Carlsencompton7016

Our results suggest that detection of urogenital pathogens is associated with lymph node metastasis for patients with HPV-positive OPSCCs. Additional studies are necessary to determine the effects of the OPSCC microbiome on disease progression and clinical outcomes.

Our results suggest that detection of urogenital pathogens is associated with lymph node metastasis for patients with HPV-positive OPSCCs. Additional studies are necessary to determine the effects of the OPSCC microbiome on disease progression and clinical outcomes.

The guided self-help exercise program called In Tune without Cords (ITwC) is effective in improving swallowing problems and communication among patients treated with a total laryngectomy (TL). This study investigated the cost-utility and cost-effectiveness of ITwC.

Patients within 5years after TL were included in this randomized controlled trial. Patients in the intervention group (n=46) received access to the self-help exercise program with flexibility, range-of-motion and lymphedema exercises, and a self-care education program. Patients in the control group (n=46) received access to the self-care education program only. MSA-2 Healthcare utilization (iMCQ), productivity losses (iPCQ), health status (EQ-5D-3L, EORTC QLU-C10D) and swallowing problems (SwalQol) were measured at baseline, 3- and 6-months follow-up. Hospital costs were extracted from medical files. Mean total costs and effects (quality-adjusted life-years (QALYs) or SwalQol score) were compared with regression analyses using bias-corrected accelerated bootstrapping.

Mean total costs were non-significantly lower (-€685) and QALYs were significantly higher (+0.06) in the intervention compared to the control group. The probability that the intervention is less costly and more effective was 73%. Sensitivity analyses with adjustment for baseline costs and EQ-5D scores showed non-significantly higher costs (+€119 to +€364) and QALYs (+0.02 to+0.03). A sensitivity analysis using the QLU-C10D to calculate QALYs showed higher costs (+€741) and lower QALYs (-0.01) and an analysis that used the SwalQol showed higher costs (+€232) and higher effects (improvement of 6 points on a 0-100 scale).

ITwC is likely to be effective, but possibly at higher expenses.

NTR5255.

NTR5255.

In times of health resource reallocation, capacities must remain able to meet a continued demand for essential, nonambulatory neurosurgical acute care. This study sought to characterize the demand for and provision of neurosurgical acute care during the coronavirus disease 2019 (COVID-19) pandemic.

This single-center cross-sectional observational analysis compared nonambulatory neurosurgical consult encounters during the peri-surge period (March 9 to May 31, 2020) with those during an analogous period in 2019. Outcomes included consult volume, distribution of problem types, disease severity, and rate of acute operative intervention.

A total of 1494 neurosurgical consults were analyzed. Amidst the pandemic surge, 583 consults were seen, which was 6.4 standard deviations below the mean among analogous 2016-2019 periods (mean 873; standard deviation 45, P= 0.001). Between 2019 and 2020, the proportion of degenerative spine consults decreased in favor of spinal trauma (25.6% vs. 34% and 51.9% vs. 41.4%, P= eater-acuity pathologies. In our continued current pandemic as well as any future situations of mass health resource reallocation, neurosurgical acute care capacities must be preserved.

Pyogenic spondylodiscitis (PSD) is a complex disorder that often required postoperative imaging. Carbon-fiber-reinforced polyether ether ketone (CFRP) is radiolucent and offers an optimal assessability of anatomic structures.

A retrospective file review of patients who were operated on for PSD using CFRP implants was performed to assess the clinical outcome, implant-associated complications, and revision surgery. A minimum follow-up of 3 months was required for evaluation of clinical and radiographic data, which included computed tomography and magnetic resonance imaging (MRI) assessment, to determine implant stability and assessability of soft tissue and nerve structures using a grading system.

Eighty-one consecutive patients with a mean of 69.5 years were identified. Debridement and stabilization were performed in 8 cervical, 17 thoracic, and 57 lumbar procedures; 72 interbody fusion procedures using cages were performed. Intraoperatively, no implant-associated complication was noted. The mean follow-up was 7 months, at which 52 patients attended. Improved mobility and reduced pain levels were reported by 87%, and MRI assessability was graded ideal. Residual sign of infection was seen in 5 cases, which influenced antibiotic therapy. Asymptomatic radiolucent zones were identified in 13 patients (16%) and screw loosening in 2 (2.4%). In 1 patient, the pedicle screw tip broke and remained within the vertebral body. A repeated procedure because of progressive vertebral body destruction, implant loosening, or subsidence was performed in 5 patients (6.1%).

The surgical treatment of PSD using CFRP is safe. The repeat procedure rate as a result of implant loosening is 6.1%. Minimal artifacts offer ideal assessability of soft tissue structures on an MRI.

The surgical treatment of PSD using CFRP is safe. The repeat procedure rate as a result of implant loosening is 6.1%. Minimal artifacts offer ideal assessability of soft tissue structures on an MRI.Pain is a common occurrence in patients with cancer, which, in some cases, is not adequately controlled with medical analgesia. Thalamotomy is a treatment option in such circumstances, but synthesis of historical evidence and thalamic stratified data are lacking. We therefore sought to systematically review evidence supporting radiofrequency thalamotomy for intractable cancer pain. This review was performed using multiple electronic databases and a (PICO) patient/problem, intervention, comparison, outcome search with the terms "radiofrequency thalamotomy" and "cancer pain." Of 22 full-text studies assessed for eligibility, 14 were included for review. Articles were excluded in which radiofrequency ablation was not used, chronic implantation was used, or the study did not include patients with cancer pain. Thirteen case series and 1 case report were included. Thalamic targets included ventral posterior, central lateral, dorsomedial, centromedian, centromedian/parafascicular, centromedian and anterior pulvinar, pulvinar, limitans, suprageniculate and posterior nuclei.