Abstract The objective of this study was to analyze the presence of tumor-associated macrophage (TAM) subpopulations M1 and M2 in squamous cell carcinoma of the lower lip (SCCLL) by immunohistochemitry, and to evaluate the possible role of these subtypes in the development of regional lymph node metastasis and their association with clinical and pathological parameters. Forty-two cases of SCCLL were divided into two groups (21 with and 21 without regional lymph node metastasis). The histopathological grade of malignancy was determined and the material was submitted to double staining with anti-CD68/anti-CD163 and anti-CD68/anti-HLA-DR monoclonal antibodies. The results were analyzed statistically using the Wilcoxon signed-rank and Spearman correlation tests. The M1 and M2 subpopulations were observed in all cases studied. No significant difference was observed between the quantities of M1 and M2 TAMs regarding tumor size (p > 0.05). A significantly larger number of M2 compared to M1 TAMs was observed in tumors without regional lymph node metastasis, tumors in early stages, and low-grade tumors (p < 0.05). No significant difference between the numbers of M1 and M2 TAMs was observed in tumors with regional lymph node metastasis, tumors in advanced stages, and high-grade tumors (p > 0.05). There was a positive weak correlation between M1 and M2 TAMs (r = 0.361; p = 0.019). The results suggest a more important role of M2 TAMs in early stages than advanced stages of lip carcinogenesis. The progression of SCCLL does not seem to be related to an imbalance of macrophage polarization in the microenvironment of these tumors.
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Πέμπτη 18 Αυγούστου 2016
Tumor-associated macrophages (TAMs): clinical-pathological parameters in squamous cell carcinomas of the lower lip
The relevance of clinical and radiographic features of jaw lesions: A prospective study
Abstract The study was carried out in a Brazilian population and the aim was to describe the prevalence and the clinic-radiographical features of jaw lesions. In addition, a comparison between the main diagnosis hypothesis and final diagnosis was accessed. A prospective study which evaluated all patients with jaw lesions diagnosed in an Oral Diagnosis Center, between August 2013 and October 2014. A total of 450 patients were observed for the first time, and 130 had some type of jaw lesion. The mean age of the patients was 35.2 years ± 17.86. Among these, 71 were women (54.62%) and 87 were Caucasian (66.92%). The mandible was affected more frequently (71.43%) than the maxilla (28.57%). Swelling and pain were the most frequent clinical signs and symptoms and were observed in 60 (42.85%) and 38 (27.14%) cases, respectively. The panoramic x-ray was the main radiographic exam utilized (88.57%). Radiolucent lesions accounted for 89 cases (63.57%) and the unilocular form was present in 114 cases (81.43%). A total of 93 cases had histopathological analyses and the periapical cyst was the most frequent lesion. In the other 47 lesions, the diagnosis was conducted by clinical and radiographic management. Bone lesions were frequent, being noted on first visit in approximately 30% of patients; in 1/3 of the cases, the diagnoses were completed with a combination of clinical and radiographic exams.
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Trends in paediatric and adult bloodstream infections at a Ghanaian referral hospital: a retrospective study
Bloodstream infections (BSI) are life-threatening emergencies. Identification of the common pathogens and their susceptibility patterns is necessary for timely empirical intervention.
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Hepatic Sinusoidal Dilatation: A Review of Causes with Imaging-Pathologic Correlation
Hepatic sinusoids are vascular conduits connecting the portal triad with the central vein. Multiple conditions can lead to sinusoidal dilatation and congestion with resultant stasis of blood within the lumen. The altered hemodynamics associated with hepatic sinusoidal dilatation generally result in heterogeneous enhancement of the hepatic parenchyma on contrast-enhanced CT and MR imaging, a pattern often described as "mosaic" enhancement. In this manuscript we review the causes of hepatic sinusoidal dilatation and the imaging manifestations on contrast-enhanced CT and MR.
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Liver function Assessment by Magnetic Resonance Imaging
Liver function assessment by hepatocyte specific contrast-enhanced MR is becoming a new biomarker. Liver function can be assessed by T1 mapping (reduction rate), signal intensity measurement (relative enhancement ratio) before and after GD-EOB-DTPA (gadoxetic acid) administration, as alternative to Tc-99m galactosyl serum albumin scintigraphy, 99m Tc-labelled mebrofenin scintigraphy and indocyanine green clearance test. MRI assessment of liver function can enable diagnosis of cirrhosis, non-alcoholic fatty liver disease associated fibrosis and steatohepatitis, primary sclerosing cholangitis, toxic hepatitis, chemotherapy and radiotherapy related changes, which may be only visible on hepatobiliary phase images.
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Magnetic Resonance Imaging of Liver Metastasis
Liver magnetic resonance imaging (MRI) is becoming the gold standard in liver metastasis detection and treatment response assessment. The most sensitive MR sequences are diffusion weighted images and hepatobiliary phase images after Gd-EOB-DTPA. Peripheral ring enhancement, diffusion restriction and hypointensity on hepatobiliary phase images are hallmarks of liver metastases. In patients with normal ultrasonography (US), computed tomography (CT) and positron emission tomography (PET)-CT findings and high clinical suspicion of metastasis, MRI should be performed for diagnosis of unseen metastasis.
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Serratia marcescens on Mac Agar
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Microbiome: A Cultural Revolution
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Streptococcal Toxic Shock Syndrome: Life Saving Role of Peritoneal Lavage and Drainage
PURPOSE: We encountered a case where an infection with group A streptococcus (GAS; ie, Streptococcus pyogenes) initially caused primary peritonitis and then subsequently caused streptococcal toxic shock syndrome. The patient's life was likely saved by an emergency laparotomy followed by extensive peritoneal lavage and drainage. CASE PRESENTATION: A 40-year-old woman was admitted to the Emergency Department for lower abdominal pain and numbness in the extremities. She presented with systemic inflammatory response syndrome. An emergency laparotomy was performed, and ascites that resembled pus and general peritonitis were noted. Peritoneal lavage and drainage were performed, and GAS was isolated from peritoneal fluid. Gram staining of cervical polyp specimens revealed Gram-positive bacteria. CONCLUSIONS: The patient was diagnosed with streptococcal toxic shock syndrome due to an ascending GAS infection originating from vagina.
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microRNA-145 Mediates the Inhibitory Effect of Adipose Tissue-Derived Stromal Cells on Prostate Cancer
Stem Cells and Development , Vol. 0, No. 0.
