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Παρασκευή 20 Οκτωβρίου 2017

Importance of neoadjuvant chemotherapy in olfactory neuroblastoma treatment: Series report and literature review

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Publication date: Available online 20 October 2017
Source:Acta Otorrinolaringológica Española
Author(s): Ricardo Bartel, Xavier Gonzalez-Compta, Enric Cisa, Francesc Cruellas, Alberto Torres, Aleix Rovira, Manel Manos
Introduction and objectivesOlfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/−adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature.MethodsA retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution.Results9 patients were included. Mean follow-up of 52.5 months (range 10–107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%.ConclusionNeoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications.



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Cutaneous atypical papular CD8+ lymphoproliferative disorder at acral sites in a renal transplant patient

Summary

A 20-year-old woman presented with a 2-month history of an acute symmetrical eruption, manifesting as asymptomatic ill-defined erythematous macules and hyperkeratotic papules on the palms. The patient was a renal transplant recipient, and the lesions had developed 2 months post-transplantation. Histologically, the eruption shared features of a reactive inflammatory condition called papular eruption of atypical CD8+ lymphocytes as well as primary cutaneous acral CD8+ T-cell lymphoma (a provisional indolent entity in the new World Health Organisation classification of lymphoid neoplasms, 2016). The latter disorder has been described to occur at acral sites in immunocompetent patients, whereas the former has previously been described only in patients infected with human immunodeficiency virus. The lesions in our patient healed after topical treatment with corticosteroids and alteration of immunosuppressive therapy, supporting the role of immunosuppression in this case. We classified our patient's condition as lying in the spectrum of the aforementioned two conditions, but the relationship between both diseases remains to be clarified. Awareness of these unusual conditions may prevent the use of unnecessary aggressive therapies in similar patients.



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Association of Mannose-Binding Lectin rs1800450 and Tumor Necrotic Factor-α rs1800620 Polymorphism with Helicobacter pylori in Type II Diabetes Mellitus

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Oct 2017, Vol. 36, No. 5: 236-241.


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Anti-hLCN6 Monoclonal Antibody

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Oct 2017, Vol. 36, No. 5: 242-242.


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A new endoscopic technique to close big nasal septal perforations: prospective evaluation of the double meat hook technique in 19 consecutive cases

Abstract

Despite the variety of surgical techniques available to close big symptomatic septum perforations, closure rates of 30 to 70% indicate the difficulty of obtaining a good end result.

The double meat hook technique is a new endoscopically assisted technique that delivers excellent visualization and control of mucosal flap elevation, extension and suturing.

Mucosa from the nasal floor, lateral nasal wall and inferior turbinate bone are valuable donor site extensions.

There is no need for additional incisions into the nasal septal mucosa in order to perform a tension-free closure. Preservation of the structural integrity and blood supply of the mucosal flaps, possibly contributes to a high closure rate and delivers a physiological result.

This article is protected by copyright. All rights reserved.



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Current Use of Baseline Medical Treatment in Chronic Rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)

Abstract

Objectives

According to clinical and comissioning guidelines for chronic rhinosinusitis (CRS), patients being referred to secondary care should have failed primary medical treatment with nasal douching (ND) and intranasal corticosteroids (INCS). The study objectives were to identify the rate of specific medical therapy in CRS patients and establish any differences in medication use, for both CRS and associated medical conditions, between CRS phenotypes.

Design and setting

Case-control study in a secondary care setting.

Methods

Participant-reported study-specific questionnaire capturing free text data on current medication use at the time of study entry. Qualitative interviews with 21 participants also explored their experience of CRS and its management.

Particpants

Patients with both without (CRSsNPs) and with polyps (CRSwNPs).

Main outcome measures

Reported use of CRS-related and non-related medications.

Results

Within a total of 1243 CRS participants, current INCS usage was low (18% in CRSwNPs, 12% in CRSsNPs); ND was being performed by only 1% of all participants. Bronchodilators and inhaled corticosteroids use was significantly higher in CRSwNPs participants (p < 0.0001). Antidepressants use was significantly higher in CRSsNPs (14% versus 7%, p < 0.0002). There were no significant regional variations in rates of INCS use, nor any significant influence of social deprivation.

Conclusions

The current use of baseline medical therapy in CRS appears to be very low, representing a combination of poor patient compliance, possible ineffectiveness of treatment and a lack of familiarity with current guidelines amongst general practitioners and some ENT specialists. Work is needed to disseminate guidelines to all practitioners involved and reduce unnecessary burden on existing healthcare resources for this common condition by ensuring timely referral and definitive management.

This article is protected by copyright. All rights reserved.



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Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Abstract

Background

Grass pollen–related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood.

Methods

We examined 1120 children (age 4–18y) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight Phleum pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA.

Results

The analysis of IgE responses against eight Phleum pratense molecules showed 87profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by higher serum total IgE, higher grass-specific serum IgE and higher number and degree of sensitization to pollens. The most frequent IgE sensitization profile was the monomolecular Phl p 1. Sensitization to Phl p 7 was a reliable biomarker of asthma, whereas Phl p 12 of oral allergy syndrome. Sensitization to Phl p 7 was associated with a higher severity of SAR, and complex profiles were associated with longer disease duration.

Conclusions

In a large pediatric population, the complexity of IgE sensitization profiles against Phleum pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7 and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response.

This article is protected by copyright. All rights reserved.



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ATA Announces Recipients of 2017 Special Awards

American Thyroid Association's 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

The post ATA Announces Recipients of 2017 Special Awards appeared first on American Thyroid Association.



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American Thyroid Association’s 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

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American Thyroid Association's 2017 Van Meter Award Lecture Delivered by Megan R. Haymart, MD

The ATA announced the Van Meter Award recipient

 October 19, 2017—The American Thyroid Association (ATA) is pleased to announce that the 2017 Van Meter Award recipient is Megan R. Haymart, MD, Megan R. Haymart, MDAssistant Professor of Medicine at the University of Michigan, Ann Arbor. The Van Meter Award recognizes outstanding contributions to research on the thyroid gland or related subjects by an investigator who is age 45 or under. At the ATA annual meeting in Victoria, British Columbia, Dr. Haymart will deliver the Van Meter Lecture at 8:05 am on October 19, 2017. Her lecture is titled "Implications of Diagnosing  Low-Risk Thyroid Cancer." The award winner is kept secret until the time of the lecture.

Dr. Haymart received her MD from the Johns Hopkins University School of Medicine. She completed an internship in Internal Medicine at Johns Hopkins Hospital and a fellowship in Endocrinology, Diabetes, and Metabolism at the University of Wisconsin.

Since joining the ATA in 2007, Dr. Haymart has donated a great deal of time and enthusiasm to the ATA, serving on the Public Health Committee (2010−12) and the Finance and Audit Committee (2012−18), which she now chairs.  She participated in Strategic Planning for the ATA in 2012; and has attended every annual meeting since 2006.   She serves on the editorial boards of Thyroid and Journal of Clinical Endocrinology and Metabolism (JCEM) and is an associate editor of VideoEndocrinology.  She is currently a candidate for the ATA Board of Directors.  In addition, she is a member of the Endocrine Society's Annual Meeting Steering Committee.

In the eight years since she began her independent career at the University of Michigan, Dr. Haymart has earned a reputation as one of the national leaders in thyroid clinical research. She has recently secured two major research grants, one to study the role of patient and physician perceptions in treatment decision-making in thyroid cancer care, and the other to study incidental thyroid cancer discovery and strategies to minimize over-diagnosis and over-treatment. Both are critical issues for the field.

She has published many important papers in high-profile journals. Dr. Haymart's CV lists 46 peer-reviewed publications, of which she is the first author of 17. These papers offer important new insights into thyroid cancer care and identify directions for future health services research.

Dr. Haymart's expertise also is recognized by frequent invitations to speak at national conferences—including the 2009, 2013, and 2016 ATA annual meetings and the 2011 and 2016 Endocrine Society annual meetings—and to give presentations, such as those at the University of Wisconsin (2012, 2014), the Washington Hospital Center (2014), and Johns Hopkins (2016).

Dr. Haymart's accomplishments, their impact on the field of thyroid cancer, and her contributions to thyroidology make her an ideal recipient of the Van Meter Award.  The Van Meter is supported by an endowment gift from the estate of long-time member, Dr. Jacob Robbins; and by an annual contribution from Mary Ann Liebert, Inc., publishers.

