Prognostic Survival Associated With Left-Sided vs Right-Sided Colon Cancer: A Systematic Review and Meta-analysis.

Prognostic Survival Associated With Left-Sided vs Right-Sided Colon Cancer: A Systematic Review and Meta-analysis.

JAMA Oncol. 2016 Oct 27;:

Authors: Petrelli F, Tomasello G, Borgonovo K, Ghidini M, Turati L, Dallera P, Passalacqua R, Sgroi G, Barni S

Abstract
Importance: Primary tumor location is emerging as an important prognostic factor owing to distinct biological features. However, the side of origin of colon cancer (CC) still does not represent a prognostic parameter when deciding for adjuvant or palliative chemotherapy.
Objective: To determine the prognostic role of left vs right-sidedness of primary tumor location in patients with CC.
Data Sources: We searched PubMed, EMBASE, The Cochrane Library, Web of Science, LILACS, CINAHL, and SCOPUS for prospective or retrospective studies reporting data on overall survival for left-sided colon cancer (LCC) compared with right-sided colon cancer (RCC).
Study Selection: Studies were selected if: (1) side of CC was reported among variables entered into survival analysis, (2) survival information was available (overall survival [OS] was reported in the article as hazard ratio (HR) according to multivariate analysis, (3) articles were published in the English language.
Data Extraction and Synthesis: Data were pooled using HRs for OS of LCC vs RCC according to fixed or random-effects models. Subgroup analysis and multivariate random-effects model meta-regression was also implemented adjusting for stage distribution, sample size, race, year of publication, type and quality of studies, and adjuvant chemotherapy.
Main Outcomes and Measures: HRs for OS (the primary outcome measure) were pooled to provide an aggregate value. In this analysis, all HRs with 95% CIs were pooled to obtain prognostic information on the location of the primary tumor (left vs right location site of CC) independent of other common clinicopathological covariates.
Results: An analysis was made from the 66 studies conducted. It included 1 437 846 patients with a median follow-up of 65 months. Left sided primary tumor location was associated with a significantly reduced risk of death (HR, 0.82; 95% CI, 0.79-0.84; P < .001) and this was independent of stage, race, adjuvant chemotherapy, year of study, number of participants, and quality of included studies.
Conclusions and Relevance: Based on these results, CC side should be acknowledged as a criterion for establishing prognosis in all stages of disease. It should be considered when deciding treatment intensity in metastatic settings, and should represent a stratification factor for future adjuvant studies.

PMID: 27787550 [PubMed - as supplied by publisher]

http://ift.tt/2eWLBls

Is surgery indicated for elderly patients with early stage nonsmall cell lung cancer, in the era of stereotactic body radiotherapy?

Is surgery indicated for elderly patients with early stage nonsmall cell lung cancer, in the era of stereotactic body radiotherapy?

Medicine (Baltimore). 2016 Oct;95(43):e5212

Authors: Nguyen NP, Godinez J, Shen W, Vinh-Hung V, Gorobets H, Thariat J, Ampil F, Vock J, Karlsson U, Chi A, International Geriatric Radiotherapy Group

Abstract
BACKGROUND: The aim of this article is to assess the influence of comorbidities among elderly patients (at least 70 year old) undergoing surgery for early stage nonsmall cell lung cancer (NSCLC) and to explore the tolerability and efficacy of surgery in relation to stereotactic body radiotherapy (SBRT) in this patient population.
METHODS: A review of the literature on the prevalence of comorbidities among elderly patients with early stage NSCLC, and the impact of comorbidity factors on survival following surgery was conducted. Survival rates and the incidence of complications following SBRT for this patient population were also identified.
RESULTS: Comorbidities in elderly patients with early stage NSCLC may preclude surgery or lead to poor survival following surgery. However, chronological age alone should not be used as a deciding factor to deny curative treatment in elderly, but fit patients. Stereotactic body radiotherapy is well tolerated by elderly lung cancer patients and may result in survival rates similar to that following surgery.
CONCLUSION: SBRT should be the treatment of choice for early stage NSCLC in elderly patients with multiple comorbidities that preclude surgery. The roles of surgery and SBRT for elderly, -fit patients with early stage NSCLC needs to be further defined in future prospective trials.

PMID: 27787380 [PubMed - in process]

http://ift.tt/2fdyFvl

Targeting the androgenic pathway in elderly patients with castration-resistant prostate cancer: A meta-analysis of randomized trials.

Targeting the androgenic pathway in elderly patients with castration-resistant prostate cancer: A meta-analysis of randomized trials.

Medicine (Baltimore). 2016 Oct;95(43):e4636

Authors: Roviello G, Cappelletti MR, Zanotti L, Gobbi A, Senti C, Bottini A, Ravelli A, Bonetta A, Paganini G, Generali D

Abstract
BACKGROUND: The novel hormonal drugs have recently entered in the armamentarium of therapies for treatment of metastatic castration-resistant prostate cancer (CRPC). First reports are available for their use in elderly men with CRPC.
METHOD: A meta-analysis of randomized controlled trials (RCTs) has been performed. PubMed, the Cochrane Library, and American Society of Clinical Oncology (ASCO) University Meeting were searched for data on the use of new hormonal treatment in elderly patients with CRPC.
RESULTS: Nine studies for a total of 3512 elderly patients were available for meta-analysis. Six studies reported outcomes of patients aged >75 years old while 2 studies reported on patients aged >70 years old. The pooled analysis of the androgen synthesis inhibitors revealed significantly increased overall survival (OS) due to antiandrogen agents compared with placebo or placebo and prednisone (hazard ratio (HR) for death: HR = 0.74, 95% CI: 0.67-0.82; P < 0.00001). Moreover, the new antiandrogenic therapy significantly improved the progression-free survival (HR = 0.45, 95% CI: 0.31-0.65; P < 0.0001). The incidence of any grade ≥3 adverse effect was only moderately higher during with the antiandrogenic therapy as compared to the control arms (response rate = 1.03, 95% CI: 0.88-1.20; P = 0.72).
CONCLUSION: This study confirmed that agents targeting the androgen axis (i.e., enzalutamide, abiraterone) significantly prolonged OS in elderly men with CRPC.

PMID: 27787354 [PubMed - in process]

http://ift.tt/2eWKeTz

Assessing the Financial Burden Associated With Treatment Options for Resectable Pancreatic Cancer.

Assessing the Financial Burden Associated With Treatment Options for Resectable Pancreatic Cancer.

Ann Surg. 2016 Oct 25;

Authors: Cerullo M, Gani F, Chen SY, Canner JK, Herman JM, Laheru D, Pawlik TM

Abstract
OBJECTIVE: The aim of this study is to assess the financial burden associated with treatment options for resectable pancreatic cancer.
BACKGROUND: As the volume of cancer care increases in the United States, there is growing interest among both clinicians and policy-makers to reduce its financial impact on the healthcare system. However, costs relative to the survival benefit for differing treatment modalities used in practice have not been described.
METHODS: Patients undergoing resection for pancreatic cancer were identified in the Truven Health MarketScan database. Associations between chemoradiation therapies and survival were performed using parameterized multivariable accelerated failure time models. Median payments over time were calculated for surgery, chemoradiation, and subsequent hospitalizations.
RESULTS: A total of 2408 patients were included. Median survival among all patients was 21.1 months [95% confidence interval (CI): 19.8-22.5 months], whereas median follow-up time was 25.1 months (95% CI: 23.5-26.5 months). After controlling for comorbidity, receipt of neoadjuvant therapy, and nodal involvement, a longer survival was associated with undergoing combination gemcitabine and nab-paclitaxel [time ratio (TR) = 1.26, 95% CI: 1.02-1.57, P = 0.035) or capecitabine and radiation (TR = 1.25, 95% CI: 1.04-1.51, P = 0.018). However, median cumulative payments for gemcitabine with nab-paclitaxel were highest overall [median $74,051, interquartile range (IQR): $38,929-$133,603).
CONCLUSIONS: Total payments for an episode of care relative to improvement in survival vary significantly by treatment modality. These data can be used to inform management decisions about pursuing further care for pancreatic cancer. Future investigations should seek to refine estimates of the cost-effectiveness of different treatments.

PMID: 27787294 [PubMed - as supplied by publisher]

http://ift.tt/2fmjjDK

Initial testing of VS-4718, a novel inhibitor of focal adhesion kinase (FAK), against pediatric tumor models by the Pediatric Preclinical Testing Program.

Initial testing of VS-4718, a novel inhibitor of focal adhesion kinase (FAK), against pediatric tumor models by the Pediatric Preclinical Testing Program.

Pediatr Blood Cancer. 2016 Oct 27;:

Authors: Kurmasheva RT, Gorlick R, Kolb EA, Keir ST, Maris JM, Lock RB, Carol H, Kang M, Reynolds CP, Wu J, Houghton PJ, Smith MA

Abstract
VS-4718, a novel inhibitor of focal adhesion kinase (FAK), was tested against the Pediatric Preclinical Testing Program's (PPTP's) in vitro cell line panel and showed a median relative IC50 of 1.22 μM. VS-4718 was tested in vivo against the PPTP xenograft models using a dose of 50 mg/kg administered by the oral route twice daily for 21 days. VS-4718 induced significant differences in an event-free survival distribution compared with control in 18 of 36 of the evaluable solid tumor xenografts and in 0 of 8 acute lymphoblastic leukemia (ALL) xenografts, but no xenograft lines showed tumor regression. Future plans include further evaluation of the role of FAK inhibition in combination with ABL kinase inhibitors for Ph(+) ALL.

PMID: 27786412 [PubMed - as supplied by publisher]

http://ift.tt/2fdyzni

Emerging Point-of-Care Technologies for Sickle Cell Disease Screening and Monitoring.

