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Eight Weeks of Self-Resisted Neck Strength Training Improves Neck Strength in Age-Grade Rugby Union Players: A Pilot Randomized Controlled Trial.

Sports Health 2021 Sep 24:19417381211044736. Epub 2021 Sep 24.

Department for Health, University of Bath, Bath, UK.

Background: Greater neck strength is associated with fewer head and neck injuries. Neck-strengthening programs are commonly burdensome, requiring specialist equipment or significant time commitment, which are barriers to implementation.

Hypothesis: Completing a neck-strengthening program will increase isometric neck strength in age-group rugby players. Read More

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September 2021

Cochlear Implant Failure in the Pediatric Population.

J Audiol Otol 2021 Sep 23. Epub 2021 Sep 23.

Department of Otorhinolaryngology, Head and Neck Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.

Background And Objectives: In cochlear implant (CI) surgery, the results and causes of revision and reimplantation may guide surgeons in establishing surgical protocols for revision surgery with safe audiological outcomes. The aim of this study was to review our experience in terms of etiology, surgical strategy, and hearing outcomes in pediatric patients who underwent CI removal and reimplantation.

Subjects And Methods: All patients received implants of the same brand. Read More

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September 2021

A Prediction Model for Selective Use of Facial Computed Tomography in Blunt Head Trauma Patients.

Plast Reconstr Surg 2021 Oct;148(4):583e-591e

From the Departments of Radiology, Surgery, and Dentistry, National Yang-Ming University Hospital; School of Medicine and Department of Dentistry, Dental School, National Yang-Ming University; and Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University.

Background: Head trauma patients may have concomitant facial fractures, which are usually underdetected by head computed tomography alone. This study aimed to identify the clinical indicators of facial fractures and to develop a risk-prediction model to guide the discriminative use of additional facial computed tomography in head trauma.

Methods: The authors retrospectively reviewed head trauma patients undergoing simultaneous head and facial computed tomography at a Level II trauma center from 2015 to 2018. Read More

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October 2021

A narrative review of fluorescence imaging in robotic-assisted surgery.

Laparosc Surg 2021 Jul 25;5. Epub 2021 Jul 25.

Department of Research, Intuitive Surgical, Inc., Sunnyvale, CA, USA.

Objective: In this review, we provide examples of applications of fluorescence imaging in urologic, gynecologic, general, and endocrine surgeries.

Background: While robotic-assisted surgery has helped increase the availability of minimally invasive procedures across surgical specialties, there remains an opportunity to reduce adverse events associated with open, laparoscopic, and robotic-assisted methods. In 2011, fluorescence imaging was introduced as an option to the da Vinci Surgical System, and has been standard equipment since 2014. Read More

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Towards precision oncology in angiosarcomas using next generation "omic" technologies.

Oncotarget 2021 Sep 14;12(19):1953-1955. Epub 2021 Sep 14.

Division of Medical Oncology, National Cancer Centre Singapore, Singapore.

Angiosarcomas are a group of aggressive tumors of vascular origin. Although thought to be a rare cancer constituting just 1-2% of all soft tissue sarcomas, recent observations suggest that angiosarcomas are more common amongst Asian populations as compared to the West, suggesting the possibility of distinct genetic or environmental triggers influencing its pathogenesis. Advances in genomic sequencing efforts have led to the discovery of ultraviolet mutation signatures and high tumor mutation burden as common features of angiosarcoma of the head and neck. Read More

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September 2021

Successful outcome of retrograde pancreatojejunostomy for chronic pancreatitis and infected pancreatic cysts: A case report.

World J Clin Cases 2021 Aug;9(24):7224-7230

Department of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan.

Background: Chronic pancreatitis occasionally requires surgical treatment that can be performed with various techniques. Often, this type of surgery presents with postoperative complications. We report a case of a successful retrograde pancreatojejunostomy for chronic pancreatitis and infected pancreatic cysts. Read More

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Clinical Heterogeneity of Differentiated Thyroid Cancer between Children Less than 10 Years of Age and Those Older than 10 Years: A Retrospective Study of 70 Cases.