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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Surveying the Literature: Synopsis of Recent Key Publications

No abstract available

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Effect of Stellate Ganglion Block on the Regional Hemodynamics of the Upper Extremity: A Randomized Controlled Trial

BACKGROUND: BACKGROUND:The success of stellate ganglion block (SGB) is traditionally determined on the basis of findings such as Horner's syndrome, temperature rise in the face, hyperemia of the tympanic membrane, and nasal congestion. However, decreases in vascular resistance and increases in blood flow in the arm may be more meaningful findings. To date, the effect of SGB on the regional hemodynamics of the arm has not been evaluated using pulsed-wave Doppler ultrasound. METHODS: METHODS:A total of 52 patients who were to undergo orthopedic surgery of the forearm were randomly assigned to either the mepivacaine group (SGB with 5 mL of 0.5% mepivacaine) or the saline group (SGB with 5 mL of normal saline). Before surgery, a single anesthesiologist performed a SGB under ultrasound guidance. The temperature of the upper extremity and the resistance index and blood flow in the brachial artery were measured before SGB, 15 and 30 minutes after SGB, and 1 hour after surgery. The severity of pain, requirement for rescue analgesics, and side effects of the local anesthetic agent were all documented. RESULTS: RESULTS:After SGB, the resistance index decreased significantly and the blood flow increased significantly in the brachial artery of members of the mepivacaine group (15 minutes: P = .004 and P

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Postoperative Outcomes in Obstructive Sleep Apnea Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis of Comparative Studies

BACKGROUND: BACKGROUND:Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: METHODS:A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed. The search was constrained to studies in adult cardiac surgical patients with diagnosed or suspected OSA. All included studies must report at least 1 postoperative complication. The primary outcome is major adverse cardiac or cerebrovascular events (MACCEs) up to 30 days after surgery, which includes death from all-cause mortality, myocardial infarction, myocardial injury, nonfatal cardiac arrest, revascularization process, pulmonary embolism, deep venous thrombosis, newly documented postoperative atrial fibrillation (POAF), stroke, and congestive heart failure. Secondary outcome is newly documented POAF. The other exploratory outcomes include the following: (1) postoperative tracheal intubation and mechanical ventilation; (2) infection and/or sepsis; (3) unplanned intensive care unit (ICU) admission; and (4) duration of stay in hospital and ICU. Meta-analysis and meta-regression were conducted using Cochrane Review Manager 5.3 (Cochrane, London, UK) and OpenBUGS v3.0, respectively. RESULTS: RESULTS:Eleven comparative studies were included (n = 1801 patients; OSA versus non-OSA: 688 vs 1113, respectively). MACCEs were 33.3% higher odds in OSA versus non-OSA patients (OSA versus non-OSA: 31% vs 10.6%; odds ratio [OR], 2.4; 95% confidence interval [CI], 1.38–4.2; P = .002). The odds of newly documented POAF (OSA versus non-OSA: 31% vs 21%; OR, 1.94; 95% CI, 1.13–3.33; P = .02) was higher in OSA compared to non-OSA. Even though the postoperative tracheal intubation and mechanical ventilation (OSA versus non-OSA: 13% vs 5.4%; OR, 2.67; 95% CI, 1.03–6.89; P = .04) were significantly higher in OSA patients, the length of ICU stay and hospital stay were not significantly prolonged in patients with OSA compared to non-OSA. The majority of OSA patients were not treated with continuous positive airway pressure therapy. Meta-regression and sensitivity analysis of the subgroups did not impact the OR of postoperative complications for OSA versus non-OSA groups. CONCLUSIONS: CONCLUSIONS:Our meta-analysis demonstrates that after cardiac surgery, MACCEs and newly documented POAF were 33.3% and 18.1% higher odds in OSA versus non-OSA patients, respectively. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Accepted for publication August 16, 2017. Funding: The STOP-Bang tool is proprietary to University Health Network. This study is supported by University Health Network Foundation, and Department of Anesthesiology, University Health Network, University of Toronto. Conflicts of Interest: See Disclosures at the end of the article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://ift.tt/KegmMq). Reprints will not be available from the authors. Address correspondence to Frances Chung, MD, FRCPC, Department of Anesthesiology and Pain Medicine, Toronto Western Hospital, University Health Network, 399 Bathurst St, Toronto, Ontario, M5T 2S8, Canada. Address e-mail to frances.chung@uhn.ca. © 2017 International Anesthesia Research Society

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Physiology and Role of Intraocular Pressure in Contemporary Anesthesia

More than 26 million Americans suffer with cataracts, and with 3.6 million cataract extractions performed annually in the United States, it is the most common surgical procedure. The integrity of the delicate structures of the eye that mediate vision is dependent on the intraocular pressure (IOP). Yet, IOP acts to compress the vessels within the globe—akin to a Starling resistor—and is a key component that determines the ocular perfusion pressure, defined as the difference between arterial pressure and IOP. The retina is one of the most metabolically active tissues in the body, and its functional integrity is dependent on an adequate blood supply, with retinal function linearly related to the ocular perfusion pressure. Retinal cell death has been demonstrated at low perfusion pressures (below 50 mm Hg). Modern ophthalmic surgery involves globe irrigation, manipulation, and instrumentation, resulting in dynamic pressure fluxes within the eye. Marked elevations of IOP (up to 4–5 times the normal value) with consequent borderline retinal and optic disk perfusion pressures occur for prolonged periods during many ophthalmic procedures. General surgeries, including laparoscopic, spinal, and cardiac procedures, especially, with their demand for steep Trendelenburg or prolonged prone positioning and/or hypotensive anesthesia, can induce IOP changes and ocular perfusion imbalance. These rapid fluctuations in IOP, and so in perfusion, play a role in the pathogenesis of the visual field defects and associated ocular morbidity that frequently complicate otherwise uneventful surgeries. The exact etiology of such outcomes is multifactorial, but ocular hypoperfusion plays a significant and frequently avoidable role. Those with preexisting compromised ocular blood flow are especially vulnerable to intraoperative ischemia, including those with hypertension, diabetes, atherosclerosis, or glaucoma. However, overly aggressive management of arterial pressure and IOP may not be possible given a patient's comorbidity status, and it potentially exposes the patient to risk of catastrophic choroidal hemorrhage. Anesthetic management significantly influences the pressure changes in the eye throughout the perioperative period. Strategies to safeguard retinal perfusion, reduce the ischemic risk, and minimize the potential for expulsive bleeding must be central to the anesthetic techniques selected. This review outlines: important physiological principles; ophthalmic and general procedures most likely to develop damaging IOP levels and their causative factors; the effect of anesthetic agents and techniques on IOP; recent scientific evidence highlighting the significance of perfusion changes during surgery; and key aspects of postoperative visual loss and management approaches for high-risk patients presenting for surgery. Accepted for publication September 6, 2017. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Dermot J. Kelly, MRCPI, FFARCSI, DABA, Department of Anesthesia, Royal Victoria Eye and Ear Hospital, Adelaide Rd, Dublin 2, Ireland. Address e-mail to drdermotkelly@gmail.com. © 2017 International Anesthesia Research Society

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Insight Into Our Technology: Anesthesia Information Management Systems

Anesthesia information management systems (AIMS) have evolved from simple, automated intraoperative record keepers in a select few institutions to widely adopted, sophisticated hardware and software solutions that are integrated into a hospital's electronic health record system and used to manage and document a patient's entire perioperative experience. AIMS implementations have resulted in numerous billing, research, and clinical benefits, yet there remain challenges and areas of potential improvement to AIMS utilization. This article provides an overview of the history of AIMS, the components and features of AIMS, and the benefits and challenges associated with implementing and using AIMS. As AIMS continue to proliferate and data are increasingly shared across multi-institutional collaborations, visual analytics and advanced analytics techniques such as machine learning may be applied to AIMS data to reap even more benefits. Accepted for publication September 8, 2017. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Allan F. Simpao, MD, MBI, Department of Anesthesiology and Critical Care, Division of General Anesthesia, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104. Address e-mail to simpaoa@email.chop.edu. © 2017 International Anesthesia Research Society

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Fatigue Risk Management: The Impact of Anesthesiology Residents’ Work Schedules on Job Performance and a Review of Potential Countermeasures

Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being. We then propose countermeasures that have been implemented to mitigate the effects of fatigue and describe how training programs or practice groups who must work overnight can adapt these strategies for use in a hospital setting. Countermeasures include the use of scheduling interventions, strategic naps, microbreaks, caffeine use during overnight and extended shifts, and the use of bright lights in the clinical setting when possible or personal blue light devices when the room lights must be turned off. Although this review focuses primarily on anesthesiology residents in training, many of the mitigation strategies described here can be used effectively by physicians in practice. Accepted for publication September 8, 2017. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Keith J. Ruskin, MD, Department of Anesthesia and Critical Care, University of Chicago, 5841 S Maryland Ave, MC4028, Chicago, IL 60637. Address e-mail to ruskin@uchicago.edu. © 2017 International Anesthesia Research Society

