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.

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.

Implementing a Tailored Psychosocial Distress Screening Protocol in a Head and Neck Cancer Program

xlomafota13 shared this article with you from Inoreader Implementing a Tailored Psychosocial Distress Screening Protocol in a Head and Neck Cancer Program Via The Laryngoscope Objectives/Hypothesis Psychosocial distress is common among patients with head and neck cancer (HNC) and is associated with poorer quality of life and clinical outcomes. Despite these risks, distress screening is not widely implemented in HNC care. In this study, we investigated the prevalence of psychosocial distress and its related factors in routine care of patients with HNC. Methods Data from medical records between September 2017 and March 2020 were analyzed. Psychosocial distress was measured by the National Comprehensive Cancer Network's Distress Thermometer (DT), and a modified HNC-specific problem list; depression and anxiety were assessed using the Patient Health Questionnaire-4. Descriptive statistics and logistic regression were conducted to report prevalence of distress, depression and anxiety, and factors associated with clinical distress. Implementation outcomes, including rates of referrals and follow-up for distressed patients, are also reported. Results Two hundred and eighty seven HNC patients completed the questionnaire (age 64.3 ± 14.9 years), with a mean distress score of 4.51 ± 3.35. Of those, 57% (n = 163) reported clinical distress (DT ≥ 4). Pain (odds ratio [OR] = 3.31, 95% CI = 1.75–6.26), fatigue (OR = 2.43, 95% CI = 1.1.7–5.05), anxiety (OR = 1.63, 95% CI = 1.30–2.05), and depression (OR = 1.51, 95% CI = 1.04–2.18) were significantly associated with clinical distress (P < .05). Of patients identified as distressed, 79% received same-day psychosocial evaluation. Conclusions Clinical distress was identified in 57% of patients who completed the questionnaire, suggesting that an ultra-brief psychosocial screening protocol can be implemented in routine ambulatory oncology care, and identifies patients whose distress might otherwise go unrecognized. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The programmed gene expression change in mouse skin after ultraviolet radiation damage

xlomafota13 shared this article with you from Inoreader The programmed gene expression change in mouse skin after ultraviolet radiation damage Via Experimental Dermatology ABSTRACT Ultraviolet (UV) radiation is a major cause of skin damage and carcinogenesis. Here we systematically analyze the acute gene expression change in skin in vivo after UV exposure, aiming to establish the common C57BL/6 mouse strain as a convenient model for future pathological research and drug discovery. The back fur of C57BL/6 mice was depilated, and a mixed UV light source was used to irradiate the skin. Full thickness skin samples were collected at 0, 0.5h, 2h, 6h, 12h, and 24h. Total RNAs were extracted and subjected to RNA sequencing analysis. We found that the gene expression change in mouse skin is highly similar to previous reports in human skin. These include down-regulation of differentiation-related genes and extracellular matrix genes, and up-regulation of cytokine/chemokine genes. An early wave of activator protein 1 (AP-1) expression is induced, whereas activation of the p53 pathway is not significant. The impact of the AP-1 transcription factors and the antioxidant t ea polyphenols is discussed. The analysis of acute gene expression change in skin after UV irradiation provides a starting point to investigate how the skin responds to genotoxic stress. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

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