No improvement in long-term survival for epithelial ovarian cancer patients: A population-based study between 1989 and 2014 in the Netherlands

Publication date: January 2018
Source:European Journal of Cancer, Volume 88
Author(s): M. Timmermans, G.S. Sonke, K.K. Van de Vijver, M.A. van der Aa, R.F.P.M. Kruitwagen
AimThis study investigates changes in therapy and long-term survival for patients with epithelial ovarian cancer (EOC) in the Netherlands.MethodsAll patients with EOC, including peritoneal and fallopian tube carcinoma, diagnosed in the Netherlands between 1989 and 2014 were selected from the Netherlands Cancer Registry. Changes in therapy were studied and related to overall survival (OS) using multivariable Cox regression models.ResultsA total of 32,540 patients were diagnosed with EOC of whom 22,047 (68%) had advanced stage disease. In early stage, lymph node dissection as part of surgical staging procedures increased over time from 4% in 1989–1993 to 62% in 2009–2014 (P < 0.001). In advanced stage, the number of patients receiving optimal treatment with surgery and chemotherapy increased from 55% in 1989–1993 to 67% in 2009–2014 (P < 0.001). Five-year survival rates improved in both early stage (74% versus 79%) and advanced stage (16% versus 24%) as well as in all patients combined (31% versus 34%). Ten-year survival rates, however, slightly improved in early stage (62% versus 67%) and advanced stage (10% versus 13%) but remained essentially unchanged at 24% for all patients combined.ConclusionDespite intensified treatment and staging procedures, long-term survival for women with EOC has not improved in the last 25 years. The observed improvements in 5-year OS reflect a more prolonged disease control rather than better chances for cure. Furthermore, the apparent better long-term outcome, when early and advanced stage patients are analysed separately, is largely due to improved staging procedures and the ensuing stage migration. These effects disappear in a combined analysis of all patients.



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Facial Contouring Surgery—Malarplasty

No abstract available

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Review of 494 Consecutive Breast Augmentation Patients: System to Improve Patient Outcomes and Satisfaction

Background: Breast augmentation continues to be one of the most common surgical procedures performed by plastic surgeons. As implant options expand, controlling the numerous variables required for a successful result will prove increasingly challenging. The purpose of this study was to outline specific steps that can be taken during the patient consultation and during surgery to decrease complications and improve overall patient satisfaction and patient outcomes. Methods: A retrospective review of 494 consecutive patients who underwent primary augmentation mammaplasty performed by a single surgeon was undertaken. Surgical outcomes were recorded and compared with previously published results. Patient satisfaction was measured using the BREAST-Q Augmentation Module. Results: Patients were followed for an average of 6 months (range, 0–45 months). Of the 494 patients, 1.3% developed capsular contracture. Other complications included 0.6% asymmetry, 0.4% malposition, 0.2% hematoma, and 0.2% rippling. The median BREAST Q score for the patient's overall satisfaction with outcome was 86%. The median BREAST Q score for patient's satisfaction with the plastic surgeon, medical team, and office staff was 100% in each case. The median score for psychological well-being, physical well-being, and sexual well-being was 100%, 90%, and 88%, respectively. Conclusions: The system outlined in this study showed very low rates of complications and high scores for patient satisfaction. Following a system like this will become increasingly important as breast augmentation continues to become more popular, implant options continue to expand, and social media continues to be used by patients to share surgical experiences.

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Is There More than One Variant of Noninvasive Follicular Neoplasm with Papillary-like Nuclear Features?

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 433-436.


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Does Antithyroid Drug Treatment Improve Outcomes in Wild-Type Offspring of Mothers with Thyroid Hormone Resistance?

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 426-429.


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Punctate Echogenic Foci on Thyroid Ultrasound Do Not Necessarily Represent Calcifications on Histopathology

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 415-418.


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Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 411-414.


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Significant Variations of Thyroid Testing in the U.S. Argue for Improved Standardization of Practice Patterns

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 419-421.


