Estimating the Esophagus Cancer Incidence Rate in Ardabil, Iran: A Capture-Recapture Method.

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Estimating the Esophagus Cancer Incidence Rate in Ardabil, Iran: A Capture-Recapture Method.

Iran J Cancer Prev. 2016 Feb;9(1):e3972

Authors: Khodadost M, Yavari P, Khodadost B, Babaei M, Sarvi F, Khatibi SR, Barzegari S

Abstract
BACKGROUND: Accurate cancer registry and awareness of cancer incidence rate is essential in order to define strategies for cancer prevention and control programs. Capture-recapture methods have been recommended for reducing bias and increase the accuracy of cancer incidence estimation.
OBJECTIVES: This study aimed to estimate the esophagus cancer incidence by capture-recapture method based on Ardabil population-based cancer registry data.
PATIENTS AND METHODS: Total new cases of esophagus cancer reported by three sources of pathology reports, medical records, and death certificates to Ardabil province cancer registry center in 2006 and 2008 were enrolled in the study. All duplicated cases between three sources were identified and removed using Excel software. Some characteristics such as name, surname, father's name, date of birth and ICD codes related to their cancer type were used for data linkage and finding the common cases among three sources. The incidence rate per 100,000 was estimated based on capture-recapture method using the log-linear models. We used BIC, G(2) and AIC statistics to select the best-fit model.
RESULTS: After removing duplicates, total 471 new cases of esophagus cancer were reported from three sources. The model with linkage between pathology reports, medical record sources and independence with the death certificates source was the best fitted model. The reported incidence rate for the years 2006 and 2008 was 18.77 and 18.51 per 100,000, respectively. In log-linear analysis, the estimated incidence rate for the years 2006 and 2008 was 49.71 and 53.87 per 100,000 populations, respectively.
CONCLUSIONS: Based on the obtained results, it can be concluded that none of the sources of pathology reports, death certificates and medical records individually or collectively were fully covered the incidence cases of esophagus cancer and need to apply some changes in data abstracting and case finding.

PMID: 27413513 [PubMed]

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Health Manpower Development (HMD) Corner Stone of Improving National Health System.

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Health Manpower Development (HMD) Corner Stone of Improving National Health System.

Iran J Cancer Prev. 2016 Feb;9(1):e5625

Authors: Akbari ME

PMID: 27366316 [PubMed]

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Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women.

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Cost-Effectiveness of Three Rounds of Mammography Breast Cancer Screening in Iranian Women.

Iran J Cancer Prev. 2016 Feb;9(1):e5443

Authors: Haghighat S, Akbari ME, Yavari P, Javanbakht M, Ghaffari S

Abstract
BACKGROUND: Breast cancer is the most common cancer in Iranian women as is worldwide. Mammography screening has been introduced as a beneficial method for reducing mortality and morbidity of this disease.
OBJECTIVES: We developed an analytical model to assess the cost effectiveness of an organized mammography screening program in Iran for early detection of the breast cancer.
PATIENTS AND METHODS: This study is an economic evaluation of mammography screening program among Iranian woman aged 40 - 70 years. A decision tree and Markov model were applied to estimate total quality adjusted life years (QALY) and lifetime costs.
RESULTS: The results revealed that the incremental cost effectiveness ratio (ICER) of mammography screening in Iranian women in the first round was Int. $ 37,350 per QALY gained. The model showed that the ICER in the second and third rounds of screening program were Int. $ 141,641 and Int. $ 389,148 respectively.
CONCLUSIONS: Study results identified that mammography screening program was cost-effective in 53% of the cases, but incremental cost per QALY in the second and third rounds of screening are much higher than the accepted payment threshold of Iranian health system. Thus, evaluation of other screening strategies would be useful to identify more cost-effective program. Future studies with new national data can improve the accuracy of our finding and provide better information for health policy makers for decision making.

PMID: 27366315 [PubMed]

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Effects of Two Common Promoter Polymorphisms of Transforming Growth Factor-β1 on Breast Cancer Risks in Ahvaz, West South of Iran.

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Effects of Two Common Promoter Polymorphisms of Transforming Growth Factor-β1 on Breast Cancer Risks in Ahvaz, West South of Iran.

Iran J Cancer Prev. 2016 Feb;9(1):e5266

Authors: Parvizi S, Mohammadzadeh G, Karimi M, Noorbehbahani M, Jafary A

Abstract
BACKGROUND: Transforming growth factor-β1 (TGF-β1) has a critical role in breast cancer initiation and progression.
OBJECTIVES: We have investigated the possible differences in two promoter polymorphisms (-509C/T and -800G/A) of TGF-β1 gene between breast cancer cases and controls.
PATIENTS AND METHODS: A total of 100 patients with confirmed breast cancer and 100 subjects without breast cancer was selected. Two promoter polymorphisms (-509C/T and -800G/A) of TGF-β1 gene were genotyped using PCR-based restriction fragment length polymorphism (RFLP) method.
RESULTS: The allele frequencies were 63% for C allele and 37% for T allele of SNP -509C/T and 66% for G allele and 34% for A allele of SNP -800G/A. Although no significant difference has observed between two groups, according to the genotype distribution, However, the TT genotype of -509 and AA genotype of -800 was significantly associated with breast cancer risk [odds ratio (OR) = 2.409; 95% confidence interval (CI) = 1.087 - 5.337, P = 0.030; and OR = 2.383; CI = 1.039 - 5.40, P = 0.040, respectively]. In addition, a multinomial logistic regression model shown, homozygous of -800 G/A (OR = 0.570; 95% CI = 0.362 - 0.896, P = 0.015); and HDL-C (OR = 0.935; 95% CI = 0.906 - 0.965, P < 0.001) were the selected variables associated with the presence of breast cancer. Haplotype analysis has shown no significant association between TGF-β1 haplotypes and breast cancer risk.
CONCLUSIONS: Our results indicated that among two promoter polymorphisms of the TGF-β1gene, -800G/A compared to -509C/T is more associated with breast cancer.

