OtoRhinoLaryngology News: 09/09/16

Παρασκευή 9 Σεπτεμβρίου 2016

Effects of isotretinoin on body mass index, serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients.

Effects of isotretinoin on body mass index, serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients.

Postepy Dermatol Alergol. 2016 Aug;33(4):294-9

Authors: Cemil BC, Ayvaz HH, Ozturk G, Ergin C, Akıs HK, Gonul M, Arzuhal E

Abstract
INTRODUCTION: Isotretinoin has been successfully used for the treatment of acne vulgaris.
AIM: To investigate the effects of isotretinoin on body mass index (BMI), to determine whether isotretinoin causes any changes in serum adiponectin, leptin, and ghrelin levels in acne vulgaris patients, and to correlate variables.
MATERIAL AND METHODS: Thirty-two patients were included in this study. Oral isotretinoin was begun at a dose of 0.5-0.6 mg/kg and raised to 0.6-0.75 mg/kg. Pretreatment and posttreatment third-month BMI and adiponectin, leptin, and ghrelin serum levels were measured.
RESULTS: The pre- and posttreatment BMI values were not significantly different. In addition, serum adiponectin and leptin levels were significantly increased following isotretinoin therapy while serum ghrelin levels were not different.
CONCLUSIONS: Isotretinoin may exert its anti-inflammatory activity by increasing leptin and adiponectin levels.

PMID: 27605902 [PubMed]

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Concomitant appearance of morphea and vitiligo in a patient with autoimmune thyroiditis.

Concomitant appearance of morphea and vitiligo in a patient with autoimmune thyroiditis.

Postepy Dermatol Alergol. 2016 Aug;33(4):314-6

Authors: Yorulmaz A, Kilic S, Artuz F, Kahraman E

PMID: 27605907 [PubMed]

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Clinical and dermoscopic features of atypical abdominal brachytherapy-induced angiosarcoma.

Clinical and dermoscopic features of atypical abdominal brachytherapy-induced angiosarcoma.

Postepy Dermatol Alergol. 2016 Aug;33(4):311-3

Authors: Bergler-Czop B, Hadasik K, Brzezińska-Wcisło L

PMID: 27605906 [PubMed]

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Adverse reactions to nonsteroidal anti-inflammatory drugs and hypersensitivity to lipid transfer proteins.

Adverse reactions to nonsteroidal anti-inflammatory drugs and hypersensitivity to lipid transfer proteins.

Postepy Dermatol Alergol. 2016 Aug;33(4):309-10

Authors: Nucera E, Di Rienzo A, Ricci AG, Buonomo A, Mezzacappa S, Schiavino D

PMID: 27605905 [PubMed]

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Tear trough deformity: different types of anatomy and treatment options.

Tear trough deformity: different types of anatomy and treatment options.

Postepy Dermatol Alergol. 2016 Aug;33(4):303-8

Authors: Jiang J, Wang X, Chen R, Xia X, Sun S, Hu K

Abstract
AIM: To explore the efficacy of tear trough deformity treatment with the use of hyaluronic acid gel or autologous fat for soft tissue augmentation and fat repositioning via arcus marginalis release.
MATERIAL AND METHODS: Seventy-eight patients with the tear trough were divided into three groups. Class I has tear trough without bulging orbital fat or excess of the lower eyelid skin. Class II is associated with mild to moderate orbital fat bulging, without excess of the lower eyelid skin. Class III is associated with severe orbital fat bulging and excess of the lower eyelid skin. Class I or II was treated using hyaluronic acid gel or autologous fat injections. Class III was treated with fat repositioning via arcus marginalis release. The patients with a deep nasojugal groove of class III were treated with injecting autologous fat into the tear trough during fat repositioning lower blepharoplasty as a way of supplementing the volume added by the repositioned fat.
RESULTS: Seventy-eight patients with tear trough deformity were confirmed from photographs taken before and after surgery. There were some complications, but all had complete resolution.
CONCLUSIONS: Patients with mild to moderate peri-orbital volume loss without severe orbital fat bulging may be good candidates for hyaluronic acid filler or fat grafting alone. However, patients with more pronounced deformities, severe orbital fat bulging and excess of the lower eyelid skin are often better served by fat repositioning via arcus marginalis release and fat grafting.

PMID: 27605904 [PubMed]

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The role of serum vitamin D levels in vitiligo.

The role of serum vitamin D levels in vitiligo.

Postepy Dermatol Alergol. 2016 Aug;33(4):300-2

Authors: Karagün E, Ergin C, Baysak S, Erden G, Aktaş H, Ekiz Ö

Abstract
INTRODUCTION: Vitiligo is a common acquired pigmentary skin disorder. Vitamin D is responsible for skin pigmentation, increases tyrosinase activity and melanogenesis, and exhibits immunoregulatory functions. Low levels of vitamin D are associated with many autoimmune diseases, including systemic lupus, diabetes mellitus, rheumatoid arthritis, multiple sclerosis and alopecia areata. Few reports have evaluated serum vitamin D levels in vitiligo patients, and their results are conflicting.
AIM: To evaluate serum vitamin D levels of vitiligo patients and compare the results with controls.
MATERIAL AND METHODS: In total, 50 vitiligo patients and 47 controls were enrolled in the study. Vitamin D levels were measured from blood samples. Group comparisons were performed using appropriate statistical methods.
RESULTS: The patients had lower serum vitamin D levels than the controls, but this difference was not significant (p = 0.570).
CONCLUSIONS: It remains unknown whether vitamin D deficiency causes vitiligo. Larger controlled studies are required to prove whether low circulating vitamin D is a causative factor in vitiligo.

PMID: 27605903 [PubMed]

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The correlation between the psoriasis area severity index and ischemia-modified albumin, mean platelet volume levels in patients with psoriasis.

The correlation between the psoriasis area severity index and ischemia-modified albumin, mean platelet volume levels in patients with psoriasis.

Postepy Dermatol Alergol. 2016 Aug;33(4):290-3

Authors: Işik S, Kılıç S, Öğretmen Z, Çakır DÜ, Türkön H, Cevizci S, Hız MM

Abstract
INTRODUCTION: Ischemia-modified albumin (IMA), a novel ischemia marker, and mean platelet volume (MPV), a determinant of platelet activation, have been reported as elevated markers in cardiovascular risk factors such as atherosclerosis, metabolic syndrome, diabetes mellitus (DM), hypertension, and dyslipidemia. As psoriasis is a chronic inflammatory disease having comorbidities, IMA and MPV can help determine the risk factors for psoriasis.
AIM: To investigate the correlation between the psoriasis area severity index (PASI), IMA and MPV levels in patients with psoriasis.
MATERIAL AND METHODS: This cross-sectional, case-control study was performed between January 2014 and December 2014 at the University hospital in Çanakkale, Turkey. Forty-five patients with psoriasis and 44 healthy volunteers over 18 years of age were included in the study. In the psoriasis patient group, clinical features and PASI scores were recorded. Serum IMA and MPV concentrations were evaluated in both groups.
RESULTS: The mean IMA values were 0.85 ±0.15 and 0.79 ±0.09 (in the psoriasis patients and control groups, respectively), and there was a statistically significant difference (p = 0.048). Ischemia-modified albumin levels were not correlated with PASI scores (r = 0.024; p = 0.889) but were correlated with disease duration (r = 0.323; p = 0.048). There was no statistically significant difference between the MPV values of the two groups (8.98 ±1.14 and 9.19 ±1.28 in the psoriasis patients and control groups, respectively) (p = 0.435).
CONCLUSIONS: Ischemia-modified albumin may be used as a marker for detecting oxidative stress in patients with psoriasis, especially those with a long disease duration.

PMID: 27605901 [PubMed]

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Carotid intima-media thickness in patients with mild or moderate psoriasis.

Carotid intima-media thickness in patients with mild or moderate psoriasis.

Postepy Dermatol Alergol. 2016 Aug;33(4):286-9

Authors: Bańska-Kisiel K, Haberka M, Bergler-Czop B, Brzezińska-Wcisło L, Okopień B, Gąsior Z

Abstract
INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with a significantly higher morbidity and various comorbidities (obesity, metabolic syndrome, diabetes). Previous studies focused mainly on patients with severe psoriasis who were found to have increased markers of early atherosclerosis, higher intima-media thickness (IMT) values.
AIM: To evaluate the association between the severity or duration of psoriasis and carotid IMT in patients with mild and moderate psoriasis.
MATERIAL AND METHODS: We studied seventy four patients with mild and moderate psoriasis. Clinical assessment and common carotid artery (CCA) IMT measurements were performed in all patients.
RESULTS: The mean CCA IMT value was 1.03 ±0.37 mm, mean PASI score (psoriasis area severity index) was 18.6 ±10.5. There was a significant association between PASI score and IMT values (r = 0.33; p = 0.007) adjusted for age, psoriasis duration, blood pressure and smoking. However, we found no correlations between carotid IMT and disease duration or other clinical variables.
CONCLUSIONS: The severity of psoriasis is associated with carotid IMT even in patients with mild and moderate psoriasis.

