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Objective: Stage 3 patients with clinically positive nodal metastasis are treated with therapeutic neck dissection and adjuvant systemic therapy. The aim of our study was to examined the predictability of pre‐operative CT as a nodal drainage assessment tool. Methods: Retrospective review of all patients with clinically positive head and neck cutaneous melanoma between 2010 and 2019. Clinical disease was diagnosed as radiological suspicious, biopsy‐proven node. A pre‐operative CT evaluation for nodal metastasis was compared to pathology report. Results: A total of 53 patients were included. Forty patients (75.5%) were males with a mean age of 59 (SD 15.52). The majority of patients (26.4%) had an unknown primary site. The most common sites for primary were the cheek in eight patients (15.1%) followed by forehead (9.4%) and lateral neck (9.4%). Preoperative CT predicted nodal disease in 84.6% of cases. The primary region that mainly failed from the previously described clinical prediction was the upper anterior neck with 83.3% parotid involvement. A total of 10 patients (18.9%) were diagnosis with non‐clinical nodes on pathology with a median non‐clinical node of 1 (range 1–2). Of them, 9 (90%) were in the same clinical levels detected by CT. Pre‐operative CT was associated with a neck level accuracy of 98.1%. Conclusion: Stage 3 head and neck melanoma with clinically positive nodal metastasis that are eligible for an adjuvant systemic treatment, may benefit from a highly selective neck dissection according to their pre‐operative imaging studies. This should be further evaluated in a large‐scale clinical trial. Level of Evidence: 3 Laryngoscope, 134:4292–4297, 2024 [ABSTRACT FROM AUTHOR]

Objective: We recently described the development of the Neck Fibrosis Scale (NFS). In this submission, we confirm domain structure and validate a scoring system for the NFS. Study Design: Prospective cross‐sectional study. Methods: Between January 2020 and December 2021, 127 head and neck cancer patients with varying degrees of cutaneous neck fibrosis completed the original 15 item NFS. Exploratory factor analysis was used to identify optimal groupings with similar underlying factors. The association between the domains of the NFS and various measures of neck morbidity (i.e., construct validity) were assessed using gamma regression. Results: Exploratory factor analysis confirmed 13 of the 15 items from the NFS mapped onto two factors, which were labelled 'physical' and 'emotional' domains. Of the remaining two items, 'energy' did not load uniquely onto one factor and was removed. 'Neck‐swelling' did not load on either factor (loadings <0.3) but was retained within the physical domain based on clinical importance. This resulted in a revised 14‐item questionnaire. Internal consistency for these two domains was high (>0.8, p < 0.01). Both the physical and emotional domains of the revised NFS show strong correlation with the neck dissection impairment index and neck range of motion. The physical domain strongly correlated with neck elasticity (0.902 [95%CI 0.839–0.972], p < 0.01). Patients receiving multimodal therapy had physical domain scores that were 31.6% [95% 13.9–51.8] higher (worse) than unimodal therapy patients. Conclusions: A domain structure and scoring strategy have been developed for the NFS. Future efforts should be directed toward an evaluation of responsiveness. Level of Evidence: NA Laryngoscope, 133:2198–2202, 2023 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Sarcopenia is a hallmark of aging and its identification may help predict adverse postoperative events in patients undergoing head and neck surgery. The study objective was to assess the relationship between sarcopenia and postoperative complications and length of stay in patients undergoing major head and neck cancer surgery. Study Design: Prospective cohort study. Methods: A prospective cohort study was performed of patients 50 years and older undergoing major head and neck surgery. Sarcopenia was defined as low muscle mass (determined by neck muscle cross‐sectional imaging) with either low muscle strength (grip strength) or low muscle performance (timed walk test). Logistic regression was applied on binary outcomes, and linear regression was used for log‐transformed length of hospital stay (LOS). Univariate and multivariate analyses were performed. Results: Of the 251 patients enrolled, pre‐sarcopenia was present in 34.9% (n = 87) and sarcopenia in 15.6% (n = 39) of patients. Patients with sarcopenia were more likely to be older (P =.001), female (P =.001), have a lower body mass index (P =.001), and lower preoperative hemoglobin (P <.001). On univariate analysis, the presence and severity of sarcopenia was associated with the development of medical complications (P =.029), higher grade of complications (P =.032), LOS (P =.015), and overall survival (P =.001). On multivariate analysis, sarcopenia was associated with a longer LOS (β = 0.32 [95% CI: 0.19–0.45], P <.001) and worse overall survival (HR = 2.21 [95% CI: 1.01–4.23], P =.017). Conclusions: Sarcopenia may aid in the prediction of prolonged hospital stay and death in patients who are candidates for major head and neck surgery. Level of Evidence: 3 Laryngoscope, 132:356–363, 2022 [ABSTRACT FROM AUTHOR]

Background: High-altitude pulmonary edema (HAPE) is a common cause of hospitalization in high altitude areas with significant morbidity. The clinical presentation of HAPE can overlap with a broad spectrum of cardiopulmonary diseases. Also, it is associated with varied radiological manifestations mimicking other conditions and often leading to unnecessary and inappropriate treatment. Patients and methods: The primary aim of the study was to study the various radiological manifestations of HAPE through real-world chest radiographs. We present six different chest X-ray patterns of HAPE as a pictorial assay, at initial presentation, and after the resolution of symptoms with supplemental oxygen therapy and bed rest alone. Results: HAPE can present as bilateral symmetrical perihilar opacities, bilateral symmetrical diffuse opacities, unilateral diffuse opacities, bilateral asymmetrical focal opacities, and even lobar consolidation with lower zone or less commonly upper zonal predilection. These presentations can mimic many common conditions like heart failure, acute respiratory distress syndrome, pulmonary embolism, aspiration pneumonitis, pneumonia, malignancy, and tuberculosis. Conclusion: A holistic clinical--radiological correlation coupled with analysis of the temporal course can help high-altitude physicians in differentiating true HAPE from its mimics. [ABSTRACT FROM AUTHOR]