PMID: 27366314 [PubMed]

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Evaluating the Prevalence of the Epidermal Growth Factor Receptor in Transitional Cell Carcinoma of Bladder and its Relationship With Other Prognostic Factors.

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Evaluating the Prevalence of the Epidermal Growth Factor Receptor in Transitional Cell Carcinoma of Bladder and its Relationship With Other Prognostic Factors.

Iran J Cancer Prev. 2016 Feb;9(1):e4022

Authors: Parvin M, Sabet-Rasekh P, Hajian P, Mohammadi Torbati P, Sabet-Rasekh P, Mirzaei H

Abstract
BACKGROUND: The most common malignancy in the urinary system has been bladder cancer and the most predominant histologic subtype has been transitional cell carcinoma (TCC). There were many molecular risk factors, related with poor prognosis. One of these factors was expression of epidermal growth factor receptor (EGFR).
OBJECTIVES: The aim of this study was to evaluate the prevalence of the epidermal growth factor receptor in transitional cell carcinoma of bladder and its relationship with other prognostic factors.
PATIENTS AND METHODS: This analytic descriptive study has performed with 61 patients with TCC of bladder after radical cystectomy whom have been hospitalized in Labbafinejad hospital in Tehran, Iran between 2007 and 2010. We have used Chi-square and t-test to analyze our data samples.
RESULTS: Records of 61 patients have studied. Fifty three of the total samples were positive for EGFR expression (86.9%). Fifty samples of these fifty-three belonged to men and three others were women's samples (P = 0.46). Among the group with EGFR expression the results were as follows: 25 patients (47.2%) were 60 years old or less and 28 patients (52.8%) were older than 60 (P = 0.023), 16 patients (30.2%) had invasion to lamina properia, and the rest of them had invasion to deeper layers (P = 0.56). For most patients we could not determine the invasion of tumoral cells into the lymph nodes (Nx) (P = 0.067). Thirty four patients (64.2%) had not lymphovascular invasion (P = 0.44) and in forty three of patients (81.1%), perineural invasion have not seen (P = 0.23). Finally, 36 patients (67.9%) were grade 3 (P = 0.27).
CONCLUSIONS: In this study we have concluded that most patients had EGFR positive expression. Also, except for the age, there was not any significant relation between expression of EGFR and the other prognostic factors such as, gender, invasion of the tumor into the layers, involving the lymph nodes, lymphovascular or perineural invasion, and grading.

PMID: 27366313 [PubMed]

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New Developments in Chronic Myeloid Leukemia: Implications for Therapy.

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New Developments in Chronic Myeloid Leukemia: Implications for Therapy.

Iran J Cancer Prev. 2016 Feb;9(1):e3961

Authors: Tabarestani S, Movafagh A

Abstract
CONTEXT: Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by overproduction of immature and matured myeloid cells in the peripheral blood, bone marrow and spleen.
EVIDENCE ACQUISITION: A hallmark of CML is the presence of (9; 22) (q34; q11) reciprocal translocation, which is cytogenetically visible as Philadelphia chromosome (Ph) and results in the formation of BCR-ABL1 fusion protein. This fusion protein is a constitutively active tyrosine kinase which is necessary and sufficient for malignant transformation. The introduction of imatinib, a BCR-ABL1- targeting tyrosine kinase inhibitor (TKI) has revolutionized CML therapy. Subsequently, two other TKIs with increased activity against BCR-ABL1, dasatinib and nilotinib, were developed and approved for CML patients. Nevertheless, CML therapy faces major challenges.
RESULTS: The first is the development of resistance to BCR-ABL1 inhibitors in some patients, which can be due to BCR-ABL1 overexpression, differences in cellular drug influx and efflux, activation of alternative signaling pathways, or emergence of BCR-ABL1 kinase domain mutations during TKI treatment. The second is the limited efficiency of BCR-ABL1-TKIs in blast crisis (BC) CML. The third is the insensitivity of CML stem cells to BCR-ABL1 inhibitors. Conventional chemotherapeutics and BCR-ABL1 inhibitors which act by inhibiting cell proliferation and inducing apoptosis, are ineffective against quiescent CML stem cells.
CONCLUSIONS: A better understanding of the mechanisms that underlie TKI resistance, progression to BC, genomic instability and stem cell quiescence is essential to develop curative strategies for patients with CML.

PMID: 27366312 [PubMed]

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Autophagy Gene Activity May Act As a Key Factor for Sensitivity of Tumor Cells to Oncolytic Vesicular Stomatitis Virus.

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Autophagy Gene Activity May Act As a Key Factor for Sensitivity of Tumor Cells to Oncolytic Vesicular Stomatitis Virus.