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Effects of Pharmacological Agents on Human Amniotic Fluid-Derived Stem Cells in Culture
Stem Cells and Development , Vol. 0, No. 0.
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Paramedics receive PETA award after saving squirrel
ENFIELD, Conn. — After saving a squirrel with a cup stuck on its head, two paramedics are set to receive top honors from PETA.
Video of the rescue went viral last week, and has garnered over 300,000 page views on the Enfield EMS Facebook page.
"These rescuers' kindness and quick thinking saved this squirrel from the pain and terror of slowly starving to death or being run over by a car, unable to see around the cup stuck on his head," PETA Vice President of Communications Colleen O'Brien said.
Paramedics Ralph Armstrong and Keith Taylor used a blanket to capture the agitated mammal before pulling the cup off its head. In recognition of their kind act, PETA will bequeath the two with the Compassionate Action Award, as well as vegan cookies, reported WTNH.
"PETA reminds everyone to crush cans and cups before throwing them in the trash, in order to protect wildlife from getting trapped inside," said O'Brien.
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Genome-Wide Association Analysis Identifies Dcc as an Essential Factor in the Innervation of the Peripheral Vestibular System in Inbred Mice
Abstract
This study aimed to investigate the genetic causes of vestibular dysfunction. We used vestibular sensory-evoked potentials (VsEPs) to characterize the vestibular function of 35 inbred mouse strains selected from the Hybrid Mouse Diversity Panel and demonstrated strain-dependent phenotypic variation in vestibular function. Using these phenotypic data, we performed the first genome-wide association study controlling for population structure that has revealed two highly suggestive loci, one of which lies within a haplotype block containing five genes (Stard6, 4930503L19Rik, Poli, Mbd2, Dcc) on Chr. 18 (peak SNP rs29632020), one gene, deleted in colorectal carcinoma (Dcc) has a well-established role in nervous system development. An in-depth analysis of Dcc-deficient mice demonstrated elevation in mean VsEP threshold for Dcc +/− mice (−11.86 dB) compared to wild-type (−9.68 dB) littermates. Synaptic ribbon studies revealed Dcc −/− (P0) and Dcc +/− (6-week-old) mice showed lower density of the presynaptic marker (CtBP2) as compared to wild-type controls. Vestibular ganglion cell counts of Dcc −/− (P0) was lower than controls. Whole-mount preparations showed abnormal innervation of the utricle, saccule, and crista ampullaris at E14.5, E16.5, and E18.5. Postnatal studies were limited by the perinatal lethality in Dcc −/− mice. Expression analyses using in situ hybridization and immunohistochemistry showed Dcc expression in the mouse vestibular ganglion (E15.5), and utricle and crista ampullaris (6-week-old), respectively. In summary, we report the first GWAS for vestibular functional variation in inbred mice and provide evidence for the role of Dcc in the normal innervation of the peripheral vestibular system.
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Comparative Auditory Neuroscience: Understanding the Evolution and Function of Ears
Abstract
Comparative auditory studies make it possible both to understand the origins of modern ears and the factors underlying the similarities and differences in their performance. After all lineages of land vertebrates had independently evolved tympanic middle ears in the early Mesozoic era, the subsequent tens of millions of years led to the hearing organ of lizards, birds, and mammals becoming larger and their upper frequency limits higher. In extant species, lizard papillae remained relatively small (<2 mm), but avian papillae attained a maximum length of 11 mm, with the highest frequencies in both groups near 12 kHz. Hearing-organ sizes in modern mammals vary more than tenfold, up to >70 mm (made possible by coiling), as do their upper frequency limits (from 12 to >200 kHz). The auditory organs of the three amniote groups differ characteristically in their cellular structure, but their hearing sensitivity and frequency selectivity within their respective hearing ranges hardly differ. In the immediate primate ancestors of humans, the cochlea became larger and lowered its upper frequency limit. Modern humans show an unusual trend in frequency selectivity as a function of frequency. It is conceivable that the frequency selectivity patterns in humans were influenced in their evolution by the development of speech.
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Supercharging Reagent for Enhanced Liquid Chromatographic Separation and Charging of Sialylated and High-Molecular-Weight Glycopeptides for NanoHPLC–ESI-MS/MS Analysis
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Fizzy Extraction of Volatile and Semivolatile Compounds into the Gas Phase
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Genome-Wide Association Analysis Identifies Dcc as an Essential Factor in the Innervation of the Peripheral Vestibular System in Inbred Mice
Abstract
This study aimed to investigate the genetic causes of vestibular dysfunction. We used vestibular sensory-evoked potentials (VsEPs) to characterize the vestibular function of 35 inbred mouse strains selected from the Hybrid Mouse Diversity Panel and demonstrated strain-dependent phenotypic variation in vestibular function. Using these phenotypic data, we performed the first genome-wide association study controlling for population structure that has revealed two highly suggestive loci, one of which lies within a haplotype block containing five genes (Stard6, 4930503L19Rik, Poli, Mbd2, Dcc) on Chr. 18 (peak SNP rs29632020), one gene, deleted in colorectal carcinoma (Dcc) has a well-established role in nervous system development. An in-depth analysis of Dcc-deficient mice demonstrated elevation in mean VsEP threshold for Dcc +/− mice (−11.86 dB) compared to wild-type (−9.68 dB) littermates. Synaptic ribbon studies revealed Dcc −/− (P0) and Dcc +/− (6-week-old) mice showed lower density of the presynaptic marker (CtBP2) as compared to wild-type controls. Vestibular ganglion cell counts of Dcc −/− (P0) was lower than controls. Whole-mount preparations showed abnormal innervation of the utricle, saccule, and crista ampullaris at E14.5, E16.5, and E18.5. Postnatal studies were limited by the perinatal lethality in Dcc −/− mice. Expression analyses using in situ hybridization and immunohistochemistry showed Dcc expression in the mouse vestibular ganglion (E15.5), and utricle and crista ampullaris (6-week-old), respectively. In summary, we report the first GWAS for vestibular functional variation in inbred mice and provide evidence for the role of Dcc in the normal innervation of the peripheral vestibular system.
