Head and Neck Diseases by Alexandros G.Sfakianakis: 12/29/15

Τρίτη 29 Δεκεμβρίου 2015

Lipidomics reveals associations of phospholipids with obesity and insulin resistance in young adults.

Lipidomics reveals associations of phospholipids with obesity and insulin resistance in young adults.

J Clin Endocrinol Metab. 2015 Dec 28;:jc20153525

Authors: Rauschert S, Uhl O, Koletzko B, Kirchberg F, Mori TA, Huang RC, Beilin LJ, Hellmuth C, Oddy WH

Abstract
CONTEXT: Obesity and related diseases have become a global public health burden. Identifying biomarkers will lead to a better understanding of the underlying mechanisms associated with obesity and the pathways leading to insulin resistance (IR) and diabetes.
OBJECTIVE: This study aimed to identify lipidomic biomarkers associated with obesity and IR using plasma samples from a population-based cohort of young adults.
DESIGN AND SETTING: The Western Australian Pregnancy Cohort (Raine) Study enrolled 2900 pregnant women from 1989 to 1991. The 20yr follow-up was conducted between March 2010 and April 2012.
PARTICIPANTS: and Samples: Plasma samples from 1176 subjects aged 20 years were analysed using mass spectrometry based metabolomics.
MAIN OUTCOME MEASURES: Associations of analytes with markers of obesity and IR including BMI, waist circumference (WC), homeostasis model assessment (HOMA-IR) and insulin, were examined. Analyses were stratified by BMI and adjusted for lifestyle and other factors.
RESULTS: WC was positively associated with seven sphingomyelins and five diacyl-phosphatidylcholines and negatively associated with two lyso-phosphatidylcholines. HOMA-IR was negatively associated with two diacyl-phosphatidylcholines and positively with one lyso-phosphatidylcholine and one diacyl-phosphatidylcholine. No significant association was found in the obese/overweight group of the HOMA-IR model. In the normal weight group, one lyso-phosphatidylcholine was increased.
CONCLUSION: A possible discriminative effect of sphingomyelins, particularly those with two double bonds, and lyso-phosphatidylcholines was identified between subjects with normal weight and obesity independent of LDL-C and HDL-C concentrations. Our results suggest weight status dependent mechanisms for the development of IR with lyso-phosphatidylcholine C14:0 as a key metabolite in non-obese IR.

PMID: 26709969 [PubMed - as supplied by publisher]

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PREDICTORS OF WHOLE-BODY INSULIN SENSITIVITY ACROSS AGES AND ADIPOSITY IN ADULT HUMANS.

PREDICTORS OF WHOLE-BODY INSULIN SENSITIVITY ACROSS AGES AND ADIPOSITY IN ADULT HUMANS.

J Clin Endocrinol Metab. 2015 Dec 28;:jc20152892

Authors: Lalia AZ, Dasari S, Johnson ML, Robinson MM, Konopka AR, Distelmaier K, Port JD, Glavin MT, Esponda RR, Nair KS, Lanza IR

Abstract
CONTEXT: Numerous factors are purported to influence insulin sensitivity including age, adiposity, mitochondrial function, and physical fitness. Univariate associations cannot address the complexity of insulin resistance syndrome or the interrelationship among potential determinants.
OBJECTIVE: To identify significant independent predictors of insulin sensitivity across a range of age and adiposity in humans.
DESIGN, SETTING AND PARTICIPANTS: Peripheral and hepatic insulin sensitivity were measured by two stage hyperinsulinemic-euglycemic clamps in 116 men and women (19-78 years). Insulin-stimulated glucose disposal (GIR), the suppression of endogenous glucose production during hyperinsulinemia (EGPSUP), and HOMA-IR were tested for associations with 11 potential predictors. Abdominal subcutaneous fat (AFSQ), visceral fat (AFVISC), intrahepatic lipid (IHL) and intramyocellular lipid (IMCL) were quantified by magnetic resonance imaging and spectroscopy. Skeletal muscle mitochondrial respiratory capacity (State 3), coupling efficiency (RCR) and reactive oxygen species production (ROS) were evaluated from muscle biopsies. Aerobic fitness was measured from whole-body maximum oxygen uptake (VO2 peak), and metabolic flexibility (ΔRQ) was determined using indirect calorimetry.
RESULTS: Multiple regression analysis revealed that AFVISC (p<0.0001) and IHL (p=0.002) were independent negative predictors of peripheral insulin sensitivity, while VO2 peak (p=0.0007) and IMCL (p=0.023) were positive predictors. Mitochondrial capacity and efficiency were not independent determinants of peripheral insulin sensitivity. The EGPSUP model of hepatic insulin sensitivity revealed % fat (p<0.0001) and AFVISC (p=0.001) as significant negative predictors. Modeling HOMA-IR identified AFVISC (p<0.0001), VO2 peak (p=0.001), and IMCL (p=0.01) as independent predictors.
CONCLUSION: The reduction in insulin sensitivity observed with aging is driven primarily by age-related changes in the content and distribution of adipose tissue and is independent of muscle mitochondrial function or chronological age.

PMID: 26709968 [PubMed - as supplied by publisher]

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Resting Energy Expenditure is Decreased in Pseudohypoparathyroidism Type 1A.

Resting Energy Expenditure is Decreased in Pseudohypoparathyroidism Type 1A.

J Clin Endocrinol Metab. 2015 Dec 28;:jc20153895

Authors: Roizen JD, Danzig J, Groleau V, McCormack S, Casella A, Harrington J, Sochett E, Tershakovec A, Zemel BS, Stallings VA, Levine MA

Abstract
CONTEXT: Pseudohypoparathyroidism type 1A (PHP1A) is caused by loss-of function mutations on the maternally-inherited GNAS allele, and is associated with early-onset obesity, neurocognitive defects and resistance to multiple hormones. The role of energy intake versus central regulation of energy expenditure in the pathophysiology of obesity remains unclear.
OBJECTIVE: The aim of this study was to evaluate resting energy expenditure (REE) in participants with PHP1A.
DESIGN: We assessed REE, biochemical, endocrine and auxological status of 12 participants with PHP1A who had normal or elevated body mass index, and used as controls a cohort of 156 obese participants.
SETTING: The Children's Hospital in Philadelphia and Sick Children's Hospital in Toronto.
PATIENTS: We assessed REE, biochemical, endocrine and auxological status of 12 participants with PHP1A who had normal or elevated body mass index, and used as controls a cohort of 156 obese participants.
MAIN OUTCOME MEASURE(S): REE as a percent of predicted REE.
RESULTS: PHP1A participants had normal endocrine status while receiving appropriate hormone replacement therapy, but had significantly decreased REE as a percent of predicted REE (using the modified Schofield equation).
CONCLUSION: Our results are consistent with reduced energy expenditure being the principle cause of obesity in PHP1A rather than it being caused by excessive energy intake or endocrine dysfunction.

PMID: 26709970 [PubMed - as supplied by publisher]

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Lipidomics reveals associations of phospholipids with obesity and insulin resistance in young adults.

Lipidomics reveals associations of phospholipids with obesity and insulin resistance in young adults.

J Clin Endocrinol Metab. 2015 Dec 28;:jc20153525

Authors: Rauschert S, Uhl O, Koletzko B, Kirchberg F, Mori TA, Huang RC, Beilin LJ, Hellmuth C, Oddy WH

PMID: 26709969 [PubMed - as supplied by publisher]

PREDICTORS OF WHOLE-BODY INSULIN SENSITIVITY ACROSS AGES AND ADIPOSITY IN ADULT HUMANS.

PREDICTORS OF WHOLE-BODY INSULIN SENSITIVITY ACROSS AGES AND ADIPOSITY IN ADULT HUMANS.

J Clin Endocrinol Metab. 2015 Dec 28;:jc20152892

Authors: Lalia AZ, Dasari S, Johnson ML, Robinson MM, Konopka AR, Distelmaier K, Port JD, Glavin MT, Esponda RR, Nair KS, Lanza IR

PMID: 26709968 [PubMed - as supplied by publisher]

Vestibular evoked myogenic potential testing for the diagnosis of conductive hearing loss: survey of pediatric otolaryngologists' knowledge and beliefs.

http:--linkinghub.elsevier.com-ihub-imag

Vestibular evoked myogenic potential testing for the diagnosis of conductive hearing loss: survey of pediatric otolaryngologists' knowledge and beliefs.

