Understanding how prevocational training on care farms can lead to functioning, motivation and well-being.

Understanding how prevocational training on care farms can lead to functioning, motivation and well-being.

Disabil Rehabil. 2016 Jan 22;:1-10

Authors: Ellingsen-Dalskau LH, Berget B, Pedersen I, Tellnes G, Ihlebæk C

Abstract
Purpose Prevocational training aims to improve basic vocational and social skills, supporting return to work for people who have been out of work for a long time. Care farms provide prevocational training; the aim of the study was to use the self-determination theory to gain an understanding of how these programmes can lead to healthy functioning and motivation for clients. Method A total of 194 participants in prevocational training on care farms answered questions about demographic information, their perception of being a colleague, the social community on the farm, experiencing nature and animals and need satisfaction. A cross-sectional design resulting in a structural equation model was used to understand how elements of the care farm context influence satisfaction of three psychological needs. Results The results showed that a feeling of being a useful colleague led to competence, experiencing a sense of group belonging led to relatedness and autonomy, while receiving social support from the farmer led to satisfaction of all three needs for the participants. Conclusions The results explain how prevocational training can stimulate participants' functionality, motivation and well-being. This understanding enables initiators and managers of prevocational training to understand and further strengthen the need-supportive elements of such programmes. Implications for Rehabilitation Prevocational training on care farms can facilitate motivation, functioning and well-being for clients. Making clients feel like useful colleagues that belong to a client group will strengthen the positive qualities of these programmes. Support, understanding and acknowledgement from the farmer are the most important elements for a positive development for the clients.

PMID: 26800961 [PubMed - as supplied by publisher]

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Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions.

Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions.

Disabil Rehabil. 2016 Jan 22;:1-6

Authors: Almeida C, Coelho JN, Riberto M

Abstract
Purpose To verify the applicability, reproducibility and validity of the SCIM III patients with non-traumatic spinal cord injury. Method The cross-sectional study included 30 patients (66% females; 41.5 ± 14.7 yo) with non-traumatic spinal cord injury of any etiology. Subjects were subjected by computerized gait analysis and answered the Brazilian versions of SCIM III (0-100 points) and FIM™ (18-126 points) by two raters (A and B) at the same day and 1 week later (A). Results The intraclass correlation coefficient for the use of SCIM III indicated appropriated intra- and inter-evaluator reproducibility (ICC = 0.9). Correlation between the SCIM III and the motor FIM™ was appropriate (r = 0.6; p = 0.0). SCIM III subscales and FIM™ domains correlated strongly for self-care (r = 0.8; p ≤ 0.001), moderately for transfers (r = 0.6; p = 0.0005) and locomotion (r = 0.6; p = 0.0006). SCIM III mobility subscale positively correlated with the cadence (r = 0.8; p ≤ 0.01), gait speed (r = 0.7; p ≤ 0.01) and step length (r = 0.6; p ≤ 0.01). Conclusions SCIM III is a reproducible functional assessment instrument and capable of evaluating the level of independence of the individual with non-traumatic spinal cord injury. The SCIM III is more sensitive than the MIF™ for non-traumatic spastic paraplegic patients with higher levels of independence, particularly if they can walk independently. Linear gait parameters correlated with its mobility subscale. Implications for Rehabilitation Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions. There are not many studies focused on patients with non-traumatic spinal cord lesion. Disability varies in severity, but frequently contributes to limitations in the activities of daily living (ADL) and participation. We do not find in the literature studies that assess the functionality of these individuals as comprehensive as ours.

PMID: 26800790 [PubMed - as supplied by publisher]

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Are web-based questionnaires accepted in patients attending rehabilitation?

Are web-based questionnaires accepted in patients attending rehabilitation?

Disabil Rehabil. 2016 Jan 22;:1-7

Authors: Engan HK, Hilmarsen C, Sittlinger S, Sandmæl JA, Skanke F, Oldervoll LM

Abstract
Purpose The aim of the present paper was to study preferences for web based self-administered questionnaires (web SAQs) vs. paper-based self-administered questionnaires (paper SAQs) and to evaluate the feasibility of using web SAQs in patients referred to cardiac, lung, occupational and cancer rehabilitation programs. Methods The patients were approached by mail and given the choice to answer the compulsory SAQs either on paper or on a web-based platform. Results Hundred and twenty seven out of 183 eligible patients (69.3%) were willing to participate and 126 completed the study. Web SAQs were preferred by 77.7%, and these patients were significantly younger, more often cohabiting and tended to have higher level of education than paper SAQ users. Mean number of data missing per patient was less among the web SAQ users than the paper SAQ users (0.55 vs. 2.15, p < 0.001). Costs related to human resources were estimated to be 60% lower with web SAQs compared to paper SAQs. Conclusions Web SAQs were well accepted among the patients scheduled for rehabilitation, led to less missing data and considerable cost savings related to human resources. Patients referred to rehabilitation should be offered the choice to complete self-administered questionnaires on internet platforms when internet access is common and available. Implications for Rehabilitation The high acceptability of web-based self-administered questionnaires among rehabilitation patients suggests that internet platforms are suitable tools to collect patient information for rehabilitation units. Web-based modes of patient data collection demonstrate low number of missing data and can therefore improve the quality of data collection from rehabilitation patients. Use of web-based questionnaires considerably reduces administrative costs of data collection in rehabilitation settings compared to traditional pen and paper methods.

PMID: 26800715 [PubMed - as supplied by publisher]

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Circulating miR-34a levels correlate with age-related hearing loss in mice and humans.

Circulating miR-34a levels correlate with age-related hearing loss in mice and humans.

Exp Gerontol. 2016 Jan 20;

Authors: Pang J, Xiong H, Yang H, Ou Y, Xu Y, Huang Q, Lai L, Chen S, Zhang Z, Cai Y, Zheng Y

Abstract
Age-related hearing loss (AHL) is a progressive neurodegenerative disease that is largely silent in its initial stages. There is no sensitive blood biomarker for diagnosis or early detection of AHL. MicroRNAs (miRNAs or miRs) are abundant and highly stable in blood, and have been recently described as powerful circulating biomarkers in a wide range of diseases. In the present study, we identified concordant increases in miR-34a levels in the cochlea, auditory cortex, and plasma of C57BL/6 mice during aging. These increases were accompanied by elevated hearing thresholds and greater loss of hair cells. Levels of miR-34a targets, silent information regulator 1 (SIRT1), B-cell lymphoma-2 (Bcl-2), and E2F transcription factor 3 (E2F3), in the cochlea, auditory cortex, and plasma decreased with aging inversely to miR-34a. Moreover, plasma miR-34a levels were significantly higher in patients with AHL compared with controls who had normal hearing and had a receiver-operating characteristic curve that distinguished AHL patients from controls. However, SIRT1, Bcl-2, and E2F3 showed no correlation with AHL in humans. In summary, circulating miR-34a level may potentially serve as a useful biomarker for early detection of AHL.

PMID: 26802970 [PubMed - as supplied by publisher]

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Nausea and Vomiting During Pregnancy is Highly Heritable.

Nausea and Vomiting During Pregnancy is Highly Heritable.

Behav Genet. 2016 Jan 22;

Authors: Colodro-Conde L, Jern P, Johansson A, Sánchez-Romera JF, Lind PA, Painter JN, Ordoñana JR, Medland SE

Abstract
Nausea and vomiting during pregnancy (NVP) affects about 70 % of all expectant mothers and commonly impacts their physical health and psychosocial functioning. The aim of this study was to estimate the heritability of the presence, duration and severity of NVP. The sample consisted of 1723 women (M age = 41.78, SD = 11.67) including twins in both complete and incomplete pairs and their sisters from two cohorts participating in the NVP Genetics Consortium. The sample comprised 159 monozygotic and 140 dizygotic complete twin pairs, and 69 twin-sister pairs. We applied an extended twin design using OpenMx and Mx for secondary analysis. Individual differences in NVP were best explained by additive genetic and unique environmental effects. Heritability estimates were 73 % (95 % CIs = 57-84 %) for presence, 51 % (95 % CIs = 36-63 %) for duration and 53 % (95 % CIs = 38-65 %) for severity of NVP. The genetic correlation between duration and severity was almost perfect. Our results show that genes play an important role in different aspects of NVP and justify the importance of searching for genetic variants.

PMID: 26801654 [PubMed - as supplied by publisher]

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Preexisting semantic representation improves working memory performance in the visuospatial domain.

Preexisting semantic representation improves working memory performance in the visuospatial domain.

Mem Cognit. 2016 Jan 22;

Authors: Rudner M, Orfanidou E, Cardin V, Capek CM, Woll B, Rönnberg J

Abstract
Working memory (WM) for spoken language improves when the to-be-remembered items correspond to preexisting representations in long-term memory. We investigated whether this effect generalizes to the visuospatial domain by administering a visual n-back WM task to deaf signers and hearing signers, as well as to hearing nonsigners. Four different kinds of stimuli were presented: British Sign Language (BSL; familiar to the signers), Swedish Sign Language (SSL; unfamiliar), nonsigns, and nonlinguistic manual actions. The hearing signers performed better with BSL than with SSL, demonstrating a facilitatory effect of preexisting semantic representation. The deaf signers also performed better with BSL than with SSL, but only when WM load was high. No effect of preexisting phonological representation was detected. The deaf signers performed better than the hearing nonsigners with all sign-based materials, but this effect did not generalize to nonlinguistic manual actions. We argue that deaf signers, who are highly reliant on visual information for communication, develop expertise in processing sign-based items, even when those items do not have preexisting semantic or phonological representations. Preexisting semantic representation, however, enhances the quality of the gesture-based representations temporarily maintained in WM by this group, thereby releasing WM resources to deal with increased load. Hearing signers, on the other hand, may make strategic use of their speech-based representations for mnemonic purposes. The overall pattern of results is in line with flexible-resource models of WM.

PMID: 26800983 [PubMed - as supplied by publisher]

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How Early Does the Brain Distinguish between Regular Words, Irregular Words, and Pseudowords during the Reading Process? Evidence from Neurochronometric TMS.

Related Articles

How Early Does the Brain Distinguish between Regular Words, Irregular Words, and Pseudowords during the Reading Process? Evidence from Neurochronometric TMS.