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Comparative Auditory Neuroscience: Understanding the Evolution and Function of Ears
Abstract
Comparative auditory studies make it possible both to understand the origins of modern ears and the factors underlying the similarities and differences in their performance. After all lineages of land vertebrates had independently evolved tympanic middle ears in the early Mesozoic era, the subsequent tens of millions of years led to the hearing organ of lizards, birds, and mammals becoming larger and their upper frequency limits higher. In extant species, lizard papillae remained relatively small (<2 mm), but avian papillae attained a maximum length of 11 mm, with the highest frequencies in both groups near 12 kHz. Hearing-organ sizes in modern mammals vary more than tenfold, up to >70 mm (made possible by coiling), as do their upper frequency limits (from 12 to >200 kHz). The auditory organs of the three amniote groups differ characteristically in their cellular structure, but their hearing sensitivity and frequency selectivity within their respective hearing ranges hardly differ. In the immediate primate ancestors of humans, the cochlea became larger and lowered its upper frequency limit. Modern humans show an unusual trend in frequency selectivity as a function of frequency. It is conceivable that the frequency selectivity patterns in humans were influenced in their evolution by the development of speech.
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Expression of amphiregulin in mucoepidermoid carcinoma of the major salivary glands: a molecular and clinicopathological study
Publication date: November 2016
Source:Human Pathology, Volume 57
Author(s): Hitomi Shinomiya, Yohei Ito, Mie Kubo, Koichiro Yonezawa, Naoki Otsuki, Shigemichi Iwae, Hiroshi Inagaki, Ken-ichi Nibu
In mucoepidermoid carcinoma (MEC), CRTC1-MAML2 fusion indicates a favorable prognosis. Amphiregulin (AREG), an epidermal growth factor receptor (EGFR) ligand, has been shown to be a downstream target of CRTC1-MAML2 fusion, and to play a role in tumor growth and survival in CRTC1-MAML2–positive MEC cell lines. The aim of this study was to characterize the AREG and EGFR expression in the fusion-positive and fusion-negative MEC of the major salivary gland. The AREG and EGFR expression were studied by immunochemistry in 33 MEC cases of the major salivary glands. CRTC1-MAML2 fusion was tested by reverse-transcription polymerase chain reaction (23 CRTC1-MAML2 fusion-positive, 10 fusion-negative). Of 23 fusion-positive cases, AREG and EGFR overexpression were detected in 17 (73.9%) and 14 (60.9%) cases, respectively. Of 10 fusion-negative cases, AREG and EGFR overexpression were detected in 1 (10%) and 3 (30.0%) cases, respectively. There was a positive correlation between CRTC1-MAML2 fusion and AREG overexpression (P < .01), but not between CRTC1-MAML2 fusion and EGFR overexpression. The AREG overexpression was associated with a longer disease-free survival of the MEC patients (P = .042), but EGFR overexpression was not. In this study, we showed that AREG overexpression was detected more frequently in the CRTC1-MAML2 fusion-positive tumors than in fusion-negative tumors. Detection of AREG expression may be useful for identifying CRTC1-MAML2–positive MECs and as a marker for favorable prognosis.
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Indolent T-cell lymphoproliferative disease of the gastrointestinal tract after treatment with adalimumab in resistant Crohn's colitis
Publication date: November 2016
Source:Human Pathology, Volume 57
Author(s): Natalia Edison, Hila Belhanes-Peled, Yuval Eitan, Yifat Guthmann, Yelena Yeremenko, Mark Raffeld, Irit Elmalah, Philippe Trougouboff
We report a case of intestinal indolent T-cell lymphoproliferative disease (TCLPD) occurring after the initiation of tumor necrosis factor–α (TNF-α) inhibitor therapy for resistant Crohn's disease. A prominent T-cell infiltrate positive for CD8, TIA-1, and T-cell receptor–βF1 was associated with the foci of active inflammation. T-cell receptor gene clonality studies (BIOMED-2) demonstrated monoclonality. After the TNF-α inhibitor treatment was withdrawn, the T-cell infiltrates regressed, but 2 years later, the same monoclonal T-cell infiltrate reappeared at the only site of active inflammation. To the best of our knowledge, this report is the first to show a link between active inflammation and the TCLPD. In addition, it suggests a possible influence of the TNF-α inhibitor treatment on the evolution of the TCLPD. A high degree of suspicion is required in the presence of any unusual lymphoid infiltrate in inflammatory bowel disease to avoid overlooking an indolent TCLPD or misdiagnose an aggressive lymphoma.
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Validation of an electronic program for pathologist training in the interpretation of a complex companion diagnostic immunohistochemical assay
Publication date: October 2016
Source:Human Pathology, Volume 56
Author(s): Eslie Dennis, Peter Banks, Lauren B. Murata, Stephanie A. Sanchez, Christie Pennington, Linda Hockersmith, Rachel Miller, Jess Lambe, Janine Feng, Monesh Kapadia, June Clements, Isabell Loftin, Shalini Singh, Ashis Das-Gupta, William Lloyd, Kenneth Bloom
Companion diagnostics assay interpretation can select patients with the greatest targeted therapy benefits. We present the results from a prospective study demonstrating that pathologists can effectively learn immunohistochemical assay–interpretation skills from digital image–based electronic training (e-training). In this study, e-training was used to train board-certified pathologists to evaluate non–small cell lung carcinoma for eligibility for treatment with onartuzumab, a MET-inhibiting agent. The training program mimicked the live training that was previously validated in clinical trials for onartuzumab. A digital interface was developed for pathologists to review high-resolution, static images of stained slides. Sixty-four pathologists practicing in the United States enrolled while blinded to the type of training. After training, both groups completed a mandatory final test using glass slides. The results indicated both training modalities to be effective. Overall, 80.6% of e-trainees and 72.7% of live trainees achieved passing scores (at least 85%) on the final test. All study participants reported that their training experience was "good" and that they had received sufficient information to determine the adequacy of case slide staining to score each case. This study established that an e-training program conducted under highly controlled conditions can provide pathologists with the skills necessary to interpret a complex assay and that these skills can be equivalent to those achieved with face-to-face training using conventional microscopy. Programs of this type are scalable for global distribution and offer pathologists the potential for readily accessible and robust training in new companion diagnostic assays linked to novel, targeted, adjuvant therapies for cancer patients.