Int J Pediatr Otorhinolaryngol. 2014 Nov;78(11):1937-9

Authors: Dargie JM, Zhou G, Dornan BK, Whittemore KR

Abstract
OBJECTIVES: To assess physicians' knowledge and beliefs regarding vestibular evoked myogenic potential (VEMP) testing in children.
METHODS: A survey was delivered via email in html format to 1069 members of the American Academy of Otolaryngology--Head and Neck Surgery who identified as pediatric otolaryngologists. Study data were collected and managed using the Research Electronic Data Capture (REDCap) tools.
RESULTS: 443 (41.4%) physicians opened the email. 190 (42.9% of opens) initiated the survey, of which 117 (61.9%) fully completed the survey of the physicians who responded to a question regarding knowledge of VEMP, 16% of respondents had never heard of the test. 16% of participants would use it in the setting of diagnosing pediatric conductive hearing loss. Responses regarding the youngest age at which VEMP is possible ranged from younger than 6 months through greater than 13 years of age. Beliefs regarding utility and reliability of VEMP varied, with 'unsure' as the most frequent response. Additionally, only 26% of pediatric otolaryngologists indicated some access to the test.
CONCLUSION: The knowledge and availability of VEMP testing in the pediatric otolaryngology community varies widely.

PMID: 25245257 [PubMed - indexed for MEDLINE]

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Peripheral facial palsy, the only presentation of a primitive neuroectodermal tumor of the skull base.

Peripheral facial palsy, the only presentation of a primitive neuroectodermal tumor of the skull base.

Int J Surg Case Rep. 2015 Dec 17;19:47-50

Authors: Kim HJ, Kang B, Joo EY, Kim EY, Kwon YS

Abstract
INTRODUCTION: Peripheral facial palsy is rarely caused by primary neoplasms, which are mostly constituted of tumors of the central nervous system, head and neck, and leukemia.
PRESENTATION OF CASE: A 2-month-old male infant presented with asymmetric facial expression for 3 weeks. Physical examination revealed suspicious findings of right peripheral facial palsy. Computed tomography of the temporal bone revealed a suspicious bone tumor centered in the right petrous bone involving surrounding bones with extension into the middle ear cavity and inner ear. Subtotal resection of the tumor was performed due to crucial structures adjacent the mass. Histopathology and immunohistochemistry of the resected tumor was consistent with primitive neuroectodermal tumor.
CONCLUSION: We report a rare case of a primitive neuroectodermal tumor located at the skull base presenting with only peripheral facial palsy.

PMID: 26710328 [PubMed - as supplied by publisher]

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Single-site multiport combined splenectomy and cholecystectomy with conventional laparoscopic instruments: Case series and review of literature.

Single-site multiport combined splenectomy and cholecystectomy with conventional laparoscopic instruments: Case series and review of literature.

Int J Surg Case Rep. 2015 Dec 17;19:41-46

Authors: Ozemir IA, Bayraktar B, Bayraktar O, Tosun S, Bilgic C, Demiral G, Ozturk E, Yigitbasi R, Alimoglu O

Abstract
INTRODUCTION: Conventional laparoscopic procedures have been used for splenic diseases and concomitant gallbladder stones, frequently in patients with hereditary spherocytosis since 1990's. The aim of this study is to evaluate the feasibility of single-site surgery with conventional instruments in combined procedures.
PRESENTATION OF CASE SERIES: Six consecutive patients who scheduled for combined cholecystectomy and splenectomy because of hereditary spherocytosis or autoimmune hemolytic anemia were included this study. Both procedures were performed via trans-umbilical single-site multiport approach using conventional instruments. All procedures completed successfully without conversion to open surgery or conventional laparoscopic surgery. An additional trocar was required for only one patient. The mean operation time was 190min (150-275min). The mean blood loss was 185ml (70-300ml). Median postoperative hospital stay was two days. No perioperative mortality or major complications occurred in our series. Recurrent anemia, hernia formation or wound infection was not observed during the follow-up period.
DISCUSSION: Nowadays, publications are arising about laparoscopic or single site surgery for combined diseases. Surgery for combined diseases has some difficulties owing to the placement of organs and position of the patient during laparoscopic surgery. Single site laparoscopic surgery has been proposed to have better cosmetic outcome, less postoperative pain, greater patient satisfaction and faster recovery compared to standard laparoscopy.
CONCLUSION: We consider that single-site multiport laparoscopic approach for combined splenectomy and cholecystectomy is a safe and feasible technique, after gaining enough experience on single site surgery.

PMID: 26708949 [PubMed - as supplied by publisher]

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Transanal evisceration of the small bowel a rare complication of rectal prolapse.

Transanal evisceration of the small bowel a rare complication of rectal prolapse.

Int J Surg Case Rep. 2015 Dec 14;19:38-40

Authors: Kornaropoulos M, Makris MC, Yettimis E, Zevlas A

Abstract
INTRODUCTION: Transanal evisceration of small bowel is an extremely rare surgical emergency. Of the nearly 70 cases reported in the literature, rectal prolapse is the predisposing factor that has been most frequently related to this pathology.
PRESENTATION OF CASE: We report a 78-year-old female with history of chronic rectal prolapse who presented in our emergency department with evisceration of small intestinal loops through the anus. In surgery after complete reduction of the eviscerated bowel into the peritoneal cavity, almost 20cm of the terminal ileum up to the ileocecal valve were necrotic and therefore a right hemicolectomy with primary anastomosis was performed. Additionally a 2cm craniocaudally tear was revealed in the antimesenteric border of the upper rectum and a Hartman procedure was also performed. The patient was discharged after 10 days.
DISCUSSION: Early recognition and timely surgical intervention offers the best prognosis, avoiding a fatal conclusion or an extensive intestinal resection.

PMID: 26708948 [PubMed - as supplied by publisher]

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More on 'No Gut Syndrome': A case report.

More on 'No Gut Syndrome': A case report.

Int J Surg Case Rep. 2015 Dec 17;19:35-37

Authors: Jain V, Huerta S

Abstract
INTRODUCTION: No Gut Syndrome refers to a condition which results after a near total enterectomy (NTE) has been performed. These patients are unable to sustain life without life-long parenteral nutrition (PN). Re-establishment of bowel continuity, complications, quality of life (QoL), and overall outcomes are important aspects to be considered in patients who might need a NTE. We have previously reported two similar cases as well as a literature review in patients with No Gut Syndrome. In the present report, we present an additional case and an update of the literature.
PRESENTATION OF THE CASE: A 62-year old man with multiple co-morbidities presented with features of acute small bowel obstruction. Exploratory laparotomy revealed severe mesenteric ischemia and extensive small bowel necrosis. Patient eventually underwent a NTE and was discharged on parenteral nutrition.
DISCUSSION: Near total enterectomy (NTE) is a clinical condition in which a patient is left without or with minimal length of small bowel along with either gastrointestinal continuity or exteriorization of the proximal end. This condition has remained a dilemma for surgeons worldwide chiefly as a result of its perceived incompatibility with life. There are only a few available options for proceeding with treatment, however maintenance on long term parenteral nutrition has shown promising results.
CONCLUSION: Long term parenteral nutrition serves as a viable treatment option for managing patients after a NTE.

PMID: 26708947 [PubMed - as supplied by publisher]

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Research Supported by the Tinnitus Research Consortium

Publication date: Available online 29 December 2015
Source:Hearing Research
Author(s): Allen F. Ryan, Robert A. Dobie, Judy R. Dubno, Brenda L. Lonsbury-Martin

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Delayed low frequency hearing loss caused by cochlear implantation interventions via the round window but not cochleostomy

Publication date: Available online 29 December 2015
Source:Hearing Research
Author(s): David Rowe, Scott Chambers, Amy Hampson, Hayden Eastwood, Luke Campbell, Stephen O'Leary
Cochlear implant recipients show improved speech perception and music appreciation when residual acoustic hearing is combined with the cochlear implant. However, up to one third of patients lose their pre-operative residual hearing weeks to months after implantation, for reasons that are not well understood. This study tested whether this "delayed" hearing loss was influenced by the route of electrode array insertion and/or position of the electrode array within scala tympani in a guinea pig model of cochlear implantation. Five treatment groups were monitored over 12 weeks: (1) round window implant; (2) round window incised with no implant; (3) cochleostomy with medially-oriented implant; (4) cochleostomy with laterally-oriented implant; and (5) cochleostomy with no implant. Hearing was measured at selected time points by the auditory brainstem response. Cochlear condition was assessed histologically, with cochleae three-dimensionally reconstructed to plot electrode paths and estimate tissue response. Electrode array trajectories matched their intended paths. Arrays inserted via the round window were situated nearer to the basilar membrane and organ of Corti over the majority of their intrascalar path compared with arrays inserted via cochleostomy. Round window interventions exhibited delayed, low frequency hearing loss that was not seen after cochleostomy. This hearing loss appeared unrelated to the extent of tissue reaction or injury within scala tympani, although round window insertion was histologically the most traumatic mode of implantation. We speculate that delayed hearing loss was related not to the electrode position as postulated, but rather to the muscle graft used to seal the round window post-intervention, by altering cochlear mechanics via round window fibrosis.

