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Assessing Symptomatic Hypocalcemia Risk After Total Thyroidectomy: A Prospective Study. 评估全甲状腺切除术后症状性低钙血症的风险:一项前瞻性研究
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1777450
Andro Košec, Ana Gašić, Filip Hergešić, Ivan Rašić, Vesna Košec, Vladimir Bedeković

Introduction  The most common postoperative complication of total thyroidectomy is hypocalcemia, usually monitored using serum parathyroid hormone and calcium values. Objective  To identify the most accurate predictors of hypocalcemia, construct a risk assesment algorithm and analyze the impact of using several calcium correction formulas in practice. Methods  A prospective, single-center, non-randomized longitudinal cohort study on 205 patients undergoing total thyroidectomy. Parathyroid hormone, serum, and ionized calcium were sampled post-surgery, with the presence of symptomatic or laboratory-verified asymptomatic hypocalcemia designated as primary outcome measures. Results  Parathyroid hormone sampled on the first postoperative day was the most sensitive predictor of symptomatic hypocalcemia development (sensitivity 80.22%, cut-off value ≤2.03 pmol/L). A combination of serum calcium and parathyroid concentration sampled on the first postoperative day predicted the development of hypocalcemia during recovery with the highest sensitivity and specificity (94% sensitivity, cut-off ≤2.1 mmol/L, and 89% specificity, cut-off ≤1.55 pmol/L, respectively). The use of algorithms and correction formulas did not improve the accuracy of predicting symptomatic or asymptomatic hypocalcemia. Conclusions  The most sensitive predictor of symptomatic hypocalcemia present on the fifth postoperative day was PTH sampled on the first postoperative day. The need for algorithms and correction formulas is limited.

引言 甲状腺全切除术术后最常见的并发症是低钙血症,通常使用血清甲状旁腺激素和血钙数值进行监测。目的 确定低钙血症最准确的预测因素,构建风险评估算法,并分析在实践中使用多种钙校正公式的影响。方法 对 205 名接受全甲状腺切除术的患者进行前瞻性、单中心、非随机纵向队列研究。手术后对甲状旁腺激素、血清和离子钙进行采样,以是否出现无症状或实验室证实的无症状低钙血症为主要结果指标。结果 术后第一天采样的甲状旁腺激素是预测症状性低钙血症发生的最灵敏指标(灵敏度为80.22%,临界值≤2.03 pmol/L)。术后第一天采样的血清钙和甲状旁腺浓度组合预测恢复期低钙血症的发生具有最高的灵敏度和特异性(灵敏度为94%,临界值≤2.1 mmol/L;特异性为89%,临界值≤1.55 pmol/L)。使用算法和校正公式并不能提高预测无症状或无症状低钙血症的准确性。结论 对术后第五天出现的无症状低钙血症最敏感的预测指标是术后第一天采样的 PTH。对算法和校正公式的需求有限。
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引用次数: 0
Diagnostic Delay in HPV-Related Oropharyngeal Squamous Cell Carcinoma. 与 HPV 相关的口咽鳞状细胞癌的诊断延迟。
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1767795
Patrick O McGarey, Osama Hamdi, Lane Donaldson, Kevin Zhan, Edwin F Crandley, David D Wilson, Austin J Sim, Paul W Read, Jonathan C Garneau, Katherine L Fedder, David C Shonka, Mark J Jameson

Introduction  Human papillomavirus-related (HPV + ) oropharyngeal squamous cell carcinoma (OPSCC) is increasing in incidence and presents diagnostic challenges given its unique clinical presentation. Objective  The purpose of the present study is to characterize the impact of the unique clinical presentation of HPV-related OPSCC on delays in diagnosis. Methods  Retrospective review of presenting symptoms and clinical characteristics of 284 patients with OPSCC treated from 2002-2014. Delay in diagnosis was defined as the presence of any of the following: multiple non-diagnostic fine needle aspirate (FNA) biopsies; two or more courses of antibiotic therapy; surgery with incorrect preoperative diagnosis; evaluation by an otolaryngologist without further workup; or surgery without definitive postoperative diagnosis. Results  p16+ tumors demonstrated a distinct clinical presentation that more commonly involved a neck mass (85.1% versus 57.3% of p16-; p  < 0.001) and less frequently included odynophagia (24.6% versus 51.7% of p16-; p  < 0.001). Patients who experienced diagnostic delay were more likely to have p16+ tumors (77.7% delayed versus 62.8% not delayed; p  = 0.006). p16+ primary tumors were more likely to be undetectable by physical examination of the head and neck including flexible laryngoscopy (19.0% versus 6.7% of p16-; p  = 0.007) and more frequently associated with nondiagnostic FNA biopsies of a cervical nodal mass (11.8% versus 3.4% of p16-, p  = 0.03). Conclusions  Compared with non-HPV related OPSCC, the unique clinical presentation and characteristics of HPV+ OPSCC are associated with an increased incidence of diagnostic delay. Targeted education of appropriate care providers may improve time to diagnosis and treatment.