PMID: 27605900 [PubMed]

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Food allergies in rural areas.

Food allergies in rural areas.

Postepy Dermatol Alergol. 2016 Aug;33(4):281-5

Authors: Stoma M, Ślaska-Grzywna B, Żukiewicz-Sobczak WA, Kostecka M, Bojanowska M, Dudziak A, Kuna-Broniowska A, Adamczuk P, Sobczak P, Andrejko D

Abstract
INTRODUCTION: A food allergy is a group of symptoms occurring in the organism and resulting from consuming some food, where the problems are conditioned by immunological mechanisms. The symptoms may become apparent first in adulthood and they may be an initial manifestation of a latent allergy. Typical symptoms of a food allergy occur in different organs, thus not only in the digestive system, but also in the skin, respiratory system and circulatory system.
AIM: To assess the frequency of food allergy onset in rural areas of the Lublin region as well as to determine which factors induce such allergies.
MATERIAL AND METHODS: A survey was conducted, involving the participation of 340 inhabitants of rural areas. The study monitored the knowledge and situation of the disease, concerning allergens, allergy symptoms, methods of treatment and opinions regarding such treatment.
RESULTS: The analysis focused on 124 people with diagnosed allergies.
CONCLUSIONS: Introducing a diet did not result in a statistically significant difference regarding elimination of the symptoms, as compared to the patients who did not follow any diet. On the other hand, pharmacological treatment causes statistically worse results than using other methods or not being treated at all. The patients in whom allergy symptoms disappeared were more convinced about the positive character of their diet than those in whom the symptoms were not eliminated. The age when the allergy becomes evident does not affect its duration, yet it matters as to the time of its later elimination. The more symptoms were experienced by a patient, the longer the duration of the allergy was.

PMID: 27605899 [PubMed]

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Preliminary studies: differences in microRNA expression in asthma and chronic obstructive pulmonary disease.

Preliminary studies: differences in microRNA expression in asthma and chronic obstructive pulmonary disease.

Postepy Dermatol Alergol. 2016 Aug;33(4):276-80

Authors: Pietrusińska M, Pająk A, Górski P, Kuna P, Szemraj J, Goździńska-Nielepkowicz A, Pietras T

Abstract
INTRODUCTION: The asthma- and chronic obstructive pulmonary disease (COPD)-related morbidity has been increasing during the recent years. Both asthma and COPD are diseases of inflammatory etiology. The increasing interest in the pathomechanisms involved in the development of obstructive pulmonary diseases seems to be fully justified. Recent research has attempted to determine the associations of microRNA with the pathogenesis of pulmonary diseases.
AIM: To assess the expression of microRNA in the blood sera of patients diagnosed with bronchial asthma and chronic obstructive pulmonary disease in comparison with healthy subjects.
MATERIAL AND METHODS: In our study, at the preliminary stage, we compared the expression of miRNA in the groups of patients with asthma and COPD versus the control group of healthy subjects.
RESULTS: A significant difference in hsa-miRNA-224, hsa-miRNA-339-5p, hsa-miRNA-382 in patients with asthma and COPD as compared with the controls was noted.
CONCLUSIONS: With such difference of expression of specific micro-RNA in serum of patient with asthma and COPD, those small non-coding RNA has to play a significant role in those diseases pathway. Therefore we expect to increase the size and differentation of the study groups in next studies.

PMID: 27605898 [PubMed]

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Specific immunotherapy with mugwort pollen allergoid reduce bradykinin release into the nasal fluid.

Specific immunotherapy with mugwort pollen allergoid reduce bradykinin release into the nasal fluid.

Postepy Dermatol Alergol. 2016 Aug;33(4):269-75

Authors: Gawlik R, Grzanka A, Jawor B, Czecior E

Abstract
INTRODUCTION: A pathomechanism of allergic rhinitis is complex. A neurogenic mechanism seems to play a significant role in this phenomenon.
AIM: The evaluation of influence of specific immunotherapy of mugwort pollen allergic patients on the bradykinin concentration in the nasal lavage fluid.
MATERIAL AND METHODS: The study included 22 seasonal allergic rhinitis patients. Thirty persons with monovalent allergy to mugwort pollen, confirmed with skin prick tests and allergen-specific immunoglobulin E, underwent a 3-year-long allergen immunotherapy with the mugwort extract (Allergovit, Allergopharma, Germany). The control group was composed of 9 persons with polyvalent sensitivity to pollen, who were treated with pharmacotherapy. Before the allergen-specific immunotherapy (AIT) and in subsequent years before the pollen seasons, a provocation allergen test with the mugwort extract was performed, together with collection of nasal fluids, where bradykinin concentration was determined according to Proud method.
RESULTS: There were similar levels of bradykinin in both groups at baseline prior to therapy (AIT group: 584.0 ±87.2 vs. controls 606.3 ±106.5 pg/ml) and changes after allergen challenge 1112.4 ±334.8 vs. 1013.3 ±305.9 pg/ml as well. The bradykinin concentration in nasal lavage fluid after mugwort challenge in 1 year was lower in the AIT group (824.1 ±184.2 pg/ml vs. 1000.4 ±411.5 pg/l; p < 005) with a further significant decrease after the 2(nd) and 3(rd) year of specific immunotherapy. Significant reduction of symptoms and medications use was observed in hyposensitized patients.
CONCLUSIONS: A decreased level of bradykinin as a result of AIT suggests that some of the symptomatic benefits of AIT may be related to the reduced release of bradykinin into nasal secretions. These values correlate with clinical improvement within the course of treatment.

PMID: 27605897 [PubMed]

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Soluble interleukin-2 receptor α and interleukin-2 serum levels in patients with basal cell carcinoma.

Soluble interleukin-2 receptor α and interleukin-2 serum levels in patients with basal cell carcinoma.

Postepy Dermatol Alergol. 2016 Aug;33(4):263-8

Authors: Sobjanek M, Bien E, Zablotna M, Sokolowska-Wojdylo M, Sikorska M, Lange M, Nowicki R

Abstract
INTRODUCTION: Basal cell carcinoma (BCC) is an immunogenic neoplasm and the imbalance in Th1/Th2 cytokines expression seems to play the major role in pathogenesis and clinical behaviour of the tumour.
AIM: To investigate the association of soluble interleukin 2α receptor (sIL-2Rα) and interleukin-2 (IL-2) serum concentrations with BCC.
MATERIAL AND METHODS: The study involved 110 individuals with BCC and 60 healthy age- and sex-matched volunteers. Serum levels of sIL-2Rα and IL-2 were measured using ELISA test.
RESULTS: We found significantly (p = 0.027) increased sIL-2Rα serum levels in BCC patients, in comparison to healthy controls. Statistically (p = 0.04) higher sIL-2Rα levels were observed in patients with more advanced tumours. Serum levels of sIL-2Rα showed a significant linear (r = 0.24, p = 0.018) correlation with tumour size. The average IL-2 serum levels in BCC patients were statistically (p = 0.039) decreased compared to controls. Significantly (p = 0.0454) lower median IL-2 levels were observed in patients with more advanced tumours. A negative correlation between sIL-2Rα and IL-2 serum concentrations was revealed (r = -0.22; p = 0.027).
CONCLUSIONS: Our results testify to the importance of the IL-2/sIL-2Rα signalling pathway in pathogenesis of BCC, suggesting that IL-2 and sIL-2Rα might be considered as potential markers of disease and targets for immunotherapy in BCC patients.

PMID: 27605896 [PubMed]

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Anti-proliferative and cytotoxic activity of rosuvastatin against melanoma cells.

Anti-proliferative and cytotoxic activity of rosuvastatin against melanoma cells.