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Research Supported by the Tinnitus Research Consortium

Publication date: Available online 29 December 2015
Source:Hearing Research
Author(s): Allen F. Ryan, Robert A. Dobie, Judy R. Dubno, Brenda L. Lonsbury-Martin

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Research Supported by the Tinnitus Research Consortium

Delayed low frequency hearing loss caused by cochlear implantation interventions via the round window but not cochleostomy

Publication date: Available online 29 December 2015
Source:Hearing Research
Author(s): David Rowe, Scott Chambers, Amy Hampson, Hayden Eastwood, Luke Campbell, Stephen O'Leary
Cochlear implant recipients show improved speech perception and music appreciation when residual acoustic hearing is combined with the cochlear implant. However, up to one third of patients lose their pre-operative residual hearing weeks to months after implantation, for reasons that are not well understood. This study tested whether this "delayed" hearing loss was influenced by the route of electrode array insertion and/or position of the electrode array within scala tympani in a guinea pig model of cochlear implantation. Five treatment groups were monitored over 12 weeks: (1) round window implant; (2) round window incised with no implant; (3) cochleostomy with medially-oriented implant; (4) cochleostomy with laterally-oriented implant; and (5) cochleostomy with no implant. Hearing was measured at selected time points by the auditory brainstem response. Cochlear condition was assessed histologically, with cochleae three-dimensionally reconstructed to plot electrode paths and estimate tissue response. Electrode array trajectories matched their intended paths. Arrays inserted via the round window were situated nearer to the basilar membrane and organ of Corti over the majority of their intrascalar path compared with arrays inserted via cochleostomy. Round window interventions exhibited delayed, low frequency hearing loss that was not seen after cochleostomy. This hearing loss appeared unrelated to the extent of tissue reaction or injury within scala tympani, although round window insertion was histologically the most traumatic mode of implantation. We speculate that delayed hearing loss was related not to the electrode position as postulated, but rather to the muscle graft used to seal the round window post-intervention, by altering cochlear mechanics via round window fibrosis.

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Research Supported by the Tinnitus Research Consortium

Delayed low frequency hearing loss caused by cochlear implantation interventions via the round window but not cochleostomy

Research Supported by the Tinnitus Research Consortium

Does the continuation of warfarin change management outcomes in epistaxis patients?

Does the continuation of warfarin change management outcomes in epistaxis patients?

J Laryngol Otol. 2015 Dec 28;:1-5

Authors: Bola S, Marsh R, Braggins S, Potter C, Hickey S

Abstract
OBJECTIVE: This study aimed to compare management, readmission rates and length of in-patient stay amongst warfarinised and non-warfarinised patients to ascertain future treatment protocols.
METHODS: A 12-month retrospective review was conducted of ENT epistaxis admissions. Admission details such as length of in-patient stay, clotting profile and management plan were recorded. Comparisons of management and outcome for warfarinised and non-warfarinised patients were made using the Fisher's exact paired t-test.
RESULTS: Of 176 epistaxis patients admitted, 31 per cent were warfarinised, 18 per cent were on another form of anticoagulation or antiplatelet therapy, and 51 per cent were not on any medication that might impose a bleeding risk. The international normalised ratio at admission was high in 13 per cent of warfarinised patients; the remaining patients had therapeutic or sub-therapeutic international normalised ratios and so warfarin was continued. The mean in-patient stay was similar for all cohorts; however, warfarinised patients had a higher readmission rate.
CONCLUSION: Warfarinised epistaxis patients may be safely managed without stopping their anticoagulation therapy, provided their international normalised ratio is at therapeutic or sub-therapeutic levels. By continuing regular anticoagulation therapy, warfarinised patients may be discharged without delay.

PMID: 26707504 [PubMed - as supplied by publisher]

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Single cannula versus double cannula tracheostomy tubes in major oral and oropharyngeal resections.

Single cannula versus double cannula tracheostomy tubes in major oral and oropharyngeal resections.

J Laryngol Otol. 2015 Dec 28;:1-5

Authors: Dhiwakar M, Nambi GI, Ramanikanth TV, Kale SM, Sivakumar MN

Abstract
OBJECTIVE: To compare the outcomes of two types of tracheostomy tubes used in major head and neck surgery.
METHODS: A retrospective study was conducted of prospectively collected data. The post-operative safety and adequacy of a single cannula tracheostomy tube was compared to a double cannula tracheostomy tube in patients undergoing tracheostomy during major oral and oropharyngeal resections.
RESULTS: Out of 46 patients with the single cannula tube, 7 (15 per cent) experienced significant obstruction warranting immediate tube removal, while another 9 (20 per cent) needed a change of tube or tube re-insertion for continued airway protection. In contrast, out of 50 patients with the double cannula tube, the corresponding numbers were 0 (p = 0.004) and 1 (2 per cent; p = 0.007) respectively.
CONCLUSION: Insertion of a double cannula (instead of a single cannula) tracheostomy tube in the course of major oral and oropharyngeal resections offers better airway protection during the post-operative period.

PMID: 26707289 [PubMed - as supplied by publisher]

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Glycine: A potential coupling agent to bond to helium plasma treated PEEK?

Publication date: Available online 29 December 2015
Source:Dental Materials
Author(s): Patrick R. Schmidlin, Marlis Eichberger, Bogna Stawarczyk
ObjectivesTo test the tensile bond strength (TBS) between two self-adhesive resin composite cements and PEEK after helium plasma treatment and used glycine as a potential coupling agent incorporated in different adhesives.MethodsIn summary, 896 air-abraded PEEK specimens were fabricated. Half of the specimens were treated with cold active inert helium plasma and the other half were left non-treated. Both groups were then split in two groups: In group 1 (n=256), 64 specimens were pre-treated with: (a) soft-liner liquid, (b) visio.link, (c) Ambarino P60 and (d) no pre-treatment (control), respectively. In group 2 (n=192), specimens were conditioned accordingly, but the adhesive materials were modified by including a commercially available glycine (Air-Flow PERIO). PEEK specimens were then luted using either RelyX Unicem or Clearfil SA Cement and TBS was measured initially and after 14 days water storage combined with 10'000 thermal cycles (16 specimens/subgroup). Fracture type analysis was performed. For statistical analyses Kolmogorov–Smirnov, Shapiro–Wilk tests, 1-, 4-way ANOVA (post hoc: Scheffé), and t-test were used (p<0.001).ResultsHelium plasma pre-treatment without glycine showed no impact on initial TBS (p>0.348). In contrast, a combination between glycine application and Softline/Ambarino P60 allowed for significantly higher initial TBS was measured after helium plasma treatment (p=0.001). However, this effect was no evident after thermo-cycling. All groups conditioned with visio.link showed the highest TBS values.SignificanceThe introduction of amine groups by simple provision of amino acids in the form of glycine can improve the bond strength after helium plasma treatment using different adhesive materials. However, using this simple approach, the method cannot withstand thermal challenge yet.

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Vitamin E intake and pancreatic cancer risk: a meta-analysis of observational studies.

Vitamin E intake and pancreatic cancer risk: a meta-analysis of observational studies.

