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Tongue Carcinoma

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2021. American College of Chest Physicians Consensus Statement on the Use of Topical Anesthesia, Analgesia, and Sedation During Flexible Bronchoscopy in Adult Patients

block, which causes temporary abolition of the gag re? ex and loss of tactile sensation over the posterior one-third of the tongue and the lateral and posterior wall of the oropharynx and hypopharynx, and the superior laryngeal nerve block, which results in loss of tactile sensation over the posterior surface of the epiglottis and the mucosa of the larynx and upper trachea. Knowledge of anatomy and special training are required to master this technique. Ef? - cacy of local nerve block using (...) was an investigator on the multicenter trial of Fospropofol; he was a recipient of grant fund- ing from Olympus America and MGI Pharma for a project assessing fospropofol for bronchoscopy and from Allegro Diagnostics Corp for assessing malignancy in patients with abnormal chest radiographs. Drs Jain, Jantz, Lee, Mackensen, and Barbour have reported to CHEST that no potential con? icts of interest exist with any companies/organizations whose products or services may be dis- cussed in this article . Other

2011 American College of Chest Physicians

2022. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Acromegaly

. Definitive therapy for acromegaly is the most helpful intervention to diminish or prevent worsening of such comorbidities (Grade C; BEL 3). • R3. The finding of hypercalcemia should prompt an evaluation for primary hyperparathyroidism and, if present, consideration of multiple endocrine neoplasia type 1 (MEN 1). Likewise, the presence of multiple family members with pituitary tumors should prompt investigation into a genetic predisposition to pituitary tumors, including MEN 1, familial acromegaly (...) . Constitutional Symptoms Fatigue and weakness are commonly described by patients with acromegaly and may be prominent symp- toms. These symptoms may reflect the associated medical consequences of acromegaly, including sleep apnea syn- drome, cardiomyopathy with reduced function, hypopitu- itarism, hyperthyroidism, depressed mood, and diabetes mellitus. 5.5.7. Neoplasms An increased risk of cancer, particularly of the colon, in patients with acromegaly has been suggested largely by retrospective studies

2011 American Association of Clinical Endocrinologists

2023. Why don’t journalists link to primary sources?

, on Wednesday, ran with the scare headline “Swimming too often in chlorinated water ‘could increase risk of developing bladder cancer’, say scientists”. There’s little point in documenting the shortcomings of Daily Mail health stories any more, but suffice to say, while the story purported to describe a , anyone who read the , or even the , would see immediately that bladder cancer wasn’t measured, and the Mail’s story was a . Of course, this is a problem that generalises well beyond science. Over and again (...) it impossible to continue. No-one needs to have their attention directed to the great dangers in professions such as fireman, policeman, coal miner, medical investigator of infectious diseases, or stunt man, or auto car racer. That the risks run by mathematicians are equally great is much less understood. The so-called ‘absent-minded professor’ may actually be the victim of a occupational hazard, one that can, and sometimes does, prove lethal. (3)On the Joys of Melancholy “Flow, my tears, fall from your

2011 Bad Science

2024. Lactational mastitis and breast abscess. Diagnosis and management in general practice

, benign phyllodes tumour • Musculoskeletal conditions – tender costochondral junctions (T ietze syndrome) – sleeping or breastfeeding in an uncomfortable position • Raynaud disease of the nipple Malignant causes • Breast cancer – lobular and ductal carcinoma – inflammatory breast cancer (may mimic bacterial mastitis) – malignant phyllodes tumour Reprinted from AuSTRALIAn F AMILy PhySICIAn VOL. 40, nO. 12, DECEMbER 2011 977Lactational mastitis and breast abscess – diagnosis and management in general (...) inflammation (mastitis) from a collection of pus in the breast (abscess) (Figure 2). ultrasound also allows guided aspiration of any abscess providing drainage and fluid for microscopy and culture. A malignant lesion may mimic an inflammatory collection on ultrasound. hence, following aspiration, if a significant lump remains, no fluid is obtained or fluid is bloodstained rather than purulent, then core biopsy is recommended to exclude breast cancer. 13 Mammography is not a first line investigation