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TPO Antibody Positivity in Pregnancy Is Associated with Metabolic Syndrome, Increased Waist Circumference, and Higher BMI in Offspring at Age 16

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 430-432.


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Are Wider TSH Cutoffs for Reflex Testing of Free T4 Feasible, Safe and Cost-Effective?

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 422-425.


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Multifocality Is Not an Independent Risk Factor for Recurrence of Papillary Thyroid Cancer

Clinical Thyroidology Nov 2017, Vol. 29, No. 11: 437-439.


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ASCO update on lymphoma

Summary

Abstracts concerning indolent and aggressive lymphoma and multiple myeloma with clinical relevance from the ASCO 2017 meeting are discussed.

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The first meeting of the Austrian Expert Panel for Molecular Cancer Profiling

Summary

Personalized medicine is rapidly changing the daily routine for the diagnostic work-up and treatment of cancer patients. Several clinical studies and programs are ongoing worldwide to implement personalized anticancer therapies particularly for relapsed/refractory malignancies. On 28 October 2016, the first meeting of the Austrian Expert Panel for Molecular Cancer Profiling was held in Salzburg with the purpose to identify clinical studies and registry programs focusing on comprehensive molecular tumor profiling and personalized cancer therapies in Austria. Representatives of the four Austrian academic centers and from two teaching hospitals were invited to present and debate the current status, challenges, and perspectives in precision oncology. To date, three clinical programs are recruiting patients with relapsed/refractory malignancies in Austria: the ONCO-T-PROFILE program at the Medical University of Innsbruck, the platform MONDTI at the Medical University of Vienna, and the ICT (Individualized Cancer Treatment) phase II trial at the Medical University of Graz. The aim of both research programs and the phase II trial is to investigate the efficacy of molecular profile-based personalized therapies in refractory and relapsed metastatic cancer patients. Furthermore, in cooperation with the AGMT (Study Group of Medical Tumor Therapy), a clinical registry will be established to monitor and to analyze the benefit of molecular profiling in real life.

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Interhemispheric motor interactions in hemiparetic children with perinatal stroke: Clinical correlates and effects of neuromodulation therapy

Perinatal ischemic stroke (PS) is the occlusion of arteries or veins that results in cerebral damage between 20 weeks gestation and 28 days of life (Raju, 2007; Nelson and Lynch, 2004). PS is common, occurring in >1:3000 live births, and accounts for most hemiparetic cerebral palsy (CP) (Kirton and DeVeber, 2013). Children with PS-induced hemiparetic CP typically manifest motor asymmetry and early hand preference in the first 4-6 months of life (Kirton et al., 2010b). How the motor system develops following such early unilateral brain injury is increasingly defined by animal (Martin et al., 2007) and human (Eyre, 2007; Staudt, 2007) studies.

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Nerve Ultrasound in Neurofibromatosis type 1: a Follow-up Study

Peripheral nerve sheath tumors (PNSTs) are one of the main characteristics of neurofibromatosis type 1 (NF1). They can undergo malignant transformation, which is a leading cause of mortality (Hirbe and Gutmann, 2014; Stucky et al., 2012).

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Founder mutation in IKBKAP gene causes vestibular impairment in familial dysautonomia

Familial dysautonomia (FD, OMIN #223900) is an inherited sensory and autonomic neuropathy (type III) mapped to the IKBKAP gene on chromosome 9 (Slaugenhaupt et al., 2001). Mutations in the gene affect the development and survival of primary afferent neurons (Norcliffe-Kaufmann et al., 2010; Macefield et al., 2011; Norcliffe-Kaufmann et al., 2017). Phenotypically, patients with FD have widespread somatosensory and autonomic deficits caused by impaired transmission of nociceptive, thermal, mechanical, chemical, metabolic, and osmotic information from the body to the brain (Norcliffe-Kaufmann et al., 2010; Gutierrez et al., 2015; Palma et al., 2015; Norcliffe-Kaufmann et al., 2017).