Med Sci Monit. 2015;21:1249-55

Authors: Peng L, Liu X, Lu Q, Tang T, Yang Z

Abstract
BACKGROUND: Some epidemiological studies have suggested that vitamin E intake reduces the risk of pancreatic cancer; however, this conclusion has not been supported by all the published studies. We conducted a meta-analysis to assess the relationship between vitamin E intake and the risk of pancreatic cancer by combining the results from published articles.
MATERIAL/METHODS: We searched the published studies that reported the relationship between vitamin E intake and pancreatic cancer risk using the PubMed, Web of Science, and Embase databases through December 31st, 2014. Based on a fixed-effects or random-effects model, the RR and 95% CI were used to assess the combined risk.
RESULTS: In total, 10 observational studies (6 case-control studies and 4 cohort studies) were included. The overall RR (95% CI) of pancreatic cancer for the highest vs. the lowest level of vitamin E intake was 0.81 (0.73, 0.89). We found little evidence of heterogeneity (I2=19.8%, P=0.255). In the subgroup analyses, we found an inverse association between vitamin E intake and pancreatic cancer risk both in the case-control and cohort studies. Additionally, this inverse association was not modified by different populations.
CONCLUSIONS: In our meta-analysis, there was an inverse association between vitamin E intake and the risk of pancreatic cancer. A high level of vitamin E might be a protective factor for populations at risk for pancreatic cancer.

PMID: 25929754 [PubMed - indexed for MEDLINE]

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Regulation and involvement of matrix metalloproteinases in vascular diseases.

Regulation and involvement of matrix metalloproteinases in vascular diseases.

Front Biosci (Landmark Ed). 2016;21:89-118

Authors: Amin M, Pushpakumar S, Muradashvili N, Kundu S, Tyagi SC, Sen U

Abstract
Matrix metalloproteinases (MMPs) are a family of zinc dependent endopeptidases whose main function is to degrade and deposit structural proteins within the extracellular matrix (ECM). A dysregulation of MMPs is linked to vascular diseases. MMPs are classified into collagenases, gelatinases, membrane-type, metalloelastase, stromelysins, matrilysins, enamelysins, and unclassified subgroups. The production of MMPs is stimulated by factors such as oxidative stress, growth factors and inflammation which lead to its up- or down-regulation with subsequent ECM remodeling. Normally, excess activation of MMPs is controlled by their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs). An imbalance of MMPs and TIMPs has been implicated in hypertension, atherosclerotic plaque formation and instability, aortic aneurysms and varicose vein wall remodeling. Also, recent evidence suggests epigenetic regulation of some MMPs in angiogenesis and atherosclerosis. Over the years, pharmacological inhibitors of MMPs have been used to modify or prevent the development of the disease with some success. In this review, we discuss recent advances in MMP biology, and their involvement in the manifestation of vascular disease.

PMID: 26709763 [PubMed - as supplied by publisher]

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Cytokine expression pattern in bone marrow microenvironment after allogeneic stem cell transplantation in primary myelofibrosis.

Cytokine expression pattern in bone marrow microenvironment after allogeneic stem cell transplantation in primary myelofibrosis.

Biol Blood Marrow Transplant. 2015 Dec 18;

Authors: Hussein K, Stucki-Koch A, Alchalby H, Triviai I, Kröger N, Kreipe H

Abstract
The only curative therapy for primary myelofibrosis (PMF) is allogeneic stem cell transplantation (ASCT). However, although we know that patients can benefit from ASCT, we do not know the changes of the expression profile of cytokines and matrix modulation factors. In this first systematic analysis, we evaluated the expression profile of 103 factors before and after transplantation in order to identify potential biomarkers. The expression of fibrosis, inflammation and angiogenesis-associated genes were analysed in a total of 42 bone marrow biopsies: PMF patients (n=14) before and after ASCT and, for control purposes, post-ASCT multiple myeloma cases (n=14) and non-neoplastic haematopoiesis (n=10). In post-ASCT PMF cases, decreased expression of tissue inhibitor of metalloproteinases (TIMP) and platelet-derived growth factor alpha (PDGFA) correlated with bone marrow remodelling and haematological remission. Expression of several other matrix factors remained at high levels and now could contribute to post-ASCT remodelling. This is the first systematic analysis of cytokine expression in post-ASCT PMF bone marrow which shows that normalisation of bone marrow microenvironment is paralleled by decreased TIMP and PDGFA expression.

PMID: 26708839 [PubMed - as supplied by publisher]

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Association of TIMP3 expression with vessel density, macrophage infiltration and prognosis in human malignant melanoma.

Association of TIMP3 expression with vessel density, macrophage infiltration and prognosis in human malignant melanoma.

Eur J Cancer. 2015 Dec 17;53:135-143

Authors: Das AM, Koljenović S, Oude Ophuis CM, van der Klok T, Galjart B, Nigg AL, van Cappellen WA, Noordhoek Hegt V, Dinjens WN, Atmodimedjo PN, Vermeulen CE, Verhoef C, Eggermont AM, Ten Hagen TL

Abstract
AIMS: Several anti-tumour properties have been ascribed to the tissue inhibitor of matrix metalloproteinases-3 (TIMP3) gene, including inhibition of neovascularisation in tumour xenografts. Reduced protein expression has been linked to promoter hypermethylation and allelic loss of heterozygosity in various human malignancies. In melanoma-positive lymph nodes from patients, we evaluated the association between TIMP3 expression, vessel density, macrophage infiltration and potential correlations with disease-free survival (DFS) and overall survival (OS).
PATIENTS AND METHODS: TIMP3 expression was analysed by immunohistochemistry (IHC) in melanoma lymph node biopsies of stage III melanoma patients (n = 43). Blood vessel density and macrophage infiltration were quantitatively assessed and correlation with TIMP3 expression was investigated. Methylation status of the gene promoter was determined using methylation-specific polymerase chain reaction (MSP). Protein expression and promoter methylation status were investigated for associations with DFS and OS.
RESULTS: Reduced expression of TIMP3, as determined by IHC, was observed in 74% of the cases (32 in 43). A significant inverse correlation was observed between TIMP3 expression and vessel density (p = 0.031). Correlation between TIMP3 expression and macrophage infiltration was not statistically significant (p = 0.369). MSP analysis revealed methylation of the gene promoter in 18% (7 in 38) of the analysed cases. No differences in OS and DFS were observed between cases with high and low TIMP3 expression. Gene promoter methylation was significantly associated with both poor 5-year DFS (p = 0.024) and OS (p = 0.034).
CONCLUSIONS: Our data indicate that TIMP3 is a dominant negative regulator of angiogenesis in cutaneous melanoma and gene silencing by promoter methylation is associated with poor outcome.

PMID: 26707830 [PubMed - as supplied by publisher]

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New advances and future directions in pediatric hematology/oncology.

New advances and future directions in pediatric hematology/oncology.

Curr Opin Pediatr. 2015 Dec 24;

Authors: Raetz E

PMID: 26709679 [PubMed - as supplied by publisher]

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Magnetic resonance thermometry: Methodology, pitfalls and practical solutions.

Magnetic resonance thermometry: Methodology, pitfalls and practical solutions.

Int J Hyperthermia. 2015 Dec 27;:1-13

Authors: Winter L, Oberacker E, Paul K, Ji Y, Oezerdem C, Ghadjar P, Thieme A, Budach V, Wust P, Niendorf T

Abstract
Clinically established thermal therapies such as thermoablative approaches or adjuvant hyperthermia treatment rely on accurate thermal dose information for the evaluation and adaptation of the thermal therapy. Intratumoural temperature measurements have been correlated successfully with clinical end points. Magnetic resonance imaging is the most suitable technique for non-invasive thermometry avoiding complications related to invasive temperature measurements. Since the advent of MR thermometry two decades ago, numerous MR thermometry techniques have been developed, continuously increasing accuracy and robustness for in vivo applications. While this progress was primarily focused on relative temperature mapping, current and future efforts will likely close the gap towards quantitative temperature readings. These efforts are essential to benchmark thermal therapy efficiency, to understand temperature-related biophysical and physiological processes and to use these insights to set new landmarks for diagnostic and therapeutic applications. With that in mind, this review summarises and discusses advances in MR thermometry, providing practical considerations, pitfalls and technical obstacles constraining temperature measurement accuracy, spatial and temporal resolution in vivo. Established approaches and current trends in thermal therapy hardware are surveyed with respect to potential benefits for MR thermometry.

PMID: 26708630 [PubMed - as supplied by publisher]

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Vibrating vaginal balls to improve pelvic floor muscle performance in women after childbirth: a protocol for a randomised controlled feasibility trial.

