Αρχειοθήκη ιστολογίου

Τετάρτη 16 Φεβρουαρίου 2022

Systematic construction and external validation of an immune‐related prognostic model for nasopharyngeal carcinoma

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Abstract

Background

We attempted to identify the most reliable immune-related index for predicting nasopharyngeal carcinoma (NPC) prognosis and to reveal its precise and integrated relationship with NPC progression.

Method

One thousand seven hundred and six patients with newly diagnosed NPC (1320 from the primary cohort and 386 from the validated cohort) from January 2010 to March 2014 were enrolled. Clinical features and 12 immune-related variables were analyzed.

Results

A high absolute lymphocyte count (ALC; >3.2 × 109/L) correlated with a poor prognosis of patients with NPC. Significant OS differences were discovered between patients with high ALC and no ALC elevation (p < 0.05, in primary cohort), showing similar prognostic risk to patients with advanced NPC (p > 0.05, in validated cohort). ALC improved the predictive performance of the basic tumor-node-metastasis prognostic model (p = 0.025), which was reliably validated in the external independent cohort.

Conclusion

High ALC is a surrogate marker for improved prognostic risk stratification in NPC.

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Immediate or interval abscess tonsillectomy? A systematic review and meta-analysis

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Eur Arch Otorhinolaryngol. 2022 Feb 15. doi: 10.1007/s00405-022-07294-x. Online ahead of print.

ABSTRACT

OBJECTIVES: Peritonsillar abscess is a common complication of acute tonsillitis. However, no consensus has been reached yet on the optimal treatment of this condition. Therefore, this study aimed to compare clinical outcomes of immediate and interval abscess tonsillectomy.

METHODS: The databases of PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for completed studies published until the 1st of November 2021. Comparative studies assessing intraoperative and postoperative outcomes of immediate and interval abscess tonsillectomy were considered, with the primary outcome being postoperative hemorrhage. Operative time, intraoperative blood loss, postoperative pain, and duration of hospital stay were classed as secondary outcomes. A random-effects pairwise meta-analysis of both randomized a nd non-randomized trials was conducted. Subgroup analysis linked to the randomization of trials was executed. Quality assessment was performed, utilizing the Cochrane risk of bias tool and ROBINS-I tool for randomized and non-randomized trials, respectively.

RESULTS: Data from 265 cases stemming from six trials were pooled together. For postoperative bleeding rates, no statistically significant difference between immediate and interval tonsillectomy was detected (OR = 1.26; 95% CI 0.27, 5.86; p = 0.77). By contrast, longer hospital stay was observed for patients subjected to interval tonsillectomy (SMD = - 0.78; CI - 1.39 to- 0.17; p = 0.01). For operative time and intraoperative blood loss, no statistically significant difference was noticed between immediate and interval tonsillectomy (SMD = 1.10; 95% CI - 0.13, 2.33; p = 0.08; and SMD = 0.04; 95% CI - 0.49, 0.57; p = 0.88; respectively).

CONCLUSIONS: This study shows that quinsy tonsillectomy appears to be a safe meth od, providing full abscess drainage and instant relief of the symptoms. Moreover, quinsy tonsillectomy was not associated with a statistically higher postoperative hemorrhage incidence rate than immediate tonsillectomy.

PMID:35169892 | DOI:10.1007/s00405-022-07294-x

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Extension of HPV vaccination to boys

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Bull Cancer. 2022 Feb 12:S0007-4551(22)00036-4. doi: 10.1016/j.bulcan.2022.01.005. Online ahead of print.

ABSTRACT

INTRODUCTION: As part of an analysis on the extension of the HPV vaccination to French boys, the French National Cancer Institute (INCa) and the French National Authority for Health (HAS) have conducted in collaboration a survey on HPV vaccine acceptance in July 2019. This survey was completed by parents of children aged 11-19 and general practitioners (GPs). Questions focused on their representations, practices and intentions in the context of the future policy change allowing boys to get vaccinated against HPV.

METHODS: The survey was conducted between June 20 and July 12, 2019. It focused on two populations: a nationally representative sample of parents with at least one girl aged 11-19 and/or one boy aged 11-14 (n=1984) and a representative sample of GPs in mainland France. Data were collected through a web-based questionnaire with a mean completion time of 10minutes for parents and GPs. The quota method was applied to ensure the representative nature of the samples based on (i) gender, age, children (girl aged 11-14 and/or boy aged 11-14) of the household, socio-professional category of the "head of the household", size of urban area and region for the parents' sample and based on (ii) gender, age, region and type of practice for the GPs' sample.