J Cogn Neurosci. 2015 Jun;27(6):1259-74

Authors: Pattamadilok C, Bulnes LC, Devlin JT, Bourguignon M, Morais J, Goldman S, Kolinsky R

Abstract
Cognitive theories on reading propose that the characteristics of written stimuli determine how they are processed in the brain. However, whether the brain distinguishes between regular words, irregular words, and pseudowords already at an early stage of the reading process is still subject to debate. Here we used chronometric TMS to address this issue. During the first 140 msec of regular word, irregular word, and pseudoword reading, TMS was used to disrupt the function of the ventral occipitotemporal, posterior middle temporal, and supramarginal gyri, which are key areas involved in orthographic, semantic, and phonological processing, respectively. Early TMS stimulation delivered on posterior middle temporal and supramarginal gyri affected regular and irregular word, but not pseudoword, reading. In contrast, ventral occipitotemporal disruption affected both word and pseudoword reading. We thus found evidence for an early distinction between word and pseudoword processing in the semantic and phonological systems, but not in the orthographic system.

PMID: 25603024 [PubMed - indexed for MEDLINE]

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Sirtuin 6 modulates hypoxia-induced autophagy in nasal polyp fibroblasts via inhibition of glycolysis.

Sirtuin 6 modulates hypoxia-induced autophagy in nasal polyp fibroblasts via inhibition of glycolysis.

Am J Rhinol Allergy. 2016 Jan 21;

Authors: Shun CT, Lin SK, Hong CY, Lin CF, Liu CM

Abstract
BACKGROUND: To elucidate the interaction between hypoxia-induced autophagy and glycolysis in nasal polyp fibroblasts, and the regulatory role of Sirtuin 6 (SIRT6) in the pathogenesis of nasal polyp.
OBJECTIVE: Through examining the expressions of lactate dehydrogenase (LDH), microtubule-associated protein II light chain 3 (LC3II) (an autophagy marker), and production of lactate under hypoxia, the interaction between autophagy and glycolysis was investigated. The role of SIRT6 on the hypoxia-induced autophagy and glycolysis was also examined.
METHODS: Nasal polyp specimens were used to examine the expressions of hypoxia-inducible factor (HIF) 1 alpha, LDH, and LC3II by Western blot analysis, and primary cultures of nasal polyp fibroblasts were established from resected nasal polyps to measure hypoxia-induced LDH and LC3II expression by Western blot analysis and lactate production by colorimetry. Forced expression of SIRT6 with a lentiviral-based technique was used to evaluate its suppressive effect on autophagy and glycolysis. Immunohistochemical staining was performed to detect the expressions of SIRT6, LDH, and beclin (another autophagy marker) in nasal polyps.
RESULTS: Expression of HIF-1 alpha, LDH, and an autophagy marker, LC3II, are increased in nasal polyp specimens, and forced expression of SIRT6 in nasal polyp fibroblasts inhibited LDH expression, lactate production under hypoxia, and SIRT6. An immunohistochemistry study of nasal polyp showed that SIRT6 expression was reduced and LDH and beclin were enhanced.
CONCLUSION: Analysis of these data indicated that hypoxia may contribute to the formation of nasal polyp by promoting autophagy in nasal polyp fibroblasts. Through the antiglycolytic activity of SIRT6, the autophagy was suppressed, which was beneficial to nasal polyp formation. Modulation of glucose metabolism through SIRT6-based strategy may possess therapeutic potential for nasal polyposis in the future.

PMID: 26803106 [PubMed - as supplied by publisher]

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Postprandial studies uncover differing effects on HDL particles of overt and subclinical hypothyroidism.

Postprandial studies uncover differing effects on HDL particles of overt and subclinical hypothyroidism.

Thyroid. 2016 Jan 22;

Authors: McGowan AN, Widdowson MW, O'Regan A, Young IS, Boran G, McEneny J, Gibney J

Abstract
CONTEXT: Overt hypothyroidism (OH) is associated with abnormal lipid metabolism and endothelial dysfunction under fasting conditions. The balance of evidence suggests similar but less marked abnormalities in subclinical hypothyroidism (SCH).
OBJECTIVE: There is little data regarding the metabolic and vascular effects of OH or SCH under postprandial conditions.
DESIGN, SETTING AND PARTICIPANTS: This was a cross-sectional study, carried out in a teaching hospital. Subjects with OH (n=21), SCH (n=28) and controls (n=44) matched for age, sex and BMI were studied under fasting and postprandial conditions.
METHODS: We compared postprandial lipid metabolism with particular emphasis on intestinally derived lipoproteins, HDL cholesterol (HDL) and endothelial function in subjects with OH, SCH and age, sex and BMI frequency-matched controls. Apolipoprotein B48 (Apo B48), a measure of intestinally derived lipoprotein was measured by ELISA. HDL was subfractionated into HDL2 and HDL3 by rapid ultracentrifugation. Functional aspects of HDL were determined by monitoring the activities of cholesteryl-ester-transfer-protein (CETP) and lecithin-cholesterol-acyl-transferase (LCAT). Systemic and HDL-associated inflammation was assessed by measuring serum-amyloid-A (SAA)-levels. Endothelial Function was assessed by flow mediated dilatation (FMD) of the brachial artery in response to hyperaemia of the forearm.
RESULTS: There were no significant between-group differences in LDL cholesterol (LDL-C) or triglyceride concentration (TG). Peak Apo B48 levels were greater in OH (p <0.001) and SCH (p<0.05) compared to control subjects. HDL AUC was lower postprandially in SCH (p <0.001), but not OH compared to control subjects. HDL2 and HDL3 associated CETP AUC was lower only in OH (p<0.005) compared to controls. FMD was reduced in OH (p<0.05) compared to SCH and controls postprandially.
CONCLUSION: Postprandial lipoprotein and vascular abnormalities differ between OH and SCH. Although both are characterized by increased intestinally derived lipoprotein particles, HDL is reduced only in SCH. Maintained HDL in OH probably reflects reduced CETP activity, which was not observed in SCH. Postprandial endothelial dysfunction is abnormal only in OH and this effect does not appear to reflect increased inflammation.

PMID: 26800752 [PubMed - as supplied by publisher]

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Balloon-assisted fistula sealing procedure for symptomatic Tarlov Cysts.

Balloon-assisted fistula sealing procedure for symptomatic Tarlov Cysts.

World Neurosurg. 2016 Jan 20;

Authors: Zheng X, Li S, Sheng H, Feng B, Zhang N, Xie C

Abstract
OBJECTIVE: Tarlov cyst is an abnormal expansion of the spinal nerve sleeve, and communicates with the subarachnoid cavity via a perineural fistula. This study is to present our experience of balloon-assisted fistula sealing procedure in treating Tarlov cyst.
METHODS: Twenty-two patients with symptomatic Tarlov cysts were surgically treated. An emulsion balloon was placed into the lumbar subarachnoid cistern through a trocar, so as to temporarily block cerebrospinal fluid flow, then the thecal sac was opened and the inlet of the fistula was sealed by suture of a muscular patch and reinforced by fibrin glue. At last the cyst wall was imbricated and the bony cavity was filled with pedicled muscle flaps.
RESULTS: Comparing the preoperative and postoperative pain scores according to visual analog scale, 2 patients were slightly improved; 18 patients were substantially improved, including 3 completely pain-free cases. Only 2 patients were unchanged in pain, and both of them were multiple cysts. As a whole, the postoperative pain score is much better than the preoperative score (2.4 vs 7.5, P<0.01). Bladder weakness was slightly improved, and bowel dysfunction was almost unchanged after operation. During follow-up, cyst recurrence was found in one patient.
CONCLUSION: The balloon-assisted fistula sealing procedure is safe and effective for Tarlov cyst, especially for the single cyst. It's a good complement to the cyst wall imbricating procedure.

PMID: 26802871 [PubMed - as supplied by publisher]

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Hybrid Operating Room for Combined Neuro-Endovascular and Endoscopic Treatment of Ruptured Cerebral Aneurysms with Intra-ventricular Hemorrhage.

Hybrid Operating Room for Combined Neuro-Endovascular and Endoscopic Treatment of Ruptured Cerebral Aneurysms with Intra-ventricular Hemorrhage.

World Neurosurg. 2016 Jan 20;

Authors: Mori R, Yuki I, Kajiwara I, Nonaka Y, Ishibashi T, Murayama Y

Abstract
BACKGROUND: Intra-ventricular hemorrhages (IVHs) due to ruptured cerebral aneurysms often have poor outcomes. Treatment challenges include co-morbidities, increased intra-cranial pressure (ICP) due to IVH, and the risk of re-bleeding.
CASE DESCRIPTION: Two cases of severe IVH accompanied by acute hydrocephalus due to ruptured aneurysm were treated with coil embolization followed by endoscopic hematoma evacuation as a single treatment session in a hybrid operating room (Hybrid OR) equipped with a multi-purpose angio biplanesystem. The first case was an 84-year-old female with a ruptured basilar top aneurysm, who presented with Hunt and Hess (H&H) Grade 5 subarachnoid hemorrhage (SAH) with packed IVH. The second case was a 43-year-old male with a ruptured anterior communicating artery aneurysm who presented with H&H Grade 5 SAH with packed IVH. In both cases, endovascular coil embolization was performed first to prevent intra-operative bleeding. The coiled aneurysms suddenly appeared on the screen of the endoscope during the hematoma removal which could have led to massive re-bleeding if not treated previously. Neither patient needed a re-insertion of the ventricular drainage or developed chronic hydrocephalus during the hospitalization. The Hybrid OR enabled the two treatment approaches to be performed without the need to transfer the patient, thereby minimizing the transition time between the modalities. Intra-operative cone-beam computed tomography contributed to the evaluation of residual clots.
CONCLUSIONS: A Hybrid OR may contribute to a combined neuro-endoscopic and endovascular treatment for ruptured cerebral aneurysms with severe intra-ventricular hemorrhage.

PMID: 26802870 [PubMed - as supplied by publisher]

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Low-cost fluorescein detection system for high-grade glioma surgery.

Low-cost fluorescein detection system for high-grade glioma surgery.

