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Tongue Carcinoma

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1861. Clinical Practice Guideline for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

of Critical Care Medicine (ACCM) is currently developing separate guidelines on analgesia and sedation for pediatric ICU patients. This version of the guidelines places a greater emphasis on the psychometric aspects of PAD monitoring tools. It includes both pharmacologic and nonpharmacologic approaches to manage PAD in ICU patients. There is also greater emphasis placed on preventing, diagnosing, and treating delirium , reflecting our growing understanding of this disease process in critically ill (...) 50% or higher in both medical and surgical ICU patients ( , . In addition to experiencing pain at rest ( ) and pain related to surgery, trauma, burns, or cancer, patients also experience procedural pain ( ). This was highlighted in the first practice guideline published on acute pain management 20 yr ago by the Agency for Health Care Policy and Research ( ). Pain related to procedures is ubiquitous, and inadequate treatment of procedural pain remains a significant problem for many ICU patients

2013 Society of Critical Care Medicine

1862. Improving Voice Outcomes After Thyroid Surgery

dissection or completion thyroidectomy, based on the extent of disease and final pathology results. Surgeons performing thyroidectomy include otolaryngologists and general surgeons. Thyroid surgery rates have tripled over the past 3 decades. Between 118,000 and 166,000 patients in the United States undergo thyroidectomy per year for benign or malignant disease. Thyroidectomy is performed on patients of both genders, but more commonly on women. Thyroid cancer is the most common malignancy of the endocrine (...) system and the cancer with the fastest growing incidence among women. It is estimated that 36,550 women and 11,470 men (48,020 total) in the United States were diagnosed with thyroid cancer in 2011, with 56,000 projected in 2012. Palpable thyroid nodules occur in 3% to 7% of the population; ultrasound indicates that the actual prevalence of thyroid nodules is up to 50%. On fine needle aspiration biopsy (FNAB), 5% of thyroid nodules are malignant and 10% are suspicious. FNAB has increased

2013 American Academy of Otolaryngology - Head and Neck Surgery

1863. Practice Guidelines for Management of the Difficult Airway

. , age, obesity, obstructive sleep apnea, history of snoring) and difficult laryngoscopy or intubation ( Category B2-H evidence ). Observational studies report difficult intubation or extubation occurring in patients with mediastinal masses ( Category B3-H evidence ). , Case reports of difficult laryngoscopy or intubation among patients with a variety of acquired or congenital disease states ( e.g. , ankylosis, degenerative osteoarthritis, subglottic stenosis, lingual thyroid or tonsillar hypertrophy (...) ( Category B4-H evidence ). One observational study reports that the laryngeal tube provides adequate ventilation for 95% of patients with pharyngeal and laryngeal tumors. ILMA. RCTs comparing the ILMA with standard laryngoscopic intubation were only available for nondifficult airway patients. Observational studies report successful intubation in 71.4–100% of difficult airway patients when an ILMA was used ( Category B3-B evidence ). One observational study indicated that when the ILMA is used

2013 American Society of Anesthesiologists

1864. Bell's palsy

for Bell’s palsy has been identified. Other conditions may cause facial paralysis, including stroke, brain tumors, tumors of the parotid gland or infratemporal fossa, cancer involving the facial nerve, and systemic and infectious diseases, including zoster, sarcoidosis, and Lyme disease. , - Bell’s palsy is typically self-limited. Bell’s palsy may occur in men, women, and children but is more common in those 15 to 45 years old; those with diabetes, upper respiratory ailments, or compromised immune (...) , skin cancers on the head or face, parotid tumors, facial/head trauma, or recent infections ( ). The timing of onset of symptoms remains important. Symptoms associated with neoplastic or infectious causes of facial paralysis often progress gradually, relative to the sudden-onset characteristic of Bell’s palsy. Symptoms suggestive of Bell’s palsy may include pain in the ear and postauricular region; weakness of facial musculature, including the inability to chew food without difficulty; poor