2011 Clinical Practice Guidelines Portal

2025. Screening: Do you follow guidelines or your gut?

of scientific research and backing. Otherwise, how would one know when to screen? Yearly? Monthly? Or — brace yourselves at this one — at the patient’s discretion? Heck, I’d consider screening at birth if I could. And if it meant longer survivals for patients, I’d take it a step further — why not screen in utero? (I say this tongue-in-cheek but also to make a point. I also realize there actually are in-utero screens, but those typically make sense!). The screen-specific to prostate cancer is indeed a simple (...) Screening: Do you follow guidelines or your gut? Screening: Do you follow guidelines or your gut? Screening: Do you follow guidelines or your gut? | | December 13, 2017 73 Shares The commentary below is meant to invoke meaningful discourse rather than incite an unpleasant argument. Less than a year ago, I heard Ben Stiller doling out kudos to his heroic doctor who diagnosed him with early-stage prostate cancer by using a simple, widespread screen. What was interesting was that Stiller

2017 KevinMD blog

2026. Are You A Victim of Excessive Daytime Sleepiness?

with good discussions on atrial fibrillation, health care, cycling This blog by Al Lewis takes apart with humor the “Wellness Ignorati”, those who believe in prodding, prying and poking employees to allegedly improve their health. The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. Topics include fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more. The Drive is hos Great info on how (...) Are You A Victim of Excessive Daytime Sleepiness? Are You A Victim of Excessive Daytime Sleepiness? | The Skeptical Cardiologist Primary Menu Search for: Are You A Victim of Excessive Daytime Sleepiness? The Skeptical Cardiologist has been analyzing the data on sleep apnea (OSA) and cardiovascular disease, utilizing his spectacular skeptical skills. Recent suggest that 30 million adults in the US have OSA and that OSA is causing all manner of problems. I note patient awareness

2017 The Skeptical Cardiologist

2027. What rejection taught this doctor

years old when I found pediatric surgery. Nine hours into a tumor resection for a 10-year-old boy, we were finally closing the abdomen. A friend of mine was a junior resident interested in pediatric surgery and came in the operating room to see what we were up to. He asked me about my rotation and I spouted off about patients and their families, the amazing operations, and how fun it was to round in the morning. The praise continued until he stopped me and said, “You know, you’re never going to get (...) to do this again.” His words washed over me, and as their meaning sunk in, I took a sharp breath. It felt as though I had the wind knocked out of me and my eyes watered up. This was the last time I was ever going to get to take care of children and do this job. I swallowed hard, bit my tongue, and tried to push the idea out of my head. After all, I had a path and a plan already, it was too late to change. But I couldn’t shake the feeling I was doing the wrong thing. The next two weeks were a blur. I

2017 KevinMD blog

2028. Are you asking students questions or “pimping?”

to be lacking in the millennial generation. Learners expect to be spoon-fed lectures with important concepts and have protected time to learn those concepts, yet a very few seem to really possess that internal drive or accountability to own medicine, own the concepts, own the pathophysiology and disease process and own their patients because it is about their livelihood. Returning to the pretzel-eating, bow-tie-wearing ID specialist’s question: Was he too hard on them? Was he being a malignant pimper (...) Are you asking students questions or “pimping?” Are you asking students questions or "pimping?" Are you asking students questions or “pimping?” | | February 10, 2017 64 Shares One of the most respected and skilled clinician-educators — of course, he is an infectious diseases specialist — at our institute came into my office, sat down and immediately starting eating pretzels. “Let me know what you think about this,” he said between bites. He went on to recapitulate a recent interaction he had

2017 KevinMD blog

2029. A specter from the implementation and demise of the ACA

squamous cell carcinoma. For me: concern and relief. When I saw Danny and Jacky back in the clinic, he had had his entire tongue removed and could no longer speak. Part of the soft tissue of his face and neck had been removed giving it a shallow sunken-in appearance. He had a feeding tube in the right side of his abdomen where he now received his nutrition. Despite his condition, he smiled. He was glad to be alive and glad to be able to spend more time with Jacky. He no longer had pain

2017 KevinMD blog

2030. MKSAP: 44-year-old woman with a painless right neck mass

identifying evidence of HPV infection does not yet influence treatment decision-making, it does provide very important information regarding prognosis. The cure rate for locally advanced cancers that are linked with HPV is markedly higher than for those not linked with this virus. Because of this difference, testing for HPV is now a widely accepted intervention for any patient diagnosed with squamous cell carcinoma of the head and neck, particularly for patients with an oropharyngeal primary tumor. A bone (...) already been established based on biopsy of the lesion at the base of the tongue. Furthermore, because the cervical lymph node is so markedly enlarged, biopsy is not needed to establish involvement. Key Point p16 immunohistochemistry testing to detect human papillomavirus is now a widely accepted standard-of-care intervention to help determine prognosis in patients with squamous cell carcinoma of the head and neck, particularly those with oropharyngeal primary tumors. This content is excerpted from