World Neurosurg. 2016 Jan 20;

Authors: Bongetta D, Zoia C, Pugliese R, Adinolfi D, Silvani V, Gaetani P

Abstract
BACKGROUND: Intraoperative fluorescein detection has been used in the fields of vascular and oncological Neurosurgery since 1948. Modifications of the optics in order to enhance the fluorescence contrast under microscopic view have been developed by many authors. The industries, during the last 10 years, provided commercial high-cost optimized apparatuses. Reviewing the literature, we found that the prototypical techniques were definitely at a low cost but lacked reliability, reproducibility and standard legal norms.
METHODS: We describe the developing of a fluorescein detection system that could be economic, simple, effective and law abiding.
RESULTS: We employed a commercial violet-blue filter designed for fluorescein excitation in endoscopic procedures and we used commercial photographic yellow optical filters for fluorescence detection. All the instrumentation is cleared for clinical use and its costs is up to 200 times lower than commercial apparatuses.
CONCLUSIONS: Our results show a good distinction of fluorescein-stained structures, with overall acceptable operating light conditions.

PMID: 26802869 [PubMed - as supplied by publisher]

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Bilateral pallidotomy for cervical dystonia after failed selective peripheral denervation.

Bilateral pallidotomy for cervical dystonia after failed selective peripheral denervation.

World Neurosurg. 2016 Jan 20;

Authors: Horisawa S, Goto S, Takeda N, Terashima H, Kawamata T, Taira T

Abstract
BACKGROUND: We investigated the utility of pallidotomy for cervical dystonia following failed selective peripheral denervation.
CASE DESCRIPTION: A 36-year-old man presented with cervical dystonia with limited range of motion of the left shoulder, particularly in abduction. His Tsui score was 8. Due to the ineffectiveness of botulinum toxin injection, he underwent selective peripheral denervation with an unsatisfactory outcome, with a postoperative Tsui score of 6. Simultaneous bilateral pallidotomy was performed with local anesthesia at one year after the initial surgery. The day after the pallidotomy, all dystonic symptoms were markedly improved except for the limited range of shoulder abduction. The Tsui score was recorded as 1 at one week after the pallidotomy. Transient aggressive behavior was the only postoperative complication in the present case. During clinical follow-up period of one year, no recurrence of the symptoms was observed.
CONCLUSIONS: Pallidotomy represents a feasible and efficacious treatment for cervical dystonia refractory to SPD without hardware related complications.

PMID: 26802868 [PubMed - as supplied by publisher]

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Isolated cortical venous thrombosis as a mimic for cortical SAH.

Isolated cortical venous thrombosis as a mimic for cortical SAH.

World Neurosurg. 2016 Jan 20;

Authors: Kim J, Huh C, Kim D, Jung C, Lee K, Kim H

Abstract
Isolated cortical venous thrombosis is very rare and poorly understood. The clinical presentation is also not well described in the literature. We report here a case of isolated cortical venous thrombosis that mimicked cortical subarachnoid hemorrhage (SAH). A 62-year-old man with a history of chronic subdural hemorrhage visited our hospital with headache. Brain computed tomography (CT) revealed a linear hyperdense area in the right central sulcus (cord sign) suggestive of isolated cortical SAH. MRI revealed susceptibility in the corresponding area. CT angiogrphy revealed no specific finding. However, transfemoral cerebral angiography (TFCA) identified filling defects in the right cortical veins. Under of isolated cortical venous thrombosis, anticoagulation therapy was used to prevent the propagation of thrombosis. The patient had no recurrence of his symptoms. If a cord sign is present on non-contrast CT images, further studies (MRI/V or TFCA) should be performed in a stepwise manner. Such considerations could prevent a fatal outcome and poor prognosis.

PMID: 26802867 [PubMed - as supplied by publisher]

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Results of spinal fusion after spinal nerve sheath tumor resection.

Results of spinal fusion after spinal nerve sheath tumor resection.

World Neurosurg. 2016 Jan 20;

Authors: Safaee M, Oh T, Barbaro NM, Chou D, Mummaneni PV, Weinstein PR, Tihan T, Ames CP

PMID: 26802866 [PubMed - as supplied by publisher]

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Reliable Intraoperative Repair Nuances of CSF Leak in Anterior Cervical Spine Surgery and Review of The Literature.

Reliable Intraoperative Repair Nuances of CSF Leak in Anterior Cervical Spine Surgery and Review of The Literature.

World Neurosurg. 2016 Jan 20;

Authors: Mitchell BD, Verla T, Reddy D, Winnegan L, Omeis I

PMID: 26802865 [PubMed - as supplied by publisher]

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Validating a Local Failure Risk Stratification for Use in Prospective Studies of Adjuvant Radiation for Bladder Cancer

Publication date: Available online 23 January 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Brian C. Baumann, Jiwei He, Wei-Ting Hwang, Kai N. Tucker, Justin E. Bekelman, Harry W. Herr, Seth P. Lerner, Thomas J. Guzzo, S. Bruce Malkowicz, John P. Christodouleas
Purpose/ObjectivesTo inform prospective trials of adjuvant radiation therapy (adj-RT) for bladder cancer after radical cystectomy, a local-regional failure (LF) risk stratification was proposed. This stratification was developed and validated using surgical databases that may not reflect the outcomes expected in prospective trials. Our purpose was to assess sources of bias that may impact the stratification model's validity or alter the LF risk estimates for each subgroup: time bias due to evolving surgical techniques; trial accrual bias due to inclusion of patients who would be ineligible for adj-RT trials due to early disease progression, death, or loss to follow-up shortly after cystectomy; bias due to different statistical methodologies to estimate LF; and subgrouping bias due to different definitions of the LF subgroups.Methods and MaterialsThe LF risk stratification was developed using a single-institution cohort (n=442, 1990-2008) and the multi-institutional SWOG 8710 cohort (n=264, 1987-1998) treated with radical cystectomy +/- chemotherapy. We evaluated the sensitivity of the stratification to sources of bias using Fine-Gray regression and Kaplan-Meier analyses.ResultsYear of radical cystectomy was not associated with LF risk on univariate or multivariate analysis after controlling for risk group. Using more stringent inclusion criteria, 26 SWOG patients (10%) and 60 (14%) from the single-institution cohort were excluded. Analysis of the remaining patients confirmed 3 subgroups with significantly different LF risk with 3-year rates of 7%, 17%, and 36%, respectively (p<0.01), nearly identical to the rates without correcting for trial accrual bias. Kaplan-Meier techniques estimated higher subgroup LF rates than competing risk analysis. The subgroup definitions used in the NRG-GU001 adj-RT trial were validated.ConclusionsThese sources of bias did not invalidate the LF risk stratification or substantially change the model's LF estimates.

Teaser

To inform trials of adjuvant radiotherapy for bladder cancer, a local-regional failure (LF) risk stratification was developed. We assessed the impact of multiple potential biases on the model's validity for predicting outcomes. The predictions were not invalidated by time bias from evolving surgical techniques, use of different statistical methods to estimate LF risk, subgrouping bias due to differing definitions for the LF subgroups, or trial accrual bias from including patients ineligible for adjuvant RT trials.


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Hypoxia potentiates the radiosensitizing effect of olaparib in human non-small cell lung cancer xenografts by contextual synthetic lethality

Publication date: Available online 23 January 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Yanyan Jiang, Tom Verbiest, Aoife M. Devery, Sivan M. Bokobza, Anika M. Weber, Katarzyna B. Leszczynska, Ester M. Hammond, Anderson J. Ryan
PurposePoly(ADP-ribose) polymerase (PARP) inhibitors potentiate radiotherapy in preclinical models of human non-small-cell lung cancer (NSCLC) and other types of cancer. However, the mechanisms underlying radiosensitization in vivo are incompletely understood. Herein, we investigated the impact of hypoxia on radiosensitization by the PARP inhibitor olaparib in human NSCLC xenograft models.Methods and MaterialsNSCLC Calu-6 and Calu-3 cells were irradiated in the presence of olaparib or vehicle under normoxic (21% O2) or hypoxic (1% O2) conditions. In vitro radiosensitivity was assessed by clonogenic survival assay and γH2AX foci assay. Established Calu-6 and Calu-3 subcutaneous xenografts were treated with olaparib (50 mg/kg, daily for 3 days), radiation (10 Gy), or both. Tumors (n=3/group) were collected 24 h or 72 h after the first treatment. Immunohistochemistry was performed to assess hypoxia (carbonic anhydrase IX (CA9)), vessels (CD31), DNA double strand breaks (DSB) (γH2AX), and apoptosis (cleaved caspase 3 (CC3)). The remaining xenografts (n=6/group) were monitored for tumor growth.ResultsIn vitro, olaparib showed a greater radiosensitizing effect on Calu-3 and Calu-6 cells in hypoxic conditions (1% O2). In vivo, Calu-3 tumors were well-oxygenated, whereas Calu-6 tumors had extensive regions of hypoxia associated with down-regulation of the homologous recombination protein RAD51. Olaparib treatment increased unrepaired DNA DSB (P<0.001) and apoptosis (P<0.001) in hypoxic cells of Calu-6 tumors following radiation, whereas it had no significant effect on radiation-induced DNA damage response in non-hypoxic cells of Calu-6 tumors or in the tumor cells of well-oxygenated Calu-3 tumors. Consequently, olaparib significantly increased radiation-induced growth inhibition in Calu-6 tumors (P<0.001) but not in Calu-3 tumors.ConclusionsOur data suggest that hypoxia potentiates the radiosensitizing effects of olaparib by contextual synthetic killing, and that tumor hypoxia may be a potential biomarker for selecting patients who may get the greatest benefit from the addition of olaparib to radiotherapy.

Teaser

We show that the PARP inhibitor olaparib enhances radiation-induced DNA damage response in the hypoxic tumor cells of Calu-6 xenografts, but not in the non-hypoxic tumor cells of Calu-6 xenografts or in the tumor cells of well-oxygenated Calu-3 xenografts. Consequently, olaparib potentiates the anti-tumor effect of radiation in hypoxic tumors, but not in well-oxygenated tumors. This suggests that hypoxia enhances the radiosensitizing effects of olaparib in human non-small-cell lung cancer (NSCLC) xenografts by contextual synthetic lethality.


