Search Results (48)

Background and Objectives: The common complaints of head and neck cancer patients receiving concurrent chemo-radiotherapy (CCRT) are dry mouth, dysphagia, trismus, hoarseness, sore throat, and oral mucosal damage, which result in retained secretions and difficult expectoration. We aimed to investigate the effect of adjuvant respiratory therapy on secretion expectoration and treatment completion in patients with head and neck cancer receiving CCRT. Materials and Methods: From November 2016 to May 2018, 56 head and neck cancer patients were recruited retrospectively, and according to their respiratory therapy in the medical record, were divided into the control group (CG, n = 27) or the research group (RG, n = 29). In the CG, the patients were treated via the teaching of routine breathing exercises and expel techniques, while patients in the RG were treated with the inhalation of a ß-agonist bronchodilator agent five times each week, in addition to the standard treatment administered in the CG. Results: The total completion rate of treatment was significantly higher in the RG (21 patients) compared with the CG (12 patients) (72.4% vs. 44.4%, p < 0.05). After therapy, the rates of clinical symptoms were significantly increased in the RG compared with the CG, including smooth expectoration (76.2% vs. 75.0%), decreased secretions (61.9% vs. 58.3%), reduced viscosity of secretions (66.7% vs. 58.3%), lower cough frequency (71.4% vs. 50.0%), improved sore throat (52.4% vs. 41.7%), and swallowing function (52.4% vs. 50.0%). The continuation of chemo-radiotherapy without disruption was higher in the RG than it was in the CG (66.7% vs. 50.0%). There was no significant difference in adverse effects between the two groups. Conclusions: Adjuvant respiratory therapy not only improves secretion expectoration, but also reduces side effects, thus promoting the completion of the CCRT schedule in patients with head and neck cancer. Full article

Air pollution is a serious public health issue in Pakistan’s metropolitan cities, including Lahore, Karachi, Faisalabad, Islamabad, and Rawalpindi. Pakistan’s urban areas are vulnerable due to air pollution drivers such as industrial activities, vehicular emissions, burning processes, emissions from brick kilns, urbanization, and other human activities that have resulted in significant human health issues. The purpose of this study was to examine the impact of air pollutants and smog, as well as their causes and effects on human health. The PRISMA technique was used to assess the impact of environmental contaminants on human health. This study looked at air pollution sources and pollutants such as PM_2.5, PM₁₀, CO₂, CO, SO_X, and NO_x from waste combustion and agriculture. The population included people of all ages and sexes from both urban and rural areas of Pakistan. Data were retrieved and analyzed using SRDR⁺ software and Microsoft Excel spreadsheets. The data suggested that Karachi and Lahore had the highest levels of air pollution and disease prevalence, which were attributed to heavy industrial activity and traffic emissions. Smog was a serious concern in Lahore during winter, contributing to the spread of several diseases. Other cities, including Islamabad, Rawalpindi, Jhang, Sialkot, Faisalabad, and Kallar Kahar, were impacted by agricultural operations, industrial pollutants, brick kilns, and urbanization. Due to these drivers of air pollution, some diseases such as respiratory and cardiovascular diseases had notably higher incidences in these cities. Other diseases were connected with air pollution exposure, asthma, eye and throat problems, allergies, lung cancer, morbidities, and mortalities. To reduce air pollution’s health effects, policies should focus on reducing emissions, supporting cleaner technologies, and increasing air quality monitoring. Full article

