In‐depth analysis of thyroid cancer mortality

paythelady.61 shared this article with you from Inoreader In‐depth analysis of thyroid cancer mortality Via Head & Neck Abstract Background There are reports of an increasing thyroid cancer mortality rate. This study aimed to analyze the latest trends in this rate over time and compare findings from different cancer registries. Methods Thyroid cancer incidence‐based mortality (IBM) rates were obtained from the Surveillance, Epidemiology, and End Results (SEER) program, including SEER‐9, SEER‐13, and SEER‐18. The National Center for Health Statistics (NCHS) thyroid cancer mortality rate was acquired for comparison. Statistical analysis was performed using the JoinPoint software. Results NCHS data revealed an overall annual percent change (APC) over 1987 to 2017 of 0.61 (P < .01), and the value was nearly four times greater for males compared to females. The overall IBM APC values for SEER‐9, SEER‐13, and SEER‐18 were also positive and statistically significant (P < .01). Conclusions The increased thyroid cancer mortality rate observed in previous studies continues to be statistically significant based on updated NCHS and SEER IBM data. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Definitive intensity‐modulated radiotherapy or surgery for early oral cavity squamous cell carcinoma: Propensity‐score‐matched, nationwide, population‐based cohort study

paythelady.61 shared this article with you from Inoreader Definitive intensity‐modulated radiotherapy or surgery for early oral cavity squamous cell carcinoma: Propensity‐score‐matched, nationwide, population‐based cohort study Via Head & Neck Abstract Background No evidence is currently available to estimate the outcomes of intensity‐modulated radiation therapy (IMRT) and surgery for patients with early oral cavity squamous cell carcinoma (E‐OCSCC). Methods We recruited patients from the Taiwan Cancer Registry Database who had received a diagnosis of E‐OCSCC. Propensity score matching was performed, and Cox proportional hazards model was used to analyze all‐cause mortality. Results In the multivariate Cox regression analyses, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for surgery compared with definitive IMRT, T2N0M0 compared with T1N0M0, and male patients compared with female patients were 0.303 (0.245, 0.375), 1.340 (1.077, 1.668), and 2.012 (1.432, 2.826), respectively. The aHRs (95% CIs) for age 61 to 70, 71 to 80, and ≧81 years compared with <40 years were 2.984 (1.43, 4.225), 3.353 (2.578, 4.112), and 4.277 (4.104, 5.679), respectively. Conclusions For patients with E‐OCSCC, surgery may be considered the first option rather than definitive IMRT. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

primary salivary gland tumors in pediatric

paythelady.61 shared this article with you from Inoreader Clinicopathological analysis and survival outcomes of primary salivary gland tumors in pediatric patients: a systematic review Via Journal of Oral Pathology & Medicine Abstract Background Salivary gland tumors are a diverse group of uncommon neoplasms that are rare in pediatric patients. The aim of this study was to evaluate the clinicopathological profile and survival outcomes of pediatric patients affected by salivary gland tumors. Materials and methods An extensive search was carried out using the MEDLINE/PubMed, EMBASE, Scopus databases, and grey literature. The risk of bias was available in all papers included. Results A total of 2,830 articles were initially retrieved with 54 remaining for data extraction, resulting in 2,937 cases. This comprised forty‐five case series' and nine cohort studies. These tumors were slightly more prevalent in females (57.4%). The patients' age ranged from 0.3 to 19 years old, with a mean age of 13.3 years. Parotid was the most affected site (81.9%), and 99.2% of cases clinically exhibited a swelling. Presence of pain/tenderness was reported in 13.5% of the cases, with an average duration of 12.6 months for the appearance of symptoms. Most of the reported cases were malignant tumors (75.4%), with mucoepidermoid carcinoma the most common tumor of all tumors (44.8%), followed by pleomorphic adenoma (24.1%). Surgery alone was the leading treatment choice in 74.9% cases and the 5‐year overall survival rate of patients was 93.1%. Patients with symptoms (P =0.001), local recurrence (P <0.001), metastasis (P <0.001), and those not undergoin g surgery or surgery combined with radiotherapy (P <0.001) showed lower survival rates. Conclusion The pediatric patients present a high frequency of malignant salivary neoplasms and a high overall survival rate. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A novel temporal‐predominant neuro‐astroglial tauopathy associated with TMEM106B gene polymorphism in FTLD/ALS‐TDP

paythelady.61 shared this article with you from Inoreader A novel temporal‐predominant neuro‐astroglial tauopathy associated with TMEM106B gene polymorphism in FTLD/ALS‐TDP Via Brain Pathology Abstract Background Polymorphisms in TMEM106B, a gene on chromosome 7p21.3 involved in lysosomal trafficking, correlates to worse neuropathological and clinical outcomes in frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS) with TDP‐43 inclusions. In a small cohort of C9orf72 expansion carriers, we previously found an atypical, neuroglial tauopathy in cases harboring a TMEM106B rs1990622 A/A genotype. Aims To test whether TMEM106B genotype affects the risk of developing atypical tauopathy under a recessive genotype model (presence versus absence of two major alleles: A/A vs. A/G and G/G). Methods We characterized the atypical tauopathy neuropathologically and determined its frequency by TMEM106B rs1990622 genotypes in 90 postmortem cases with a primary diagnosis of FTLD/ALS‐TDP [mean age at death 65.5 years (±8.1),40% female]. We investigated the effect of this new atypical tauopathy on demographics and clinical and neuropsychological metrics. We also genotyped TMEM106B in an independent series with phenotypically similar cases. Results Sixteen cases (16/90, 17.7 %) showed the temporal‐predominant neuro‐astroglial tauopathy, and 93.7% of them carried an A/A genotype (vs. ~35% in a population cohort). The odds ratio of FTLD/ALS‐TDP individuals with the A/A genotype showing neuro‐astroglial tauopathy was 13.9. Individuals with this tauopathy were older at onset (p=0.01). The validation cohort had a similarly high proportion of rs1990622 A/A genotype. TDP‐43 and tau changes co‐occur in a subset of neurons. Conclusions Our data add to the growing body of evidence that TMEM106B polymorphisms may modulate neurodegeneration. A distinctive medial temporal predominant, 4‐repeat, neuro‐astroglial tauopathy strongly correlates to TMEM106B A/A genotype in FTLD/ALS‐TDP cases. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Advanced age heightens hepatic damage in a murine model of scald burn injury

