104 research outputs found
sj-xlsx-2-aor-10.1177_00034894221098471 – Supplemental material for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study
No full textSupplemental material, sj-xlsx-2-aor-10.1177_00034894221098471 for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study by Jordan R. Salley, Andrew T. Day, Sanjana Balachandra, Joshua Mehr, Baran D. Sumer, David J. Sher, Elizabeth Mayfield Arnold, Esther Danphuong Ho, Simon Craddock Lee and Rebecca Eary in Annals of Otology, Rhinology & Laryngology</p
sj-docx-1-aor-10.1177_00034894221098471 – Supplemental material for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study
No full textSupplemental material, sj-docx-1-aor-10.1177_00034894221098471 for Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study by Jordan R. Salley, Andrew T. Day, Sanjana Balachandra, Joshua Mehr, Baran D. Sumer, David J. Sher, Elizabeth Mayfield Arnold, Esther Danphuong Ho, Simon Craddock Lee and Rebecca Eary in Annals of Otology, Rhinology & Laryngology</p
Aspiration Pneumonia and Perioperative Antibiotic Use in Transoral Robotic and Laser Microsurgery
No full textThe 53rd Annual Medical Student Research Forum at UT Southwestern Medical Center (Monday, January 26, 2015, 2-5 p.m., D1.602)INTRODUCTION: Aspiration pneumonia can follow transoral surgery for head and neck cancer due to abnormal swallowing function. While prophylactic post-operative antibiotics may decrease the incidence of this complication, excessive use can be costly, and lead to adverse reactions or antibiotic resistance. The objectives of this study are to 1) determine if the use post-op antibiotics prevent aspiration pneumonia. 2) Identify any complications related to the use of antibiotics.
METHODS: A retrospective review of 155 patients who underwent transoral surgery for squamous cell carcinoma (SCCA) between May 2008 and June 2014 was conducted and demographic data was collected. The MD Anderson dysphagia inventory (MDADI) was used to assess swallowing function.
RESULTS: Sixteen of 122 patients that received postoperative antibiotics (13.1%) developed pneumonia, compared to 4/32(12.5%) patients who did not receive antibiotics (p=0.925). Average antibiotic course was 39.2 days (median=23). Average time to infection was 290 days (median=217, range=11-979). Univariate analysis did not show a correlation between patients that developed pneumonia and antibiotic use (p=1.00), location (p=.1642), overall stage (p=.1599), comorbidity status (p=.5327), tobacco use (p=.6328), alcohol use (p=.351), and gastrostomy tube dependence (p=.254). Univariate analysis did show a correlation between pneumonia and tracheostomy placement (p=.0316), T stage (p=.0357), and days post-op of PEG placement (p=.0297). Multivariate analysis showed correlation with tracheostomy placement (p=.0236). No patients contracted C. difficile infection. No trend was observed in post-operative MDADI score.
DISCUSSION: Routine use of post-operative prophylactic antibiotic does not correlate with a decreased rate of pneumonia or improved functional outcomes. Given that tracheostomies are performed mainly for pulmonary toilet, and a larger T stage results in larger resections, the significant correlation was expected. PEG placement in pneumonia patients was significantly later than patients with no pneumonia. This, and the fact that pneumonia generally developed outside of the 30-day perioperative period, supports the idea that aspiration pneumonia development reflects a chronic worsening swallowing dysfunction. Therefore, dysphagia immediately after surgery is probably not a significant risk factor for developing aspiration pneumonia and routine post-operative antibiotic use for pneumonia prevention is not indicated after transoral surgery.Southwestern Medical Foundatio
Effect of Perioperative Hypothyroidism on Pharyngocutaneous Fistula Formation Following Total Laryngectomy
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Model to Predict Cause-Specific Mortality in Patients with Head and Neck Adenoid Cystic Carcinoma: A Competing Risk Analysis
No full textFolate Receptor Beta Targeting for In Vivo Optical Imaging of Head and Neck Squamous Cell Carcinoma
No full textThe 51st Annual Medical Student Research Forum at UT Southwestern Medical Center (Tuesday, January 22, 2013, 3-6 p.m., D1.602)OBJECTIVE: The folate receptor (FR) is a high-affinity folic acid binding endocytic receptor uncommonly expressed in normal tissues. The α isoform (FR-α) is overexpressed in a variety of epithelial neoplastic cells. In contrast, functional expression of the β isoform (FR-β) is limited to activated macrophages. Importantly, in many malignancies FR serves as a target for the delivery of tumor specific drugs and imaging markers. Folic acid conjugated fluorescent dyes have been used to guide tumor resection in mouse models and humans. However, their potential utility in head and neck squamous cell carcinoma (HNSCC) is unclear due an incomplete characterization of FR expression in such tumors. We hypothesized that tumor infiltrating macrophages expressing FR-β could allow fluorescent visualization of HNSCC tumors using folate conjugated dyes even when FR expression in cancer cells is low.