Emerging Point-of-Care Technologies for Sickle Cell Disease Screening and Monitoring.

Expert Rev Med Devices. 2016 Oct 27;

Authors: Alapan Y, Fraiwan A, Kucukal E, Hasan MN, Ung R, Kim M, Odame I, Little JA, Gurkan UA

Abstract
Introduction Sickle Cell Disease (SCD) affects 100,000 Americans and more than 14 million people globally, mostly in economically disadvantaged populations, requires early diagnosis after birth and constant monitoring throughout the life-span of the patient. Areas Covered Early diagnosis of SCD still remains a challenge in preventing childhood mortality in the developing world due to requirements of skilled personnel and high-cost of currently available modalities. On the other hand, SCD monitoring presents insurmountable challenges due to heterogeneities among patient populations, as well as in the same individual longitudinally. Here, we describe emerging point-of-care micro/nano platform technologies for SCD screening and monitoring, and critically discuss current state-of-the-art, potential challenges associated with these technologies, and future directions. Expert Commentary Recently developed microtechnologies offer simple, rapid, and affordable screening of SCD and have the potential to facilitate universal screening in resource-limited settings and developing countries. On the other hand, monitoring of SCD is more complicated compared to diagnosis and requires comprehensive validation of efficacy. Early use of novel microdevices for patient monitoring might come in especially handy in new clinical trial designs of emerging therapies.

PMID: 27785945 [PubMed - as supplied by publisher]

http://ift.tt/2eWLaHG

Momelotinib in myelofibrosis: JAK1/2 inhibitor with a role in treating and understanding the anemia.

Momelotinib in myelofibrosis: JAK1/2 inhibitor with a role in treating and understanding the anemia.

Future Oncol. 2016 Oct 27;

Authors: Winton EF, Kota V

Abstract
Myelofibrosis (MF) is a chronic malignancy of the blood-forming system caused by hyperactivation of JAK2/STAT signaling pathway. Small-molecule inhibitors of JAK2 can variably ameliorate MF-related symptoms caused by chronic inflammation and hepatosplenomegaly. Anemia is a significant problem and adverse prognostic factor in over a third of MF patients and is often worsened by JAK2 inhibitors. The JAK1/2 inhibitor momelotinib unexpectedly resulted in reduction of anemia in MF patients during Phase I/II trials. Current Phase III trials will be the basis for seeking regulatory approval of momelotinib during 2017. Studies to determine how momelotinib improves anemia are underway, potentially leading to expanded momelotinib use and/or development of other targeted therapies for treating anemia in MF and related diseases.

PMID: 27785927 [PubMed - as supplied by publisher]

http://ift.tt/2fdzaoP

Imaging on nodal staging of prostate cancer.

Imaging on nodal staging of prostate cancer.

Future Oncol. 2016 Oct 27;

Authors: Kilcoyne A, Price MC, McDermott S, Harisinghani MG

Abstract
Prostate cancer is the second most common cancer in men and is the second highest cause of cancer death in men of all races. Accurate lymph node staging is essential to ensure adequate treatment of prostate cancer. Historically, conventional imaging methods have demonstrated limited sensitivity and specificity in the detection of lymph node metastases. There are many emerging PET tracers that have recently proven to be effective. In addition, the use of ultrasmall iron oxide nanoparticle-enhanced MRI has demonstrated promising results. This review outlines the strengths and limitations of each of the different imaging modalities as well as individual tracers used, including preclinical and clinical agents.

PMID: 27785926 [PubMed - as supplied by publisher]

http://ift.tt/2eWNqi4

Inhibition of Mnk-eIF4E pathway sensitizes the efficacy to chemotherapy in anaplastic thyroid cancer.

Inhibition of Mnk-eIF4E pathway sensitizes the efficacy to chemotherapy in anaplastic thyroid cancer.

Future Oncol. 2016 Oct 27;

Authors: Hu K, Zhang J, Yu M, Xiong C

Abstract
AIM: We investigated whether MAPK-interacting kinase (Mnk) inhibition sensitizes anaplastic thyroid cancer (ATC) cellular response to chemotherapy.
MATERIALS & METHODS: In vitro and in vivo methods were used to examine the combinatory effects of cisplatin with Mnk inhibition and its underlying mechanism.
RESULTS: Mnk inhibition by pharmacological or genetic approaches inhibits proliferation and induces apoptosis of ATC cells and enhances the effects of cisplatin in in vitro and in vivo. Mechanistically, cisplatin increases eIF4E phosphorylation in a dose- and time-dependent manner in ATC cells. Mnk inhibitors sensitize the efficacy of cisplatin by inhibiting cisplatin-induced eIF4E phosphorylation.
CONCLUSION: Targeting Mnk-eIF4E pathway provides a therapeutic strategy by sensitizing ATC response to chemotherapeutic drug.

PMID: 27785922 [PubMed - as supplied by publisher]

http://ift.tt/2eWK929

Impact of (68)Ga-PSMA PET/CT on salvage radiotherapy planning in patients with prostate cancer and persisting PSA values or biochemical relapse after prostatectomy.

Related Articles

Impact of (68)Ga-PSMA PET/CT on salvage radiotherapy planning in patients with prostate cancer and persisting PSA values or biochemical relapse after prostatectomy.

EJNMMI Res. 2016 Dec;6(1):78

Authors: Bluemel C, Linke F, Herrmann K, Simunovic I, Eiber M, Kestler C, Buck AK, Schirbel A, Bley TA, Wester HJ, Vergho D, Becker A

Abstract
BACKGROUND: Salvage radiotherapy (SRT) is clinically established in prostate cancer (PC) patients with PSA persistence or biochemical relapse (BCR) after prior radical surgery. PET/CT imaging prior to SRT may be performed to localize disease recurrence. The recently introduced (68)Ga-PSMA outperforms other PET tracers for detection of recurrence and is therefore expected also to impact radiation planning. Forty-five patients with PSA persistence (16 pts) or BCR (29 pts) after prior prostatectomy, scheduled to undergo SRT of the prostate bed, underwent (68)Ga-PSMA PET/CT. The median PSA level was 0.67 ng/ml. The impact of (68)Ga-PSMA PET/CT on the treatment decision was assessed. Patients with oligometastatic (≤5 lesions) PC underwent radiotherapy (RT), with the extent of the RT area and dose escalation being based on PET positivity.
RESULTS: Suspicious lesions were detected in 24/45 (53.3 %) patients. In 62.5 % of patients, lesions were only detected by (68)Ga-PSMA PET. Treatment was changed in 19/45 (42.2 %) patients, e.g., extending SRT to metastases (9/19), administering dose escalation in patients with morphological local recurrence (6/19), or replacing SRT by systemic therapy (2/19). 38/45 (84.4 %) followed the treatment recommendation, with data on clinical follow-up being available in 21 patients treated with SRT. All but one showed biochemical response (mean PSA decline 78 ± 19 %) within a mean follow-up of 8.12 ± 5.23 months.
CONCLUSIONS: (68)Ga-PSMA PET/CT impacts treatment planning in more than 40 % of patients scheduled to undergo SRT. Future prospective studies are needed to confirm this significant therapeutic impact on patients prior to SRT.

PMID: 27785766 [PubMed - in process]

http://ift.tt/2fdyyQg

New developments in the management of non-small-cell lung cancer, focus on rociletinib: what went wrong?

Related Articles

New developments in the management of non-small-cell lung cancer, focus on rociletinib: what went wrong?

Onco Targets Ther. 2016;9:6065-6074

Authors: Van Der Steen N, Caparello C, Rolfo C, Pauwels P, Peters GJ, Giovannetti E

Abstract
Recently, the development of the third-generation epidermal growth factor receptor-small molecule inhibitor (EGFR-TKI) rociletinib had failed. In this review, the wide-ranging aspects of the evolution of EGFR-TKIs were collected, with a special focus on rociletinib. The influence of different oncogenic mutations on EGFR activity was also discussed. Resistance to the first (erlotinib, gefitinib)- and second (afatinib)-generation EGFR-TKIs provided the rationale behind the development of the third-generation inhibitors (rociletinib, osimertinib). On the basis of these data, a comparison of their efficacy on the different mutated EGFRs and the respective resistance mechanisms is further reported. Moreover, the evolution and results of the clinical trials of rociletinib (TIGER trials) are compared with the trials on osimertinib, another third-generation EGFR-TKI that now has been granted US Food and Drug Administration approval. The reasons behind the arrest in the further development of rociletinib are put in the perspective of future drug development.

PMID: 27785053 [PubMed - in process]

http://ift.tt/2fdy1Oe

Cardiac safety of systemic therapy in breast cancer patients with high risk of atherosclerosis complications.

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Cardiac safety of systemic therapy in breast cancer patients with high risk of atherosclerosis complications.

Future Oncol. 2016 Oct 27;

Authors: Matyszewski A, Czarnecka AM, Stachowiak P, Nowakowska M, Kornacewicz-Jach Z, Kasprzak JD, Szczylik C

Abstract
AIM: This study was designed to verify the efficacy of breast cancer treatment and its cardiac toxicity in population with significant cardiac comorbidities.
MATERIALS & METHODS: Prospective observational study was conducted in 48 patients.
RESULTS: The increase and dependence of echocardiographic parameter early/late were observed on hemoglobin level in all patients, and white blood cells and cholesterol in patients with diabetic were reported. Patients undergo left ventricle diameter change on treatment.
CONCLUSION: Use of potentially cardiotoxic chemo regimens in breast cancer patients with cardiac comorbidities, with optimized cardiac therapy accordingly can save patients from development of early myocardial dysfunction induced by chemotherapy - limiting factor to minimize the risk is optimization of lipid level, red blood cell count and platelets count.

PMID: 27784174 [PubMed - as supplied by publisher]

http://ift.tt/2fdzbsT

Burden of skin cancer in Belgium and cost-effectiveness of primary prevention by reducing ultraviolet exposure.