Vibrating vaginal balls to improve pelvic floor muscle performance in women after childbirth: a protocol for a randomised controlled feasibility trial.

J Adv Nurs. 2015 Dec 28;

Authors: Oblasser C, McCourt C, Hanzal E, Christie J

Abstract
AIM: This paper presents a feasibility trial protocol the purpose of which is to prepare for a future randomised controlled trial to determine the effectiveness of vibrating vaginal pelvic floor training balls for postpartum pelvic floor muscle rehabilitation.
BACKGROUND: Vibrating vaginal pelvic floor training balls are available in Austria to enhance women's pelvic floor muscles and thus prevent or treat urinary incontinence and other pelvic floor problems following childbirth. Nonetheless, there is currently little empirical knowledge to substantiate their use or assess their relative effectiveness in comparison to current standard care, which involves pelvic floor muscle exercises.
DESIGN: Single blind, randomised controlled feasibility trial with two parallel groups.
METHODS: It is planned to recruit 56 postpartum women in Vienna, who will be randomised into one of two intervention groups to use either vibrating vaginal balls or a comparator pelvic floor muscle exercises for 12 weeks. As this is a feasibility study, study design features (recruitment, selection, randomisation, intervention concordance, data collection methods and tools) will be assessed and participants' views and experiences will be surveyed. Tested outcome measures, collected before and after the intervention, will be pelvic floor muscle performance as reported by participants and measured by perineometry. Descriptive and inferential statistics and content analysis will serve the preparation of the future trial.
DISCUSSION: The results of this feasibility trial will inform the design and conduct of a full randomised controlled trial and provide insight into the experiences of women regarding the interventions and study participation.

PMID: 26708615 [PubMed - as supplied by publisher]

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CXCL16 induces angiogenesis in autocrine signaling pathway involving hypoxia-inducible factor 1α in human umbilical vein endothelial cells.

CXCL16 induces angiogenesis in autocrine signaling pathway involving hypoxia-inducible factor 1α in human umbilical vein endothelial cells.

Oncol Rep. 2015 Dec 24;

Authors: Yu X, Zhao R, Lin S, Bai X, Zhang L, Sun L, Yuan S

Abstract
Chemokine (C-X-C motif) ligand 16 (CXCL16) is a new angiogenic factor inducing angiogenesis via extracellular signal-regulated kinases pathway. To further understand the molecular mechanism underlying CXCL16‑induced angiogenesis, we explored involvement of other relevant pathways in CXCL16-induced angiogenesis. In the present study, we investigated the mechanisms underlying CXCL16-induced angiogenesis in human umbilical vein endothelial cells (HUVECs). CXCL16 promoted HUVEC proliferation, tube formation and migration. Enzyme-linked immunosorbent assay revealed that CXCL16 induced vascular endothelial growth factor secretion from HUVECs. Western blot analysis showed that CXCL16 increased the level of hypoxia‑inducible factor 1α, p-extracellular signal-regulated kinases (ERK), p-p38 and p-Akt dose- and time-dependently. ERK-, p38- and Akt-selective inhibitors significantly suppressed HUVEC proliferation, migration, tube formation and hypoxia-inducible factor 1α (HIF-1α) expression induced by CXCL16. Furthermore, CXCL16 peptides induced CXCL16 secretion via ERK, p38 and Akt pathways, which was suppressed by HIF-1α-selective inhibitor PX12. Our data suggest that CXCL16 induces angiogenesis in autocrine manner via ERK, Akt, p38 pathways and HIF-1α modulation.

PMID: 26707275 [PubMed - as supplied by publisher]

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Optimizing Successful Outcomes in Complex Spine Reconstruction Using Local Muscle Flaps.

Optimizing Successful Outcomes in Complex Spine Reconstruction Using Local Muscle Flaps.

Plast Reconstr Surg. 2016 Jan;137(1):295-301

Authors: Cohen LE, Fullerton N, Mundy LR, Weinstein AL, Fu KM, Ketner JJ, Härtl R, Spector JA

Abstract
BACKGROUND: Postoperative wound complications in patients undergoing complex spinal surgery can have devastating sequelae, including hardware exposure, meningitis, and unplanned reoperation. The literature shows that wound complication rates in this patient population approach 19 percent and, in very high-risk patients (i.e., prior spinal surgery, existing spinal wound infection, cerebrospinal fluid leak, malignancy, or history of radiation therapy), as high as 40 percent and with reoperation rates as high as 12 percent. The authors investigated whether prophylactic closure of spinal wounds with muscle flaps improves outcomes.
METHODS: A retrospective review was performed of 102 reconstructions (in 96 patients) in which spinal wound closure was performed by means of paraspinous, trapezius, or latissimus muscle advancement flaps by a single plastic surgeon (J.A.S.) from 2006 to 2014. Data regarding presurgical diagnosis, patient demographics, and incidence of postoperative complications were recorded.
RESULTS: One hundred two reconstructions were included, with follow-up ranging from 2 to 60 months. Eighty-eight reconstructions were classified as very high-risk for wound complications, defined as those having prior spinal surgery, existing spinal wound infection, cerebrospinal fluid leak, malignancy, or prior radiation therapy. Within the very high-risk group, there were six wound complications (6.8 percent), three of which (3.4 percent) required reoperation.
CONCLUSIONS: In this study, there is a markedly lower rate (6.8 percent) of postoperative wound complications compared with historical controls after closure of spinal wounds with local muscle flaps in very high-risk patients. These data encourage safe and routine use of muscle flaps for closure in this cohort of patients undergoing spinal surgery.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

PMID: 26710033 [PubMed - as supplied by publisher]

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Which is the most suitable lymph node predictor for overall survival after primary surgery of head and neck cancer: pN, the number or the ratio of positive lymph nodes, or log odds?

Abstract

Purpose

To investigate the best lymph node (LN) metastasis predictor for overall survival (OS) in head neck cancer (HNC): pN classification, number of positive lymph nodes (PNOD), lymph node ratio (LNR), or log odds of positive lymph nodes (LODDS).

Methods

In total, 225 surgically treated HNC patients were evaluated for the different LN classifications and OS.

Results

Five-year OS was 71.8 %. Mean number of yielded LN and PNOD was 25.3 ± 16.7 and 2.7 ± 5.9, respectively. 64.8 % had a LNR > 0.10 and 64.4 % a LODDS > 10. In univariable analysis, multimodal therapy (p = 0.039), advanced pT (p < 0.0001), advanced UICC stage (p = 0.029), LNR > 0.10 (p = 0.049), and LODDS > −1.0 (p = 0.021) were associated with lower OS. In multivariable analysis, advanced pT [hazard ratio (HR) 2.194; 95 % confidence interval (CI) 1.294–3.722; p = 0.004] and LODDS > −1.0 (HR 1.634; 95 % CI 1.002–2.665; p = 0.059) remained independent predictors for lower OS.

Conclusions

It seems useful to analyze the prognostic significance of LODDS in other samples of HNC.

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ERG expression in prostate cancer: biological relevance and clinical implication

Abstract

Introduction

Screening for increased levels of prostate-specific antigen (PSA) has allowed early detection of a large majority of prostate cancer (PCa) cases. However, the relative lack of specificity of PSA has resulted in significant over-diagnosis and unnecessary treatment for indolent tumors. The fusion of the transmembrane protease serine 2 with E26 transformation-specific family genes, particularly ERG, is the most widespread genetic alteration in prostate cancer, and data suggest that it is more specific for neoplastic prostate disease and may be of added prognostic value and point toward molecular subtype of PCa.

Methods

In this review, retrospective studies and clinical trials were analyzed to highlight the recent advances in our understanding of the cellular consequence of ERG rearrangement, describe its interactions with other genetic and molecular pathways, and discuss its potential diagnostic and prognostic value.

Conclusion

ERG over-expression has an emerging role in the diagnosis of PCa pathology, although there is still debate about its prognostic value. Elucidation of the mechanisms of ERG gene rearrangements and expression promises novel therapeutic and diagnostic avenues for prostate cancer.

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Both heat and new chemotherapeutic drug dioxadet in hyperthermic intraperitoneal chemoperfusion improved survival in rat ovarian cancer model

Background and Objectives

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) at the time of Cytoreductive Surgery (CRS) is an actively researched treatment in patients with advanced ovarian cancer. Relative contribution of heat and chemotherapeutic agents during HIPEC as well as efficacy of a new agent dioxadet for regional chemotherapy in a rat model of ovarian cancer was studied.

