Treatment Of Type Research Articles

FEATURES OF ANTIBACTERIAL AND LYMPHOTROPIC THERAPY IN PATIENTS WITH PLEURAL EMPYEMA

Abstract. Acute empyema belongs to the category of severe surgical pathology. The difficulty of its treatment is caused by a number of objective and subjective reasons, in particular such as wide spread of antibiotic-resistant microflora and population allergy. Carefully collected analysis, patient’s examination, study of lungs function indicators, data of laboratory and X-ray studies, performing of serological, immunological and allergic tests do not always allow to identify the cause of acute empyema and are often not sufficient to identify its etiology. In spite of a great number of proposed methods of acute pleural empyema treatment, study of long-term results of all types of treatment shows that they do not guarantee 100% success. The outlined data indicates the necessity of improvement of etiotropic therapy in patients with pleural empyema. Constant search for new effective methods of treatment of the aimed pathology proves the relevance of the theme. The data outlined in this article indicates the necessity of improvement of etiotropic therapy in patients with pleural empyema.

Alzheimer's Disease and (Phyto) Estrogen Treatment: Modification of Effects by Age, Type of Treatment, and Duration of Use.

There is a continued debate on whether menopausal hormone therapy (MHT) protects women against Alzheimer's disease (AD). It is also unclear whether phytoestrogen could be an alternative treatment for AD. To investigate whether mixed study findings may be due to differences in age at initiation of MHT and duration of prescription of different types of MHT using meta-analyses. After a systematic literature search, meta-analyses were carried out using Cochrane Revman 5.4.1.software including data from large nationwide studies of registered medically diagnosed AD and prescribed MHT. These analyses were stratified for duration and type of treatment, by age at start of prescription of therapy. Insufficient quality data were available for phytoestrogen treatment and AD meta-analyses. A total of 912,157 women were included from five registries, of whom 278,495 had developed AD during follow-up. Meta-analyses suggested a small increased AD risk after 5-10 years prescription of combination MHT regardless of age, and over 10 years only in women younger than 60 years of age. No association was seen for estrogen alone for women younger than 60 years of age, but AD risk did increase for women over 60 years of age for up to 5 years of MHT prescriptions. Combination MHT should probably be prescribed for less than 5 years after menopause to reduce risk for AD, while estrogen alone should not be prescribed to women over 60. For phytoestrogen, small treatment trials suggested some benefit of tempeh (fermented soy), which should be investigated further.

Weight changes during the initial phase of orthodontic treatment with clear aligners versus fixed appliances: a pilot prospective cohort study.

The aim was to assess adult patients' weight changes during the initial phase of orthodontic treatment (OT) with clear aligner therapy (CAT) versus fixed bracket systems (FBS). This pilot prospective cohort study included systemically-healthy adults who were treated with CAT or FBS. Participants with eating disorders and/or undergoing dietary programs were excluded. Weight was assessed using a calibrated digital scale at the start of OT (T1), 6-8 weeks (T2), and 12-16 weeks (T3) after starting OT. A questionnaire was used to record demographic variables, diet and exercise habits, self-reported compliance and discomfort during OT, and use of analgesics. Repeated measures analysis of variance was used to assess the association between treatment type (FBS versus CT) and time-period (T1, T2, T3) on participants' weight while adjusting for baseline covariates such as age, gender, height, and weight. Forty-two participants (CAT group: 22 and FBS group: 20) were analysed. In the CAT group, there was a slight initial mean weight gain of 0.2 Kg (~ 0.4 pounds) (T2-T1), and 0.8 Kg (~ 1.7 pounds) overall mean weight loss between T1 and T3. For the FBS group, there was a slight initial weight loss of 0.3 Kg (~ 0.7 pounds) (T2-T1) and no overall change between T1 and T3. Treatment type (CAT versus FBS) was not significantly associated with weight changes during the initial phase of OT. There were no significant differences in the weight changes during the initial phase of OT with CAT compared with FBS. Clear aligner therapy should not be advertised as a weight loss strategy.

Outcomes of Surgical Repair of Adult Naso-Orbital-Ethmoid Fractures: A Systematic Review and Meta-Analysis.

