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Whether patients with advanced hepatocellular carcinoma (aHCC) benefit from hepatitis C virus (HCV) eradication is uncertain. We aimed to investigate whether a survival benefit was conferred by HCV eradication in aHCC patients. This retrospective cohort study enrolled 168 HCV‐infected aHCC patients from April 2013 to January 2019. All patients were treated with sorafenib. Endpoints included overall survival (OS), progression free survival (PFS), and time to liver decompensation. Patients with undetectable HCV RNA exhibited reduced aspartate aminotransferase and alpha fetoprotein levels, as well as an attenuated proportion of aHCC at initial diagnosis but increased albumin and mean sorafenib daily dosing. Patients with undetectable HCV RNA exhibited significantly longer OS compared to patients with detectable or unknown HCV RNA, which was an independent factor of OS (HR: 0.56, 95% CI: 0.350‐0.903, P =.017). Patients with undetectable HCV RNA also presented a trend for longer PFS (HR 0.68, 95% CI: 0.46‐1.00, P =.053). The survival benefit was considered with respect to the significantly prolonged time to Child‐Pugh B scores in patients with undetectable HCV RNA (HR 0.59, 95% CI: 0.38‐0.92, P =.020). Patients with detectable HCV RNA at sorafenib initiation who further received direct acting antiviral therapy also had significantly longer OS (HR 0.11, 95% CI: 0.02‐0.81, P =.030) and PFS (HR 0.23, 95% CI: 0.06‐0.99, P =.048). In conclusion, abolishing HCV viremia preserves liver function and confers a survival benefit in advanced HCC patients on sorafenib treatment. [ABSTRACT FROM AUTHOR]

Some surgeries, a tracheostomy and oral surgeries in particular, have a higher risk of fire. Often it can occur when leaking flammable gas contacts an ignition heat source. Fire during a tracheostomy can sometimes be seen to produce different degrees of insult to the patient. The essential components of a fire, i.e., the fuel source, ignition, and an oxidizer, can be avoided or blocked in order to prevent fires from occurring. Herein, we discuss a fire during a tracheotomy, and ways to avoid its occurrence, and how to stop once it gets started. This case demonstrates 2 important points regarding tracheostomies. First, extreme caution should be exercised when cautery is used in an approximately 100% oxygen gaseous condition, and second, immediate extubation is not absolutely necessary if a fire breaks out during a tracheostomy. The procedures which can be taken when facing this type of emergency are also considered and discussed.

Intranasal teeth are uncommon, with only a few reported cases in the past few decades. The clinical manifestations of an intranasal tooth are quite variable. Unilateral nasal obstruction is a common complaint, but even though nasal symptoms are present, an intranasal tooth can be an incidental finding during routine examination in patients without nasal discomfort. Although the diagnosis is not difficult to make, a complete workup that included radiological investigations is important before any surgery is attempted. Transnasal endoscopic surgical approaches have been described with no evidence of recurrence or complications in similar cases. Herein, three patients with an intranasal tooth are described, along with possible etiologies, potential complications, differential diagnoses and their treatments.