Climate change is a global challenge that is resulting in an increased occurrence of extreme weather events. Extreme weather events have been shown to negatively impact various health conditions, leading to an overall increase in morbidity and mortality. Ear, nose, and throat (ENT) emergencies are among the most common reasons for emergency department visits (EV). Acute otitis externa (AOE), an inflammatory external auditory canal skin infection, is the second most common condition for ENT-related emergency admissions. Previously, AOE has been associated with higher temperatures during summer; However, no data exists on extreme weather events' immediate and delayed effects on AOE-related EVs. Identifying these relationships could help predict EVs, optimize health resources, and relieve its significant burden on healthcare systems. This study aimed to associate the effects of extreme weather events with the immediate and delayed risk of AOE-related EVs. A total of 1522 AOE-related EVs from the ENT outpatient clinic of the Vienna General Hospital between 2015 and 2018 were analyzed. Meteorological data for the same study period was obtained from the Austrian Central Institution for Meteorology and Geodynamics for Vienna and a distributed lag non-linear model used to associate extreme weather events with the total number of AOE-related EVs. Relative risk (RR) and cumulative RR were analyzed over a period of 14 days. AOE-related EVs showed a pronounced seasonality, with the highest occurrence in summer. The RR for AOE-related EVs was significantly increased one day after high-temperature events for seven days, to a maximum of 1.95 [1.04-3.65]. Low and high relative humidity significantly reduced the same-day occurrence of AOE-related EVs to 0.65 [0.46-0.92] and 0.74 [0.58-0.95]. Increased precipitation and wind speed significantly decreased the RR of AOE-related EVs four and seven days after occurrence. After one day, low atmospheric pressure events showed an increased RR of 1.42 [1.02-1.98] in AOE-related EVs. Extreme weather events significantly impact AOE-related EVs. While high mean temperatures were positively correlated with AOE-related EVs, low humidity was found to have a negative same-day effect, supporting the idea of multiple factors being involved in increasing the susceptibility for AOE. Knowledge of the pattern of events could allow the implementation of time-optimized prevention strategies to reduce the incidence of AOE, the frequency of EVs, and the burden on health care systems.

Thyroid hormone levels may be associated with disease outcome in head and neck squamous cell carcinoma (HNSCC). µ-Crystallin (CRYM), a thyroid hormone binding protein, blocks intracellular binding of the thyroid hormone T3 to its receptors. In this study, we aimed to analyze the association of CRYM levels with disease outcome in HNSCC patients. We retrospectively assessed immunohistochemical CRYM expression in 121 head and neck cancer patients. Preoperative thyrotropin levels could be extracted for 50 patients. Patients with low thyrotropin levels had a worse prognosis compared to euthyroid patients (5-year overall survival TSH low 20% vs. TSH norm 58%). We observed an association of CRYM+ patients with improved overall survival (5-year overall survival for CRYM+ 78.6% vs. CRYM− 56%). Interaction analysis between CRYM and HPV revealed that this effect was limited to HPV− patients (CRYM+|HPV− HR 0.12, 95% CI 0.01–0.87, p = 0.036). These results were replicated in an independent dataset. CRYM expression identified patients with favorable disease progression for HPV− HNSCC patients and could serve as a useful biomarker in this patient population. This study further confirms a correlation of thyroid hormone levels with adverse disease outcome in HNSCC patients, which could be potentially exploited as a therapeutic target.

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the treatment of cancer patients, particularly in terms of treatment choices. This study aimed to assess the effects of the COVID-19 pandemic on the management of surgically treated laryngeal squamous cell carcinoma (LSCC) patients, focusing specifically on changes in treatment modalities. We retrospectively analyzed the data from 102 patients who underwent surgical treatment for LSCC between January 1, 2019, and December 31, 2021, at our tertiary medical center. Patient demographics, histological characteristics, and treatment modalities were extracted from electronic medical records and compared between two time periods: pre-COVID-19 and during COVID-19, marked by the introduction of the hospital entry triage. Of the total patients, 53 (52%) were in the pre-COVID-19 group, and 49 (48%) were in the COVID-19 group. No significant differences in patient characteristics at the initial work-up were observed between the two groups. However, a significant shift in treatment modalities was noted. Fewer patients received postoperative adjuvant therapy in the COVID-19 group (70.5%) compared to the pre-COVID-19 group (95.5%). Importantly, this change did not significantly impact the one-year overall survival (OS) rates. The reduction in the use of postoperative adjuvant therapy during the COVID-19 pandemic may be attributed to efforts to minimize hospital visits due to the risk of COVID-19 infection. Further research is warranted to validate these findings and to investigate the potential effects of such changes in treatment modalities on the long-term survival.

Objectives: Activated platelets might play an important role in tumor progression. Mean platelet volume (MPV) has been used as a surrogate marker for platelet activation, and therefore its value as a marker of tumor prognosis has attracted recent attention. In this study, we aimed to critically evaluate the prognostic significance of the perioperative platelet count (COP), MPV and the MPV/COP ratio in head and neck cancer patients. Additionally, we explored the individual postoperative trajectory of these indices and their association with overall survival (OS) and disease-free survival (DFS). Methods: We retrospectively evaluated 122 head and neck squamous cell carcinoma patients receiving surgery with curative intent followed by postoperative radiotherapy. Platelet indices were measured preoperatively and on days 1 and 7 postoperatively. OS and DFS were analyzed using Kaplan–Meier estimators, the log-rank test and uni and multivariable Cox models. Cutoffs to dichotomize patients for Kaplan–Meier curves and log-rank tests were empirically chosen at the respective median. The median follow-up was 8.8 years. Results: The adjusted preoperative COP, MPV and MPV/COP ratio were not associated with disease outcome. A low postoperative COP and a high MPV/COP ratio on the first postoperative day were independently associated with worse OS and DFS. In comparison to the preoperative measurements, patients whose COP increased by day 1 post-op showed a better OS (hazard ratio (HR) per 50 G/L increase: 0.73, 95% confidence interval (CI): 0.58–0.93, p = 0.013) and DFS (HR per 50 G/L increase: 0.74, 95% CI: 0.58–0.94, p = 0.018) in multivariable analysis. Conclusions: Our results suggest that a low postoperative COP and a high MPV/COP ratio represent a negative prognostic factor for OS and DFS. Notably, patients with an increase in COP by day 1 post-op when compared to their preoperative value showed a significantly better OS and DFS.