引言 人乳头瘤病毒相关(HPV + )口咽鳞状细胞癌(OPSCC)的发病率越来越高,其独特的临床表现给诊断带来了挑战。本研究旨在分析 HPV 相关口咽鳞癌的独特临床表现对诊断延误的影响。方法 回顾性分析 2002-2014 年间接受治疗的 284 例 OPSCC 患者的主要症状和临床特征。诊断延迟的定义是出现以下任何一种情况:多次细针穿刺活检(FNA)无诊断结果;两个或两个以上疗程的抗生素治疗;术前诊断不正确的手术;耳鼻喉科医生评估后未做进一步检查;或术后诊断不明确的手术。结果 p16+ 肿瘤表现出独特的临床表现,更常见的是颈部肿块(85.1% 对 57.3%;P P = 0.006)。0% 对 p16- 的 6.7%;p = 0.007),并且更常与颈部结节肿块的无诊断性 FNA 活检相关(11.8% 对 p16- 的 3.4%,p = 0.03)。结论 与非 HPV 相关的 OPSCC 相比,HPV+ OPSCC 独特的临床表现和特征与诊断延迟发生率的增加有关。对适当的医疗服务提供者进行有针对性的教育可缩短诊断和治疗时间。
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引用次数: 0
A Comparative Study on the General and Otolaryngological Manifestations of COVID-19 in the Hospitalized Population of the Telangana Region During the First and Second Waves. 泰兰加纳地区第一波和第二波住院人群中 COVID-19 全身和耳鼻喉表现的比较研究。
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1777419
Uma Pokala, Shilpa Potnuru, Sasikala Kanapalli, Agni Vishnu Sailesh, Naveen P

Introduction  Some common symptoms of coronavirus disease 2019 (COVID-19) are fever, cough, and shortness of breath. But ear, nose, and throat (ENT) manifestations such as loss of smell and taste are also very common. Objectives  To compare the general and otorhinolaryngological manifestations of COVID-19 and to compare the treatments given and mortality rate during its two waves. Methods  This retrospective study was conducted on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in a tertiary care teaching hospital. Six hundred patients were included in the 1st wave sample and 516 were in the 2nd wave sample. The data collected included demographics, comorbidities, general, and ENT symptoms, need for ventilatory support, oxygen therapy, and mortality for both the waves. Results  Fever, malaise, and myalgia were more frequently presented in the first wave than in the second, whereas shortness of breath was more common in the second wave. In the second wave, a significant increase in anosmia cases was reported, whereas sore throat, nasal obstruction, dysphagia, nasal discharge, and sneezing were significantly reduced compared with the first wave ( p  < 0.001). The case fatality rate increased from 11.33 to 21.55% ( p  < 0.001) from the 1 st to the 2 nd wave. The patients who died in the second wave were younger than those in the first wave. Two doses of vaccination showed protection from the death over those not vaccinated and those who only received one dose ( p  < 0.05). Conclusion  Ear, nose, and throat (ENT) manifestations are very common along with the general symptoms. As anosmia and dysgeusia are early presenting symptoms in COVID-19 patients, all physicians should screen patients for ENT symptoms.