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Moleculo Facilitates Assembly and Binning from Soil
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Facial fractures in football: incidence, site, and mechanism of injury
Publication date: Available online 18 August 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): S.Y. Kim, C.L. Chan, D.M. Hyam
Football injuries are responsible for many of the maxillofacial injuries sustained during sporting activities. In the Australian Capital Territory (ACT), the four major types of Australian football are played in large numbers and up to a high standard. Our objective was to analyse maxillofacial fractures that were sustained during rugby league, rugby union, Australian rules, and soccer matches. We retrospectively studied 134 patients with maxillofacial fractures during the five-year period 2010-14. All patients were assessed and treated at Canberra Hospital, the major trauma centre in the ACT. Data collected from patients' records included type of football, age, sex, mechanism of injury, site of injury, and treatment. The number of people registered to play was obtained from each football governing body to find out the incidence of fractures. League had the highest incidence of facial fractures, followed by union, Australian rules, and soccer. High speed and high collision football (league and union) had a higher rate of mandibular fractures than high speed and low contact football (Australian rules and soccer) (n=43, 45% compared with n=7, 21%). Australian rules and soccer had a higher incidence of midface fractures than league and union (n=26, 79%, compared with n=52, 55%). Clash of heads was the leading cause of fractures. Collisions against other players' shoulders and forearms were more likely to cause mandible fractures. Ninety-four patients (70%) required surgical intervention. Football-related maxillofacial fractures occur regularly, and different types of football have predictable patterns of injury. Padding of the heads and elbows of players may reduce the number and seriousness of facial fractures.
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GPU-based RFA simulation for minimally invasive cancer treatment of liver tumours
Abstract
Purpose
Radiofrequency ablation (RFA) is one of the most popular and well-standardized minimally invasive cancer treatments (MICT) for liver tumours, employed where surgical resection has been contraindicated. Less-experienced interventional radiologists (IRs) require an appropriate planning tool for the treatment to help avoid incomplete treatment and so reduce the tumour recurrence risk. Although a few tools are available to predict the ablation lesion geometry, the process is computationally expensive. Also, in our implementation, a few patient-specific parameters are used to improve the accuracy of the lesion prediction.
Methods
Advanced heterogeneous computing using personal computers, incorporating the graphics processing unit (GPU) and the central processing unit (CPU), is proposed to predict the ablation lesion geometry. The most recent GPU technology is used to accelerate the finite element approximation of Penne's bioheat equation and a three state cell model. Patient-specific input parameters are used in the bioheat model to improve accuracy of the predicted lesion.
Results
A fast GPU-based RFA solver is developed to predict the lesion by doing most of the computational tasks in the GPU, while reserving the CPU for concurrent tasks such as lesion extraction based on the heat deposition at each finite element node. The solver takes less than 3 min for a treatment duration of 26 min. When the model receives patient-specific input parameters, the deviation between real and predicted lesion is below 3 mm.
Conclusion
A multi-centre retrospective study indicates that the fast RFA solver is capable of providing the IR with the predicted lesion in the short time period before the intervention begins when the patient has been clinically prepared for the treatment.
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Regional homogeneity changes between heroin relapse and non-relapse patients under methadone maintenance treatment: a resting-state fMRI study
Abstract
Background
Methadone maintenance treatment (MMT) is recognized as one of the most effective treatments for heroin addiction but its effect is dimmed by the high incidence of heroin relapse. However, underlying neurobiology mechanism of heroin relapse under MMT is still largely unknown. Here, we took advantage of a resting-state fMRI technique by analysis of regional homogeneity (ReHo), and tried to explore the difference of brain function between heroin relapsers and non-relapsers in MMT.
Methods
Forty MMT patients were included and received a 12-month follow-up. All patients were given baseline resting-state fMRI scans by using a 3.0 T GE Signa Excite HD whole-body MRI system. Monthly self-report and urine test were used to assess heroin relapse or non-relapse. Subjective craving was measured with visual analog scale. The correlation between ReHo and the degree of heroin relapse was analyzed.
Results
Compared with the non-relapsers, ReHo values were increased in the bilateral medial orbitofrontal cortex, right caudate, and right cerebellum of the heroin relapsers while those in the left parahippocampal gyrus, left middle temporal gyrus, right lingual gyrus, and precuneus were decreased in heroin relapsers. Importantly, altered ReHo in the right caudate were positively correlated with heroin relapse rates or subjective craving response.
Conclusions
Using the resting-state fMRI technique by analysis of ReHo, we provided the first resting-state fMRI evidence that right caudate may serve as a potential biomarker for heroin relapse prediction and also as a promising target for reducing relapse risk.
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Partial loss of VE-cadherin improves long-term outcome and cerebral blood flow after transient brain ischemia in mice
Abstract
Background
VE-cadherin is the chief constituent of endothelial adherens junctions. However, the role of VE-cadherin in the pathogenesis of cerebrovascular diseases including brain ischemia has not yet been investigated.
Methods
VE-cadherin heterozygous (VEC+/-) mice and wildtype controls were subjected to transient brain ischemia by 30 min filamentous middle cerebral artery occlusion (MCAo)/reperfusion.
Results
Acute lesion sizes as assessed by MR-imaging on day 3 did not differ between genotypes. Unexpectedly, however, partial loss of VE-cadherin resulted in long-term stroke protection measured histologically on day 28. Equally surprisingly, VEC+/- mice displayed no differences in post-stroke angiogenesis compared to littermate controls, but showed increased absolute regional cerebral blood flow in ischemic striatum at four weeks. The early induction of VE-cadherin mRNA transcription after stroke was reduced in VEC+/- mice. By contrast, N-cadherin and β-catenin mRNA expression showed a delayed, but sustained, upregulation up to 28 days after MCAo, which was increased in VEC+/- mice. Furthermore, partial loss of VE-cadherin resulted in a pattern of elevated ischemia-triggered mRNA transcription of pericyte-related molecules α-smooth muscle actin (α-SMA), aminopeptidase N (CD13), and platelet-derived growth factor receptor β (PDGFR-β).
Conclusions
Partial loss of VE-cadherin results in long term stroke protection. On the cellular and molecular level, this effect appears to be mediated by improved endothelial/pericyte interactions and the resultant increase in cerebral blood flow. Our study reinforces accumulating evidence that long-term stroke outcome depends critically on vascular mechanisms.