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Noninfectious Fever in the Near-Term Pregnant Rat Induces Fetal Brain Inflammation: A Model for the Consequences of Epidural-Associated Maternal Fever

BACKGROUND: BACKGROUND:Women laboring with epidural analgesia experience fever much more frequently than do women who chose other forms of analgesia, and maternal intrapartum fever is associated with numerous adverse consequences, including brain injury in the fetus. We developed a model of noninfectious inflammatory fever in the near-term pregnant rat to simulate the pathophysiology of epidural-associated fever and hypothesized that it would produce fetal brain inflammation. METHODS: METHODS:Twenty-four pregnant Sprague-Dawley rats were studied at 20 days gestation (term: 22 days). Dams were treated by injection of rat recombinant interleukin (IL)-6 or vehicle at 90-minute intervals, and temperature was monitored every 30 minutes. Eight hours after the first treatment, dams were delivered of fetuses and then killed. Maternal IL-6 was measured at delivery. Fetal brains (n = 24) were processed and stained for ED-1/CD68, a marker for activated microglia, and cell counts in the lateral septal and hippocampal brain regions were measured. Fetal brains were also stained for cyclooxygenase-2 (COX-2), a downstream marker of neuroinflammation. Eight fetal brains were further analyzed for quantitative forebrain COX-2 by Western blotting compared to a β-actin standard. Maternal temperature and IL-6 levels were compared between treatments, as were cell counts, COX-2 staining, and COX-2 levels by Mann-Whitney U test, repeated-measures analysis of variance, or Fisher exact test, as appropriate. RESULTS: RESULTS:Injection of rat IL-6 at 90-minute intervals produced an elevation of maternal temperature compared to vehicle (P

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American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors

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American Thyroid Association: Charles H. Emerson, MD, Will Lead New Board of Directors

October 19, 2017—The American Thyroid Association (ATA) announces with pleasure the election of Charles H. Emerson, MD, as president of its Board of Directors. All terms begin at the close of the Annual Meeting, taking place October 18‒22 in Victoria, British Columbia.

Additional new board members include:

Elizabeth Pearce, MD, MSc, President-Elect
Julie Ann Sosa, MD, MA, FACS, Treasurer
Douglas Forrest, PhD, Research Director
Megan Haymart, MD, Clinician Director
Thomas Giordano, MD, PhD, Pathology Director

Charles H. Emerson, MD, President

Dr. Emerson is Professor Emeritus of Medicine at the University of Massachusetts Medical School (UMASSMED). He received his MD degree from the University of Virginia and completed his internship and residency in internal medicine at the Hospital of the University of Pennsylvania (Penn) in Philadelphia. After a year of endocrine fellowship at the same institution, he served as Chief of Endocrinology at the US Army Medical Center in Augusta, GA. Following military service, he returned to Penn and completed his endocrine fellowship, where he worked on purifying thyroid stimulating antigen, the kinetics of thyrotropin releasing hormone (TRH), inappropriate TSH secretion, and the effects of lithium and stable iodine on thyroid function.

After six years as Assistant Professor of Medicine at the University of Illinois, Dr. Emerson was recruited to UMASSMED by Lewis E. Braverman, MD. The two collaborated on a study of thyroid hormone metabolism in the chorion and placenta of various species, sparked by the finding that, in experimental models of hypothyroidism, reverse T3 in amniotic fluid was derived from the mother rather than the fetus. Among the other areas of Dr. Emerson's research are the effects of recombinant TSH in humans and rats, the relationship between age and the thyrotroph response to primary hypothyroidism and, working with Dr. Ronald Lechan, the mechanism of fasting-induced suppression of ProTRH mRNA in the hypothalamic paraventricular nucleus.

Dr. Emerson has served on the VA Merit Review Board and as an ad hoc member of NIH study sections. He is a member of the Endocrine Society, the American Association of Clinical Endocrinologists, the European Thyroid Association and, since 1976, the ATA. He has served on the ATA Program, Awards, and Development Committees, and as Chair of the Membership and Bylaws Committees. He was a member of the ATA Board from 2003 to 2007 and Treasurer from 2004 to 2007.

From 2008 through 2012 he was Editor-in-Chief of the journal Thyroid. He is currently Associate Editor of Clinical Thyroidology and Associated Editor of Endocrine Practice. Dr. Emerson was awarded the ATA's Distinguished Service Award in 2010.

He writes, "My vision of the ideal ATA is that it should be an intellectual home and voice for both individuals and groups, for original groundbreaking research and education of health care workers and the public, for scholarly work by one or two people and collective synthesis of the literature by groups. Revolutionary insights are generally formulated by individuals or close collaborations between two or three investigators. These in turn are integrated into the mainstream by groups, ideally in an erudite fashion. I will strive for an agenda and allocation of resources and time that is inclusive of these outwardly competing values."

Dr. Emerson has served a year on the board as President-Elect. He will now serve a one-year term as President, followed by a one-year term as Past-President.

Elizabeth Pearce, MD, MSc, President-Elect

Dr. Pearce is Associate Professor of Medicine in the Endocrinology, Diabetes, and Nutrition Section at Boston University School of Medicine. She received her undergraduate and medical degrees from Harvard and a masters' degree in epidemiology from the Boston University School of Public Health. She completed her residency in internal medicine at Beth Israel Deaconess Medical Center, and her fellowship in endocrinology at Boston University under the mentorship of Dr. Lewis Braverman. Her research interests include the sufficiency of dietary iodine in the U.S. and globally; thyroid function in pregnancy; thyroidal effects of exposure to environmental endocrine disruptors; and the cardiovascular effects of subclinical thyroid dysfunction. She has been part of the leadership of the Iodine Global Network (IGN; formerly ICCIDD) since 2009. She is a member of the AACE Thyroid Scientific Committee and serves as faculty for the Endocrine Society's annual board review course. She has served on multiple editorial boards, including those for Endocrine Practice, Journal of Clinical Endocrinology and Metabolism, Clinical Endocrinology, European Journal of Clinical Nutrition, and Lancet Diabetes & Endocrinology.

Dr. Pearce has been a member of the American Thyroid Association since 2000. She has chaired both the ATA's Publications and Public Health Committees. She co-chaired the 2012 Annual Meeting Program Committee and the 2009 and 2016 Spring Symposia, and was a member of the Program Committee for the 2015 International Thyroid Congress. She has served as a member of the ATA Finance Committee, and currently is a member of the Guidelines Policy Task Force. She was one of the leaders of the effort to establish the ATA's Braverman Lectureship and co-chaired the task force for the 2017 Pregnancy Guidelines. She is Associate Editor for both Thyroid and Clinical Thyroidology journals. She served as a member of the Board of Directors from 2009­ to 2013. Dr. Pearce was the 2011 recipient of the ATA Van Meter Award for outstanding contributions to research on the thyroid gland.

Julie Ann Sosa, MD, MA, FACS, Treasurer

After a year as Treasurer-Elect, Dr. Sosa will now become Treasurer. She is Professor of Surgery and Medicine in Oncology at Duke University, where she serves as Chief of Endocrine Surgery and Director of the Surgical Center for Outcomes Research, as well as Leader of the Endocrine Neoplasia Diseases Group at the Duke Cancer Institute and the Duke Clinical Research Institute, a large transdisciplinary group of clinicians and researchers. She received her AB at Princeton, her MA at Oxford, and her MD at Johns Hopkins, where she also completed the Halsted residency and a fellowship. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer. She is an NIH-funded investigator and author of more than 230 peer-reviewed publications and 50 book chapters, largely focused on outcomes research and thyroid cancer, including clinical trials.

Dr. Sosa is also this year's Lewis E. Braverman Distinguished Award recipient. The Braverman Award recognizes an individual who: demonstrates excellence and passion for mentoring fellows, students, and junior faculty; has a long history of productive thyroid research; and is devoted to the ATA. At the Annual Meeting, she will present the Braverman lecture, titled "Retelling the Story of Thyroid Cancer—Rising Incidence, Mortality, and Maybe an Explanation."

In addition to Board liaison to the ATA Finance and Audit Committee and Internet Communications Committee, Dr. Sosa is a past Chair of the Program Committee and has served on the Nominating Committee and Patient Affairs and Education Committee, as well as guidelines committees for the management of thyroid nodules and differentiated thyroid cancer (2015) and hyperthyroidism/thyrotoxicosis (2011, 2016). She was vice president of the American Association of Endocrine Surgeons and serves on the Board of Directors of the International Thyroid Oncology Group as well as the Executive Council of the Society for Surgical Oncology. She is a member of the National Comprehensive Cancer Network (NCCN) Practice Guidelines Committee for Neuroendocrine Tumors. She is deputy editor of JAMA-Surgery and associate editor for World Journal of Surgery, Journal of Surgical Research, and Current Opinion in Oncology. She is on the editorial boards of the Annals of Surgical Oncology, Annals of Surgery, Hormones and Cancer, Endocrine, and Surgery. She has mentored more than 50 students, residents, and fellows.