In the frame of the I-MOVE-COVID-19 project, a cohort of 2050 patients admitted in two Spanish reference hospitals between March 2020 and December 2021 was selected and a range of clinical factor data were collected at admission to assess their impact on the risk COVID-19 severity outcomes through a multivariate adjusted analysis and nomograms. The need for ventilation and intensive care unit (ICU) admission were found to be directly associated with a higher death risk (OR 6.9 and 3.2, respectively). The clinical predictors of death were the need for ventilation and ICU, advanced age, neuromuscular disorders, thrombocytopenia, hypoalbuminemia, dementia, cancer, elevated creatin phosphokinase (CPK), and neutrophilia (OR between 1.8 and 3.5), whilst the presence of vomiting, sore throat, and cough diminished the risk of death (OR 0.5, 0.2, and 0.1, respectively). Admission to ICU was predicted by the need for ventilation, abdominal pain, and elevated lactate dehydrogenase (LDH) (OR 371.0, 3.6, and 2.2, respectively) as risk factors; otherwise, it was prevented by advanced age (OR 0.5). In turn, the need for ventilation was predicted by low oxygen saturation, elevated LDH and CPK, diabetes, neutrophilia, obesity, and elevated GGT (OR between 1.7 and 5.2), whilst it was prevented by hypertension (OR 0.5). These findings could enhance patient management and strategic interventions to combat COVID-19. Full article

Limited research has examined attention to these cigar-specific health warnings and their perceived effectiveness among young people. The objective of our study was to evaluate the attention to and perceptions of a set of cigar-specific health warnings among young adult tobacco users and non-users. Methods: Young adults ages 18–24 in Columbus, Ohio, were recruited into an eye-tracking experiment examining cigarillo packaging between May 2022 and February 2023. Participants (n = 124) were shown 12 unique, branded cigarillo packages featuring a rotation of four of the Food and Drug Administration’s mandated health warnings: (1) Cigar smoking can cause lung cancer and heart disease (“disease”); (2) tobacco smoke increases the risk of lung cancer and heart disease, even in nonsmokers (“nonsmokers”); (3) cigar smoking can cause cancers of the mouth and throat, even if you do not inhale (“inhale”); and (4) cigars are not a safe alternative to cigarettes (“alternative”). Software captured visual attention to each product package, including the health warning. Participants also ranked the most effective message to motivate people to quit; one week later, the participants (n = 118) self-reported unaided recall of the experiment. Results: Study participants were an average of 21.2 years old, 54.2% were female, 73.7% were White, 65.3% had some college education, and 26.3% reported tobacco use in the previous month. The health warning, “Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale” was ranked the most effective cigar warning (41.5%) and drew the greatest proportion of visual attention (26.1%). More than half (52.5%) recalled details regarding the health warning messages one week following the experiment, with few recalling (17.7%) specific warning message themes. Conclusions: Understanding the best performing health warnings is a crucial strategy to share accurate information on the risks of tobacco use. Our findings suggest that the warning on cancer risk even without inhaling drew the greatest visual attention and highest rating of perceived effectiveness among this sample of young adult cigarillo users and non-users. Full article

Taraxaci herba, as a traditional Chinese medicine, is the name of the Taraxacum genus in the Asteraceae family. Documented in the Tang Herbal Medicine (Tang Dynasty, AD 657–659), its medicinal properties cover a wide range of applications such as acute mastitis, lung abscess, conjunctival congestion, sore throat, damp-heat jaundice, and vision improvement. In the Chinese Pharmacopoeia (Edition 2020), more than 40 kinds of China-patented drugs containing Taraxaci herba were recorded. This review explores the evolving scientific understanding of Taraxaci herba, covering facets of ethnopharmacology, botany, phytochemistry, pharmacology, artificial cultivation, and quality control. In particular, the chemical constituents and pharmacological research are reviewed. Taraxaci herba has been certified as a traditional medicine plant, and its flavonoids, phenolic acids, and terpenoids have been identified and separated, which include Chicoric acid, taraxasterol, Taraxasteryl acetate, Chlorogenic acid, isorhamnetin, and luteolin; they are responsible for anti-inflammatory, antioxidant, antibacterial, anti-tumor, and anti-cancer activities. These findings validate the traditional uses of Taraxaci herba and lay the groundwork for further scientific exploration. The sources used in this study include Web of Science, Pubmed, the CNKI site, classic monographs, the Chinese Pharmacopoeia, the Chinese Medicine Dictionary, and doctoral and master’s theses. Full article