Background: Being able to predict negative postoperative outcomes is important for helping select patients for treatment as well for informed decision‐making by patients. Frailty measures are often time and resource intensive to use as screening measures, whereas the Braden scale, a commonly used measure to assess patients at risk of developing pressure ulcers after surgery, may be a potential tool to predict postoperative complication rates and longer length of stay (LOS) in patients undergoing major head and neck cancer surgery. Methods: A retrospective analysis of Braden scale scores was performed on a prospectively collected cohort of patients undergoing major head and neck surgery recruited between December 2011 and April 2014. The association of Braden scale score with the primary outcomes of complications and LOS was analyzed using logistic regression and linear regression models on univariate analysis (UVA), respectively. Multivariate analysis (MVA) was performed based on a backward stepwise selection algorithm. Results: There were 232 patients with a mean (SD) Braden scale score of 14.9 (2.8) with a range from 9 to 23. The Braden scale (β = −.07 per point; 95% CI −0.09, −0.04, P <.001) was an independent predictor of increased LOS on UVA, but not on MVA when adjusted for other variables. For overall complications, as well as type of complication, the Braden scale score was not a significant predictor of complications on either UVA or MVA. Conclusion: In the sample population, the Braden scale did not demonstrate an ability to predict negative outcomes in head and neck surgery patients. Level of Evidence: Level 2b individual cohort study. Being able to predict negative postoperative outcomes is important for helping select patients for treatment as well for informed decision‐making by patients. The Braden Scale, a commonly used measure to assess patients at risk of developing pressure ulcers after surgery, may be a potential tool to predict postoperative complication rates and longer length of stay in patients undergoing major head and neck cancer surgery. In the sample population the Braden scale did not demonstrate an ability to predict negative outcomes in head and neck surgery patients [ABSTRACT FROM AUTHOR]

The article "A Cross-Sectional Analysis of Psoriasis Patient Experiences on YouTube and TikTok" explores how patients with psoriasis share their experiences on social media platforms. The study analyzed 203 videos from 2007 to 2024, revealing that most videos were created by non-medical professionals, with only a small percentage by dermatologists. Patients from diverse ethnoracial backgrounds shared their psychological symptoms, treatment experiences, and satisfaction levels. While social media can provide support and understanding, it is essential for patients to seek personalized treatment from qualified medical professionals. [Extracted from the article]

The systematic review titled "Machine Learning Applications in Hidradenitis Suppurativa Diagnosis, Management, and Severity Assessment" explores the use of machine learning (ML) in diagnosing and managing hidradenitis suppurativa (HS). The review includes seven studies that applied ML models to HS, with some focusing on image-based models and others on non-image-based models. While ML shows promise in assisting with HS diagnosis and treatment, the review highlights limitations such as small sample sizes and heterogeneous literature. The authors suggest that while ML cannot replace medical expertise, it can be a valuable tool in clinical decision-making. [Extracted from the article]

Background & objectives: High-altitude pulmonary oedema (HAPE) continues to challenge the healthcare providers at remote, resource-constrained settings. High-altitude terrain itself precludes convenience of resources. This study was conducted to evaluate the rise in peripheral capillary saturation of oxygen (SpO2) by the use of a partial rebreathing mask (PRM) in comparison to Hudson's mask among patients with HAPE. Methods: This was a single-centre, randomized crossover study to determine the efficiency of PRM in comparison to Hudson's mask. A total of 88 patients with HAPE referred to a secondary healthcare facility at an altitude of 11,500 feet from January to October 2013 were studied. A crossover after adequate wash-out on both modalities was conducted for first two days of hospital admission. All patients with HAPE were managed with bed rest and stand-alone oxygen supplementation with no adjuvant pharmacotherapy. Results: The mean SpO2on ambient air on arrival was 66.92±10.8 per cent for all patients with HAPE. Higher SpO2values were achieved with PRM in comparison to Hudson's mask on day one (86.08±5.15 vs. 77.23±9.09%) and day two (89.94±2.96 vs. 83.39±5.93%). The difference was more pronounced on day one as compared to day two. Interpretation & conclusions: Mean SpO2values were found to be significantly higher among HAPE patients using PRM compared to those on Hudson's mask. Further studies to understand the translation of this incremental response in SpO2to clinical benefits (recovery times, mortality rates and hospital stay) need to be undertaken. [ABSTRACT FROM AUTHOR]

In dermatology, the applications of machine learning (ML), an artificial intelligence (AI) subset that enables machines to learn from experience, have progressed past the diagnosis and classification of skin lesions. A lack of systematic reviews exists to explore the role of ML in predicting the severity of psoriasis. This systematic review aims to identify and summarize the existing literature on predicting psoriasis severity using ML algorithms and identify gaps in current clinical applications of these tools. OVID Embase, OVID MEDLINE, ACM Digital Library, Scopus, and IEEE Xplore were searched from inception to August, 2024. A total of 30 articles met our inclusion criteria and were included in this review. One article used serum biomarkers, while the remaining 29 used image-based models. The most common severity assessment score employed by these ML models was the Psoriasis Area Severity Index score, followed by Body Surface Area, with fifteen and five articles, respectively. The small size and heterogeneity of the existing literature are the primary limitations of this review. Progress in assessing skin lesion severity through ML in dermatology has advanced, but prospective clinical applications remain limited. ML and AI promise to improve psoriasis management, especially in non-image-based applications requiring further exploration. Large-scale prospective trials using diverse image datasets are necessary to evaluate and predict the clinical value of these predictive AI models., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)