导言 2019 年冠状病毒病(COVID-19)的一些常见症状是发烧、咳嗽和呼吸急促。但耳鼻喉科(ENT)的表现也很常见,如嗅觉和味觉丧失。目的 比较 COVID-19 的一般表现和耳鼻喉科表现,并比较两次发病期间的治疗方法和死亡率。方法 该回顾性研究针对一家三级教学医院的严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)病例。第一波样本包括 600 名患者,第二波样本包括 516 名患者。收集的数据包括人口统计学、合并症、全身症状、耳鼻喉科症状、呼吸机支持需求、氧疗以及两波样本的死亡率。结果 第一波比第二波更常见发热、乏力和肌痛,而第二波更常见呼吸急促。在第二波中,无嗅病例明显增加,而咽喉痛、鼻塞、吞咽困难、流鼻涕和打喷嚏的病例与第一波相比明显减少(p p st 至第二波)。第二波接种后死亡的患者比第一波接种后死亡的患者年轻。接种两剂疫苗后,与未接种疫苗者和只接种一剂疫苗者相比,接种两剂疫苗的患者可避免死亡。由于嗅觉障碍和味觉障碍是 COVID-19 患者的早期症状,所有医生都应筛查患者的耳鼻喉症状。
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引用次数: 0
Sleep Patterns and Associated Insomnia in Junior and Senior Medical Students: A Questionnaire-Based Cross-Sectional Study. 大三和大四医学生的睡眠模式及相关失眠症:基于问卷的横断面研究。
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1776731
Ghady Dhafer Alshehri, Ahlam Ahmed Almahmoudi, Afnan Abdullah Alsaif, Bashayer Hassan Shalabi, Hana Zuhair Fatani, Fatima Hassan Aljassas, Dania Wazen Alsulami, Faris Alhejaili, Faisal Zawawi

Introduction  Appropriate quality and quantity of sleep are critical for good mental health, optimal body functioning, memory consolidation, and other cognitive processes. Objectives  To evaluate the sleeping patterns of medical students in Saudi Arabia and their relationships with psychological distress. Methods  This was a cross-sectional, self-administered, questionnaire-based study. The study included medical students from a university in Jeddah, Saudi Arabia. The Pittsburgh Sleep Quality Index (PSQI) and the Athens Insomnia Scale (AIS) were used to evaluate the prevalence and burden of inadequate sleep quality and insomnia in the participants. Results  The majority of the participants was women (76.6%). Furthermore, most participants (96.2%) were aged between 18 and 24 years old, while 54.4% of the participants were in their senior year. According to the AIS scores (mean: 15.85 ± 4.52), 98.7% of the participants exhibited insomnia symptoms. The PSQI scores (mean: 9.53 ± 5.67) revealed that 70.5% of the participants had poor sleep quality. Students in their fundamental and junior years had significantly higher percentages of insomnia symptoms and poor sleep quality compared with students in their senior years. Conclusion  The prevalence of insomnia and poor sleep quality is high among medical students. Therefore, appropriate strategies for early detection and intervention are warranted.

导言 适当的睡眠质量和数量对良好的心理健康、最佳的身体机能、记忆巩固和其他认知过程至关重要。目标 评估沙特阿拉伯医科学生的睡眠模式及其与心理困扰的关系。方法 这是一项横断面自填式问卷调查研究。研究对象包括沙特阿拉伯吉达一所大学的医学生。采用匹兹堡睡眠质量指数(PSQI)和雅典失眠量表(AIS)来评估参与者睡眠质量不足和失眠的发生率和负担。结果 大部分参与者为女性(76.6%)。此外,大多数参与者(96.2%)的年龄介于 18 至 24 岁之间,54.4%的参与者正在读高三。根据 AIS 评分(平均值:15.85 ± 4.52),98.7% 的参与者有失眠症状。PSQI 分数(平均值:9.53 ± 5.67)显示,70.5%的参与者睡眠质量较差。与高年级学生相比,低年级和高三学生的失眠症状和睡眠质量差的比例明显更高。结论 医学生失眠和睡眠质量差的发病率很高。因此,有必要采取适当的策略进行早期检测和干预。
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引用次数: 0
Olfactory Dysfunction in Adults from Rio Grande do Norte: A Cross-Sectional Study. 北里奥格兰德州成年人的嗅觉功能障碍:一项横断面研究
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-04-01 DOI: 10.1055/s-0043-1777448
Henrique de Paula Bedaque, Emerson Kennedy Ribeiro de Andrade Filho, Caio de Oliveira Rabelo, José Eduardo Nóbrega Moura, Kelvin Leite Moura, José Diniz Junior, Maria Luisa Nobre Medeiros E Silva Guimarães