Postepy Dermatol Alergol. 2016 Aug;33(4):257-62

Authors: Maj M, Czajkowski R, Zegarska B, Kowaliszyn B, Pokrywczynska M, Drewa T

Abstract
INTRODUCTION: Statins are considered potential candidate agents for melanoma chemoprevention. Statin-induced mevalonate pathway inhibition leads to reduction of cholesterol synthesis and also to decreased cellular levels of non-steroidal isoprenoids, geranylgeranyl pyrophosphate and farnesyl pyrophosphate. This results in the impairment of protein prenylation which affects carcinogenesis.
AIM: To analyze anti-proliferative and cytotoxic activity of rosuvastatin against melanoma cells.
MATERIAL AND METHODS: Melanoma cell lines (A375 and WM1552C) and normal fibroblasts (BJ) were used as the primary research material. Cells were treated with rosuvastatin at concentrations ranging from 0.01 µM to 10 µM. Cell viability was analyzed with the use of an MTT assay. Expression of proliferation marker Ki67 was assessed on the basis of immunofluorescence staining.
RESULTS: Rosuvastatin reduced A375 and BJ cell viability in a time- and dose-dependent manner. After 72 h incubation, the IC50, half maximal inhibitory concentration, was 2.3 µM for melanoma cells and 7.4 µM for normal fibroblasts. In turn, rosuvastatin exhibited relatively lower activity against WM1552C cells. A significant reduction of Ki67 expression was also noted for BJ fibroblasts after prolonged incubation with the tested drug.
CONCLUSIONS: The results indicate that the anti-melanoma properties of rosuvastatin are highly dependent on the tumor cell line assessed. However, the concentrations required to decrease melanoma cell viability in vitro exceed the plasma concentrations reached in patients treated with rosuvastatin at well-tolerated doses. What is more disturbing, reduction of proliferation and viability observed in BJ fibroblasts indicated that rosuvastatin at high doses may be toxic for normal cells.

PMID: 27605895 [PubMed]

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Role of immunoglobulin G antibodies in diagnosis of food allergy.

Role of immunoglobulin G antibodies in diagnosis of food allergy.

Postepy Dermatol Alergol. 2016 Aug;33(4):253-6

Authors: Gocki J, Bartuzi Z

Abstract
This paper presents current views on the role of immunoglobulin G (IgG) antibodies in the reactions with food antigens in the digestive tract and their role in the diagnosis of food allergy based on the assays of specific IgG class antibodies, with a special focus on contemporary practice guidelines. In the light of current scientific knowledge, the IgG-specific antibody-mediated reactions are a body's natural and normal defensive reactions to infiltrating food antigens, which are considered as pathogens. On the other hand, specific IgG antibodies against food allergens play a crucial role in the induction and maintaining of immunological tolerance to food antigens. The statements of many scientific societies stress that sIgG are of no significant importance in the diagnosis of food allergy since their presence is associated with a normal immune response to food allergens and attests to a protracted exposure to food antigens.

PMID: 27605894 [PubMed]

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Interleukin-17 inhibitors. A new era in treatment of psoriasis and other skin diseases.

Interleukin-17 inhibitors. A new era in treatment of psoriasis and other skin diseases.

Postepy Dermatol Alergol. 2016 Aug;33(4):247-52

Authors: Wasilewska A, Winiarska M, Olszewska M, Rudnicka L

Abstract
Psoriasis is a chronic skin disease caused by the excessive secretion of inflammatory cytokines. Available therapeutic options include biologic drugs such as tumor necrosis factor alpha inhibitors and interleukin 12/23 (IL-12/23) inhibitors. The recent discovery of IL-17, which contributes to development of psoriasis, opened new possibilities for further treatment modalities. Currently, one anti-IL17 biological agent is approved for the treatment - a fully human monoclonal antibody that targets IL-17A (secukinumab). Further clinical trials, including a humanized IgG4 specific for IL-17 (ixekizumab) and a fully human antibody that targets the IL-17 receptor A (brodalumab).

PMID: 27605893 [PubMed]

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Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study.

Effect of Laryngopharyngeal Neuromuscular Electrical Stimulation on Dysphonia Accompanied by Dysphagia in Post-stroke and Traumatic Brain Injury Patients: A Pilot Study.

Ann Rehabil Med. 2016 Aug;40(4):600-10

Authors: Ko KR, Park HJ, Hyun JK, Seo IH, Kim TU

Abstract
OBJECTIVE: To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI).
METHODS: Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks. All of the patients were evaluated before and at 2 and 4 weeks into the study. The outcome measurements included perceptual, acoustic and aerodynamic analyses. The correlation between dysphonia and swallowing function was also investigated.
RESULTS: There were significant differences in the GRBAS (grade, roughness, breathiness, asthenia and strain scale) total score and sound pressure level (SPL) between the two groups over time. The NMES relative to the CST group showed significant improvements in total GRBAS score and SPL at 2 weeks, though no inter-group differences were evident at 4 weeks. The improvement of the total GRBAS scores at 2 weeks was positively correlated with the improved pharyngeal phase scores on the functional dysphagia scale at 2 weeks.
CONCLUSION: The results demonstrate that laryngopharyngeal NMES in post-stroke or TBI patients with dysphonia can have promising effects on phonation. Therefore, laryngopharyngeal NMES may be considered as an additional treatment option for dysphonia accompanied by dysphagia after stroke or TBI.

PMID: 27606266 [PubMed]

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Computed tomography morphometric analysis of the central clival depression and petroclival angle for application of the presigmoid approach in the pediatric population.

Computed tomography morphometric analysis of the central clival depression and petroclival angle for application of the presigmoid approach in the pediatric population.

J Pediatr Neurosci. 2016 Apr-Jun;11(2):109-11

Authors: Desai SK, Baymon D, Sieloff E, Maynard K, Moisi M, Patel AP, Patterson JT

Abstract
AIMS: Lateral transtemporal approaches are useful for addressing lesions located ventral to the brainstem, especially when the pathologic diagnosis of the tumor dictates that a gross or near total resection improves outcomes. One approach, the presigmoid approach receives little attention in the pediatric population thus far. We sought to characterize morphometric changes, particularly the clival depth and the petroclival Cobb angle, that occur in the temporal bones of children and draw implications about doing a presigmoid approach in children.
SETTINGS AND DESIGN: This study was a retrospective study performed at John Sealy Hospital, a level-one trauma center that takes care of pediatric injuries as well.
SUBJECTS AND METHODS: We performed a morphometric analysis of noncontrast computed tomography head studies in 96 boys and 67 girls. Central clival depth and petroclival angle were obtained in the axial plane at the level of the internal auditory meatus using the method described by Abdel Aziz et al.
STATISTICAL ANALYSIS USED: Descriptive statistics and Student's t-test to compare groups were calculated using Microsoft Excel.
RESULTS: We found no gender difference in mean central clival depth or petroclival angle (P = 0.98 and P = 0.61, respectively). However, when we broke our cohort by age into those younger than 9 years of age and those 10 years or older, we found the petroclival angle decreased by 6.2° which was statistically significant (P < 0.000000006).
CONCLUSIONS: These findings suggest that a presigmoid retrolabyrinthine approach is useful for children 9 years of age and younger as the petroclival angle appears to decrease resulting in a shallower clival depression in these patients.

PMID: 27606016 [PubMed]

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Preliminary cross-sectional reliability and validity of the Skull Base Inventory (SBI) quality of life questionnaire.

Preliminary cross-sectional reliability and validity of the Skull Base Inventory (SBI) quality of life questionnaire.

J Otolaryngol Head Neck Surg. 2016;45(1):45

Authors: Larjani S, Monteiro E, Witterick I, Vescan A, Zadeh G, Gentili F, Goldstein DP, de Almeida JR

Abstract
BACKGROUND: The Skull Base Inventory (SBI) was developed to assess the quality of life of patients undergoing endoscopic or open approaches for anterior and central skull base pathologies. In this study, we sought to establish the discriminative and evaluative properties for this instrument.
METHODS: The SBI was administered in a cross-sectional fashion to patients who previously had skull base surgery after treatment and then again 2 weeks after completing the instrument. Internal consistency, test-retest reliability, and construct validity were determined. Four constructs were evaluated with the following a priori hypotheses: lower scores will be seen in patients with 1.malignant versus benign histology, 2.a history of radiation versus none, and those with 3.recurrences versus no recurrence, and 4.items deemed relevant versus irrelevant by respondents.
RESULTS: Fifty-two patients completed the questionnaire; 32 had endoscopic and 20 open surgeries. Internal consistency was good (>0.7 and <0.95) for all domains except one. Test-retest reliability was good (>0.70) for 38 of 41 items. Four constructs were evaluated and three were consistent with a priori hypotheses (p < 0.05). The instrument failed to confirm the hypothesis that malignant tumours are associated with poorer scores than benign.
CONCLUSIONS: The SBI demonstrated preliminary reliability and validity for discriminative use.

PMID: 27604801 [PubMed - in process]

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[Immunotherapeutic studies of head and neck tumors : Highlights of the 2016 ASCO Annual Meeting].

[Immunotherapeutic studies of head and neck tumors : Highlights of the 2016 ASCO Annual Meeting].