Douglas Forrest, PhD, Research Director

Dr. Forrest is Senior Investigator in the Laboratory of Endocrinology and Receptor Biology at the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) at the National Institutes of Health (NIH). He received his PhD at Glasgow University for studies on feline leukemia virus. His life-long interest in thyroid hormone was first sparked during training at the European Molecular Biology Laboratory in Heidelberg and the Karolinska Institute in Stockholm.

In the United States, Dr. Forrest previously held faculty appointments as Assistant Professor, then Associate Professor at the Department of Human Genetics at Mount Sinai School of Medicine. His experience includes teaching and obtaining NIH and international grants. He has served on grant study sections and on the editorial boards of Thyroid, Endocrinology, Molecular Endocrinology, and Frontiers in Endocrinology. He has mentored trainees who have pursued careers in independent research, clinical practice, industry, and scientific administration.

Dr. Forrest's research interests concern thyroid hormone functions in mammalian development and disease with emphasis on basic and translational studies of thyroid hormone receptors and deiodinase enzymes. His contributions have been recognized with the ATA Van Meter Award and the Merck Prize of the European Thyroid Association. He has presented the Shizume Lecture of the Japanese Thyroid Association and the Pitt-Rivers Lecture of the British Endocrine Society.

A member of the ATA since 1999, Dr. Forrest has served on the Annual Meeting Program Committee, the Awards Committee, the Planning Committee for the Spring Summit on "The thyroid in pregnancy and development," and the Basic Research Guidelines Task Force. He co-authored the "ATA Guide to investigating thyroid hormone economy and action in rodent and cell models." He was co-chair with Elizabeth Pearce of the 82nd Annual Meeting in Quebec City. He currently serves on the Trainee Career and Advancement Committee as chair of the Basic Track and is a keen advocate for all trainees in the thyroid field.

Megan Haymart, MD, Clinician Director

Dr. Haymart is Associate Professor of Medicine in the Division of Metabolism, Endocrinology, and Diabetes and Hematology/Oncology at the University of Michigan. She received her MD degree from Johns Hopkins Medical School. She completed her internal medicine residency at Johns Hopkins Hospital and her endocrinology fellowship at the University of Wisconsin.

Dr. Haymart's clinical focus is thyroid cancer and thyroid nodules, working with a multidisciplinary endocrine oncology team at the University of Michigan. Her research focus is on variation in the management of thyroid disorders, with an emphasis on the role of patients, providers, and health systems in treatment decision-making. With R01 funding from the National Cancer Institute (NCI) of the National Institutes of Health (NIH), she is currently evaluating treatment decision-making in low-risk thyroid cancer. With R01 funding from the Agency for Healthcare Research and Quality (AHRQ), she is investigating the role of imaging in the over-diagnosis of low-risk thyroid cancer.

In addition to her clinical efforts and research endeavors, Dr. Haymart is involved in creating the National Comprehensive Cancer Network (NCCN) thyroid carcinoma guidelines. She is the recent recipient of the University of Michigan's Jerome Conn Award for Research Excellence. She currently serves as chair of the ATA Finance and Audit Committee and is on the Endocrine Society's Annual Meeting Steering Committee. She served on the editorial board of the Journal of Clinical Endocrinology and Metabolism (JCEM) from 2013 to 2016 and currently serves on the editorial boards of Thyroid (since 2013) and Endocrine Today (since 2017). She is also Associate Editor for VideoEndocrinology (2014‒present).

Thomas Giordano, MD, PhD, Pathology Director

Dr. Giordano is the Henry Clay Bryant Professor of Pathology in the Department of Pathology, University of Michigan Medical School, and holds a joint appointment in the Metabolism and Endocrinology Division of the school's Department of Internal Medicine. After receiving his BA from Johns Hopkins University, Dr. Giordano earned his MD and PhD in a combined program at the Rutgers University and UMDNJ's Robert Wood Johnson Medical School. His graduate studies in the Department of Microbiology involved the regulation of gene expression. He completed residency training in anatomic pathology at the National Cancer Institute (NCI) and fellowship training in oncologic pathology at Memorial Sloan-Kettering Cancer Center. Both residency and fellowship training permitted extensive exposure to endocrine pathology. He then joined the faculty at the University of Michigan Medical School.

Dr. Giordano is an endocrine and molecular pathologist with long-standing interests in thyroid and adrenocortical neoplasia. His specific academic interests in thyroid cancer include molecular and genomic profiling and tumor classification. He served as co-chair of The Cancer Genome Atlas's (TCGA's) Papillary Thyroid Carcinoma project, which he led from its initiation to publication in Cell in 2014. He also was instrumental in convincing the TCGA leadership to conduct their Adrenal Cortical Carcinoma project and served as co-chair of this study until its publication in Cancer Cell in 2016. He also served on the Analysis Working group for the TCGA Pheochromocytoma project, published in Cancer Cell in 2017. He currently serves on
the TCGA Steering Committee for the PanCancerAtlas project, the goal of which is to collectively evaluate the genomics of all tumors studied by TCGA.

Dr. Giordano regularly attends the ATA Annual Meeting and has participated on their Tumor Board for the last two years. He is a member of the ATA Laboratory Services Committee and ATA Anaplastic Thyroid Cancer (ATC) Guidelines Task Force.

Nominating Process

The ATA thanks this year's nominating committee, chaired by David Steward, and is extremely grateful to all who are willing to stand for election and to serve on the Board of Directors. Special thanks to those who will retire from the Board this year: Anthony Hollenberg, MD, Jacqueline Jonklaas, MD, outgoing Past-President Anthony Bianco, MD, PhD, and outgoing Treasurer David H. Sarne, who has served for six years in that position. Additional thanks to current President John Morris, MD, who now continues to serve as Past-President of the Board.

###

 

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

 

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

 

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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The ATA announced the John B. Stanbury Thyroid Pathophysiology Medal recipient

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American Thyroid Association's 2017 Stanbury Medal to Be Awarded to James A. Fagin, MD

The ATA announced the John B. Stanbury Thyroid Pathophysiology Medal recipient

James A. Fagin, MDOctober 16, 2017—The American Thyroid Association (ATA) announces with pleasure that the 2017 John B. Stanbury Thyroid Pathophysiology Medal will be awarded to James A. Fagin, MD. Dr. Fagin specializes in research of the pathogenesis of thyroid cancer at Memorial Sloan-Kettering Cancer Center in New York, where he is Chief of Endocrinology and a member of the Human Oncology and Pathogenesis Program.

The Stanbury Medal recognizes outstanding research contributions, conceptual or technical, to the understanding of thyroid physiology or the pathophysiology of thyroid disease, which have had a major impact on research or clinical practice. The medal is conferred at the ATA Annual Meeting, held this year from October 18 to 22 in Victoria, British Columbia, just prior to the Sawin Historical Vignette on Friday, October 20 at 4:00 pm.

Dr. Fagin received his MD from the University of Buenos Aires School of Medicine. His postdoctoral training included an internship at Rawson Hospital in Buenos Aires, then a position as Senior House Officer and Medical Registrar in General Medicine at several hospitals in London. Next, he was a Fellow in the Endocrinology and Nuclear Medicine Unit at Hospital Italiano in Buenos Aires, a Research Fellow in Endocrinology at VA Wadsworth Medical Center in Los Angeles, and a Research Scientist at Cedars-Sinai Medical Center (CSMC) in Los Angeles.

While at CSMC, Dr. Fagin developed an interest in the growth of pituitary tumors and the role of paracrine regulation of insulin-like growth factors. He later investigated these topics in his own lab, where he began to focus on the genetic basis of thyroid cancer. He was the first to establish that benign and malignant thyroid tumors were clonal, including many of the tumors arising within multinodular goiters, which until that point were thought to be primarily hyperplastic nodules.

Dr. Fagin played a leading role in determining the mechanisms of RET recombination in post-Chernobyl pediatric thyroid cancers, through his mentorship of, and subsequent partnership with, Dr. Yuri Nikiforov. He continued to research radiation-induced thyroid cancer and identified a comprehensive set of fusion events associated with the disease, several of which had not previously been discovered. Other research projects followed, many supported by NIH, National Cancer Institute, and American Diabetes Association grants. Most recently, Dr. Fagin has turned his attention to the pathogenesis of poorly differentiated and anaplastic thyroid cancers.