Related Articles

Burden of skin cancer in Belgium and cost-effectiveness of primary prevention by reducing ultraviolet exposure.

Prev Med. 2016 Oct 3;93:177-182

Authors: Pil L, Hoorens I, Vossaert K, Kruse V, Tromme I, Speybroeck N, Brochez L, Annemans L

Abstract
Skin cancer (melanoma- and non-melanoma skin cancer) is one of the most rapidly increasing cancers worldwide. This study analysed the current and future economic burden of skin cancer in Belgium and the cost-effectiveness of primary prevention of skin cancer. A retrospective bottom-up cost-of-illness study was performed, together with a Markov model in order to analyse the cost-effectiveness and the budget impact analysis of primary prevention of skin cancer in Belgium. Total prevalence of skin cancer in Belgium was estimated to triple in the next 20years. The total economic burden of skin cancer in 2014 in Belgium was estimated at €106 million, with a cumulative cost of €3 billion in 2034. The majority of this total cost was due to melanoma (65%). Over a period of 50years, both a sensitisation campaign and a total ban on sunbed use would lead to a gain in quality-adjusted life-years and cost-savings. For every euro invested in the campaign, €3.6 would be saved on the long-term for the healthcare payer. Policy makers and clinicians should promote UV protection strategies, as they were estimated to be dominant strategies.

PMID: 27713103 [PubMed - as supplied by publisher]

http://ift.tt/2dCZOUH

Novel insights into esophageal diagnostic procedures.

Related Articles

Novel insights into esophageal diagnostic procedures.

Ann N Y Acad Sci. 2016 Sep;1380(1):162-177

Authors: Savarino E, Ottonello A, Tolone S, Bartolo O, Baeg MK, Farjah F, Kuribayashi S, Shetler KP, Lottrup C, Stein E

Abstract
The 21st century offers new advances in diagnostic procedures and protocols in the management of esophageal diseases. This review highlights the most recent advances in esophageal diagnostic technologies, including clinical applications of novel endoscopic devices, such as ultrathin endoscopy and confocal laser endomicroscopy for diagnosis and management of Barrett's esophagus; novel parameters and protocols in high-resolution esophageal manometry for the identification and better classification of motility abnormalities; innovative connections between esophageal motility disorder diagnosis and detection of gastroesophageal reflux disease (GERD); impedance-pH testing for detecting the various GERD phenotypes; performance of distensibility testing for better pathophysiological knowledge of the esophagus and other gastrointestinal abnormalities; and a modern view of positron emission tomography scanning in metastatic disease detection in the era of accountability as a model for examining other new technologies. We now have better tools than ever for the detection of esophageal diseases and disorders, and emerging data are helping to define how well these tools change management and provide value to clinicians. This review features novel insights from multidisciplinary perspectives, including both surgical and medical perspectives, into these new tools, and it offers guidance on the use of novel technologies in clinical practice and future directions for research.

PMID: 27681220 [PubMed - in process]

http://ift.tt/2dwnPvw

The sensory system of the esophagus--what do we know?

Related Articles

The sensory system of the esophagus--what do we know?

Ann N Y Acad Sci. 2016 Sep;1380(1):91-103

Authors: Brock C, Gregersen H, Gyawali CP, Lottrup C, Furnari M, Savarino E, Novais L, Frøkjaer JB, Bor S, Drewes AM

Abstract
The nervous innervation and complex mechanical function of the esophagus make sensory evaluation difficult. However, during the last decades, several new techniques have made it possible to gain insight into pain processing of nociceptive signals. The current review highlights the sensory innervation and possibilities for quantitative sensory testing, the mechanosensory properties, the potential of high-resolution manometry and imaging, and the sensory system in special conditions, such as Barrett's esophagus. It is mandatory to understand the complex pathophysiology of the esophagus to enhance our understanding of esophageal disorders, but it also increases the complexity of future experimental and clinical studies. The new methods, as outlined in the current review, provide the possibility for researchers to enhance the quality of interdisciplinary research and to gain more knowledge about sensory symptoms and treatment possibilities.

PMID: 27598834 [PubMed - in process]

http://ift.tt/2eWITMQ

Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505).

Related Articles

Comparison of oxaliplatin and paclitaxel-induced neuropathy (Alliance A151505).

Support Care Cancer. 2016 Dec;24(12):5059-5068

Authors: Pachman DR, Qin R, Seisler D, Smith EM, Kaggal S, Novotny P, Ruddy KJ, Lafky JM, Ta LE, Beutler AS, Wagner-Johnston ND, Staff NP, Grothey A, Dougherty PM, Cavaletti G, Loprinzi CL

Abstract
PURPOSE: Oxaliplatin and paclitaxel are commonly used chemotherapies associated with acute and chronic neuropathies. There is a need to better understand the similarities and differences of these clinical syndromes.
METHODS: Neuropathy data were pooled from patients receiving adjuvant oxaliplatin and weekly paclitaxel or every 3 weeks of paclitaxel. Patients completed daily questionnaires after each chemotherapy dose and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire for patients with chemotherapy-induced peripheral neuropathy before each chemotherapy cycle and for 12 months post-treatment.
RESULTS: Acute neuropathy symptoms from both drugs peaked around day 3. Acute symptoms experienced in cycle 1 predicted occurrence in subsequent cycles. Paclitaxel-induced acute symptoms were similar in intensity in each cycle and largely resolved between cycles. Oxaliplatin-induced acute symptoms were about half as severe in the first cycle as in later cycles and did not resolve completely between cycles. Both drugs caused a predominantly sensory chronic neuropathy (with numbness and tingling being more common than pain). Oxaliplatin-induced neuropathy worsened after the completion of treatment and began to improve 3 months post-treatment. In contrast, paclitaxel-induced neuropathy began improving immediately after chemotherapy cessation. During treatment, the incidence of paclitaxel sensory symptoms was similar in the hands and feet; with oxaliplatin, the hands were affected more than the feet. Both paclitaxel- and oxaliplatin-induced acute neurotoxicity appeared to predict the severity of chronic neuropathy, more prominently with oxaliplatin.
CONCLUSIONS: Knowledge of the similarities and differences between neuropathy syndromes may provide insight into their underlying pathophysiology and inform future research to identify preventative treatment approaches.

PMID: 27534963 [PubMed - in process]

http://ift.tt/2fdC8tF

Loss of Keratin 17 induces tissue-specific cytokine polarization and cellular differentiation in HPV16-driven cervical tumorigenesis in vivo.

Related Articles

Loss of Keratin 17 induces tissue-specific cytokine polarization and cellular differentiation in HPV16-driven cervical tumorigenesis in vivo.

Oncogene. 2016 Oct 27;35(43):5653-5662

Authors: Hobbs RP, Batazzi AS, Han MC, Coulombe PA

Abstract
Despite preventive human papilloma virus (HPV) vaccination efforts, cervical cancer remains a leading cause of death in women worldwide. Development of therapeutic approaches for cervical cancer are hampered by a lack of mechanistic insight during tumorigenesis. The cytoskeletal protein Keratin 17 (KRT17;K17) is robustly expressed in a broad array of carcinomas, including in cervical tumors, where it has both diagnostic and prognostic value. In this study, we have established multiple functional roles for K17 in the promotion of cervical tumorigenesis in vivo using the established HPV16(tg) mouse model for cervical squamous cell carcinoma. In HPV16(tg/+);Krt17(-/-)relative to HPV16(tg/+) reference female mice, onset of cervical lesions is delayed and closely paralleled by marked reductions in hyperplasia, dysplasia and vascularization. In addition, loss of Krt17 is associated with a cytokine polarization and recruitment of effector immune cells to lesion-prone cervical epithelia. Further, we observed marked enhancement of terminal differentiation in HPV16(tg/+);Krt17(-/-)cervical epithelium accompanied by a stimulation and expansion in the expression of p63, a known basal/reserve cell marker in this tissue. Altogether, the data suggest that the loss of Krt17 may foster an overall protective environment for lesion-prone cervical tissue. In addition to providing new insights into the immunomodulatory and cellular mechanisms of cervical tumorigenesis, these findings may help guide the development of future therapies including vaccines.

PMID: 27065324 [PubMed - in process]

http://ift.tt/2eWLTbY

Postoperative radiotherapy for lung cancer: Is it worth the controversy?

Postoperative radiotherapy for lung cancer: Is it worth the controversy?

Cancer Treat Rev. 2016 Oct 14;51:10-18

Authors: Billiet C, Peeters S, Decaluwé H, Vansteenkiste J, Mebis J, Ruysscher D

Abstract
INTRODUCTION: The role of postoperative radiation therapy (PORT) in patients with completely resected non-small cell lung cancer (NSCLC) with pathologically involved mediastinal lymph nodes (N2) remains unclear. Despite a reduction of local recurrence (LR), its effect on overall survival (OS) remains unproven. Therefore we conducted a review of the current literature.
METHODS: To investigate the benefit and safety of modern PORT, we identified published phase III trials for PORT. We investigated modern PORT in low-risk (ypN0/1 and R0) and high-risk (ypN2 and/or R1/2) patients with stage III-N2 NSCLC treated with induction chemotherapy and resection.
RESULTS: Seventeen phase III trials using PORT were selected. Of all PORT N2 studies, 4 were eligible for evaluation of LR, all in high-risk patients only. In these high-risk patients receiving PORT, the mean LR rate at 5years was 20.9% (95% CI 16-24). Two trials were suitable to assess LR rates after chemotherapy and surgery without PORT. In these low-risk patients, the mean 5-year LR was 33.1% (95% CI 27-39). No significant difference in non-cancer deaths between PORT vs. non-PORT patients was observed in N2 NSCLC.
CONCLUSION: PORT is worth the controversy because data illustrate that PORT may increase the OS. However, prospective randomized trials are needed to verify this.

