OtoRhinoLaryngology News

Παρασκευή 25 Αυγούστου 2017

Local gene therapy durably restores vestibular function in a mouse model of Usher syndrome type 1G.

Local gene therapy durably restores vestibular function in a mouse model of Usher syndrome type 1G.

Proc Natl Acad Sci U S A. 2017 Aug 23;:

Authors: Emptoz A, Michel V, Lelli A, Akil O, Boutet de Monvel J, Lahlou G, Meyer A, Dupont T, Nouaille S, Ey E, Franca de Barros F, Beraneck M, Dulon D, Hardelin JP, Lustig L, Avan P, Petit C, Safieddine S

Abstract
Our understanding of the mechanisms underlying inherited forms of inner ear deficits has considerably improved during the past 20 y, but we are still far from curative treatments. We investigated gene replacement as a strategy for restoring inner ear functions in a mouse model of Usher syndrome type 1G, characterized by congenital profound deafness and balance disorders. These mice lack the scaffold protein sans, which is involved both in the morphogenesis of the stereociliary bundle, the sensory antenna of inner ear hair cells, and in the mechanoelectrical transduction process. We show that a single delivery of the sans cDNA by the adenoassociated virus 8 to the inner ear of newborn mutant mice reestablishes the expression and targeting of the protein to the tips of stereocilia. The therapeutic gene restores the architecture and mechanosensitivity of stereociliary bundles, improves hearing thresholds, and durably rescues these mice from the balance defects. Our results open up new perspectives for efficient gene therapy of cochlear and vestibular disorders by showing that even severe dysmorphogenesis of stereociliary bundles can be corrected.

PMID: 28835534 [PubMed - as supplied by publisher]

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Relational quality, illness interference, and partner support in Ménière's disease.

Relational quality, illness interference, and partner support in Ménière's disease.

Int J Audiol. 2017 Aug 24;:1-7

Authors: Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E

Abstract
OBJECTIVE: The current study aimed to better understand how patients and their significant others (SOs) cope with Menière's disease (MD).
DESIGN: The study used a cross-sectional design and the data were collected using questionnaires.
STUDY SAMPLE: Seventy-five dyads in which one person had MD.
RESULTS: SOs of patients with MD not only experienced activity and participation restrictions but also had positive experiences. In relational quality, the SOs reported uncertainty of their future, limited visits in noisy places, limited activities as walking, watching TV, and participating in social life. The illness interference correlated with the patients' complaints, and most significant was the problem of imbalance. The quality of life was significantly reduced in patients with MD, and the illness interference in terms of quality of life was correlated with the SOs in items related to mood and anxiety. The stress related conditions of the SOs were correlated with two positive items (e.g. alleviating the stress factor). The SOs could also identify one positive item (i.e., improved relationship).
CONCLUSIONS: Perceptions of MD as interfering in couples' lives influence dyadic coping in unique ways. The current study identified that dyadic coping has both positive aspects and limitations as a consequence of their partner's MD.

PMID: 28835146 [PubMed - as supplied by publisher]

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Evaluation of two methods for topical application of contrast medium to the pharyngeal and laryngeal region of horses.

Evaluation of two methods for topical application of contrast medium to the pharyngeal and laryngeal region of horses.

Am J Vet Res. 2017 Sep;78(9):1098-1103

Authors: Colbath AC, Valdés-Martínez A, Leise BS, Hackett ES

Abstract
OBJECTIVE To determine the pharyngeal and laryngeal distribution of radiopaque contrast medium administered orally or via nasopharyngeal catheter to standing horses. ANIMALS 5 healthy adult horses. PROCEDURES A crossover study was conducted. Radiopaque contrast medium (12 mL) was administered orally and via nasopharyngeal catheter to each horse. Pharyngeal and laryngeal distribution of contrast medium was determined by examination of radiographs obtained immediately after administration of contrast medium, compared with those obtained before administration. Regional distribution of contrast medium was graded. Endoscopic examination of the nasopharynx, laryngopharynx, and larynx was performed to confirm radiographic results. RESULTS Examination of radiographs obtained after nasopharyngeal administration revealed contrast medium in the nasopharynx (n = 5), oropharynx (2), laryngopharynx (3), and larynx (5) of the 5 horses. Examination of radiographs obtained after oral administration revealed contrast medium in the oropharynx (n = 4) and larynx (1) of the 5 horses. Endoscopic examination confirmed radiographic findings and was found to be sensitive for detection of contrast medium in the laryngopharynx, whereby detection rates were higher for both administration methods. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that medication administered by use of a nasopharyngeal catheter will result in topical distribution within the nasopharynx, including the dorsal surface of the soft palate, and larynx, although distribution should be evaluated in horses with clinical airway disease to confirm these findings. Oral administration did not result in consistently detectable topical laryngeal distribution but could be used for selected conditions (eg, palatitis).

