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  • 1
    Online Resource
    Online Resource
    30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 24 ( 2022-12-12), p. 7371-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 24 ( 2022-12-12), p. 7371-
    Abstract: Background: Obstructive sleep apnea (OSA) is a chronic disorder of the upper airway. OSA surgery has oftentimes been researched based on the outcomes of single-institutional facilities. We retrospectively analyzed a multi-institutional national database to investigate the outcomes of OSA surgery and identify risk factors for complications. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2008–2020) to identify patients who underwent OSA surgery. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. Additionally, we assessed risk-associated factors for complications, including comorbidities and preoperative blood values. Results: The study population included 4662 patients. Obesity (n = 2909; 63%) and hypertension (n = 1435; 31%) were the most frequent comorbidities. While two (0.04%) deaths were reported within the 30-day postoperative period, the total complication rate was 6.3% (n = 292). Increased BMI (p = 0.01), male sex (p = 0.03), history of diabetes (p = 0.002), hypertension requiring treatment (p = 0.03), inpatient setting (p 〈 0.0001), and American Society of Anesthesiology (ASA) physical status classification scores ≥ 4 (p 〈 0.0001) were identified as risk-associated factors for any postoperative complications. Increased alkaline phosphatase (ALP) was identified as a risk-associated factor for the occurrence of any complications (p = 0.02) and medical complications (p = 0.001). Conclusions: OSA surgery outcomes were analyzed at the national level, with complications shown to depend on AP levels, male gender, extreme BMI, and diabetes mellitus. While OSA surgery has demonstrated an overall positive safety profile, the implementation of these novel risk-associated variables into the perioperative workflow may further enhance patient care.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11247371
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 2
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    Online Resource
    Early Outcomes and Risk Factors in Orthognathic Surgery for Mandibular and Maxillary Hypo- and Hyperplasia: A 13-Year Analysis of a Multi-Institutional Database
    MDPI AG ; 2023
    In:  Journal of Clinical Medicine Vol. 12, No. 4 ( 2023-02-11), p. 1444-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 4 ( 2023-02-11), p. 1444-
    Abstract: Background: Orthognathic surgery (OS) is a frequently performed procedure for the correction of dentofacial deformities and malocclusion. Research on OS is mostly limited to single-surgeon experience or single-institutional reports. We, therefore, retrospectively analyzed a multi-institutional database to investigate outcomes of OS and identify risk factors for peri- and postoperative complications. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2008–2020) to identify patients who underwent OS for mandibular and maxillary hypo- and hyperplasia. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. We also evaluated risk factors for complications. Results: The study population included 674 patients, 48% of whom underwent single jaw surgery, 40% double jaw surgery, and 5.5% triple jaw surgery. The average age was 29 ± 11 years, with an equal gender distribution (females: n = 336; 50%, males: n = 338; 50%). Adverse events were relatively rare, with a total of 29 (4.3%) complications reported. The most common surgical complication was superficial incisional infection (n = 14; 2.1%). While the multivariable analysis revealed isolated single lower jaw surgery (p = 0.03) to be independently associated with surgical complication occurrence, it also identified an association between the outpatient setting and the frequency of surgical complications (p = 0.03) and readmissions (p = 0.02). In addition, Asian ethnicity was identified as a risk factor for bleeding (p = 0.003) and readmission (p = 0.0009). Conclusion: Based on the information recorded by the ACS-NSQIP database, our analysis underscored the positive (short-term) safety profile of OS. We found OS of the mandible to be associated with higher complication rates. The calculated risk role of OS in the outpatient setting warrants further investigation. A significant correlation between Asian OS patients and postoperative adverse events was found. Implementation of these novel risk factors into the surgical workflow may help facial surgeons refine their patient selection and improve patient outcomes. Future studies are needed to investigate the causal relationships of the observed statistical correlations.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12041444