PMID: 27788387 [PubMed - as supplied by publisher]

http://ift.tt/2fmjXRG

Roles of OCT4 in tumorigenesis, cancer therapy resistance and prognosis.

Roles of OCT4 in tumorigenesis, cancer therapy resistance and prognosis.

Cancer Treat Rev. 2016 Oct 14;51:1-9

Authors: Villodre ES, Kipper FC, Pereira MB, Lenz G

Abstract
OCT4 (POU5F1) is a major regulator of cell pluripotency and plays an important role not only during embryogenesis but also in tumorigenesis. It has been studied in various types of cancers, since stemness is an important factor for cancer growth and therapy. Here we present basic information about the OCT4 gene, its isoforms and pseudogenes besides discussing the current literature in which OCT4 is linked to cancer, emphasizing its roles in tumorigenesis and therapy. The majority of studies indicated a negative correlation between the expression of OCT4 and prognosis, and only in testicular germ cell tumor this correlation was positive. Using The Cancer Genome Atlas database we showed that OCT4 expression correlated negatively with patient survival in pancreatic cancer. All those different impacts of OCT4 on cancer indicate the biological complexity of this transcription factor in biology and, therefore, also in cancer.

PMID: 27788386 [PubMed - as supplied by publisher]

http://ift.tt/2dSAwQ7

The Preventive Effect of the Traditional Japanese Herbal Medicine, Hochuekkito, against Influenza A Virus via Autophagy in vitro.

The Preventive Effect of the Traditional Japanese Herbal Medicine, Hochuekkito, against Influenza A Virus via Autophagy in vitro.

Pharmacology. 2016 Oct 28;99(3-4):99-105

Authors: Takanashi K, Dan K, Kanzaki S, Hasegawa H, Watanabe K, Ogawa K

Abstract
BACKGROUND: Hochuekkito (HKT), a traditional Japanese herbal medicine, enhances the immunity of elderly or weak individuals. It is also known to have preventive effects against influenza clinically. However, the detailed mechanisms of the preventive effects have not been clarified. We examined the relationship between the preventive effects of HKT and autophagy, a known stress response and quality control mechanism, using Madin-Darby canine kidney cells and influenza A/PR/8/34 (H1N1) virus.
METHODS: The effect of HKT on autophagy in influenza A virus (IAV)-infected cells was assessed by Western blotting and fluorescence microscopy using an RFP-GFP-LC3B sensor kit.
RESULTS: In Western blotting, treatment with HKT before IAV infection (pre-HKT) tended to induce autophagy in IAV-infected cells at an early stage of infection, eventually suppressing IAV-induced autophagy. Moreover, several autolysosomes, indicative of normal autophagosome-lysosome fusion, were observed in Pre-HKT cells transduced with RFP-GFP-LC3B but not in untreated IAV-infected cells.
CONCLUSIONS: These findings indicated that IAV-mediated inhibition of the fusion of autophagosomes with lysosomes was prevented by HKT treatment before infection. According to these results, we propose that this phenomenon is one of the preventive effects of HKT against IAV.

PMID: 27788517 [PubMed - as supplied by publisher]

http://ift.tt/2e3MedU

Macrophage migration inhibitory factor: a potential driver and biomarker for head and neck squamous cell carcinoma.

Macrophage migration inhibitory factor: a potential driver and biomarker for head and neck squamous cell carcinoma.

Oncotarget. 2016 Oct 25;:

Authors: Wang SS, Cen X, Liang XH, Tang YL

Abstract
Macrophage migration inhibitory factor (MIF), a pleiotropic proinflammatory cytokine, has been showed to be associated with the immunopathogenesis of many diseases. Recent study demonstrated that MIF promoted tumorigenesis and tumor progression and played a critical role in various kinds of human cancer including head and neck squamous cell carcinoma(HNSCC). Hence, in this paper we retrospected the relationship between MIF and angiogenesis, epithelial-mesenchymal transition (EMT), inflammation, immune response, hypoxia microenvironment, and discussed whether it is a promising biomarker for diagnosis and supervisor of HNSCC.

PMID: 27788497 [PubMed - as supplied by publisher]

http://ift.tt/2eYsuGe

Laparoscopic resection of a gastric schwannoma: A case report.

Laparoscopic resection of a gastric schwannoma: A case report.

Int J Surg Case Rep. 2016 Oct 20;28:335-339

Authors: Vargas Flores E, Bevia Pérez F, Ramirez Mendoza P, Velázquez García JA, Ortega Román OA

Abstract
INTRODUCTION: Mesenchymal tumors of the gastrointestinal tract are a group spindle cell tumors which include gastrointestinal stromal tumors, leiomyomas, leiomyosarcomas and schwannomas (Nishida and Hirota, 2000). Schwannomas generally present as a slow and asymptomatic growing mass in the gastrointestinal tract typically arising in the gastric submucosa accounting for up to 0.2% of gastric tumors (Melvin and Wilkinson, 1993; Sarlomo-Rikala M, Miettinen, 1995).
TREATMENT: with negative surgical margin resection (as approached in this case) is considered the standard treatment.
PRESENTATION OF CASE: A 60-year-old woman was referred to our general surgery service for dyspepsia. During her evaluation a gastric mass was incidentally found on upper GI endoscopy which showed a submucosal exophytic neoplasm at the gastric antrum. The patient was discharged following an uneventful recovery from a successful surgical laparoscopic tumor resection.
DISCUSSION: Schwannomas are benign neurogenic tumors that originate from Schwann cells. They commonly occur in the head and neck but are rare in the GI tract (Menno et al., 2010). The differential diagnosis between gastric schwannomas and GISTs can be difficult in the preoperative assessment. With the advent of immunohistochemical staining techniques it is now possible to make a differential diagnosis based on their distinctive immunophenotypes. Gastric schwannomas are consistently positive for S-100 protein and negative for c-kit; conversely, 95% of GISTs are positive for c-kit and negative for S-100 protein in up to 98 to 99% of the cases.
CONCLUSION: Gastric schwannomas should be included in the differential diagnosis of any gastric submucosal mass. Negative margin resection as seen with this patient is the standard surgical treatment as there is low malignant transformation potential.

PMID: 27788385 [PubMed - as supplied by publisher]

http://ift.tt/2e3JXPS

Disparate Regulatory Mechanisms Control Fat3 and P75NTR Protein Transport through a Conserved Kif5-Interaction Domain.

Disparate Regulatory Mechanisms Control Fat3 and P75NTR Protein Transport through a Conserved Kif5-Interaction Domain.

PLoS One. 2016;11(10):e0165519

Authors: Cheng H, Burroughs-Garcia J, Birkness JE, Trinidad JC, Deans MR

Abstract
Directed transport delivers proteins to specific cellular locations and is one mechanism by which cells establish and maintain polarized cellular architectures. The atypical cadherin Fat3 directs the polarized extension of dendrites in retinal amacrine cells by influencing the distribution of cytoskeletal regulators during retinal development, however the mechanisms regulating the distribution of Fat3 remain unclear. We report a novel Kinesin/Kif5 Interaction domain (Kif5-ID) in Fat3 that facilitates Kif5B binding, and determines the distribution of Fat3 cytosolic domain constructs in neurons and MDCK cells. The Kif5-ID sequence is conserved in the neurotrophin receptor P75NTR, which also binds Kif5B, and Kif5-ID mutations similarly result in P75NTR mislocalization. Despite these similarities, Kif5B-mediated protein transport is differentially regulated by these two cargos. For Fat3, the Kif5-ID is regulated by alternative splicing, and the timecourse of splicing suggests that the distribution of Fat3 may switch between early and later stages of retinal development. In contrast, P75NTR binding to Kif5B is enhanced by tyrosine phosphorylation and thus has the potential to be dynamically regulated on a more rapid time scale.

PMID: 27788242 [PubMed - in process]

http://ift.tt/2eYv7YD

Retrospective Review of the Anaesthetic Management of Maxillectomies and Mandibulectomies for Benign Tumours in Sub-Saharan Africa.

Retrospective Review of the Anaesthetic Management of Maxillectomies and Mandibulectomies for Benign Tumours in Sub-Saharan Africa.

PLoS One. 2016;11(10):e0165090

Authors: White MC, Horner KC, Lai PS

Abstract
BACKGROUND: Safe anaesthesia is a crucial component of safe surgical care, yet anaesthetic complications are common in resource-limited settings. We describe differences in anaesthetic needs for Mandibulectomy vs. Maxillectomy in three sub-Saharan African countries.
MATERIALS AND METHODS: Retrospective review of patients undergoing minor Mandibulectomy, major Mandibulectomy, or Maxillectomy in Togo, Guinea and Republic of the Congo. Surgeries were performed on the Africa Mercy, an international non-governmental hospital ship. Primary outcomes were need for advanced airway management and intra-operative blood loss. Secondary outcomes were time under general anaesthesia and hospital length of stay. Multivariate regression determined the association between operation type and each outcome measure.
RESULTS: 105 patients were included (25 minor Mandibulectomy, 58 major Mandibulectomy, 22 Maxillectomy procedures). In-hospital mortality was 0%. 44/105 (41.9%) required an advanced airway management technique to achieve intubation, although in all cases this was anticipated prior to the procedure; no differences were noted between surgical procedure (p = 0.72). Operative procedure was a significant risk factor for intra-operative blood loss. Patients undergoing Maxillectomy lost on average 851.5 (413.3, 1289.8, p = 0.0003) mL more blood than patients undergoing minor Mandibulectomy, and 507.3 (150.3, 864.3, p = 0.007) mL more blood than patients undergoing major Mandibulectomy. Patients undergoing Maxillectomy had a significantly higher time under general anaesthesia than those undergoing minor Mandibulectomy. There was no significant difference in hospital length of stay between operation type.
CONCLUSION: Anaesthetic considerations for minor Mandibulectomy, major Mandibulectomy, and Maxillectomy differ with respect to intra-operative blood loss and time under general anaesthesia, but not need for advanced airway management or length of stay. Although advanced airway management was required in 41.9% of patients, there were no unanticipated difficult airways. With appropriate training and resources, safe anaesthesia can be delivered to patients from low-income countries requiring major head and neck surgery.