Methods

Sixty rats were divided into three groups: no treatment control group (n = 19), hyperthermia without chemotherapy (HIPEP) (n = 14), HIPEC + cisplatin (n = 14), HIPEC + dioxadet (n = 13). The intra-abdominal tumor was not resected. End points were: median survival (primary), cause of death (secondary).

Results

The median survival of the animals in the control group, HIPEP group, HIPEC + cisplatin, HIPEC + dioxadet were 9 (CI; 8–23), 22.5 (CI; 12–43), 25.5 (CI; 13–62), 49 (Cl; 28–70) days, respectively. The P-values control versus HIPEP, HIPEC + cisplatin versus HIPEC + dioxadet were 0.006, 0.002, and 0.001, respectively.

Conclusion

During HIPEC both the heat and the cytotoxic drug had antitumor effects in a rat ovarian cancer model. Dioxadet showed potential as a drug for regional chemotherapy. J. Surg. Oncol. © 2015 Wiley Periodicals, Inc.

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Targeting KRAS for diagnosis, prognosis, and treatment of pancreatic cancer: Hopes and realities

Publication date: February 2016
Source:European Journal of Cancer, Volume 54
Author(s): Barbara Bournet, Camille Buscail, Fabrice Muscari, Pierre Cordelier, Louis Buscail
Mutation of the KRAS oncogene in pancreatic cancer is responsible for permanent activation of the P21 RAS protein and the cascade of signalling pathways. Consequently, multiple cellular processes, such as transformation, proliferation, invasion, and survival are activated. The aim of this review was to present all potential clinical applications of targeting KRAS in terms of diagnosis and management of pancreatic adenocarcinoma. Quantitative polymerase chain reaction technology provides reliable assessment of KRAS mutations, both in tissues and from fine-needle aspiration biopsies. Numerous studies report that the combination of endoscopic ultrasound-guided cytopathology and a KRAS mutation assay can improve the positive and differential diagnosis of pancreatic cancer, differentiating between benign versus malignant solid pancreatic cancer, and reducing false-negative results compared to cytopathology alone. In addition, the presence of a KRAS mutation is frequently associated with a worse prognosis, both in cases of advanced and resected tumours. However, the KRAS mutation assay is not as efficient at predicting a response to both anti-epidermal growth factor receptor treatments and/or chemotherapy. Targeting of KRAS to treat pancreatic adenocarcinoma has been applied at different stages of RAS molecular intracellular processes: at the transcription level with antisense or interference RNA, at the posttranslational level with inhibitors of farnesyl transferase or anti-RAS vaccination peptides, and to target multiple signalling pathways using inhibitors of mitogen-activated protein kinase, phosphoinositide 3-kinase, AKT, mammalian target of rapamycin, RAF. Despite some encouraging results at pre-clinical and phase I stages, no significant clinical benefits have been observed. Combinatory approaches with standard chemotherapy will be welcome.

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‘Tablet burden’ in patients with metastatic breast cancer

Publication date: March 2016
Source:European Journal of Cancer, Volume 55
Author(s): Marina Milic, Anna Foster, Karim Rihawi, Alan Anthoney, Chris Twelves
The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored.AimWe sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment.MethodsOne hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets.ResultsThe patients (mean age 60, range 31–95) were all female and taking a median of six tablets (range 0–31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience.ConclusionTablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC.

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Impact of surgical staging on prognosis in patients with borderline ovarian tumours: A meta-analysis

Publication date: February 2016
Source:European Journal of Cancer, Volume 54
Author(s): Seung-Hyuk Shim, Soo-Nyung Kim, Phill-Seung Jung, Meari Dong, Jung Eun Kim, Sun Joo Lee
BackgroundTo quantify the effect of complete surgical staging (CSS) on prognosis in borderline ovarian tumour (BOT) patients through a meta-analysis.MethodsWe systematically reviewed published studies comparing CSS with incomplete surgical staging (ISS) in BOT patients through April 2015. End-points were recurrence and mortality rates. Study design features that possibly affected participant selection, recurrence/death detection, and manuscript publication were assessed. For pooled estimates of the effect of CSS on recurrence/death, random- or fixed-effects meta-analytical models were used after assessing cross-study heterogeneity.ResultsEighteen observational studies (CSS, 1297 patients; ISS, 1473 patients) met our search criteria. Fixed-effects model-based meta-analysis indicated a reduced recurrence risk among CSS patients (odds ratio [OR]=0.64; 95% confidence interval [CI]: 0.47–0.87, P < 0.05, I² = 25.6). However, no significant between-group difference in mortality was observed (OR = 0.98; 95% CI: 0.42–2.29, P = 0.97, I² = 0). In subgroup analysis by histology, CSS was associated with a reduced recurrence risk in 16 studies of all histologic types (OR = 0.66; 95% CI: 0.48–0.91, P < 0.05, I² = 31.9) but not in two studies of only mucinous disease (OR = 0.41; 95% CI: 0.13–1.30, P = 0.13, I² = 0). In subgroup analyses with four studies with recurrence data according to fertility-sparing surgery, no significant association was found (OR = 0.51; 95% CI: 0.18–1.43, P = 0.20, I² = 0). There was no evidence of publication bias.ConclusionsIn this meta-analysis based on observational studies, CSS appeared to significantly reduce recurrence among BOT patients. No survival impact was observed. Longer-term randomised controlled trials could verify this relationship but appear infeasible for this rare tumour.

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Transition guidelines: An important step in the future care for childhood cancer survivors. A comprehensive definition as groundwork

Publication date: February 2016
Source:European Journal of Cancer, Volume 54
Author(s): R.L. Mulder, H.J.H. van der Pal, G.A. Levitt, R. Skinner, L.C.M. Kremer, M.C. Brown, E. Bárdi, R. Windsor, G. Michel, E. Frey
Evidence-based clinical practice guidelines are essential to ensure that childhood cancer survivors at risk of chronic health conditions receive effective long-term follow-up care. However, adult survivors of childhood cancer are not always engaged in recommended health promotion and follow-up practices, as many centres do not have a formal transition programme that prepares survivors and their families for successful transfer from child-centred to adult-oriented healthcare. The need for a specific pan-European guideline for the transition of care for childhood cancer survivors has been recognised. The first step is to define the concept of transition of care for survivors of childhood cancer based on existing evidence.

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Opioid switching in cancer pain: from the beginning to nowadays

Publication date: Available online 29 December 2015
Source:Critical Reviews in Oncology/Hematology
Author(s): Sebastiano Mercadante, Eduardo Bruera
Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations.

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Knowledge of pathologically versus clinically negative lymph nodes is associated with reduced use of radioactive iodine post-thyroidectomy for low-risk papillary thyroid cancer.

Knowledge of pathologically versus clinically negative lymph nodes is associated with reduced use of radioactive iodine post-thyroidectomy for low-risk papillary thyroid cancer.

Endocrine. 2015 Dec 26;

Authors: Ruel E, Thomas S, Dinan MA, Perkins JM, Roman SA, Sosa JA

Abstract
Cervical lymph node metastases are common in papillary thyroid cancer (PTC). Clinically negative lymph nodes confer uncertainty about true lymph node status, potentially prompting empiric postoperative radioactive iodine (RAI) administration even in low-risk patients. We examined the association of clinically (cN0) versus pathologically negative (pN0) lymph nodes with utilization of RAI for low-risk PTC. Using the National Cancer Database 1998-2011, adults with PTC who underwent total thyroidectomy for Stage I/II tumors 1-4 cm were evaluated for receipt of RAI based on cN0 versus pN0 status. Cut-point analysis was conducted to determine the number of pN0 nodes associated with the greatest decrease in the odds of receipt of RAI. Survival models and multivariate analyses predicting RAI use were conducted separately for all patients and patients <45 years. 64,980 patients met study criteria; 39,778 (61.2 %) were cN0 versus 25,202 (38.8 %) pN0. Patients with pN0 nodes were more likely to have negative surgical margins and multifocal disease (all p < 0.001). The mean negative nodes reported in surgical pathology specimens was 4; ≥5 pathologically negative lymph nodes provided the best cut-point associated with reduced RAI administration (OR 0.91, CI 0.85-0.97). After multivariable adjustment, pN0 patients with ≥5 nodes examined were less likely to receive RAI compared to cN0 patients across all ages (OR 0.89, p < 0.001) and for patients aged <45 years (0R 0.86, p = 0.001). Patients with <5 pN0 nodes did not differ in RAI use compared to cN0 controls. Unadjusted survival was improved for pN0 versus cN0 patients across all ages (p < 0.001), but not for patients <45 years (p = 0.11); adjusted survival for all ages did not differ (p = 0.13). Pathological confirmation of negative lymph nodes in patients with PTC appears to influence the decision to administer postoperative RAI if ≥5 negative lymph nodes are removed. It is possible that fewer excised lymph nodes may be viewed by clinicians as incidentally resected and thus may suboptimally represent the true nodal status of the central neck. Further research is warranted to determine if there is an optimal number of lymph nodes that should be resected to standardize pathological diagnosis.