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Consensus statement of proton therapy in early stage and locally advanced non–small cell lung cancer

Publication date: Available online 23 January 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Joe Y. Chang, Salma K. Jabbour, Dirk De Ruysscher, Steven E. Schild, Charles B. Simone, Ramesh Rengan, Steven Feigenberg, Atif J. Khan, Noah C. Choi, Jeffrey D. Bradley, Xiaorong R. Zhu, Antony J. Lomax, Bradford S. Hoppe
Radiation dose escalation has been shown to improve local control and survival in non–small cell lung cancer (NSCLC) patients in some studies but randomized data has not supported this premise, possibly due to adverse effects. Because of the physical characteristics of the Bragg peak, proton therapy (PT) delivers minimal exit dose distal to the target volume resulting in better sparing of normal tissues in comparison to photon based radiotherapy. This is particularly important for lung cancer due to the proximity of lung, heart, esophagus, major airways, large blood vessels and spinal cord. However, PT is associated with more uncertainty due to finite range of proton beam and motion for thoracic cancers. PT is more costly than traditional photon therapy but may reduce side effects and toxicity-related hospitalization which has its own associated cost. The cost of PT is decreasing over time due to reduced prices for the building, machine, maintenance, overhead and newer, shorter treatment programs. PT is improving rapidly as more research is performed particularly with the implementation of 4-dimensional CT based motion management and intensity-modulated proton therapy (IMPT). Due to these controversies, there is much debate in the oncology community about which lung cancer patients benefit significantly from proton therapy. The PTCOG thoracic subcommittee task group intends to address the issues of proton therapy indications, advantages/limitations, cost effectiveness, technology improvement, clinical trials and future research directions. This consensus report can be used to guide clinical practice and indications for proton therapy, insurance approval, and clinical/translational research directions.



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The Impact of Axillary Lymph Node Dissection on Breast Skin Thickening During and After Radiotherapy for Breast Cancer

Publication date: Available online 23 January 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Mylin A. Torres, Xiaofeng Yang, Samantha Noreen, Hao Chen, Tatiana Han, Simone Henry, Donna Mister, Fundagal Andic, Qi Long, Tian Liu
PurposeThis prospective study was conducted to determine predictors of epidermal thickening during and after whole breast radiotherapy (XRT) using objective measurements acquired with ultrasound.Methods and MaterialsFollowing breast conserving surgery, 70 women received a definitive course of whole breast XRT (50 Gy plus boost). Prior to XRT, at week 6 of XRT, and 6 weeks post XRT, subjects underwent objective ultrasound measurements of epidermal thickness over the lumpectomy cavity and all four quadrants of the treated breast. A skin thickness ratio (STRA) was then generated normalizing for corresponding measurements taken of the untreated breast.ResultsBaseline measurements indicated that 87% of patients had skin thickening in the treated versus untreated breast (mean increase of 27%, SD of 0.29) prior to XRT. The STRA increased significantly by week 6 of XRT (mean 25% (SD .46) and continued to increase significantly 6 weeks post XRT (mean 33% (SD .46) above baseline measurements (p<0.001 for both timepoints). In multivariable analysis, breast volume (p=0.003) and surgical evaluation of the axilla with full lymph node dissection (p<0.05) predicted for more severe changes in STRA 6 weeks after XRT compared with baseline. STRA measurements correlated with physician ratings of skin toxicity according to RTOG grading criteria.ConclusionsThis is one of the first studies to objectively document that lymph node surgery impacts XRT-induced skin thickening in breast cancer patients. Surgical evaluation of the axilla with a complete lymph node dissection was associated with the most severe XRT-induced skin changes following XRT completion. These results may inform future studies aimed at minimizing side effects of XRT and surgery, particularly when surgical lymph node assessments may not alter breast cancer management or outcome.

Teaser

This prospective cohort study of 70 breast cancer patients treated with partial mastectomy and whole breast radiotherapy was conducted to determine predictors of breast skin thickening during and after radiotherapy using objective measurements with ultrasound tissue characterization. Complete axillary lymph node dissection was associated with significantly more radiotherapy-induced changes in breast epidermal thickness 6 weeks after radiotherapy treatment than sentinel lymph node biopsy alone or no axillary surgical evaluation.


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Imprinting defects at human 14q32 locus alters gene expression and is associated with the pathobiology of osteosarcoma.

Imprinting defects at human 14q32 locus alters gene expression and is associated with the pathobiology of osteosarcoma.

Oncotarget. 2016 Jan 21;

Authors: Shu J, Li L, Sarver AE, Pope EA, Varshney J, Thayanithy V, Spector L, Largaespada DA, Steer CJ, Subramanian S

Abstract
Osteosarcoma is the most common primary bone malignancy affecting children and adolescents. Although several genetic predisposing conditions have been associated with osteosarcoma, our understanding of its pathobiology is rather limited. Here we show that, first, an imprinting defect at human 14q32-locus is highly prevalent (87%) and specifically associated with osteosarcoma patients < 30 years of age. Second, the average demethylation at differentially methylated regions (DMRs) in the 14q32-locus varied significantly compared to genome-wide demethylation. Third, the 14q32-locus was enriched in both H3K4-me3 and H3K27-me3 histone modifications that affected expression of all imprinted genes and miRNAs in this region. Fourth, imprinting defects at 14q32 - DMRs are present in triad DNA samples from affected children and their biological parents. Finally, imprinting defects at 14q32-DMRs were also observed at higher frequencies in an Rb1/Trp53 mutation-induced osteosarcoma mouse model. Further analysis of normal and tumor tissues from a Sleeping Beauty mouse model of spontaneous osteosarcoma supported the notion that these imprinting defects may be a key factor in osteosarcoma pathobiology. In conclusion, we demonstrate that imprinting defects at the 14q32 locus significantly alter gene expression, may contribute to the pathogenesis of osteosarcoma, and could be predictive of survival outcomes.

PMID: 26802029 [PubMed - as supplied by publisher]

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XIAP-associating factor 1, a transcriptional target of BRD7, contributes to endothelial cell senescence.

XIAP-associating factor 1, a transcriptional target of BRD7, contributes to endothelial cell senescence.

Oncotarget. 2016 Jan 15;

Authors: Heo JI, Kim W, Choi KJ, Bae S, Jeong JH, Kim KS

Abstract
X-linked inhibitor of apoptosis (XIAP)-associated factor 1 (XAF1) is well known as an antagonist of XIAP-mediated caspase inhibition. Although XAF1 serves as a tumor-suppressor gene, the role of XAF1 in cellular senescence remains unclear. We found that XAF1 expression was increased by genotoxic agents, such as doxorubicin and ionizing radiation in pulmonary microvascular endothelial cells, consequently leading to premature senescence. Conversely, downregulation of XAF1 in premature senescent cells partially overcame endothelial cell senescence. p53 knockdown, but not p16 knockdown, abolished senescence phenotypes caused by XAF1 induction. XAF1 expression was transcriptionally regulated by Bromodomain 7 (BRD7). XAF1 induction with interferon-gamma (IFN-γ) treatment was abrogated by BRD7 knockdown, which resulted in blocking interferon-induced senescence. In lung cancer cells, XAF1 tumor suppressor activity was decreased by BRD7 knockdown, and inhibition of tumor growth by IFN-γ did not appear in BRD7-depleted xenograft tumors. These data suggest that XAF1 is involved in BRD7-associated senescence and plays an important role in the regulation of endothelial senescence through a p53-dependent pathway. Furthermore, regulation of the BRD7/XAF1 system might contribute to tissue or organismal aging and protection against cellular transformation.

PMID: 26802028 [PubMed - as supplied by publisher]

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Chromosomal anomalies at 1q, 3, 16q, and mutations of SIX1 and DROSHA genes underlie Wilms tumor recurrences.

Chromosomal anomalies at 1q, 3, 16q, and mutations of SIX1 and DROSHA genes underlie Wilms tumor recurrences.

Oncotarget. 2016 Jan 20;

Authors: Spreafico F, Ciceri S, Gamba B, Torri F, Terenziani M, Collini P, Macciardi F, Radice P, Perotti D

Abstract
Approximately half of children suffering from recurrent Wilms tumor (WT) develop resistance to salvage therapies. Hence the importance to disclose events driving tumor progression/recurrence. Future therapeutic trials, conducted in the setting of relapsing patients, will need to prioritize targets present in the recurrent lesions. Different studies identified primary tumor-specific signatures associated with poor prognosis. However, given the difficulty in recruiting specimens from recurrent WTs, little work has been done to compare the molecular profile of paired primary/recurrent diseases. We studied the genomic profile of a cohort of eight pairs of primary/recurrent WTs through whole-genome SNP arrays, and investigated known WT-associated genes, including SIX1, SIX2 and micro RNA processor genes, whose mutations have been recently proposed as associated with worse outcome. Through this approach, we sought to uncover anomalies characterizing tumor recurrence, either acquired de novo or already present in the primary disease, and to investigate whether they overlapped with known molecular prognostic signatures.Among the aberrations that we disclosed as potentially acquired de novo in recurrences, some had been already recognized in primary tumors as associated with a higher risk of relapse. These included allelic imbalances of chromosome 1q and of chromosome 3, and CN losses on chromosome 16q. In addition, we found that SIX1 and DROSHA mutations can be heterogeneous events (both spatially and temporally) within primary tumors, and that their co-occurrence might be positively selected in the progression to recurrent disease. Overall, these results provide new insights into genomic and genetic events underlying WT progression/recurrence.

PMID: 26802027 [PubMed - as supplied by publisher]

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Overexpression of NDRG2 Increases Iodine Uptake and Inhibits Thyroid Carcinoma Cell Growth In Situ and In Vivo.

Overexpression of NDRG2 Increases Iodine Uptake and Inhibits Thyroid Carcinoma Cell Growth In Situ and In Vivo.

Oncol Res. 2016;23(1):43-51

Authors: Yin A, Wang C, Sun J, Gao J, Tao L, Du X, Zhao H, Yang J, Li Y

Abstract
Medullary thyroid carcinoma (MTC) is an uncommon and highly aggressive tumor of the neuroendocrine system, which derives from the neuroendocrine C cells of the thyroid gland. Except for surgical resection, there are not very many effective systemic treatment options for MTC. N-Myc downstream-regulated gene 2 (NDRG2) had a significantly lower expression in MTC compared with normal thyroid tissue. However, the function of NDRG2 in MTC oncogenesis is largely unknown. In this study, we found that overexpression of NDRG2 inhibited the proliferation of TT cells (human medullary thyroid carcinoma cells) in vitro and suppressed the development of MTC in a nude mouse xenograft model. Further analysis revealed that NDRG2 arrested the cell cycle G0/G1 phase progression and induced TT cell apoptosis. Moreover, NDRG2 overexpression may mediate the antiproliferative effect by reducing cyclin D1 and cyclin E protein levels. We also found aberrant NDRG2-mitigated TT cell migration and invasion in vitro. Sodium/iodide symporter (NIS) mediates active I(-) transport into the thyroid follicular cells, and radionuclide treatment is a promising therapy for MTC. Our current data revealed that NDRG2 overexpression enhanced NIS level in TT cells and increased their iodine uptake in vitro. Furthermore, (99m)TcO4(-) radionuclide imaging of the xenograft tumors indicated that NDRG2 could promote NIS-mediated radionuclide transport. In conclusion, the present study suggested that NDRG2 is a critical molecule in the regulation of MTC biological behavior and a potential promoter in radioactive iodine therapy.