PMID: 27788172 [PubMed - in process]

http://ift.tt/2e3N7Dl

3D printed polyurethane prosthesis for partial tracheal reconstruction: a pilot animal study.

3D printed polyurethane prosthesis for partial tracheal reconstruction: a pilot animal study.

Biofabrication. 2016 Oct 27;8(4):045015

Authors: Jung SY, Lee SJ, Kim HY, Park HS, Wang Z, Kim HJ, Yoo JJ, Chung SM, Kim HS

Abstract
A ready-made, acellular patch-type prosthesis is desirable in repairing partial tracheal defects in the clinical setting. However, many of these prostheses may not show proper biological integration and biomechanical function when they are transplanted. In this study, we developed a novel 3D printed polyurethane (PU) tracheal scaffold with micro-scale architecture to allow host tissue infiltration and adequate biomechanical properties to withstand physiological tracheal condition. A half-pipe shaped PU scaffold (1.8 cm of height, 0.18 cm thickness, and 2 cm of diameter) was fabricated by 3D printing of PU 200 μm PU beam. The 3D printed tracheal scaffolds consisted of a porous inner microstructure with 200 × 200 × 200 μm(3) sized pores and a non-porous outer layer. The mechanical properties of the scaffolds were 3.21 ± 1.02 MPa of ultimate tensile strength, 2.81 ± 0.58 MPa of Young's modulus, and 725% ± 41% of elongation at break. To examine the function of the 3D printed tracheal scaffolds in vivo, the scaffolds were implanted into 1.0 × 0.7 cm(2) sized anterior tracheal defect of rabbits. After implantation, bronchoscopic examinations revealed that the implanted tracheal scaffolds were patent for a 16 week-period. Histologic findings showed that re-epithelialization after 4 weeks of implantation and ciliated respiratory epithelium with ciliary beating after 8 weeks of implantation were observed at the lumen of the implanted tracheal scaffolds. The ingrowth of the connective tissue into the scaffolds was observed at 4 weeks after implantation. The biomechanical properties of the implanted tracheal scaffolds were continually maintained for 16 week-period. The results demonstrated that 3D printed tracheal scaffold could provide an alternative solution as a therapeutic treatment for partial tracheal defects.

PMID: 27788126 [PubMed - in process]

http://ift.tt/2eYrNgh

Performance Characteristics of Adenoid Cystic Carcinoma of the Salivary Glands in Fine-Needle Aspirates.

Performance Characteristics of Adenoid Cystic Carcinoma of the Salivary Glands in Fine-Needle Aspirates.

Arch Pathol Lab Med. 2016 Nov;140(11):1183

Authors: Al-Abbadi MA, Aziz L

PMID: 27788050 [PubMed - in process]

http://ift.tt/2e3QIl1

Clinical benefits of polyurethane nasal packing in endoscopic sinus surgery.

Clinical benefits of polyurethane nasal packing in endoscopic sinus surgery.

Eur Arch Otorhinolaryngol. 2016 Oct 27;

Authors: Piski Z, Gerlinger I, Nepp N, Revesz P, Burian A, Farkas K, Lujber L

Abstract
The benefits of nasal packing after endoscopic sinus surgery (ESS) are still debated in the literature. Our aims were to evaluate the efficacy, and the clinical effects of a totally degradable nasal dressing used after ESS. Thirty patients with chronic rhinosinusitis with nasal polyps were enrolled in a prospective, randomized, double-blind, controlled study. Every patient underwent ESS and a polyurethane nasal dressing was used in one nasal fossa and the contralateral fossa was left unpacked. The extent of mucosal edema, crust formation, bleeding tendency, presence of synechiae, amount of nasal discharge, and the patency of the ostiomeatal complex (OMC) was evaluated during nasal endoscopy on the first, fourth, and twelfth postoperative weeks. All clinical findings were statistically analyzed. Endoscopy showed a significant improvement in the patency of the OMC on the side with resorbable material at 4 weeks after surgery. Follow-up at week 12 showed that in addition to the OMC patency scores, synechia formation and nasal discharge were also significantly improved in the packed fossa. Polyurethane packing is an effective alternative for nasal packing following functional endoscopic sinus surgery.

PMID: 27787624 [PubMed - as supplied by publisher]

http://ift.tt/2eYsupI

Nasal Dorsum Mass in an Infant.

Nasal Dorsum Mass in an Infant.

JAMA Otolaryngol Head Neck Surg. 2016 Oct 27;:

Authors: Cai Y, Betman S, Haddad J

PMID: 27787565 [PubMed - as supplied by publisher]

http://ift.tt/2e3Li9r

Trimmed Lateral Crura of Lower Lateral Cartilages as Spreader Grafts-Reply.

Trimmed Lateral Crura of Lower Lateral Cartilages as Spreader Grafts-Reply.

JAMA Facial Plast Surg. 2016 Oct 27;:

Authors: Hassouneh B, Brenner MJ, Kim DW

PMID: 27787552 [PubMed - as supplied by publisher]

http://ift.tt/2eYtFp7

Injection Pharyngoplasty With Autologous Fat as Treatment for Stress Velopharyngeal Insufficiency in Brass and Woodwind Musicians.

Injection Pharyngoplasty With Autologous Fat as Treatment for Stress Velopharyngeal Insufficiency in Brass and Woodwind Musicians.

JAMA Otolaryngol Head Neck Surg. 2016 Oct 27;:

Authors: Syamal MN, Bryson PC

Abstract
Importance: Stress velopharyngeal insufficiency (SVPI) is an uncommon but often career-threatening condition affecting professional brass and woodwind musicians.
Objectives: To review the evaluation of and treatment for SVPI in professional musicians with lipoinjection to the posterior pharyngeal wall.
Design, Setting, and Participants: A retrospective medical record and literature review. Two professional musicians with SVPI treated with autologous lipoinjection to the posterior pharyngeal wall were included. Nasopharyngoscopy was performed while patients played their instrument both before and after injection.
Main Outcomes and Measures: To assess the effectiveness of autologous fat injection to the posterior pharyngeal wall to treat stress velopharyngeal insufficiency in 2 professional instrumentalists. Successful treatment was the absence of VPI during playing as visualized by flexible nasopharyngoscopy.
Results: After autologous lipoinjection of the posterior pharyngeal wall, 1 patient resumed full play with complete resolution, now 3 years after lipoinjection pharyngoplasty. The other patient received temporary resolution. Both had no surgical complications. Stress VPI is often a career-threatening condition for professional brass and woodwind musicians, with a cited incidence of 34%. Various treatment options in the literature include observation, speech and language pathology referral for pharyngeal strengthening, lipoinjection of the soft palate, and more invasive options, such as sphincter pharyngoplasty, pharyngeal flaps and V-Y pushback.
Conclusions and Relevance: Autologous fat injection pharyngoplasty of the posterior pharyngeal wall may be a less invasive treatment option for musicians with SVPI.

PMID: 27787538 [PubMed - as supplied by publisher]

http://ift.tt/2e3NI8g

Spatial Release From Masking in Children: Effects of Simulated Unilateral Hearing Loss.

Spatial Release From Masking in Children: Effects of Simulated Unilateral Hearing Loss.

Ear Hear. 2016 Oct 26;

Authors: Corbin NE, Buss E, Leibold LJ

Abstract
OBJECTIVES: The purpose of this study was twofold: (1) to determine the effect of an acute simulated unilateral hearing loss on children's spatial release from masking in two-talker speech and speech-shaped noise, and (2) to develop a procedure to be used in future studies that will assess spatial release from masking in children who have permanent unilateral hearing loss. There were three main predictions. First, spatial release from masking was expected to be larger in two-talker speech than in speech-shaped noise. Second, simulated unilateral hearing loss was expected to worsen performance in all listening conditions, but particularly in the spatially separated two-talker speech masker. Third, spatial release from masking was expected to be smaller for children than for adults in the two-talker masker.
DESIGN: Participants were 12 children (8.7 to 10.9 years) and 11 adults (18.5 to 30.4 years) with normal bilateral hearing. Thresholds for 50%-correct recognition of Bamford-Kowal-Bench sentences were measured adaptively in continuous two-talker speech or speech-shaped noise. Target sentences were always presented from a loudspeaker at 0° azimuth. The masker stimulus was either co-located with the target or spatially separated to +90° or -90° azimuth. Spatial release from masking was quantified as the difference between thresholds obtained when the target and masker were co-located and thresholds obtained when the masker was presented from +90° or -90° azimuth. Testing was completed both with and without a moderate simulated unilateral hearing loss, created with a foam earplug and supra-aural earmuff. A repeated-measures design was used to compare performance between children and adults, and performance in the no-plug and simulated-unilateral-hearing-loss conditions.
RESULTS: All listeners benefited from spatial separation of target and masker stimuli on the azimuth plane in the no-plug listening conditions; this benefit was larger in two-talker speech than in speech-shaped noise. In the simulated-unilateral-hearing-loss conditions, a positive spatial release from masking was observed only when the masker was presented ipsilateral to the simulated unilateral hearing loss. In the speech-shaped noise masker, spatial release from masking in the no-plug condition was similar to that obtained when the masker was presented ipsilateral to the simulated unilateral hearing loss. In contrast, in the two-talker speech masker, spatial release from masking in the no-plug condition was much larger than that obtained when the masker was presented ipsilateral to the simulated unilateral hearing loss. When either masker was presented contralateral to the simulated unilateral hearing loss, spatial release from masking was negative. This pattern of results was observed for both children and adults, although children performed more poorly overall.
CONCLUSIONS: Children and adults with normal bilateral hearing experience greater spatial release from masking for a two-talker speech than a speech-shaped noise masker. Testing in a two-talker speech masker revealed listening difficulties in the presence of disrupted binaural input that were not observed in a speech-shaped noise masker. This procedure offers promise for the assessment of spatial release from masking in children with permanent unilateral hearing loss.