2013 American Academy of Otolaryngology - Head and Neck Surgery

1865. Laryngeal cancer Full Text available with Trip Pro

Laryngeal cancer Laryngeal cancer - Wikipedia Laryngeal cancer From Wikipedia, the free encyclopedia Laryngeal cancer Other names Cancer of the larynx, laryngeal carcinoma Larynx cancer - endoscopic view Laryngeal cancer are mostly , reflecting their origin from the skin of the larynx. can develop in any part of the , but the cure rate is affected by the location of the tumour. For the purposes of tumour , the larynx is divided into three anatomical regions: the (true vocal cords, anterior (...) on the site, stage (tumour size, nodal spread, distant ), and histological type. The overall health and wishes of the patient must also be taken into account. A prognostic multigene classifier has been shown to be potentially useful for the distinction of laryngeal cancer of low or high risk of recurrence and might influence the treatment choice in future. Staging [ ] Epithelial tumors are classified according to the guidelines set by the International Union Against Cancer (UICC) (3,4). Staging considers

2012 Wikipedia

1866. Infectious causes of cancer

cause cancer in animals, especially leukemias and lymphomas. Human T cell lymphotropic virus ( ) was the first human discovered by and colleagues at . The virus causes , a disease first described by Takatsuki and colleagues in Japan and other neurological diseases. is the most recently discovered human cancer virus, isolated from tissues in 2008, by the same group that discovered /HHV-8 in 1994, using a new technology called . About 80% of Merkel cell carcinomas are caused by Merkel cell (...) polyomavirus; the remaining tumors have an unknown etiology and possibly a separate histogenesis. This is the only member of this group of viruses known to cause human cancer but other polyomaviruses are suspects for being additional cancer viruses. does not directly cause cancer, but it is associated with a number of malignancies, especially , , and . Kaposi's sarcoma is caused by . -related cases of anal cancer and cervical cancer are commonly caused by . After HIV destroys the immune system, the body

2012 Wikipedia

1867. HPV-positive oropharyngeal cancer

in advanced cases, with up to 90% local control and disease specific survival. Postoperative swallowing was excellent in 87%, but long term dysphagia was associated with larger (T4) cancers, especially if involving the base of the tongue. The details of the surgical approach depend on the location and size of the primary tumour and its N stage. to examine the draining lymph nodes may be carried out simultaneously or as a second staging procedure. For tumours of the tonsil and lateral pharyngeal wall (...) accept reduced radiation. Carcinoma of unknown primary [ ] In some situations HPV+OPC may present with cervical lymph nodes but no evident disease of a primary tumour (T0 N1-3) and is therefore classed as . The lack of any such evidence of a primary tumour occurs in 2-4% of patients presenting with metastatic cancer in the cervical nodes. The incidence of HPV positivity is increasing at a similar rate to that seen in OPC. In such situations, resection of the lingual and palatine tonsils, together

2012 Wikipedia

1868. Unhealthy Times of Kings & Queens

VI was a heavy smoker, and as a consequence he developed peripheral vascular disease causing intermittent claudication (leg pain while walking, due to impaired blood supply), lung cancer, and coronary artery disease. In 1949 he had an operation called a lumbar sympathectomy to relieve a blockage in an artery in his right leg. His left lung, with its malignant tumour, was excised in 1951. After the War cigarettes were cheap, widely advertised, and readily available. It therefore wasn’t surprising (...) Unhealthy Times of Kings & Queens Unhealthy Times of Kings & Queens - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website Unhealthy Times of Kings & Queens September 25, 2018 We have put together an exhibition of the Kings and Queens, their illnesses, their deaths, and the public health messages their stories portray. The messages include preventable diseases such as obesity, smoking, and vaccination