PMID: 26802650 [PubMed - as supplied by publisher]

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Targeting of radiolabeled J591 antibody to PSMA-expressing tumors: optimization of imaging and therapy based on non-linear compartmental modeling.

Targeting of radiolabeled J591 antibody to PSMA-expressing tumors: optimization of imaging and therapy based on non-linear compartmental modeling.

EJNMMI Res. 2016 Dec;6(1):7

Authors: Fung EK, Cheal SM, Fareedy SB, Punzalan B, Beylergil V, Amir J, Chalasani S, Weber WA, Spratt DE, Veach DR, Bander NH, Larson SM, Zanzonico PB, Osborne JR

Abstract
BACKGROUND: We applied a non-linear immunokinetic model to quantitatively compare absolute antibody uptake and turnover in subcutaneous LNCaP human prostate cancer (PCa) xenografts of two radiolabeled forms of the humanized anti-prostate-specific membrane antigen (PSMA) monoclonal antibody J591 ((124)I-J591 and (89)Zr-J591). Using the model, we examined the impact of dose on the tumor and plasma positron emission tomography (PET)-derived time-activity curves. We also sought to predict the optimal targeting index (ratio of integrated-tumor-to-integrated-plasma activity concentrations) for radioimmunotherapy.
METHODS: The equilibrium rates of antibody internalization and turnover in the tumors were derived from PET images up to 96 h post-injection using compartmental modeling with a non-linear transfer rate. In addition, we serially imaged groups of LNCaP tumor-bearing mice injected with (89)Zr-J591 antibody doses ranging from antigen subsaturating to saturating to examine the suitability of using a non-linear approach and derived the time-integrated concentration (in μM∙hours) of administered tracer in tumor as a function of the administered dose of antibody.
RESULTS: The comparison of (124)I-J591 and (89)Zr-J591 yielded similar model-derived values of the total antigen concentration and internalization rate. The association equilibrium constant (k a) was twofold higher for (124)I, but there was a ~tenfold greater tumoral efflux rate of (124)I from tumor compared to that of (89)Zr. Plots of surface-bound and internalized radiotracers indicate similar behavior up to 24 h p.i. for both (124)I-J591 and (89)Zr-J591, with the effect of differential clearance rates becoming apparent after about 35 h p.i. Estimates of J591/PSMA complex turnover were 3.9-90.5 × 10(12) (for doses from 60 to 240 μg) molecules per hour per gram of tumor (20 % of receptors internalized per hour).
CONCLUSIONS: Using quantitative compartmental model methods, surface binding and internalization rates were shown to be similar for both (124)I-J591 and (89)Zr-J591 forms, as expected. The large difference in clearance rates of the radioactivity from the tumor is likely due to differential trapping of residualizing zirconium versus non-residualizing iodine. Our non-linear model was found to be superior to a conventional linear model. This finding and the calculated activity persistence time in tumor have important implications for radioimmunotherapy and other antibody-based therapies in patients.

PMID: 26801327 [PubMed]

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The effect of weight-bearing asymmetry on dynamic postural stability in healthy young individuals

Publication date: March 2016
Source:Gait & Posture, Volume 45
Author(s): Digna de Kam, Jip. F. Kamphuis, Vivian Weerdesteyn, Alexander C.H. Geurts
BackgroundIn people with lateralized disorders, such as stroke, Weight-Bearing Asymmetry (WBA) is common. It is associated with postural instability, however, WBA is one of several abnormalities that may affect postural stability in these disorders. Therefore, we investigated the isolated effects of WBA on dynamic postural stability in healthy individuals.MethodsTen young participants were subjected to multidirectional stance perturbations by support surface translations at three levels of WBA (0, 10 and 20% of body weight unloading of one leg). The stepping threshold was determined iteratively for each condition and in four perturbation directions (forward, backward, leftward and rightward). The stepping threshold was defined as the highest perturbation intensity recovered from with a feet-in-place response. The Margin of Stability (MOS) at the stepping threshold was defined as the smallest distance between the vertical projection of the Extrapolated Center of Mass (XCOM) and the edge of the base of support.ResultsWBA decreased the stepping threshold (stability decreased) for perturbations towards the loaded side (translations towards the unloaded side), whereas it increased stepping thresholds for perturbations towards the unloaded side. No significant effects of WBA were found on the MOS. WBA increased the frequency of stepping with the unloaded leg upon forward and backward perturbations.ConclusionWBA increased dynamic stability towards the unloaded leg following external balance perturbations and resulted in a greater probability of stepping with this leg. Future studies are needed to evaluate the functional significance of these WBA-related effects on postural stability in people with lateralized disorders.



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USE OF A SIMPLE THERMALISED NEUTRON FIELD FOR QUALITY ACCEPTANCE OF WHOLE BODY TLDS.

USE OF A SIMPLE THERMALISED NEUTRON FIELD FOR QUALITY ACCEPTANCE OF WHOLE BODY TLDS.

Radiat Prot Dosimetry. 2016 Jan 21;

Authors: Gilvin PJ, Baker ST, Eakins JS, Tanner RJ

Abstract
The individual monitoring service of Public Health England (PHE) uses Harshaw™ whole-body and extremity thermoluminescent dosemeters (TLDs) with high-sensitivity lithium fluoride LiF:Mg,Cu,P, together with Harshaw 8800™ automated readers. The neutron-insensitive, (6)Li-depleted variety of TLD material is used by PHE because the service provides separate neutron and photon dosemeters. The neutron dosemeters are not sensitive to photons and vice versa. Since insensitivity to neutrons is a supply requirement for TLDs, there is a need to test every new (annual) consignment for this. Because it is thermal neutrons that produce a response in (6)Li TLDs, a thermal field is needed. To this end, PHE has adopted the simple approach of sandwiching the TLDs between two ISO water-filled slab phantoms. In this arrangement, the fast neutrons from an Am-Be source are effectively thermalised. Details of the method are given, together with the results of supporting MCNP calculations and some typical results.

PMID: 26801052 [PubMed - as supplied by publisher]

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Surgical Results and Oncologic Outcomes for Rectal Cancer with Tailored Mesorectal Excision over Two Decades.

Surgical Results and Oncologic Outcomes for Rectal Cancer with Tailored Mesorectal Excision over Two Decades.

World J Surg. 2016 Jan 22;

Authors: Law WL, Foo DC

Abstract
OBJECTIVE: This study aimed to compare the characteristics of the tumors, the management strategy, and oncologic outcomes of patients with rectal cancer surgery in these two periods: period 1 (1993-2001) and period 2 (2002-2011).
METHODS: All patients who underwent radical resection of rectal cancer from 1993 to 2011 were included. Comparisons of the patients' demographics, characteristics, operating results, and oncologic outcome between the two periods were undertaken.
RESULTS: Radical resection for rectal cancer was performed in 1611 patients (993 men). Patients were significantly older and more had comorbid medical diseases in period 2. More laparoscopic resections were performed and more patients had preoperative chemoradiation in period 2. The postoperative mortality was significantly lower and the hospital stay was significantly shorter in period 2. In those with non-metastatic cancer, the 5-year local recurrences of patients in period 1 and period 2 were 11.9 and 5.9 %, respectively. (p = 0.002) The patients in period 2 had significantly better 5-year overall (68.1 vs. 60.2 %, p = 0.003) and 5-year cancer-specific survival (76.1 vs. 69.4 %, p < 0.001) when compared with those treated in period 1. The improvement occurred mainly in patients with abdominoperineal resection and those with stage III diseases. In the multivariate analysis, among the other histological factors, operations performed in period 2 and laparoscopic surgery were independent factors associated with better overall survival.
CONCLUSIONS: Significant improvement in the surgical outcomes in terms of a lower recurrence rate and better survival was achieved in the recent years with the increase in neoadjuvant therapy and the application of laparoscopic surgery.

PMID: 26801507 [PubMed - as supplied by publisher]

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Surgical Apgar Score Predicted Postoperative Morbidity After Esophagectomy for Esophageal Cancer.

Surgical Apgar Score Predicted Postoperative Morbidity After Esophagectomy for Esophageal Cancer.

World J Surg. 2016 Jan 22;

Authors: Eto K, Yoshida N, Iwatsuki M, Kurashige J, Ida S, Ishimoto T, Baba Y, Sakamoto Y, Miyamoto Y, Watanabe M, Baba H

Abstract
BACKGROUND: Recently, a simple and easy complication prediction system, the Surgical Apgar Sore (SAS) calculated by three intraoperative parameters (estimated blood loss, lowest mean arterial pressure, and lowest heart rate), has been proposed for general surgery. This study aimed to determine if the SAS could accurately predict perioperative morbidity in patients undergoing esophagectomy for esophageal cancer.
METHODS: We investigated 399 patients who underwent esophagectomy at the Kumamoto University Hospital between April 2007 and March 2015. Clinical data, including intraoperative parameters, were collected retrospectively. Patients had postoperative morbidities classified as Clavien-Dindo grade III or more. Univariate and multivariate analyses were performed to elucidate factors that affected the development of complications.
RESULTS: The mean age of the study population was 65.7 years, 357 patients (89.5 %) were male. The frequency of any morbidity was 32.3 %. Univariate analyses showed that the SAS as well as preoperative chemotherapy, volume of bleeding, and reconstruction of organs were associated with morbidities. Multivariate analysis showed that a SAS < 5 was found to be an independent risk factor for morbidities.
CONCLUSION: The SAS is considered to be useful for predicting the development of postoperative morbidities after esophagectomy for esophageal cancer.

PMID: 26801506 [PubMed - as supplied by publisher]

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New Portal-Superior Mesenteric Vein Reconstructions Using First Jejunal Vein Flap in Pancreaticoduodenectomy.

New Portal-Superior Mesenteric Vein Reconstructions Using First Jejunal Vein Flap in Pancreaticoduodenectomy.