RESULTS: Although most GPs were very favourable towards HPV vaccination (94%), they considered it one of the most challenging vaccinations to get parents to adhere to (82%). A notable percentage of parents have unfavourable opinions towards HPV vaccination (25%). The three main barriers cited by parents of non-vaccinated girls were: the fear of adverse effects, the lack of information, and the fact that the GP did not propose it. Regarding the extension of HPV vaccination to boys, 84 % of GPs would recommend this vaccination to boys if it wa s included in the vaccination schedule, and 88 % of those who did not routinely recommend HPV vaccination to girls would be more likely to offer it to girls if the extension was recommended.

PMID:35168764 | DOI:10.1016/j.bulcan.2022.01.005

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Vax1 rs7078160 polymorphisms and non-syndromic cleft lip

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Braz J Otorhinolaryngol. 2022 Jan 29:S1808-8694(22)00003-9. doi: 10.1016/j.bjorl.2022.01.002. Online ahead of print.

NO ABSTRACT

PMID:35168926 | DOI:10.1016/j.bjorl.2022.01.002

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Early death in supraglottic laryngeal squamous cell carcinoma: A population-based study

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Ear Nose Throat J. 2022 Feb 16:1455613221078184. doi: 10.1177/01455613221078184. Online ahead of print.

ABSTRACT

BACKGROUND: Supraglottic laryngeal squamous cell carcinoma (LSCC) is the second most common type of laryngeal cancer with a poor prognosis. Current population-based estimates of the early death rate and associated factors for early death of supraglottic LSCC are lacking. The purpose of this study was to assess the early death rate and related factors for early dea th in patients with supraglottic LSCC.

METHODS: We identified 3733 adult patients diagnosed with supraglottic LSCC between 2010 and 2017 for whom the vital status at 3 months was known from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were staged according to the seventh edition of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system. The early death (survival time ≤ 3 months) rate was calculated. Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with the early death rate.

RESULTS: 313 (8.38%) of the 3733 patients died within 3 months of diagnosis of supraglottic LSCC. Of these, 225 patients died from cancer-specific causes. Multivariate logistic regression analyses confirmed that advanced age, male sex, advanced T stage, advanced N stage, advanced M stage, and not undergoing treatment (surgery, radiotherapy, and chemotherapy) had significant c orrelations with all-cause early death in supraglottic LSCC. In addition, advanced age, advanced T stage, advanced N stage, advanced M stage, and not undergoing treatment (surgery, radiotherapy, and chemotherapy) were significantly correlated with cancer specificity in supraglottic LSCC.

CONCLUSION: When a tumor is newly diagnosed, we should pay close attention to sex, age, unmarried status and AJCC TNM staging to quickly detect supraglottic LSCC patients with a tendency toward early death. These findings have implications for precise prognosis prediction and individualized and personalized patient counseling and therapy.

PMID:35171058 | DOI:10.1177/01455613221078184

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Bilateral Pulsatile Tinnitus Caused by Bilateral Dilated Mastoid Emissary Vein

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Ear Nose Throat J. 2022 Feb 16:1455613221077597. doi: 10.1177/01455613221077597. Online ahead of print.

ABSTRACT

Pulsatile tinnitus is a rhythmic type of tinnitus. Most cases are caused by vascular disorders and present as synchronous with the patient's heartbeat. A dilated mastoid emissary vein may cause pulsatile tinnitus. Here, we report the first case of bilateral pulsatile tinnitus caused by dilated bilateral mastoid emissary vein. The patient suffered from bilateral pu lsatile tinnitus for 2 years. His bilateral tinnitus disappeared temporarily when the bilateral mastoid processes were compressed. Temporal bone computed tomographic (CT) showed the bilateral dilated mastoid emissary canals. Cranial Magnetic resonance venograms (MRV) showed the bilateral dilated mastoid emissary veins. We explained the risk of surgery to the patient. Because the patient could tolerate his tinnitus and did not have a hemangioma or tumor, he did not choose to undergo surgery.

PMID:35171065 | DOI:10.1177/01455613221077597

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