Eur Thyroid J 2021 Jul 17;10(5):364-371. Epub 2021 Jun 17.

Department of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, China.

Objectives: The objectives of this study were to explore the clinical heterogeneity of differentiated thyroid cancer (DTC) between prepubertal children and adolescents and guide clinical treatment.

Methods: A retrospective study included patients with DTC aged ≤19 years in Beijing Children's Hospital from June 2014 to June 2019. All patients were enrolled and divided into 2 subgroups based on the threshold age of 10 years, namely the childhood group (CG) (≤10 years old); and the adolescent group (AG) (between 10 and 19 years old). Read More

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Post-chemotherapy and targeted therapy imaging of the chest in lung cancer.

Clin Radiol 2021 Sep 17. Epub 2021 Sep 17.

Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Non-small-cell lung cancer (NSCLC) is frequently diagnosed when it is not amenable to local therapies; therefore, systemic agents are the mainstay of therapy for many patients. In recent years, treatment of advanced NSCLC has evolved from a general approach primarily involving chemotherapy to a more personalised strategy in which biomarkers such as the presence of genomic tumour aberrations and the expression of immune proteins such as programmed death-ligand 1 (PD-L1), in combination with other elements of clinical information such as histology and clinical stage, guide management. For instance, pathways resulting in uncontrolled growth and proliferation of tumour cells due to epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements may be targeted by tyrosine kinase inhibitors (TKIs). Read More

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September 2021

Defining the microbiome of the head and neck: A contemporary review.

Am J Otolaryngol 2021 Sep 11;43(1):103224. Epub 2021 Sep 11.

University of Connecticut Health Center Department of Otolaryngology-Head and Neck Surgery, United States of America. Electronic address:

Objective: The purpose of this paper is to define the microbiome of the head and neck by characterizing and distinguishing the commensal bacteria from pathogenic species.

Study Design: Literature review.

Methods: Pubmed and Google scholar databases were queried for relevant articles. Read More

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September 2021

Review of prophylactic swallowing interventions for head and neck cancer.

Int J Nurs Stud 2021 Aug 27;123:104074. Epub 2021 Aug 27.

The First Hospital of Jilin University, No.71 Xinmin street, Changchun, Jilin 130021, China. Electronic address:

Background: Head and neck cancer treatment destroys nerves and/or organs associated with swallowing. Previous studies have investigated the efficacy of exercises for muscles used in swallowing before treatment in reducing disuse atrophy and delaying the occurrence of muscle fibrosis. However, the rehabilitation effects of training and the optimal intervention strategy are unknown. Read More

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Intraparenchymal hemorrhage after serial ventricular reservoir taps in neonates with hydrocephalus and association with neurodevelopmental outcome at 2 years of age.

J Neurosurg Pediatr 2021 Sep 17:1-8. Epub 2021 Sep 17.

7Division of Neuroscience, Department of Neurosurgery, University Medical Center Utrecht, and Utrecht University, Utrecht, The Netherlands.

Objective: Decompressing the ventricles with a temporary device is often the initial neurosurgical intervention for preterm infants with hydrocephalus. The authors observed a subgroup of infants who developed intraparenchymal hemorrhage (IPH) after serial ventricular reservoir taps and sought to describe the characteristics of IPH and its association with neurodevelopmental outcome.

Methods: In this multicenter, case-control study, for each neonate with periventricular and/or subcortical IPH, a gestational age-matched control with reservoir who did not develop IPH was selected. Read More

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September 2021

Which LABA/LAMA should be chosen in COPD patients in real life?

Pulm Pharmacol Ther 2021 Sep 13:102076. Epub 2021 Sep 13.

Institute of Clinical Physiology, National Research Council, Pisa, Italy.

Background: Given COPD heterogeneity, we do not know if some LABA/LAMAs are more suitable for some COPD phenotypes. This real-life database study aimed to evaluate retrospectively the 4 LABA/LAMA effectiveness and highlight possible specificities that could better guide us in choosing the right LABA/LAMA to be used.

