The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally, and to identify those with highest relevance to them in ...addition to the more general issues covered by the core European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30).
A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30, which is widely used in research and in care and addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues that they would include in a thyroid cancer-specific QoL module.
The literature search and expert discussion provided a list of 71 QoL issues that was rated by thyroid cancer patients (n = 110) from seven countries. All issues were of high priority to at least some of the patients. The most frequently selected issues were sudden attacks of tiredness, exhaustion, quality of sleep, employment, social support, fear of cancer progression, fear of second operation, difficulties swallowing, and globus sensation.
Thyroid cancer patients cross-culturally rate fatigue-related issues as highly important for their QoL, calling for increased efforts to find successful treatments for this problem. Vocational rehabilitation is also highly relevant for them and should therefore be an important aim of multidisciplinary care. The third important area of concern is psychological issues, especially fear of progression and of additional treatments.
Nanoparticles (NPs) are released from orthopedic and neurosurgical prostheses and can interact with a number of blood components once in the bloodstream. Potential toxic effects of Co and Cr NPs on ...blood platelets have not been thoroughly investigated. The aim of this study was to analyze the effect of Co and Cr NPs on platelet function in vitro. The ability of the tested NPs to induce platelet activation and aggregation was measured using light transmission aggregometry, flow cytometry, and quartz crystal balance with dissipation (QCM-D). This was confirmed by transmission electron microscopy (TEM), scanning electron microscopy, and optical and immunofluorescence microscopy. Perfusion of QCM-D sensor crystals with platelet-rich-plasma in the presence of Co 28 nm, CoO 50 nm, Co
2
O
3
50 nm, Co
3
O
4
30-50nm, Cr 35-45nm, Cr
2
O
3
60 nm NPs (0.5-5.0 µg/mL) resulted in significant changes in frequency and dissipation, indicating that these NPs caused platelet microaggregation. Transmission electron microscopy also revealed that Cr NPs led to platelet swelling and lysis. Our study shows that both Co and Cr NPs affect platelet function in vitro with two distinct mechanisms. While Co NPs result in standard platelet aggregation, Cr NPs cause both platelet aggregation and decreased platelet membrane integrity and lysis. Based on these findings, monitoring serum NP levels and platelet-mediated hemostasis can be advised in patients with metal-on-metal Co-Cr prostheses.
Purpose
Accurate knowledge of greater palatine foramen (GPF) and greater palatine canal (GPC) anatomy is necessary to avoid injury to the greater palatine artery (GPA) when performing a variety of ...anesthesiologic, dental or surgical procedures. The aim of this paper was to perform a systematic review and meta-analysis of literature on the anatomy and localization of bony structures associated with the GPA, namely the GPF and GPC.
Methods
A systematic literature search was performed using PubMed, Embase, ScienceDirect, and Web of Science databases. Seventy-five studies were included in the meta-analysis (
n
= 22,202 subjects).
Results
The meta-analysis showed that the GPF is positioned 17.21 mm (95% CI = 16.34–18.09 mm) from the posterior nasal spine, 2.56 mm (95% CI = 1.90–3.22 mm) from the posterior border of the hard palate, 46.24 mm (95% CI = 44.30–48.18 mm) from the anterior nasal spine, 15.22 mm (95% CI = 15.00–15.43 mm) from the midline maxillary suture, 37.32 mm (95% CI = 36.19–38.45 mm) from the incisive foramen, and opposite the third maxillary molar (M3) in 64.9% (58.7–70.7%) of the total population.
Conclusion
An up-to-date, comprehensive analysis of GPF and GPC clinical anatomy is presented. The results from this evidence-based anatomical study provides a unified set of data to aid clinicians in their practice.
The purpose of the study was to pilot-test a questionnaire measuring health-related quality of life (QoL) in thyroid cancer patients to be used with the European Organisation for Research and ...Treatment of Cancer (EORTC) core questionnaire EORTC QLQ-C30. A provisional questionnaire with 47 items was administered to patients treated for thyroid cancer within the last 2 years. Patients were interviewed about time and help needed to complete the questionnaire, and whether they found the items understandable, confusing or annoying. Items were kept in the questionnaire if they fulfilled pre-defined criteria: relevant to the patients, easy to understand, not confusing, few missing values, neither floor nor ceiling effects, and high variance. A total of 182 thyroid cancer patients in 15 countries participated (
= 115 with papillary,
= 31 with follicular,
= 22 with medullary,
= 6 with anaplastic, and
= 8 with other types of thyroid cancer). Sixty-six percent of the patients needed 15 min or less to complete the questionnaire. Of the 47 items, 31 fulfilled the predefined criteria and were kept unchanged, 14 were removed, and 2 were changed. Shoulder dysfunction was mentioned by 5 patients as missing and an item covering this issue was added. To conclude, the EORTC quality of life module for thyroid cancer (EORTC QLQ-THY34) is ready for the final validation phase IV.
