Post-radiotherapy tissue changes in laryngeal cancer can hinder accurate imaging assessment of recurrence and tumour extent. We compared pre-operative magnetic resonance imaging staging performance in recurrent laryngeal cancer versus primary laryngeal cancer.

Retrospective single-centre study of 51 total laryngectomy patients (2012–2021). Magnetic resonance imaging assessments of invasion/extension were compared with histopathology (reference standard) to compute accuracy, sensitivity and specificity.

Magnetic resonance imaging accuracy differed between groups. In the recurrent laryngeal cancer group, accuracy was highest for lymph node metastasis (88.5 per cent) and extra-laryngeal spread (76.9 per cent), whereas it was lowest for cartilage invasion (53.9 per cent) and paraglottic involvement (57.8 per cent). In the primary laryngeal cancer group, magnetic resonance imaging performed best for subglottic and supraglottic extension (76.0 per cent each) and cartilage invasion (72.0 per cent), but showed limited accuracy for extra-laryngeal spread (36.0 per cent) and lymph node metastasis (60.0 per cent).

Magnetic resonance imaging tended to overestimate tumour extent in both groups. It was sensitive overall, but less specific in certain subsites, particularly the paraglottic region. Negative nodal findings may be reassuring, although conclusions regarding nodal status remain limited.

Impaired social functioning substantially affects the quality of life of patients with schizophrenia; however, it remains unclear whether the factors associated with social functioning differ according to relapse frequency. This study aimed to examine the differences in these factors among Japanese outpatients with schizophrenia, stratified by relapse frequency.

This nationwide cross-sectional study, the Multicenter Treatment Survey and Assessments for Schizophrenia in Psychiatric Clinics (MUSASI), was conducted in 330 psychiatric clinics in Japan between September and October 2023. A total of 10,081 patients diagnosed with schizophrenia-related disorders were analyzed. Patients were categorized as nonrelapsers, low-frequency relapsers (1–2 relapses), or high-frequency relapsers (≥3 relapses). Social functioning was assessed using the Social and Occupational Functioning Assessment Scale, with scores ≥61 defined as high functioning.

This study included 3,670 nonrelapsers, 4,428 low-frequency relapsers, and 1,983 high-frequency relapsers. Overall, 55.8% (n = 5,631) of patients were classified as having high social functioning. Across all groups, employment, shorter periods of instability during the past year, lower Clinical Global Impression–Severity scores, and fewer negative symptoms were significantly associated with higher social functioning. Group-specific associations were also observed: in nonrelapsers and low-frequency relapsers, positive symptoms and medication-related factors were relevant, whereas in low- and high-frequency relapsers, marital history was associated, and in high-frequency relapsers, the absence of tardive dyskinesia emerged as a factor.

Factors associated with social functioning differed according to relapse frequency, highlighting the need for relapse frequency-based, stratified intervention strategies.

To investigate whether socioeconomic deprivation is associated with residual or recurrent cholesteatoma following primary mastoidectomy.

A retrospective cohort study included all patients undergoing primary mastoidectomy for cholesteatoma in National Health Service Tayside between 2012 and 2020. Socioeconomic status was assessed using the Scottish Index of Multiple Deprivation 2020 and divided into quintiles. Patients were stratified into paediatric (≤16 years) and adult (>16 years) groups. Recurrence/residual rates across Scottish Index of Multiple Deprivation quintiles were compared using Fisher’s exact tests, and time to recurrence was analysed using Kaplan–Meier survival curves.

One hundred eighty-four patients were included (59 children, 125 adults). Recurrence/residual occurred in 39 per cent of children and 24 per cent of adults. In children, higher deprivation was significantly associated with risk of recurrence/residual disease (p = 0.0013). No significant association was observed in adults.

Socioeconomic deprivation is linked to higher recurrence/residual in children, highlighting disparities in postoperative outcomes and the importance of targeted follow-up.

Chronic subdural hematoma (cSDH) is a prevalent neurosurgical condition, particularly in the elderly. In cases of surgical evacuation, there is conflicting evidence regarding the impact of early versus late mobilization on patient outcomes.

To understand the current state of the literature, we performed a comprehensive systematic review of studies comparing early and late mobilization protocols in cSDH patients following surgical evacuation. We conducted a supplementary meta-analysis to assess the effects of early versus late mobilization for recurrence and postoperative complication outcomes.

Of the 1295 identified articles, 4 studies comprising 622 patients were included. Early mobilization (EM) was typically defined as ambulation ≤ 48 hours post-surgery and late mobilization as bed rest for ≥48 hours or more, though definitions varied between studies. EM did not increase cSDH recurrence in any study. Two studies reported decreased medical complications in the EM group. Two studies suggested a shorter hospital stay with EM, and one study reported significantly better functional recovery on follow-up. A supplementary meta-analysis did not find any significant differences in recurrence or medical complications across studies.