World J Surg. 2016 Jan 22;

Authors: Takemura N, Miki K, Kosuge T

Abstract
Pancreaticoduodenectomy (PD) is the only potential treatment for pancreatic head adenocarcinomas, which are sometimes located close to or invade the portal-superior mesenteric vein (PSMV). Surgeons often attempt to obtain a negative resectional margin after resection of the PSMV. This attempt requires PSMV reconstruction through graft replacements or end-to-end anastomosis; however, possible complications should be concerned including anastomosis stenosis, damage to some of the PSMV branches, prosthetic graft infection, and that associated with autologous graft harvesting. The first jejunal artery and vein are often resected in PD with the intent of lymphadenectomy. In this study, jejunal vein flap was used for PSMV reconstruction without causing damage to any of the PSMV branches in two patients. Here, we describe the new methods of PSMV reconstruction using first jejunal vein flap in PD.

PMID: 26801505 [PubMed - as supplied by publisher]

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Safety and Efficacy of Outpatient Percutaneous Endoscopic Gastrostomy for Patients with Head and Neck Cancer.

Safety and Efficacy of Outpatient Percutaneous Endoscopic Gastrostomy for Patients with Head and Neck Cancer.

Am Surg. 2015 Feb;81(2):214-217

Authors: Boll J, Daly S, Smolevitz J, Francescatti A, Myers J, Bines S, Luu M

PMID: 26803136 [PubMed - as supplied by publisher]

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Solid-type primary intraosseous squamous-cell carcinoma in the mandible: Report of a rare case.

Solid-type primary intraosseous squamous-cell carcinoma in the mandible: Report of a rare case.

Hematol Oncol Stem Cell Ther. 2016 Jan 16;

Authors: Alotaibi O, Al-Zaher N, Alotaibi F, Khoja H, Qannam A

Abstract
Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare malignant neoplasm that has an exquisitely exclusive affection to the jawbone. It is defined as squamous cell carcinoma arising within the jaw and developing from residual odontogenic epithelium or from a preexisting odontogenic cyst or tumor. The solid-type of this tumor is a central jaw carcinoma arising de novo and has no initial connection with the oral mucosa. Herein, we report a case of solid-type PIOSCC involving the mandible in a 37-year-old male patient elucidating its histopathological and imaging findings. The patient underwent surgical resection followed by post-operative adjuvant radiotherapy. The close 2-year follow up of the patient revealed neither locoregional nor distant metastasis.

PMID: 26802621 [PubMed - as supplied by publisher]

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Pre-treatment SNOT-22 Score Predicts Response to Endoscopic Polypectomy in Clinic (EPIC) Our experience in 30 adults.

Pre-treatment SNOT-22 Score Predicts Response to Endoscopic Polypectomy in Clinic (EPIC) Our experience in 30 adults.

Clin Otolaryngol. 2016 Jan 23;

Authors: Caulley L, Lasso A, Rudmik L, Kilty SJ

Abstract
Endoscopic polypectomy in clinic (EPIC) has demonstrated substantial short-term improvement in patient reported quality of life measures and a pilot economic analysis of EPIC confirmed its cost-effectiveness in comparison to endoscopic sinus surgery. The purpose of this study was to evaluate if pre-treatment Sino Nasal Outcome Tests-22 (SNOT-22) score predicts response to EPIC treatment in parallel to the results found for endoscopic sinus surgery. Depending on the baseline SNOT-22 group the probability of achieving minimal clinically important difference was 75-100% post-EPIC. The relative improvement in quality of life on average was 62% with 90% realising a minimal clinically important difference in their SNOT-22 score. These results are comparable to what has been found for endoscopic sinus surgery. The results of this study reflect the published results of the effect of endoscopic sinus surgery on SNOT-22 scores 6 months post-intervention which themselves have been shown to predict SNOT-22 scores at 18 months post-endoscopic sinus surgery. In select patients with chronic rhinosinusitis with nasal polyps the EPIC procedure may provide SNOT-22 score improvements similar to those seen with patients who undergo endoscopic sinus surgery This article is protected by copyright. All rights reserved.

PMID: 26802485 [PubMed - as supplied by publisher]

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Role of fine needle aspiration cytology in the differential diagnosis of vascular anomalies from other lesions in the head and neck region.

Role of fine needle aspiration cytology in the differential diagnosis of vascular anomalies from other lesions in the head and neck region.

Phlebology. 2016 Jan 22;

Authors: He J, Zhu H, Zhang C, Wang Y, Zheng J, Qiu W

Abstract
OBJECTIVE: To summarise the role of fine needle aspiration cytology in the differential diagnosis of vascular anomalies from other lesions in the head and neck region by presenting five interesting cases reported from our hospital data.
METHOD: Five patients ranging in age from 3 months to 25 years old were diagnosed with vascular anomalies based on their histories, clinical examinations, imaging examinations and ultrasonic testing. The previous diagnosis of these patients were corrected by fine needle aspiration cytology in our hospital and the proper treatment was administered.
RESULT: Two cases were wrongly treated in a local hospital. All five of the patients underwent operations after excluding vascular anomalies by fine needle aspiration cytology.
CONCLUSION: Fine needle aspiration cytology should be used in the following situations to prevent misdiagnoses and the mistreatment as vascular anomalies: when imaging examination and ultrasonic testing lead to a diagnosis of vascular malformation, but the history or clinical examination does not confirm this diagnosis; when lesions are treated as "vascular malformations" by sclerotherapy, and the hydatid fluid is not like blood or lymph fluid; and when propranolol is used to treat the proliferation stage of "haemangiomas" with without any effect.

PMID: 26802064 [PubMed - as supplied by publisher]

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Hemangiopericytoma arising from the cartilage of the external auditory canal.

Hemangiopericytoma arising from the cartilage of the external auditory canal.

Head Neck. 2016 Jan 23;

Authors: Castiglione M, Nardo L, Ottaviani F

Abstract
BACKGROUND: Hemangiopericytomas (HPCs) are soft tissue tumors with histological variability and unpredictable clinical and biological behavior. HPCs in the head and neck are uncommon, the growth pattern is nonspecific; thus, diagnosis is often made by exclusion.
METHODS: A 43-year-old man complained of a short history of right ear pain associated with a growing mass in the right external auditory canal. Subsequent hearing loss in the right ear brought the patient to undergo a CT scan and an MRI. The relevant literature was also reviewed.
RESULTS: The imaging revealed a neoplasm arising from the floor of the right external auditory canal. The neoplasm was removed with the diagnosis of HPC.
CONCLUSION: The literature reports few cases of HPC of the external auditory canal. Their rarity in this area leads to difficulties in diagnosis. Morphology is not predictive of their behavior, so close follow-up is mandatory for their correct management. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 26801951 [PubMed - as supplied by publisher]

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Guidelines and parameters: percutaneous sclerotherapy for the treatment of head and neck venous and lymphatic malformations.

Guidelines and parameters: percutaneous sclerotherapy for the treatment of head and neck venous and lymphatic malformations.

J Neurointerv Surg. 2016 Jan 22;

Authors: Heit JJ, Do HM, Prestigiacomo CJ, Delgado-Almandoz JA, English J, Gandhi CD, Albequerque FC, Narayanan S, Blackham KA, Abruzzo T, Albani B, Fraser JF, Heck DV, Hussain MS, Lee SK, Ansari SA, Hetts SW, Bulsara KR, Kelly M, Arthur AS, Patsalides A, Pride GL, Powers CJ, Alexander MJ, Meyers PM, Jayaraman MV, SNIS Standards and Guidelines committee

PMID: 26801946 [PubMed - as supplied by publisher]

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Ultrasound guided assessment of thyroid nodules based on the 2014 British Thyroid Association Guidelines for the Management of Thyroid cancer - How we do it.

Ultrasound guided assessment of thyroid nodules based on the 2014 British Thyroid Association Guidelines for the Management of Thyroid cancer - How we do it.

Clin Otolaryngol. 2016 Jan 23;

Authors: Kanona H, Virk JS, Offiah C, Stimpson P

Abstract
OBJECTIVES: To measure our clinical practice against the new gold standard British thyroid Association (BTA) Guideline on the ultrasound assessment of thyroid nodules.
DESIGN: Prospective Patient Archive and Communication System (PACS) search.
SETTING: A tertiary referral head and neck centre in London.
PARTICIPANTS: Three hundred and fifty nine thyroid radiology ultrasound (US) reports were examined.
MAIN OUTCOME MEASURES: Strict compliance with BTA reporting guidelines by provision of a 'U score' and the reporting of recognised features associated with benign and suspicious thyroid on US scan. We also recorded the type of radiology reporter and correlation of US findings against FNAC.
RESULTS: U scores were provided in 2 (1.5% of 132), 15 (18% of 83) and 33 (22.9% of 144) US scan reports for each respective audit cycle. Using a 2-sided Fischer's Exact Test, there was significant improvement between the 1(st) and 2(nd) cycle and the 1(st) and 3(rd) cycle (p<0.0001), but no significant improvement between the 2(nd) and 3(rd) cycle (p<0.499). Head and Neck Radiologists were largely responsible for reporting U scores in 2 (100%), 11 (73.3%) and 27 (81.8%) of the US scans for each audit cycle (p<0.0002).
CONCLUSION: Our audit demonstrates a modest, but significant improvement in adherence to the BTA guidance following an educational programme. In future, it may be helpful to develop reporting proformas with minimum data fields. This would guide clinicians and provide reassurance that all the relevant features have been considered and also provide a useful tool for future research and audit. Close liaison with colleagues from radiology is important in this regard. This article is protected by copyright. All rights reserved.

PMID: 26801368 [PubMed - as supplied by publisher]

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Inhibition of heme oxygenase-1 enhances the chemosensitivity of laryngeal squamous cell cancer Hep-2 cells to cisplatin.

Inhibition of heme oxygenase-1 enhances the chemosensitivity of laryngeal squamous cell cancer Hep-2 cells to cisplatin.