HNO. 2016 Sep 7;

Authors: Busch CJ, Laban S, Knecht R, Hoffmann TK

Abstract
Immunotherapeutic drugs in the form of novel immune checkpoint inhibitors have had a significant impact on and revival of the treatment standards for head and neck tumors. Recently, at the annual meeting of the American Society of Clinical Oncology (ASCO) several innovative immunotherapies in head and neck cancer were presented, which might lead to a paradigm shift in the palliative as well as curative setting in the near future.The most common approaches are antibodies targeting the programmed cell death 1 (PD-1) axis. These therapies seem to be effective in a significant proportion of patients (independent of human papillomavirus) and show an extended duration of response.In a phase III trial for palliative second-line therapy, the PD-1 antibody nivolumab demonstrated a significant improvement in survival in patients with head and neck squamous cell carcinoma (HNSCC) who were experiencing disease progression after platinum-based therapy; therefore, the Food and Drug Administration gave it a breakthrough therapy designation.Further clinical trials focusing on first-line palliative treatment (compared with the EXTREME protocol) as well as neoadjuvant therapies using immune checkpoint-inhibitors are ongoing. However, valid testing systems (e. g., PD-L1 testing) as well as reliable predictive markers for patient selection are necessary to avoid increasing public health costs and to protect patients from potentially serious adverse events.

PMID: 27604282 [PubMed - as supplied by publisher]

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[Treatment of head and neck squamous cell carcinoma recurrences and distant metastases : Highlights of the ASCO Meeting 2016].

[Treatment of head and neck squamous cell carcinoma recurrences and distant metastases : Highlights of the ASCO Meeting 2016].

HNO. 2016 Sep 7;

Authors: Bußmann L, Busch CJ, Knecht R

Abstract
This year particularly phase II studies were presented at the 2016 ASCO Annual Meeting, in which new drugs (monoclonal antibodies, small molecules) were investigated in patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC). Notably, there was a great number of studies investigating carcinoma of the nasopharynx. The studies presented in this article summarize the different therapeutic concepts in the treatment of R/M-HNSCC and represent the variety of therapeutic approaches in the recurrent and metastatic setting.

PMID: 27604281 [PubMed - as supplied by publisher]

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The Lung Function Impairment in Non-Atopic Patients With Chronic Rhinosinusitis and Its Correlation Analysis.

The Lung Function Impairment in Non-Atopic Patients With Chronic Rhinosinusitis and Its Correlation Analysis.

Clin Exp Otorhinolaryngol. 2016 Sep 8;

Authors: Zhang L, Zhang L, Zhang CH, Fang XB, Huang ZX, Shi QY, Wu LP, Wu P, Wang ZZ, Liao ZS

Abstract
Objectives: Chronic rhinosinusitis (CRS) is common disease in otorhinolaryngology and will lead to lower airway abnormality. However, the only lung function in CRS patients and associated factors have not been much studied.
Methods: One hundred patients with CRS with nasal polyps (CRSwNP group), 40 patients with CRS without nasal polyps (CRSsNP group), and 100 patients without CRS were enrolled. The difference in lung function was compared. Meanwhile, CRSwNP and CRSsNP group were required to undergo a bronchial provocation or dilation test. Additionally, subjective and objective outcomes were measured by the visual analogue scale (VAS), 20-item Sino-Nasal Outcome Test (SNOT-20), Lund-Mackay score, Lund-Kennedy endoscopic score. The correlation and regression methods were used to analyze the relationship between their lung function and the above parameters.
Results: The forced expiratory volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75) of CRSwNP group were significantly lower than other groups (P<0.05). On peak expiratory flow, there was no difference between three groups. In CRSwNP group, FEV1 was negatively correlated with peripheral blood eosinophil count (PBEC) and duration of disease (r=-0.348, P=0.013 and r=-0.344, P=0.014, respectively), FEF25-75 negatively with VAS, SNOT-20 (r=-0.490, P=0.028 and r=-0.478, P=0.033, respectively) in CRSsNP group. The incidence of positive bronchial provocation and dilation test was lower in CRSwNP group (10% and 0%, respectively), with both 0% in CRSsNP group. The multiple linear regression analysis indicated that change ratio of FEV1 before and after bronchial provocation or dilation test were correlated with PBEC in CRSwNP group (β=0.403, P=0.006).
Conclusion: CRS leading to impaired maximum ventilation and small airway is associated with the existence of nasal polyp. Lung function impairments can be reflected by PBEC, duration, VAS, and SNOT-20. In CRSwNP patients, PBEC is independent predictor of FEV1 change ratio.

PMID: 27604625 [PubMed - as supplied by publisher]

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Serum Uric Acid Relation for Hearing Threshold Shift.

Serum Uric Acid Relation for Hearing Threshold Shift.

Clin Exp Otorhinolaryngol. 2016 Sep 8;

Authors: Yang HF, Kao TW, Peng TC, Sun YS, Liaw FY, Wang CC, Hsueh JT, Chen WL

Abstract
Objectives: The effects of serum uric acid (UA) level on a variety of diseases were found from experimental and observational studies via oxidative stress and anti-oxidants. However, research on the association of UA and hearing thresholds is relatively sparse. We investigated this issue in the U.S. general population to evaluate the relationship of serum UA levels and pure tone threshold of hearing.
Methods: Forty four thousand eighty four eligible participants aged 20 to 69 years who have serum UA data and received Audiometry Examination Component were enrolled from the National Health and Nutrition Examination Survey 1999-2004. Hearing thresholds (dB) as a pure tone average at low frequencies (0.5, 1, 2 kHz) and at high frequencies (3, 4, 6, and 8 kHz) were computed. Multivariate linear regression models and tertile-based analysis with an extended-model approach for covariates adjustment were used to assess the correlation between serum UA level and hearing thresholds.
Results: In the adjusted mode of tertile-based analysis, the regression coefficients elucidated as the change of log-transformed mean hearing thresholds upon comparing participants in the highest tertile of serum UA to those in the lowest tertile were -0.067 (P=0.023) in high frequency and -0.058 (P=0.054) in low frequency. After adjusting for multiple pertinent covariates, inverse association between tertiles of serum UA and hearing thresholds remained essentially unchanged. The negative trends between serum UA and hearing thresholds were statistically significant (P for trends <0.05) in tertile-based multiple linear regressions.
Conclusion: Individuals with elevated UA levels independently were found to be inversely associated with hearing thresholds for pure tone audiometry in a nationally representative sample of U.S. adults.

PMID: 27604624 [PubMed - as supplied by publisher]

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Assessment and treatment of short-term and working memory impairments in stroke aphasia: a practical tutorial.

http:--media.wiley.com-assets-7315-19-Wi

Assessment and treatment of short-term and working memory impairments in stroke aphasia: a practical tutorial.

Int J Lang Commun Disord. 2015 Nov-Dec;50(6):721-36

Authors: Salis C, Kelly H, Code C

Abstract
BACKGROUND: Aphasia following stroke refers to impairments that affect the comprehension and expression of spoken and/or written language, and co-occurring cognitive deficits are common. In this paper we focus on short-term and working memory impairments that impact on the ability to retain and manipulate auditory-verbal information. Evidence from diverse paradigms (large group studies, case studies) report close links between short-term/working memory and language functioning in aphasia. This evidence leads to the hypothesis that treating such memory impairments would improve language functioning. This link has only recently been acknowledged in aphasia treatment but has not been embraced widely by clinicians.
AIMS: To examine the association between language, and short-term and working memory impairments in aphasia. To describe practical ways of assessing short-term and working memory functioning that could be used in clinical practice. To discuss and critically appraise treatments of short-term and working memory reported in the literature.
METHODS & PROCEDURES: Taking a translational research approach, this paper provides clinicians with current evidence from the literature and practical information on how to assess and treat short-term and working memory impairments in people with aphasia. Published treatments of short-term and/or working memory in post-stroke aphasia are discussed through a narrative review.
MAIN CONTRIBUTIONS: This paper provides the following. A theoretical rationale for adopting short-term and working memory treatments in aphasia. It highlights issues in differentially diagnosing between short-term, working memory disorders and other concomitant impairments, e.g. apraxia of speech. It describes short-term and working memory assessments with practical considerations for use with people with aphasia. It also offers a description of published treatments in terms of participants, treatments and outcomes. Finally, it critically appraises the current evidence base relating to the treatment of short-term and working memory treatments.
CONCLUSIONS: The links between short-term/working memory functioning and language in aphasia are generally acknowledged. These strongly indicate the need to incorporate assessment of short-term/working memory functioning for people with aphasia. While the supportive evidence for treatment is growing and appears to highlight the benefits of including short-term/working memory in aphasia treatment, the quality of the evidence in its current state is poor. However, because of the clinical needs of people with aphasia and the prevalence of short-term/working memory impairments, incorporating related treatments through practice-based evidence is advocated.