Iran J Cancer Prev. 2016 Feb;9(1):e3919

Authors: Nabizadeh A, Bamdad T, Arefian E, Razavi Nikoo SH

Abstract
BACKGROUND: Beclin1 is an important, primary molecule for autophagy.
OBJECTIVES: It is suggested that the control of the autophagy path increases the sensitivity of tumor cells to VSV.
MATERIALS AND METHODS: In this study, the degree of Beclin1 gene expression in two cell lines, HeLa and A549, has been examined and the percentage of living cells subsequent infection with virus has been evaluated by MTT assay method.
RESULTS: The results showed that the degree of Beclin1 gene expression in HeLa cells in comparison with A549 cells has reduced, and the sensitivity of these cells to vesicular stomatits virus (VSV) oncolysis is more than A549.
CONCLUSIONS: It seems that by using some methods for reducing autophagy, it is possible to make tumor cells more sensitive to virotherapy and even other treatments.

PMID: 27366311 [PubMed]

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Barriers for Early Detection of Cancer Amongst Urban Indian Women: A Cross Sectional Study.

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Barriers for Early Detection of Cancer Amongst Urban Indian Women: A Cross Sectional Study.

Iran J Cancer Prev. 2016 Feb;9(1):e3900

Authors: Kadam YR, Quraishi SR, Dhoble RV, Sawant MR, Gore AD

Abstract
BACKGROUND: Cancer is a leading cause of death globally. Every year, millions of cancer patients could be saved from premature death and and suffering if they had timely access to early detection and treatment. There are two main components of early detection: early diagnosis and screening. In India, cancers of cervix, breast, mouth/oropharynx are the most frequent cancers in women. These cancers are amenable to early detection. More than two third of the cancer patients are already in an advanced and incurable stage at the time of diagnosis.
OBJECTIVES: This study was designed with the aim to know the reasons for non availment of cancer screening procedures and early diagnostic facilities.
MATERIALS AND METHODS: This cross-sectional study was planned in Sangli, Miraj and Kupwad Corporation area during October 2013 - March 2014 by a pretested questionnaire. Women of 25 years and above were study subjects selected randomly from a cluster sample of ward with estimated sample size of 559 women. Statistical analysis was done with the help of IBM SPSS 22.
RESULTS: Nearly 74% of women said that cancer is curable. For awareness about signs and symptoms, risk factors and screening test 82.3% women scored less than 50% of total score. Only 17.7% women had awareness score more than 50%. But their attitude score was > 50% in 85.2% of women. For practice score, 24.4% women scored > 50%. Significant association was found between awareness, attitude and practice scores and education, occupation and history of cancer in family, friends and neighborhood of respondents.
CONCLUSIONS: Low awareness is the main barrier for undergoing cancer screening and early detection. There is a need of effective health education programme.

PMID: 27366310 [PubMed]

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Molecular Detection and Typing of Human Papillomaviruses in Paraffin-Embedded Cervical Cancer and Pre-Cancer Tissue Specimens.

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Molecular Detection and Typing of Human Papillomaviruses in Paraffin-Embedded Cervical Cancer and Pre-Cancer Tissue Specimens.

Iran J Cancer Prev. 2016 Feb;9(1):e3752

Authors: Mahmoodi P, Motamedi H, Seyfi Abad Shapouri MR, Bahrami Shehni M, Kargar M

Abstract
BACKGROUND: Cervical cancer is one of the important reasons of mortality among females. Prevention, early diagnosis and immediate treatment can affect the rate of mortality in this cancer and several epidemiological studies have shown a strong relationship between human papilloma viruses (HPVs) and cervical cancer.
OBJECTIVES: The present study was conducted to survey HPV infections in a women population with cervical cancer and cervical dysplasia/metaplasia in southwest of Iran.
MATERIALS AND METHODS: 72 paraffin-embedded cervical biopsies which had been previously archived from women with cervical cancer and cervical dysplasia were examined by polymerase chain reaction (PCR). Afterward, the detected HPV strains were typed by restriction fragment length polymorphism (RFLP) analysis of PCR amplicons.
RESULTS: 60 out of 72 samples had necessary requirements and HPV DNA was detected in 43.3% of these samples. Most HPV positive samples belonged to women aged from 48 to 63 years. On the other hand, HPV infection among patients with squamous cell carcinoma (SCC) was 48.78% and in women with dysplasia/metaplasia was 26.66%. The most prevalent type of the human papilloma virus was HPV16 (100%).
CONCLUSIONS: Knowing the most prevalent type of the human papilloma viruses circulating in the population (HPV16) can be applied in the future screening and managing programs of this major disease and also in vaccination against the prevalent types of the virus. Meanwhile, it seems that more studies should be performed to determine the role of different risk factors involved in development of the disease, especially those related with social behaviors and traditions with respect to different areas.

PMID: 27366309 [PubMed]

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Pancreatic Lymphangioma as a Rare Pancreatic Mass: A Case Report.

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Pancreatic Lymphangioma as a Rare Pancreatic Mass: A Case Report.