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Chronic deep brain stimulation normalizes scalp EEG activity in isolated dystonia

Dystonia is a movement disorder characterized by involuntary sustained or intermittent muscle contractions causing abnormal movements and postures (Albanese et al., 2013). It is recognized as a circuit disorder involving the basal ganglia, thalamus, cortex and cerebellum (Marsden et al., 1985; Vitek et al., 1999; Neychev et al., 2011). Deep brain stimulation (DBS) of the globus pallidus (GP; (Kupsch et al., 2006; Vidailhet et al., 2007; Volkmann et al., 2014)), subthalamic nucleus (STN; (Ostrem et al., 2011)) or thalamus (Fukaya et al., 2007; Mure et al., 2014) is able to improve dystonic symptoms, but its mechanism of action is unknown (Tisch et al., 2007; Vidailhet et al., 2013).

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Comprehensive assessment of the impact of life habits on sleep disturbance, chronotype, and daytime sleepiness among high-school students

Sleep affects adolescents in various ways. However, the effects of multiple factors on sleep hygiene remain unclear. A comprehensive assessment of the effects of life habits on sleep in high-school students was conducted.

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Abnormal functional connectivity of high-frequency rhythms in drug-naïve schizophrenia

Schizophrenia (SZ) is a severe and chronic mental disorder characterized by distinct positive symptoms (e.g., delusions and hallucinations), negative symptoms (e.g., diminished expression or abolition of motivation), and cognitive deficits. Although the exact pathophysiology remains unclear, recent neuroimaging-based evidence points to the "dysconnection hypothesis" as a core pathophysiological mechanism of SZ (Friston, 1998; Ribolsi et al., 2009; Schmitt et al., 2011; Stephan et al., 2006). According to this hypothesis, patients with SZ have an impaired brain network, which leads to deviation from optimum functional connectivity reflected in at least some symptoms of SZ (Ćurčić-Blake et al., 2017; Mulert et al., 2011).

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Re: re: Mandibular stability using sliding compared with conventional four-hole plates for fixation after bilateral sagittal split ramus osteotomy for mandibular setback

In response to Jain and Shetty,1 we would like to apologise for the errors in our paper that was published in your journal recently.2 The sentence: "These authors all used four-hole sliding plates to fix the mandibular bony segments" should have read: "These authors all used four-hole plates to fix the mandibular bony segments". It referred to earlier studies by Abeltins et al,3 Ballon et al,4 and Landes and Ballon,5 in which they all used four-hole plates to fix proximal and distal segments of mandible.

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The effectiveness of topical colloidal silver in recalcitrant chronic rhinosinusitis: a randomized crossover control trial

Recalcitrant chronic rhinosinusitis without polyposis (CRSsP) is a challenging condition to manage as traditional medical therapies and surgery fail to provide satisfactory clinical improvements. Colloidal sil...

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Communication Capacity Research in the Majority World: Supporting the human right to communication specialist services

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A human right to literacy education: Implications for serving Syrian refugee children

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Rural and remote speech–language pathology service inequities: An Australian human rights dilemma

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Correction to: Pascoe et al., Beyond lip service: Towards human rights-driven guidelines for South African speech-language pathologists

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Correction to: Certolizumab Pegol in the Treatment of Psoriasis and Psoriatic Arthritis: Preliminary Real-Life Data

Abstract

In the original publication, part Fig. 3b and c were interchanged. The correct versions are given below.

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Ensuring more opportunity for robotics

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Removing the urinary catheter on post-operative day 2 after robot-assisted laparoscopic radical prostatectomy: a feasibility study from a single high-volume referral centre

