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  1. AU="Shiner, Yotam"
  2. AU="Ali, Mir Mohammad"
  3. AU="Weck Melanie"
  4. AU=Martinez-Riera Jose Ramon AU=Martinez-Riera Jose Ramon
  5. AU="Spano, Luana"
  6. AU="Macomb, Christopher V"
  7. AU="Cylwik, Jolanta"
  8. AU="Mirzabeigi, Parastoo"
  9. AU="Lesage, C"
  10. AU=Kim Donghyun AU=Kim Donghyun
  11. AU="Weisburd, Ben"
  12. AU="van den Berg, Linda M"
  13. AU="Kurochkina, Yu D"
  14. AU="H Cao"
  15. AU="Elias, Rui"
  16. AU="Hofstaedter, Ferdinand"
  17. AU="Ross, Ashley E"
  18. AU="Luque Alarcón, Mónica"

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  1. Artikel ; Online: Emerging Clinical Features of Acute Mastoiditis in Israel: A Registry Based Cohort.

    Samuel, Orit / Saliba, Walid / Stein, Nili / Shiner, Yotam / Cohen-Kerem, Raanan

    The Pediatric infectious disease journal

    2024  

    Abstract: Background and objectives: Acute mastoiditis (AM) is a severe infection in the young population, with possible life-threatening complications. This study aimed to characterize AM presentation, symptoms and signs, complications, and management, over a ... ...

    Abstract Background and objectives: Acute mastoiditis (AM) is a severe infection in the young population, with possible life-threatening complications. This study aimed to characterize AM presentation, symptoms and signs, complications, and management, over a period of 10 years.
    Methods: This large-scale population-based cohort studied "Clalit Health Care" records, to include patients <18 years diagnosed with AM, hospitalized between the years 2008-2018. After validation, we investigated clinical symptoms and signs, pneumococcal vaccination status, complications, laboratory and microbiological parameters, imaging, antibiotic treatment and surgical interventions.
    Results: AM was diagnosed in 1189 patients, mean age of 2.71 years and 591 (49.71%) were female. Most presented with protrusion of pinna (83.1%), retro auricular redness (73.5%) and fever (71.8%). Patients <2 years of age had more symptoms (3.8 ± 1.4, opposed to 3.6 ± 1.5, P = 0.006) and showed higher white blood cell count and C-reactive protein values. Local and intracranial complications occurred in 233 (20.8%) and 75 (6.5%) patients, respectively. Complications were associated with increased white blood cell count and C-reactive protein and related to bacterial type, specifically Fusobacterium necrophorum (P < 0.0001), for which 50% had an intracranial complication. Between the years 2008-2018, Streptococcus pneumoniae-positive cultures decreased (30.9% to 10.3%, P > 0.0001) as opposed to group-A Streptococcus (10.9% to 30.9%, P = 0.002).
    Conclusions: This study shows a difference in AM appearance in the <2 years population and the association between white blood cell count, C-reactive protein and microbiology results with the occurrence of a complication. This may play a role in the management process, such as imaging and intervention needs. Although performed during the pneumococcal vaccine era, the disease microbiology was shown to change significantly throughout the study.
    Sprache Englisch
    Erscheinungsdatum 2024-03-28
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 392481-6
    ISSN 1532-0987 ; 0891-3668
    ISSN (online) 1532-0987
    ISSN 0891-3668
    DOI 10.1097/INF.0000000000004325
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Risk factors for recurrent acute mastoiditis in pediatric patients: a registry-based cohort study.

    Shiner, Yotam Aharon / Samuel, Orit / Saliba, Walid / Stein, Nili / Kerem, Nogah / Cohen-Kerem, Raanan

    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

    2024  Band 281, Heft 5, Seite(n) 2699–2705

    Abstract: Objective: To describe characteristics of pediatric patients with recurrent acute mastoiditis, and to identify risk factors for this condition.: Study design: A retrospective cohort study.: Setting: Data based on electronic medical records of the ... ...

