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Παρασκευή, 28 Ιουλίου 2017

Erratum

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Publication date: Available online 27 July 2017
Source:Annals of Allergy, Asthma & Immunology





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Prenatal particulate matter exposure and wheeze in Mexican children: effect modification by prenatal psychosocial stress

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Publication date: Available online 27 July 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Maria José Rosa, Allan C. Just, Itai Kloog, Ivan Pantic, Lourdes Schnaas, Alison Lee, Sonali Bose, Yueh-Hsiu Mathilda Chiu, Hsiao-Hsien Leon Hsu, Brent Coull, Joel Schwartz, Sheldon Cohen, Martha María Téllez Rojo, Robert O. Wright, Rosalind J. Wright
BackgroundAir pollution exposure in childhood is associated with greater incidence and exacerbation of asthma, particularly in children whose parents report high levels of psychological stress. However, this interaction has not been completely elucidated in pregnancy.ObjectiveTo examine whether the association between prenatal exposure to particulate matter no larger than 2.5 μm in diameter (PM2.5) and wheeze in children is modified by prenatal stress.MethodsMexican women were recruited during pregnancy (N = 552). Residential prenatal daily exposure to PM2.5 was estimated using a satellite-based spatiotemporally resolved prediction model and averaged over trimesters. Maternal stress was indexed by maternal negative life events (NLE) score (range 0–11) ascertained during mid to late pregnancy. NLE scores were dichotomized at the median as low (NLE score ≤ 3) and high (NLE score > 3) stress. Reports of ever wheeze and wheeze in the past 12 months (current wheeze) for children were obtained using the International Study of Asthma and Allergies in Childhood survey at 48 months. The association between prenatal PM2.5 and wheeze was analyzed using a modified Poisson regression and stratified by low vs high stress.ResultsGreater PM2.5 exposure during the first trimester was associated with increased risk of current wheeze among children with mothers reporting high prenatal stress (relative risk 1.35, 95% confidence interval 1.00–1.83, per interquartile range increase 3.8 μg/m3) but not among those reporting low stress (relative risk 0.84, 95% confidence interval 0.61–1.16, per interquartile range increase 3.8 μg/m3; P for interaction = .04).ConclusionIncreased prenatal stress enhanced the association between PM2.5 exposure in early pregnancy, and child wheeze at 48 months of age. It is important to consider chemical and nonchemical stressors together to more comprehensively characterize children's environmental risk.



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Vitamin D, high-sensitivity C-reactive protein, and airway hyperresponsiveness in infants with recurrent respiratory symptoms

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Publication date: Available online 28 July 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Anette M. Määttä, Anne Kotaniemi-Syrjänen, Kristiina Malmström, L. Pekka Malmberg, Jouko Sundvall, Anna S. Pelkonen, Mika J. Mäkelä
BackgroundVitamin D insufficiency might be associated with biased T-cell responses resulting in inflammatory conditions such as atopy and asthma. Little is known about the role of vitamin D in low-grade systemic inflammation and airway hyperresponsiveness (AHR) in young children.ObjectiveTo evaluate whether vitamin D insufficiency and increased serum high-sensitivity C-reactive protein (hs-CRP) are linked to AHR in symptomatic infants.MethodsSeventy-nine infants with recurrent or persistent lower respiratory tract symptoms underwent comprehensive lung function testing and a bronchial methacholine challenge test. In addition, skin prick tests were performed and serum 25-hydroxyvitamin D (S-25-OHD), hs-CRP, total immunoglobulin E, and blood eosinophil levels were determined.ResultsS-25-OHD was lowest in infants with blood eosinophilia and AHR (n = 10) compared with those with eosinophilia only (n = 6) or AHR only (n = 50) or those with neither (n = 13; P = .035). Moreover, vitamin D insufficiency (S-25-OHD <50 nmol/L) was most common in infants with blood eosinophilia and AHR (P = .041). Serum hs-CRP was lower in infants with recurrent physician-diagnosed wheezing (P = .048) and in those with blood eosinophilia (P = .015) than in infants without these characteristics and was not associated with S-25-OHD or AHR. S-25-OHD levels were significantly lower (median 54 nmol/L) during the autumn-winter season than in the spring-summer season (median 63 nmol/L; P = .026).ConclusionVitamin D insufficiency could underlie eosinophilia and AHR in infants with troublesome lung symptoms, whereas hs-CRP–mediated low-grade systemic inflammation is rare in early childhood wheezing.



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Oncogenic signalling pathways in benign odontogenic cysts and tumours