PMID: 27787392 [PubMed - as supplied by publisher]

http://ift.tt/2eYudeX

Does CYP2E1 RsaI/PstI polymorphism confer head and neck carcinoma susceptibility?: A meta-analysis based on 43 studies.

Does CYP2E1 RsaI/PstI polymorphism confer head and neck carcinoma susceptibility?: A meta-analysis based on 43 studies.

Medicine (Baltimore). 2016 Oct;95(43):e5156

Authors: Zhuo X, Song J, Liao J, Zhou W, Ye H, Li Q, Xiang Z, Zhang X

Abstract
BACKGROUND: Previous reports showed that CYP2E1 RsaI/PstI polymorphism may be a risk factor for cancers. Published meta-analyses in 2010 and 2011, respectively, on the relationship of CYP2E1 RsaI/PstI polymorphisms with the susceptibility to head and neck carcinoma (HNC) have generated inconsistent results. Thus, this study aimed to conduct an updated meta-analysis involving published studies up to Nov 2015 to get a more confidential result.
METHODS: Eligible studies up to Nov 2015 were retrieved and screened. Data were extracted and a quantitative meta-analysis was conducted. Subgroup analyses on ethnicity, source of controls, sample size, genotyping method, smoking status, and drinking status were also performed.
RESULTS: Forty-one publications including a total of 43 case-control studies were selected for analysis. The overall data under a homozygote comparison model indicated a significant association of CYP2E1 RsaI/PstI polymorphisms with HNC risk (c2c2 vs c1c1: odds ratio [OR] = 1.97; 95% confidence interval [CI] = 1.53-2.53). Similar results were observed in the Asian subgroup (c2c2 vs c1c1: OR = 1.98; 95%CI = 1.51-2.60; c2 vs c1: OR = 1.20; 95%CI = 1.03-1.39) and mixed population (c2 vs c1: OR = 1.41; 95%CI = 1.06-1.86) when the data were stratified by ethnicities. Interestingly, increased cancer risk only was shown among never-smokers (c2c2+c1c2 vs c1c1: OR = 1.44; 95%CI = 1.05-1.98) but not ever-smokers.
CONCLUSION: CYP2E1 RsaI/PstI polymorphisms may modify the susceptibility to HNC, particularly among Asians, mixed population, and never-smokers. Future large and well-designed studies are needed to verify this conclusion.

PMID: 27787372 [PubMed - in process]

http://ift.tt/2e3MI3E

Enhanced attention to speaking faces versus other event types emerges gradually across infancy.

Enhanced attention to speaking faces versus other event types emerges gradually across infancy.

Dev Psychol. 2016 Nov;52(11):1705-1720

Authors: Bahrick LE, Todd JT, Castellanos I, Sorondo BM

Abstract
The development of attention to dynamic faces versus objects providing synchronous audiovisual versus silent visual stimulation was assessed in a large sample of infants. Maintaining attention to the faces and voices of people speaking is critical for perceptual, cognitive, social, and language development. However, no studies have systematically assessed when, if, or how attention to speaking faces emerges and changes across infancy. Two measures of attention maintenance, habituation time (HT) and look-away rate (LAR), were derived from cross-sectional data of 2- to 8-month-old infants (N = 801). Results indicated that attention to audiovisual faces and voices was maintained across age, whereas attention to each of the other event types (audiovisual objects, silent dynamic faces, silent dynamic objects) declined across age. This reveals a gradually emerging advantage in attention maintenance (longer HTs, lower LARs) for audiovisual speaking faces compared with the other 3 event types. At 2 months, infants showed no attentional advantage for faces (with greater attention to audiovisual than to visual events); at 3 months, they attended more to dynamic faces than objects (in the presence or absence of voices), and by 4 to 5 and 6 to 8 months, significantly greater attention emerged to temporally coordinated faces and voices of people speaking compared with all other event types. Our results indicate that selective attention to coordinated faces and voices over other event types emerges gradually across infancy, likely as a function of experience with multimodal, redundant stimulation from person and object events. (PsycINFO Database Record

PMID: 27786526 [PubMed - in process]

http://ift.tt/2eYxtXu

Adaptive Intuitionistic Fuzzy Enhancement of Brain Tumor MR Images.

Adaptive Intuitionistic Fuzzy Enhancement of Brain Tumor MR Images.

Sci Rep. 2016 Oct 27;6:35760

Authors: Deng H, Deng W, Sun X, Ye C, Zhou X

Abstract
Image enhancement techniques are able to improve the contrast and visual quality of magnetic resonance (MR) images. However, conventional methods cannot make up some deficiencies encountered by respective brain tumor MR imaging modes. In this paper, we propose an adaptive intuitionistic fuzzy sets-based scheme, called as AIFE, which takes information provided from different MR acquisitions and tries to enhance the normal and abnormal structural regions of the brain while displaying the enhanced results as a single image. The AIFE scheme firstly separates an input image into several sub images, then divides each sub image into object and background areas. After that, different novel fuzzification, hyperbolization and defuzzification operations are implemented on each object/background area, and finally an enhanced result is achieved via nonlinear fusion operators. The fuzzy implementations can be processed in parallel. Real data experiments demonstrate that the AIFE scheme is not only effectively useful to have information from images acquired with different MR sequences fused in a single image, but also has better enhancement performance when compared to conventional baseline algorithms. This indicates that the proposed AIFE scheme has potential for improving the detection and diagnosis of brain tumors.

PMID: 27786240 [PubMed - in process]

http://ift.tt/2e3MIRq

Do demographics and tumour-related factors affect nodal yield at neck dissection? A retrospective cohort study.

Do demographics and tumour-related factors affect nodal yield at neck dissection? A retrospective cohort study.

J Laryngol Otol. 2016 Oct 27;:1-5

Authors: Lim RS, Evans L, George AP, de Alwis N, Stimpson P, Merriel S, Giddings CE, Billah B, Smith JA, Safdar A, Sigston E

Abstract
BACKGROUND: Nodal metastasis is an important prognostic factor in head and neck squamous cell carcinoma. This study aimed to determine the average nodal basin yield per level of neck dissection, and to investigate if age, gender, body mass index, tumour size, depth of tumour invasion and p16 status influence nodal yield.
METHOD: A retrospective review of 185 patients with head and neck squamous cell carcinoma generated 240 neck dissection specimens.
RESULTS: The respective mean nodal yields for levels I, II, III, IV and V were 5.27, 9.43, 8.49, 7.43 and 9.02 in non-cutaneous squamous cell carcinoma patients, and 4.2, 7.57, 9.65, 4.33 and 12.29 in cutaneous squamous cell carcinoma patients. Multiple regression analysis revealed that p16-positive patients with mucosal squamous cell carcinoma yielded, on average, 2.4 more nodes than their p16-negative peers (p = 0.04, 95 per cent confidence interval = 0.116 to 4.693). This figure was 3.84 (p = 0.008, 95 per cent confidence interval = 1.070 to 6.605) for p16-positive patients with oral cavity squamous cell carcinoma.
CONCLUSION: In mucosal squamous cell carcinoma, p16-positive status significantly influenced nodal yield, with the impact being more pronounced in oral cavity squamous cell carcinoma patients.

PMID: 27786150 [PubMed - as supplied by publisher]

http://ift.tt/2eYsuGj

Temporomandibular disorder in otolaryngology: systematic review.

Temporomandibular disorder in otolaryngology: systematic review.

J Laryngol Otol. 2016 Oct 27;:1-7

Authors: Stepan L, Shaw CL, Oue S

Abstract
BACKGROUND: Temporomandibular disorder poses a diagnostic challenge to otolaryngologists as orofacial pain, headache and otology symptoms are very common in temporomandibular disorder, and mimic a number of otolaryngological conditions. Missed diagnosis of temporomandibular disorder can lead to unnecessary investigation and treatment, resulting in further patient suffering.
OBJECTIVES: To review the current literature and propose management pathways for otolaryngologists to correctly differentiate temporomandibular disorder from other otolaryngological conditions, and to initiate effective treatment for temporomandibular disorder in collaboration with other health professionals.
METHOD: A systematic review using PubMed and Medline databases was conducted, and data on temporomandibular disorder in conjunction with otolaryngological symptoms were collected for analysis.
RESULTS: Of 4155 potential studies, 33 were retrieved for detailed evaluation and 12 met the study criteria. There are questionnaires, examination techniques and radiological investigations presented in the literature to assist with distinguishing between otolaryngological causes of symptoms and temporomandibular disorder. Simple treatment can be initiated by the otolaryngologist.
CONCLUSION: Initial temporomandibular disorder treatment steps can be undertaken by the otolaryngologist, with consideration of referral to dentists, oral and maxillofacial surgeons, or physiotherapists if simple pharmacological treatment or temporomandibular disorder exercise fails.

PMID: 27786149 [PubMed - as supplied by publisher]

http://ift.tt/2e3OMIZ

Cardiopulmonary functions and adenotonsillectomy: surgical indications need revision.

Cardiopulmonary functions and adenotonsillectomy: surgical indications need revision.

