining in early, mid and late latencies. The early response is site and subject specific. Later response may be consistent with TMS-modulated alpha activity that is not site specific but is unique to the individual. TEP remaining after removal of AEP is unique and can provide insight into TMS-evoked potentials and other modulated oscillatory dynamics. PMID:35082350 | DOI:10.1038/s41598-022-05397-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modulation Depth Discrimination by Cochlear Implant Users

xlomafota13 shared this article with you from Inoreader Modulation Depth Discrimination by Cochlear Implant Users Via Journal of the Association for Research in Otolaryngology Abstract Cochlear implants (CIs) convey the amplitude envelope of speech by modulating high-rate pulse trains. However, not all of the envelope may be necessary to perceive amplitude modulations (AMs); the effective envelope depth may be limited by forward and backward masking from the envelope peaks. Three experiments used modulated pulse trains to measure which portions of the envelope can be effectively processed by CI users as a function of AM frequency. Experiment 1 used a three-interval forced-choice task to test the ability of CI users to discriminate less-modulated pulse trains from a fully modulated standard, without controlling for loudness. The stimuli in experiment 2 were identical, but a two-interval task was used in which participants were required to choose the less-modulated interval, ignoring loudness. Catch trials, in which judgements based on level or modulation depth would give opposing answers, were included. Experiment 3 employed novel stimuli whose modulation envelope could be modified below a variable point in the dynamic range, without changing the loudness of the stimulus. Overall, results showed that substantial portions of the envelope are not accurately encoded by CI users. In experiment 1, where loudness cues were available, participants on average were insensitive to changes in the bottom 30% of their dynamic range. In experiment 2, where loudness was controlled, participants appeared insensitive to changes in the bottom 50% of the dynamic range. In experiment 3, participants were insensitive to changes in the bottom 80% of the dynamic range. We discuss potential reasons for this insensitivity and implications for CI speech-processing strategies. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.