EM after cSDH surgery may reduce postoperative complications and potentially improve recovery without appearing to affect recurrence rates. However, data interpretation was limited by heterogeneous study designs, definitions of mobilization and outcome measures. Further multicenter trials with consistent protocols and outcome scales are warranted to further establish optimal mobilization strategies.

The optimal duration for maintaining antidepressant treatment in individuals with obsessive-compulsive disorder (OCD) who achieve symptom stabilization remains unclear.

This systematic review and pairwise meta-analysis of double-blind randomized placebo-controlled trials (DBRPCTs) compared antidepressant maintenance and antidepressant discontinuation groups in terms of relapse rate at each DBRPCT study endpoint (primary outcome), OCD symptom improvement, all-cause discontinuation, and adverse event-related discontinuation. Furthermore, relapse rates at 4, 8, 12, 16, 20, and 24 weeks were compared between the groups. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. The absolute risk reduction (ARR) and number needed to treat to benefit (NNTB) for relapse rates were also estimated.

Nine trials (n = 1084; mean age: 32.8 years; proportion of males: 53.3%) were included. The antidepressant maintenance group had lower relapse rates at each DBRPCT study endpoint (RR [95% CI] = 0.53 [0.42–0.68]; ARR = 21.0%; NNTB = 5) and lower all-cause and adverse event-related discontinuation rates than the antidepressant discontinuation group. The maintenance group also exhibited lower relapse rates at 4 weeks (RR [95% CI] = 0.47 [0.31–0.70]; ARR: not significant; NNTB: not significant), 8 weeks (0.42 [0.31–0.57]; 12.0%; 8), 12 weeks (0.43 [0.32–0.56]; 18.0%; 6), 16 weeks (0.41 [0.32–0.52]; 25.0%; 4), 20 weeks (0.43 [0.34–0.53]; 26.0%; 4), and 24 weeks (0.42 [0.33–0.52]; 27.0%; 4) than the discontinuation group. Moreover, the maintenance group outperformed the discontinuation group regarding OCD symptom improvement.

Individuals with OCD may benefit from continued antidepressant treatment, provided that it is well tolerated.

Late-life depression (LLD) is characterized by repeated recurrent depressive episodes even with maintenance treatment. It is unclear what clinical and cognitive phenotypic characteristics present during remission predict future recurrence.

Participants (135 with remitted LLD and 69 comparison subjects across three institutions) completed baseline phenotyping, including psychiatric, medical, and social history, psychiatric symptom and personality trait assessment, and neuropsychological testing. Participants were clinically assessed every two months for two years while receiving standard antidepressant treatment. Analyses examined group differences in phenotypic measure using general linear models. Concurrent associations between phenotypic measures and diagnostic groups were examined using LASSO logistic regression.

Sixty (44%) LLD participants experienced a relapse over the two-year period. Numerous phenotypic measures across all domains differed between remitted LLD and comparison participants. Only residual depressive symptom severity, rumination, medical comorbidity, and executive dysfunction significantly predicted LLD classification. Fewer measures differed between relapsing and sustained remission LLD subgroups, with the relapsing group exhibiting greater antidepressant treatment intensity, greater fatigue, rumination, and disability, higher systolic blood pressure, greater life stress and lower instrumental social support. Relapsing group classification was informed by antidepressant treatment intensity, lower instrumental social support, and greater life stress.

A wide range of phenotypic factors differed between remitted LLD and comparison groups. Fewer measures differed between relapsing and sustained remission LLD subgroups, with less social support and greater stress informing vulnerability to subsequent relapse. This research suggests potential targets for relapse prevention and emphasizes the need for clinically translatable relapse biomarkers to inform care.

The aim of this study was to evaluate the rate of dysplasia and carcinoma-ex-papillomatosis in patients with recurrent respiratory papillomatosis and assess for any risk factors.

A 15-year retrospective observational cohort study was performed from a single centre. Data on patient demographics, treatment history and pathology results were extracted from clinical records.

Of the 123 patients identified, nine had juvenile-onset recurrent respiratory papillomatosis and 114 had adult-onset recurrent respiratory papillomatosis. Thirteen (11 per cent) of patients with adult-onset recurrent respiratory papillomatosis had dysplasia, and one patient progressed to carcinoma-ex-papillomatosis. Patients with evidence of dysplasia had an average older age of disease onset compared to those without dysplasia (49 years vs 39 years, p = 0.03).

An older age of recurrent respiratory papillomatosis onset was the only risk factor for dysplasia. Gender, tobacco use, subglottic or tracheal involvement, number of surgeries and cidofovir were not prognostic factors in this series.