Iran J Cancer Prev. 2016 Feb;9(1):e3505

Authors: Talaiezadeh A, Ranjbari N, Bakhtiari M

Abstract
INTRODUCTION: Cystic lymphangiomas of abdomen has mostly involved mesentery and retro peritoneum that should be considered as a differential diagnosis of abdominal masses. Pancreatic lymphangiomas were extremely rare that should be differentiated from neoplastic pancreatic cysts. Patients have commonly presented with epigastric pain and a relevant palpable epigastric mass.
CASE PRESENTATION: A 65-year-old lady who has presented with epigastric pain, then during investigations, a cystic tumor which located in the tail of pancreas, has found. Whereas definite diagnosis of tumor with routine procedures was impossible, the tumor has completely resected by distal pancreatectomy and splenectomy. Pathology and IHC was suggestive of benign lymphangioma.
CONCLUSIONS: According to this presentation diagnosis of cystic lymphangioma of the tail of pancreas should be considered as a differential diagnosis of pancreatic cystic lesions and complete excision has been the treatment of choice.

PMID: 27366308 [PubMed]

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XRCC1 and OGG1 Gene Polymorphisms and Breast Cancer: A Systematic Review of Literature.

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XRCC1 and OGG1 Gene Polymorphisms and Breast Cancer: A Systematic Review of Literature.

Iran J Cancer Prev. 2016 Feb;9(1):e3467

Authors: Sanjari Moghaddam A, Nazarzadeh M, Noroozi R, Darvish H, Mosavi Jarrahi A

Abstract
CONTEXT: Known polymorphisms of DNA repair genes can be associated with the risk of many types of cancer. There is no consensus regarding association between XRCC1 and OGG1 with breast cancer (BC).
OBJECTIVES: The aim of this study is to collect relevant published studies systematically.
DATA SOURCES: Sixty-two publications were identified through searching PubMed, PubMed Central, ISI web of knowledge, and reference list of related articles.
STUDY SELECTION: We performed a systematic review according MOOSE guideline criteria. All longitudinal cohort and case-control studies investigating association of any type and grade of breast cancer with XRCC1 and OGG1 gene and their polymorphisms were eligible for initial inclusion.
DATA EXTRACTION: Two authors screened titles and abstracts and extracted all needed information from eligible studies. Four research methodological components causing bias for the association between gene polymorphisms and breast cancer risk, including source of controls sampling, population ethnicity, sample size of studies and menopausal status of cases and controls was used for assessment of quality of studies.
RESULTS: A total of 14,793 breast cancer cases and 15,409 controls were included in assessment of XRCC1 Arg194Trp. Four studies showed significant association and one study showed protective effect of XRCC1 Arg194Trp and BC. A total of 7,716 cases and 7,370 controls were included for XRCC1 Arg280His. Only one study showed significant association of XRCC1 Arg280His and breast cancer (OR = 1.82 (1.06 - 3.15). A total of 27,167 cases and 31,998 controls were included to estimate association between XRCC1 Arg399Gln polymorphism and breast cancer. Seven studies showed significant association and one showed protective effect of XRCC1 Arg399Gln and BC. A total of 9,417 cases and 11,087 controls were included for OGG1 Ser326Cys. Among studies focused on OGG1 Ser326Cys, none showed significant association with breast cancer.
CONCLUSIONS: Systematic search of major databases identify many studies addressing the relationship between BC and susceptible alleles in the base excision repair genes and the fact that there are many variations in the magnitude of association depending on inheritance model and the population of the study.

PMID: 27366307 [PubMed]

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Polymorphous Low-Grade Adenocarcinoma of the Palate: A Rare Case Report.

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Polymorphous Low-Grade Adenocarcinoma of the Palate: A Rare Case Report.

Iran J Cancer Prev. 2016 Feb;9(1):e3447

Authors: Sathyanarayanan R, Suresh V, Therese Thomas BA

Abstract
INTRODUCTION: Polymorphous low-grade adenocarcinoma (PLGA) has been known as a comparatively less aggressive malignant tumor that predominantly occurs in the minor salivary glands. It has presented as a painless, slow growing tumor in the oral cavity. It has been reported to occur rarely in the palate and the prognosis of this lesion is far better than adenocarcinoma as the regional metastasis would be very minimal. A clear difference between the biologic behaviors of adenocarcinoma and PLGA has been reported in literature.
CASE PRESENTATION: A 63-year-old female reported at our institute with a swelling in relation to her upper left back region of her jaw for three months, gradual in onset and associated with pain. After clinical and radiological examination, the differential diagnosis were consolidated abscess or minor salivary gland tumor. An incisional biopsy was done and the lesion was diagnosed as PLGA. The lesion was treated by wide excision and reconstruction with immediate obturator. The post-operative follow up showed no evidence of recurrence and the healing was satisfactory.
CONCLUSIONS: The site of predilection of PLGA is more in favor of palate (49 - 77.8%) followed by either upper lip or buccal mucosa (7.4 - 13.4%). There are sporadic reports of metastasis sometimes even transformation to a high grade adenocarcinoma, sometimes ending in mortality. Cervical lymph node metastasis is rare with reported incidence of 5 - 15% and is more commonly seen in recurrent tumor than the initial diseases. Extra palatal PLGAs present with significant papillary growth or arising from ventral surface of tongue frequently metastasize to cervical lymph nodes. Distant metastasis is very rare with an incidence of 7.5% and the site involved is the lung which is attributed to the inadequate control of the disease.

