Sclerosing bone dysplasias : genetic, clinical and radiology update of hereditary and non-hereditary disorders

There is a wide variety of hereditary and non-hereditary bone dysplasias, many with unique radiographic findings. Hereditary bony dysplasias include osteopoikilosis, osteopathia striata, osteopetrosis, progressive diaphyseal dysplasia, hereditary multiple diaphyseal sclerosis and pyknodysostosis. Non-hereditary dysplasias include melorheostosis, intramedullary osteosclerosis and overlap syndromes. Although many of these dysplasias are uncommon, radiologists should be familiar with their genetic, clinical and imaging findings to allow for differentiation from acquired causes of bony sclerosis. We present an overview of hereditary and non-hereditary bony dysplasias with focus on the pathogenesis, clinical and radiographic findings of each disorder.

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Will the 8th editions of the UICC & AJCC staging manuals improve the pathological diagnosis of extranodal extension from cervical lymph nodes?

Publication date: Available online 5 July 2017
Source:Oral Oncology
Author(s): Andrew W. Barrett




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Impact of early prophylactic feeding on long term tube dependency outcomes in patients with head and neck cancer

Publication date: September 2017
Source:Oral Oncology, Volume 72
Author(s): Teresa Brown, Merrilyn Banks, Brett G.M. Hughes, Charles Lin, Lizbeth M. Kenny, Judith D. Bauer
ObjectivesProphylactic gastrostomy tube (PGT) is frequently used in patients with head and neck cancer (HNSCC). There are concerns this leads to tube dependency but this phenomena is not well defined. This study aimed to determine whether early feeding via PGT impacted on longer term tube feeding outcomes.Materials and methodsPatients with HNSCC with PGT were observed monthly post-treatment regarding tube use and time to removal up to twelve months. Patients were from a randomised controlled trial comparing an early feeding intervention via the PGT (n=57) versus usual care which commenced feeding when clinically indicated (n=67).ResultsPatient characteristics; male (88%), mean age 60±10.1years, oropharyngeal tumours (76%), receiving chemoradiotherapy (82%). Tubes were used by 87% (108/124) on completion of treatment and 66% (83/124) one month post. No differences in tube use between groups at any time point or tube removal rates over 12months (p=0.181). In patients free of disease (n=99), the intervention had higher tube use at 4months (p=0.003) and slower removal rates (p=0.047). Overall ten patients had their tube in-situ at 12months (8%) but five were awaiting removal (4% true dependency rate). Of the five patients legitimately using the tube, only one (<1%) was from severe dysphagia post definitive chemoradiotherapy.ConclusionPGT use is high in the acute phase post-treatment. Encouraging early use may prolong time to tube removal but it does not increase long term dependency rates beyond four months post treatment. Monitoring tube use is important to prevent over-estimation of dependency rates.Clinical trial registrationThis trial has been registered in the Australian New Zealand Clinical Trials registry as ACTRN12612000579897. Available at http://ift.tt/17L6Qgm.



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Editorial Board/Aims & Scope

Publication date: August 2017
Source:Oral Oncology, Volume 71





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Predictors of readmissions after head and neck cancer surgery: A national perspective

Publication date: August 2017
Source:Oral Oncology, Volume 71
Author(s): Michelle M. Chen, Ryan K. Orosco, Jeremy P. Harris, Julie B. Porter, Eben L. Rosenthal, Wendy Hara, Vasu Divi
ObjectivesSurgical oncology patients have multiple comorbidities and are at high risk of readmission. Prior studies are limited in their ability to capture readmissions outside of the index hospital that performed the surgery. Our goal is to evaluate risk factors for readmission for head and neck cancer patients on a national scale.Material and methodsA retrospective cohort study of head and neck cancer patients in the Nationwide Readmissions Database (2013). Our main outcome was 30-day readmission. Statistical analysis included 2-sided t tests, χ², and multivariate logistic regression analysis.ResultsWithin 30days, 16.1% of 11,832 patients were readmitted and 20% of readmissions were at non-index hospitals, costing $31million. Hypopharyngeal cancer patients had the highest readmission rate (29.6%), followed by laryngeal (21.8%), oropharyngeal (18.2%), and oral cavity (11.6%) cancers (P<0.001). Half of readmissions occurred within 10days and were often associated with infections (27%) or wound complications (12%). Patients from lower household income areas were more likely to be readmitted (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.16–2.05). Patients with valvular disease (OR, 2.07; 95% CI, 1.16–3.69), rheumatoid arthritis/collagen vascular disease (OR, 2.05; 95% CI, 1.27–3.31), liver disease (OR, 2.02, 95% CI, 1.37–2.99), and hypothyroidism (OR 1.30; 95% CI, 1.02–1.66) were at highest risk of readmission.ConclusionThe true rate of 30-day readmissions after head and neck cancer surgery is 16%, capturing non-index hospital readmissions which make up 20% of readmissions. Readmissions after head and neck cancer surgery are most commonly associated with infections and wound complications.



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Parental encouragement and autonomy-granting and adolescents' use of organized and unorganized leisure time

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May depressed and anxious patients with carcinoid syndrome benefit from treatment with selective serotonin reuptake inhibitors (SSRIs)? : findings from a case report

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