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Analysis of number needed to treat for droxidopa in patients with symptomatic neurogenic orthostatic hypotension
Abstract
Background
Droxidopa is an orally active prodrug that significantly improved dizziness/lightheadedness measured using the Orthostatic Hypotension Symptom Assessment (OHSA) Item 1 in patients with neurogenic orthostatic hypotension (nOH) caused by primary autonomic failure (Parkinson disease, multiple system atrophy, and pure autonomic failure), dopamine β-hydroxylase deficiency, or nondiabetic autonomic neuropathy. The efficacy and safety of droxidopa were assessed by determining the number needed to treat (NNT) and the number needed to harm (NNH).
Methods
Data collected in randomized, placebo-controlled clinical studies in adults with a clinical diagnosis of symptomatic nOH were pooled for efficacy and safety analyses. NNT and NNH were calculated as reciprocals of the risk difference (difference in event rates) for droxidopa versus placebo.
Results
The NNT for droxidopa for improvement in OHSA Item 1 was <10. The NNH for adverse events (AEs) leading to discontinuation in the pooled studies was 81. The likelihood of being helped or harmed (LHH) calculated from pooled analysis of the NNT for ≥2 units of improvement in OHSA Item 1 score and the NNH for discontinuations due to AEs were 7.8, 8.8, 3.1, and 3.5 for weeks 1, 2, 4, and 8 after randomization, respectively.
Conclusions
Droxidopa is efficacious for treatment of nOH, with an NNT below 10 and an acceptable tolerability profile with NNH ranging from 23 to 302 in the pooled analysis of frequently occurring AEs. Based on the LHH for the pooled analysis at week 1, droxidopa is 7.8 times more likely than placebo to show a clinical benefit than result in discontinuation because of an AE.
Trial registrations
ClinicalTrials.gov identifiers: NCT00782340, first received October 29, 2008; NCT00633880, first received March 5, 2008; and NCT01176240, first received July 30, 2010.
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Benefits and Limitations of Prenatal Screening for Prader-Willi Syndrome
Abstract
This review the status of genetic laboratory testing in Prader-Willi syndrome (PWS) due to different genetic subtypes, most often a paternally derived 15q11-q13 deletion, with benefits and limitations related to prenatal screening. Medical literature was searched for prenatal screening and genetic laboratory testing methods in use or under development and discussed in relationship to PWS. Genetic testing includes six established laboratory diagnostic approaches for PWS with direct application to prenatal screening. Ultrasonographic, obstetric and cytogenetic reports were summarized in relationship to the cause of Prader-Willi syndrome and identification of specific genetic subtypes including maternal disomy 15. Advances in genetic technology were described for diagnosing PWS specifically DNA methylation and high-resolution chromosomal SNP microarrays as current tools for genetic screening and incorporating next generation DNA sequencing for noninvasive prenatal testing (NIPT) using cell-free fetal DNA. Positive experiences are reported with NIPT for detection of numerical chromosomal problems (aneuploidies) but not for structural problems (microdeletions). These reports will be discussed along with future directions for genetic screening of PWS. In summary, this review describes and discusses the status of established and ongoing genetic testing options for PWS applicable in prenatal screening including NIPT and future directions for early diagnosis in Prader-Willi syndrome.
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Chirurgie discale de l’articulation temporo-mandibulaire
Publication date: Available online 17 August 2016
Source:Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Author(s): J. Potier, J.-M. Maes, R. Nicot, T. Dumousseau, M. Cotelle, J. Ferri
Les dysfonctions de l'articulation temporo-mandibulaire (ATM) sont fréquents et peuvent avoir des répercussions fonctionnelles et algiques majeures. Leur traitement ne fait pas consensus. La littérature souligne le rôle prépondérant des traitements conservateurs (kinésithérapie, antalgiques, gouttières occlusales) en première intention. Au cours des dernières décennies, les techniques de chirurgie mini-invasive (arthroscopie, arthrocentèse) ont connu un grand essor. Ces techniques se sont révélées efficaces et fiables, surtout chez les patients présentant un déplacement discal antérieur irréductible (DDI) ou réductible (DDR), ainsi que dans le cadre d'arthopathies. Le but de notre travail était de faire le point sur la place de la chirurgie discale.Temporomandibular joint (TMJ) disorders are a common disease and may be responsible for major functional and painful repercussions. Treatment is not consensual. The literature highlights the role of conservative treatments (physiotherapy, analgesics, splints) in a first attempt. Minimally invasive surgical techniques (arthroscopy, arthrocentesis) have developed rapidly in recent decades. They have proven effective and reliable, especially in patients suffering from irreducible or reducible anterior disc dislocation or presenting with arthopathies. The goal of our work was to make an update about disk surgery.
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Laparoscopic repair of sliding inguinal hernia in female children
Abstract
Purpose
To evaluate the safety and feasibility of laparoscopic repair of sliding inguinal hernia in female children.
Methods
Laparoscopic percutaneous extraperitoneal closure (LPEC) was performed in 482 female inguinal hernia children between 2006 and 2015. Fourteen of these patients were associated with sliding inguinal hernia, and these 14 patients were enrolled and reviewed retrospectively.
Results
The mean age and the body weight at the operation was 9.6 months and 7.8 kg. Seven patients required the reduction of the ovary under general anesthesia. Laparoscopy, however, revealed that five patients had severe sliding of fallopian tube into the inguinal canal. One of these five patients received a simple LPEC, but developed the recurrence due to the low ligation of the hernia sac, and needed the second hernia repair under inguinal approach. Other four patients with fallopian tube sliding required the dissection of the fallopian tube and peritoneal repair, or the conversion to inguinal approach; therefore they had longer surgical time compared to those without fallopian tube sliding.
Conclusion
LPEC is safe and feasible for the sliding inguinal hernia repair except the cases with fallopian tube sliding. Patients with fallopian tube sliding required additional procedure or conversion to inguinal approach.
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Risk factors and prevention for surgical intestinal disorders in extremely low birth weight infants
Abstract
Purpose
Surgical intestinal disorders (SID), such as necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI), are serious morbidities in extremely low birth weight (ELBW, birth weight <1000 g) infants. From 2010, we performed enteral antifungal prophylaxis (EAP) in ELBWI to prevent for SID. The aim of this study was to identify disease-specific risk factors and to evaluate the efficacy of prevention for SID in ELBW infants.
Methods
A retrospective chart review of all consecutive patients between January 2006 and March 2015, which included 323 ELBW infants who were admitted to Shizuoka Children's Hospital, was conducted.