paythelady.61 shared this article with you from Inoreader Advanced age heightens hepatic damage in a murine model of scald burn injury Via Journal of Trauma and Acute Care Surgery - Published Ahead-of-Print Background: Elderly burn patients exhibit a lower survival rate compared with younger counterparts. The liver is susceptible to damage after burn injury, which predisposes to poor outcomes. Lipid homeostasis and the antioxidant glutathione system play fundamental roles in preserving liver integrity. Herein, we explored changes in these major pathways associated with liver damage in the aging animals after burn injury. Methods: We compared liver enzymes, histology, lipid-peroxidation, and glutathione-metabolism profiles from young and aged female mice after a 15% total-body-surface-area burn. Mice were euthanized at 24hours after injury, and livers and serum were collected. Results: Aged burn animals exhibited elevated (p View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fast Track Pathway Provides Safe, Value Based Care on Busy Acute Care Surgery Service

paythelady.61 shared this article with you from Inoreader Fast Track Pathway Provides Safe, Value Based Care on Busy Acute Care Surgery Service Via Journal of Trauma and Acute Care Surgery - Published Ahead-of-Print Abstract: Background Fast track(FT) pathways have been adopted across a multitude of elective surgeries but have been slow to be adopted into the acute care surgery(ACS) realm. We hypothesized that a FT pathway for acute cholecystitis patients would decrease patient length of stay and resource utilization. Methods All patients at two hospitals, one with a FT pathway and one with a traditional pathway, that underwent an urgent laparoscopic cholecystectomy for acute cholecystitis between May 1, 2019 and October 31, 2019 were queried using CPT codes. Exclusion criteria were conversion to open or partial cholecystectomy. Retrospective chart review was used to gather demographics, operative, hospital course, and outcomes. Time to OR, hospital length of stay, and resource utilization were the primary outcomes. Results There was a total of 479 urgent laparoscopic cholecystectomies performed, four hundred and thirty(89.8%) were performed under the FT pathway. The median[IQR] time to the OR was not different: 14.1 hours[8.3-29.0 hours] for FT and 18.5 hours[11.9-25.9 hours] for traditional(p=0.316). However, the median length of stay was shorter by 15.9 hours in the FT cohort(22.6 hours, [14.2-40.4] vs 38.5 hours,[28.3-56.3];p0.2 for all). On multivariate analysis, having a fast track pathway was an independent predictor of discharge within 24 hours of surgical consultation(OR 7.65, 95% CI 2.90-20.15, p View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

TRAUMA PATIENT TRANSPORT TIMES UNCHANGED DESPITE TRAUMA CENTER PROLIFERATION: A 10 YEAR REVIEW

paythelady.61 shared this article with you from Inoreader TRAUMA PATIENT TRANSPORT TIMES UNCHANGED DESPITE TRAUMA CENTER PROLIFERATION: A 10 YEAR REVIEW Via Journal of Trauma and Acute Care Surgery - Published Ahead-of-Print Introduction In certain regions of the U.S. there has been a dramatic proliferation of trauma centers. The goal of our study was to evaluate transport times during this period of trauma center proliferation. Methods Aggregated data summarizing level I trauma center admissions in Arizona between 2009 and 2018 were provided to our institution by the Arizona Department of Health Services. We evaluated patient demographics, transport times and injury severity for both rural and urban injuries. Results Data included statistics summarizing 266,605 level I trauma admissions in the state of Arizona. The number of state-designated trauma centers during this time increased from 14 to 47, with level I centers increasing from 8 to 13. Slight decreases in mean ISS (rural 9.4 vs. 8.4; urban 7.9 vs 7.0) were observed over this period. Median transport time for cases transported from the injury scene directly to a level I center remained stable in urban areas at 0.9 hours in both 2009 and 2018. In rural areas, transport times for these cases were approximately double, but also stable, with median times of 1.8 and 1.9 hours. Transport times for cases requiring inter-facility transfer prior to admission at a level I center increased by 0.3 hours for urban injuries (5.3 hours to 5.6) and 0.9 hours for rural injuries (5.6 to 6.5). Conclusion Despite the 3-fold increase in the number of state-designated trauma centers, transport time has not decreased in urban or rural areas. This finding highlights the need for regulatory oversight regarding the number and geographic placement of state-designated trauma centers. Level of Evidence III The authors declare no conflicts of interest. The study was presented as a Quickshot at the 79th Annual Meeting of AAST & Clinical Congress of Acute Care Surgery held online instead of Waikoloa, Hawaii, September 9-12, 2020. Corresponding Author: Jordan A. Weinberg, MD, Division Chief, Trauma/Acute General Surgery, Trauma Administration, St. Joseph's Hospital and Medical Center, 350 W. Thomas Road, Phoenix, AZ 85013. Tel: (602) 406-3157. Email: JordanWeinberg@Creighton.edu © 2020 Lippincott Williams & Wilkins, Inc. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.