PMID: 27366306 [PubMed]

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Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation.

Predicting Extrathyroidal Extension in Patients With Papillary Thyroid Microcarcinoma According to a BRAF Mutation.

Clin Exp Otorhinolaryngol. 2016 Jul 2;

Authors: Lee DY, Hwang SM, An JH, Son KR, Baek SK, Kim SG, Chae YS, Jung KY

Abstract
Objectives: The aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE.
Methods: We analyzed the medical records of 332 patients with PTMC (140 in the BRAF- group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated.
Results: Tumor size and US group were significantly correlated with gross ETE in the BRAF- and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF- group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively.
Conclusion: Excluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.

PMID: 27416738 [PubMed - as supplied by publisher]

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Treatment for Acute Tympanic Membrane Perforation.

Treatment for Acute Tympanic Membrane Perforation.

Clin Exp Otorhinolaryngol. 2016 Jul 1;

Authors: Yang J, Lou ZC

PMID: 27416737 [PubMed - as supplied by publisher]

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The Prognostic Role of the Surgical Approach and Adjuvant Therapy in Operable Mucosal Melanoma of the Head and Neck.

The Prognostic Role of the Surgical Approach and Adjuvant Therapy in Operable Mucosal Melanoma of the Head and Neck.

Clin Exp Otorhinolaryngol. 2016 Jul 1;

Authors: Lee G, Baek CH, Choi NY, Chung MK

Abstract
Objectives: The aim of this study was to investigate the prognostic impact of the surgical approach and adjuvant treatment in operable malignant melanoma of head and neck (MMHN).
Methods: Retrospective reviews of 31 patients who underwent surgery-based treatment with curative intent, either by the endoscopic or external approach, for MMHN were performed to analyze recurrence patterns, salvage modalities, and oncological outcomes (disease-specific survival and disease-free survival).
Results: Overall recurrence rate was 61% (19/31). In stage III patients (n=24), 50% (12/24) developed recurrences with a median recurrence-free period of 6.0 months, and 30% (4/12) of them was successfully salvaged by reoperation with adjuvant radiotherapy. On the contrary, all stage IVA patients (n=7) developed recurrences with a median recurrence-free period of 4.4 months. Distant metastasis was the most common pattern of failure and no patients were salvaged. Among variables, age and T classification, not the surgical approach, were significant prognosticators for disease-free survival and disease-specific survival. Adjuvant radiotherapy was associated with a lower rate of local failure, compared to surgery alone (hazard ratio, 0.02; 95% confidence interval, 0.06 to 0.75; P=0.02). However, adjuvant systemic therapy was not effective in reducing the risk of failures for any pattern.
Conclusion: Our data suggested that meticulous surgical resection, either by the endoscopic or external approach, with adjuvant radiotherapy increases the local control rate in MMHN.

PMID: 27416736 [PubMed - as supplied by publisher]

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Electromyography-Guided Botulinum Toxin Injection Into the Cricothyroid Muscles in Bilateral Vocal Fold Abductor Paralysis.

Electromyography-Guided Botulinum Toxin Injection Into the Cricothyroid Muscles in Bilateral Vocal Fold Abductor Paralysis.

Clin Exp Otorhinolaryngol. 2016 Jul 2;

Authors: Sahin M, Aydogdu I, Akyildiz S, Erdinc M, Ozturk K, Ogut F

Abstract
Objectives: Bilateral vocal fold abductor paralysis (BVFAP) both deteriorates quality of life and may cause life-threatening respiratory problems. The aim of this study was to reduce respiratory symptoms in BVFAP patients using cricothyroid (CT) botulinum toxin (BTX) injection.
Methods: Before and 2 weeks and 4 months after bilateral BTX injection into the CT muscles under electromyography; alterations in respiratory, acoustic, aerodynamic and quality of life parameters were evaluated in BVFAP patients with respiratory distress. For the respiratory evaluation modified Borg scale and spirometry, for the voice and aerodynamic evaluations Voice Handicap Index-30 (VHI-30), GRBAS, acoustic analysis (sound pressure level, F0, jitter%, shimmer%, noise-to-harmonic ratio) and maximum phonation time and for the quality of life assessment Short Form-36 (SF-36) form were used.
Results: All patients were female with a mean age of 47±8.1 years. There was a mean time of 11.8±5.5 (minimum 2, maximum 23) months between BVFAP development and BTX injection. In all cases, other than one case with unknown aetiology, the cause of vocal fold paralysis was prior thyroid surgery. In total 18.6±3.1 units of BTX were applied to the CTs. In the preinjection period, and the 2nd week and 4th month after injection, the Borg dyspnea scale was 7.3/5.3/5.0, FIV1 (forced inspiratory volume in one second) was 1.7/1.7/1.8 L, peak expiratory flow (PEF) was 1.4/1.7/2.1 L/sec, maximum phonation time was 7.0/6.4/6.2 seconds and VHI-30 was 63.2/52.2/61.7 respectively. There was no significant alteration in acoustic analysis parameters. Many of the patients reported transient dysphagia within the first week. There were insignificant increases in SF-36 sub-scale values.
Conclusion: After BTX injection, improvements in the mean Borg score, PEF and FIV1 values and SF-36 sub-scale scores showed the restricted success of this approach. This modality may be kept in mind as a transient treatment option for patients refused persistent tracheotomy or ablative airway surgeries.