2018 CEBM blog

1869. Oprah Winfrey for President? Does anyone remember all the pseudoscience and quackery she’s promoted?

this blog longer than seven years, because that’s the last time I wrote about Ms. Tinkham. Basically, Ms. Tinkham was diagnosed with breast cancer. Unfortunately, she was also inspired by Oprah and her promotion of The Secret to . It , though. It was of , whom you might remember as the man responsible for the “pH Miracle Living” quackery, where acid was The One True Cause of All Disease, particularly but also and , and who is now in . Tinkham was fortunate in that she did fairly well for three years (...) program said, “We don’t take positions on the opinions of our guests. Rather, we offer a platform for guests to share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them.” When McCarthy’s views have been discussed on the air, statements from the Centers for Disease Control and Prevention and the American Academy of Pediatrics saying that there’s no scientific evidence of a vaccine-autism link have been read. Overall, Oprah had a malign

2018 Respectful Insolence

1870. Stephen Colbert sells out to Gwyneth Paltrow and Goop

. Dochniak (MJD) Johnny efficiently asks, Why? MJD says, Here’s a snippet from the book that speaks volumes: Furthermore, in a blog post from Respectful Insolence (2011) titled, “Steve Jobs, neuroendocrine tumors, and alternative medicine” author Dr. David Gorski (a.k.a. Orac) writes, “If there’s one thing we’re learning increasingly about cancer, it’s that biology is king and queen, and that our ability to fight biology is depressingly limited. In retrospect, we can now tell that Jobs clearly had (...) a tumor that was unusually aggressive for an insulinoma. Such tumors are usually pretty indolent and progress only slowly. Indeed, I’ve seen patients and known a friend of a friend who survived many years with metastatic neuroendocrine tumors with reasonable quality of life. Jobs was unfortunate in that he appears to have had an unusually aggressive form of the disease that probably would have killed him no matter what. That’s not to say that we shouldn’t take into account his delay in treatment

2018 Respectful Insolence

1871. Guidelines for preventive activities in general practice (8th edition)

-Guérin BMD Bone mineral density BMI Body mass index BNP B-type natriuretic peptide BP Blood pressure BRCA1 Breast cancer susceptibility gene 1 BRCA2 Breast cancer susceptibility gene 2 CA Cancer antigen CA125 Cancer antigen 125 CF Cystic fibrosis CHD Coronary heart disease CKD Chronic kidney disease COPD Chronic obstructive pulmonary disease CRC Colorectal cancer CRP High sensitivity C-Reactive Protein CT Computerised tomography CVD Cardiovascular disease DBP Diastolic blood pressure DNA (...) 34 6.1 Immunisation 34 6.2 STIs 37 7. Prevention of chronic disease 40 7.1 Smoking 42 7.2 Overweight 43 7.3 Nutrition 45 7.4 Early detection of problem drinking 47 7.5 Physical activity 49x Guidelines for preventive activities in general practice 8th edition 8. Prevention of vascular and metabolic disease 50 8.1 Assessment of absolute cardiovascular risk 50 8.2 BP 51 8.3 Cholesterol and other lipids 53 8.4 T ype 2 diabetes 55 8.5 Stroke 57 8.6 Kidney disease 58 9. Early detection of cancers 60

2012 Clinical Practice Guidelines Portal

1872. Position paper on hereditary angioedema

swelling of the gastrointestinal tract may result in abdominal pain, vomiting and hypotension. The most serious manifestation is laryngeal swelling, which was reported in older cohort studies to result in fatal asphyxiation in up to a third of patients 2 . Attacks may be preceded by a prodrome of tingling, or a non-itchy rash (erythema marginatum 3 ) anywhere on the body. Affected patients also have higher than expected rates of autoimmune disease 4, 5 . 1.2 Historical facts The first description (...) of HAE has been attributed to Robert Graves, who in 1843 described a patient with “a tumor rising on the forehead in the space of half an hour” and then later “sometimes the lips, inside of the mouth, palate, and uvula are attacked giving rise to a very considerable inconvenience” 6 . The superceded term angioneurotic edema (a synonym for angioedema) is derived from Heinrich Quincke’s original explanation that swelling arose from increased vascular permeability that could affect not only the face

