scholarly journals Swallowing Outcomes in Elderly Patients following Microvascular Reconstruction of the Head and Neck

2018 ◽  
Vol 159 (2) ◽  
pp. 320-327 ◽  
Author(s):  
Mitchell L. Worley ◽  
Evan M. Graboyes ◽  
Julie Blair ◽  
Suhael Momin ◽  
Kent E. Armeson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Academic Medical Center ◽  
Multivariable Analysis ◽  
Aerodigestive Tract ◽  
Microvascular Reconstruction ◽  
Upper Aerodigestive Tract ◽  
Swallowing Function ◽  
Swallowing Outcomes

Objective To describe swallowing outcomes in elderly patients undergoing microvascular reconstruction of the upper aerodigestive tract and identify risk factors for poor postoperative swallowing function. Study Design Case series with chart review. Setting Academic medical center. Subjects and Methods Sixty-six patients aged ≥70 years underwent microvascular reconstruction of the upper aerodigestive tract. The primary outcome measure was the Functional Oral Intake Scale (FOIS); preoperative and postoperative scores were dichotomized to define “good swallowing” and “poor swallowing.” Logistic regression was performed to identify risk factors for poor postoperative swallowing function. Results In total, 91% of reconstructions were performed for oncologic defects. The most common defect site was the oral cavity (67%), and the anterolateral thigh (29%) was the most frequently used donor site. At 3-year follow up, 75% of patients had good swallowing function with 95% of patients who achieved good swallowing function doing so within 6 months of surgery. On multivariable analysis, patients with pT4 tumors (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.0-25.6) and those undergoing at least partial glossectomy (OR, 4.7; 95% CI, 1.1-20.7) were more likely to experience poor swallowing function at 6-month follow-up. Conclusion Approximately half of elderly patients achieve good swallowing function within 6 months following microvascular reconstruction of the upper aerodigestive tract. Elderly patients with pT4 tumors and those requiring glossectomy are at highest risk for poor swallowing outcomes. These data can be used to inform preoperative patient counseling and design interventions aimed at improving swallowing function in those at high risk for poor outcomes.

Evaluation of the correlation between risk factors and mortality in elderly patients with femoral neck fracture with 5-year follow-up

2008 ◽  
Vol 149 (11) ◽  
pp. 493-503 ◽  
Author(s):  
Andor Sebestyén ◽  
Imre Boncz ◽  
Ferenc Tóth ◽  
Márta Péntek ◽  
József Nyárády ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fracture ◽  
Neck Fracture

A csípőtáji törésekhez idős korban magas halálozás társul. A szakirodalomban kevés a nagy beteganyagot feldolgozó, országos kiterjedésű ellátórendszer adatain alapuló feldolgozás. Célkitűzés: A tanulmány célja a 60 év feletti akut, monotraumás combnyaktöröttek primer ellátását követő halálozások vizsgálata havonta és évente ötéves utánkövetéssel, valamint a különböző rizikófaktoraik halálozásra gyakorolt hatásainak értékelése az egyes időperiódusokban. Módszer: Az adatok az Országos Egészségbiztosítási Pénztár adatbázisából származnak. Az értékelés bázisát a fekvőbeteg-ellátást végző intézményekből combnyaktörés primer műtéti ellátását követően 2000. évben emittált betegek képezik. Bemutatjuk az átlagos évenkénti, havonkénti és heti halálozási arányokat, valamint rizikótényezők szerinti alakulásukat havonként és évenként. A rizikótényezők és a halálozás kapcsolatának értékelése logisztikus és Cox-regressziós analízissel történik. Eredmények: A tanulmányban 3783 fő került elemzésre. Átlagéletkoruk 77,97 (SD 8,52) év. A halálozás az első héten 1,71%, 30 napon belül 8,99%, az első évben 30,74%, öt év alatt 61,88% volt. A halálozás havi szinten az első 5 hónapig mutat csökkenést, éves szinten az első év után stagnál. A rizikófaktorok közül a férfinem és a magasabb életkor öt évig, a kísérőbetegségek hatásai a negyedik évig, a laterális combnyaktöréstípus és a 12 órán túli ellátás két évig, a korai lokális szövődmények egy évig, a hétvégi ellátások az első hónapban eredményeznek magasabb halálozási kockázatot. Az országos és egyetemi ellátásokat követően az első évben alacsonyabb a halálozási kockázat. Következtetések: A csípőtáji törések managementjében a halálozások csökkentése érdekében hangsúlyozzuk a 12 órán belüli ellátás, a törési típusnak megfelelő módszerválasztás, a hét minden napján történő azonos ellátási feltételek biztosítása, az ellátások centrumokba történő szervezése, a beteg általános állapotának és kísérőbetegségeinek megfelelő akut ellátás és az utókezelések fontosságát.

Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma

2012 ◽  
Vol 270 (7) ◽  
pp. 1981-1989 ◽  
Author(s):  
Antoine Digonnet ◽  
Marc Hamoir ◽  
Guy Andry ◽  
Vincent Vander Poorten ◽  
Missak Haigentz ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract

Delayed Upper Aerodigestive Tract Perforation from Anterior Cervical Spine Hardware: Treatment and Swallowing Outcomes

Dysphagia ◽  
2021 ◽  
Author(s):  
Hannah G. Kay ◽  
Benjamin Campbell ◽  
Jean-Nicolas Gallant ◽  
Catherine Carlile ◽  
Patty Wright ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Tract Perforation ◽  
Swallowing Outcomes

Efficacy and safety of surgery for spontaneous pneumothorax in elderly patients

2019 ◽  
Author(s):  
Shunichi Nagata ◽  
Mitsugu Omasa ◽  
Kosuke Tokushige ◽  
Takao Nakanishi ◽  
Hideki Motoyama
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Spontaneous Pneumothorax ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Efficacy And Safety ◽  
Air Leaks ◽  
Grade 3

Abstract OBJECTIVES There is no clear consensus on the surgical indications for spontaneous pneumothorax in elderly patients. In this study, we aimed to assess the efficacy and safety of surgical treatment of spontaneous pneumothorax in patients aged ≥70 years. We also sought to identify the risk factors for postoperative prolonged air leaks and complications in such patients. METHODS Data pertaining to 104 elderly patients who underwent surgery out of 206 patients (aged ≥70 years) who were diagnosed with spontaneous pneumothorax at our institution between 1994 and 2018 were retrospectively reviewed. The incidences of postoperative persistent air leaks (≥2 days) and postoperative complications (≥grade 3; Clavien–Dindo classification) were analysed for efficacy and safety assessment, respectively. RESULTS Median postoperative air leaks continued for 0 days (range 0–25); 14.4% patients developed ≥grade 3 postoperative complications. On the basis of results of multivariable analysis, it was observed that a higher PaCO2 level was significantly associated with prolonged postoperative air leaks [odds ratio (OR) 1.08, 95% confidence interval (CI) 1.00–1.17; P = 0.047]. Poorer performance status was associated with a significantly increased risk of postoperative complications, as assessed by multivariable analysis (OR 6.13, 95% CI 1.38–27.3; P = 0.017). The recurrence rate was 4.8%; mortality rate of patients was 2.9%. Three-year survival rate after surgery was 73.8%. CONCLUSIONS Surgical treatment of spontaneous pneumothorax may be effective and safe in selected elderly patients. Moreover, higher PaCO2 and poorer performance status were independent risk factors for postoperative persistent air leaks and complications, respectively.

Risk factors for esophageal cancer and the multiple occurrence of carcinoma in the upper aerodigestive tract

Surgery ◽  
2002 ◽  
Vol 131 (1) ◽  
pp. S1-S6 ◽  
Author(s):  
Masaru Morita ◽  
Hiroshi Saeki ◽  
Masaki Mori ◽  
Hiroyuki Kuwano ◽  
Keizo Sugimachi
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Multiple Occurrence

scholarly journals Immunoglobulin Abnormalities in Gaucher Disease: an Analysis of 278 Patients Included in the French Gaucher Disease Registry