Background: In otorhinolaryngology and head and neck surgery, oxygen is a therapeutic tool used for various pathologies. Oxidative stress is the imbalance between the production of free radicals (ROS) and the antioxidant capacity of the body, which can represent the pathogenesis of several pathologies or contribute to their worsening. This narrative review aims to analyze the benefits, indications, and side effects of hyperbaric oxygen therapy (HBOT) in different head and neck disorders. Methods: The search was carried out on multiple electronic databases such as PubMed and Google Scholar, and prospective, randomized, and reviewed studies were analyzed from January 1982 to February 2024. Results and Conclusions: The most common tools used to manage oxidative stress in the ear, nose, and throat (ENT) field are continuous positive airway pressure (CPAP) and HBOT. A common ENT pathology, while the latter can be used for osteoradionecrosis treatment in head and neck cancer patients, infections, malignant external otitis, head and neck reconstruction, facial cosmetic surgery, and among patients with sudden sensorineural hearing loss. From our analysis, it emerged that HBOT is a currently used effective therapy in various ENT pathologies’ treatment, alone or in association with other treatments; it can guarantee functional recovery and healing depending on the type of pathology for which it is used and on its severity. Full article

Background: Nirmatrelvir/Ritonavir has been shown to reduce the risk of COVID-19 progression by 88% compared to placebo, while Molnupiravir reduced it by 31%. However, these two agents have not been compared head-to-head. We therefore compared the safety and efficacy of both agents for the treatment of mild-to-moderate COVID-19 in immunocompromised cancer patients. Methods: We identified 240 cancer patients diagnosed with COVID-19 and treated with Molnupiravir or Nirmatrelvir/Ritonavir. Patients were matched using a 1:2 ratio based on age group (18–64 years vs. ≥65) and type of cancer. The collected data included demographics, comorbidities, and treatment outcome. Results: Both groups had comparable characteristics and presenting symptoms. However, dyspnea was more prevalent in the Molnupiravir group, while sore throat was more prevalent in the Nirmatrelvir/Ritonavir group. The rate of disease progression was comparable in both groups by univariate and multivariable analysis. Treatment with Molnupiravir versus Nirmatrelvir/Ritonavir revealed no significant difference in disease progression by multivariable analysis (adjusted OR = 1.31, 95% CI: 0.56–3.14, p = 0.70). Patients who received Nirmatrelvir/Ritonavir, however, were significantly more prone to having drug–drug interactions/adverse events (30% vs. 0%, p < 0.0001). Conclusions: In the treatment of mild-to-moderate COVID-19 in cancer patients, Molnupiravir was comparable to Nirmatrelvir/Ritonavir in preventing progression to severe disease/death and rebound events, and it had a superior safety profile. Full article

In recent years, there has been a notable rise in the number of patients afflicted with laryngeal diseases, including cancer, trauma, and other ailments leading to voice loss. Currently, the market is witnessing a pressing demand for medical and healthcare products designed to assist individuals with voice defects, prompting the invention of the artificial throat (AT). This user-friendly device eliminates the need for complex procedures like phonation reconstruction surgery. Therefore, in this review, we will initially give a careful introduction to the intelligent AT, which can act not only as a sound sensor but also as a thin-film sound emitter. Then, the sensing principle to detect sound will be discussed carefully, including capacitive, piezoelectric, electromagnetic, and piezoresistive components employed in the realm of sound sensing. Following this, the development of thermoacoustic theory and different materials made of sound emitters will also be analyzed. After that, various algorithms utilized by the intelligent AT for speech pattern recognition will be reviewed, including some classical algorithms and neural network algorithms. Finally, the outlook, challenge, and conclusion of the intelligent AT will be stated. The intelligent AT presents clear advantages for patients with voice impairments, demonstrating significant social values. Full article