Introduction  Smell is one of the senses of the human body, and it can be affected by several factors, such as viral infections, traumatic brain injury, iatrogenesis, smoking, and neurodegenerative and systemic diseases. Objectives  The main goal of the present study is to describe the epidemiology of olfactory disorders in Rio Grande do Norte (RN). More specifically, to determine the prevalence of olfactory dysfunction and to identify the main risk factors related to these dysfunctions in the state's population. Methods  A total of 180 volunteers living in the RN underwent the Connecticut Clinical Research Center (CCCRC) smell test and a clinical and demographic questionnaire. Results  A total of 58.89% of the patients presented normosmia and 87.78% were classified as having between normal and mild hyposmia. A statistically significant relationship was found between worse performance in the test and nasal surgery ( p  = 0.041) and the subjective feeling of not having an accurate sense of smell ( p  = 0.006 on the right nostril). There was no statistical relationship between the olfactory status and the report of coronavirus disease 2019 (COVID-19) infection ( p  = 0.254). Conclusion  The occurrence of altered sense of smell in our study was different from that reported in other studies that used the same test. The relationship with COVID-19 was not clear.

引言 嗅觉是人体的感官之一,它可能受到多种因素的影响,如病毒感染、脑外伤、先天性疾病、吸烟、神经退行性疾病和全身性疾病。本研究的主要目的是描述北里奥格兰德州(RN)嗅觉障碍的流行病学。更具体地说,是确定该州人口中嗅觉功能障碍的患病率,并找出与这些功能障碍相关的主要风险因素。方法 共有 180 名居住在罗德西亚州的志愿者接受了康涅狄格州临床研究中心(CCCRC)的嗅觉测试以及临床和人口调查问卷。结果 58.89% 的患者嗅觉正常,87.78% 的患者嗅觉正常至轻度减退。测试结果较差与鼻腔手术(p = 0.041)和嗅觉不准确的主观感觉(右鼻孔 p = 0.006)之间有统计学意义。嗅觉状况与冠状病毒病 2019(COVID-19)感染报告之间没有统计学关系(p = 0.254)。结论 在我们的研究中,嗅觉改变的发生与其他使用相同测试的研究报告不同。与 COVID-19 的关系尚不明确。
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引用次数: 0
Effects of Maxillary Movements on Lips Following Orthognathic Surgery: A Retrospective Non-Randomized Clinical Trial. 正颌手术后上颌骨移动对嘴唇的影响:一项回顾性非随机临床试验
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1773759
Soodeh Tahmasbi, Kasra Rahimipour, Mahshid Namdari, Reza Tabrizi, Fatemesadat Seyedzadeghomi

Introduction  Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery. Objective  To assess the upper lip changes following Le Fort I osteotomy for maxillary advancement and/or impaction. Methods  In the present retrospective non-randomized clinical trial, we evaluated 3 groups of patients who underwent Le Fort I osteotomy of the maxilla. Group 1 (n = 35) underwent maxillary advancement, group 2 (n = 14), maxillary impaction, and group 3 (n = 11) was submitted to both maxillary advancement and impaction. The lip thickness of all patients was measured preoperatively, and the participants in each group were categorized into two subgroups: thin (< 12 mm) and thick (> 12 mm) lip. The primary (before orthognathic surgery) and final (after orthodontic bracket removal) lateral cephalograms of the patients were analyzed using the Dolphin software. Comparisons were made using the paired t -test and linear regression in the IBM SPSS Statistics for Windows software. Results  The length of the upper lip increased by 1 mm ( p  = 0.012) on average following maxillary advancement, and it decreased by 0.43 mm ( p  = 0.24) on average following maxillary impaction. In the maxillary advancement group, the change in angulation of the incisors predicted the incisal display ( p  = 0.03). In the maxillary impaction group, skeletal changes in the vertical dimension predicted changes in upper lip length ( p  = 0.033). Conclusions  Le Fort I osteotomy for maxillary advancement significantly increases the length of the upper lip. The assessment of lip thickness prior to surgery can help predict the postoperative results. Changing the angulation of the incisors can predict the incisal display. In maxillary impaction, skeletal changes in the vertical dimension can predict the changes in the length of the upper lip.