Methods: We searched for subjects (1,779) adherent to umeclidinium/vilanterol (UM/VI), indacaterol/glycopyrronium (IND/GLY), aclidinium/formoterol (ACLI/FOR) and tiotropium/olodaterol (TIO/OLO) treatments in our prescribing/dispensing database. Read More

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September 2021

Group-guided individual functional parcellation of the hippocampus and application to normal aging.

Hum Brain Mapp 2021 Sep 16. Epub 2021 Sep 16.

State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China.

Aging is closely associated with cognitive decline affecting attention, memory and executive functions. The hippocampus is the core brain area for human memory, learning, and cognition processing. To delineate the individual functional patterns of hippocampus is pivotal to reveal the neural basis of aging. Read More

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September 2021

A practical guide on the use of imiquimod cream to treat lentigo maligna.

Australas J Dermatol 2021 Sep 16. Epub 2021 Sep 16.

Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.

Lentigo maligna (LM) is a common in situ melanoma subtype arising on chronically sun-damaged skin and mostly affects the head and neck region. Localisation in cosmetically sensitive areas, difficulty to obtain wide resection margins and advanced patient age/comorbidities have encouraged investigation of less invasive therapeutic strategies than surgery in managing complex cases of LM. Radiotherapy and imiquimod have emerged as alternative treatment options in this context. Read More

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September 2021

From Galen to Eustachio: Discovering the Anatomy of the Facial Nerve.

Otol Neurotol 2021 Oct;42(9):1434-1441

Department of Head and Neck Surgery, David Geffen School of Medicine and Center for Medieval and Renaissance Studies, UCLA, Los Angeles, California.

Objective: To discuss the historical relevance of the original illustrations and descriptions of the facial nerve during the Italian Renaissance (ca. late 14th to early 17th centuries).

Material And Methods: Graphic and textual information related to facial nerve discoveries were harvested from the works of the study period's anatomists, with special attention to those of Leonardo da Vinci, Andreas Vesalius, Gabrielle Falloppio, and Bartolomeo Eustachio. Read More

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October 2021

Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?

Front Med (Lausanne) 2021 30;8:735150. Epub 2021 Aug 30.

Department of Functional Biology, Immunology Area, Faculty of Medicine, University of Oviedo, Oviedo, Spain.

Although psoriatic arthritis (PsA) primarily leads to joint and skin damage, it is associated with higher prevalence of metabolic syndrome (MetS) and its components, namely hypertension, dyslipidemia, obesity, and type II diabetes. Additionally, chronic inflammation is known to aggravate these cardiometabolic factors, thus explaining the enhanced cardiovascular (CV) morbidity and mortality in RA. Furthermore, emerging evidence suggest that some risk factors can fuel inflammation, thus pointing to a bidirectional crosstalk between inflammation and cardiometabolic factors. Read More

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Structure-based classification predicts drug response in EGFR-mutant NSCLC.

Nature 2021 Sep 15. Epub 2021 Sep 15.

Department of Biostatistics, MD Anderson Cancer Center, Houston, TX, USA.

Epidermal growth factor receptor (EGFR) mutations typically occur in exons 18-21 and are established driver mutations in non-small cell lung cancer (NSCLC). Targeted therapies are approved for patients with 'classical' mutations and a small number of other mutations. However, effective therapies have not been identified for additional EGFR mutations. Read More

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September 2021

A guide for optimal iodine staining and high-throughput diceCT scanning in snakes.

Ecol Evol 2021 Sep 26;11(17):11587-11603. Epub 2021 Jun 26.

Museum of Zoology University of Michigan Ann Arbor MI USA.