2012 Clinical Practice Guidelines Portal

1873. Surgical simulation: skills transfer to the operating room: a systematic review

and Waxman 2006). The numbers of animals needed as well as cultural, financial and ethical issues limit their use. Cadaveric models The limited supply of cadavers in Australia, coupled with concerns regarding disease transmission from human tissues and fluids, and ethical and cultural issues, limit this mode of training. Ex vivo animal tissue models Using anatomic sections or tissues from euthanased animals (ex vivo) is another form of simulation in surgical skills training. Dedicated ‘wet rooms’ within


1874. Management of suspected viral encephalitis in children Full Text available with Trip Pro

cerebrovascular accidents Neoplastic Paraneoplastic encephalitis Primary brain tumour Metastases Metabolic encephalopathy Hepatic encephalopathy Renal encephalopathy Hypoglycaemia Toxins (alcohol, drugs) Hashimoto's disease Septic encephalopathy Mitochondrial diseases Other Antibody-mediated encephalitis: VGKC complex or NMDA receptor Drug reactions Encephalitis lethargica Haemophagocytic Lymphohistiocytosis (HLH) syndrome (usually children) Epilepsy Functional disorder In this table some of the important (...) | | | • Airways, Breathing, Circulation • Mini-mental state, cognitive function, behaviour (when possible) • Evidence of prior seizures (tongue biting, injury) • Subtle motor seizures (mouth, digit, eyelid twitching) • Meningism • Focal neurological signs • Papilloedema • Flaccid paralysis (anterior horn cell involvement) • Rash (purpuric – meningococcus; vesicular – hand foot and mouth disease; varicella zoster; rickettsial disease) • Injection sites of drug abuse • Bites from animals (rabies) or insects

2012 British Infection Association

1875. Guidelines on Equipment to Manage a Difficult Airway During Anaesthesia Background Paper

. It has a role as a ventilation/oxygenation bridge and secondary rescue device. 81 The Combitube™ has demonstrated superiority over other supraglottic ventilation devices in resuscitation in relation to ease of ventilation and insertion. 82,83 The device has advantages in patients with massive bleeding, regurgitation and limited mouth opening. 84 It also minimises the risk of aspiration. 55 Complications are rare 85,86 but include piriform sinus perforation, oesophageal laceration and tongue (...) -Mac). The E-Mac has better illumination than the A-Mac. 96 In unexpectedly difficult laryngoscopy the E-Mac provided a better glottic view than the A- Mac. 97 Laryngoscopes with a high proximal flange, such as the A-Mac, might cause more trauma to the maxillary incisors. 98 Macintosh modified the laryngoscope blade to allow the tip to “fit into the angle made by the epiglottis and the base of the tongue”. 99 Tension by the tip of the Macintosh blade on the hyoepiglottic ligament in the vallecula

2012 Australian and New Zealand College of Anaesthetists

1876. Surgical simulation for training: skills transfer to the operating room (update)

and Waxman 2006). The numbers of animals needed as well as cultural, financial and ethical issues limit their use. Cadaveric models The limited supply of cadavers in Australia, coupled with concerns regarding disease transmission from human tissues and fluids, and ethical and cultural issues, limit this mode of training. Ex vivo animal tissue models Using anatomic sections or tissues from euthanased animals (ex vivo) is another form of simulation in surgical skills training. Dedicated ‘wet rooms’ within


1877. ACR-ASNR-SPR Practice Guideline for the Performance of Magnetic Resonance Imaging (MRI) of the Head and Neck

better signal-to- noise ratios [35]. 2. Paranasal sinuses and nasal cavity Computed tomography is the imaging modality of choice for inflammatory disorders of the paranasal sinuses and nasal cavity, with MRI reserved for evaluating complications of inflammatory and neoplastic sinus disease [36- 38], including orbital, skull base, and intracranial extension [25,28,39-41]. For all suspected neoplasms, and to distinguish tumors from mucosal thickening and secretions, MRI with contrast enhancement (...) Clin N Am 2004;14:679-694. 41. Smoker WR. Chapter 27: Oral cavity: anatomy and pathology. In: Som PM, Curtin HD, eds. Head and Neck Imaging. 4th ed. Philadelphia, Pa: Mosby; 2003:1377-1364. 42. Hudgins PA. Sinonasal imaging. Neuroimaging Clin N Am 1996;6:319-331. 43. Kubal WS. Sinonasal imaging: malignant disease. Semin Ultrasound CT MR 1999;20:402-425. 44. Hermans R, De Vuysere S, Marchal G. Squamous cell carcinoma of the sinonasal cavities. Semin Ultrasound CT MR 1999;20:150-161. 45. Eisen MD