PMID: 27416735 [PubMed - as supplied by publisher]

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In Reply: Treatment for Acute Tympanic Membrane Perforation.

In Reply: Treatment for Acute Tympanic Membrane Perforation.

Clin Exp Otorhinolaryngol. 2016 Jul 1;

Authors: Lee JH, Lee JS, Kim DK, Park CH, Lee HR

PMID: 27416734 [PubMed - as supplied by publisher]

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Parameters of Stromal Activation and Epithelial to Mesenchymal Transition as Predictive Biomarkers for Induction Chemotherapy in Patients With Locally Advanced Oral Cavity and Oropharyngeal Squamous Cell Cancer.

Parameters of Stromal Activation and Epithelial to Mesenchymal Transition as Predictive Biomarkers for Induction Chemotherapy in Patients With Locally Advanced Oral Cavity and Oropharyngeal Squamous Cell Cancer.

Clin Exp Otorhinolaryngol. 2016 Jul 2;

Authors: Geweiler J, Inhestern J, Berndt A, Guntinas-Lichius O

Abstract
Objectives: Induction chemotherapy (IC) is likely to be effective for biologically distinct subgroups of oral cancer and biomarker development may lead to identification of those patients.
Methods: We evaluated immune cell infiltration, stroma formation and structure of the invasive front as well as the immunohistochemical expression of alpha smooth muscle actin (ASMA), CD163, E-cadherin, N-cadherin, and the laminin gamma 2 chain in pretreatment biopsy specimens and surgical resections after IC in 20 patients with locally advanced oral cancer who were treated in a prospective, ongoing, phase II trial on IC using docetaxel, cisplatin, and 5-fluorouracil (TPF).
Results: Significant negative prognostic factors for incomplete pathological tumor response to IC were alcohol abuse (P=0.032), cN+ (P=0.042), and <30% tumor reduction after first cycle of IC (P=0.034). Of the investigated histological parameters and biomarkers only a low membrane-bound expression of E-cadherin showed a trend to be associated with incomplete response to IC (P=0.061). Low expression of ASMA in stromal vessels and a strong tumor invasion front were significantly associated to tumor recurrence (P=0.024 and P=0.004, respectively). The median follow-up of all patients was 35 months. Alcohol abuse (P<0.001), <30% tumor reduction after first cycle of IC (P=0.005), and a strong tumor invasion front (P=0.019) were negative prognostic factors for overall survival.
Conclusion: A strong predictive biomarker among the investigated parameters for benefitting from TPF IC could not be found. The extent of the tumor invasion front was a negative prognostic marker for recurrence and survival in oral cancer treated by TPF IC followed by surgery and postoperative radiochemotherapy.

PMID: 27416733 [PubMed - as supplied by publisher]

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Modified Friedman stage in predicting glossopharyngeal obstruction in obstructive sleep apnea.

Modified Friedman stage in predicting glossopharyngeal obstruction in obstructive sleep apnea.

Acta Otolaryngol. 2016 Jul 15;:1-4

Authors: Wu D, Qin J, Guo X, Dai P, Li S, Han D

Abstract
CONCLUSIONS: Modified Friedman stage can be used to predict glossopharyngeal obstruction better than before in patients with obstructive sleep apnea (OSA).
OBJECTIVE: To evaluate the diagnostic value of modified Friedman stage in predicting glossopharyngeal obstruction in patients with OSA.
METHODS: Eighty-five OSA patients with Friedman stage III were divided into IIIa group and IIIb group based on an imaginary line drawn in the horizontal and middle position of the soft palate. Polysomnography (PSG) was performed after nasopharyngeal tube (NPT) insertion (NPT-PSG) to diagnose glossopharyngeal obstruction. Apnea-hypopnea index (AHI) determined by NPT-PSG (NPT-AHI) and glossopharyngeal obstruction result determined by NPT-PSG (NPT-PSG result) were compared between the two groups.
RESULTS: There were significant differences in NPT-AHI (p < 0.01) and NPT-PSG result (p < 0.01) between the two groups.

PMID: 27420295 [PubMed - as supplied by publisher]

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Modified Friedman stage in predicting glossopharyngeal obstruction in obstructive sleep apnea.

Modified Friedman stage in predicting glossopharyngeal obstruction in obstructive sleep apnea.

Acta Otolaryngol. 2016 Jul 15;:1-4

Authors: Wu D, Qin J, Guo X, Dai P, Li S, Han D

Abstract
CONCLUSIONS: Modified Friedman stage can be used to predict glossopharyngeal obstruction better than before in patients with obstructive sleep apnea (OSA).
OBJECTIVE: To evaluate the diagnostic value of modified Friedman stage in predicting glossopharyngeal obstruction in patients with OSA.
METHODS: Eighty-five OSA patients with Friedman stage III were divided into IIIa group and IIIb group based on an imaginary line drawn in the horizontal and middle position of the soft palate. Polysomnography (PSG) was performed after nasopharyngeal tube (NPT) insertion (NPT-PSG) to diagnose glossopharyngeal obstruction. Apnea-hypopnea index (AHI) determined by NPT-PSG (NPT-AHI) and glossopharyngeal obstruction result determined by NPT-PSG (NPT-PSG result) were compared between the two groups.
RESULTS: There were significant differences in NPT-AHI (p < 0.01) and NPT-PSG result (p < 0.01) between the two groups.