引言 嘴唇对面部吸引力和正颌外科手术的决定起着至关重要的作用。目的 评估因上颌骨前移和/或阻塞而接受 Le Fort I 截骨术后上唇的变化。方法 在本回顾性非随机临床试验中,我们对 3 组接受 Le Fort I 上颌骨截骨术的患者进行了评估。第一组(35 人)接受上颌前移术,第二组(14 人)接受上颌阻滞术,第三组(11 人)同时接受上颌前移术和上颌阻滞术。术前测量了所有患者的嘴唇厚度,并将每组患者分为薄唇(< 12 毫米)和厚唇(> 12 毫米)两组。使用 Dolphin 软件对患者的初次(正颌手术前)和最终(正畸托槽移除后)侧向头影进行分析。在 IBM SPSS Statistics for Windows 软件中使用配对 t 检验和线性回归进行比较。结果 上颌骨前移术后,上唇长度平均增加了 1 毫米(p = 0.012),而上颌骨阻塞术后,上唇长度平均减少了 0.43 毫米(p = 0.24)。在上颌前突组中,切牙角度的变化可以预测切迹的显示 ( p = 0.03)。在上颌阻塞组,垂直维度的骨骼变化可预测上唇长度的变化 ( p = 0.033)。结论 用于上颌前突的 Le Fort I 截骨术可显著增加上唇长度。术前对嘴唇厚度的评估有助于预测术后效果。改变切牙的角度可以预测切口的显示效果。在上颌阻塞术中,垂直维度的骨骼变化可以预测上唇长度的变化。
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引用次数: 0
Fast-Tracking of Publication Times of Otolaryngology Papers During the COVID-19 Pandemic. 在 COVID-19 大流行期间快速跟踪耳鼻喉科论文的发表时间。
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1767806
Irit Duek, Nidal Muhanna, Yahav Oron, Yohai Shraga, Omer J Ungar

Introduction  The outbreak of COVID-19 has produced an unprecedented number of trials and articles. Objective  To study the impact of the COVID-19 pandemic on otolaryngology-head and neck surgery (ORL-HNS) journal processing times. Methods  Original papers search of published in selected ORL-HNS journals in terms of times from submission-to-acceptance (S-A), acceptance-to-first online publication (A-P), and submission-to-online publication (S-P). Papers were divided into those published in the pre-COVID-19 era and those during the COVID-19 era. The latter were further divided into unrelated to COVID-19 and related to COVID-19. Results  A total of 487 articles from 5 selected ORL-HNS journals were included, of which 236 (48.5%) were published during the pre-COVID-19 era and 251 (51.5%) were published during the COVID-19 era. Among them, 180 (37%) papers were not related to COVID-19, and 71 (14.5%) were related to COVID-19. The S-A duration of COVID-19-related articles was significantly shorter compared with that of papers submitted in the pre-COVID-19 era and to papers submitted in the COVID-19 era but unrelated to COVID-19 (median 6 to 34 days compared to 65 to 125 and 46 to 127, respectively) in all 5 journals. The most prominent reductions in S-A and S-P times were documented in the laryngology and otology/neurotology disciplines, respectively. Conclusions  Processing times of the included papers were significantly shorter in most of the selected ORL-HNS journals during the COVID-19 era compared with the pre-COVID-19 era. COVID-19-related papers were processed more rapidly than non-COVID-19-related papers. These findings testify to the possibility of markedly expediting S-P times and hopefully set a precedent for postpandemic publishing schedules. Level Of Evidence: 5.

引言 COVID-19 的爆发产生了前所未有的大量试验和文章。目的 研究 COVID-19 大流行对耳鼻咽喉头颈外科(ORL-HNS)期刊处理时间的影响。方法 按照从投稿到接受(S-A)、从接受到首次在线发表(A-P)和从投稿到在线发表(S-P)的时间对选定的耳鼻咽喉头颈外科(ORL-HNS)期刊上发表的原创论文进行检索。论文分为前 COVID-19 时代发表的论文和 COVID-19 时代发表的论文。后者又分为与 COVID-19 无关的论文和与 COVID-19 相关的论文。结果 从 5 种选定的 ORL-HNS 期刊中共收录了 487 篇文章,其中 236 篇(48.5%)发表于前 COVID-19 时代,251 篇(51.5%)发表于 COVID-19 时代。其中 180 篇(37%)与 COVID-19 无关,71 篇(14.5%)与 COVID-19 有关。在所有 5 种期刊中,COVID-19 相关论文的 S-A 持续时间明显短于前 COVID-19 时代发表的论文,也短于 COVID-19 时代发表但与 COVID-19 无关的论文(中位数分别为 6 至 34 天和 65 至 125 天和 46 至 127 天)。S-A和S-P时间缩短最明显的学科分别是喉科学和耳科学/神经科学。结论 COVID-19 时代与 COVID-19 之前相比,大多数所选 ORL-HNS 期刊收录论文的处理时间明显缩短。与 COVID-19 相关的论文比与 COVID-19 无关的论文处理速度更快。这些发现证明了明显加快S-P时间的可能性,并有望为流行病后的出版时间表开创先例。证据等级:5.
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引用次数: 0
Neck Dissection with Harmonic Instruments and Electrocautery: A Systematic Review. 使用谐波器械和电烧进行颈部解剖:系统综述。
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-05 eCollection Date: 2024-10-01 DOI: 10.1055/s-0044-1779010
Rogério Aparecido Dedivitis, Leandro Luongo de Matos, Mario Augusto Ferrari Castro, Sílvia Migueis Picado Petrarolha, Luiz Paulo Kowalski