PMID: 28836843 [PubMed - in process]

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[Management of T3 supraglottic carcinoma: a retrospective study].

[Management of T3 supraglottic carcinoma: a retrospective study].

Zhonghua Zhong Liu Za Zhi. 2017 Aug 23;39(8):613-617

Authors: Liu WS, Li ZJ, Zhang GF, Xu ZG, Tang PZ, Tu GY

Abstract
Objective: To discuss the strategy of therapeutic management of T3 supraglottic carcinoma. Methods: A retrospective analysis of 459 patients with T3 supraglottic carcinoma treated in our hospital was performed. We evaluated the results of different managements, including surgery alone, preoperative radiotherapy, postoperative radiotherapy and radiotherapy alone. The extent of the lesion was also put into analysis. Statistical analysis of the overall survival (OS), cause-specific survival (CSS), local control (LC), regional control(RC), function-conservation (FC) were performed with the statistical package from SPSS. Results: In all patients, the rates of 5-year OS, CSS, LC, RC and FC were 64.2%, 71.2%, 87.8%, 78.8% and 64.5% respectively. The OS, LC and FC of the patients treated by surgery alone, preoperative radiotherapy and postoperative radiotherapy had no significant difference, and were remarkably better than that of patients treated by radiotherapy alone (P<0.001). In 412 patients treated by surgery, 300 patients received function-conservation laryngectomy. 209 patients (50.7%, 209/412) survived and maintained well-function of larynx for 5 years, which was significantly better than those in the radiotherapy alone group (27.7%, 13/47). The patients with the lesion invading the pre-epiglottic space but limited in supraglottic area had better OS (70.2%), LC (93.5%) and FC (85.1%). The rate of 5-year neck lymphatic metastasis was 56.2%(258/459), and the 5-year OS of patients with N0, N1, N2 and N3 stage were 76.0%, 66.2%, 50.5% and 13.0% respectively. Conclusions: Surgical treatment was the best therapeutic approach for T3 supraglottic laryngeal carcinoma. Most patients with T3 lesions are suitable for function-conservation laryngectomy. Surgical procedure was determined by tumor invaded location and extension. The combined therapy of surgery and radiotherapy had no significant advantage.

PMID: 28835085 [PubMed - in process]

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Local gene therapy durably restores vestibular function in a mouse model of Usher syndrome type 1G.

Local gene therapy durably restores vestibular function in a mouse model of Usher syndrome type 1G.

Proc Natl Acad Sci U S A. 2017 Aug 23;:

PMID: 28835534 [PubMed - as supplied by publisher]

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Relational quality, illness interference, and partner support in Ménière's disease.

Relational quality, illness interference, and partner support in Ménière's disease.

Int J Audiol. 2017 Aug 24;:1-7

Authors: Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E

PMID: 28835146 [PubMed - as supplied by publisher]

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Correction to: Thyroid 2017;27:315-389. DOI: 10.1089/thy.2016.0457.

Correction to: Thyroid 2017;27:315-389. DOI: 10.1089/thy.2016.0457.

Thyroid. 2017 Aug 24;:

Authors:

PMID: 28836913 [PubMed - as supplied by publisher]

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Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia.

Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia.

Otolaryngol Head Neck Surg. 2017 Jul;157(1):80-84

Authors: Sanuki T, Yumoto E

Abstract
Objectives Standard treatments of adductor spasmodic dysphonia (AdSD) provide temporary relief of symptoms. Type 2 thyroplasty offers a long-term solution; however, long-term voice outcome data are lacking. The objective of this study was to assess the long-term voice outcomes of type 2 thyroplasty with titanium bridges through use of a validated voice questionnaire. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Forty-seven consecutively enrolled patients with AdSD underwent type 2 thyroplasty with titanium bridges between August 2006 and November 2014. Questionnaires were completed during regularly scheduled follow-ups and, in some cases, were sent to patients who missed follow-up appointments. In 2015, questionnaires were mailed to all 47 patients and included a Voice Handicap Index-10 evaluation, as well as questions on postoperative vocal symptoms, surgical site, and status of the implanted titanium bridges. Results Of 47 patients with AdSD, 31 (66%) completed the questionnaires. The average follow-up interval was 41.3 months. No patient reported experiencing an adverse event around the surgical site, and almost all were satisfied with their voices postoperatively. The mean postoperative (>3 years) Voice Handicap Index-10 score improved significantly, from 26.3 to 9.4 (n = 17, P = .0009). Conclusions Type 2 thyroplasty for AdSD significantly improved patient quality of life and voice symptoms and continued to do so long after the surgery. The results of this study suggest that type 2 thyroplasty provides relief from vocal symptoms in patients with AdSD for >3 years.