2020 ◽  
Vol 21 (4) ◽  
pp. 1247 ◽  
Author(s):  
Yann Nguyen ◽  
Jérôme Stirnemann ◽  
Florent Lautredoux ◽  
Bérengère Cador ◽  
Monia Bengherbia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gaucher Disease ◽  
Multivariable Analysis ◽  
Autosomal Recessive Disorder ◽  
Hematologic Malignancies ◽  
Severe Thrombocytopenia ◽  
Cox Models ◽  
Non Hodgkin Lymphoma ◽  
Polyclonal Gammopathy

Gaucher disease (GD) is a rare lysosomal autosomal-recessive disorder due to deficiency of glucocerebrosidase; polyclonal gammopathy (PG) and/or monoclonal gammopathy (MG) can occur in this disease. We aimed to describe these immunoglobulin abnormalities in a large cohort of GD patients and to study the risk factors, clinical significance, and evolution. Data for patients enrolled in the French GD Registry were studied retrospectively. The risk factors of PG and/or MG developing and their association with clinical bone events and severe thrombocytopenia, two markers of GD severity, were assessed with multivariable Cox models and the effect of GD treatment on gammaglobulin levels with linear/logarithmic mixed models. Regression of MG and the occurrence of hematological malignancies were described. The 278 patients included (132 males, 47.5%) were followed up during a mean (SD) of 19 (14) years after GD diagnosis. PG occurred in 112/235 (47.7%) patients at GD diagnosis or during follow-up and MG in 59/187 (31.6%). Multivariable analysis retained age at GD diagnosis as the only independent risk factor for MG (> 30 vs. ≤30 years, HR 4.71, 95%CI [2.40–9.27]; p < 0.001). Risk of bone events or severe thrombocytopenia was not significantly associated with PG or MG. During follow-up, non-Hodgkin lymphoma developed in five patients and multiple myeloma in one. MG was observed in almost one third of patients with GD. Immunoglobulin abnormalities were not associated with the disease severity. However, prolonged surveillance of patients with GD is needed because hematologic malignancies may occur.

scholarly journals Mandibular Tori Limiting Treatment of Carcinoma of the Upper Aerodigestive Tract

2019 ◽  
Vol 12 ◽  
pp. 117954761985659
Author(s):  
Christopher M Low ◽  
Daniel L Price ◽  
Jan L Kasperbauer
Keyword(s):  
Anterior Commissure ◽  
Aerodigestive Tract ◽  
Surgical Removal ◽  
Robotic Assistance ◽  
Direct Visualization ◽  
Upper Aerodigestive Tract ◽  
First Case ◽  
Mandibular Tori ◽  
The Right

Background: Mandibular tori are a rare cause of difficult direct visualization of the upper aerodigestive tract. In the setting of aerodigestive tract pathology necessitating direct visualization, removal of mandibular tori may be required to facilitate treatment. Methods: In the first case, large bilateral symmetric mandibular tori were removed to facilitate access to the anterior commissure and removal of a T1 glottic squamous cell carcinoma (SCC). In the second case, large bilateral mandibular tori were removed to access a markedly exophytic SCC in the right vallecula. Subsequently, the tumor was removed with robotic assistance with excellent exposure. Results: Both patients were free of recurrence at last follow-up. Conclusion: Mandibular tori are an uncommon cause of difficult direct laryngoscopy. In situations that require direct visualization of the anterior commissure or base of tongue for diagnosis and management of lesions, surgical removal of the tori may be required as in the cases presented here.

scholarly journals DNA methylation changes associated with risk factors in tumors of the upper aerodigestive tract

Epigenetics ◽  
2012 ◽  
Vol 7 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Samson Mani ◽  
Kasia Szymańska ◽  
Cyrille Cuenin ◽  
David Zaridze ◽  
Karen Balassiano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dna Methylation ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract

41-Month Follow-Up of Risk Factors Correlated With New Coronary Events in 708 Elderly Patients

1989 ◽  
Vol 37 (6) ◽  
pp. 501-506 ◽  
Author(s):  
Wilbert S. Aronow ◽  
Abbe H. Herzig ◽  
Fritzner Etienne ◽  
Peter D'Alba ◽  
Jocelyn Ronquillo
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Coronary Events
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