PMID: 26123369 [PubMed - indexed for MEDLINE]

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Cognitive Mechanisms in Chronic Tinnitus: Psychological Markers of a Failure to Switch Attention.

Cognitive Mechanisms in Chronic Tinnitus: Psychological Markers of a Failure to Switch Attention.

Front Psychol. 2016;7:1262

Authors: Trevis KJ, McLachlan NM, Wilson SJ

Abstract
The cognitive mechanisms underpinning chronic tinnitus (CT; phantom auditory perceptions) are underexplored but may reflect a failure to switch attention away from a tinnitus sound. Here, we investigated a range of components that influence the ability to switch attention, including cognitive control, inhibition, working memory and mood, on the presence and severity of CT. Our participants with tinnitus showed significant impairments in cognitive control and inhibition as well as lower levels of emotional well-being, compared to healthy-hearing participants. Moreover, the subjective cognitive complaints of tinnitus participants correlated with their emotional well-being whereas complaints in healthy participants correlated with objective cognitive functioning. Combined, cognitive control and depressive symptoms correctly classified 67% of participants. These results demonstrate the core role of cognition in CT. They also provide the foundations for a neurocognitive account of the maintenance of tinnitus, involving impaired interactions between the neurocognitive networks underpinning attention-switching and mood.

PMID: 27605920 [PubMed]

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Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain.

Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain.

Forsch Komplementmed. 2016;23(4):223-229

Authors: Weinschenk S, Göllner R, Hollmann MW, Hotz L, Picardi S, Hubbert K, Strowitzki T, Meuser T, Heidelberg University Neural Therapy Education and Research Group (The HUNTER group)h

Abstract
BACKGROUND: Neck reflex points (NRP) are tender soft tissue areas of the cervical region that display reflectory changes in response to chronic inflammations of correlated regions in the visceral cranium. Six bilateral areas, NRP C0, C1, C2, C3, C4 and C7, are detectable by palpating the lateral neck. We investigated the inter-rater reliability of NRP to assess their potential clinical relevance.
METHODS: 32 consecutive patients with chronic neck pain were examined for NRP tenderness by an experienced physician and an inexperienced medical student in a blinded design. A detailed description of the palpation technique is included in this section. Absence of pain was defined as pain index (PI) = 0, slight tenderness = 1, and marked pain = 2. Findings were evaluated either by pair-wise Cohen's kappa (ĸ) or by percentage of agreement (PA).
RESULTS: Examiners identified 40% and 41% of positive NRP, respectively (PI > 0, physician: 155, student: 157) with a slight preference for the left side (1.2:1). The number of patients identified with >6 positive NRP by the examiners was similar (13 vs. 12 patients). ĸ values ranged from 0.52 to 0.95. The overall kappa was ĸ = 0.80 for the left and ĸ = 0.74 for the right side. PA varied from 78.1% to 96.9% with strongest agreement at NRP C0, NRP C2, and NRP C7. Inter-rater agreement was independent of patients' age, gender, body mass index and examiner's experience.
CONCLUSION: The high reproducibility suggests the clinical relevance of NRP in women.

PMID: 27607183 [PubMed - as supplied by publisher]

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Effects of Age and Body Mass Index on Thoracolumbar Spine X-Ray for Diagnosing Osteoporosis in Elderly Women: Tianliao Old People (TOP) Study 07.

Effects of Age and Body Mass Index on Thoracolumbar Spine X-Ray for Diagnosing Osteoporosis in Elderly Women: Tianliao Old People (TOP) Study 07.

PLoS One. 2016;11(9):e0161773

Authors: Chang YF, Chang CS, Wang MW, Wu CF, Chen CY, Chang HJ, Kuo PH, Wu CH

Abstract
PURPOSE: The aim of this study was to determine the effects of diagnostic discordance with or without a thoracolumbar spine lateral view X-ray in patients with osteoporosis.
METHODS: We randomly enrolled 368 women over 65 years old (74.3 ± 6.0 years) from Tianliao Township in 2009 (response rate: 75.7%). A diagnosis of osteoporosis was confirmed using one of these criteria: (1) a history of non-traumatic fracture, (2) vertebral fractures based on a thoracolumbar spine lateral view X-ray, or (3) a bone mineral density T-score ≤ -2.5 for the total hip, the femoral neck, the lumbar spine, or all 3 sites. The prevalence of osteoporosis in three groups was compared based on Model I (criteria 1+2) vs. Model II (criteria 1+3) vs. Model III (criteria 1+2+3). The role of thoracolumbar X-ray reflected by the diagnostic discordance of osteoporosis between Models II and III was evaluated.
RESULTS: The overall prevalence of osteoporosis was 78.3% (Model III, age-standardized 78.1%). The diagnostic discordance was 17.4% in the 368 participants. A logistic regression model showed that age was negatively associated with diagnostic discordance (odds ratio [OR] = 0.93, 95% confidence interval [CI]: 0.88-0.98, p < 0.05), but body mass index was positively associated (OR = 1.07, 95% CI: 1.00-1.15, p < 0.05).
CONCLUSIONS: A thoracolumbar spine lateral view X-ray should be added for women ≥ 65 years old or with a body mass index ≥ 25 kg/m2 to minimize the diagnostic discordance in osteoporosis, especially in highly endemic regions.

PMID: 27606706 [PubMed - as supplied by publisher]

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Autologous fat injection therapy including a high concentration of adipose-derived regenerative cells in a vocal fold paralysis model: animal pilot study.

Autologous fat injection therapy including a high concentration of adipose-derived regenerative cells in a vocal fold paralysis model: animal pilot study.

J Laryngol Otol. 2016 Sep 8;:1-9

Authors: Nishio N, Fujimoto Y, Suga K, Iwata Y, Toriyama K, Takanari K, Kamei Y, Yamamoto T, Gotoh M

Abstract
OBJECTIVES: To verify the effectiveness and safety of the addition of adipose-derived regenerative cells to autologous fat injection therapy.
METHODS: Unilateral vocal fold paralysis models were made by cutting the right recurrent laryngeal nerve in two pigs. At day 30, 0.5 ml adipose-derived regenerative cells mixed with 1 ml autologous fat was injected into the right vocal fold of one pig, with the other receiving 0.5 ml Ringer's solution mixed with 1 ml autologous fat. At day 120, fibrescopy, laser Doppler flowmeter, computed tomography, vocal function evaluation and histological assessment were conducted.
RESULTS: Although histological assessment revealed atrophy of the thyroarytenoid muscle fibre in both pigs, there was remarkable hypertrophy of the thyroarytenoid muscle fibre in the area surrounding the adipose-derived regenerative cells injection site.
CONCLUSION: The addition of a high concentration of adipose-derived regenerative cells to autologous fat injection therapy has the potential to improve the treatment outcome for unilateral vocal fold paralysis.

PMID: 27604559 [PubMed - as supplied by publisher]

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A survey of ENT experience in South West Peninsula general practitioner trainees: how can post-graduate ENT training be improved?

A survey of ENT experience in South West Peninsula general practitioner trainees: how can post-graduate ENT training be improved?

J Laryngol Otol. 2016 Sep 8;:1-4

Authors: Easto RH, Reddy V

Abstract
OBJECTIVES: To assess how much ENT experience regional general practitioner trainees received, both in their undergraduate and post-graduate training, and to establish if trainees felt they required further ENT training to manage ENT complaints.
METHODS: An online survey was emailed to general practitioner trainees in Cornwall and Devon.
RESULTS: Of 200 general practitioner trainees, 121 (60.5 per cent) responded to the survey. Of these respondents, 95.9 per cent felt ENT experience was important as a general practitioner; however, 59.5 per cent had no ENT experience in their post-graduate training. Sixty-five per cent of trainees had not had any formal ENT teaching since leaving medical school; however, 93.4 per cent would attend a 1-day course if offered the opportunity locally. Finally, 75.8 per cent of trainees would have liked an ENT post during their post-graduate training.
CONCLUSION: Further ENT training is required for doctors in general practitioner training schemes to aid improvement of patient care. The most logical way to enhance ENT training in a post-graduate setting is through up-to-date courses held locally with a faculty made up of experts working within the specialty.

PMID: 27604454 [PubMed - as supplied by publisher]

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The Incudostapedial Versus Malleostapedial Bone-Cement Rebridging: Which One Should We Really Prefer?

The Incudostapedial Versus Malleostapedial Bone-Cement Rebridging: Which One Should We Really Prefer?

Ann Otol Rhinol Laryngol. 2016 Sep 7;

Authors: Kalcioglu MT, Serifler S, Egilmez OK

PMID: 27605439 [PubMed - as supplied by publisher]

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Feasibility Study for Transnasal Endoscopic Repair of Orbital Floor Fracture With Alloplastic Implant.