    Abstract Objective: To describe characteristics of pediatric patients with recurrent acute mastoiditis, and to identify risk factors for this condition.
    Study design: A retrospective cohort study.
    Setting: Data based on electronic medical records of the largest Health Maintenance Organization in Israel.
    Methods: Children hospitalized due to acute mastoiditis during the years 2008-2018 were identified, and their diagnosis was verified. Patients with recurrent acute mastoiditis were identified and grouped, and their characteristics were outlined and compared to those of the original group to identify risk factors for recurrence.
    Results: During the 11-year period, a total of 1115 cases of children hospitalized due to acute mastoiditis were identified with a weighted incidence rate of 7.8/100,000. Of this group, 57 patients were diagnosed with recurrence following a full clinical recovery. The incidence proportion of recurrent acute mastoiditis was 5.1% (57/1115), male-to-female ratio was 27:30, 73.4% were younger than 24 months, the median period from the first episode was 3.4 months (IQR 2.0;10.0), and 82.5% of the patients (n = 47) had a single recurrence, whereas 18.5% (n = 10) had two recurrences or more. Mastoidectomy and swelling over the mastoid area during the first episode were identified as the main risk factors for recurrent mastoiditis HR = 4.7 [(2.7-8.2), p < 0.001] and HR = 2.55 [(1.4-4.8), p = 0.003], respectively. Mastoidectomy was the only independent significant risk factor for recurrence in a multivariate analysis.
    Conclusions: Mastoidectomy and swelling over the mastoid area during the first episode of acute mastoiditis were found strongly related independent risk factor for future recurrent episodes of acute mastoiditis.
    Mesh-Begriff(e) Child ; Humans ; Male ; Female ; Infant ; Mastoiditis/epidemiology ; Mastoiditis/diagnosis ; Cohort Studies ; Retrospective Studies ; Mastoid/surgery ; Risk Factors ; Registries ; Acute Disease ; Anti-Bacterial Agents/therapeutic use
    Chemische Substanzen Anti-Bacterial Agents
    Sprache Englisch
    Erscheinungsdatum 2024-02-12
    Erscheinungsland Germany
    Dokumenttyp Journal Article
    ZDB-ID 1017359-6
    ISSN 1434-4726 ; 0937-4477
    ISSN (online) 1434-4726
    ISSN 0937-4477
    DOI 10.1007/s00405-024-08473-8
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel: [EARLY LARYNGEAL CANCER - TREATMENT OUTCOMES OF TRANSORAL LASER MICROSURGERY].

    Shiner, Yotam / Lubianiker, Barak / Doweck, Ilana

    Harefuah

    2020  Band 159, Heft 1, Seite(n) 77–82

    Abstract: Aims: To evaluate predictive factors for local control, larynx preservation and overall survival in patients with early laryngeal cancer, who were treated with endoscopic transoral CO2 laser microsurgery.: Background: Transoral laser microsurgery ( ... ...

    Abstract Aims: To evaluate predictive factors for local control, larynx preservation and overall survival in patients with early laryngeal cancer, who were treated with endoscopic transoral CO2 laser microsurgery.
    Background: Transoral laser microsurgery (TLM) is the treatment of choice for early laryngeal cancer. The current study aimed to assess the outcomes and validity of carbon dioxide (CO2) laser microsurgery in patients with early larynx cancer and to determine predictors for outcomes.
    Methods: A retrospective study included all patients who were treated with laser microsurgery, in the Department of Otolaryngology, Head and Neck Surgery, Carmel Medical Center, Haifa, between the years 2009-2016. We evaluated outcomes according to local control, margin status, larynx preservation, and overall survival. Cordectomy types I-V were classified by the European Laryngological Society (ELS).
    Results: Laser microsurgery was performed in 74 patients with early laryngeal cancer, mean age 68.2±10.4 years, M: F 65:9, mean follow-up 58±28 months. Seventy-three percent (73%) were smokers. Primary tumor location was glottic in 68 patients (92%), supraglottic (5 patients - 7%), and subglottic (1 patient - 1%). Tumor stage was as follows: Tis: 18 patients (24%), T1a: 35 patients (47%), T1b:10 patients (14%) and T2: 11 patients (15%). In 72 patients (97%), margins were taken from the patient side, 64% (46 patients) had negative margins, whereas 26 patients (36%) had positive margins. Patients with positive margins had either further laser surgery (19%), or radiotherapy (14%). Two patients were not treated for positive margins, both had recurrent disease in a mean follow-up of 26 months, and both had total laryngectomy. Five years local control rate (LCR) stratified by stage was as follows: Tis-81.5%, T1a- 88%, T1b-100% and T2 - 58% (NS). Overall 5-year local control rate (LCR) was 83%, with no significant difference between patients with positive or negative margins. Overall 5-year survival was 87% and organ preservation rate was 93.
    Conclusions: Laser microsurgery provides an excellent rate of disease free/overall survival for early laryngeal cancer and has a valuable role in organ preservation. No significant differences were found in LRC and overall survival between patients with positive margins compared to patients with negative margins, most probably due to immediate further intervention in patients with positive margins.
    Mesh-Begriff(e) Aged ; Humans ; Laryngeal Neoplasms ; Laser Therapy ; Microsurgery ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Treatment Outcome
    Sprache Hebräisch
    Erscheinungsdatum 2020-02-11
    Erscheinungsland Israel
    Dokumenttyp Journal Article
    ZDB-ID 953872-0
    ISSN 0017-7768
    ISSN 0017-7768
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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