PMID: 27420295 [PubMed - as supplied by publisher]

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[Headhache secondary to intracranial hypotension in a Lumbar Spinal Stenosis Surgery].

[Headhache secondary to intracranial hypotension in a Lumbar Spinal Stenosis Surgery].

Rev Fac Cien Med Univ Nac Cordoba. 2016;73(2):122-125

Authors: Hidalgo-Mendía B, Angulo-Taberno M, Jaroid-Audes R, Untoria-Agustín C, Rivero-Zelada D

Abstract
Intracraneal hypotension headache is a well known syndrome in neurosurgery practice. In most cases cerebrospinal fluid leaks are caused by medical interventions, such as lumbar puncture, peridural anesthesia and surgical interventions on the spine. Clinical symptoms tipically show orthostatic headache that resolves in supine position, and other symptoms like neck tightness, vertigo and diplopia. RMI diagnostic confirms paquimeningeal enhancement and subdural hygromas. Conservative treatment usually includes bed resting, hydratation and administration of caffeine or glucocorticoids, resolving spontaneously in one to four months. The importance of the diagnosis lies in the differential diagnosis with other causes of headache, as symptomatic limiting factor in the rehabilitation of the patient and the same favorable prognosis.

PMID: 27420146 [PubMed - as supplied by publisher]

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Minimally invasive atlantoaxial fusion: cadaveric study and report of 5 clinical cases.

Minimally invasive atlantoaxial fusion: cadaveric study and report of 5 clinical cases.

J Neurosurg Spine. 2016 Jul 15;:1-6

Authors: Srikantha U, Khanapure KS, Jagannatha AT, Joshi KC, Varma RG, Hegde AS

Abstract
OBJECTIVE Minimally invasive techniques are being increasingly used to treat disorders of the cervical spine. They have a potential to reduce the postoperative neck discomfort subsequent to extensive muscle dissection associated with conventional atlantoaxial fusion procedures. The aim of this paper was to elaborate on the technique and results of minimally invasive atlantoaxial fusion. MATERIALS Minimally invasive atlantoaxial fusion was done initially in 4 fresh-frozen cadavers and subsequently in 5 clinical cases. Clinical cases included patients with reducible atlantoaxial instability and undisplaced or minimally displaced odontoid fractures. The surgical technique is illustrated in detail. RESULTS Among the cadaveric specimens, all C-1 lateral mass screws were in the correct position and 2 of the 8 C-2 screws had a vertebral canal breach. Among clinical cases, all C-1 lateral mass screws were in the correct position. Only one C-2 screw had a Grade 2 vertebral canal breach, which was clinically insignificant. None of the patients experienced neurological worsening or implant-related complications at follow-up. Evidence of rib graft fusion or C1-2 joint fusion was successfully demonstrated in 4 cases, and flexion-extension radiographs done at follow-up did not show mobility in any case. CONCLUSIONS Minimally invasive atlantoaxial fusion is a safe and effective alternative to the conventional approach in selected cases. Larger series with direct comparison to the conventional approach will be required to demonstrate clinical benefit presumed to be associated with a minimally invasive approach.

PMID: 27420396 [PubMed - as supplied by publisher]

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Applying the COM-B behaviour model and behaviour change wheel to develop an intervention to improve hearing-aid use in adult auditory rehabilitation.

Applying the COM-B behaviour model and behaviour change wheel to develop an intervention to improve hearing-aid use in adult auditory rehabilitation.

Int J Audiol. 2016 Jul;55(sup3):S90-S98

Authors: Barker F, Atkins L, de Lusignan S

Abstract
OBJECTIVES: To introduce a psychological model of behaviour; the COM-B model and describe how this has been used in combination with the behaviour change wheel (BCW) in developing an intervention which aims to promote regular, long-term use of hearing aids by adults with acquired hearing loss.
DESIGN: Qualitative structured interview study using the COM-B model to identify the determinants of behavioural planning on the part of audiologists; a potentially important factor in encouraging long-term hearing-aid use.
STUDY SAMPLE: Ten audiologists drawn from a random sample of five English audiology departments.
RESULTS: The analysis suggests that behavioural planning might be more likely to occur if audiologists' psychological capability, physical and social opportunity, and reflective and automatic motivation were addressed. This analysis forms the basis of an intervention design, using the BCW, to encourage behavioural planning by audiologists and subsequent hearing-aid use by people with hearing loss.
CONCLUSIONS: The COM-B model and BCW can be applied successfully in the context of audiology to analyse the behaviour of both people with hearing loss and professionals working with them, supplying information that is being used in intervention design. The effectiveness of the intervention will be tested in a clinical trial.

PMID: 27420547 [PubMed - as supplied by publisher]

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Application of the transtheoretical model of behaviour change for identifying older clients' readiness for hearing rehabilitation during history-taking in audiology appointments.

Application of the transtheoretical model of behaviour change for identifying older clients' readiness for hearing rehabilitation during history-taking in audiology appointments.

