Keybloch0538

Elderly individuals account for one-third of all hospitalizations. The goal of this study was to evaluate the prevalence of dysphagia in elderly patients admitted to a tertiary care center. It also sought to investigate how dysphagia is identified, how it covaries with malnutrition and other conditions, and how it impacts hospital stay.

Case Series.

A retrospective chart review was performed. All patients >65 years admitted to a tertiary care center in January and February 2016 were included. Patients with primary psychiatric diagnoses and patients with upper aerodigestive tract malignancy or surgery were excluded.

A total of 655 patients were identified. Mean age was 76.6 years. Twenty-four percent (155 patients) had dysphagia while 43% (282 patients) had malnutrition. Thirteen percent (84 patients) had both dysphagia and malnutrition. Fifty percent of patients who had malnutrition were seen by speech language pathology (SLP). One hundred percent of malnourished patients that saw SLP were identified as having dysphagia. Three hundred and eighty-two patients (58%) were seen by the dietician but not by SLP. Multiple logistic regression indicated that the presence of dysphagia was positively associated with age, presence of malnutrition, admission to either cardiology or neurology service as compared to medicine service, and history of stroke.

One-quarter of elderly patients admitted to our tertiary care center had dysphagia. Dysphagia, especially when linked with malnutrition, has poorer outcomes and increased healthcare costs. RG7388 Our data suggests a possible disconnect between malnutrition diagnosis and dysphagia identification. This is an important area of intervention that has the potential to improve the treatment and outcomes of these patients.

4 Laryngoscope, 2021.

4 Laryngoscope, 2021.

ABO blood group may affect risk of SARS-CoV-2 infection and/or severity of COVID-19. We sought to determine whether IgG, IgA and neutralizing antibody (nAb) to SARS-CoV-2 vary by ABO blood group.

Among eligible convalescent plasma donors, ABO blood group was determined via agglutination of reagent A1 and B cells, IgA and IgG were quantified using the Euroimmun anti-SARS-CoV-2 ELISA, and nAb titres were quantified using a microneutralization assay. Differences in titre distribution were examined by ABO blood group using non-parametric Kruskal-Wallis tests. Adjusted prevalence ratios (aPR) of high nAb titre (≥1160) were estimated by blood group using multivariable modified Poisson regression models that adjusted for age, sex, hospitalization status and time since SARS-CoV-2 diagnosis.

Of the 202 potential donors, 65 (32%) were blood group A, 39 (19%) were group B, 13 (6%) were group AB, and 85 (42%) were group O. Distribution of nAb titres significantly differed by ABO blood group, whereas there were no significant differences in anti-spike IgA or anti-spike IgG titres by ABO blood group. There were significantly more individuals with high nAb titre (≥1160) among those with blood group B, compared with group O (aPR=1·9 [95%CI=1·1-3·3], P=0·029). Fewer individuals had a high nAb titre among those with blood group A, compared with group B (aPR=0·6 [95%CI=0·4-1·0], P=0·053).

Eligible CCP donors with blood group B may have relatively higher neutralizing antibody titres. Additional studies evaluating ABO blood groups and antibody titres that incorporate COVID-19 severity are needed.

Eligible CCP donors with blood group B may have relatively higher neutralizing antibody titres. Additional studies evaluating ABO blood groups and antibody titres that incorporate COVID-19 severity are needed.

To evaluate the diagnostic accuracy of Delphian lymph node (DLN) metastasis for the prediction of central lymph node (CLN) metastasis and lateral lymph node (LLN) metastasis.

Two authors independently reviewed the six databases (Cochrane database, Embase, Google Scholar, PubMed, SCOPUS, and Web of Science). Four parameters were extracted from each study true positive, true negative, false positive, and false negative. The quality of the methodology was evaluated using the Quality Assessment of Diagnostic Accuracy Studies ver. 2 tool.

The diagnostic odds ratio of DLN in CLN metastasis was 8.859 (95% confidence interval [CI], 4.419; 16.578). The area under the summary receiver operating characteristic curve was 0.748. The diagnostic odds ratio of DLN in LLN metastasis was 7.61 (95% CI, 4.48; 12.94). The area under the summary receiver operating characteristic curve was 0.837. DLN metastasis was moderately predictive of CLN metastasis (sensitivity = 32%, specificity = 95%), LLN metastasis (sensitivity = 52%, specificity = 89%), and contralateral CLN metastasis (sensitivity = 46%, specificity = 85%). DLN metastasis had statistically significant correlation with specific clinicopathological characteristics, including younger age (< 45 years old), bilaterality, capsule invasion, extrathyroidal extension, lymphovascular invasion, male sex, multifocality, and tumor size (> 1 cm).

The higher specificities of DLN pathology may help predict central and lateral compartment involvement in patients with thyroid cancer.

N/A Laryngoscope, 2021.

N/A Laryngoscope, 2021.Loss of myelin and altered oligodendrocyte distribution in the cerebral cortex are commonly observed both in postsurgical tissue derived from different focal epilepsies (such as focal cortical dysplasias and tuberous sclerosis) and in animal models of focal epilepsy. Moreover, seizures are a frequent symptom in demyelinating diseases, such as multiple sclerosis, and in animal models of demyelination and oligodendrocyte dysfunction. Finally, the excessive activity reported in demyelinated axons may promote hyperexcitability. We hypothesize that the extracellular potassium rise generated during epileptiform activity may be amplified by the presence of axons without appropriate myelin coating and by alterations in oligodendrocyte function. This process could facilitate the triggering of recurrent spontaneous seizures in areas of altered myelination and could result in further demyelination, thus promoting epileptogenesis.