Diffusible iodine-based contrast-enhanced computed tomography (diceCT) visualizes soft tissue from micro-CT (µCT) scans of specimens to uncover internal features and natural history information without incurring physical damage via dissection. Unlike hard-tissue imaging, taxonomic sampling within diceCT datasets is currently limited. To initiate best practices for diceCT in a nonmodel group, we outline a guide for staining and high-throughput µCT scanning in snakes. Read More

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September 2021

[Prognostic value of the age-adjusted Charlson comorbidity index in patients over 60 years old with laryngeal squamous cell carcinoma].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Aug;56(8):837-843

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Caner/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

To evaluate the value of the age-adjusted Charlson comorbidity Index (ACCI) in predicting the prognosis and guiding the clinical treatment of laryngeal squamous cell carcinoma (LSCC) in patients over 60 years old. Retrospective analysis of 249 cases of LSCC in Shanxi Provincial Cancer Hospital and First Hospital of Shanxi Medical University from 2008 to 2015 was performed. There were 234 males and 15 females, aged from 60 to 88 years. Read More

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Differential diagnoses of solitary and multiple pigmented lesions of the oral mucosa: Evaluation of 905 specimens submitted to histopathological examination.

Head Neck 2021 Sep 14. Epub 2021 Sep 14.

Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Background: The aim was to analyze the frequency, clinical and demographic features of solitary and multiple/diffuse oral pigmented lesions submitted to histopathological examination, and to summarize the features that guide the clinical differential diagnosis.

Methods: Clinical and demographic data were retrieved from biopsy records and descriptive statistics were performed.

Results: Nine hundred and five (0. Read More

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September 2021

Multidisciplinary quality improvement initiative to optimize acute neurovascular imaging for transient ischemic attack or minor stroke.

CJEM 2021 Sep 13. Epub 2021 Sep 13.

Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.

Background: Neurovascular imaging for patients with high-risk transient ischemic attack (TIA) or minor stroke in the emergency department (ED) with computed tomography angiography (CTA) of the head and neck is the guideline-recommended standard of care, but it is underutilized in routine practice. We conducted a quality initiative to improve adherence to guidelines.

Methods: Between January 2017 and March 2019, we implemented a decision support tool integrated into the electronic ordering system to guide ED physicians to order a CTA on patients with high-risk TIA or minor stroke defined as ongoing neurological deficits in the ED or resolved motor or speech deficits in the preceding 48 h. Read More

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September 2021

Utility of Nasal Access Guides in Endoscopic Endonasal Skull Base Surgery: Assessment of Use during Cadaveric Dissection and Workflow Analysis in Surgery.

J Neurol Surg B Skull Base 2021 Oct 10;82(5):540-546. Epub 2020 Sep 10.

Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States.

 A nasal access guide (NAG) for endoscopic endonasal approaches (EEAs) to the skull-base has been developed and approved for clinical use but its utility has not been formally investigated.  The study aims to assess the effect of a NAG on endoscopic visualization during cadaveric dissection and to perform a workflow analysis with process-based performance measures in the operating room and their effect on clinical outcomes.  Skull-base course participants were observed during hands-on cadaveric dissection with and without NAG. Read More

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October 2021

Registry-based pilot epidemiological study of traumatic brain injury in a tertiary trauma care center in Kerala, India - Difficulties encountered during data collection warranting the need for standardized electronic database.

Vinu V Gopal

Surg Neurol Int 2021 16;12:414. Epub 2021 Aug 16.

Associate Professor, Department of Neurosurgery, Government Medical College, Kottayam, Kerala, India.

Background: Head injury is referred to as a "silent epidemic" globally. Studies regarding epidemiology of head injury are very few especially in Kerala and most have conflicting reports. Unlike developed countries, there is no well-established system for collecting and managing information on traumatic brain injury (TBI) in India, especially in Kerala. Read More

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Economic impact of COVID-19 pandemic on healthcare facilities and systems: International perspectives.

Best Pract Res Clin Anaesthesiol 2021 Oct 17;35(3):293-306. Epub 2020 Nov 17.

Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA. Electronic address:

International hospitals and healthcare facilities are facing catastrophic financial challenges related to the COVID-19 pandemic. The American Hospital Association estimates a financial impact of $202.6 billion in lost revenue for America's hospitals and healthcare systems, or an average of $50. Read More

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October 2021

A comparison of patient-specific instrumentation to navigation for conducting humeral head osteotomies during shoulder arthroplasty.