SUBJECTS AND METHODS: Immunohistochemistry was performed on a tissue microarray (TMA) containing primary tumor tissue and matched tumor free surgical margins from 22 patients who underwent HNSCC resection. Primary tumor sites included the oral tongue, base of tongue, tonsil, supraglottic larynx, glottic larynx and hypopharynx. We evaluated the expression of FR-α, FR-β, TGF-β, CD68 and arginase-1. To examine the use of folate targeting for image guided surgery, orthotopic xenograft HNSCC tumor models were generated from nude mice. The mice received 0.8 mg/kg intravenous injections of fluorescein isothiocyanate conjugated folate (Folate-FITC) and were imaged for fluorescent emission under 495nm light two hours later.
RESULTS: No FR-α expression was observed in any TMA tumor specimen. All tumor samples demonstrated positive FR-β expression. Cellular morphology and CD68 expression identified the FR-β expressing cells as tumor infiltrating macrophages. No association was observed between FR-β staining and either TGF-β or arginase-1 staining. In tumor xenograft mouse models, tumors showed strong fluorescence in vivo after folate-FITC injection. Normal salivary glands and surrounding neck muscles did not demonstrate significant fluorescence. Histologic examination of the xenografts revealed that fluorescence within the tumors was confined to areas of inflammatory cell infiltration, consistent with our TMA data. Conclusion: HNSCC tumors contain a significant population of FR-β expressing macrophages. In contrast to many other carcinomas, the HNSCC tumor cells in our TMA did not express FR-α. By targeting tumor infiltrating macrophages, the folate linked delivery of fluorescent dyes can facilitate image guided HNSCC resection even when the tumor cells themselves do not express FR.Southwestern Medical Foundatio
An Eye-Controlled Wearable Communication and Control System for Als Patients: Smarteyes
No full textALS (Amyotrophic Lateral Sclerosis) is a progressive neurodegenerative disease that involves the malfunctioning of motor neurons. The ability of the brain to initiate and control muscle movement is lost subsequent to death of motor neurons. People with ALS present the greatest challenge regarding communication issues. Besides, caring for a loved one with ALS is not an easy task. In this study, we developed an eye-controlled wearable system called "SmartEyes" which improves the life qualities of ALS patients and their caregivers by offering two important skills. The first skill is communicating through predefined voice messages generated by a computer and the second one is controlling several peripherals located in the patient's environment. The developed system is novel in that; the patients can easily vocalize their needs and requests with a few sequential eye movements. Moreover, they can control several household items including desk lamp, rolling curtain, television and air conditioner in the same way. The preliminary experiments showed that the performance of the system is satisfactory. The accuracy of the system commands based on pupil gaze direction was tested on several users and about an accuracy of 89% was achieved. It is believed that the developed system has attracted the patients' and their caregivers' interest very much and this is the main motivation in improving our system.TUBITAK [TEYDEB-1512, 2120141]; KOSGEB R&D and Innovation ProgramThe study was supported by TUBITAK TEYDEB-1512 program with Grant number 2120141 and KOSGEB R&D and Innovation Program. The authors would like to express their deepest gratitude to Dr. Alper Kaya (executive board member of the Alliance of ALS/MND Associations) for his support and encouragement throughout the SmartEyes project. The authors would also like to thank Asst. Prof. Dr. Fikret Ari for his tremendous support for the development of Control Module.Emerging Sources Citation Inde
Transoral Resection Technique and Resected Tissue Volume in Patients with Oropharyngeal Squamous Cell Carcinoma
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