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These surgeries may alter immune function and microbiota, thereby altering the risks of certain diseases.[2] The altered immune function and dysbiosis after appendectomy or tonsillectomy may also alter the risk of allergic diseases. Patients received dual appendectomy-tonsillectomy was at the highest risk of AR (adjusted hazard ratio [aHR] 3.17, 95% confidence interval [CI] 2.28-4.42), followed by those received tonsillectomy (aHR 3.09, 95% CI 2.99-3.20) and those received appendectomy (aHR 1.11, 95% CI 1.09-1.13). The selected patients had no allergic diseases prior to enrollment; 276 patients received dual appendectomy-tonsillectomy (Group 1), 175,353 patients received appendectomy (Group 2), 20,624 patients received tonsillectomy (Group 3), and 20,930,884 patients received no related surgery (Group 4), as displayed in Table 1. [Extracted from the article]

Objectives RA damages the joints and increases the risks of total knee replacement (TKR) and total hip replacement (THR). However, the benefits of biologics in preventing TKR or THR remain unclear. Methods This retrospective nationwide study used the 2000–2013 claims-based National Health Insurance dataset. Biologics are reimbursed for refractory cases. The risks of TKR and THR in the biologic cohort were compared with those of an age- and sex-matched csDMARD cohort. A multivariate Cox regression model was used to investigate the benefits of bDMARDs for TKR and THR. Results TKR was performed in 5979 biologic cases and 11 958 matched controls, of which 249 (4.16%) and 871 (7.28%) cases received TKR, respectively. THR was performed in 6245 biologic cases and 12 490 matched controls, of which 159 (2.55%) and 516 (4.13%) cases had THR, respectively. The biologic cohort had significantly lower incidence rates of TKR (11.73 vs 16.33/1000 person-years, P  < 0.001) and THR (7.09 vs 9.16/1000 person-years, P  < 0.001). After adjustment for confounding factors, the regular bDMARD subgroup (average dose >0.95 defined daily dose/day) had significantly lower risks of TKR (aHR: 0.55, 95% CI: 0.38, 0.81) and THR (aHR: 0.63, 95% CI: 0.40, 0.98). Those without MTX use, with steroid use, with biologic switch, and overlapping antiphospholipid syndrome had significantly higher risks of TKR and THR. Conclusions Compared with the csDMARD cohort, the risks of TKR and THR in the bDMARD cohort were the same as those in the low-to-moderate dose subgroups and significantly lower in those with regular bDMARD use. [ABSTRACT FROM AUTHOR]

Objective: Salvage endoscopic nasopharyngectomy (ENPG) is a reasonable choice for resectable recurrent nasopharyngeal carcinoma (rNPC). However, in past decades, complete removal of the tumor was not feasible when the recurrent lesion was adjacent to the internal carotid artery (ICA). The present article introduces innovative strategies to ensure sufficient surgical margins while avoiding accidental injury to the ICA. Study Design: Retrospective study. Setting: Tertiary care center. Methods: We retrospectively reviewed rT2-3 rNPC patients with tumor lesions adjacent to the ICA (<5 mm) who underwent ENPG at the Sun Yat-sen University Cancer Center between January 2015 and June 2020. Thirty-seven patients were selected for this study. Seventeen patients underwent ENPG using direct dissection, 10 patients underwent endoscopic-assisted transcervical protection of the parapharyngeal ICA combined with ENPG, and 10 patients underwent ICA embolization followed by ENPG. Results: With a median follow-up duration of 31 months (range, 5 to 53 months), the 2-year overall survival, progression-free survival, locoregional recurrence-free survival, and distant metastasis-free survival rates of salvage ENPG for rNPC adjacent to the ICA were 88.7%, 72.0%, 72.0%, and 97.3%, respectively. The incidences of grade 1-2 and grade 3-5 postoperative complications were 16.2% and 13.5%, respectively. Two patients experienced ICA rupture during direct dissection but were out of danger after vascular embolization therapy. One patient had a positive margin. Two patients had severe nasopharyngeal wound infections with mucosal flap necrosis. Conclusion: ENPG combined with ICA pretreatment allows the feasible and effective resection of rNPC lesions adjacent to the ICA. [ABSTRACT FROM AUTHOR]