Introduction  The harmonic scalpel (HS) is a technique introduced to reduce blood loss and intraoperative time during neck dissection (ND). Objective  To compare the results of HS with traditional hemostasis in ND through a systematic review and metanalysis. Methods  A computer-based strategy of systematic literature survey included research in the MEDLINE, EMBASE, and Cochrane Library databases from January 2007 up to August 2022. The survey strategy employed was [harmonic scalpel OR ultrasonic scalpel] AND neck dissection. Results  There were 61 articles identified that addressed the use of HS in patients undergoing ND. From those, 10 randomized clinical trials were selected, comprising 264 cases of ND using HS and 262 cases of ND without HS. Conclusion  The use of HS for ND significantly reduces the operative time, intraoperative bleeding, volume of draining fluid, and the number of ligatures.

引言 谐波手术刀(HS)是为减少颈部解剖(ND)术中失血量和缩短术中时间而引入的一种技术。目的 通过系统综述和荟萃分析比较谐波刀与传统止血法在 ND 中的效果。方法 采用基于计算机的系统文献调查策略,纳入 2007 年 1 月至 2022 年 8 月期间 MEDLINE、EMBASE 和 Cochrane Library 数据库中的研究。采用的调查策略为[谐波手术刀或超声波手术刀]和颈部解剖。结果 共发现 61 篇关于在接受 ND 的患者中使用 HS 的文章。从中筛选出 10 项随机临床试验,包括 264 例使用 HS 的 ND 和 262 例未使用 HS 的 ND。结论 在 ND 中使用 HS 可显著减少手术时间、术中出血量、引流液量和结扎次数。
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引用次数: 0
Role of Virtual Bronchoscopy in Evaluation of Suspected Foreign Body in Children's Tracheobronchial Tree. 虚拟支气管镜在评估儿童气管支气管疑似异物中的作用。
IF 1 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-02-05 eCollection Date: 2024-07-01 DOI: 10.1055/s-0043-1778015
Rachana M Prajapati, Jayman B Raval, Ranjan G Aiyer

Introduction  The presence of foreign bodies in the airways remain a diagnostic challenge to healthcare professionals. They can become life threatening emergencies that require immediate intervention or go unnoticed for weeks and even months. Prevention is best but early recognition remains a critical factor in treatment of foreign body inhalation in children. Objective  To study the diagnostic advantages of virtual over rigid bronchoscopy in the evaluation of children with suspected foreign body in the tracheobronchial tree and plan for early management. Methods  A crossectional study conducted at a tertiary care hospital & medical college in India. A total 24 patients (0-12-years-old) who presented with complaints of sudden onset of coughing, choking, and breathing difficulty were included during the 2-year duration, from January 2018 to December 2019. All patients underwent virtual and rigid bronchoscopy. Results  In 8 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. There was one case in which virtual bronchoscopy showed no foreign body, but rigid bronchoscopy detected it. In 15 cases virtual and rigid bronchoscopy did not show foreign bodies. The sensitivity, specificity, positive and negative predictive value of virtual bronchoscopy were 88.88, 100, 100, and 93.75%, respectively. Conclusions  Virtual bronchoscopy is less invasive and does not require general anesthesia but cost and availability are limitations. It can be used as method of investigation in children with suspected foreign body aspiration.