2012 American Society of Neuroradiology

1878. 2012 ACCF/AHA/ACR/SCAI/SIR/STS/SVM/SVN Key Data Elements and Definitions for Peripheral Atherosclerotic Vascular Disease

2012 ACCF/AHA/ACR/SCAI/SIR/STS/SVM/SVN Key Data Elements and Definitions for Peripheral Atherosclerotic Vascular Disease and Jack A. Ziffer Kerry J. Stewart, Diane Treat-Jacobson, Gilbert R. Upchurch, Jr, Christopher J. White Jeffrey W. Olin, Judith G. Regensteiner, Robert H. Rosenwasser, Peter Sheehan, A. Kern, David J. Malenka, Edward T. Martin, Emile R. Mohler III, Timothy Murphy, Chaturvedi, Michael D. Dake, Jerome L. Fleg, Alan T. Hirsch, Michael R. Jaff, John Mark A. Creager, Michael (...) Belkin, Edward I. Bluth, Donald E. Casey, Jr, Seemant Standards for Peripheral Atherosclerotic Vascular Disease) Force on Clinical Data Standards (Writing Committee to Develop Clinical Data American College of Cardiology Foundation/American Heart Association Task Definitions for Peripheral Atherosclerotic Vascular Disease : A Report of the 2012 ACCF/AHA/ACR/SCAI/SIR/STS/SVM/SVN Key Data Elements and ISSN: 1524-4539 Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 0009

2012 Society for Cardiovascular Angiography and Interventions

1879. Infections Associated with Personal Service Establishments: Piercing and Tattooing

draft and Michele Wiens for providing research assistance. May 2012 National Collaborating Centre for Environmental Health 8 Appendix Methods The Ebsco database collection was used to search scientific literature using the following keyword terms, either alone or in combination: piercing, tattooing, permanent makeup, body modification, body art, branding, scarification, ear stapling, and tongue splitting. Word variants were considered along with outcomes for practices, such as infection and disease (...) -use of tattooing ink between clients. • Use of tap water to dilute ink or rinse needles between colour changes has been implicated in outbreaks of mycobacterium infections during tattooing. • The majority of identified studies consists of case reports, which provide limited information on disease transmission risks for specific services. Introduction Personal Service Establishments (PSEs) are a growing industry that encompasses services such as piercing, tattooing, and body modification

2012 National Collaborating Centre for Environmental Health

1880. Oral health care in care homes -best practice model

for denture Care 24 rEFErENCES 26 2 APPENdICES 31 Appendix 1 – Statistics 31 Appendix 2 – Summary of CDS Questionnaire Regarding 32 Domiciliary Dental Care Appendix 3 – Sample Care Plan 34 Appendix 4 – Sample Audit Tool for Residential 36 and Nursing Homes Appendix 5 – Resources 41 Appendix 6 – Glossary of Terms 45 Appendix 7 – Membership of GAIN Sub-Group 47 Appendix 8 – Acknowledgement of Contribution 48 3 INTrOduCTION The necessity for prevention of dental disease in older adults* in care facilities (...) basic approach to maintaining optimum oral health applies; good daily oral hygiene and mouth care, limited use of sugary foods and drinks, and regular dental check-ups. By using this approach the potential for unwanted consequences like dental pain, dental decay, gum disease, and infection are minimised and other interrelated aspects like nutrition, quality of life and self-esteem are optimised. Although there is no published research in Northern Ireland describing the state of oral health

2012 Regulation and Quality Improvement Authority

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