Adult naso-orbital-ethmoid (NOE) fractures are estimated to account for 5% of all adult facial fractures without published consensus on management. The purpose of this investigation was to assess the available literature regarding the treatment and outcomes of adult naso-orbital-ethmoid fractures. Cochrane Library, PubMed, Scopus, and CINAHL. Following PRISMA guidelines, databases were searched from inception through July 25, 2024 for studies pertaining to the treatment of NOE fractures. Measures of interest included patient demographics, associated fractures, type of intervention, and complications. A total of 16 studies were included for meta-analysis, consisting of 459 patients. The patients included in the analysis had a mean age of 30.6 years (95% CI: 26.9-34.3 years) with a male-to-female gender ratio of 2.7:1. Operative intervention, specifically open reduction and internal fixation (ORIF) (90.1%; 95: CI: 76.6-98.1%), was the most commonly performed management. Closed reduction has been reported for all three types. The most frequently reported complications included nasolacrimal duct obstruction (38.6%; 95% CI: 10.6-71.7%), postoperative epiphora (24.9%; 95% CI: 6.4-50.4%), and telecanthus (20.9%; 95% CI: 1.7-53.5%). Surgical intervention can be considered for all NOE types. Despite surgical intervention, NOE fractures remain difficult to treat, and inadequate repair may result in complications. Laryngoscope, 2024.

Intrapartum Ultrasound Guidance to Make Safer Any Obstetric Intervention: Fetal Head Rotation, Assisted Vaginal Birth, Breech Delivery of the Second Twin.

Intrapartum ultrasound (US) is more reliable than clinical assessment in determining parameters of crucial importance to optimize the management of labor including the position and station of the presenting part. Evidence from the literature supports the role of intrapartum US in predicting the outcome of labor in women diagnosed with slow progress during the first and second stage of labor, and randomized data have demonstrated that transabdominal US is far more accurate than digital examination in assessing fetal position before performing an instrumental delivery. Intrapartum US has also been shown to outperform the clinical skills in predicting the outcome and improving the technique of instrumental vaginal delivery. On this basis, some guidelines recommend intrapartum US to ascertain occiput position before performing an instrumental delivery. Manual rotation of occiput posterior position (MROP) and assisted breech delivery of the second twin are other obstetric interventions that can be performed during the second stage of labor with the support of intrapartum US. In this review article we summarize the existing evidence on the role of intrapartum US in assisting different types of obstetric intervention with the aim to improve their safety.

The effect of titanium surface treatment by application of constant potential or current on the viability of pre-osteoblast cells: an in-vitro study.

The aim of this study was to investigate the impact of electrochemical treatment of a titanium surface employing constant current and potential on the viability of the tissue cells attached to the surface and determining the safety limits for this type of treatment. Pre-osteoblast cells (pOB) were cultured and seeded onto titanium discs. The cell-seeded discs were then exposed to a range of contant direct electrical potentials (-6V-6V) or contant direct electrical currents (-12.5mA, -25mA, or -50mA) using a three-electrode system connected to a potentiostat. Cell viability was assessed using live/dead assay and fluorescence microscopy. Exposure of cells to high negative potentials caused cell detachment, while exposure to positive ones led to cell death on the cpTi surfaces. However, cellular viability was preserved when the electrical potentials were kept between -3 and +3V. Cells retained 80% viability when subjected to -12.5mA currents with an initial pOB cell count of 5 × 104. However, when the initial cell count was elevated to 1 × 105, the cells demonstrated the ability to withstand an even greater current (-25mA) while preserving their vitality at the same level. Treatment of a titanium dental implant surface employing constant potential or current can harm cells surrounding dental implants. However, this damage can be minimized by keeping the potential within a safety limit.

California Medicaid to cover traditional healing

Last week California announced that Medi‐Cal, the state's Medicaid program, will pay for substance use disorder (SUD) treatment with “traditional health care practices in use since time immemorial,” according to a press release from Gov. Gavin Newsom. The two types of treatment covered include those used by Native Americans.

Home-Based Digital Exercise Training Program to Improve Physical Function of Older Sepsis Survivors: Protocol of the HEAL Sepsis Randomized Clinical Trial.