J Laryngol Otol. 2016 Oct 27;:1-5

Authors: Mahajan M, Thakur JS, Azad RK, Mohindroo NK, Negi PC

Abstract
OBJECTIVE: To assess cardiac functions in adenotonsillar or tonsillar hypertrophy.
METHODS: A prospective, interventional, academic centre based study was conducted on 25 children with adenotonsillar or tonsillar hypertrophy. All patients underwent pulsed 2-dimensional Doppler echocardiography, pulse oximetry and 12-lead electrocardiography. These assessments were repeated three months later to determine the impact of adenotonsillectomy.
RESULTS: There were significant differences in mean arterial oxygen saturation, pulmonary flow acceleration time and mean pulmonary artery pressure post-operatively. Adenotonsillectomy led to significant improvements in pulmonary flow acceleration time and pulmonary flow velocity time index, while tonsillectomy resulted in right ventricular early and late diastolic velocity index improvement.
CONCLUSION: Upper airway obstruction in children affects cardiac functioning and this can subsequently lead to morbidity and delayed growth. Hence, revision of surgical indications is advocated in adenotonsillar hypertrophy to avoid irreversible damage to cardiopulmonary functions.

PMID: 27786148 [PubMed - as supplied by publisher]

http://ift.tt/2eYwjLQ

Anticholinergic medication use is associated with globus pharyngeus.

Anticholinergic medication use is associated with globus pharyngeus.

J Laryngol Otol. 2016 Oct 27;:1-5

Authors: Haft S, Carey RM, Farquhar D, Mirza N

Abstract
BACKGROUND: Globus pharyngeus has been linked to salivary hypofunction. We hypothesise that a considerable portion of the globus experienced by patients is due to a drying effect secondary to anticholinergic medication use; this study aimed to determine their association.
METHODS: A cross-sectional study was conducted of 270 patients who presented to a laryngology practice over 6 months. Participants rated globus sensation on a 5-point severity scale, with those scoring 0 considered as controls (non-globus). Participants were excluded if they had a likely cause of globus. Scores were compared with participants' medication lists, co-morbidities, age and gender, and evaluated using multivariate analysis, with significance set at p < 0.05.
RESULTS: Any participant taking at least 2 anticholinergic medications had a 3.52 increased odds (p = 0.02) of experiencing globus. A previous diagnosis of gastroesophageal reflux disease was also significantly associated with globus (p = 0.004), with an odds ratio of 3.75.
CONCLUSION: A substantial portion of idiopathic globus may be due to anticholinergic use or reflux. The findings implicate medication use as a risk factor for globus. An awareness of these associations is invaluable for identifying cause and treating globus.

PMID: 27786147 [PubMed - as supplied by publisher]

http://ift.tt/2e3ONN5

Real-time genomic characterization utilizing circulating cell-free DNA in patients with anaplastic thyroid carcinoma.

Real-time genomic characterization utilizing circulating cell-free DNA in patients with anaplastic thyroid carcinoma.

Thyroid. 2016 Oct 27;

Authors: Sandulache VC, Williams MD, Lai SY, Lu C, William WN, Busaidy N, Cote GJ, Singh R, Luthra R, Cabanillas M

Abstract
BACKGROUND: Anaplastic thyroid carcinoma (ATC) is an aggressive disease which requires rapid diagnosis and multimodality treatment. Recent advances in targeted therapeutics provide ATC patients with previously unavailable treatment options, which may improve clinical outcomes in the coming years. Continued development of high throughput next generation sequencing provides clinicians with an unparalleled ability to characterize the genomic background of tumors in order to guide treatment selection and clinical trial enrollment.
METHODS: We evaluated 23 patients with ATC treated at the University of Texas MD Anderson Cancer Center (UTMDACC) between 8/2015 and 4/2016. All patients underwent next generation sequencing using an institutional tissue-based DNA platform (50 genes) and a commercially available cell-free circulating DNA (cfDNA) platform (70 genes).
RESULTS: Sequencing data was successfully obtained for both platforms on all patients. The most commonly mutated genes noted on both platforms were TP53 (15/23, 65%) and BRAF (11/23, 48%). Concordance between the tumor and cfDNA data was high for BRAF, PIK3CA, NRAS, PTEN and moderate for TP53. Concordance was highest in patients who underwent dual platform sequencing prior to initiation of definitive treatment and lowest in patients who underwent cfDNA analysis following treatment. Nineteen patients had treatment at UTMDACC following cfDNA sequencing. One patient was observed and 3 patients opted for hospice. At time of last contact 15/23 (65%) patients were alive.
CONCLUSIONS: Next generation sequencing platforms offer clinicians an opportunity to identify targetable oncogenic events in ATC. To our knowledge, this is the largest sequential cohort of ATC patients who have undergone targeted genomic profiling. Based on these data, we recommend utilization of both tumor-based and cfDNA analysis in the context of clinical trial development and application. Integration of these or similar platforms in clinical trials implementation may have the potential to transform clinical outcomes for patients with ATC.

PMID: 27785980 [PubMed - as supplied by publisher]

http://ift.tt/2eWLfLx

Comparing Hypertropia in Upgaze and Downgaze Distinguishes Congenital From Acquired Fourth Nerve Palsies.

Background: Isolated fourth nerve palsies are commonly caused by decompensation of a congenitally dysfunctional superior oblique muscle ("decompensated congenital palsies"). Distinguishing such palsies at initial presentation from palsies caused by presumed microvascular ischemia ("ischemic palsies") has value for patient reassurance and in forestalling ancillary testing. Abnormally large vertical fusional amplitudes traditionally have been used to identify decompensated congenital palsies, but that may not be a reliable distinguishing feature. This study was undertaken to determine if the amount of hypertropia in upgaze and downgaze might be a more efficient separator. We also studied traumatic and tumorous fourth nerve palsies to see if they could be distinguished from decompensated congenital palsies by using this hypertropia comparison. Methods: Retrospective review of case records of patients diagnosed with isolated fourth nerve palsies at the University of Michigan Neuro-Ophthalmology Clinics over the past 15 years. We recorded the age, gender, vascular risk factors, duration of follow-up, cause, side of palsy, and alignment measurements in all patients. Results: Inclusion criteria were met by 118 patients. Hypertropia was equal or greater in upgaze than downgaze in 50 of the 58 decompensated congenital palsies (86%) in whom those data were recorded. Hypertropia was never greatest in upgaze in the 15 patients with traumatic palsies. Vertical fusional amplitudes were increased in only 15 of 27 patients (56%) with decompensated palsies in whom those data were recorded. Torsional misalignment on double Maddox rod testing was present in 16 (94%), 13 (87%), and 3 (100%) patients with ischemic, traumatic, and tumorous palsies, but also in 19 patients (54%) with decompensated congenital palsies in whom those data were recorded. Conclusions: Hypertropia greater in upgaze than downgaze or equal in upgaze and downgaze was an efficient separator of congenital from ischemic and tumorous fourth nerve palsies, being characteristic of patients with decompensated congenital palsies and never present in patients with ischemic, traumatic, or tumorous palsies. Vertical fusional amplitudes and torsional misalignment did not effectively differentiate between the patient groups. Comparing the hypertropia in upgaze and downgaze improved differential diagnosis and reduces the potential for unnecessary ancillary tests. (C) 2016 by North American Neuro-Ophthalmology Society

http://ift.tt/2dS608O

Literature Commentary.

In this issue of Journal of Neuro-Ophthalmology, Tariq Bhatti, MD and Mark Moster, MD, will discuss the following 6 articles: 1. Granet DB, Hodgson N, Godfrey KJ, Ventura R, Kikkawa DO, Levi L, Kinori M. Chemodenervation of extraocular muscles with botulinum toxin in thyroid eye disease. Graefes Arch Clin Exp Ophthalmol. 2016;254:999-1003. 2. Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, Kuntz N, Massey JM, Melms A, Murai H, Nicolle M, Palace J, Richman DP, Verschuuren J, Narayanaswami P. International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016;87:419-425. 3. Vodopivec I, Oakley DH, Perugino CA, Venna N, Hedley-Whyte ET, Stone JH. A 44-year-old man with eye, kidney, and brain dysfunction. Ann Neurol. 2016;79:507-519. 4. Martens C, Goplen FK, Nordfalk KF, Aasen T, Nordahl SH. Prevalence and characteristics of positional nystagmus in normal subjects. Otolaryngol Head Neck Surg. 2016;154:861-867. 5. Tur C, Goodkin O, Altmann DR, Jenkins TM, Miszkiel K, Mirigliani A, Fini C, Gandini Wheeler-Kingshott CA, Thompson AJ, Ciccarelli O, Toosy AT. Longitudinal evidence for anterograde trans-synaptic degeneration after optic neuritis. Brain. 2016;139:816-828. 6. Zhang Z, Wu S, Jonas JB, Zhang J, Liu K, Lu Q, Wang N. Dynein, kinesin and morphological changes in optic nerve axons in a rat model with cerebrospinal fluid pressure reduction: the Beijing Intracranial and Intraocular Pressure (iCOP) study. Acta Opthalmologica. 2016;94:266-275. (C) 2016 by North American Neuro-Ophthalmology Society

http://ift.tt/2flRYSb

Temporary Lumbar Drain as Treatment for Pediatric Fulminant Idiopathic Intracranial Hypertension.