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662592-1
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  • 3
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    Online Resource
    An ACS-NSQIP Data Analysis of 30-Day Outcomes Following Surgery for Bell’s Palsy
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Journal of Craniofacial Surgery
    Details
    In: Journal of Craniofacial Surgery, Ovid Technologies (Wolters Kluwer Health)
    Abstract: There exists a paucity of large-scale, multi-institutional studies that investigate the outcomes of surgery for Bell’s palsy (BP). Here, we utilize a large, multi-institutional database to study the risk factors and early-stage outcomes following surgical procedures in BP. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program database (2008–2019) to identify patients who underwent surgery for the diagnosis of BP. We extracted data on comorbidities and preoperative blood values, and 30-day postoperative outcomes. Results: Two hundred fifty-seven patients who underwent surgery for BP symptoms over the 12-year review period were identified. Muscle grafts (n=50; 19%) and fascial grafts (n=48; 19%) accounted for the majority of procedures. The most common comorbidities were hypertension (n=89; 35%) and obesity (n=79; 31%). Complications occurred in 26 (10.1%) cases. Additionally, length of hospital stay was significantly associated with both surgical and medical complications (3.9±4.7 versus 1.5±2.0; P 〈 0.01) and (3.2±3.8 versus 1.4±2.0; P 〈 0.01), respectively. Preoperative creatinine, blood urea nitrogen, and alkaline phosphatase were identified as potential predictors of poor postoperative outcomes. Conclusion: Based on multi-institutional analysis, complication rates following surgery for BP were found to be overall low and seen to correlate with length of hospital stay. Reoperations and readmissions were the most frequent complications after surgery for BP. The preoperative evaluation of routine laboratory values may help refine patient eligibility and risk stratification. In addition, our findings call for future large-scale prospective studies in the field of facial palsy surgery to further improve the quality of care and optimize perioperative protocols.
    Type of Medium: Online Resource
    ISSN: 1049-2275
    URL: Article
    DOI: 10.1097/SCS.0000000000009739
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2060546-8
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  • 4
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    Online Resource
    Sailing the Seven Seas: A Multinational Comparison of ChatGPT’s Performance on Medical Licensing Examinations
    Springer Science and Business Media LLC ; 2023
    In:  Annals of Biomedical Engineering
    Details
    In: Annals of Biomedical Engineering, Springer Science and Business Media LLC
    Abstract: The use of AI-powered technology, particularly OpenAI’s ChatGPT, holds significant potential to reshape healthcare and medical education. Despite existing studies on the performance of ChatGPT in medical licensing examinations across different nations, a comprehensive, multinational analysis using rigorous methodology is currently lacking. Our study sought to address this gap by evaluating the performance of ChatGPT on six different national medical licensing exams and investigating the relationship between test question length and ChatGPT’s accuracy. Methods We manually inputted a total of 1,800 test questions (300 each from US, Italian, French, Spanish, UK, and Indian medical licensing examination) into ChatGPT, and recorded the accuracy of its responses. Results We found significant variance in ChatGPT’s test accuracy across different countries, with the highest accuracy seen in the Italian examination (73% correct answers) and the lowest in the French examination (22% correct answers). Interestingly, question length correlated with ChatGPT’s performance in the Italian and French state examinations only. In addition, the study revealed that questions requiring multiple correct answers, as seen in the French examination, posed a greater challenge to ChatGPT. Conclusion Our findings underscore the need for future research to further delineate ChatGPT’s strengths and limitations in medical test-taking across additional countries and to develop guidelines to prevent AI-assisted cheating in medical examinations.