While sepsis, an exaggerated response to infection, can affect people of all age groups, it is more prevalent in middle-aged and older adults. Older adults suffer worse short-term and long-term outcomes than younger patients. Older sepsis survivors are commonly discharged to long-term acute care facilities, where they often die within 1 year. Those who return home from the hospital lose the momentum of physical function improvement after early inpatient rehabilitation, and often face exacerbation of comorbidities and decline in physical function. Additionally, patients who are discharged home often live at distant locations and are not able to commute to rehabilitation centers due to their poor health status. Therefore, remotely delivered exercise interventions tailored to this population hold promise to improve physical function safely and effectively after sepsis. However, this type of intervention has yet to be tested in this population. This study aims to assess the safety, feasibility, and ease of recruitment and retention of participants for a remotely delivered physical activity intervention for improving physical function in middle-aged and older sepsis survivors. The proposed intervention will be delivered through a digital health platform that comprises a patient-facing mobile app and a 12-week physical activity program specifically designed for middle-aged and older sepsis survivors with poor health status who may face challenges participating in traditional out-patient or community-based exercise interventions. This study is ongoing and plans to enroll 40 sepsis survivors aged 55 years and older who will be randomized to either a remotely delivered exercise intervention group or a control group (electronic health diary). Both groups will use a tablet containing the Health in Motion app (Blue Marble Health). The intervention group will receive a clinician-designed personalized avatar-guided home exercise program and reminders while the control group will self-report daily activities using the in-app health diary feature. This study is the first to use a home-based, remotely monitored 12-week exercise program to improve physical function in sepsis survivors. This study will evaluate the safety, feasibility, and efficacy, providing the necessary knowledge to design and calculate power for future larger trials. This study will provide important information for planning a future randomized clinical trial to test the efficacy of a remotely delivered exercise intervention in this high-risk population. ClinicalTrials.gov NCT05568511; https://clinicaltrials.gov/study/NCT05568511. DERR1-10.2196/60270.

Real-world usage pattern, effectiveness and safety of oral tramadol/dexketoprofen trometamol fixed-dose combination in moderate-to-severe acute pain in Asia: a prospective, multicentre, observational study

ObjectivesThis study aims to determine the usage pattern, effectiveness and safety of oral tramadol 75 mg and dexketoprofen trometamol 25 mg fixed-dose combination (TRAM/DKP FDC) in the short-term treatment of...

Clinical investigation into risk factors for delirium post-cardiac surgery and its implications for nursing intervention guided by behavior change theory

BackgroundThis study explores the factors contributing to the occurrence of delirium following cardiac surgery and devises nursing strategies rooted in behavior change theory.MethodsA cohort of 320 cardiac surgery patients was selected, categorized into two groups: 93 cases where postoperative delirium (POD) was anticipated, and 227 cases where it was not. Preoperative, intraoperative, and postoperative factors of POD were scrutinized using single-factor analysis, while binary logistic regression analysis was employed to pinpoint risk factors.ResultsAmong the 320 patients, 93 displayed POD symptoms post-surgery, yielding an incidence of 29.06%. Preoperative univariate analysis disclosed significant differences in gender, age, smoking, hypertension, and diabetes (P < 0.05). Intraoperatively, significant differences were noted in the American Society of Anesthesiologists (ASA) anesthesia grade (II, III, and IV), surgery time, cardiopulmonary bypass duration, and aortic occlusion duration (P < 0.05). Post-surgery, significant differences were observed in the duration of Intensive Care Unit (ICU) stay, mechanical ventilation time, and visual analogue scale (VAS) scores (P < 0.05). Multivariate Logistic regression identified surgery time (OR = 2.334, P < 0.001), ICU admission duration (OR = 1.457, P < 0.001), mechanical ventilation time (OR = 1.235, P = 0.004), and VAS scores (OR = 2.986, P < 0.001) as independent risk factors for POD. ROC curve analysis indicated higher sensitivity and specificity in predicting POD with surgery time, ICU stay duration, mechanical ventilation time, and VAS scores.ConclusionIrrespective of the surgical intervention type, surgery time, ICU stay duration, mechanical ventilation time, and VAS scores are recognized as risk factors for POD in cardiac surgery patients. Hence, continuous patient monitoring and early intervention tailored to specific risk factors are essential in clinical practice to mitigate POD incidence.