Feasibility Study for Transnasal Endoscopic Repair of Orbital Floor Fracture With Alloplastic Implant.

Ann Otol Rhinol Laryngol. 2016 Sep 7;

Authors: Engle RD, Chaskes M, Wladis E, Pinheiro-Neto CD

Abstract
OBJECTIVE: Fractures of the orbital floor are common yet repaired by various techniques, including open periorbital, transantral endoscopic, and endoscopic endonasal approaches. To date, endoscopic endonasal repair of an orbital floor fracture using an alloplastic implant has not been described. We aim to determine the technique and limitations of completely endoscopic endonasal orbital floor repair using an alloplastic implant.
STUDY DESIGN: Cadaveric anatomic study and retrospective case series.
METHODS: Cadaveric study of 12 sides with endoscopic sinonasal dissection followed by the creation and repair of an isolated orbital floor fracture using an alloplastic implant. Four representative patient cases are presented in which the techniques developed in the cadaveric study were employed. Patients were selected for this technique based on the results of the cadaveric study.
RESULTS: Cadaveric study demonstrated feasibility of access and repair for fractures that did not extend lateral to the infraorbital canal or anterior to the nasolacrimal duct. In all cadaveric sides and in all 4 patient cases, successful alloplastic orbital floor reconstruction was achieved.
CONCLUSION: This method of repair is feasible for selected patients and may be considered in cases of favorable fracture anatomy with or without concomitant indication for an ipsilateral sinus procedure.

PMID: 27605438 [PubMed - as supplied by publisher]

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Bronchial Compression and Tracheosophageal Fistula Secondary to Prolonged Esophageal Foreign Body.

Bronchial Compression and Tracheosophageal Fistula Secondary to Prolonged Esophageal Foreign Body.

Ann Otol Rhinol Laryngol. 2016 Sep 7;

Authors: Liming BJ, Fischer A, Pitcher G

Abstract
INTRODUCTION: Foreign body ingestion is a common pediatric problem that can have a delayed presentation, as presented herein.
CASE REPORT: We present the case of a 15-year-old female who developed bronchial compression and an acquired tracheoesophageal fistula secondary to a longstanding esophageal foreign body.
DISCUSSION: There are several challenges in diagnosis and management of this unusual situation. We review the literature regarding prolonged retention of foreign bodies and the challenges in diagnosis in the developmentally disabled child.
CONCLUSION: Providers must have a high suspicion for foreign bodies in the case of unusual symptoms present in children with neurodevelopmental delays.

PMID: 27605437 [PubMed - as supplied by publisher]

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Development of an Innovative 3D Printed Rigid Bronchoscopy Training Model.

Development of an Innovative 3D Printed Rigid Bronchoscopy Training Model.

Ann Otol Rhinol Laryngol. 2016 Sep 7;

Authors: Al-Ramahi J, Luo H, Fang R, Chou A, Jiang J, Kille T

Abstract
OBJECTIVES: The objective of this study was to create a 3D printed airway model simulating the size and mechanical properties of various age groups for foreign body removal training.
METHODS: Three-dimensional printing technology was used to print the anatomically correct airway from rubber-like translucent material, simulating the mechanical properties of human airway tissue. The model's effectiveness in trainee education was evaluated by otolaryngology residents with varying levels of experience. As part of an Airway Emergencies course, a rigid bronchoscopy procedure was performed on the 3D printed model as well as a porcine model. The participants completed surveys comparing the validity of the 2 models and the effectiveness of the overall training experience.
RESULTS: The 3D printed model, which is accurate in terms of anatomy and mechanical properties, was found to be comparable to a porcine model in regards to participant satisfaction as well as face validity.
CONCLUSIONS: The 3D printed airway model is able to be accurately scaled to various sizes and simulate the mechanical properties of the desired age group. The 3D printed model provides an excellent alternative to animal models in terms of practicality, logistics of use, and anatomical accuracy.

PMID: 27605436 [PubMed - as supplied by publisher]

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Treating Pediatric Anterior Glottic Web: Single-Center Experience of 20 Patients with Comparison among Techniques.

Treating Pediatric Anterior Glottic Web: Single-Center Experience of 20 Patients with Comparison among Techniques.

Clin Otolaryngol. 2016 Sep 8;

Authors: Alkan U, Nachalon Y, Vaisbuch Y, Katz O, Hamzany Y, Stern Y

Abstract
All currently used web-repair techniques are safe and effective. Simple division of the web with application of mitomycin C yields poor results. Of the 4 techniques tested, keel placement offers the best long-term outcome. All children with congenital anterior glottic web should be evaluated for 22q11.2DS. Postoperative follow-up of at least one year is advised This article is protected by copyright. All rights reserved.

PMID: 27608279 [PubMed - as supplied by publisher]

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Analytical Performance of a Gene Expression Classifier for Medullary Thyroid Carcinoma.

Analytical Performance of a Gene Expression Classifier for Medullary Thyroid Carcinoma.

Thyroid. 2016 Sep 7;

Authors: Pankratz DG, Hu Z, Kim SY, Monroe RJ, Wong MG, Traweek ST, Kloos RT, Walsh PS, Kennedy GC

Abstract
BACKGROUND: To demonstrate the analytical validity of an RNA classifier for medullary thyroid carcinoma (MTC).
METHODS: Fresh-frozen tissue specimens were obtained from commercial sources, and MTC diagnoses were confirmed by histopathology review. De-identified patient fine-needle aspiration biopsies (FNABs) and whole blood from normal donors were obtained. Total RNA was extracted, amplified, and hybridized to custom microarrays for gene expression analysis. Gene expression data was normalized and classified via a machine learning algorithm. Positive control materials were produced from MTC tissues and tested across multiple experiments and laboratories. 27 MTC tissue specimens were used to evaluate the sensitivity of the MTC classifier. Gene expression data from tissues and FNABs were used to model classifier response to mixtures of MTC samples with normal thyroid tissue, a benign thyroid nodule, a Hürthle cell adenoma and whole blood. Select mixture conditions were confirmed in vitro. Assay tolerance to RNA input variation (5-25ng) and genomic DNA contamination (30% by mass) was evaluated. The intra- and inter-run reproducibility, and inter-laboratory accuracy of MTC classifier results were characterized.
RESULTS: MTC classifier sensitivity of 96.3% (95% CI: 81.0%-99.9%) was determined retrospectively using 27 MTC confirmed tissue specimens. One false negative result in a necrotic tissue implicated sample necrosis in reduced classifier sensitivity. Dilution modeling of MTC samples with normal or benign tissues showed consistent detection of MTC down to 20% sample proportions, with in vitro confirmation of 20% analytical sensitivity. Classifier tolerance to RNA input variation (5-25ng), genomic DNA contamination (30% by mass), and an interfering substance (blood) was demonstrated with 100% accurate classifier results under all tested conditions. The maximum observed run-to-run score difference for a single FNAB sample was ~1 unit, compared to the average score difference between 38 MTC and non-MTC FNABs of ~32 units. MTC classifier results for 20 tissues processed from total RNA in two different laboratories showed 100% concordance.
CONCLUSIONS: The MTC classifier, offered as part of the routine molecular testing of cytology-indeterminate thyroid nodules, demonstrates robust analytical sensitivity, specificity, accuracy and reproducibility.

PMID: 27605259 [PubMed - as supplied by publisher]

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Quality of life priorities in patients with thyroid cancer - a multi-national EORTC phase I study.

Quality of life priorities in patients with thyroid cancer - a multi-national EORTC phase I study.

Thyroid. 2016 Sep 7;

Authors: Singer S, Husson O, Tomaszewska IM, Locati L, Kiyota N, Scheidemann-Wesp U, Hofmeister D, Winterbotham M, Brannan C, Araujo C, Gamper E, Kulis D, Rimmele H, Andry G, Licitra L

Abstract
Background The objectives of this study were to determine quality of life (QoL) issues that are relevant to thyroid cancer patients cross-culturally and to identify those with highest relevance to them in addition to the more general issues covered by the core QoL questionnaire EORTC QLQ-C30. Methods A systematic literature search provided a list of potentially relevant QoL issues to supplement the core questionnaire EORTC QLQ-C30 which is widely used in research and in care and that addresses QoL issues relevant to all groups of cancer patients. A panel of experts revised this list, and thyroid cancer patients rated the issues regarding their relevance for QoL by selecting the 25 issues they would include in a thyroid cancer specific QoL module. Results The literature search and expert discussion provided a list of 71 QoL issues which was rated by thyroid cancer patients (n=110) from seven countries. All issues were of high priority to at least some of the patients. The most frequently selected issues were sudden attacks of tiredness, exhaustion, quality of sleep, employment, social support, fear of cancer progression, fear of second operation, difficulties swallowing, and globus sensation. Conclusions Thyroid cancer patients cross-culturally rate fatigue related issues as highly important for their QoL, calling for increased efforts to find successful treatments for this problem. Vocational rehabilitation is also highly relevant for them and should therefore be an important aim of multi-disciplinary care. The third important area of concern is psychological issues, especially fear of progression and of additional treatments.