    Type of Medium: Online Resource
    ISSN: 0090-6964 , 1573-9686
    URL: Article
    DOI: 10.1007/s10439-023-03338-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1477155-X
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  • 5
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    Unraveling the Role of Epithelial–Mesenchymal Transition in Adenoid Cystic Carcinoma of the Salivary Glands: A Comprehensive Review
    MDPI AG ; 2023
    In:  Cancers Vol. 15, No. 11 ( 2023-05-24), p. 2886-
    Details
    In: Cancers, MDPI AG, Vol. 15, No. 11 ( 2023-05-24), p. 2886-
    Abstract: Salivary adenoid cystic carcinoma (SACC) is considered a challenging malignancy; it is characterized by a slow-growing nature, yet a high risk of recurrence and distant metastasis, presenting significant hurdles in its treatment and management. At present, there are no approved targeted agents available for the management of SACC and systemic chemotherapy protocols that have demonstrated efficacy remain to be elucidated. Epithelial–mesenchymal transition (EMT) is a complex process that is closely associated with tumor progression and metastasis, enabling epithelial cells to acquire mesenchymal properties, including increased mobility and invasiveness. Several molecular signaling pathways have been implicated in the regulation of EMT in SACC, and understanding these mechanisms is crucial to identifying new therapeutic targets and developing more effective treatment approaches. This manuscript aims to provide a comprehensive overview of the latest research on the role of EMT in SACC, including the molecular pathways and biomarkers involved in EMT regulation. By highlighting the most recent findings, this review offers insights into potential new therapeutic strategies that could improve the management of SACC patients, especially those with recurrent or metastatic disease.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers15112886
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2527080-1
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  • 6
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    Online Resource
    Postoperative free flap monitoring in reconstructive surgery—man or machine?
    Frontiers Media SA ; 2023
    In:  Frontiers in Surgery Vol. 10 ( 2023-2-22)
    Details
    In: Frontiers in Surgery, Frontiers Media SA, Vol. 10 ( 2023-2-22)
    Abstract: Free tissue transfer is widely used for the reconstruction of complex tissue defects. The survival of free flaps depends on the patency and integrity of the microvascular anastomosis. Accordingly, the early detection of vascular comprise and prompt intervention are indispensable to increase flap survival rates. Such monitoring strategies are commonly integrated into the perioperative algorithm, with clinical examination still being considered the gold standard for routine free flap monitoring. Despite its widespread acceptance as state of the art, the clinical examination also has its pitfalls, such as the limited applicability in buried flaps and the risk of poor interrater agreement due to inconsistent flap (failure) appearances. To compensate for these shortcomings, a plethora of alternative monitoring tools have been proposed in recent years, each of them with inherent strengths and limitations. Given the ongoing demographic change, the number of older patients requiring free flap reconstruction, e.g., after cancer resection, is rising. Yet, age-related morphologic changes may complicate the free flap evaluation in elderly patients and delay the prompt detection of clinical signs of flap compromise. In this review, we provide an overview of currently available and employed methods for free flap monitoring, with a special focus on elderly patients and how senescence may impact standard free flap monitoring strategies.
    Type of Medium: Online Resource
    ISSN: 2296-875X
    URL: Article
    DOI: 10.3389/fsurg.2023.1130566
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2773823-1
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  • 7
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    Online Resource
    Bilateral Keloid Formation after Otoplasty in the Presence of Prolonged Mask Wearing
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Plastic and Reconstructive Surgery - Global Open Vol. 11, No. 6 ( 2023-06-30), p. e5086-
    Details
    In: Plastic and Reconstructive Surgery - Global Open, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 6 ( 2023-06-30), p. e5086-
    Abstract: Prominent ears are the most frequently observed congenital deformity of the head and neck. Various techniques have been proposed for their aesthetic correction. Typically, surgical treatment for protruding ears involves a combination of suture, cutting, and scoring techniques. Herein, we present the clinical case of an 11-year-old child who developed bilateral keloid formations 12 months after otoplasty. Keloids and hypertrophic scars can result from extensive retroauricular skin excisions that do not allow for tension-free wound closure. In addition, skin tension and friction on immature surgical scars are common risk factors for keloid formation. To comply with school guidelines aimed at reducing the transmission of SARS-CoV-2, the patient has consistently worn FFP2 masks with ear loops positioned behind the concha. Although masks play a critical role in preventing the spread of infectious diseases, they can lead to friction in the postauricular area. In light of the presented case, it is important to examine potential cofactors that may contribute to keloid formation after otoplasty, as well as suggest a strategy to safeguard the retroauricular scar.