Effect of providing cooling techniques (pre-cooling &amp; per-cooling) on cognitive function

The implementation of cooling techniques plays a crucial role in minimizing exercise-induced hyperthermia, thereby enhancing performance and preserving cognitive function during training. However, studies on the effect of cooling techniques on cognitive function have yielded mixed results due to inconsistent methodologies, unclear implementation guidelines, variations in cooling protocols, types of exercise, different environmental temperature, and variations in subject fitness levels. Therefore, this study compared the effectiveness of different cooling techniques in improving cognitive function during high-intensity exercise. Eleven young, healthy adult men, aged 18 to 28 years, with a Body Mass Index (BMI) ranging from 18.5 to 24.9 kg/m², normal blood pressure, and a resting heart rate (RHR) between 60 and 100 bpm, were recruited for this study. This research employed a crossover design. The subjects received three types of interventions in a random order: 1) pre-cooling using an ice vest for 30 minutes before training; 2) pre-cooling by consuming an ice slushy at a dosage of 7 g/kg of body weight over 30 minutes; and 3) a combination of both methods. The washout period between interventions was 72 hours. The results indicate a significant decrease in cognitive performance in the pre-cooling and per-cooling groups, with p-values of &lt;0.001 (pre-cooling) and 0.014 (per-cooling). In contrast, cognitive performance in the group receiving the combination of the two methods was maintained (p = 0.641). The combination of pre-cooling with an ice vest and per-cooling with an ice slushy can help maintain cognitive function after high-intensity exercise compared to using either method alone.

Влияние некоторых видов обработки на продолжительность сушки и органолептические показатели нарезанных баклажанов

Abstract. Eggplant is a common vegetable crop from the Solanaceae family, whose share of global vegetable harvests in 2022 was about 5 %. However, eggplant is thermophylic and its fruits cannot withstand low temperatures due to physiological disorders and quality reduction. This fact and thin covering tissues make the shelf life of eggplant fruits short. For this reason, improving existing methods for preserving the quality and extending the period of use of eggplants is relevant. One of the most popular methods of preserving fresh plant raw materials is drying, but it requires the selection of a method (including pre-treatment of raw materials) and process parameters to preserve the quality of dried products. In the course of the study, the influence of certain types of physical and chemical pre-treatment (microwave frequencies, citric acid, sodium chloride, their combinations) on the drying time and organoleptic characteristics of sliced eggplant fruits of the Chernomor variety was studied. It was found that various types of treatments used influenced the duration of drying of eggplants: treatments with microwave frequencies and citric acid led to a reduction in process time by 31-43 minutes compared to the control; treatments with sodium chloride solution and complex treatments, on the contrary, increased the duration by more than 3 hours. Organoleptic evaluation of dried eggplants showed that the best characteristics were provided by treatment with 1% and 5% citric acid solutions. While pre-treatment with microwave frequencies and NaCl with various parameters gave an unpleasant taste and was accompanied by darkening of the product. The data obtained can be used to improve existing methods of drying eggplants. Key words: eggplants, drying, organoleptic characteristics, super high frequency, citric acid, sodium chloride

Auer rod-positive acute leukemia with predominantly lymphoid immunophenotype: Report on 11 cases and review of literature.

Auer rods (AuRs) are prominent intracellular structures found almost exclusively in myeloid cell malignancies, such as acute myeloid leukemia (AML), chronic and juvenile myelomonocytic leukemia and myelodysplastic syndrome. Extremely rare AuRs have been reported in patients with acute lymphoblastic leukemia (ALL) or among ambiguous lineage leukemia patients with a dominantly lymphoblastic immunophenotype. We report diagnostic and follow-up data of an international cohort of 11 children suffering from leukemias with AuRs and with significant presence of T and myeloid markers, majority of whom categorized as early T-cell precursor (ETP, n=7); or T-ALL (ETP status unknown, n=2), ALAL (acute leukemia of ambiguous lineage, n=1), and AML reclassified from ALAL (n=1). We described other diagnostic details and treatment types and responses. Moreover, we summarize previously published data. Among the four patients who started and remained on ALL-type therapy, all were in the first complete remission, whereas both patients who started and remained on AML-type therapy relapsed and died. Of the patients who followed either a combined ALL/AML protocol (Interfant 06) or who switched from one of the two types of therapy to the other, one patient died, and the remaining four were in first complete remission at the most recent follow-up. We also searched for similar cases in the literature and found only three additional children with nonmyeloid leukemia and AuRs and 10 adults with this type of leukemia. Briefly, ALL- or combined ALL/AML-type therapy may be effective for treating AuR-positive leukemia patients with a lymphoid immunophenotype.