2017 KevinMD blog

2031. Thanks for listening

Thanks for listening db's Medical Rants » Blog Archive » Thanks for listening Internal medicine, American health care, and especially medical education 5 Posted by rcentor | Posted on 16-04-2017 Category : When we walked into the room, you could sense the anger and frustration on the patient’s face, as well as two other relatives in the room. We knew that the patient had had lung cancer for several months and had failed radiation and chemotherapy. He had labored breathing and looked miserable (...) not provide radiation to the upper chest mass. He had clear metastases on CXR. When we examined him, he was tachypneic and he was visibly uncomfortable breathing, yet his oxygen saturation was in the 90s. His lung sounds were clear. His heart was regular and without murmurs or rubs. We told him that we we might be able to eliminate the cancer, but that we would do everything possible to make him feel better. We told him that we would work to get a different oncologist. After we left the room, the team

2017 db's Medical Rants blog

2032. Patient Modesty: Volume 79

diseases, cancer, etc. I list the numbers directly from the National Institutes of Health site for FY16 for ALL categories that are GENDER specific (there also is funding at the NIH for categories that benefit all genders, like Lung Cancer, but that is not shown below). You will see that males get about 5% the funding for gender specific research, females get about 95% of gender specific research funds awarded by Congress in the US. Note Breast Cancer alone gets more than Men’s Prostate Cancer funding (...) . This is been true for MANY years. How is this equitable? How is it our Congress feels females are more equal than males? NIH Research Funding ($ Millions) - FY16 Breast Cancer - 699 Cervical Cancer - 103 Endometriosis - 11 Estrogen - 201 Fibroid Tumors (Uterine) - 10 HPV and/or Cervical Cancer Vaccine - 32 Ovarian Cancer - 123 Uterine Cancer - 54 Violence Against Women - 32 Vulvodynia - 2 Women’s Health - 4140 Prostate Cancer - 299 And yes, the ONLY male specific category funded was Prostate Cancer…Nothing

2017 Bioethics Discussion Blog

2033. Incidence of contralateral-bilateral nodes in the human papillomavirus era. (Abstract)

Incidence of contralateral-bilateral nodes in the human papillomavirus era. HPV-positive oropharyngeal squamous cell carcinoma has a more favorable prognosis when compared to HPV-negative disease, regardless of the presence of nodal metastases. However, the importance of contralateral neck treatment based on HPV status has not been well studied. Given the historically poor prognostic implications of cervical nodal metastases, this study sought to elucidate the relationship between HPV status (...) and contralateral/bilateral nodal metastasis in patients with oropharyngeal squamous cell carcinoma.Retrospective cohort analysis.Data were collected on patients with oropharyngeal squamous cell carcinoma from 2001 to 2014. Nodal status was determined by contrast-enhanced computed tomography, positron emission tomography, or surgical pathology when available. Survival rates and associations between HPV status and demographic/tumor characteristics were assessed.Of 178 total patients, 46 (26.0%) had contralateral

2016 Laryngoscope

2034. Transoral Robotic Surgery-Assisted Endoscopy With Primary Site Detection and Treatment in Occult Mucosal Primaries. (Abstract)

occult mucosal malignancy.Success rate of identifying occult mucosal malignancy; usage of radiation therapy and chemotherapy.Overall, 60 patients (mean [SD] age, 55.5 [8.9] years) were identified; 48 of the 60 patients (80.0%) had a mucosal primary identified during their TORS-assisted endoscopic procedure. The mean (SD) size of the identified mucosal primary lesions was 1.3 (0.1) cm. All mucosal primaries, when found, originated in the oropharynx including the base of tongue in 28 patients (58 (...) %), palatine tonsil in 18 patients (38%), and glossotonsillar sulcus in 2 patients (4%). Among patients in this study, 40 (67%) did not receive chemotherapy, and 15 (25%) did not receive radiation therapy.Advances in transoral surgical techniques have helped identify occult oropharyngeal malignancies that traditionally have been treated with comprehensive radiation to the entire pharyngeal axis. We demonstrate the efficacy of a TORS-assisted approach to identify and surgically treat the primary tumor

2016 JAMA otolaryngology-- head & neck surgery

2035. Investigation and management of the unknown primary with metastatic neck disease: United Kingdom National Multidisciplinary Guidelines. Full Text available with Trip Pro