PMID: 28463639 [PubMed - indexed for MEDLINE]

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Head and neck lymphatic malformation and treatment: Clinical study of 23 cases.

http:--linkinghub.elsevier.com-ihub-imag

Head and neck lymphatic malformation and treatment: Clinical study of 23 cases.

Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Dec;133(6):393-396

Authors: Lerat J, Mounayer C, Scomparin A, Orsel S, Bessede JP, Aubry K

Abstract
OBJECTIVES: Head and neck lymphatic malformation is a rare benign tumor, mainly affecting children under 1 year of age. Total resection is often difficult, and recurrence is frequent. Functional and esthetic sequelae are a major issue.
MATERIALS AND METHODS: A single-center retrospective study recruited patients with head and neck lymphatic malformation managed surgically, with or without associated sclerosis by alcohol, bleomycin or aetoxisclerol, between January 1, 2004 and December 31, 2013. Local control, recurrence and complications rates were analyzed, as were swallowing disorder, tracheostomy and impaired phonation.
RESULTS: Twenty-three patients, with a mean age of 15.80 years, were included. Location was suprahyoid in 17 cases (73.91%) and infrahyoid in 6 (26.09%). There were 11 macrocysts (47.82%), 2 microcysts (8.70%) and 10 mixed lesions (43.48%). Three patients showed spontaneous resolution; 12 patients (52.17%) underwent a single surgical procedure, 2 (8.7%) multiple procedures, 2 (8.7%) 1 surgical procedure and 1 sclerosis, 2 (8.7%) 1 surgical procedure and multiple scleroses, and 2 (8.7%) multiple procedures and multiple scleroses. The local control rate was 69.56%. There were 8 recurrences (34.78%), all in suprahyoid microcystic or mixed lesions. There were 2 complications (8.7%): 1 severe upper cervical edema following sclerosis of the floor of the mouth, and 1 postsurgical palsy of the marginal mandibular branch of the facial nerve. In 1 case (4.35%), a nasogastric tube was required for 6 days, without tracheostomy.
CONCLUSION: Recurrence was frequent, with non-negligible functional and esthetic impact, especially in case of suprahyoid and microcystic lesion.

PMID: 27497629 [PubMed - indexed for MEDLINE]

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Response to “GHB concentration in breast milk of narcoleptic women treated with sodium oxybate. How important it is to be careful when interpreting values.” (Letter to the Editor by Busardò PB and Pichini S)

Publication date: Available online 24 August 2017
Source:Sleep Medicine
Author(s): E.C. Barker, M.P. Puchowicz, J.J. Letterio, K.M. Sharkey

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Idiopathic Rem Sleep Behavior Disorder In The Elderly Spanish Community: A Primary Care Center Study With A Two-Stage Design Using Video-Polysomnography

Publication date: Available online 24 August 2017
Source:Sleep Medicine
Author(s): Montserrat Pujol, Jesús Pujol, Tomás Alonso, Araceli Fuentes, Mercè Pallerola, Jovita Freixenet, Ferran Barbé, Manel Salamero, Joan Santamaría, Alex Iranzo
ObjectiveTo examine the presence and characteristics of idiopathic REM sleep behavior disorder (IRBD) in a representative Caucasian sample from the elderly community of Lleida, Spain, attending primary care centers.MethodsParticipants were individuals aged 60 years or older who underwent routine visits in two primary care centers. They underwent a two-stage study; a validated screening single question for IRBD diagnosis (RBD1Q) followed by, in those who endorsed positive answer, clinical assessment by a neurologist plus video-polysomnography (V-PSG).ResultsOf 539 individuals (56.4% women, mean age 72.86 ± 8.20 years), 28 (5.2%) endorsed positively the RBD1Q. Four of these 28 refused further assessments. Four of the 24 remaining subjects underwent clinical assessment but refused V-PSG. Of the 20 who underwent clinical assessment plus V-PSG, REM sleep was not recorded in four (20%, all four taking antidepressants). V-PSG ruled out RBD in 12 subjects who had obstructive sleep apnea (n=9), periodic limb movement disorder in sleep (n=2) and normal sleep (n=1). IRBD was diagnosed in four individuals giving an estimated prevalence of 0.74%(95% CI= 0.29-1.89). They were three men and one woman between 74 and 82 years of age who never reported dream-enacting behaviors to their doctors because they thought they represented a normal phenomenon despite suffering sleep-related injuries. These patients had history of violent sleep behaviors with an interval between estimated RBD onset and V-PSG of 4.5 ± 4.2 years.ConclusionsIRBD is not uncommon in the elderly community and its demographic and clinical profile is similar to those diagnosed in sleep centers.

