2021

Routine Use of Swallowing Outcome Measures Following Head and Neck Cancer in a Multidisciplinary Clinic Setting (2021)

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Type of publication:
Journal article

Author(s):
*Annette C. Zuydam, Simon N. Rogers, Kate Grayson, *Clare F. Probert

Citation:
International Archives of Otorhinolaryngology, 2021; 25(02): e185-e192

Abstract:
Introduction: Chemoradiotherapy treatment for head and neck cancer (HNC) can have a major impact on swallowing function and health-related quality of life. The use of outcome measures in early detection of patients with swallowing problems provides the opportunity for targeting speech and language therapy (SLT) interventions to aid adaption and promote better clinical outcomes.
Objective: The purpose of the present study was to assess relationships between four outcomes measures over time, in a cohort of HNC patients, treated by (chemo-) radiotherapy.
Methods: Data were collected at 3 months and 12 months, on 49 consecutive patients with primary squamous cell cancer of the oropharynx, nasopharynx or hypopharynx stage T1–4, N0–2b, M0 disease.
Results: Out of 49 eligible patients, 45 completed assessment at 3 months and 20 at 12 months. The 3-month outcomes gave a strong indication of performance at 1 year. There were several strong correlations found between measures. The strongest was between the 3-month Performance Status Scale for Head and Neck Cancer (PSSHN) and the 12-month PSSHN (rs ¼ 0.761, n ¼ 17), the 12-month PSSHN and the 12-month
Functional Oral Intake Scale (FOIS) (rs ¼ 0.823, n ¼ 20), and the 12-month University of Washington Head and Neck Quality of Life (UWQoL) swallow and the 12-month Water Swallow Test (WST) capacity (rs ¼ 0.759, n ¼ 17).
Conclusion: The UW-QoL swallow item and WST are easy to incorporate into routine care and should be used as part of a standard assessment of swallow outcome. These measures can serve to help screen patients for dysfunction and focus allocation of resources for those who would benefit from more comprehensive assessment and intervention by SLT.

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Optimising patients with long-term spinal cord injury for nephrectomy: A review of pre-, peri- and post-operative factors to safeguard outcomes (2021)

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Type of publication:
Journal article

Author(s):
*Donati-Bourne J.; *Mohamed W.G.E.; *Pillai P.; *O'Dair J.; Kasmani Z.; Bhatt R.I.

Citation:
Journal of Clinical Urology; 2021, Volume: 14 issue: 2, page(s): 78-84

Abstract:
Objectives: To review the potential challenges a urologist may encounter when embarking on simple/partial/radical nephrectomy in patients with long-term spinal cord injury and propose strategies to pre-empt and manage these.
Material(s) and Method(s): Comprehensive literature review via PubMed, MEDLINE and Google Scholar searching for relevant scientific articles published to date in English. Recommendations for strategies to safeguard surgical outcomes discussed with a panel of experienced upper-tract urologists.
Result(s): Pre-operative considerations: – urethral assessment via flexible cystoscopy due to higher incidence of urethral pathology in spinal cord injury; – assessing for chronic constipation and distended bowel; and – considering glomerular filtration rate assessment by radio-isotope techniques, such as 51chromium-EDTA Perioperative considerations: – adequate theatre staffing for safe patient transfer; and – planned choice of incision, due to higher incidence of previous abdominal surgery, stoma bags and/or foreign body devices. Post-operative considerations: – ensuring attending medical staff are trained to recognise autonomic dysreflexia; – early remobilisation with physiotherapists experienced in treating spinal cord injury; and – attentive antibiotic stewardship due to higher risk of hospital-acquired or urinary infections
Conclusion(s): Patients with long-term spinal cord injury pose significant potential challenges in the pre-, periand post-operative stages of nephrectomy. Familiarisation and optimisation of such factors is recommended to safeguard outcomes.
Level of Evidence: Not applicable for this multicentre audit.

Thyrotoxicosis and the consumption of bovine thyroid tissue (2021)

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Type of publication:
Journal article

Author(s):
S Senthilkumaran, *F Benita, P Thirumalaikolundusubramanian, K Swaminathan

Citation:
QJM : monthly journal of the Association of Physicians; Jul 2021; vol. 114 (no. 4); p. 253-254

Abstract:
Thyrotoxicosis due to consumption of bovine thyroid tissue is called hamburger thyroiditis. Despite bovine meat consumption in India and Asia, it is surprising to note that very few thyrotoxicosis from food contamination has been reported from Asia. We report a case of exogenous thyrotoxicosis due to bovine thyroid tissue consumption probably for the first time from Asia, to create an awareness of this entity among physicians and practitioners and others to consider this entity while handling patients with features of thyrotoxicosis of recent onset.