Taking what you get or Getting what you Need: A Qualitative Study on Experiences with Mental Health and Welfare Services in Long-Term Recovery in First-Episode Psychosis.

How people in long-term recovery (clinical and personal) in first-episode psychosis (schizophrenia and bipolar spectrum disorders) experience the mental health and welfare services they interact with is not frequently studied but has significant implications. We therefore aimed to explore which aspects of these services people with FEP evaluate as important for their long-term recovery. Twenty participants in clinical and/or personal recovery from two Norwegian long-term follow-up studies after FEP (TOP 10-year and TIPS 20-year) were sampled for this interview-based qualitative study. The research-team included service user experience. A deductive analysis based on personal accounts of recovery generated five service aspects. Few specific types of interventions were reported to promote recovery although medications, psychotherapy and employment support were mentioned. Participants valued services based in collaboration and that focused on their resources rather than limitations. The importance of long-term follow-up with a consistent aim was highlighted, as was the inclusion of caregivers and peers. Welfare services contributed to recovery by supporting basic needs and safety, but some experienced social exclusion when not participating in the labor market. This study is unique in exploring the role of services, including welfare, in long-term FEP recovery from service user perspectives. Participants evaluated that services played a more indirect role in long-term recovery by supporting their personal resources, although what they needed from services had frequently not been offered. Their expertise by experience contributes valuable knowledge. Better service coordination and consistent implementation of this knowledge are crucial to support recovery in FEP.

GINGIVAL MARGIN, CORRECTION IN ORTHOPEDIC DENTISTRY

A big problem for obtaining aesthetic and functional results of dental treatment is the condition of the gingival papillae. The effectiveness of orthopedic interventions without high-quality correction of the marginal edge of the gums can lead to an unsatisfactory result and the occurrence of numerous complications Materials and methods. A literature search was conducted in the PubMed and Medline databases for the period 2000-2024, for which the following keywords were used: correction of soft gingival tissues, fixed dentures, effectiveness, front group of teeth. A general search revealed 112 sources regarding gingival margin correction in fixed dentures. The primary exclusion referred to literary sources in which the correction of the gingival margin applied to all types of prosthetics. Literary sources that contained only reference information were included in the secondary exclusion. As a result, only relevant full-text articles in professional journals remained (n=25). The purpose of the research is to analyze the methods of gingival margin correction in orthopedic dentistry at the current stage, to formulate relevant tasks for further research. Research results. Methods of restoration of the aesthetics of the marginal part of the gums during orthopedic treatment are divided into the following groups: plastic of soft and bone tissues; laboratory and technical procedures; use of materials for artificial gums. It has been established that the plastic-surgical method is used for the loss of the gingival papilla, defects of the ridge of the alveolar process, asymmetric contour of the gums, and their unaesthetic shape. Correction of the gums allows to achieve satisfactory aesthetic results both at the final stage of orthopedic treatment (prosthetics with fixed orthopedic prostheses) and at the intermediate stage of temporary prosthetics with plastic fixed prostheses. It was found that the most common methods of gingival margin correction are flap operations on the gums using the technique of lateral movement of the muco-osseous flap. These include the following types of interventions: endothelial modification from the tooth-alveolar ridge; oblique displaced flap; periosteally stimulated flap; partial or complete split flap. The positive effect of hyaluronic acid on the healing of the gingival margin and tissue regeneration has been proven. Several researches have shown the positive effects of hyaluronic acid on gingival margin healing and tissue regeneration due to its properties to stimulate cell adhesion, migration and proliferation, mediate cell signaling. The authors indicate a better effectiveness of hyaluronic acid in relation to periodontal parameters during the correction of the marginal gingival margin. The use of a laser scalpel is characterized by less pronounced traumatization of tissues, lower temporary costs for intervention, reduced blood loss, less pronounced signs of inflammation in the postoperative period, relative simplicity and cost-effectiveness of use. Conclusions. To date, only a combination of various orthopedic and surgical manipulations allows to achieve an optimal aesthetic result during prosthetics with fixed dentures of the front group of teeth.