Laryngeal cancer (LCA) is a serious disease with a concerning global rise in incidence. Accurate treatment for LCA is particularly challenging in later stages, due to its complex nature as a head and neck malignancy. To address this challenge, researchers have been actively developing various analysis methods and tools to assist medical professionals in efficient LCA identification. However, existing tools and methods often suffer from various limitations, including low accuracy in early-stage LCA detection, high computational complexity, and lengthy patient screening times. With this motivation, this study presents an Automated Laryngeal Cancer Detection and Classification using a Dwarf Mongoose Optimization Algorithm with Deep Learning (ALCAD-DMODL) technique. The main objective of the ALCAD-DMODL method is to recognize the existence of LCA using the DL model. In the presented ALCAD-DMODL technique, a median filtering (MF)-based noise removal process takes place to get rid of the noise. Additionally, the ALCAD-DMODL technique involves the EfficientNet-B0 model for deriving feature vectors from the pre-processed images. For optimal hyperparameter tuning of the EfficientNet-B0 model, the DMO algorithm can be applied to select the parameters. Finally, the multi-head bidirectional gated recurrent unit (MBGRU) model is applied for the recognition and classification of LCA. The simulation result analysis of the ALCAD-DMODL technique is carried out on the throat region image dataset. The comparison study stated the supremacy of the ALCAD-DMODL technique in terms of distinct measures. Full article

Background and Objectives: The rate of head and neck cancer (HNC) is expected to increase by 30% by 2030. However, there are many similarities between the symptomatology of a benign and a malign diagnosis; thus, a protocol for conducting a full head and neck examination is of high importance since the absence of adenopathy does not exclude a malignant diagnosis and also a favorable prognosis. Material and methods: The current study presents a retrospective study on 515 adult patients who underwent a biopsy for possible head and neck tumor pathology. Results: The patients identified with cancer were older than the rest of the group, with a higher developing trend in men than in women. However, the top 10 symptomatology patterns were identical in the malign and benign groups, meaning that new HNC may be missed due to the common symptomatology between benign and malign outcomes. Conclusions: The importance of a full ear, nose, and throat (ENT) examination may be of significant relevance for a proper diagnosis that can improve the overall prognosis of a patient with cancer. The absence of routine screening tests and screening guidelines for oral and pharyngeal cancers represents a significant barrier to secondary HNC prevention. Full article

The endotracheal tube (ETT) with laryngeal adhesive electrodes for intraoperative neural monitoring (IONM) may be related to laryngopharyngeal complications, such as postoperative sore throat (POST), hoarseness, and coughing. We aimed to evaluate the effects of the ETT with laryngeal adhesive electrodes for IONM on the occurrence of laryngopharyngeal complications during thyroidectomy. In this retrospective study, we included 176 patients who underwent thyroidectomy for thyroid cancer between September 2020 and February 2021. The patients were categorized into control (n = 108) and IONM (n = 68) groups. Patients in the IONM group were intubated with the ETT with surface electrodes. Characteristics of the patients and surgery, perioperative variables, and laryngopharyngeal complications, including POST, hoarseness, and cough, were evaluated. The severity and incidence of POST were comparable between the two groups on postoperative days 0, 1, and 2 (p = 0.103, 0.386, and 0.056, respectively). Furthermore, no significant differences were observed in the occurrence of postoperative hoarseness and cough between the groups. The ETT with laryngeal adhesive electrodes for IONM during thyroidectomy did not affect the incidence and severity of postoperative laryngopharyngeal complications, including POST, hoarseness, and cough. Further prospective, double-blinded, randomized clinical trials are required to gain a clearer understanding. Full article