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Publication date: September 2017
Source:Oral Oncology, Volume 72
Author(s): Marina Gonçalves Diniz, Carolina Cavalieri Gomes, Sílvia Ferreira de Sousa, Guilherme Machado Xavier, Ricardo Santiago Gomez
The first step towards the prevention of cancer is to develop an in-depth understanding of tumourigenesis and the molecular basis of malignant transformation. What drives tumour initiation? Why do most benign tumours fail to metastasize? Oncogenic mutations, previously considered to be the hallmark drivers of cancers, are reported in benign cysts and tumours, including those that have an odontogenic origin. Despite the presence of such alterations, the vast majority of odontogenic lesions are benign and never progress to the stage of malignant transformation. As these lesions are likely to develop due to developmental defects, it is possible that they harbour quiet genomes. Now the question arises – do they result from DNA replication errors? Specific candidate genes have been sequenced in odontogenic lesions, revealing recurrent BRAF mutation in the case of ameloblastoma, KRAS mutation in adenomatoid odontogenic tumours, PTCH1 mutation in odontogenic keratocysts, and CTNNB1 (Beta-catenin) mutation in calcifying odontogenic cysts. Studies on these benign and rare entities might reveal important information about the tumorigenic process and the mechanisms that hinder/halt neoplastic progression. This is because the role of relatively common oncogenic mutations seems to be context dependent. In this review, each mutation signature of the odontogenic lesion and the affected signalling pathways are discussed in the context of tooth development and tumorigenesis. Furthermore, behavioural differences between different types of odontogenic lesions are explored and discussed based on the molecular alteration described. This review also includes the employment of molecular results for guiding therapeutic approaches towards odontogenic lesions.



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Outcome following radiotherapy for head and neck basal cell carcinoma with ‘aggressive’ features

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Publication date: September 2017
Source:Oral Oncology, Volume 72
Author(s): Anupam Rishi, Shao Hui Huang, Brian O'Sullivan, David P Goldstein, Lin Lu, Jolie Ringash, John Waldron, Woody Wells, Alex Sun, Andrew Hope, Peter Chung, Meredith Giuliani, Anna Spreafico, Li Tong, Wei Xu, Andrew Bayley
ObjectivesThe literature demonstrates that 'aggressive' head-and-neck basal cell carcinomas (HN-BCC) have a higher than expected relapse rate with unfavorable outcomes. We report outcomes following definitive (dRT) or post-operative radiotherapy (PORT) for these tumors.MethodsWe reviewed all HN-BCC patients with 'aggressive' features (primary lesions diameter >10mm, >2 recurrences, or extra-cutaneous extension), treated with megavoltage dRT or PORT between 1998 and 2013. Loco-regional control (LRC) and relapse-free survival (RFS) were estimated using the competing risk method, and overall survival (OS) by Kaplan-Meier method. Univariable analysis explored factors associated with relapse.ResultsA total of 108 histologically confirmed 'aggressive' HN-BCC patients were identified, including 38 (35%) presenting de novo and 70 (65%) treated for recurrence (rBCC). dRT was offered to 72 (66.7%) patients and PORT to 36 (33.3%). Median follow-up was 3.5years. Actuarial 3-year LRC, RFS, and OS were 87% (95% confidence interval: 77–92), 82% (72–89), and 87% (80–94), respectively. LRC rates for dRT and PORT were similar [hazard ratio (HR) 0.61 (0.17–2.23), p=0.46]. Factors associated with higher risk of relapse were: rBCC [HR 7.96 (1.03–61.71), p=0.047], 'H-zone' (mid face, eyes, and ears) location [HR 3.13 (1.07–9.19), p=0.04], tumor size [HR 1.32 (1.08–1.6), p=0.006], nodal involvement [HR 3.68 (1.11–12.2), p=0.03] and stage [HR 3.13 (1.19–8.26), p=0.02].ConclusionRT is an effective treatment for 'aggressive' HN-BCC when used as a definitive modality or as PORT. Non-surgical management with definitive radiotherapy provides an alternative effective option if surgery is not used.



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Prognostic factors and occult nodal disease in mucoepidermoid carcinoma of the oral cavity and oropharynx: An analysis of the National Cancer Database

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Publication date: September 2017
Source:Oral Oncology, Volume 72
Author(s): Mark A. Ellis, Evan M. Graboyes, Terry A. Day, David M. Neskey
ObjectivesMucoepidermoid carcinoma (MEC) is an uncommon malignancy that most commonly occurs in the parotid gland followed by the minor salivary glands of the upper aerodigestive tract, most notably in the oral cavity (OC) and oropharynx (OP). Because of its rarity, few studies have been performed that are specific to MEC within the OC and OP. The objective of this study is to describe the tumor characteristics and prognostic features for MEC of the OC and OP.Materials and MethodsThe National Cancer Database (NCDB) was used for this study. The primary outcome measure was 5-year overall survival (OS). The secondary outcome measure was occult nodal disease. Fischer's exact tests, chi-square tests, log-rank tests and Cox proportional hazards analyses were performed.ResultsWe identified 3005 patients with MEC of the OC/OP. The 5-year overall survival for MEC of the OC and OP was 87%. Increasing age, male sex, Charlson/Deyo comorbidity score of 2+, clinical T3-4 tumors, nodal+disease, high grade tumors and positive margins were independently associated with decreased 5-year OS. Occult nodal disease occurred in 14.1% and 17.3% of high grade and clinical T3-T4 tumors respectively.ConclusionMEC of the OC/OP has an excellent survival as the majority of these patients have low/intermediate grade and early stage disease. Negative prognosticators include increasing age, male sex, Charlson/Deyo comorbidity score of 2+, clinical T3-4 tumors, nodal+ disease, high grade tumors and positive margins. Our findings justify strong consideration of prophylactic neck dissection for high grade and clinical T3-4 tumors.



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Metastatic malignant PEComa of the leg with identification of ATRX mutation by next-generation sequencing



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