Int J Audiol. 2016 Jul;55(sup3):S42-S51

Authors: Ekberg K, Grenness C, Hickson L

Abstract
OBJECTIVES: The transtheoretical model (TTM) of behaviour change focuses on clients' readiness for adopting new health behaviours. This study explores how clients' readiness for change can be identified through their interactions with audiologists during history-taking in initial appointments; and whether clients' readiness has consequences for the rehabilitation decisions they make within the initial appointment.
DESIGN: Conversation analysis (CA) was used to examine video-recorded initial audiology appointments with older adults with hearing impairment.
STUDY SAMPLE: The data corpus involved 62 recorded appointments with 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 appointments.
RESULTS: Clients' readiness for change could be observed through their interaction with the audiologist. Analysis demonstrated that the way clients described their hearing in the history-taking phase had systematic consequences for how they responded to rehabilitation recommendations (in particular, hearing aids) in the management phase of the appointment. In particular, clients identified as being in a pre-contemplation stage-of-change were more likely to display resistance to a recommendation of hearing aids (80% declined).
CONCLUSIONS: The transtheoretical model of behaviour change can be useful for helping audiologists individualize management planning to be congruent with individual clients' needs, attitudes, desires, and psychological readiness for action in order to optimize clients' hearing outcomes.

PMID: 27420546 [PubMed - as supplied by publisher]

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Application of health behaviour theory to hearing healthcare research: The state of play and beyond.

Application of health behaviour theory to hearing healthcare research: The state of play and beyond.

Int J Audiol. 2016 Jul;55(sup3):S1-S2

Authors: Ferguson MA, Coulson NS, Henshaw H, Heffernan E

PMID: 27420545 [PubMed - as supplied by publisher]

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Introduction.

Introduction.

Int J Audiol. 2016 Jul 15;:1

Authors:

PMID: 27416849 [PubMed - as supplied by publisher]

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Clinical outcome of head and neck cancer patients: a comparison between ENT patients referred via the 2 weeks wait pathway and alternative routes in the UK health system.

Clinical outcome of head and neck cancer patients: a comparison between ENT patients referred via the 2 weeks wait pathway and alternative routes in the UK health system.

Eur Arch Otorhinolaryngol. 2016 Jul 14;

Authors: Wong BY, Fischer S, Cruickshank HE

Abstract
2 weeks wait (2ww) referral was intended to improve cancer outcomes in the UK. However, a previous study found that 2ww failed to detect early stage head and neck cancer. There is no current study to examine the survival outcome of head and neck cancer patients diagnosed on 2ww and non-2ww pathways. The aim of this study is to compare the outcome of cancer patients diagnosed on these pathways. We performed a retrospective review of head and neck cancer patients diagnosed between 2009 and 2013 in the ENT Department at Mid-Yorkshire NHS Hospitals Trust. Gender, age, disease staging, treatment modalities, route of referrals along with survival data were documented. Survival analysis was performed for 2ww and non-2ww cancer patients. There were 4123 patients referred on 2ww during the study period. 147 patients were diagnosed with cancers on 2ww and 89 patients were diagnosed on non-2ww. There were no statistical differences in clinical staging (p = 0.416) and overall survival (p = 0.376) between 2ww and non-2ww patients. This study failed to demonstrate a better overall survival in head and neck cancer patients diagnosed on 2ww pathway within the ENT cohort. Current referral system needs to be refined to improve the survival outcome in head and neck cancer patients.

PMID: 27416743 [PubMed - as supplied by publisher]

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Analysis of voice quality in patients with late-onset Pompe disease.

Analysis of voice quality in patients with late-onset Pompe disease.

Orphanet J Rare Dis. 2016;11(1):99

Authors: Szklanny K, Gubrynowicz R, Iwanicka-Pronicka K, Tylki-Szymańska A

Abstract
BACKGROUND: Pompe disease is a progressive metabolic myopathy. Disease progression is characterized, among other features, by progressive dysfunction of the voice apparatus. The aim of this study was to employ electroglottographic, acoustic and nasalance measurement methods on patients with late-onset Pompe disease in order to provide detailed information on the effect of the disease on voice quality. Voice quality is the key factor for estimating the effectiveness of ERT in late-onset Pompe disease. The study compared clinical phoniatric examination with electroglottographic, acoustic and nasalance measurement methods. The consistency of the aforementioned analyses was assessed.
METHODS: The study examined 19 patients with late-onset Pompe disease (including 9 with the juvenile form of the disease). Of these, a total of 17 patients underwent otolaryngological examination with detailed phoniatric evaluation of their articulatory organs. Electroglottographic recordings and nasalance measurements (using the nasalance Separator Handle) were obtained from all patients. MATLAB (COVAREP toolkit) was used to analyse voice recording data.
RESULTS: Dysphonia observed in patients with late-onset Pompe disease is mainly caused by dysfunction of vocal fold closure and weakness of vocal muscle. However, substantial speech nasality is caused by insufficient closure of the soft palate. Electroglottographic signal analysis, acoustic and nasalance testing methods indicated that more significant changes in the function of the voice apparatus presented in the juvenile form than in the adult form of late-onset Pompe disease.
CONCLUSIONS: It was found that speech nasality and electroglottographic tests are more repeatable, comparable and versatile than phoniatric examination, allowing for earlier detection of voice pathology in late-onset Pompe disease. These sensitive and non-invasive acoustic and electroglottographic methods allow for the tracking of changes in voice as patients undergo treatment or as the disease progresses.

PMID: 27417441 [PubMed - in process]

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