PMID: 27605136 [PubMed - as supplied by publisher]

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MULTIFOCALITY IN SPORADIC MEDULLARY THYROID CARCINOMA: AN INTERNATIONAL MULTICENTER STUDY.

MULTIFOCALITY IN SPORADIC MEDULLARY THYROID CARCINOMA: AN INTERNATIONAL MULTICENTER STUDY.

Thyroid. 2016 Sep 7;

Authors: Essig G, Porter K, Schneider DF, Arpaia D, Lindsey SC, Busonero G, Fineberg D, Fruci B, Boelaert K, Smit J, Meijer J, Duntas LH, Sharma N, Costante G, Filetti S, Sippel RS, Biondi B, Topliss DJ, Pacini F, Maciel RM, Walz P, Kloos RT

Abstract
BACKGROUND: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. We assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to more accurately assess risks associated with alternative surgical approaches.
METHODS: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983 to 2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed.
RESULTS: Patients from 4 continents and 7 countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) of patients, while multifocal disease was noted in 50/312 (16.0%) of sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) of cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) of cases (p<0.001 by Fisher's Exact Test). No geographic differences in focality were identified.
CONCLUSIONS: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery as less complete thyroid surgery may fail to fully address the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.

PMID: 27604949 [PubMed - as supplied by publisher]

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Impaired Ventilation and Oxygenation After Emergency Cricothyrotomy: Recommendations for the Management of Suboptimal Invasive Airway Access.

Impaired Ventilation and Oxygenation After Emergency Cricothyrotomy: Recommendations for the Management of Suboptimal Invasive Airway Access.

A A Case Rep. 2016 Sep 7;

Authors: Warner MA, Smith HM, Zielinski MD

Abstract
Invasive airway access by emergent cricothyrotomy remains an essential treatment modality in "can't intubate/can't ventilate" scenarios. Although numerous commercial devices are available, limited comparative data exist with regard to the ventilation and oxygenation parameters of these devices. We report a case of severely compromised respiratory function while using the Quicktrach II, a commercially available emergency cricothyrotomy device. Because of oxygenation and ventilatory insufficiency, our patient required emergent removal of the device and surgical tracheostomy to improve respiratory function. When confronted with a difficult airway, anesthesiologists and surgeons should be aware of commonly encountered cricothyrotomy devices and their potential limitations.

PMID: 27607408 [PubMed - as supplied by publisher]

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[A Case of Spontaneous Cerebrospinal Fluid Leak Associated with Cervical Spondylosis].

[A Case of Spontaneous Cerebrospinal Fluid Leak Associated with Cervical Spondylosis].

No Shinkei Geka. 2016 Sep;44(9):767-72

Authors: Arai A, Miyamoto H, Shiomi R, Tatsumi S, Kohmura E

Abstract
Spontaneous cerebrospinal fluid leak and intracranial hypotension associated with cervical spondylosis have rarely been observed, and only a few cases are reported. A 69-year-old woman, previously treated for rectal and thyroid cancer, complained of a non-postural persistent headache. The patient regularly practiced aerobic exercise, but a month earlier she had started experiencing headache and neck pain while exercising. Computed tomography(CT)showed bilateral chronic subdural hematomas, and magnetic resonance imaging(MRI)revealed diffuse dural enhancement and tonsillar herniation. We drained the subdural hematomas and replaced the ventricular reservoir to safely access the cerebrospinal fluid space. After surgery, the persistent headache disappeared for several days, but a postural headache emerged. CT myelogram showed extradural accumulation of the contrast medium at the C2-5 level with cervical spondylosis. The patient was treated with conservative therapy of bed rest and intravenous fluid hydration for two weeks, and the headache improved. CT myelogram after treatment showed no extradural accumulation of the contrast medium. Spontaneous cerebrospinal fluid leak associated with cervical spondylosis could be induced by the repeated minor mechanical stress caused by physical exercise. Therefore, the possibility that non-postural persistent headache may be caused by spontaneous cerebrospinal fluid leak should not be underestimated.

PMID: 27605479 [PubMed - in process]

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Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

HEAD NECK

1.	ORIGINAL RESEARCH HEAD&NECK
	2016-01-01
	German National Library of Science and Technology (TIB)
2.	Head and neck cancer specialist offers us wonderful support.
	Green K 2016-08-01
	My husband Jerry was diagnosed with mouth cancer in January 2014 aged 45. A month later he went in for an operation and had a radical neck dissection. The floor of his mouth was replaced with skin from his forearm and part of his tongue was removed.
	Europe PubMed Central

3.	[Head and neck intensity-modulated radiation therapy: Normal tissues dose constraints. Pharyngeal constrictor muscles and larynx].
	Graff, P 2016-09-01
	PMID:27599684
	Science.gov (United States)
4.	[Treatment of head and neck squamous cell carcinoma recurrences and distant metastases : Highlights of the ASCO Meeting 2016].
	Bußmann, L 2016-09-01
	PMID:27604281
	Science.gov (United States)
5.	Searching beyond the usual papillomavirus suspects in squamous carcinomas of the vulva, penis and head andneck.
	Félez-Sánchez, Marta 2016-09-01
	PMID:27600594
	Science.gov (United States)
6.	Patients' experience of temporary tracheostomy after microvascular reconstruction for cancer of the head andneck.
	Rogers SN 2016-09-01
	A temporary tracheostomy is commonly done in patients who have reconstruction after the ablation of advanced oral cancer to provide easy access to a secure airway in case a haematoma forms or the patient needs a return to theatre. Although relatively simple to do, we know little about the patients' experience, and to find out, we designed a three-stage study. First, we conducted semi-structured interviews to identify items related to the functional, emotional, and social impacts of the tracheostomy, on the ward and on removal (n=15 patients). Secondly, we used these items to develop a short, one-page questionnaire in collaboration with the Patient and Carer Support Group and Research Forum, and thirdly, we did a cross-sectional postal survey of 125 patients who had had a temporary tracheostomy as part of free tissue reconstruction between January 2013 and July 2015. Of them, 86 responded (69% response rate). Generally patients reported a negative experience. In the cross-sectional survey most responders (n=52, 60%) stated that they would "very much" avoid a tracheostomy if at all possible. The main problems concerned fear and communication, and between one-third and one-half stated that they had had "very much" or "quite a bit" of a problem in regard to choking, discomfort, attracting attention, sleeping, and general management (other than the suctioning). This feedback should form part of the information that is given to patients; it should also enable us to reflect on optimal perioperative care, and help to inform the debate about the selection criteria.
	Europe PubMed Central
7.	Patients' experience of temporary tracheostomy after microvascular reconstruction for cancer of the head andneck.
	Rogers, S N 2016-09-01
	PMID:27596013
	Science.gov (United States)
8.	Immunohistochemical pattern analysis of squamous cell carcinoma: Lung primary and metastatic tumors ofhead and neck.
	Ichinose, Junji 2016-10-01
	PMID:27597287
	Science.gov (United States)
9.	Docetaxel plus cetuximab biweekly is an active regimen for the first-line treatment of patients with recurrent/metastatic head and neck cancer.
	Posch D 2016-01-01
	For patients with recurrent/metastatic (R/M) head and neck squamous cell carcinoma (SCCHN) limited therapeutic options exist. Only a subset of patients is suitable for combination chemotherapy regimens. Biweekly docetaxel plus cetuximab might be an alternative option. Thus, we performed this retrospective analysis in unselected patients in order to investigate the efficacy and safety of this regimen. Thirty-one patients receiving off protocol docetaxel (50 mg/m(2)) plus cetuximab (500 mg/m(2)) biweekly were included. Data collection included baseline demographic, response rate (ORR), disease control rate (DCR), overall survival (OS), progression free survival (PFS) as well as toxicity. OS and PFS were 8.3 months (95% CI 4.8-11.8) and 4.0 months (95% CI 1.0-7.0), respectively. Three (9.7%) patients achieved a complete response and one patient (3.2%) a partial response. The DCR was 41.9% and we observed an ORR of 12.9%. The one-year survival rate was 25.8%. The therapy was well tolerated and the most common grade 3/4 adverse events were neutropenia (19.4%), hypomagnesaemia (12.9%) and acne-like rash (9.7%). Biweekly cetuximab/docetaxel is an effective regimen and well tolerated in R/M SCCHN patients not suitable for platinum doublet treatment. Further evaluation of this regimen in prospective clinical trials is warranted.
	Europe PubMed Central

