Category: Medicine

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COVID-19 : SARS-CoV-2 Isolated From Middle Ear, Mastoid Bone

SARS-CoV-2 has been isolated from mastoid-bones and middle-ear autopsy specimens from two patients who died with COVID-19, which has implications for otolaryngology practice, according to a new report.

“Identification of a new area of body infected by the SARS-CoV-2 virus is relevant and helpful for understanding risk for transmitting infection during procedures,” said Dr. C. Matthew Stewart of Johns Hopkins School of Medicine, in Baltimore, Maryland.

“Knowledge of these proven risks can help protect healthcare providers during physical examination and common procedures of the ear and mastoid,” he told Reuters Health by email.

Middle-ear effusions have been shown to contain some non-SARS-CoV-2 coronaviruses, but there are no human data relating to the SARS-CoV-2 virus in the middle ear.

Dr. Stewart and colleagues selected three COVID-19-positive decedents and performed bilateral cortical mastoidectomy and exposure of the aditus.

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Outpatient Brain Tumor Surgery Feasible & Safe

As an ever-increasing number of complex surgeries are regularly being performed in an outpatient setting at ambulatory surgical centers, some brain tumor resections may be safe and feasible for appropriately selected patients, new research suggests.

Unadjusted results from a large feasibility study that included more than 300 patients who underwent craniotomy for resection of meningioma showed that among those who were treated in an outpatient setting, mortality and complication rates were significantly lower than for their inpatient counterparts.

Although adjusted analysis showed that between-group differences were no longer significant, outpatient surgery was still not associated with increased mortality or adverse events (AEs).

In addition, patients with low comorbidity rates appeared to be the group “most suitable for outpatient treatment,” the investigators note.

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Recognizing Factors Contributing to PTSD May Improve Clinical Care in Patients with Breast Cancer

An article published in Cancer discussed the risk factors for posttraumatic stress disorder (PTSD) in patients with breast cancer, as well as the role of inflammation and endocrine function.

“Although treating a patient’s breast cancer to give them the best odds of survival is critical, reducing potentially harmful effects on mental health also should be considered when possible so as to give the patient the best QOL both during and after cancer. In addition to improving QOL, to our knowledge the impact of PTSD symptoms on appropriate follow-up for cancer recurrence surveillance is not yet known and warrants further investigation.

In a meta-analysis of 38 studies evaluating breast cancer diagnoses and treatment, it was determined that 10% of women develop PTSD after a diagnosis of breast cancer. Moreover, a cancer diagnosis increases the lifetime risk of PTSD by a factor of 1.66 compared with those who have never been diagnosed with cancer. Importantly though, several environmental and biological risk factors for PTSD have been identified among this patient population.

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