Results
The number of infants with NEC, FIP, and MRI was 9, 12, and 13, respectively; 28 in 323 ELBW infants died. The control group defined the cases were not SID. In-hospital mortality was higher in infants with NEC relative to those in the control group. On logistic regression analysis, low gestational age and cardiac malformations were associated with increased risk of NEC. IUGR were associated with increased risk of MRI. EAP decreased risk of NEC and FIP. Low gestational weight and NEC were associated with increased risk of death.
Conclusion
Survival to hospital discharge after operation for NEC in ELBW infants remains poor. EAP decreased risk of NEC and FIP in ELBW infants.
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Efficacy of ethanol locks to reduce the incidence of catheter-related bloodstream infections for home parenteral nutrition pediatric patients: comparison of therapeutic treatment with prophylactic treatment
Abstract
Purpose
Children with intestinal failure (IF) requiring central venous catheters (CVCs) often experience frequent catheter-related bloodstream infections (CRBSIs), which is a serious and life-threatening complication. To reduce the incidence of CRBSI, prophylactic ethanol lock therapy (ELT) was initiated.
Methods
Patients with IF received home parenteral nutrition via a silicone tunneled CVC. All of them had received therapeutic ELT from January 2009 (first period) and prophylactic ELT from December 2012 (second period). Prophylactic ELT refers to ethanol lock for 2 h during the monthly hospital visit. We compared the CRBSI rate and number of CVC replacements between both periods.
Results
Four patients received 19 CVCs for a total of 5623 catheter days. In the first period, there were 12 CRBSIs in 1823 catheter days (rate 6.77 per 1000 catheter days). In the second period, there were 9 CRBSIs in 3800 catheter days (rate 3.13 per 1000 catheter days). Overall, the rate of CVC replacement decreased from 4.92 to 1.72 per 1000 catheter days (p = 0.04). No adverse reactions were experienced during ethanol instillation.
Conclusion
Monthly prophylactic ELT for IF patients is considered to be a safe and effective modality for reducing the replacement of CVCs due to CRBSIs.
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Evaluation of the intraoperative risk factors for esophageal anastomotic complications after primary repair of esophageal atresia with tracheoesophageal fistula
Abstract
Purpose
The aim of this study is to identify the risk factors for esophageal anastomotic stricture (EAS) and/or anastomotic leakage (EAL) after primary repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) in infants.
Methods
A retrospective chart review of 52 patients with congenital EA/TEF between January 2000 and December 2015 was conducted. Univariate and multivariate analyses were performed to identify the risk factors for anastomotic complications.
Results
Twenty-four patients were excluded from the analysis because they had insufficient data, trisomy 18 syndrome, delayed anastomosis, or multi-staged operations; the remaining 28 were included. Twelve patients (42.9 %) had anastomotic complications. EAS occurred in 12 patients (42.9 %), and one of them had EAL (3.57 %). There was no correlation between anastomotic complications and birth weight, gestational weeks, sex, the presence of an associated anomaly, age at the time of repair, gap between the upper pouch and lower pouch of the esophagus, number of sutures, blood loss, and gastroesophageal reflux. Anastomosis under tension and tracheomalacia were identified as risk factors for anastomotic complications (odds ratio 15, 95 % confidence interval (CI) 1.53–390.0 and odds ratio 8, 95 % CI 1.33–71.2, respectively).
Conclusion
Surgeons should carefully perform anastomosis under less tension to prevent anastomotic complications in the primary repair of EA/TEF.
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Three-Dimensional Culture Assay to Explore Cancer Cell Invasiveness and Satellite Tumor Formation
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Thymuskarzinome
Zusammenfassung
Thymuskarzinome sind etwa 10-mal seltener als Thymome, wegen ihrer größeren Aggressivität, selteneren chirurgischen Sanierbarkeit und der mangelnden Verfügbarkeit langfristig wirksamer onkologischer Strategien klinisch aber äußerst relevant. Bei Kindern und Jugendlichen sind Thymuskarzinome zudem häufiger als Thymome und müssen besonders in dieser Altersgruppe gegen Keimzelltumoren abgegrenzt werden. Darüber hinaus ergeben sich für den Pathologen zwei weitere typische Schwierigkeiten: die therapeutisch wichtige Unterscheidung zwischen Thymuskarzinomen und ähnlich aussehenden Thymomen sowie die Differenzierung zwischen Thymuskarzinomen und histologisch ähnlich erscheinenden Metastasen oder Ausläufern anderer Primärtumoren. Die Überwindung dieser diagnostischen Herausforderungen steht im Zentrum der neuen WHO-Klassifikation der Thymuskarzinome. Ziel der vorliegenden Arbeit ist es, die diagnostisch wichtigen Neuerungen der neuen WHO-Klassifikation der Thymuskarzinome darzustellen und therapierelevante differenzialdiagnostische Fragen zu beantworten.
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A common misapplication of statistical inference: Nuisance control with null-hypothesis significance tests
Source:Brain and Language, Volume 162
Author(s): Jona Sassenhagen, Phillip M. Alday
Experimental research on behavior and cognition frequently rests on stimulus or subject selection where not all characteristics can be fully controlled, even when attempting strict matching. For example, when contrasting patients to controls, variables such as intelligence or socioeconomic status are often correlated with patient status. Similarly, when presenting word stimuli, variables such as word frequency are often correlated with primary variables of interest. One procedure very commonly employed to control for such nuisance effects is conducting inferential tests on confounding stimulus or subject characteristics. For example, if word length is not significantly different for two stimulus sets, they are considered as matched for word length. Such a test has high error rates and is conceptually misguided. It reflects a common misunderstanding of statistical tests: interpreting significance not to refer to inference about a particular population parameter, but about 1. the sample in question, 2. the practical relevance of a sample difference (so that a nonsignificant test is taken to indicate evidence for the absence of relevant differences). We show inferential testing for assessing nuisance effects to be inappropriate both pragmatically and philosophically, present a survey showing its high prevalence, and briefly discuss an alternative in the form of regression including nuisance variables.
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Cetylev (acetylcysteine) Effervescent Tablets for Oral Solution: Recall - Inadequate Seal of Blister Pack
Audience: Pharmacy, Nursing, Emergency Medicine [Posted 08/18/2016] ISSUE: Arbor Pharmaceuticals, LLC announced a voluntary recall of three (3) lots of Cetylev (acetylcysteine) effervescent tablets for oral solution, 500 mg, due to an...
