Variations in concerns reported on the Patient Concerns Inventory (PCI) in head and neck cancer patients from different health settings across the world

Background: The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow-up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL). Methods: Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias. Results: There were 2136 patients with a median total number of PCI items selected of 5 (2-10). “Fear of the cancer returning” (39%) and “dry mouth” (37%) were most common. Twenty-five percent (524) reported less than good QOL. Conclusion: There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case-mix variables. There was a strong progressive association between the number of PCI items and QOL

ACUTE UPPER AIRWAY OBSTRUCTION IN RHEUMATOID ARTHRITIS: CASE REPORT AND LITERATURE REVIEW

Introduction. Cricoarytenoid arthritis in rheumatoid arthritis (RA) is not infrequent and symptoms can range from mild, nonspecific laryngeal complains to acute upper airway obstruction. Case report. We report a case of bilateral vocal cord palsy due to cricoarytenoid joint (CAJ) involvement in a RA patient presenting with respiratory distress and stridor. The diagnosis was confirmed by flexible laryngoscopy. The patient responded well to systemic corticosteroids and did not require tracheostomy. There was no recurrence of the symptoms after corticosteroid dose tapering and the patient was discharged after 2 weeks. Conclusion. Cricoarytenoid arthritis should be suspected in RA patients presenting with acute airway compromise. Prompt recognition of this condition and appropriate management can be life-saving

Nonrespiratory Complications and Obesity in Patients Dying with COVID-19 in Italy

Objective: This study aimed to assess the impact of obesity on nonrespiratory complications in patients dying with coronavirus disease (COVID-19). Methods: Medical charts of 3,694 of patients dying with COVID-19 in Italy were reviewed to extract information on demographics, preexisting comorbidities, and in-hospital complications leading to death. Multivariate logistic regressions were performed to assess the association of obesity with nonrespiratory complications. These analyses were adjusted for age, gender, and number of preexisting comorbidities. Results: Obesity was present in 411/3,694 (11.1%) patients dying with COVID-19. Obesity was significantly associated with increased probability of experiencing acute renal failure (adjusted odds ratio [OR], 1.33; 95% CI: 1.04-1.71) and shock (adjusted OR, 1.54; 95% CI: 1.19-1.99). The associations of obesity with acute renal failure and shock were stronger in patients aged < 60 years (adjusted OR, 2.00; 95% CI: 1.09-3.67 and OR, 2.37; 95% CI 1.29-4.36) than in those aged 60 years or older (adjusted OR, 1.20; 95% CI: 0.90-1.60 and OR, 1.22; 95% CI: 0.91-1.65). Conclusions: In patients dying with COVID-19 in Italy, obesity is associated with an increased probability of nonrespiratory complications, particularly shock and acute renal failure. These associations seem stronger in younger than in older adults. Strategies should be put in place in patients with COVID-19 with obesity to prevent these complications