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Purpose: The purpose of this study is to determine the magnitude of change that is clinically meaningful in the EORTC QLQ-C30 and EORTC QLQ-HN35 instruments in head and neck cancer patients. Methods: Two hundred and twenty-two patients completed the EORTC QLQ-C30 and EORTC QLQ-HN35 at baseline and follow-up one to two months later. Minimal clinically important differences (MCIDs) were calculated through anchor- and distribution-based methods for improvement and deterioration. Karnofsky Performance status (KPS) was used as the anchor to determine meaningful change. Results: In the group of patients who deteriorated, more scales and symptoms demonstrated statistically significant meaningful change. EORTC QLQ-C30 meaningful change values for deterioration with KPS anchor ranged from 7.2 (physical functioning) to 16.7 units (Global Health Status), and for improvement ranged from 10.0 (role functioning) to 16.7 units (Global Health Status). Conclusions: We report—for the first time, to the best of our knowledge—MCID for EORTC QLQ-C30 and QLQ-HN35 in head and neck cancer patients. Knowledge of meaningful change in these questionnaires allows physicians to assess patient change over time, along with evaluating the impact of treatment on quality of life. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to assess the outcome of the patients who required intensive care unit (ICU) admittance after surgical drainage of an odontogenic cervicofacial infection and identify the variables that are able to predict severe infection or a high possibility of complications. Patients and methods: This is a retrospective cohort study including all adult patients admitted to our hospital over the period 2011–2020 due to odontogenic cervicofacial infection and required ICU admittance. The study was approved by the hospital’s scientific committee (no 814-9/8/2021). Results: 51 patients were included (mean age 43.2 years). 11.7% of the patients had major comorbidities, such as diabetes or immunosuppression. At presentation, fever was recorded in 55% patients and trismus in 92.8%, with a mean delay from symptoms to hospital admission at 3 days. 23% of patients had a post-extraction infection, 61% pericoronitis and 15% other odontogenic infections. The mean duration of hospitalization was 9.16 days whereas the mean ICU length of stay was 3.76 days. 84.3% of patients showed improvement, 13.7% deteriorated with a need of reoperation and one death was reported. ICU length of stay was associated with an 89% reduced rate when positive microbe identification was feasible, whereas rate of complications was 4-fold higher in patients with prolonged ICU length of stay. Conclusions: Patients with deep cervicofacial odontogenic infections who require ICU management have a favourable clinical outcome. A minority of these patients will not improve in a short time frame or develop complications which require further management. [ABSTRACT FROM AUTHOR]

Introduction Objective Methods Results Conclusions The International Hidradenitis Suppurativa Severity Score System (IHS4) is a validated tool that measures inflammatory lesions, including draining tunnels, in hidradenitis suppurativa (HS).To evaluate secukinumab efficacy using IHS4 in patients with moderate to severe HS.Data from the SUNSHINE and SUNRISE trials, which assessed subcutaneous secukinumab 300 mg every 2 (SECQ2W) and 4 (SECQ4W) weeks in adults with moderate to severe HS, were analyzed. Assessments included changes from baseline in IHS4 and severity classification up to Week 52; IHS4‐55, IHS4‐75, IHS4‐90 responses (55%, 75% and 90% reduction in IHS4) and concordance between IHS4‐55 and HS clinical response (HiSCR), at Weeks 16 and 52.In total, 1084 patients (SECQ2W = 361; SECQ4W = 360; placebo = 363) were analyzed. At Week 16, SECQ2W and SECQ4W demonstrated a numerically higher reduction in IHS4 from baseline versus placebo (adjusted mean [95% CI]: −10.80 [−12.30 to −9.30] and −9.46 [−10.96 to −7.96] vs. −4.92 [−6.43 to −3.41]); the reduction was maintained until Week 52 in both dose regimens. A greater proportion of patients achieved IHS4‐55 with SECQ2W (43.4%) and SECQ4W (39.5%) versus placebo (31.5%) at Week 16, with further improvement at Week 52. Similar trends were observed for IHS4‐75 and IHS4‐90 responses. While no patients had mild disease based on IHS4 (80.7% had severe and 19.3% had moderate HS) at baseline, a greater proportion of patients were categorized as having mild disease at Week 16 in the SECQ2W (25.9%) and SECQ4W (24.0%) groups versus placebo (16.4%); this trend continued up to Week 52 in both dose regimens. Strong concordance (>85%) was observed between IHS4‐55 and HiSCR.Both SECQ2W and SECQ4W demonstrated efficacy in improving treatment response as measured by IHS4 and reducing disease severity versus placebo at Week 16 and these improvements were sustained through Week 52. These findings support that the dynamic and dichotomous IHS4 can efficiently detect treatment response changes in clinical trial settings. [ABSTRACT FROM AUTHOR]

Introduction: Diagnosis of acral melanocytic lesions can be challenging. The BRAAFF checklist was introduced as a tool to help differentiate between acral nevi and melanoma but has not been validated. Methods: We asked raters with varying expertise in dermatoscopy to diagnose dermatoscopic images of 533 acral nevi and 144 melanomas via an online platform with and without use of the BRAAFF checklist. From the ratings, we calculated sensitivity, specificity, and interrater agreement. Additionally, a new simplified version of the checklist was also tested. Results: We collected 6,880 ratings from 175 readers. The BRAAFF checklist achieved a sensitivity of 92.5% and a specificity of 65.0%, which was similar to diagnosis from pattern recognition (sensitivity 90.0%, specificity: 72.1%). Interrater agreement for the BRAAFF criteria ranged from fair to moderate, with lowest agreement for parallel ridge and fibrillar pattern (alpha = 0.31) and highest for asymmetry of colors and structures (alpha = 0.46). Agreement and diagnostic accuracy were higher for more experienced readers. A simplified version with only two criteria achieved similar sensitivity (95.0%) and lower specificity (60.0%) as the original BRAAFF checklist. Conclusion: The BRAAFF checklist is a useful tool for the diagnosis of melanocytic acral lesions with acceptable sensitivity and reasonable specificity but is not superior to pattern recognition. A simplified version of the checklist could be easier to use with equal sensitivity while exhibiting a modest reduction in specificity. [ABSTRACT FROM AUTHOR]

The article discusses the validation of the BAUSSS biomarker as a risk staging tool for patients with primary melanoma. The BAUSSS algorithm incorporates Breslow thickness, age, ulceration, subtype, sex, and site to assess prognosis. The authors compare the BAUSSS biomarker to other nomograms and conclude that Lifemath is the most reliable online tool for melanoma prognosis. They address concerns raised by another study and maintain that BAUSSS is a simple and effective predictor of survival risk in melanoma patients. The addition of sentinel lymph node biopsy status to BAUSSS improves accuracy but may not be meaningful in all cases. [Extracted from the article]