PMID: 26708045 [PubMed - as supplied by publisher]

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An unexpected finding in the resection specimen of a carcinoma of the oral cavity: A case report.

An unexpected finding in the resection specimen of a carcinoma of the oral cavity: A case report.

Int J Surg Case Rep. 2015 Dec 17;19:55-59

Authors: Olthof DC, Bun RJ, Dutrieux RP, Houdijk AP

Abstract
INTRODUCTION: The occurrence of two synchronous, primary cancers is rare. Thyroid carcinoma is incidentally found in the resection specimen after surgery for head and neck cancer in 0.3-1.9% of the patients.
PRESENTATION OF CASE: In this report, we describe the case of a 72-year-old patient in whom a primary (synchronous) papillary thyroid carcinoma was found coincidentally upon pathologic examination of lymph nodes recovered from the cervical neck lymph node dissection specimen after a 'commando' procedure for carcinoma of the oral cavity.
DISCUSSION AND CONCLUSION: There is no gold standard concerning treatment of the incidentally discovered thyroid gland carcinoma. The decision to perform surgery depends on the life expectancy of the patient, whether the thyroid gland demonstrates clinical or radiologic lesions, the already completed treatment for the head and neck cancer and should always be adjusted to the specific patient.

PMID: 26710330 [PubMed - as supplied by publisher]

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Peripheral facial palsy, the only presentation of a primitive neuroectodermal tumor of the skull base.

Peripheral facial palsy, the only presentation of a primitive neuroectodermal tumor of the skull base.

Int J Surg Case Rep. 2015 Dec 17;19:47-50

Authors: Kim HJ, Kang B, Joo EY, Kim EY, Kwon YS

PMID: 26710328 [PubMed - as supplied by publisher]

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Treacher Collins Syndrome: A Systematic Review of Evidence-Based Treatment and Recommendations.

Treacher Collins Syndrome: A Systematic Review of Evidence-Based Treatment and Recommendations.

Plast Reconstr Surg. 2016 Jan;137(1):191-204

Authors: Plomp RG, van Lieshout MJ, Joosten KF, Wolvius EB, van der Schroeff MP, Versnel SL, Poublon RM, Mathijssen IM

Abstract
BACKGROUND: No reviews or guidelines are available on evidence-based treatment for the multidisciplinary approach in Treacher Collins syndrome. The authors' aim is to provide an evidence-based review of multidisciplinary treatment of Treacher Collins syndrome based on levels of evidence and supported with graded recommendations.
METHODS: A systematic search was performed by means of the PubMed, Web-of-Science, Embase, and Cochrane Central databases (1985 to January of 2014). Included were clinical studies (with five or more Treacher Collins syndrome patients) related to therapy, diagnosis, or risk of concomitant diseases. Level of evidence of the selected articles was rated according to the American Society of Plastic Surgeons evidence-based clinical practice guidelines. After two panelists had reviewed each abstract separately, a consensus method was used to solve any disagreements concerning article inclusion.
RESULTS: Of the 2433 identified articles, 63 studies (Level of Evidence II through V) were included. Conclusions and recommendations were extracted consecutively for the following items: upper airway; ear, hearing, and speech; the eye, eyelashes, and lacrimal system; growth, feeding, and swallowing; the nose; psychosocial factors; and craniofacial reconstruction.
CONCLUSIONS: In this systematic review, current evidence for the multidisciplinary treatment of Treacher Collins syndrome is provided, recommendations for treatment are made, and a proposed algorithm for treatment is presented. Although some topics are well supported, others, especially ocular, nasal, speech, feeding, and swallowing problems, lack sufficient evidence. In addition, craniofacial surgical reconstruction lacks a sufficient level of evidence to provide a sound basis for a full treatment protocol. Despite the rarity of the syndrome, more research is needed to compare outcomes of several surgical treatments, especially in orbitozygomatic/maxillary regions.

PMID: 26710023 [PubMed - as supplied by publisher]

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Nucleotide Excision Repair and head and neck cancers.

Nucleotide Excision Repair and head and neck cancers.

Front Biosci (Landmark Ed). 2016;21:55-69

Authors: Merolla F, Mascolo M, Ilardi G, Siano M, Russo D, Graziano V, Celetti A, Staibano S

Abstract
Genome integrity maintenance is crucial for cell survival and for counteracting cancer onset and progression. Mammary cells invest great amount of energy in DNA repair, in order to avoid errors accumulation in DNA sequence. Nucleotide Excision Repair (NER) removes a broad spectrum of DNA damages, mainly bulky DNA lesions. Tissues of Head and Neck region are heavily exposed to bulky lesions inducing carcinogens, this making NER process of great interest in the field. Here we review the recent literature about NER in HNC and we also discuss the role played by NER in HNSCC in the chromatin context; to this aim we particularly focus on the role played by histones chaperon CAF-1, essential in restoring the chromatin structure following DNA replication and DNA damage repair, including NER. A better understanding of basic mechanisms underlying the DNA damage response, particularly involving NER, especially in the chromatin context, will provide us with new promising way to bypass the repair block, possibly becoming an unexpected mode of "transversal" control also of the proliferative deregulation, classically observed in HNSCC.

PMID: 26709761 [PubMed - as supplied by publisher]

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Cortical Activation Patterns Correlate With Speech Understanding After Cochlear Implantation.

Cortical Activation Patterns Correlate With Speech Understanding After Cochlear Implantation.

Ear Hear. 2015 Dec 23;

Authors: Olds C, Pollonini L, Abaya H, Larky J, Loy M, Bortfeld H, Beauchamp MS, Oghalai JS

Abstract
OBJECTIVES: Cochlear implants are a standard therapy for deafness, yet the ability of implanted patients to understand speech varies widely. To better understand this variability in outcomes, the authors used functional near-infrared spectroscopy to image activity within regions of the auditory cortex and compare the results to behavioral measures of speech perception.
DESIGN: The authors studied 32 deaf adults hearing through cochlear implants and 35 normal-hearing controls. The authors used functional near-infrared spectroscopy to measure responses within the lateral temporal lobe and the superior temporal gyrus to speech stimuli of varying intelligibility. The speech stimuli included normal speech, channelized speech (vocoded into 20 frequency bands), and scrambled speech (the 20 frequency bands were shuffled in random order). The authors also used environmental sounds as a control stimulus. Behavioral measures consisted of the speech reception threshold, consonant-nucleus-consonant words, and AzBio sentence tests measured in quiet.
RESULTS: Both control and implanted participants with good speech perception exhibited greater cortical activations to natural speech than to unintelligible speech. In contrast, implanted participants with poor speech perception had large, indistinguishable cortical activations to all stimuli. The ratio of cortical activation to normal speech to that of scrambled speech directly correlated with the consonant-nucleus-consonant words and AzBio sentences scores. This pattern of cortical activation was not correlated with auditory threshold, age, side of implantation, or time after implantation. Turning off the implant reduced the cortical activations in all implanted participants.
CONCLUSIONS: Together, these data indicate that the responses the authors measured within the lateral temporal lobe and the superior temporal gyrus correlate with behavioral measures of speech perception, demonstrating a neural basis for the variability in speech understanding outcomes after cochlear implantation.

PMID: 26709749 [PubMed - as supplied by publisher]

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TLR4 down-regulation identifies high risk HPV infection and integration in head and neck squamous cell carcinomas.

TLR4 down-regulation identifies high risk HPV infection and integration in head and neck squamous cell carcinomas.