Over the years Dr. Fagin has been welcomed as a national and international speaker at pathology and endocrinology conferences and as an invited professor at universities worldwide. He has presented his research findings in more than 150 publications in prestigious journals and over 50 books, of which he is the author or coauthor. In addition, he has mentored dozens of graduate students, clinical and postdoctoral fellows, and junior faculty members in their research projects.

Dr. Fagin served the ATA as President in 2011, the ATA Board of Directors, as Co-chair of the Annual Meeting Program Committee, Chair of the Research Committee and contributed to the society in many other leadership roles since he joined in 1991.  He was an author on the ATA Guidelines for management of medullary thyroid cancer in 2014.  He was awarded the Sidney H. Ingbar Distinguished Lectureship in 2008.

Dr. Fagin's research productivity, his continued contributions to the understanding of the pathophysiology of thyroid disease, along with his mentorship and the ability to translate his findings for the world, all make him a superb awardee for the Stanbury Medal.

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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ATA selects Sidney H. Ingbar Distinguished Award recipient

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American Thyroid Association's 2017 Sidney H. Ingbar Distinguished Award Lecture Delivered by Yuri Nikiforov, MD, PhD

ATA selects Sidney H. Ingbar Distinguished Award recipient

Yuri Nikiforov, MD, PhDOctober 16, 2017—The American Thyroid Association (ATA) is pleased to announce that the 2017 Sidney H. Ingbar Distinguished Award will be received by Yuri Nikiforov, MD, PhD, who is Vice Chair and Director of the Division of Molecular and Genomic Pathology, Department of Pathology, University of Pittsburgh School of Medicine (UPMC).

The Sidney H. Ingbar Distinguished Lectureship Award, en dowed by contributions to honor the memory of Sidney H. Ingbar, recognizes outstanding academic achievements in thyroidology, in keeping with the innovation and vision that epitomized Dr. Ingbar's brilliant investigative career. The Ingbar award is conferred upon an established investigator who has made major contributions to thyroid-related research over many years. At the ATA annual meeting in Victoria, British Columbia, Dr. Nikiforov will deliver the Ingbar Lecture at 1:00 pm on October 21, 2017. His lecture title is "Genomic Evolution of Thyroid Nodules and Cancer – New Answers to Old Questions."

Dr. Nikiforov received his MD with Honors from Minsk Medical Institute in Belarus and his PhD from the same Institute's Laboratory of Experimental Pathology. He then spent 15 years in postdoctoral research, in both pathology and endocrinology, first at the Minsk City Hospital, then at the Rhode Island City Hospital/Brown University, the Cedars-Sinai Medical Center/UCLA School of Medicine in Los Angeles, and the University of Cincinnati College of Medicine. He is certified in Anatomic Pathology by the American Board of Pathology.

With his colleagues, Dr. Nikiforov documented the genetic changes to the thyroid that occur in the setting of radiation injury, resulting in malignant transformation. His patients for this study were children who had been exposed to radiation by the Chernobyl nuclear plant accident. This and other basic science discoveries over the years are combined with his work in thyroid cancer diagnosis (introducing mutational markers, enabling highly accurate diagnoses in thyroid nodules, and more) and with developing a method for molecular testing to identify thyroid cancers, thereby reducing the number of surgeries.

In addition to many academic honors and awards, both national and international, Dr. Nikiforov currently serves on the editorial boards of three journals—Endocrine PathologyHuman Pathology, and Thyroid Research—and has served on the boards of two additional journals in the past.

Dr. Nikiforov joined the ATA in 2000 and has served and contributed to the Research and Program Committees, Guidelines for Management of Anaplastic Thyroid Cancer; and, Differentiated Thyroid Cancer; as well as, annual meeting faculty over many years.

Lectures and seminars on thyroid health, pathology, research, clinical care, and molecular genetics have called Dr. Nikiforov to universities, symposia, conferences, and annual meetings around the world. He has published substantial numbers of peer-reviewed articles (his CV lists 158 in which he has taken part), additional articles (25), books (2), book chapters (10), and several other publications.

As Dr. Sally Carty, Chief of the Division of Endocrine Surgery at UPMC, states in her award nomination letter, "Dr. Nikiforov humbly, ably, and outstandingly embodies" the qualities required for the Ingbar Award. She continues, he is "a pluripotent thyroidologist, scientist, mentor, and instigator of change of behalf of patients."

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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Paul Starr Award recipient 2017

American Thyroid Association's 2017 Paul Starr Award Lecture to Be Delivered by Quan-Yang Duh, MD, FACS

The ATA announced the Paul Starr Award recipient

 October 16, 2017—The American Thyroid Association (ATA) announces with pleasure that the 2017 Paul Starr Award recipient is Quan-Yang Duh, MD, FACS, Professor of Surgery and Chief of Endocrine Surgery at the University of San Francisco (UCSF). Dr. Duh is also Attending Surgeon at the Veterans Affairs Medical Center in San Francisco.

The Paul Starr Award is presented to an outstanding contributor to clinical thyroidology. At the ATA annual meeting in Victoria, British Columbia, Dr. Duh will deliver the Starr Lecture at 1:00 pm on October 20, 2017. His lecture is titled "Technical and Technological Advances that Changed Thyroid Surgery."

Dr. Duh joined the ATA in 1990 and has served on the editorial boards of Thyroid and VideoEndocrinology; as well as several committees, ATA Research, Surgical Affairs and Annual Meeting Program Committee.

Dr. Duh is recognized nationally and internationally as a leader in endocrine surgery. He graduated Phi Beta Kappa and Summa Cum Laude from Yale University, then attended UCSF Medical School, where he graduated Alpha Omega Alpha (Honor Medical Society). He then did a surgical residency and a fellowship in endocrine surgery at UCSF and subsequently joined their surgical faculty.

As a teacher, a researcher, and a surgeon, Dr. Duh has served as a mentor to more than 100 surgery and research fellows, has assured the future of endocrinology and endocrine surgery.  In addition, Dr. Duh has written more than 300 peer-reviewed articles and has been a committee member for many practice guidelines involving thyroid cancer, parathyroid surgery, pheochromocytoma, and adrenal surgery.

As stated in his letters of nomination for the Paul Starr Award, Dr. Duh's superb skills and expertise, his wealth of knowledge, and his approachable manner and kindness lead all who work with him and learn from him—including his patients—to trust and admire him. He is indeed an outstanding contributor to clinical thyroidology.

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

 

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ATA selects Lewis E. Braverman Distinguished Lectureship Award recipient

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American Thyroid Association's 2017 Lewis E. Braverman Distinguished Award Lecture Delivered by Julie Ann Sosa, MD, MA, FACS

ATA selects Lewis E. Braverman Distinguished Lectureship Award recipient

Julie Ann Sosa, MD, MA, FACSOctober 16, 2017—The American Thyroid Association (ATA) is pleased to announce that the 2017 Lewis E. Braverman Distinguished Lectureship Award recipient is Julie Ann Sosa, MD, MA, FACS, Professor of Surgery and Medicine in Oncology, Duke Cancer Institute and Duke Clinical Research Institute. The Braverman Award recognizes an individual who: demonstrates excellence and passion for mentoring fellows, students, and junior faculty; has a long history of productive thyroid research; is devoted to the ATA.

At the ATA annual meeting in Victoria, British Columbia, Dr. Sosa will deliver the Braverman Lecture at 1:00 pm on October 19, 2017. Her lecture title is "Retelling the Story of Thyroid Cancer—Rising Incidence, Mortality, and Maybe an Explanation."

Dr. Sosa received her MD from the Johns Hopkins University School of Medicine and completed her internship and residency in General Surgery at Johns Hopkins Hospital. For 10 years she worked at Yale University School of Medicine, first as Assistant Professor of Surgery, then as Associate Professor, then as Director of the Clinical and Health Services Research Group in the Division of Endocrine Surgery, and finally as Leader of the Clinical Research Program in Endocrine Cancers at Smilow Cancer Hospital. She began her work at Duke University in early 2013 and has continued following her passions at that institution.

She has been tireless and selfless in her commitment to her trainees. At Yale and Duke, she has mentored more than 60 individuals, with many of whom she has collaborated on scientific presentations, articles, and book chapters. These mentees have gone on to successful academic and research careers. At Yale she developed a reputation among medical students as the ultimate mentor for anyone interested in building a solid foundation in research and publications. Dr. Sosa expected hard work, absolute commitment, and excellence, and she supported and guided her mentees through impactful research worthy of publication. Of her more than 250 publications, 166 have a learner as co-author, with 140 of those having the mentee as first author.