Summary Objectives The recurrent laryngeal nerve and its branches form a great variety of anastomoses. These nerve communications can alter the innervation patterns of the laryngeal muscles and can ...affect both the diagnosis and treatment of paralyzed vocal cords. The aim of this study was to assess the prevalence and anatomical characteristics of the laryngeal nerve connections, and to review their function and clinical significance. Study Design Meta-analysis and systematic review. Methods The major electronic databases were thoroughly searched to identify all studies reporting data on the anastomoses of the laryngeal nerves. Data on the prevalence of each type of anastomosis were extracted and pooled into a meta-analysis using MetaXL version 3.0 (EpiGear International Pty. Ltd., Wilston, Queensland, Australia). Results Twenty-two cadaveric studies (n = 1404 hemilarynges) were included in the meta-analysis. The two most common communications were Galen's anastamosis and the arytenoid plexus. The pooled prevalence estimate for Galen's anastamosis was 76.7% (95% confidence interval CI: 59.0–90.0), of which the single trunk type was most common (92.3%). The arytenoid plexus had a pooled prevalence estimate of 79.7% (95% CI: 41.1–100). Conclusions Owing to the high prevalences and variability of nerve connections in the larynx, detailed anatomical knowledge of these anastomoses can be crucial for the accurate interpretation of laryngoscopy results, reducing iatrogenic injury during surgical procedures, and facilitating the development of novel strategies for treating laryngeal paralyses.
Abstract Objectives To assess the cuspal deflection and cervical microleakage scores of standardised large mesio-occlusal-distal (MOD) cavities filled with different restoration protocols: (1) ...conventional resin restoratives, (2) bulk fill flowable base materials ‘capped’ with a conventional dimethacrylate resin-based composite (RBC) or (3) bulk fill resin restorative materials. Methods Standardised MOD cavities were prepared in sixty-four sound maxillary premolar teeth and randomly allocated to eight groups. Restorations were placed in conjunction with a universal bonding system and resin restorative materials were irradiated with a quartz-tungsten-halogen light-curing-unit. Restoration protocol (eight oblique increments of conventional resin restorative, bulk fill flowable base and two occlusal ‘capping’ RBC increments (three increments in total) or bulk fill resin restorative (two increments)) was the dependent variable. A twin channel deflection measuring gauge measured the buccal and palatal cuspal deflections. Teeth were thermally fatigued, immersed in a 0.2% basic fuchsin dye for 24 h, sectioned and examined for cervical microleakage score. Results Post hoc Tukey's tests highlighted significant differences in the mean total cuspal deflection values between resin restoratives ( p < 0.0001) and restoration protocol ( p < 0.005). In general (albeit product dependently), an increase in mean total cuspal deflection and concomitant decrease in cervical microleakage score was evident for bulk fill flowable base materials with occlusal ‘capping’ RBC increments (restoration protocol 2) compared with bulk fill resin restoratives (restoration protocol 3). Conclusions Not all bulk fill flowable materials or bulk fill resin restoratives behave in a similar fashion when used to restore standardised MOD cavities in maxillary premolar teeth and material selection is vital in the absence of clinical data. Clinical significance Poorly performing bulk fill flowable materials or bulk fill restoratives can be identified using the cuspal deflection and cervical microleakage protocol which could save the complications encountered clinically when restoring Class II restorations.
Abstract Context Cachexia is commonly found in cancer patients and has profound consequences yet there is only one questionnaire that examines the patient’s perspective. Objective To report a ...rigorously developed module for patient self-reported impact of cancer cachexia. Methods Module development followed published guidelines. Patients from across the cancer cachexia trajectory were included. In Phase 1, HRQOL issues were generated from a literature review and interviews with patients in four countries. The issues were revised based on patient and health care professional (HCP) input. In Phase 2, questionnaire items were formulated and translated into the languages required for Phase 3, the pilot phase, in which patients from eight countries scored the relevance and importance of each item, and provided qualitative feedback. Results A total of 39 patients and 12 HCPs took part in Phase 1. The literature review produced 68 HRQOL issues, with 22 new issues arising from the patient interviews. Following patient and HCP input, 44 issues were formulated into questionnaire items in Phase 2. 110 patients took part in Phase 3. One item was reworded and 20 items were deleted as a consequence of patient feedback. Conclusions The QLQ-CAX24 is a cancer cachexia-specific questionnaire, comprising 24 items, for HRQOL assessment in clinical trials and in practice. It contains five multi-item scales (food aversion, eating and weight-loss worry, eating difficulties, loss of control and physical decline) and four single items.
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