导言 气道异物仍然是医护人员面临的诊断难题。这些异物可能成为危及生命的紧急情况,需要立即进行干预,也可能在数周甚至数月后才被发现。预防是最好的办法,但早期识别仍是治疗儿童异物吸入的关键因素。目的 研究在评估气管支气管树疑似异物患儿时,虚拟支气管镜比硬质支气管镜的诊断优势,并制定早期治疗计划。方法 在印度的一家三级医院和医学院进行了一项横断面研究。在 2018 年 1 月至 2019 年 12 月的 2 年时间内,共纳入了 24 名主诉突然出现咳嗽、呛咳和呼吸困难的患者(0-12 岁)。所有患者均接受了虚拟和硬质支气管镜检查。结果 8 例患者通过虚拟支气管镜检查发现的异物经硬质支气管镜检查证实。1例患者的虚拟支气管镜检查未发现异物,但硬质支气管镜检查发现了异物。有 15 例虚拟和硬质支气管镜检查均未发现异物。虚拟支气管镜检查的敏感性、特异性、阳性预测值和阴性预测值分别为 88.88%、100%、100% 和 93.75%。结论 虚拟支气管镜检查创伤较小,无需全身麻醉,但成本和可用性是其局限性。虚拟支气管镜可作为疑似异物吸入儿童的检查方法。
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引用次数: 0
Evaluation and Treatment of Dysphagia in Public and Private Intensive Care Units (ICUs) in Greece. 希腊公立和私立重症监护病房(ICU)中吞咽困难的评估和治疗。
IF 1.1 Q3 Medicine Pub Date : 2024-02-05 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1767676
Soultana L Papadopoulou, Evangelia Kitsanou, Ermioni Brahimi, Georgios Papathanakos, Ioannis Andrianopoulos, Stavroula J Theodorou, Vasilios Koulouras, Nafsica Ziavra

Introduction  Dysphagia is a significant but underrecognized clinical issue in the intensive care unit (ICU), and it is associated with various complications. Despite its clinical importance, there is limited research and no Greek ICU-specific guidelines for managing dysphagic patients. Additionally, only a few ICUs in Greece have dysphagia specialists, specifically speech-language pathologists (SLPs) providing their expertise. Objective  Τo identify the current practices for dysphagia management (screening, assessment, treatment) and gain insight into ICU directors' awareness/perceptions of the prevalence, complications, and risk of dysphagia. Materials and Methods  We identified 138 Greek ICUs. Data were collected from ICU (including pediatric and neonatal) directors, working in public and private hospitals, via a 24-item, anonymous online questionnaire, within a 4-month period. Results  Our survey was completed by 45 ICU directors. Most participants (84.4%) reported that dysphagia is a relevant clinical problem in their ICU, and 51.1% estimated a frequency rate < 20%. Non-instrumental approaches are mainly utilized to screen and diagnose dysphagia, whereas enteral nutrition and diet modifications are used to manage dysphagia. Additionally, 64.4% of ICU directors agreed that SLPs are essential for the management of dysphagic patients, and 66.7%, that awareness of dysphagia in their ICU could be increased. Conclusion  The current study documented the methods and approaches used to manage dysphagic patients in Greek ICUs. The ICU directors seem to recognize the clinical significance of dysphagia and its complications. According to our findings, the employment of SLPs could result in a more comprehensive and intensive approach and improve the quality of care for these patients.

导言 吞咽困难是重症监护病房(ICU)中一个重要但未得到充分认识的临床问题,它与各种并发症有关。尽管吞咽困难具有重要的临床意义,但希腊针对吞咽困难患者管理的研究和重症监护病房指南却十分有限。此外,希腊只有少数重症监护室有吞咽困难专家,特别是提供专业知识的语言病理学家(SLP)。目的 Τo 确定目前吞咽困难管理(筛查、评估、治疗)的做法,并深入了解 ICU 主任对吞咽困难患病率、并发症和风险的认识/看法。材料和方法 我们确定了 138 家希腊 ICU。在为期 4 个月的时间内,我们通过 24 个项目的匿名在线问卷向公立和私立医院的 ICU(包括儿科和新生儿科)主任收集了数据。结果 45 名重症监护室主任完成了我们的调查。大多数参与者(84.4%)表示,吞咽困难是其重症监护室的一个相关临床问题,51.1%的参与者估计了吞咽困难的发生率 结论 本次研究记录了希腊重症监护室管理吞咽困难患者的方法和途径。ICU 主任似乎认识到了吞咽困难及其并发症的临床意义。根据我们的研究结果,SLP 的使用可以带来更全面、更深入的方法,并提高对这些患者的护理质量。
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引用次数: 0
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International Archives of Otorhinolaryngology
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