Investigation and management of the unknown primary with metastatic neck disease: United Kingdom National Multidisciplinary Guidelines. This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It discusses the evidence base pertaining to the management of metastatic neck disease in the setting of an unknown primary and provides recommendations on the work up and management for this group of patients receiving cancer (...) care. Recommendations • All patients presenting with confirmed cervical lymph node metastatic squamous cell carcinoma and no apparent primary site should undergo: ○ Positron emission tomography-computed tomography whole-body scan. (R) ○ Panendoscopy and directed biopsies. (R) ○ Bilateral tonsillectomy. (R) • Tongue base mucosectomy can be offered if facilities and expertise exists. (G) • Concomitant chemotherapy with radiation should be considered in patients with an unknown primary. (R

2016 Journal of Laryngology & Otology

2036. A european multicenter study evaluating the flex robotic system in transoral robotic surgery. (Abstract)

as for resection of benign and malignant lesions. A total of 80 patients were enrolled. Access and visualization of five anatomic subsites (base of tongue, palatine tonsil area, epiglottis, posterior pharyngeal wall, and false vocal cords) were individually graded by the surgeon. Setup times, access and visualization times, surgical results, and adverse events were documented.The relevant anatomic structures could be exposed and visualized properly in 75 patients, who went on to have a surgical procedure

2016 Laryngoscope

2037. Evaluation of buccal cell samples for studies of oral microbiota. Full Text available with Trip Pro

Evaluation of buccal cell samples for studies of oral microbiota. The human microbiota is postulated to affect cancer risk, but collecting microbiota specimens with prospective follow-up for diseases will take time. Buccal cell samples have been obtained from mouthwash for the study of human genomic DNA in many cohort studies. Here, we evaluate the feasibility of using buccal cell samples to examine associations of human microbiota and disease risk.We obtained buccal cells from mouthwash in 41 (...) existing buccal cell collections in large prospective cohorts allows investigations of the role of oral microbiota in chronic disease etiology in large population studies possible today. Cancer Epidemiol Biomarkers Prev; 26(2); 249-53. ©2016 AACR.©2016 American Association for Cancer Research.

2016 Cancer Epidemiology & Biomarkers and Prevention

2038. Isolated tubercular hypoglossal nerve paralysis. (Abstract)

Isolated tubercular hypoglossal nerve paralysis. Hypoglossal nerve palsy is not an uncommon neurological finding but primary nasopharyngeal tuberculosis (TB) presenting as hypoglossal nerve palsy is very rare. A 31-year-old woman presented with headache and progressive tongue deviation towards the right side. Diagnostic nasal endoscopy revealed soft tissue mass lesion on the posterior wall of nasopharynx while MRI revealed isointense tumour in nasopharynx with normal hypoglossal nerve and brain

2016 Tropical Doctor

2039. Sycrest - asenapine

and bradykinesia that were dose-dependent from 0.025 mg/kg onwards. Decreased reactivity to environmental stimuli was not present until dystonia and bradykinesia were observed. There were mild slow tongue protrusions at baseline that decreased in frequency by about 50% at highest doses. Asenapine produced mild chewing mouth movements. There were no effects on lip movements or stereotyped behavior. and no effects on eye blinking, sedation or arousal were observed with asenapine. Cardiovascular system The main (...) distribution of radioactivity throughout the body was noted in rats with transfer of radioactivity across the blood brain and placental barriers. In rabbits, transfer of radioactivity across the placental barrier was also noted. In rats, the tissues with the greatest uptake were the liver, kidney cortex, eye choroid and lacrimal gland. Extensive distribution of radioactivity in selected tissues was also observed in dogs (tongue, gall bladder, liver, lungs, pancreas, the gastrointestinal (GI) tract

2010 European Medicines Agency - EPARs

2040. PecFent - fentanyl

Marketing authorisation number(s): PL 16260/0003 o Member State of source: UK The applicant applied for the following indication: Management of breakthrough pain (BTP) in adults who are already receiving maintenance opioid therapy for chronic cancer pain. Breakthrough pain is a transitory exacerbation of pain that occurs on a background of otherwise controlled persistent pain. 1.1. Submission of the dossier The applicant Archimedes Development Ltd submitted on 17 April 2009 an applic procedure falling (...) subcutaneous, episodes of acute for chronic cancer hat occurs on a background of otherwise controlled w minutes. The ability to achieve a rapid analgesic ement programme experiencing such minutes and the median number of episodes is 4 per management. BTP It has been shown Procedures, other taining products (FEBT=fentanyl effervescent buccal tablet, Effentora and fentanyl nasal yl as a controlled ell as fast onset of lecular weight, ncy and lipid solubility. Through nasal administration, gastrointestinal

2010 European Medicines Agency - EPARs

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