Abstract

The indwelling urinary catheter (UC) is a significant bother for men after radical prostatectomy (RP) and should be removed as soon as possible without jeopardizing the outcome. Our aim was to assess the feasibility and safety of its removal on postoperative day (POD) 2 after robot-assisted laparoscopic RP (RALP). A consecutive series of patients undergoing RALP for localized prostate cancer (PCa) were prospectively enrolled. Inclusion criteria were: no bladder-neck reconstruction, watertight urethrovesical anastomosis at 150 ml filling, ≤ 200 ml of intraoperative bleeding, ≤ 80 ml of fluid from the drain on POD 1, clear urine from the UC on POD 2. Patients were discharged on POD 2. Continence was assessed at catheter removal and 1, 3 and 6 months after surgery. Urethrovesical anastomosis was performed with a standard technique on 3 layers. Sixty-six patients were enrolled. The UC was removed on POD 2 in all the cases and 96.4% of the patients were discharged on POD 2. Re-catheterization was needed 16 times and it was always performed easily. Twenty-four complications were reported by 20 patients, mostly Clavien–Dindo (CD) grade II; 2 CD IIIB complications were observed. No anastomotic strictures were diagnosed. At catheter removal, 29% of the patients were completely continent, 41% at 1 month, 67% at 3 months and 92% at 6 months. In selected patients, removing the UC 48 h after RALP is feasible and safe and has no negative impact on continence if compared with the best international standards.

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A Stable Fe 2 O 3 /Expanded Perlite Composite Catalyst for Degradation of Rhodamine B in Heterogeneous Photo-Fenton System

Abstract

A stable and efficient Fe₂O₃/expanded perlite (Fe₂O₃-Ep) composite catalyst was synthesized by a simple hydrothermal method for degradation of refractory contaminants in heterogeneous photo-Fenton system. X-ray diffraction and FT-IR analyses confirmed the presence of the Fe₂O₃ in the synthesized catalyst. The catalytic activity of the Fe₂O₃-Ep catalyst was evaluated by the degradation of rhodamine B (RhB, 5 mg/L) and metronidazole (MET, 5 mg/L) in the presence of H₂O₂ under visible light irradiation. The Fe₂O₃-Ep catalyst exhibited high efficiency for degradation of RhB at a wide pH range from 2 to 10 and showed excellent catalytic property for decomposition of MET as well. The degradation ratio of RhB was achieved 99%, and the removal ratio of COD was 62% within 90 min at the best experimental conditions (0.5 g/L of Fe₂O₃-Ep catalyst, 2 mL/L of H₂O₂). Furthermore, iron leaching of the Fe₂O₃-Ep catalyst during the catalytic degradation reaction was negligible and the catalyst still exhibited high catalytic activity and stability after five cycles. These results show that the catalyst can be used as a highly efficient heterogeneous photo-Fenton catalyst for the degradation of non-biodegradable refractory pollutants in water.

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Cancers, Vol. 9, Pages 160: Integrative Bioinformatic Analysis of Transcriptomic Data Identifies Conserved Molecular Pathways Underlying Ionizing Radiation-Induced Bystander Effects (RIBE)

Cancers, Vol. 9, Pages 160: Integrative Bioinformatic Analysis of Transcriptomic Data Identifies Conserved Molecular Pathways Underlying Ionizing Radiation-Induced Bystander Effects (RIBE)

Cancers doi: 10.3390/cancers9120160

Authors: Constantinos Yeles Efstathios-Iason Vlachavas Olga Papadodima Eleftherios Pilalis Constantinos Vorgias Alexandros Georgakilas Aristotelis Chatziioannou

Ionizing radiation-induced bystander effects (RIBE) encompass a number of effects with potential for a plethora of damages in adjacent non-irradiated tissue. The cascade of molecular events is initiated in response to the exposure to ionizing radiation (IR), something that may occur during diagnostic or therapeutic medical applications. In order to better investigate these complex response mechanisms, we employed a unified framework integrating statistical microarray analysis, signal normalization, and translational bioinformatics functional analysis techniques. This approach was applied to several microarray datasets from Gene Expression Omnibus (GEO) related to RIBE. The analysis produced lists of differentially expressed genes, contrasting bystander and irradiated samples versus sham-irradiated controls. Furthermore, comparative molecular analysis through BioInfoMiner, which integrates advanced statistical enrichment and prioritization methodologies, revealed discrete biological processes, at the cellular level. For example, the negative regulation of growth, cellular response to Zn2+-Cd2+, and Wnt and NIK/NF-kappaB signaling, thus refining the description of the phenotypic landscape of RIBE. Our results provide a more solid understanding of RIBE cell-specific response patterns, especially in the case of high-LET radiations, like α-particles and carbon-ions.