Chest disease refers to a variety of lung disorders, including lung cancer (LC), COVID-19, pneumonia (PNEU), tuberculosis (TB), and numerous other respiratory disorders. The symptoms (i.e., fever, cough, sore throat, etc.) of these chest diseases are similar, which might mislead radiologists and health experts when classifying chest diseases. Chest X-rays (CXR), cough sounds, and computed tomography (CT) scans are utilized by researchers and doctors to identify chest diseases such as LC, COVID-19, PNEU, and TB. The objective of the work is to identify nine different types of chest diseases, including COVID-19, edema (EDE), LC, PNEU, pneumothorax (PNEUTH), normal, atelectasis (ATE), and consolidation lung (COL). Therefore, we designed a novel deep learning (DL)-based chest disease detection network (DCDD_Net) that uses a CXR, CT scans, and cough sound images for the identification of nine different types of chest diseases. The scalogram method is used to convert the cough sounds into an image. Before training the proposed DCDD_Net model, the borderline (BL) SMOTE is applied to balance the CXR, CT scans, and cough sound images of nine chest diseases. The proposed DCDD_Net model is trained and evaluated on 20 publicly available benchmark chest disease datasets of CXR, CT scan, and cough sound images. The classification performance of the DCDD_Net is compared with four baseline models, i.e., InceptionResNet-V2, EfficientNet-B0, DenseNet-201, and Xception, as well as state-of-the-art (SOTA) classifiers. The DCDD_Net achieved an accuracy of 96.67%, a precision of 96.82%, a recall of 95.76%, an F1-score of 95.61%, and an area under the curve (AUC) of 99.43%. The results reveal that DCDD_Net outperformed the other four baseline models in terms of many performance evaluation metrics. Thus, the proposed DCDD_Net model can provide significant assistance to radiologists and medical experts. Additionally, the proposed model was also shown to be resilient by statistical evaluations of the datasets using McNemar and ANOVA tests. Full article

Oral cancer is introduced as the uncontrolled cells’ growth that causes destruction and damage to nearby tissues. This occurs when a sore or lump grows in the mouth that does not disappear. Cancers of the cheeks, lips, floor of the mouth, tongue, sinuses, hard and soft palate, and lungs (throat) are types of this cancer that will be deadly if not detected and cured in the beginning stages. The present study proposes a new pipeline procedure for providing an efficient diagnosis system for oral cancer images. In this procedure, after preprocessing and segmenting the area of interest of the inputted images, the useful characteristics are achieved. Then, some number of useful features are selected, and the others are removed to simplify the method complexity. Finally, the selected features move into a support vector machine (SVM) to classify the images by selected characteristics. The feature selection and classification steps are optimized by an amended version of the competitive search optimizer. The technique is finally implemented on the Oral Cancer (Lips and Tongue) images (OCI) dataset, and its achievements are confirmed by the comparison of it with some other latest techniques, which are weight balancing, a support vector machine, a gray-level co-occurrence matrix (GLCM), the deep method, transfer learning, mobile microscopy, and quadratic discriminant analysis. The simulation results were authenticated by four indicators and indicated the suggested method’s efficiency in relation to the others in diagnosing the oral cancer cases. Full article

Checkpoint inhibitors can be a highly effective antitumor therapy but only to a subset of patients, presumably due to immunotherapy resistance. Fluoxetine was recently revealed to inhibit the NLRP3 inflammasome, and NLRP3 inhibition could serve as a target for immunotherapy resistance. Therefore, we evaluated the overall survival (OS) in patients with cancer receiving checkpoint inhibitors combined with fluoxetine. A cohort study was conducted among patients diagnosed with lung, throat (pharynx or larynx), skin, or kidney/urinary cancer treated with checkpoint inhibitor therapy. Utilizing the Veterans Affairs Informatics and Computing Infrastructure, patients were retrospectively evaluated during the period from October 2015 to June 2021. The primary outcome was overall survival (OS). Patients were followed until death or the end of the study period. There were 2316 patients evaluated, including 34 patients who were exposed to checkpoint inhibitors and fluoxetine. Propensity score weighted Cox proportional hazards demonstrated a better OS in fluoxetine-exposed patients than unexposed (HR: 0.59, 95% CI 0.371–0.936). This cohort study among cancer patients treated with checkpoint inhibitor therapy showed a significant improvement in the OS when fluoxetine was used. Because of this study’s potential for selection bias, randomized trials are needed to assess the efficacy of the association of fluoxetine or another anti-NLRP3 drug to checkpoint inhibitor therapy. Full article