Dr. Sosa has published extensively on the management of patients with benign and malignant thyroid disease. Recently she was lead investigator on a paper published in the Annals of Surgery (the highest impact surgical journal) that was first to determine the number of total thyroid-ectomies per surgeon per year associated with the lowest risk of complications for patients. The manuscript was declared the most viewed paper published in 2016 in that journal. She is also the principal or coinvestigator of three current thyroid-related investigations, has been involved in a great many more, and has been involved in clinical trials for patients with thyroid cancer.

Since joining the ATA in 2006, she has served as Program Chair of the 2013 Annual Meeting and on the ATA Board of Directors, currently treasurer-elect, and as an active member on committees such as nominating, membership and guidelines policies.  She has served as faculty for many annual meetings, participated in strategic planning and presented at the Ridgway Trainee Conference.  She is a coauthor on the ATA's clinical guidelines for managing patients with hyperthyroidism; differentiated thyroid cancer; and anaplastic thyroid cancer.

Dr. Sosa contributes on editorial boards as well as in leadership roles and faculty for other medical and surgical societies devoted to care of the endocrine patient.

Dr. Julie Ann Sosa embodies the spirit of the Lewis E. Braverman Distinguished Award in her passion for selfless mentoring of others, her long and valuable intellectual efforts in the field of thyroid research, and her energetic devotion to the ATA.

###

The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health.  These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

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External validation of a cancer risk prediction model for suspected head and neck cancer referrals

Abstract

Head and neck cancer (HNC) affects more than 9000 new patients every year in England and Wales with an additional 1200 in Scotland. 1,2 Patients are urgently referred to head and neck clinics for further assessment when a suspicion of cancer is raised in the primary care setting. In England, the referral criteria are based on the NICE recommendations for symptoms associated with HNC. 2 A different combination of symptoms is described in the Scottish cancer referral guidelines. 3 There is currently no unified referral proforma across the different UK cancer networks.

This article is protected by copyright. All rights reserved.



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A review of periorbital cellulitis guidelines in Fifty-One Acute Admitting Units in the United Kingdom

Abstract

Periorbital cellulitis is an acute infection of the periorbital soft tissues with potential sight and life threatening complications that most commonly occurs in children[1]. Post-septal abscess formation can cause loss of sight; furthermore, posterior spread of infection may progress to cavernous sinus thrombosis and intracranial infection[1, 2]. In England April 2014-March 2015, 3687 patients attended hospital with periorbital cellulitis costing the National Health Service over £9.5 million per annum before considering the cost of treating its complications[3].

This article is protected by copyright. All rights reserved.



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Post-operative corticosteroid irrigation for chronic rhinosinusitis after endoscopic sinus surgery: a meta-analysis

Abstract

Background

Recently, topical steroid therapy delivery using high-volume sinonasal irrigations has been used more frequently, following endoscopic sinus surgery (ESS), to improve drug delivery into the paranasal sinuses.

Objective

The goal of this study was to perform a systematic review with meta-analysis of the efficacy of steroid nasal irrigation on postoperative management of CRS following ESS.

Methods

Five databases (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) from inception to March 2017 were independently reviewed by two researchers. Studies that scored CRS endoscopic findings and CRS-related quality of life postoperatively before and after steroid nasal irrigation, and that compared the effects of steroid nasal irrigation (treatment groups) with saline alone irrigation (control group) were included in the analysis.

Results

Twelve studies (n=360) met inclusion criteria. Steroid nasal irrigation significantly reduced the endoscopic score compared with pretreatment values and also improved quality of life. Adverse effects following steroid nasal irrigation such as increased intraocular pressure and hypothalamus-pituitary-adrenal axis disturbance were not significant. However, compared with saline alone irrigation, the additional effects of steroid irrigation were not significant in the view of the endoscopic score and disease-specific quality of life.

Conclusion

Although steroid nasal irrigation would not induce adverse effects related to systemic steroid absorption, the beneficial effects of additional steroids in saline irrigation were ambiguous in regards to endoscopic score and CRS-related quality of life improvement compared with saline alone irrigation. However, further clinical trials with robust research methodologies should be conducted to confirm the results of this study.

This article is protected by copyright. All rights reserved.



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Influence of Backside Loading on the Floating Mass Transducer: an in vitro experimental study

Abstract

Hypothesis

The vibration of the floating mass transducer (FMT) of a single active middle-ear implant (AMEI) is distinctly influenced by the properties of the material coupled to its back side.

Background

In round window vibroplasty, the FMT needs to be padded against the surrounding bone opposite from the round window membrane. This represents one factor influencing its performance as a round window driver. Therefore, we examined the effects of different materials linked to the back side of an FMT on its vibration range.

Methods

The back side of an FMT was glued to a silicone cylinder 1.0 mm in diameter and 1.0 mm – 1.5 mm in length and of 40A, 50A or 70A Shore hardness; to cartilage of equivalent size; or to a round window soft coupler (RWSC), all firmly fixed on a steel plate. The vibrations were determined by a laser Doppler vibrometer (LDV) measuring the velocity of the centre point on the front side of the FMT.

Results

The materials on the back side of the FMT significantly influenced the vibration range of the FMT. The RWSC and silicone of 40A Shore hardness allowed for the highest detected velocities, while cartilage led to a distinct reduction similarly to 70A silicone.

Conclusion

The coupling on the back side of an FMT distinctly affects its vibration range. In this regard, the RWSC and silicone of 40A Shore hardness yield the least impairment of vibration. Thus, the RWSC may be a feasible option in round window vibroplasty when additionally connected to the FMT opposite from the round window membrane.

This article is protected by copyright. All rights reserved.



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Efficacy of Laryngectomy alone for Treatment of Locally Advanced Laryngeal Cancer: A Stage and Subsite Specific Survival Analysis

Abstract

Objective

Total laryngectomy is a well-established treatment for locally advanced laryngeal cancer. Evidence for the benefit of post-operative radiotherapy after laryngectomy in patients with locally advanced primaries and N0 or N1 nodal disease is limited. This study aims to determine whether total laryngectomy alone is adequate therapy for certain patient subgroups with locally advanced laryngeal cancer.

Design

We performed a retrospective survival analysis of patients in the surveillance epidemiology and end results (SEER) database with locally advanced laryngeal cancer between 2004-2012.

Outcome Measures

Primary outcome measure was overall survival.

Results

For all patients with T3-4aN0-1 tumors, overall survival was worse for those treated with laryngectomy only when compared using the Kaplan-Meier with a Log-Rank test and when accounting for demographic and tumor data using a Cox multivariate regression. Other independent predictors of poor survival included age > 65 years old, Medicaid or uninsured payor status, supraglottic primary and N1 nodal disease. Stage and subsite specific analysis revealed that patients with T4a primary tumors, N1 nodal disease and supraglottic subsite had worse overall survival when treated with laryngectomy alone. Alternatively, patients with T3 primary tumors, N0 nodal disease, glottic subsite had equivalent overall survival and disease specific survival when treated with laryngectomy alone versus laryngectomy with post-operative radiotherapy.

Conclusion

Locally advanced laryngeal cancer patients with T3 primaries, no nodal disease or primaries of the glottis may not benefit from post operative radiotherapy when treated with primary total laryngectomy.

This article is protected by copyright. All rights reserved.



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Age of Diagnosis, Incidence and Prevalence of Recurrent Respiratory Papillomatosis – A South African Perspective

Abstract

Objectives

To determine the distribution of the age of onset of recurrent respiratory papillomatosis (RRP) and to determine the incidence and prevalence of RRP in both adults and children in the Free State province of South Africa in order to provide data from a population in sub-Saharan African.

Design

Retrospective record review.

Participants

All patients with recurrent respiratory papillomatosis in the Free State province of South Africa between 2011 and 2015.

Main outcome measures

Distribution of the age of diagnosis of RRP and incidence and prevalence of RRP.

Results

The best fitting mixture distribution for the age of diagnosis of RRP was a two-component mixture of log-normal distributions. Within the first component (JoRRP), the age of diagnosis was significantly lower in patients with HPV11 disease (median 3.2 year) than those with HPV6 disease (median 5.6 years) (p=0.021), while in the second component (AoRRP), there was no significant difference in the age of diagnosis between HPV11 disease (30.7 year) and HPV6 disease (median 44.0 years) (p=0.0696).

The incidence and prevalence of JoRRP were 1.34/100000 population/year and 3.88/100000 population, respectively, while the incidence and prevalence of AoRRP were 0.18/100000 population/year and 0.38/100000 population, respectively.

Conclusion

RRP in the Free State province of South Africa is a disease with a predominantly juvenile onset, with AoRRP having a lower prevalence than in Europe. This is probably reflective of the situation in sub-Saharan Africa.