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Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps

Abstract

Background

Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series. The positive experience with both flaps raised the question of which flap should be the first option for the treatment of ischiatic and perineal pressure sores.

Methods

IGAP and GT flaps were dissected in 21 fresh human cadavers to allow comparison of anatomical features. In a series of 60 patients, the authors used both the gluteal thigh and the IGAP flap to cover 76 ischiatic and perineal ulcers.

Results

The IGAP flap was found to be wider and thicker than the gluteal thigh, but presented a shorter pedicle. All flaps healed uneventfully. Recurrent ulcers were treated successfully with both flaps.

Conclusions

Both flaps are suitable for coverage ischiatic and perineal sores. Due to its anatomical features, the IGAP flap should be considered the first choice of treatment for ischiatic ulcers. The gluteal thigh flap should be used in the recurrent sores.

Level of Evidence: Level IV, therapeutic study.

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Restoration of motor control and proprioceptive and cutaneous sensation in humans with prior upper-limb amputation via multiple Utah Slanted Electrode Arrays (USEAs) implanted in residual peripheral arm nerves

Despite advances in sophisticated robotic hands, intuitive control of and sensory feedback from these prostheses has been limited to only 3-degrees-of-freedom (DOF) with 2 sensory percepts in closed-loop contr...

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Reconstruction of acquired ischiatic and perineal defects: an anatomical and clinical comparison between gluteal thigh and inferior gluteal perforator flaps

Abstract

Background

Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series. The positive experience with both flaps raised the question of which flap should be the first option for the treatment of ischiatic and perineal pressure sores.

Methods

IGAP and GT flaps were dissected in 21 fresh human cadavers to allow comparison of anatomical features. In a series of 60 patients, the authors used both the gluteal thigh and the IGAP flap to cover 76 ischiatic and perineal ulcers.

Results

The IGAP flap was found to be wider and thicker than the gluteal thigh, but presented a shorter pedicle. All flaps healed uneventfully. Recurrent ulcers were treated successfully with both flaps.

Conclusions

Both flaps are suitable for coverage ischiatic and perineal sores. Due to its anatomical features, the IGAP flap should be considered the first choice of treatment for ischiatic ulcers. The gluteal thigh flap should be used in the recurrent sores.

Level of Evidence: Level IV, therapeutic study.

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Ocular torsion responses to sinusoidal electrical vestibular stimulation

Publication date: 15 January 2018
Source:Journal of Neuroscience Methods, Volume 294
Author(s): Stuart W. Mackenzie, Raymond F. Reynolds
BackgroundEye movements evoked by electrical vestibular stimulation (EVS) offer potential for diagnosing vestibular dysfunction. However, ocular recording techniques are often too invasive or impractical for routine clinical use. Furthermore, the kinematic nature of the EVS signal is not fully understood in terms of movement sensations.New methodWe apply sinusoidal EVS stimuli varying from 0.05 to 20Hz, and record the eye in darkness using an infrared camera. Eye movement was measured offline using commercially available software to track iris striations. Response gain and phase were calculated separately for eye position, velocity and acceleration across all frequencies, to determine how the brain interprets the EVS signal.ResultsOcular torsion responses were observed at the same frequency as the stimulus, for all frequencies, while lateral/vertical responses were minimal or absent. Response gain and phase resembled previously reported responses to natural rotation, but only when analysing eye velocity, not position or acceleration.Comparison with existing method(s)Our method offers a simple, affordable, reliable and non-invasive method for tracking the ocular response to EVS. It is more convenient than scleral coil recordings, or marking the sclera to aid video tracking. It also allows us to assess the torsional VOR at frequencies not possible with natural stimuli.ConclusionsOcular torsion responses to EVS can be readily assessed using sinusoidal stimuli combined with an infrared camera. Gain and phase analysis suggests that the central nervous system interprets the stimulus as head roll velocity. Future work will assess the diagnostic potential for patients with vestibular disorders.



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