JSES Int 2021 Sep 14;5(5):875-880. Epub 2021 Jul 14.

Investigations performed at the Roth|McFarlane Hand and Upper Limb Center Biomechanics Laboratory, London, ON, Canada.

Background: The humeral head osteotomy during shoulder arthroplasty influences humeral component height, version and possibly neck-shaft angle. These parameters all potentially influence outcomes of anatomic and reverse shoulder replacement to a variable degree. Patient-specific guides and navigation have been studied and utilized clinically for glenoid component placement. Read More

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September 2021

Imaging of dental infections.

Emerg Radiol 2021 Sep 7. Epub 2021 Sep 7.

Department of Radiology, University of Florida College of Medicine-Jacksonville, 655 West 8th Street, Jacksonville, FL, 32209, USA.

Dental infections are a common presentation in the emergency department (ED). To help guide clinical management for these infections, the radiologist must be familiar with the anatomy of the oral cavity and neighboring structures, the range of appearance of dental infections, and the routes along which they may spread. Computed tomography (CT) is often performed when severe dental infections are suspected. Read More

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September 2021

A 14-Marker Multiplexed Imaging Panel for Prognostic Biomarkers and Tumor Heterogeneity in Head and Neck Squamous Cell Carcinoma.

Front Oncol 2021 19;11:713561. Epub 2021 Aug 19.

Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Recent advances made in treatment for head and neck squamous cell carcinoma (HNSCC) highlight the need for new prediction tools to guide therapeutic strategies. In this study, we aimed to develop a HNSCC-targeting multiplex immunohistochemical (IHC) panel that can evaluate prognostic factors and the intratumor heterogeneity of HNSCC. To identify IHC-based tissue biomarkers that constitute new multiplex IHC panel, a systematic review and meta-analysis were performed to analyze reported IHC biomarkers in laryngeal and pharyngeal SCC in the period of 2008-2018. Read More

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Should Sentinel Lymph Node Biopsy Status Guide Adjuvant Radiation Therapy in Patients With Merkel Cell Carcinoma?

Adv Radiat Oncol 2021 Nov-Dec;6(6):100764. Epub 2021 Jul 31.

Department of Radiation Oncology, University of California San Francisco, San Francisco, California.

Purpose: Radiation of the draining lymph node basin remains controversial for Merkel cell carcinoma, particularly in the era of sentinel lymph node biopsy (SLNB).

Methods And Materials: Based on a 20-year experience using SLNB-guided adjuvant radiation therapy (RT), we conducted a retrospective review of clinically node-negative patients testing 2 hypotheses: (1) whether nodal RT could be safely omitted in SLNB-negative Merkel cell carcinoma and (2) whether the excised primary site should always be radiated. Clinically node-positive patients were excluded. Read More

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Enhanced Visualization Methods for First Transurethral Resection of Bladder Tumour in Suspected Non-muscle-invasive Bladder Cancer: A Health Technology Assessment.


Ont Health Technol Assess Ser 2021 12;21(12):1-123. Epub 2021 Aug 12.

Background: Bladder cancer begins in the innermost lining of the bladder wall and, on histological examination, is classified as one of two types: non-muscle-invasive bladder cancer (NMIBC) or muscle-invasive bladder cancer. Transurethral resection of bladder tumour (TURBT) is the standard treatment for people with NMIBC, but the high rate of cancer recurrence after first TURBT is a challenge that physicians and patients face. Tumours seen during follow-up may have been missed or incompletely resected during first TURBT. Read More

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Multi-disciplinary management of patients with benign airway strictures: A review.

Respir Med 2021 Aug 21;187:106582. Epub 2021 Aug 21.

Interventional Pulmonology, Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, IL, USA. Electronic address:

Histologically benign airway strictures are frequently misdiagnosed as asthma or COPD and may present with severe symptoms including respiratory failure. A clear understanding of pathophysiology and existing classification systems is needed to determine the appropriate treatment options and predict clinical course. Clinically significant airway strictures can involve the upper and central airways extending from the subglottis to the lobar airways. Read More

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