Clarkfitzpatrick4097

ing the possible implications of surgery, should they consider it as an option.

Using automated algorithms, a total of 12,369 questions from online back and neck medical forums were scraped and analysed. Secondary analysis categorized fear-related themes that were mentioned by users. Identifying and addressing patients' fear has potential to improve communication and therapeutic outcome. For example, questions regarding surgery were typically asked after the option was mentioned by a physician. This insight should encourage physicians to devote extra time explaining the possible implications of surgery, should they consider it as an option.

The clinical course in metastatic castrate-resistant prostate cancer (mCRPC) can be complicated when patients have disease progression after prior treatment with second generation hormone therapy (second HT), such as enzalutamide or abiraterone. Currently, limited data exist regarding the optimal choice of chemotherapy for mCRPC after failing second generation hormone therapy. We sought to evaluate three common chemotherapy regimens in this setting.

We retrospectively identified 150 mCRPC patients with disease progression on enzalutamide or abiraterone. Of these 150 patients, 92 patients were chemo-naïve while 58 patients had previously received docetaxel chemotherapy before being started on second HT. Elexacaftor After failing second HT, 90 patients were assigned for docetaxel-alone (group A), 33 patients received carboplatin plus docetaxel (group B), while 27 patients received cabazitaxel-alone (Group C). A favorable response was defined by more than or equal to 50% reduction in prostate-specific antigen from the be response compared to patients in group (A) (OR = 2.625, 95%CI 1.15-5.99) and almost three times compared to patients in group (C) (OR = 2.975, 95%CI 1.04-8.54) (P = .0442). 30-month overall survival was 70.7%, 38.9% and 30.3% for group (B), (A), and (C), respectively (P = .008). We report a Hazard Ratio of 3.1 (95% CI, 1.31-7.35; P = .0037) between patients in group (A) versus those in group (B) and a Hazard Ratio of 4.18 (95% CI, 1.58-11.06; P = .0037) between patients in group (C) compared to those in group (B) CONCLUSION This data demonstrates improved response and overall survival in treatment-refractory mCRPC with a chemotherapy regimen of docetaxel plus carboplatin when compared to docetaxel alone or cabazitaxel alone. Further investigations are required.

To evaluate laryngopharyngeal sensation at specific subsites using a novel adaptation of a buckling force aesthesiometer for delivery of calibrated tactile stimuli.

Cross-sectional.

Twenty-two healthy adults (12 men, 10 women) were tested for responses to tactile forces, using 30-mm 6-0, 5-0, and 4-0 nylon monofilaments to map sensation of the aryepiglottic (AE) fold, lateral pyriform sinus (PS), and medial PS bilaterally. The outcome measures were the laryngeal adductor reflex (LAR) and patient reported rating of perceptual strength.

Rates of triggered LAR response grew monotonically with increasing tactile force at a mean (SD) stimulus duration of 663 (164) msec across all three subsites. The AE fold and medial PS had similar profiles and were the most responsive, while the lateral PS was the least responsive. Low force (6-0) response rate was ≤14% for all subsites. High force (4-0) response rate was 91% for AE fold and medial PS, and 23% for lateral PS. The perceptual strength gradient was in the lateral to medial trajectory.

Normative data for LAR response rates to low, medium, and high stimulation forces will be useful to assess sensory dysfunction in a variety of laryngopharyngeal disorders, including aspiration, dysphagia, chronic cough, and spasmodic dysphonia. In turn, that information will guide the creation of innovative treatments. LAR response profiles to low and high force stimuli will inform the development of screening tools to diagnose laryngopharyngeal hypersensitivity and hyposensitivity conditions.

3b Laryngoscope, 2020.

3b Laryngoscope, 2020.Roller pumps have been widely used in the ventricular assist field for many years, while the significant hemolysis caused by its mechanical stress is still a fundamental problem. Although the usual under-occlusion setting was considered as an effective method to reduce the hemolysis rate, its nonocclusive condition of the whole process may cause serious backflow results, which exactly places many restrictions on this method. In this study, the simulation experiments based on computational fluid dynamics (CFD) is conducted, and the occlusion angle is proposed and used to explore a more reliable adjustment form of the occlusion condition. The parameterized geometry of a roller pump is established based on the occlusion angle and other parameters. In order to simulate the motion of the roller, the dynamic mesh mode is introduced to the CFD model, and the analytic formulations used to determine the boundary position are derived. In the whole operation process of the roller pump, four feature positions of the rollers were focused and extracted, and the flow characteristics and the shear stress distribution at these positions were demonstrated. It was found that the entry and exit of the rollers could cause clear shear stress peak, especially when one roller entered, the peak got extremely high. Furthermore, the roller pumps with different occlusion angles were compared, and the results showed that decreasing the occlusion angle could lead to a notable decrease in the amplitude and range of high shear stress and the hemolysis index with a small loss of the occlusion duration. It can be concluded that appropriately decreasing the occlusion angle may be an effective method to alleviate the hemolysis which should be given more attention.

For the biochemical follow-up of benign thyroid nodules, some authors recommend periodic lifelong measurement of thyroid-stimulating hormone (TSH) to assess for the development of toxic nodules over time. The purpose of this retrospective study was to assess the incidence of thyroid dysfunction over time in patients with benign thyroid nodule(s), with a normal TSH at diagnosis and to identify any factors that may predict biochemical dysfunction over time.

Medical records of patients with the diagnosis of thyroid nodule(s) between January 2011 and August 2014 were reviewed. Patients who had TSH measurement within 1year of initial diagnostic ultrasound (US) were included.

One-hundred fifty-seven patients identified with thyroid nodule(s) satisfied inclusion criteria. At a median follow-up of 45 (34-63) months, 13 (8.3%) patients developed thyroid dysfunction. The mean initial TSH in the group which developed subclinical hyperthyroidism (0.65mIU/mL) was statistically different from the group that did not develop thyroid dysfunction (1.