Apoptosis. 2016 Jan 22;

Authors: Lv X, Song DM, Niu YH, Wang BS

Abstract
It has been previously reported that cisplatin is a well-known anticancer drug being used against a wide range of malignancies including head and neck, ovarian and non-small cell lung carcinoma, and demonstrated its anticancer activity by reacting with DNA or changing cell structure, immune response, reactive oxygen species level (ROS). In this research we proved that cisplatin induced cell injuries and heme oxygenase-1 (HO-1) expression in laryngeal squamous cell cancer Hep-2 cells through ROS generation. The induction of HO-1 clearly protected Hep-2 cells from cisplatin-induced cell death and ROS reaction, and the inhibitor of HO-1 enhanced the cell death and ROS generation induced by cisplatin. Furthermore, the HO-1 expression induced by cisplatin was strongly inhibited by the knockdown of nuclear factor-erythroid-2-related factor-2 (Nrf-2), and the oxidative damages induced by cisplatin were significantly enhanced. Therefore, it may be concluded that the inhibition of HO-1 or the knockdown of Nrf-2 significantly enhanced cisplatin's anticancer effects on Hep-2 cells. In clinic, with the overexpression of HO-1 in laryngeal squamous cancer tissues, the combination of cisplatin with the inhibitor of HO-1 or Nrf-2 siRNA may act as a new method to the treatment of laryngeal squamous cancer.

PMID: 26801320 [PubMed - as supplied by publisher]

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In reference to Natural history and management of fanconi anemia patients with head and neck cancer: A 10-year follow-up.

In reference to Natural history and management of fanconi anemia patients with head and neck cancer: A 10-year follow-up.

Laryngoscope. 2016 Jan 23;

Authors: Alter BP, Rosenberg PS

PMID: 26801202 [PubMed - as supplied by publisher]

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Microsomal PGE2 synthase-1 regulates melanoma cell survival and associates with melanoma disease progression.

Microsomal PGE2 synthase-1 regulates melanoma cell survival and associates with melanoma disease progression.

Pigment Cell Melanoma Res. 2016 Jan 23;

Authors: Kim SH, Hashimoto Y, Cho SN, Roszik J, Milton DR, Dal F, Kim SF, Menter DG, Yang P, Ekmekcioglu S, Grimm EA

Abstract
COX-2 and its product PGE2 enhance carcinogenesis and tumor progression, which has been previously reported in melanoma. As most COX inhibitors cause much toxicity, the downstream microsomal PGE2 synthase-1 (mPGES1) is a consideration for targeting. Human melanoma TMAs were employed for testing mPGES1 protein staining intensity and percentage levels and both increased with clinical stage; employing a different Stage III TMA, mPGES1 intensity (not percentage) associated with reduced patient survival. Our results further show that iNOS was also highly expressed in melanoma tissues with high mPGES1 levels, and iNOS-mediated NO promoted mPGES1 expression and PGE2 production. An mPGES1specific inhibitor (CAY10526) as well as siRNA attenuated cell survival and increased apoptosis. CAY10526 significantly suppressed tumor growth and increased apoptosis in melanoma xenografts. Our findings support the value of a prognostic and predictive role for mPGES1, and suggest targeting this molecule in the PGE2 pathway as another avenue toward improving melanoma therapy. This article is protected by copyright. All rights reserved.

PMID: 26801201 [PubMed - as supplied by publisher]

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ATP-Evoked Intracellular Ca(2+) Signaling of Different Supporting Cells in the Hearing Mouse Hemicochlea.

ATP-Evoked Intracellular Ca(2+) Signaling of Different Supporting Cells in the Hearing Mouse Hemicochlea.

Neurochem Res. 2016 Jan 22;

Authors: Horváth T, Polony G, Fekete Á, Aller M, Halmos G, Lendvai B, Heinrich A, Sperlágh B, Vizi ES, Zelles T

Abstract
Hearing and its protection is regulated by ATP-evoked Ca(2+) signaling in the supporting cells of the organ of Corti, however, the unique anatomy of the cochlea hampers observing these mechanisms. For the first time, we have performed functional ratiometric Ca(2+) imaging (fura-2) in three different supporting cell types in the hemicochlea preparation of hearing mice to measure purinergic receptor-mediated Ca(2+) signaling in pillar, Deiters' and Hensen's cells. Their resting [Ca(2+)]i was determined and compared in the same type of preparation. ATP evoked reversible, repeatable and dose-dependent Ca(2+) transients in all three cell types, showing desensitization. Inhibiting the Ca(2+) signaling of the ionotropic P2X (omission of extracellular Ca(2+)) and metabotropic P2Y purinergic receptors (depletion of intracellular Ca(2+) stores) revealed the involvement of both receptor types. Detection of P2X2,3,4,6,7 and P2Y1,2,6,12,14 receptor mRNAs by RT-PCR supported this finding and antagonism by PPADS suggested different functional purinergic receptor population in pillar versus Deiters' and Hensen's cells. The sum of the extra- and intracellular Ca(2+)-dependent components of the response was about equal with the control ATP response (linear additivity) in pillar cells, and showed supralinearity in Deiters' and Hensen's cells. Calcium-induced calcium release might explain this synergistic interaction. The more pronounced Ca(2+) leak from the endoplasmic reticulum in Deiters' and Hensen's cells, unmasked by cyclopiazonic acid, may also suggests the higher activity of the internal stores in Ca(2+) signaling in these cells. Differences in Ca(2+) homeostasis and ATP-induced Ca(2+) signaling might reflect the distinct roles these cells play in cochlear function and pathophysiology.

PMID: 26801171 [PubMed - as supplied by publisher]

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Hyoid surgery alone for obstructive sleep apnea: A systematic review and meta-analysis.

Hyoid surgery alone for obstructive sleep apnea: A systematic review and meta-analysis.

Laryngoscope. 2016 Jan 23;

Authors: Song SA, Wei JM, Buttram J, Tolisano AM, Chang ET, Liu SY, Certal V, Camacho M

Abstract
OBJECTIVES/HYPOTHESIS: The primary objective was to determine if sleep study variables (e.g., apnea-hypopnea index [AHI] and lowest oxygen saturation) and quantitative sleepiness data improve following isolated hyoid surgery for obstructive sleep apnea (OSA).
STUDY DESIGN: Systematic review and meta-analysis.
METHODS: Nine databases, including PubMed, were searched through September 5, 2015.
RESULTS: Four hundred ninety-eight studies were screened, 64 were reviewed, and nine studies met inclusion criteria. A total of 101 patients were identified who underwent hyoid surgery alone for treatment of OSA. Subanalyses were performed for: 1) type of surgery, 2) primary versus secondary hyoid surgery, 3) positional versus nonpositional OSA, 4) age, and 5) body mass index. In patients undergoing isolated hyoid surgery, the AHI decreased from a mean ± standard deviation of 37.3 ± 21.1 (95% confidence interval [CI]: 33.1, 41.5) to 23.0 ± 18.6 (95% CI: 19.3, 26.7) events/hour, which correspond to a 38.3% reduction (P < .0001). AHI reduced by 38.3% for hyoid myotomy with suspension, by 50.7% for hyothyroidopexy, and by 7.1% for hyoid expansion. The Epworth Sleepiness Scale decreased by 3.2 points from 10.3 ± 4.9 (95% CI: 8.8, 11.8) to 7.1 ± 4.2 (95% CI: 5.8, 8.4; P = .0027).
CONCLUSIONS: Isolated hyoid surgery has reduced OSA severity and improved sleepiness in adults. Hyothyroidopexy provided a 50.7% reduction in AHI, followed by hyoid myotomy with suspension (38.3% reduction in AHI) and hyoid expansion (7.1% reduction in AHI). The current literature lacks high-quality evidence with regard to hyoid surgery, and additional studies are needed to further elucidate the effect of hyoid surgery in OSA.
LEVEL OF EVIDENCE: NA Laryngoscope, 2015.

PMID: 26801005 [PubMed - as supplied by publisher]

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Management of rhinosinusitis during pregnancy: systematic review and expert panel recommendations.

Management of rhinosinusitis during pregnancy: systematic review and expert panel recommendations.

Rhinology. 2016 Jan 23;

Authors: Lal D, Jategaonkar AA, Borish L, Chambliss LR, Gnagi SH, Hwang PH, Rank MA, Stankiewicz JA, Lund VJ

Abstract
BACKGROUND: Management of rhinosinusitis during pregnancy requires special considerations.
OBJECTIVES: 1. Conduct a systematic literature review for acute and chronic rhinosinusitis (CRS) management during pregnancy. 2. Make evidence-based recommendations.
METHODS: The systematic review was conducted using MEDLINE and EMBASE databases and relevant search terms. Title, abstract and full manuscript review were conducted by two authors independently. A multispecialty panel with expertise in management of Rhinological disorders, Allergy-Immunology, and Obstetrics-Gynecology was invited to review the systematic review. Recommendations were sought on use of following for CRS management during pregnancy: oral corticosteroids; antibiotics; leukotrienes; topical corticosteroid spray/irrigations/drops; aspirin desensitization; elective surgery for CRS with polyps prior to planned pregnancy; vaginal birth versus planned Caesarian for skull base erosions/ prior CSF rhinorrhea.
RESULTS: Eighty-eight manuscripts underwent full review after screening 3052 abstracts. No relevant level 1, 2, or 3 studies were found. Expert panel recommendations for rhinosinusitis management during pregnancy included continuing nasal corticosteroid sprays for CRS maintenance, using pregnancy-safe antibiotics for acute rhinosinusitis and CRS exacerbations, and discontinuing aspirin desensitization for aspirin exacerbated respiratory disease. The manuscript presents detailed recommendations.
CONCLUSIONS: The lack of evidence pertinent to managing rhinosinusitis during pregnancy warrants future trials. Expert recommendations constitute the current best available evidence.

PMID: 26800862 [PubMed - as supplied by publisher]

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Using postoperative SNOT-22 to help predict the probability of revision sinus surgery.

Using postoperative SNOT-22 to help predict the probability of revision sinus surgery.

Rhinology. 2016 Jan 23;

Authors: Rudmik L, Soler ZM, Hopkins C

Abstract
BACKGROUND: There is a need to develop a patient-level strategy to identify those at higher risk of requiring revision ESS since this may assist clinicians in tailoring their postoperative management. This study evaluated whether identifying changes in the post- operative 22-item Sinonasal Outcome Test (SNOT-22) can help identify patients at increased risk of needing revision sinus surgery for refractory chronic rhinosinusitis (CRS).
METHODS: 668 CRS patients undergoing primary ESS with complete 60-month follow-up were evaluated in this prospective, longitudinal cohort study. Outcomes were evaluated in an unselected cohort and a low-risk cohort, which was comprised of patients without a history of asthma or aspirin sensitivity.
RESULTS: Failing to achieve an improvement of greater than one minimal clinically important difference (MCID; 9 points) at 3 months after primary ESS and a deterioration of greater than one MCID (ie. over 9 points) from the 3- to 12-month follow-up periods was associated with an increased risk of revision ESS in both the unselected and low-risk CRS cohorts.
CONCLUSION: Outcomes from this study suggest that identifying MCID changes in the SNOT-22 score within 12 months after primary ESS can identify patients at increased risk for needing revision surgery.