This article is protected by copyright. All rights reserved.



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Impact of dermatology eConsults on access to care and skin cancer screening in underserved populations: A model for teledermatology services in community health centers

The clinical outcome of teledermatology with dermoscopy in large-scale primary care networks remains unclear.

http://ift.tt/2yWbLkR

Changing antimalarial agents after inefficacy or intolerance in patients with cutaneous lupus erythematosus: A multicenter observational study

Changing from one antimalarial (AM) agent to another is often recommended in cutaneous lupus erythematosus (CLE) when the first AM agent is ineffective or poorly tolerated.

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Dermoscopic technique for the evaluation of the nail unit



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2017 Distinguished Service Award

American Thyroid Association's 2017 Distinguished Service Award to Be Presented to Bryan R. Haugen, MD

ATA selects DSA

October 16, 2017—The American Thyroid Association (ATA) announces with pleasure that the 2017 Distinguished Service Award (DSA) will be presented to Bryan R. Haugen, MD. Dr. Haugen is Professor of Medicine and Pathology at the University of Colorado,  is Head of the Division of Endocrinology, Diabetes, and Metabolism, and holds the Mary Rossick Kern and Jerome H. Kern Chair in Endocrine Neoplasms Research. He is also a staff physician at the University of Colorado Hospital in Aurora and at the VA Medical Center in Denver.

The Distinguished Service Award recognizes an ATA member who has made important and continuing contributions to the American Thyroid Association. Dr. Haugen's award will be given at the ATA annual meeting, October 18 to 22, in Victoria, British Columbia, just prior to the Sawin Historical Vignette on Friday, October 20 at 4:00 pm.

Dr. Haugen received his MD from Mayo Medical School in Rochester, Minnesota. He then served his internship, residency in internal medicine, and both clinical and research fellowships in endocrinology, all at the University of Colorado Health Sciences Center.

He is considered an eloquent leader and researcher in the field of thyroid cancer molecular mechanisms. Dr. Haugen's research commitment is demonstrated by the substantial NIH independent funding he continues to receive. His publications describing detailed research and experimentation number in the hundreds, and he is welcomed as a speaker on his specialties at conferences, symposia, and universities around the world.  In clinical practice, Dr. Haugen has had a great interest in caring for patients with thyroid cancer and helping to find better treatments and management strategies for more than 20 years.

Dr. Haugen has served in leadership positions in the ATA over many years, as co-chair of the Annual Meeting Program committee, as a fundraiser for the E. Chester Ridgway Legacy Fund in support of the Ridgway Trainee Conference.  He has trained numerous postdoctoral candidates from around the country and the world, thereby extending his impact on the future of thyroid research and clinical practice.  Since joining the ATA in 1994, his commitment has set a high bar. He served as ATA president in 2012-2013, and received its Paul Starr award in 2012.

His model of service extends to many other professional organizations, contributed significantly to committees at the university, state, national, and international levels, and served on the editorial boards, or as an editor or reviewer, for a dozen journals. Other honors include recognition as one of the Best Doctors in America from 2006 through 2014, the Farahe Maloof Lectureship at Massachusetts General Hospital in 2012, and the Clinical Innovation Award from the University of Colorado Hospital in 2015.

A notable contribution to the ATA was his chairmanship of the 2015 Thyroid Nodule and Thyroid Cancer ATA Guidelines. Dr. Haugen "orchestrated the panel members through a massive undertaking, always with the highest quality in mind and with a collaborative spirit," according to Dr. Gregory Randolph of the Massachusetts Eye and Ear Infirmary in his recommendation letter for this award.

Dr. Haugen has contributed his time, talents, energy, perspective, and leadership to the Association throughout his career, thereby meriting this year's ATA Distinguished Service Award.

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The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 94th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:

  • The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
  • Annual scientific meetings
  • Biennial clinical and research symposia
  • Research grant programs for young investigators
  • Support of online professional, public, and patient educational programs
  • Development of guidelines for clinical management of thyroid disease and thyroid cancer

The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).

 

The post 2017 Distinguished Service Award appeared first on American Thyroid Association.



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A Corrosive Force in Medical Care

Are RVUs slowly but surely killing the art of medicine?
Medscape

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Novel Injectable Tissue-Regeneration Facial Procedure

A discussion with Dr Steven Cohen, who is behind this potential breakthrough antiaging treatment.
Medscape Plastic Surgery

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Trastuzumab-Emtansin vs. Capecitabin plus Lapatinib bei Patienten mit vorbehandeltem HER2-positivem metastasierten Mammakarzinom



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Amelioration of natural killer cell function driven by invariant natural killer T cell activation in multiple myeloma

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Publication date: Available online 20 October 2017
Source:Clinical Immunology
Author(s): Tomonori Iyoda, Satoru Yamasaki, Michihiro Hidaka, Fumio Kawano, Yu Abe, Kenshi Suzuki, Norimitsu Kadowaki, Kanako Shimizu, Shin-ichiro Fujii
NK cells represent a first line of defense, but are progressively dysregulated in multiple myeloma (MM) patients. To restore and facilitate their antitumor effect, NK cells are required in sufficient quantities and must be stimulated. We initially assessed the frequency of NKT and NK cells from 34 MM patients. Both of frequencies in PBMCs correlated with those in BMMNCs irrespective of low numbers of BMMNCs. Then, we assessed the adjunctive effect of NKT cell stimulation with CD1d and α-GalCer complex on the NK cells. The expression of NKG2D on CD56dimCD16+ NK cells and DNAM-1 on CD56brightCD16 NK cells increased after NKT cell activation. Apparently, NK cell-mediated antitumor effects were dependent on NKG2D and DNAM-1 ligands on myeloma cells. Thus, NK cell function in patients could be ameliorated, beyond the effect of immunosuppression, by NKT cell activation. This NKT-driven NK cell therapy could represent a potential new target modality.



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Investigating the minimal clinically important difference for SNOT-22 symptom domains in surgically managed chronic rhinosinusitis

Background

Prior work has described 5 domains within the 22-item Sino-Nasal Outcomes Test (SNOT-22) that allow for stratification of symptoms into similar clusters and that can be used to direct therapy. Although the outcomes of various interventions on these symptom domains have been reported, minimal clinically important difference (MCID) values have not been investigated, which has limited clinical interpretation of these results.

Methods

This study was designed as a secondary analysis of a prospective, multi-institutional, observational cohort. A total of 276 patients with medically refractory CRS who underwent surgical management were enrolled. Distribution-based methods (half-standard deviation, standard error of measurement, Cohen's d, and the minimum detectable change) were used to compute MCID values for both SNOT-22 total and domain scores. The Medical Outcomes Study Short Form 6D (SF-6D) health utility score was used to operationalize anchor-based associations using receiver-operating characteristic (ROC) curves.

Results

The mean MCID of several distribution-based methods for total SNOT-22 scores was 9.0, in agreement with previously published metrics. Average MCID values for the rhinologic, extranasal rhinologic, ear/facial, psychological, and sleep domain scores were 3.8, 2.4, 3.2, 3.9, and 2.9, respectively. Anchor-based approaches with the SF-6D did not have strong predictive accuracy across total SNOT-22 scores or domains (ROC areas under-the-curve ≤ 0.71), indicating weak associations between improvement in SNOT-22 scores and health utility as measured by the SF-6D.

Conclusion

This estimation of MCID values for the SNOT-22 symptom domains allows for improved clinical interpretation of results from past, present, and future rhinologic outcomes research.



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Dermatologist and Patient Preferences in Choosing Treatments for Moderate to Severe Psoriasis

Abstract

Introduction

The objective of the study was to determine the relative importance (RI) of treatment attributes psoriasis patients and physicians consider when choosing between biologic therapies based on psoriasis severity.

Methods

A discrete choice experiment (DCE) weighting preference for eight sets of hypothetical treatments for moderate or severe psoriasis was conducted. DCE hypothetical treatments were defined and varied on combinations of efficacy, safety, and dosing attributes [frequency/setting/route of administration (ROA)].

Results

When assuming moderate psoriasis in the patient DCE, ROA (RI 29%) and efficacy (RI 27%) drive treatment choices. When assuming severe disease in the DCE, patients preferred treatments with higher efficacy (RI 36%); ROA was relatively less important (RI 15%). From the physician perspective, ROA (RI 32%) and efficacy (RI 26%) were most important for moderate psoriasis patients. In the physician model for severe psoriasis, efficacy (RI 42%) was the predominant driver followed by ROA (RI 22%). Regardless of severity, probability of loss of response within 1 year was the least important factor.

Conclusions

The severity of disease is a critical element in psoriasis treatment selection. There are high levels of alignment between physician- and patient-derived preferences in biologic treatment choice selection for psoriasis.