Implementation of a Technology-Enabled Diabetes Self-Management Peer Coaching Intervention for Patients With Poorly Controlled Diabetes: Quasi-Experimental Case Study.

Patients with diabetes experience worse health outcomes and greater health care expenditure. Improving diabetes outcomes requires involved self-management. Peer coaching programs can help patients engage in self-management while addressing individual and structural barriers. These peer coaching programs can be scaled with digital platforms to efficiently connect patients with peer supporters who can help with diabetes self-management. This study aimed to evaluate the implementation of a technology-enabled peer coaching intervention to support diabetes self-management among patients with uncontrolled diabetes. MetroPlusHealth, a predominant Medicaid health maintenance organization based in New York City, partnered with Pyx Health to enroll 300 Medicaid patients with uncontrolled diabetes into its 6-month peer coaching intervention. Pyx Health peer coaches conduct at least 2 evidence-based and goal-oriented coaching sessions per month with their assigned patients. These sessions are focused on addressing both behavioral and social determinants of health (SDoH) with the goal of helping patients increase their diabetes self-management literacy, implement self-management behaviors, and reduce barriers to ongoing self-care. Data analyzed in this study included patient demographic data, clinical data (patient's hemoglobin A1c [HbA1c]), and program implementation data including types of behavioral determinants of health and SDoH reported by patients and types of interventions used by peer coaches. A total of 330 patients enrolled in the peer mentoring program and 2118 patients were considered to be on a waitlist group and used as a comparator. Patients who enrolled in the peer coaching program were older; more likely to be English speakers, female, and African American; and less likely to be White or Asian American or Pacific Islander than those in the waitlist condition, and had similar HbA1c laboratory results at baseline (intervention group 10.59 vs waitlist condition 10.62) Patients in the enrolled group had on average a -1.37 point reduction in the HbA1c score (n=70; pre: 10.99, post 9.62; P<.001), whereas patients in the waitlist group had a -0.16 reduction in the HbA1c score (n=207; pre 9.75, post 9.49; P<.001). Among a subsample of participants enrolled in the program with at least 2 HbA1c scores, we found that endorsement of emotional health issues (β=1.344; P=.04) and medication issues (β=1.36; P=.04) were significantly related to increases in HbA1c. This analysis of a technology-enabled 1-on-1 peer coaching program showed improved HbA1c levels for program participants relative to nonprogram participants. Results suggested participants with emotional stressors and medication management issues had worse outcomes and many preferred to connect through phone calls versus an app. These findings support the effectiveness of digital programs with multimodal approaches that include human support for improving diabetes self-management in a typically marginalized population with significant SDoH barriers.

Three-Dimension Grid Plate Effecting in Mandibular Fracture Fixation

Introduction: The mandibular angle fractures in the region of the body represent the highest incidence of fractures in mandibles and therefore deserve special attention and care. The use of three-dimensional plates has shown good results in this type of treatment and use has increased every day. Case Report: The authors describe two cases of mandibular fractures treated with grid miniplate. In case 1, was carried out extra-oral access for fracture reduction in angle. In case 2 was also carried out extra-oral access for fracture reduction in mandibular body. The monitoring showed the surgical success and the absence of postoperative complications. The grid miniplate has shown a great treatment option in cases of fractures of the mandibular body and angle for ease of use and lower rates of postoperative complications. Conclusion: The use of a three-dimensional grid plate has proven to be a viable alternative for the osteosynthesis of mandibular fractures. The results have significant clinical implications and encourage its use.

Psychological Well-Being and Quality of Life in Laryngeal Cancer Patients across Tumor.