PMID: 26800771 [PubMed - as supplied by publisher]

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Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis.

Effectiveness of interventions to directly support food and drink intake in people with dementia: systematic review and meta-analysis.

BMC Geriatr. 2016;16(1):26

Authors: Abdelhamid A, Bunn D, Copley M, Cowap V, Dickinson A, Gray L, Howe A, Killett A, Lee J, Li F, Poland F, Potter J, Richardson K, Smithard D, Fox C, Hooper L

Abstract
BACKGROUND: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with cognitive impairment or dementia (across all settings, levels of care and support, types and degrees of dementia). Interventions included oral nutrition supplementation, food modification, dysphagia management, eating assistance and supporting the social element of eating and drinking.
METHODS: We comprehensively searched 13 databases for relevant intervention studies. The review was conducted with service user input in accordance with Cochrane Collaboration's guidelines. We duplicated assessment of inclusion, data extraction, and validity assessment, tabulating data, carrying out random effects meta-analysis and narrative synthesis.
RESULTS: Forty-three controlled interventions were included, disappointingly none were judged at low risk of bias. Oral nutritional supplementation studies suggested small positive short term but unclear long term effects on nutritional status. Food modification or dysphagia management studies were smaller and of low quality, providing little evidence of an improved nutritional status. Eating assistance studies provided inconsistent evidence, but studies with a strong social element around eating/drinking, although small and of low quality provided consistent suggestion of improvements in aspects of quality of life. There were few data to address stakeholders' questions.
CONCLUSIONS: We found no definitive evidence on effectiveness, or lack of effectiveness, of specific interventions but studies were small and short term. People with cognitive impairment and their carers have to tackle eating problems despite this lack of evidence, so promising interventions are listed. The need remains for high quality trials tailored for people with cognitive impairment assessing robust outcomes.
SYSTEMATIC REVIEW REGISTRATION: The systematic review protocol was registered (CRD42014007611) and is published, with the full MEDLINE search strategy, on Prospero [1].

PMID: 26801619 [PubMed - as supplied by publisher]

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A statistical analysis of cervical auscultation signals from adults with unsafe airway protection.

A statistical analysis of cervical auscultation signals from adults with unsafe airway protection.

J Neuroeng Rehabil. 2016;13(1):7

Authors: Dudik JM, Kurosu A, Coyle JL, Sejdić E

Abstract
BACKGROUND: Aspiration, where food or liquid is allowed to enter the larynx during a swallow, is recognized as the most clinically salient feature of oropharyngeal dysphagia. This event can lead to short-term harm via airway obstruction or more long-term effects such as pneumonia. In order to non-invasively identify this event using high resolution cervical auscultation there is a need to characterize cervical auscultation signals from subjects with dysphagia who aspirate.
METHODS: In this study, we collected swallowing sound and vibration data from 76 adults (50 men, 26 women, mean age 62) who underwent a routine videofluoroscopy swallowing examination. The analysis was limited to swallows of liquid with either thin (<5 cps) or viscous (≈300 cps) consistency and was divided into those with deep laryngeal penetration or aspiration (unsafe airway protection), and those with either shallow or no laryngeal penetration (safe airway protection), using a standardized scale. After calculating a selection of time, frequency, and time-frequency features for each swallow, the safe and unsafe categories were compared using Wilcoxon rank-sum statistical tests.
RESULTS: Our analysis found that few of our chosen features varied in magnitude between safe and unsafe swallows with thin swallows demonstrating no statistical variation. We also supported our past findings with regard to the effects of sex and the presence or absence of stroke on cervical ausculation signals, but noticed certain discrepancies with regards to bolus viscosity.
CONCLUSIONS: Overall, our results support the necessity of using multiple statistical features concurrently to identify laryngeal penetration of swallowed boluses in future work with high resolution cervical auscultation.

PMID: 26801236 [PubMed - as supplied by publisher]

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Inhibition of heme oxygenase-1 enhances the chemosensitivity of laryngeal squamous cell cancer Hep-2 cells to cisplatin.

Inhibition of heme oxygenase-1 enhances the chemosensitivity of laryngeal squamous cell cancer Hep-2 cells to cisplatin.

Apoptosis. 2016 Jan 22;

Authors: Lv X, Song DM, Niu YH, Wang BS

Abstract
It has been previously reported that cisplatin is a well-known anticancer drug being used against a wide range of malignancies including head and neck, ovarian and non-small cell lung carcinoma, and demonstrated its anticancer activity by reacting with DNA or changing cell structure, immune response, reactive oxygen species level (ROS). In this research we proved that cisplatin induced cell injuries and heme oxygenase-1 (HO-1) expression in laryngeal squamous cell cancer Hep-2 cells through ROS generation. The induction of HO-1 clearly protected Hep-2 cells from cisplatin-induced cell death and ROS reaction, and the inhibitor of HO-1 enhanced the cell death and ROS generation induced by cisplatin. Furthermore, the HO-1 expression induced by cisplatin was strongly inhibited by the knockdown of nuclear factor-erythroid-2-related factor-2 (Nrf-2), and the oxidative damages induced by cisplatin were significantly enhanced. Therefore, it may be concluded that the inhibition of HO-1 or the knockdown of Nrf-2 significantly enhanced cisplatin's anticancer effects on Hep-2 cells. In clinic, with the overexpression of HO-1 in laryngeal squamous cancer tissues, the combination of cisplatin with the inhibitor of HO-1 or Nrf-2 siRNA may act as a new method to the treatment of laryngeal squamous cancer.

PMID: 26801320 [PubMed - as supplied by publisher]

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Solid-type primary intraosseous squamous-cell carcinoma in the mandible: Report of a rare case.

Solid-type primary intraosseous squamous-cell carcinoma in the mandible: Report of a rare case.

Hematol Oncol Stem Cell Ther. 2016 Jan 16;

Authors: Alotaibi O, Al-Zaher N, Alotaibi F, Khoja H, Qannam A

Abstract
Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare malignant neoplasm that has an exquisitely exclusive affection to the jawbone. It is defined as squamous cell carcinoma arising within the jaw and developing from residual odontogenic epithelium or from a preexisting odontogenic cyst or tumor. The solid-type of this tumor is a central jaw carcinoma arising de novo and has no initial connection with the oral mucosa. Herein, we report a case of solid-type PIOSCC involving the mandible in a 37-year-old male patient elucidating its histopathological and imaging findings. The patient underwent surgical resection followed by post-operative adjuvant radiotherapy. The close 2-year follow up of the patient revealed neither locoregional nor distant metastasis.

PMID: 26802621 [PubMed - as supplied by publisher]

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Atypical manifestations of Epstein-Barr virus in children: a diagnostic challenge.

Atypical manifestations of Epstein-Barr virus in children: a diagnostic challenge.

J Pediatr (Rio J). 2016 Jan 20;

Authors: Bolis V, Karadedos C, Chiotis I, Chaliasos N, Tsabouri S

Abstract
OBJECTIVE: Clarify the frequency and the pathophysiological mechanisms of the rare manifestations of Epstein-Barr virus infection.
SOURCES: Original research studies published in English between 1985 and 2015 were selected through a computer-assisted literature search (PubMed and Scopus). Computer searches used combinations of key words relating to "EBV infections" and "atypical manifestation."
SUMMARY OF THE FINDINGS: Epstein-Barr virus is a herpes virus responsible for a lifelong latent infection in almost every adult. The primary infection concerns mostly children and presents with the clinical syndrome of infectious mononucleosis. However, Epstein-Barr virus infection may exhibit numerous rare, atypical and threatening manifestations. It may cause secondary infections and various complications of the respiratory, cardiovascular, genitourinary, gastrointestinal, and nervous systems. Epstein-Barr virus also plays a significant role in pathogenesis of autoimmune diseases, allergies, and neoplasms, with Burkitt lymphoma as the main representative of the latter. The mechanisms of these manifestations are still unresolved. Therefore, the main suggestions are direct viral invasion and chronic immune response due to the reactivation of the latent state of the virus, or even various DNA mutations.
CONCLUSIONS: Physicians should be cautious about uncommon presentations of the viral infection and consider EBV as a causative agent when they encounter similar clinical pictures.

PMID: 26802473 [PubMed - as supplied by publisher]

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Synchronous presentation of invasive ductal carcinoma and mantle cell lymphoma: a diagnostic challenge in menopausal patients.

Synchronous presentation of invasive ductal carcinoma and mantle cell lymphoma: a diagnostic challenge in menopausal patients.

J Surg Case Rep. 2016;2016(1)

Authors: Woo EJ, Baugh AD, Ching K

Abstract
Synchronous presentation of breast carcinoma and non-Hodgkin lymphoma (NHL) is a rare occurrence (Bradford PT, Freedman DM, Goldstein AM, Tucker MA. Increased risk of second primary cancers after a diagnosis of melanoma. Arch Dermatol 2010; 146: :265-72; Dutta Roy S, Stafford JA, Scally J, Selvachandran SN. A rare case of breast carcinoma co-existing with axillary mantle cell lymphoma. World J Surg Oncol 2003; 1: :27; Suresh Attili VS, Dadhich HK, Rao CR, Bapsy PP, Batra U, Anupama G et al. A case of breast cancer coexisting with B-cell follicular lymphoma. Austral Asian J Cancer 2007; 6: :155-6). In particular, only two reported cases on synchronous presentation of invasive ductal carcinoma (IDC) and mantle cell lymphoma (MCL) exist in the English literature. Owing to the rarity, there is a lack of consensus about underlying mechanism as well as optimal treatment strategy, and diagnosing both malignancies together without a delay remains a complex clinical challenge. We report a case of synchronous presentation of IDC and MCL in a 67-year-old female patient whose MCL diagnosis was delayed due to a misinterpretation of her B symptoms as postmenopausal, with a review of the literature on concurrently occurring breast carcinoma and NHL.

PMID: 26801778 [PubMed]

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