Funding

Janssen Pharmaceuticals.



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NY-ESO-1- and survivin-specific T-cell responses in the peripheral blood from patients with glioma

Abstract

The prognosis for patients with glioblastoma is grim. Ex vivo expanded tumor-associated antigen (TAA)-reactive T-cells from patients with glioma may represent a viable source for anticancer-directed cellular therapies. Immunohistochemistry was used to test the survivin (n = 40 samples) and NY-ESO-1 (n = 38 samples) protein expression in tumor specimens. T-cells from peripheral blood were stimulated with TAAs (synthetic peptides) in IL-2 and IL-7, or using a combination of IL-2, IL-15 and IL-21. CD4+ and CD8+ T-cells were tested for antigen-specific proliferation by flow cytometry, and IFN-γ production was tested by ELISA. Twenty-eight out of 38 cancer specimens exhibited NY-ESO-1 protein expression, 2/38 showed a strong universal (4+) NY-ESO-1 staining, and 9/40 cancer lesions exhibited a strong (4+) staining for survivin. We could detect antigen-specific IFN-γ responses in 25% blood samples for NY-ESO-1 and 30% for survivin. NY-ESO-1-expanded T-cells recognized naturally processed and presented epitopes. NY-ESO-1 or survivin expression in glioma represents viable targets for anticancer-directed T-cells for the biological therapy of patients with glioma.



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Clinical and immunologic evaluation of three metastatic melanoma patients treated with autologous melanoma-reactive TCR-transduced T cells

Abstract

Malignant melanoma incidence has been increasing for over 30 years, and despite promising new therapies, metastatic disease remains difficult to treat. We describe preliminary results from a Phase I clinical trial (NCT01586403) of adoptive cell therapy in which three patients received autologous CD4+ and CD8+ T cells transduced with a lentivirus carrying a tyrosinase-specific TCR and a marker protein, truncated CD34 (CD34t). This unusual MHC Class I-restricted TCR produces functional responses in both CD4+ and CD8+ T cells. Parameters monitored on transduced T cells included activation (CD25, CD69), inhibitory (PD-1, TIM-3, CTLA-4), costimulatory (OX40), and memory (CCR7) markers. For the clinical trial, T cells were activated, transduced, selected for CD34t+ cells, then re-activated, and expanded in IL-2 and IL-15. After lymphodepleting chemotherapy, patients were given transduced T cells and IL-2, and were followed for clinical and biological responses. Transduced T cells were detected in the circulation of three treated patients for the duration of observation (42, 523, and 255 days). Patient 1 tolerated the infusion well but died from progressive disease after 6 weeks. Patient 2 had a partial response by RECIST criteria then progressed. After progressing, Patient 2 was given high-dose IL-2 and subsequently achieved complete remission, coinciding with the development of vitiligo. Patient 3 had a mixed response that did not meet RECIST criteria for a clinical response and developed vitiligo. In two of these three patients, adoptive transfer of tyrosinase-reactive TCR-transduced T cells into metastatic melanoma patients had clinical and/or biological activity without serious adverse events.



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Fourteenth Meeting of the Network Italiano per la Bioterapia dei Tumori (NIBIT) on Cancer Bio-Immunotherapy, Siena, Italy, October 13–15, 2016



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Körper- und Selbsterleben nach minimalinvasiver Hautverjüngung

Zusammenfassung

Hintergrund

Weltweit nutzen mehr und mehr Menschen Botulinumtoxin A (BoNT-A) und Hyaluronsäurefiller zur Hautverjüngung, auch in Deutschland.

Fragestellung

Studie zu Körperbild und Selbstwerterleben von Frauen mit BoNT-A- und/oder Hyaluronsäurefillerbehandlung.

Material und Methoden

Es füllten 145 Frauen, die um eine Behandlung mit BoNT-A und/oder Hyaluronsäurefillern nachsuchten, den Body Dysmorphic Disorder Questionnaire, die Rosenberg-Selfesteem-Skala und Fragebogen zu Einstellungen und Motiven zu körperoptimierenden Maßnahmen sowie zu ihren demografischen Merkmalen aus. Anhand dieser Instrumente wurden das Körper- und Selbstbild sowie die Einstellungen und Motive für die Inanspruchnahme minimalinvasiver Hautverjüngung erhoben.

Ergebnisse

Nutzerinnen minimalinvasiver Hautverjüngung verfügen über einen hohen Bildungsgrad und ein überdurchschnittlich hohes monatliches Nettoeinkommen. Sie leben häufiger in einer Partnerschaft, im Vergleich zu in Berlin lebenden Frauen gleichen Alters. Die Nutzerinnen von BoNT-A und/oder Hyaluronsäurefillern weisen keine Auffälligkeiten in Körperbild und Selbstwerterleben auf. Sie zeigen insgesamt eine moderat-positive Einstellung zu körperoptimierenden Verfahren, und 91 % der Nutzerinnen erreichen ihr Normgewicht (Body-Mass-Index [BMI] ≤25 kg/m2) im Vergleich zu 56 % der deutschen Frauen in der gleichen Altersspanne (25 bis ≥75 Jahre).

Schlussfolgerung

In der ersten Studie mit in Deutschland lebenden Nutzerinnen von BoNT-A und/oder Hyaluronsäurefillern zu Körper- und Selbstbild wiesen die Nutzerinnen keine Hinweise auf Störungen des Körper- und Selbstbilds auf.



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Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl

A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws.



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Lung adenocarcinoma metastastic lesion in the internal auditory meatus

Metastasis to the cerebellopontine angle (CPA) or internal auditory meatus (IAM) is rare.

We report a rare case of a 69-year-old woman with metastatic lung adenocarcinoma, who presented with 2 weeks history of left-sided hearing loss and progressively worsening vertigo. Examination revealed a left-sided facial nerve palsy while pure tone audiometry (PTA) showed a new left-sided deafness. MRI showed a new enhancing soft tissue lesion in the left IAM, highly suspicious of new metastases from her progressive lung cancer, which contributed to her neuro-otological symptoms. Subsequent MRI scans 4 months later also showed new brain metastases. She continued to be managed with supportive palliative care in view of her extensive disease.



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Strange case of dimorphic skin rash in a patient with cirrhosis: atypical herpes simplex and sweets syndrome

A middle-aged man with decompensated cirrhosis and a dimorphic multisite skin rash is diagnosed with rare atypical herpes simplex infection, manifesting Sweet's syndrome (SS) in the absence of other described associations. SS, an acute febrile neutrophilic dermatosis, has three common forms—classical or idiopathic, malignancy associated and drug induced. Systemic autoimmune, connective tissue diseases and infections are also strong associations. The latter is commonly described in Gram-positive bacteria, salmonellosis and Yersinia. Herpes infections are a rare cause of SS, reported only thrice in literature, one with concomitant lupus, the second with associated mycobacterial infection and third, in metastatic breast disease in contrast to our patient. Atypical rash, especially if dimorphic, warrants histopathological evaluation to confirm underlying disease.



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Lipoid proteinosis

Description

A 25-year-old man, born of a non-consanguineous marriage, presented with a history of progressively increasing, asymptomatic, pinhead-sized small lesions over the eyelid along with hoarseness of voice since early childhood. There was a preceding history of developing small vesicular and crusted lesions over the face which healed spontaneously with scarring. He had no history of photosensitivity, dyspnoea, dysphagia, seizures, visual disturbances, respiratory obstruction or restricted tongue movement. No one else in the family had similar complaints. Mucocutaneous examination revealed multiple, skin coloured, linearly arranged, closely aggregated 1–2 mm-sized papules predominantly over both upper eyelid margins (figure 1A). The facial skin was waxy in appearance with multiple, ill-defined atrophic superficial scars of varying sizes (figure 1B). Corrugated, rough, keratotic, ill-defined plaques were present over bilateral elbows and knees (figure 1C). The tongue was hypertrophied and showed dental impressions (figure 1D). Skin...



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Renal cell carcinoma metastases to the maxillary sinus

Metastasis of renal cell carcinoma (RCC) to the head and neck region is rare. We report the case of a 65-year-old man with history of RCC, presented 7 years after nephrectomy, adrenalectomy and lung metastasectomy for his primary tumour, with symptoms of nasal obstruction, postnasal drip, productive cough and pressure sensation in the left maxillary sinus. CT revealed a unilateral, irregular opacification in the left maxillary sinus with bony erosion of the infraorbital canal wall. A yellow cystic lesion was completely removed from the maxillary sinus during functional endoscopic sinus surgery and histopathological analysis confirmed the diagnosis of a metastatic RCC. Patient continued to be managed with his pre-existing treatment for advanced RCC.



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