Background/Objectives: Laryngeal cancer significantly impacts patients' psychological well-being and quality of life (QoL). This study aims to evaluate the psychological impact and QoL in patients with laryngeal cancer, focusing on differences based on tumor stage and treatment. Methods: This longitudinal study included 75 patients diagnosed with laryngeal cancer. Participants were assessed at diagnosis and 3 months post-treatment using validated tools such as the Hospital Anxiety and Depression Scale (HADS) and the EORTC QLQ-H&N35 questionnaire. This study analyzed the impact of tumor stage, treatment type, and demographic factors on psychological well-being and QoL. Results: Patients with early-stage tumors (Stage I) reported significantly better psychological well-being and QoL compared to those with more advanced tumors (Stages III and IV) both before and after treatment. The non-significant p-values in advanced stages suggest a uniformity of severe distress and poor QoL among these patients. Treatment led to significant reductions in anxiety and depression in early-stage patients, while those with advanced-stage disease showed less improvement. Conclusions: The findings highlight the critical need for early psychological intervention, particularly in advanced-stage laryngeal cancer patients who continue to experience substantial psychological distress and poor QoL despite treatment. Integrating comprehensive psychological support into standard care is essential to improve overall outcomes for these patients.

Decreased Neutrophil-to-lymphocyte Ratio in Patients with Vitiligo: National Data Analysis.

Vitiligo is characterized by depigmented skin lesions involving melanocyte defects and immune dysregulation. Haematological markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been explored in various skin disorders. Given vitiligo's proposed pathogenesis, we hypothesized differences in NLR and PLR in vitiligo patients compared to controls. In a national retrospective cohort study (2005-2020) in Israel, blood count data from patients diagnosed with vitiligo (ICD-10 codes) were analysed, excluding patients with recent infections, surgeries, or malignancies. Controls matched for age and sex were selected. Sub-analyses examined age groups, treatment type, and matched controls. Children (n = 3,796) and adults (n = 38,608) with vitiligo showed significant differences in gender distribution, cell counts, and ratios. Vitiligo patients (n = 38,358) exhibited lower NLR, decreased neutrophils and platelets, and increased lymphocytes compared with controls. Non-systemically treated vitiligo patients (n = 33,871) displayed lower NLR and neutrophils compared with matched controls. Systemically treated vitiligo patients (n = 4,487) showed lower NLR, higher PLR, and reduced lymphocytes. Logistic regression identified associations between increased lymphocyte and platelet counts and being systemically treated. This study highlights significant haematological differences in vitiligo patients, emphasizing the potential utility of NLR as an accessible tool for vitiligo assessment. Further investigations are warranted to elucidate the roles of neutrophils and lymphocytes in vitiligo pathogenesis.

Presentation and Optimal Management of Anterior and Central Skull Base Osteoradionecrosis: Systematic Review and Meta-Analysis.

To conduct a systematic review and meta-analysis to compare the efficacy of conservative treatment versus surgical debridement versus debridement followed by vascularized tissue coverage to provide evidence-based guidance on the management of osteoradionecrosis of the anterior and central skull base. PubMed, Embase, and Cochrane Library. Systematic review and data sources including PubMed, Embase, and Cochrane Library were accessed using PRISMA guidelines. Meta-analysis was performed on treatment type and resolution of osteoradionecrosis. A total of 13 articles met the inclusion criteria. Patients were categorized into conservative medical treatment versus surgical treatment. Conservative treatment included patients undergoing hyperbaric oxygen therapy, antibiotics, pentoxifylline-tocopherol-clodronate, or a combination of the three. Eight out of 197 patients treated with conservative therapy had resolution of symptoms (4.1%) while 135 of 188 patients treated with surgical intervention had resolution of symptoms (71.8%). Of these, 104 patients (91.2%) in the vascularized tissue group experienced resolution of symptoms. Surgery was superior to medical treatment alone in the resolution of skull base osteoradionecrosis. Vascularized surgical treatment fared significantly better when compared with both surgical debridement only and/or medical treatment. Our findings suggest that surgical treatment should be considered earlier in patients with skull base osteoradionecrosis to prevent severe or fatal sequelae. NA Laryngoscope, 2024.