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Skeletal and dental stability after intraoral vertical ramus osteotomy: a long-term follow-up
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): E. Schilbred Eriksen, P.J. Wisth, S. Løes, K. Moen
The purpose of this study was to elucidate the long-term skeletal and dental stability after combined orthodontic and orthognathic surgical treatment of mandibular prognathism with the intraoral vertical ramus osteotomy (IVRO) as the surgical technique followed by 6 weeks of intermaxillary fixation (IMF). Thirty-six patients were included in the study. Mean age at surgery was 21.6 years. Lateral cephalograms and study casts obtained before the start of treatment (T0), and 8 weeks (T1), 1 year (T2), and 12.5 years (T3) after the operation were evaluated. Mean mandibular setback measured at point B was 8.3mm. Between T1 and T2, a mean anterior relapse of 12% of the setback was observed. Between T2 and T3, the anterior relapse persisted, but decreased to 7% of the setback measured at point B. Despite dental adjustments in both jaws, a statistically significant reduction in overjet was observed during both observation periods. However, the change of the mandible in an anterior direction was small and of minor clinical importance for most of the patients. In conclusion these results indicate that combined orthodontic and orthognathic surgical treatment of mandibular prognathism with the IVRO as the surgical procedure followed by 6 weeks of IMF provides predictable and good long-term clinical results.
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A randomized double-blind controlled trial of the use of dydrogesterone in women with threatened miscarriage in the first trimester: study protocol for a randomized controlled trial
Miscarriage is a common complication of pregnancy occurring in 15–20 % of all clinically recognized pregnancies. Currently, there is still no good scientific evidence to support the routine use of progestogens...
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Multiple modes of hippocampal–prefrontal interactions in memory-guided behavior
Publication date: October 2016
Source:Current Opinion in Neurobiology, Volume 40
Author(s): Justin D Shin, Shantanu P Jadhav
The hippocampus and prefrontal cortex are crucial for learning and memory-guided behavior, but neural mechanisms underlying their coordinated operation are currently unclear. Recent evidence indicates that different network activity patterns, each marked by local field potential signatures, play distinct roles in mediating long-range interactions between these regions to support memory processing. We propose that network patterns underlie multiple communication modes between these regions, and support different cognitive demands during ongoing behavior. Network patterns may represent a fundamental neurophysiological mechanism through which the hippocampus communicates memory-related information with other regions. Dissecting the causal roles of these network patterns in cognitive processes has the potential to delineate a coherent and dynamic functional organization across hippocampal and prefrontal networks during memory-guided behavior.
Graphical abstract
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Radiothérapie des cancers de l’oropharynx
Source:Cancer/Radiothérapie
Author(s): S. Servagi Vernat, F. Tochet, L. Vieillevigne, Y. Pointreau, P. Maingon, P. Giraud
Les indications, doses, techniques de radiothérapie, association à une chimiothérapie concomitante des cancers de l'oropharynx sont présentées. Les recommandations de délinéation des volumes cibles et organes à risques sont détaillés.Indication, doses, technique of radiotherapy and concomitant chemotherapy for oropharynx carcinoma are presented. The recommendations for delineation of the target volumes and organs at risk are detailed.
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Radiothérapie des tumeurs hépatiques
Source:Cancer/Radiothérapie
Author(s): E. Rio, F. Mornex, D. Peiffert, A. Huertas
Les évolutions technologiques récentes ont permis de développer le concept de « radiothérapie hépatique focalisée ». Il convient de distinguer les tumeurs primitives de celles secondaires car les indications sont restreintes et doivent être discutées en alternative aux traitements chirurgicaux ou médicaux. Dans ce cas, pour les carcinomes hépatocellulaires de 5 à 10cm (voire plus), une irradiation conformationnelle avec ou sans modulation d'intensité est réalisée. La radiothérapie en conditions stéréotaxiques est en cours d'évaluation et est souvent préférée à la radiofréquence pour les tumeurs primitives ou secondaires (en général de moins de 5cm). Les mouvements de la tumeur (et du foie) liés à la respiration doivent être pris en compte. Il faut respecter des critères dosimétriques stricts avec une attention toute particulière sur les histogrammes dose–volume (HDV) du foie non tumoral ainsi que des organes creux, notamment en cas de radiothérapie en conditions stéréotaxiques.Recent technological developments led to develop the concept of focused liver radiation therapy. We must distinguish primary and secondary tumors as the indications are restricted and must be discussed as an alternative to surgical or medical treatments. For hepatocellular carcinoma 5 to 10cm (or more), a conformational radiation with or without intensity modulation is performed. Stereotactic body radiotherapy (SBRT) is being evaluated and is increasingly proposed as an alternative to radiofrequency ablative treatment for primary or secondary tumors (typically less than 5cm). Tumor (and liver) movements induced by respiratory motions must be taken into account. Strict dosimetric criteria must be met with particular attention to the dose–volume histograms to liver and the hollow organs, including cases of SBRT.
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Radiothérapie des tumeurs des glandes salivaires
Source:Cancer/Radiothérapie
Author(s): S. Servagi-Vernat, F. Tochet
Les indications, doses et techniques de radiothérapie des cancers des glandes salivaires sont présentées, ainsi que l'apport des neutrons et des ions carbones. Les recommandations de délinéation des volumes cibles et organes à risques sont détaillées.Indication, doses, and technique of radiotherapy for salivary glands carcinoma are presented, and the contribution of neutrons and carbon ions. The recommendations for delineation of the target volumes and organs at risk are detailed.
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Radiothérapie des cancers de vessie
Source:Cancer/Radiothérapie
Author(s): O. Riou, B. Chauvet, J.-L. Lagrange, P. Martin, C. Llacer Moscardo, M. Charissoux, O. Lauche, N. Aillères, P. Fenoglietto, D. Azria
Le traitement de référence des tumeurs de vessie infiltrant le muscle est la cystectomie totale. La chimioradiothérapie concomitante s'est imposée comme une alternative thérapeutique à une chirurgie radicale en vue d'une stratégie de conservation vésicale ou chez un patient non opérable du fait de maladies associées. L'analyse des données de la littérature montre des taux de contrôle local avec conservation vésicale à 5 ans de 40 à 65 %, et une probabilité de survie globale de 40 à 50 % à 5 ans avec une qualité de vie excellente. Cet article établit les recommandations françaises pour la réalisation de la radiothérapie des cancers de vessie : indications, examens nécessaires, technique, dosimétrie, délivrance et guidage par l'image.Surgery (radical cystectomy) is the standard treatment of muscle-invasive bladder cancer. Radiochemotherapy has risen as an alternative treatment option to surgery as part as organ-sparing combined modality treatment or for patients unfit for surgery. Radiochemotherapy achieves 5-year bladder intact survival of 40 to 65% and 5-year overall survival of 40 to 50% with excellent quality of life. This article introduces the French recommendations for radiotherapy of bladder cancer: indications, exams, technique, dosimetry, delivery and image guidance.