Front Biosci (Elite Ed). 2016;8:15-28

Authors: Pannone G, Bufo P, Pace M, Lepore S, Russo GM, Rubini C, Franco R, Aquino G, Santoro A, Campisi G, Rodolico V, Bucci E, Ilardi G, Mascolo M, Merolla F, Lo Muzio L, Natalicchio I, Colella G, Laurenzana I, Trino S, Leonardi R, Bucci P

Abstract
TLRs are main actors of the innate immune response against HPV. There are very few studies on the role of TLRs mediated HPV clearance in Head and Neck oncology. Our aim was to evaluate whether TLR4 expression identifies HPV infection and/or HR-HPV integration status in oral and oropharyngeal cancers. By immunohistochemistry we assessed TLR4 levels in OSCC/OPSCC. To detect viral integration or episomic status In situ hybridization for HPV-DNA and Pyro-sequencing techniques have been performed. The relationship between TLR4 expression with HPV infection status has been investigated. ISH HPV positive samples have reported lower levels of TLR4 intensity than negative samples (p = .002). There was no statistical correlation between TLR4 intensity and PCR HPV results (p more than 0.0.5). Point-biserial correlation coefficient revealed significant association between TLR4 expression and HR-HPV integration status (p = .0001) and between TLR4 expression index and HR-HPV infection (p = .001). These data have shown that TLR4 down-regulation is strongly associated to both HPV-16 infection and its integration into the host DNA.

PMID: 26709642 [PubMed - as supplied by publisher]

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[Cayler syndrome: A case report and review of the literature].

[Cayler syndrome: A case report and review of the literature].

Ann Chir Plast Esthet. 2015 Dec 17;

Authors: Bellaiche J, Correia N, Bouche Pillon Persyn MA, Chiriac S, Bodin F, François C

Abstract
BACKGROUND AND PURPOSE: Facial asymmetries to the tears are rare. We report a pediatric original case that may fall within the framework of a Cayler syndrome. Through its clinical presentation, we will discuss differential diagnoses, associated forms, its etiology, and its management.
CASE REPORT: At the maternity unit, in a male infant, after vaginal delivery at term without extraction, was discovered a lack of mobility of the labial commissure on the right side, only when crying. The rest of the examination was unremarkable, except ipsilateral microtia. Genetically, karyotype was 46,XY, 22q11 without microdeletion. The head and neck MRI and echocardiogram were normal.
DISCUSSION AND CONCLUSION: Asymmetry with tears has been described in the literature, through association with microdeletion 22q11 syndrome. The originality of this case was the presence of an isolated muscle abnormality. Muscles affected by this syndrome are: Musculus depressor labii inferioris, the Depressor anguli oris, and Mentalis musculus. The three muscles can be affected concomitantly. Isolated involvment of the Depressor anguli oris muscle has also been described. The mechanical dysfunction can be either linked to muscle innervation agenesis or to a defect thereof. There is no specific treatment. The symptoms improve with age by decreasing the frequency of crying. However, it is important to know this pathology in order to seek an optimum balance further in search of associated abnormalities (FISH 22q11, cardiac Doppler ultrasound) but also to educate, to reassure families often worried by the situation.

PMID: 26709147 [PubMed - as supplied by publisher]

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CpG-Oligodeoxynucleotides in Chronic Rhinosinusitis Cell Culture.

CpG-Oligodeoxynucleotides in Chronic Rhinosinusitis Cell Culture.

In Vivo. 2016 01-02;30(1):47-52

Authors: Birk R, Aderhold C, Hörmann K, Wenzel A, Kramer B, Eschenhagen T, Sommer JU

Abstract
In chronic rhinosinusitis (CRS) an important feature is the infiltration of eosinophils, triggered by T-helper type 2 cells (TH2). Binding of the CpG oligodeoxynucleotide (CpG-ODN) ligand to toll-like receptor 9 (TLR9) induces a shift from a TH2- to a TH1-type response. We evaluated the hypothesis that CpG-ODN could reduce the predominantly TH2-driven response in our cultures.
MATERIALS AND METHODS: Twenty samples from CRS patients with (CRSwNP) and without nasal polyposis (CRSsNP) were cultivated. The expression of interleukin 5 (IL-5), eotaxin 3 and matrix metalloprotease 9 (MMP-9) were evaluated with and without CpG-ODN.
RESULTS: Addition of CpG did not influence the expression of IL-5 and eotaxin-3 DNA. Elevated MMP-9 expression in cultures from CRSwNP and CRSsNP patients could be established.
CONCLUSION: CpG does not reduce the attraction of eosinophils since no reduced IL-5 expression was measured in our cultures. Yet, MMP-9 - an important factor in tissue remodelling - was elevated in cultures from CRS patients.

PMID: 26709128 [PubMed - as supplied by publisher]

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Expression of Serum Sialic Acid, Early Antigen-IgA, and Viral Capsid Antigen-IgA in Nasopharynx Cancer Patients: The Diagnostic Implication of Combined Assays.

Expression of Serum Sialic Acid, Early Antigen-IgA, and Viral Capsid Antigen-IgA in Nasopharynx Cancer Patients: The Diagnostic Implication of Combined Assays.

Med Sci Monit. 2015;21:4068-4073

Authors: Sun Y, Sun C, Zhang E

Abstract
BACKGROUND Ebstein-Barr virus (EBV) plays a critical role in nasopharynx cancer, which can be effectively monitored by serum levels of early antigen antibody (EA-IgA) and viral capsid antigen antibody (VCA-IgA). This study explored the diagnostic value of combined assays of sialic acid (SA), EA-IgA, and VCA-IgA via the expressional assay. MATERIAL AND METHODS A total of 42 nasopharynx cancer patients and 42 benign rhinitis and healthy controls were recruited in this study. Serum EA-IgA and VCA-IgA were tested by enzyme-linked immunosorbent assay (ELISA) and enzymatic assay of serum SA. Specificity and sensitivity of those 3 assays were compared. The diagnostic value of each parameter was evaluated by ROC curves. RESULTS All 3 indexes (SA, EA-IgA and VCA-IgA) showed elevated serum levels in nasopharynx cancer patients when compared to those with rhinitis, who had higher levels than healthy individuals. Concentrations of these factors were also positively correlated with the TNM staging of cancer. The sensitivity and specificity were 30.95% and 83.33% (in SA), 57.14% and 95.24% (in EA-IgA), and 76.19% and 92.86% (in VCA-IgA), respectively. VCA-IgA had the highest sensitivity among all 3 indexes. The combined assay increased the diagnostic sensitivity to 92.86% without compromising specificity. CONCLUSIONS SA, EA-IgA, and VCA-IgA levels were significantly elevated in nasopharynx patients' serum. The combined assay may have clinical value in diagnosis and monitoring.

PMID: 26709095 [PubMed - as supplied by publisher]

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Prevalence, diagnosis and management of ectopic thyroid glands.

Prevalence, diagnosis and management of ectopic thyroid glands.

Int J Surg. 2015 Dec 17;

Authors: Santangelo G, Pellino G, De Falco N, Colella G, D'Amato S, Maglione MG, De Luca R, Canonico S, De Falco M

Abstract
Ectopic thyroid tissue (ETT) is an uncommon entity that may be found anywhere along the line of the obliterated thyroglossal duct, usually from the tongue to the diaphragm. We performed a retrospective analysis of patients undergoing surgical treatment for thyroid disease between January 2000 and December 2013,, seeking for ETT All patients with prior neck surgery or trauma were excluded.The clinic-pathologic features, prevalence and diagnosis of the lesions were collected and analysed. Out of 3092 included patients, 28 ETT were identified (0.9%). The anatomical site of ETT was as follows: lateral cervical in 6 (21.4%), along the thyroglossal duct in 6 (21.4%), mediastinal in 5 (17.9%), lingual in 5 (17.9%), sublingualin 3 (10.7%), and submandibular in 3 (10.7%). Histopathology revealed 27 benign lesions and 1 (3.6%) papillary carcinoma. ETT is found in less than 1% of patients receiving thyroid surgery. Diagnosis of ETT requires clinical imaging. Surgery is a prudent choice due to the potential of malignant evolution of ETT.

PMID: 26708843 [PubMed - as supplied by publisher]

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Αρχειοθήκη ιστολογίου

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Η λίστα ιστολογίων μου

Τρίτη 29 Δεκεμβρίου 2015

Abstract

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