Fulminant idiopathic intracranial hypertension (FIIH) is a subtype of idiopathic intracranial hypertension (IIH) characterized by rapid, severe, progressive vision loss. Surgical intervention is often performed either as a cerebrospinal fluid (CSF) shunt procedure or an optic nerve sheath fenestration or, at times, both. These surgical procedures carry a significant risk of morbidity and failure. We present 2 patients in whom a temporary lumbar drain was successfully used in the management of medically undertreated pediatric FIIH, and circumvented the need for surgical intervention. (C) 2016 by North American Neuro-Ophthalmology Society

http://ift.tt/2dS4fsg

Maxillofacial Infections of Odontogenic Origin: Epidemiological, Microbiological and Therapeutic Factors in an Indian Population

Abstract

Odontogenic fascial space infections are commonly encountered by the oral and maxillofacial surgeon. A retrospective study of the epidemiological characteristics, microbiological analysis and treatment response to odontogenic infections treated in the oral and maxillofacial unit of a Dental school is presented. A retrospective analysis of case records of all odontogenic infections that reported to the oral and maxillofacial surgery unit in a Dental school over a period of 2 years was performed. Epidemiological data, microbiological profile and treatment responses were analysed. All data were subjected to statistical analysis using SPSS statistical package. Mann–Whitney U test, Kruskal–Wallis test and nonparametric tests were carried out. A total of 2,140 patients were included in this study. Mandibular third molars were the offending tooth in nearly 40 % of cases with 107 patients becoming symptomatic following a dental extraction procedure. All patients were treated with surgical incision and drainage, antibiotics and local wound care. More than 95 % cases needed intraoral incisions. Penicillin was the drug in most of the cases. The pterygomandibular space was the most commonly involved with 15 % reporting with multiple fascial space involvement. Microbiological analysis showed a predominance of aerobic gram positive organisms with Streptococcus sanguis most commonly isolated. Peptostreptococci and Propionibacterium were the common anaerobes isolated. More than 80 % of the strains isolated were sensitive to penicillin. The average length of stay was 6.3 days. Inadequate documentation with regards to referral patterns, antibiotic history was commonly observed in case records. Penicillin continues to remain the drug of choice for a vast majority of maxillofacial infections of odontogenic origin. A delay in reporting can lead to worsening of symptoms with consequent increase in surgical morbidity and costs of treatment. Preventive dental care remains the best option available to mitigate the consequences of poor oral hygiene. Poor awareness among patient population for regular dental reviews and oral hygiene maintenance emphasises the need for sensitisation and education programs.

http://ift.tt/2eBFPYe

A Clinico-Pathological Study of Cervical Lymph Nodes

Abstract

Cervical lymphadenopathy is one of the commonest presenting complaint of patient in ENT OPD Fine Needle Aspiration Cytology (FNAC) is one of the most reliable, less expensive, and basic diagnostic procedure for the definitive and conclusive diagnosis for the immune system which reciprocates in the form of enlarged lymph nodes. A study was conducted in ENT Department of Santosh Medical College, Ghazibad from August 2015 to May 2016 on 64 patients with enlarged cervical lymph nodes. FNAC was done to make the diagnosis. Out of 64 patients (51.5 %) was reactive non-specific, 28 % tubercular, 3.1 % lymphoma and 17 % were malignant. FNAC is one of the most dependable diagnostic tools in case of cervical lymphadenopathy for early diagnosis and detection for the better management.

http://ift.tt/2eTa0IJ

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Abstract

Vasoconstrictors agents is used in septal surgery, in attempt to improve haemostasis and thereby improve the surgical field. We aimed to compare the effect of lignocaine with adrenaline injection and alone lignocaine injection with topical adrenalin on perioperative hemodynamic effect, hemorrhage and postoperative pain. Patients undergoing surgery were randomised into two groups: group I in whom infiltration was performed with lignocaine (2 %) with adrenaline (1:100,000), group II in whom infiltration was performed with lignocaine (2 %) injection with topical adrenalin application (1:10,000). The two groups were matched by age, sex, body weight, pre-anesthesia blood pressure, heart rate, oxygen pressure and hemorrhage. The hemostatic effects postoperative pain in each group were analyzed. No statistically significant differences in operation time, hemodynamic effect, and intraoperative blood loss were reached between the two groups of patients (p > 0.05). But also group I had significantly better pain scores versus control group in the 2nd, 4th, 6th postoperative hours (p < 0.05). We suggest that the use of adrenaline infiltration during septal surgery is unnecessary and may subject the patient to the risk of cardiogenic side-effects of systemic absorption.

http://ift.tt/2eBHKMj

Otological Manifestations of Nonseptic Lateral Sinus Thrombosis: A Review

Abstract

Nonseptic lateral sinus thrombosis differs from septic lateral sinus thrombosis in that it is not associated with ear or sinus infection. Etiologies of these conditions are different and management of these conditions are different. Nonseptic lateral sinus thrombosis requires medical line of management and anticoagulant therapy where as septic lateral sinus thrombosis treatment involves surgical exploration of the mastoid cavity, sinus decompression, and long-term antibiotic therapy. Mastoid changes are frequently detected on computed tomography or magnetic resonance imaging in cases of nonseptic lateral sinus thrombosis. An otolaryngologic evaluation is usually required to exclude coexisting mastoiditis. An otologist should be familiar with the septic lateral sinus thrombosis and existence of nonseptic variant lateral sinus thrombosis for early recognition and initiation of appropriate treatment.

http://ift.tt/2eBIfpP

Maxillofacial Infections of Odontogenic Origin: Epidemiological, Microbiological and Therapeutic Factors in an Indian Population

Abstract

Odontogenic fascial space infections are commonly encountered by the oral and maxillofacial surgeon. A retrospective study of the epidemiological characteristics, microbiological analysis and treatment response to odontogenic infections treated in the oral and maxillofacial unit of a Dental school is presented. A retrospective analysis of case records of all odontogenic infections that reported to the oral and maxillofacial surgery unit in a Dental school over a period of 2 years was performed. Epidemiological data, microbiological profile and treatment responses were analysed. All data were subjected to statistical analysis using SPSS statistical package. Mann–Whitney U test, Kruskal–Wallis test and nonparametric tests were carried out. A total of 2,140 patients were included in this study. Mandibular third molars were the offending tooth in nearly 40 % of cases with 107 patients becoming symptomatic following a dental extraction procedure. All patients were treated with surgical incision and drainage, antibiotics and local wound care. More than 95 % cases needed intraoral incisions. Penicillin was the drug in most of the cases. The pterygomandibular space was the most commonly involved with 15 % reporting with multiple fascial space involvement. Microbiological analysis showed a predominance of aerobic gram positive organisms with Streptococcus sanguis most commonly isolated. Peptostreptococci and Propionibacterium were the common anaerobes isolated. More than 80 % of the strains isolated were sensitive to penicillin. The average length of stay was 6.3 days. Inadequate documentation with regards to referral patterns, antibiotic history was commonly observed in case records. Penicillin continues to remain the drug of choice for a vast majority of maxillofacial infections of odontogenic origin. A delay in reporting can lead to worsening of symptoms with consequent increase in surgical morbidity and costs of treatment. Preventive dental care remains the best option available to mitigate the consequences of poor oral hygiene. Poor awareness among patient population for regular dental reviews and oral hygiene maintenance emphasises the need for sensitisation and education programs.

http://ift.tt/2eBFPYe

A Clinico-Pathological Study of Cervical Lymph Nodes

Abstract

Cervical lymphadenopathy is one of the commonest presenting complaint of patient in ENT OPD Fine Needle Aspiration Cytology (FNAC) is one of the most reliable, less expensive, and basic diagnostic procedure for the definitive and conclusive diagnosis for the immune system which reciprocates in the form of enlarged lymph nodes. A study was conducted in ENT Department of Santosh Medical College, Ghazibad from August 2015 to May 2016 on 64 patients with enlarged cervical lymph nodes. FNAC was done to make the diagnosis. Out of 64 patients (51.5 %) was reactive non-specific, 28 % tubercular, 3.1 % lymphoma and 17 % were malignant. FNAC is one of the most dependable diagnostic tools in case of cervical lymphadenopathy for early diagnosis and detection for the better management.

http://ift.tt/2eTa0IJ

Hemodynamic Effects of Topical Adrenaline During Septoplasty

Abstract

Vasoconstrictors agents is used in septal surgery, in attempt to improve haemostasis and thereby improve the surgical field. We aimed to compare the effect of lignocaine with adrenaline injection and alone lignocaine injection with topical adrenalin on perioperative hemodynamic effect, hemorrhage and postoperative pain. Patients undergoing surgery were randomised into two groups: group I in whom infiltration was performed with lignocaine (2 %) with adrenaline (1:100,000), group II in whom infiltration was performed with lignocaine (2 %) injection with topical adrenalin application (1:10,000). The two groups were matched by age, sex, body weight, pre-anesthesia blood pressure, heart rate, oxygen pressure and hemorrhage. The hemostatic effects postoperative pain in each group were analyzed. No statistically significant differences in operation time, hemodynamic effect, and intraoperative blood loss were reached between the two groups of patients (p > 0.05). But also group I had significantly better pain scores versus control group in the 2nd, 4th, 6th postoperative hours (p < 0.05). We suggest that the use of adrenaline infiltration during septal surgery is unnecessary and may subject the patient to the risk of cardiogenic side-effects of systemic absorption.

http://ift.tt/2eBHKMj

Otological Manifestations of Nonseptic Lateral Sinus Thrombosis: A Review

Abstract

Nonseptic lateral sinus thrombosis differs from septic lateral sinus thrombosis in that it is not associated with ear or sinus infection. Etiologies of these conditions are different and management of these conditions are different. Nonseptic lateral sinus thrombosis requires medical line of management and anticoagulant therapy where as septic lateral sinus thrombosis treatment involves surgical exploration of the mastoid cavity, sinus decompression, and long-term antibiotic therapy. Mastoid changes are frequently detected on computed tomography or magnetic resonance imaging in cases of nonseptic lateral sinus thrombosis. An otolaryngologic evaluation is usually required to exclude coexisting mastoiditis. An otologist should be familiar with the septic lateral sinus thrombosis and existence of nonseptic variant lateral sinus thrombosis for early recognition and initiation of appropriate treatment.

http://ift.tt/2eBIfpP