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Radiothérapie des cancers du larynx
Source:Cancer/Radiothérapie
Author(s): Y. Pointreau, C. Lafond, F. Legouté, P. Trémolières, S. Servagi-Vernat, P. Giraud, P. Maingon, G. Calais, M. Lapeyre
La radiothérapie conformationnelle avec modulation d'intensité (RCMI) est la technique de référence dans le traitement des cancers du larynx (en dehors de ceux de stade T1 du plan glottique). Les tumeurs localisées de stade T1 et T2 peuvent être traitées soit par irradiation externe (exclusive), soit par chirurgie conservatrice. Pour les tumeurs nécessitant une laryngectomie totale (stade T2 ou T3), une chimiothérapie d'induction suivie d'une radiothérapie externe exclusive ou une chimioradiothérapie concomitante exclusive d'emblée peuvent être proposées. Pour les cancers de stade T4, une chirurgie est proposée. La prise en charge des aires ganglionnaires sera le plus souvent fonction du traitement initial de la tumeur primitive. En cas de tumeur en place, les doses à visée curative sont de 70Gy et les doses prophylactiques de 50Gy, en irradiation classique avec 2Gy par fraction ou avec boost intégré (70Gy par fractions de 2Gy et 56Gy par fractions de 1,8Gy ou 70Gy par fractions de 2,12Gy). Après chirurgie, l'indication est retenue pour les cancers évolués, avec des niveaux de doses selon des critères anatomopathologiques (66Gy en cas de résection R1, 50 à 54Gy en cas de résection complète). La définition des volumes tumoraux et ganglionnaires repose sur des recommandations.Intensity-modulated radiotherapy is the gold standard in the treatment of larynx cancers (except T1 glottic tumour). Early T1 and T2 tumours may be treated by exclusive radiation or surgery. For tumours requiring total laryngectomy (T2 or T3), induction chemotherapy followed by exclusive radiotherapy or concurrent chemoradiotherapy is possible. For T4 tumour, surgery must be proposed. The treatment of lymph nodes is based on the initial treatment of the primary tumour. In non-surgical procedure, in case of sequential radiotherapy, the curative dose is 70Gy and the prophylactic dose is 50Gy. An integrated simultaneous boost radiotherapy is allowed (70Gy in 2Gy per fraction and 56Gy in 1.8Gy per fraction or 70Gy in 2.12Gy per fraction). Postoperatively, radiotherapy is used in locally advanced cancer with dose levels based on pathologic criteria (66Gy for R1 resection, 50 to 54Gy for complete resection). Volume delineation was based on guidelines.
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Radiothérapie des lymphomes
Source:Cancer/Radiothérapie
Author(s): I. Barillot, M.A. Mahé, D. Antoni, C. Hennequin
La radiothérapie des lymphomes hodgkinien a évolué au cours du temps, mais garde une place prépondérante lors de la prise en charge des tumeurs de stade précoce. Ses indications sont plus limitées pour les lymphomes non hodgkinien, mais les techniques obéissent aux mêmes principes, quel que soit le type histologique. Cette revue présente les recommandations françaises en termes de préparation et de choix des techniques d'irradiation.Radiotherapy for Hodgkin's lymphoma has evolved over time but retains a dominant position in the treatment of early stage tumours. Its indications are more limited for non-Hodgkin's lymphomas, but the techniques follow the same principles whatever the histological type. This review presents the French recommendations in terms of preparation and choice of irradiation techniques.
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Recommandations en radiothérapie externe et curiethérapie (Recorad) : 2e édition
Source:Cancer/Radiothérapie
Author(s): M.-A. Mahé, I. Barillot, B. Chauvet
La première édition du Guide des procédures de radiothérapie externe, parue en 2007, avait comme objectifs de produire des recommandations visant à optimiser, harmoniser et homogénéiser les pratiques. Cette seconde édition, incluant la curiethérapie, garde les mêmes objectifs en tenant compte des développements technologiques actuels (radiothérapie conformationnelle avec modulation d'intensité, radiothérapie stéréotaxique, curiethérapie en trois dimensions) et des résultats récents de la littérature. Dans la première partie sont abordés des principes généraux d'intérêt quotidien (rappels réglementaires, qualité–sécurité, gestion des risques, partage des tâches) et dans la seconde les étapes de prise en charge pour chaque localisation tumorale.In 2007, a first edition was published with the objective to produce guidelines for optimization, harmonization and homogenization of practices in external radiation therapy in France. The second edition, including brachytherapy, has the same objective and takes into account recent technologic improvements (intensity modulation radiation therapy, stereotactic radiotherapy, and 3-dimension brachytherapy) and results of literature. The first part is about daily use of general principles (quality, security, image-guided radiation therapy) and the second is to describe each treatment step in main cancers.
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Relationship Between the Eating Assessment Tool-10 and Objective Clinical Ratings of Swallowing Function in Individuals with Head and Neck Cancer
Abstract
The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC. Forty-four HNC participants completed the EAT-10 and a standardized videofluoroscopy swallow study. Blinded raters determined airway safety using the penetration–aspiration scale (PAS) and swallowing function using the modified barium swallow impairment profile (MBSImP™©). Participants were stratified into three groups (pre-treatment through 1 year post-treatment, 1–5 years post-treatment, and >5 years post-treatment). Independent t tests, Pearson's and Spearman's Rho correlations, and a Bonferroni correction for multiple comparisons were performed. EAT-10 scores were significantly higher in HNC patients with unsafe swallowing (M 24.45, SD 8.32) compared to those with safe swallowing (M 16.20, SD 12.14), t(21) = −2.36, p < 0.04. Significant correlations were revealed between EAT-10 scores and the MBSImP™© (pharyngeal composite), and PAS scores (p < 0.05) for the pre-treatment to within 1 year post-treatment group. No associations, however, were observed for HNC patients in the time groups representing greater than 1-year post cancer treatment.
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