    Type of Medium: Online Resource
    ISSN: 2169-7574
    URL: Article
    DOI: 10.1097/GOX.0000000000005086
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2723993-7
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  • 8
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    Online Resource
    Olfactory and gustatory dysfunctions are difficult to evaluate in hospitalized COVID-19 patients
    Elsevier BV ; 2021
    In:  American Journal of Otolaryngology Vol. 42, No. 6 ( 2021-11), p. 103169-
    Details
    In: American Journal of Otolaryngology, Elsevier BV, Vol. 42, No. 6 ( 2021-11), p. 103169-
    Type of Medium: Online Resource
    ISSN: 0196-0709
    URL: Article
    DOI: 10.1016/j.amjoto.2021.103169
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 2041649-0
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  • 9
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    Online Resource
    Data Sheet 1.docx
    Frontiers Media SA ; 2024
    In:  Frontiers in Oncology Vol. 14 ( 2024-9-5)
    Details
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 14 ( 2024-9-5)
    Abstract: Recurrent and metastatic head and neck squamous cell carcinoma (HNSCC) is characterized by a complex therapeutic management that needs to be discussed in multidisciplinary tumor boards (MDT). While artificial intelligence (AI) improved significantly to assist healthcare professionals in making informed treatment decisions for primary cases, an application in the even more complex recurrent/metastatic setting has not been evaluated yet. This study also represents the first evaluation of the recently published LLM ChatGPT 4o, compared to ChatGPT 4.0 for providing therapy recommendations. Methods The therapy recommendations for 100 HNSCC cases generated by each LLM, 50 cases of recurrence and 50 cases of distant metastasis were evaluated by two independent reviewers. The primary outcome measured was the quality of the therapy recommendations measured by the following parameters: clinical recommendation, explanation, and summarization. Results In this study, ChatGPT 4o and 4.0 provided mostly general answers for surgery, palliative care, or systemic therapy. ChatGPT 4o proved to be 48.5% faster than ChatGPT 4.0. For clinical recommendation, explanation, and summarization both LLMs obtained high scores in terms of performance of therapy recommendations, with no significant differences between both LLMs, but demonstrated to be mostly an assisting tool, requiring validation by an experienced clinician due to a lack of transparency and sometimes recommending treatment modalities that are not part of the current treatment guidelines. Conclusion This research demonstrates that ChatGPT 4o and 4.0 share a similar performance, while ChatGPT 4o is significantly faster. Since the current versions cannot tailor therapy recommendations, and sometimes recommend incorrect treatment options and lack information on the source material, advanced AI models at the moment can merely assist in the MDT setting for recurrent/metastatic HNSCC.
    Type of Medium: Online Resource
    ISSN: 2234-943X
    URL: Article
    URL: Article
    DOI: 10.3389/fonc.2024.1455413
    DOI: 10.3389/fonc.2024.1455413.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2024
    detail.hit.zdb_id: 2649216-7
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  • 10
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    Online Resource
    1,8-cineole (eucalyptol): A versatile phytochemical with therapeutic applications across multiple diseases
    Elsevier BV ; 2023
    In:  Biomedicine & Pharmacotherapy Vol. 167 ( 2023-11), p. 115467-
    Details
    In: Biomedicine & Pharmacotherapy, Elsevier BV, Vol. 167 ( 2023-11), p. 115467-
    Type of Medium: Online Resource
    ISSN: 0753-3322
    URL: Article
    DOI: 10.1016/j.biopha.2023.115467
    RVK:
    XA 10000
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 1501510-5
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