10.	Sperm with fibrous sheath dysplasia and anomalies in head-neck junction: focus on centriole and centrin 1.
	Moretti, E 2016-09-01
	PMID:27596234
	Science.gov (United States)
11.	T cell abundance in blood predicts acute organ toxicity in chemoradiotherapy for head and neck cancer.
	Beschel LM 2016-08-01
	Treatment of head and neck squamous cell carcinoma (HNSCC) by chemoradiotherapy (CRT) often results in high-grade acute organ toxicity (HGAOT). As these adverse effects impair the patients' quality of life and the feasibility of the planned therapy, we sought to analyze immunological parameters in tumor material and blood samples obtained from 48 HNSCC patients in order to assess the potential to predict the individual acute organ toxicity. T cells in the tumor stroma were enriched in patients developing HGAOT whereas levels of soluble factors in the plasma and gene expression in whole blood did not coincide with the occurrence of acute organ toxicity. In contrast, the frequency and absolute numbers of selected leukocyte subpopulations measured in samples of peripheral blood mononuclear cells (PBMCs) directly before the beginning of CRT were significantly different in patients with HGAOT as compared to those without. When we validated several potential markers including the abundance of T cells in a small prospective study with 16 HNSCC patients, we were able to correctly predict acute organ toxicity in up to 81% of the patients. We conclude that analysis of PBMCs by fluorescence-activated cell sorting (FACS) might be a convenient strategy to identify patients at risk of developing HGAOT caused by CRT, which might allow to adapt the treatment regimen and possibly improve disease outcome.
	Europe PubMed Central
12.	Mutational load and mutational patterns in relation to age in head and neck cancer.
	Meucci S 2016-08-01
	Head and neck squamous cell carcinoma (HNSCC) is a cancer with well-defined tumor causes such as HPV infection, smoking and drinking. Using The Cancer Genome Atlas (TCGA) HNSCC cohort we systematically studied the mutational load as well as patterns related to patient age in HNSCC. To obtain a homogenous set we excluded all patients with HPV infection as well as wild type TP53. We found that the overall mutational load is higher in patients of old age. Through unsupervised hierarchical clustering, we detected distinct mutational clusters in very young as well as very old patients. In the group of old patients, we identified four enriched pathways ("Axon Guidance", "ECM-Receptor Interaction", "Focal Adhesion" and "Notch Signaling") that are only sporadically mutated in the other age groups. Our findings indicate that the four pathways regulate cell motility, tumor invasion and angiogenesis supposedly leading to less aggressive tumors in older age patients. Importantly, we did not see a strict pattern of genes always mutated in older age but rather an accumulation of mutations in the same pathways. Our study provides indications of age-dependent differences in mutational backgrounds of tumors that might be relevant for treatment approaches of HNSCCs patients.
	Europe PubMed Central
13.	Mutational load and mutational patterns in relation to age in head and neck cancer.
	Meucci, Stefano 2016-08-16
	PMID:27596625
	Science.gov (United States)
14.	A meta-analysis of weekly cisplatin versus three weekly cisplatin chemotherapy plus concurrent radiotherapy (CRT) for advanced head and neck cancer (HNC).
	Guan, Jian 2016-09-01
	PMID:27602493
	Science.gov (United States)
15.	Chemoprevention of Head and Neck Squamous Cell Carcinoma (HNSCC) With Valproic Acid
	2016-09-05
	Head and Neck Squamous Cell Carcinoma
	Science.gov (United States)

16.	Safety of drug treatments for head and neck cancer.
	Galot R 2016-08-01
	The treatment of squamous cell carcinoma of the head and the neck depends on the disease's stage. In locally-advanced stage disease, multimodal treatment strategies, including surgery, radiotherapy and chemotherapy, give the best outcome in terms of overall survival. Those treatments are not without negligeable adverse events, which can lead to late debilitating toxicities. In recurrent/metastatic disease, not amenable to surgery or radiation therapy, palliative chemotherapy is the most appropriate treatment.This review aims to provide an overview of the safety of standard drug regimens used to treat SCCHN in daily practice, including platinum-based chemoradiation, induction chemotherapy, cetuximab and immunotherapy. The toxicities induced by single modality radiotherapy, or those resulting from surgery, are not part of the discussion.Toxicities observed with multimodal treatment of SCCHN are the highest we can tolerate in terms of treatment-related mortality, morbidity and late consequences. Patients at high risk of developing such complications should be identified upfront for optimal prevention and management. There is a medical need to identify less toxic regimens without compromising the treatment efficacy, especially for patients with Human Papilloma Virus-induced oropharyngeal cancers. Finally, it is crucial in future trials to better standardize the scales used to report treatment related adverse events.
	Europe PubMed Central
17.	Survival and Surgical Outcomes for Pediatric Head and Neck Melanoma.
	Richards, Morgan K 2016-09-01
	PMID:27607058
	Science.gov (United States)
18.	Electromyography and Mechanomyography Signals During Swallowing in Healthy Adults and Head and NeckCancer Survivors.
	Constantinescu G 2016-08-01
	Surface electromyography (sEMG) is used as an adjuvant to dysphagia therapy to demonstrate the activity of submental muscles during swallowing exercises. Mechanomyography (MMG) has been suggested as a potential superior alternative to sEMG; however, this advantage is not confirmed for signal acquired from submental muscles. This study compared the signal-to-noise ratio (SNR) obtained from sEMG and MMG sensors during swallowing tasks, in healthy participants and those with a history of head and neck cancer (HNC), a population with altered anatomy and a high incidence of dysphagia. Twenty-two healthy adults and 10 adults with a history of HNC participated in this study. sEMG and MMG signals were acquired during dry, thin liquid, effortful, and Mendelsohn maneuver swallows. SNR was compared between the two sensors using repeated measures ANOVAs and subsequent planned pairwise comparisons. Test-retest measures were collected on 20 % of participants. In healthy participants, MMG SNR was higher than that of sEMG for dry [t(21) = -3.02, p = 0.007] and thin liquid swallows [t(21) = -4.24, p < 0.001]. Although a significant difference for sensor was found in HNC participants F(1,9) = 5.54, p = 0.043, planned pairwise comparisons by task revealed no statistically significant difference between the two sensors. sEMG also showed much better test-retest reliability than MMG. Biofeedback provided as an adjuvant to dysphagia therapy in patients with HNC should employ sEMG technology, as this sensor type yielded better SNR and overall test-retest reliability. Poor MMG test-retest reliability was noted in both healthy and HNC participants and may have been related to differences in sensor application.
	Europe PubMed Central
19.	[Immunotherapeutic studies of head and neck tumors : Highlights of the 2016 ASCO Annual Meeting].
	Busch, C-J 2016-09-01
	PMID:27604282
	Science.gov (United States)
20.	Dose-volume analysis of radiation-induced trismus in head and neck cancer patients.
	Gebre-Medhin M 2016-09-01
	Trismus is a treatment-related late side effect in patients treated for cancer in the head and neck region (HNC). The condition can have a considerable negative impact on nutrition, dental hygiene, ability to speak and quality of life. We have previously studied trismus within the frame of a randomized phase 3 study of HNC patients treated with mainly three-dimensional (3D) conformal radiotherapy (CRT) and found a strong association to mean radiation dose to the mastication muscles, especially the ipsilateral masseter muscle (iMAS). In the present study we have investigated trismus prevalence and risk factors in a more recent cohort of patients, treated with todays' more updated radiation techniques.Maximal interincisal distance (MID) was measured on 139 consecutive patients. Trismus was defined as MID ≤35 mm. Patient-, disease- and treatment-specific data were retrospectively recorded. Differences between groups were analyzed and mean absorbed dose to mastication structures was evaluated. Dosimetric comparisons were made between this study and our previous results.The prevalence of trismus was 24% at a median of 16 months after completion of radiotherapy. In bivariate analysis treatment technique (3DCRT vs. intensity modulated radiotherapy or helical tomotherapy), tumor site (oropharynx vs. other sites) and mean radiation doses to the ipsilateral lateral pterygoid muscle, the paired masseter muscles and the iMAS were significantly associated with MID ≤35 mm. In multivariable analysis only mean radiation dose to the iMAS was significantly associated to MID ≤35 mm.Mean radiation dose to the ipsilateral masseter muscle is an important risk factor for trismus development. Dose reduction to this structure during radiotherapy should have a potential to diminish the prevalence of trismus in this patient group.
	Europe PubMed Central

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Αρχειοθήκη ιστολογίου

Παρασκευή 9 Σεπτεμβρίου 2016