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Functional outcomes and quality of life after total laryngectomy with noncircumferential radial forearm free tissue transfer.

Functional outcomes and quality of life after total laryngectomy with noncircumferential radial forearm free tissue transfer.

Head Neck. 2017 Aug 24;:

Authors: Graville DJ, Palmer AD, Chambers CM, Ottenstein L, Whalen B, Andersen PE, Wax MK, Cohen JI

Abstract
BACKGROUND: The purpose of this study was to compare long-term functional and quality of life (QOL) outcomes after total laryngectomy with primary closure and those who underwent reconstruction with noncircumferential radial free forearm tissue transfer (RFFTT).
METHODS: Sixty-seven patients were identified by chart review and underwent long-term follow-up using QOL surveys and standardized interviews.
RESULTS: The RFFTT group had significantly higher rates of chemotherapy, gastric tube (G-tube) at surgery, and postoperative stricture. At follow-up, most patients (88%) had a tracheoesophageal prosthesis (TEP) and were using it as their primary communication method. Diet and swallowing outcomes were comparable and no one had a G-tube. Device life and TEP complications did not differ significantly. Only voice-related QOL differed significantly between the RFFTT group and those who had undergone total laryngectomy without adjuvant treatment.
CONCLUSION: Despite more extensive treatment, the reconstructed group achieved comparable outcomes to those who had undergone total laryngectomy with adjuvant treatment.

PMID: 28837753 [PubMed - as supplied by publisher]

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Endoscopic electrocauterization of pyriform sinus fistula.

Endoscopic electrocauterization of pyriform sinus fistula.

Eur Arch Otorhinolaryngol. 2017 Aug 23;:

Authors: Ishinaga H, Kobayashi M, Qtsu K, Nishida K, Sakaida H, Kitano M, Nakamura S, Chiyonobu K, Takeuchi K

Abstract
To determine the efficacy of endoscopic electrocauterization for pyriform sinus fistula (PSF) using a flexible Bugbee cautery electrode. From 2009 to 2016, a total of eight patients with acute suppurative thyroiditis or cervical abscess secondary to PSF were retrospectively registered in our study (three males, five females; median age 6.5 years). All patients underwent endoscopic electrocauterization as treatment for PSF. Six of eight patients had no recurrence after the initial endoscopic electrocauterization of PSF. One patient with recurrence developed symptoms 9 days after cauterization and another experienced recurrence after 2 years. Mean follow-up for the eight patients was 50 months (range 5-96 months). No post-operative complication was reported. Endoscopic electrocauterization appears to be a less-invasive, safe, and effective method for the treatment of PSF.

PMID: 28836049 [PubMed - as supplied by publisher]

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Basaloid adenocarcinoma of the lacrimal sac: A rare entity and approach to management.

Basaloid adenocarcinoma of the lacrimal sac: A rare entity and approach to management.

Orbit. 2017 Aug 24;:1-4

Authors: Huggins AB, Stefanyszyn MA, Nyquist G, Rabinowitz MP

Abstract
Presented is a rare case of basaloid adenocarcinoma of the lacrimal sac. Low grade features of this malignancy permitted a conservative surgical approach to maximize functional and cosmetic outcomes. This is retrospective case description of a single 77-year-old-female patient who underwent a dacryocystorhinostomy with silicone tubes at an outside hospital for epiphora, but was referred to the Wills Eye Hospital Oculoplastics Department for a lacrimal sac biopsy showing low-grade carcinoma with basaloid features. She was treated with complete excision of the mass, common canaliculus and distal canaliculi, and the nasolacrimal duct. The associated maxillary, lacrimal, and ethmoidal bones were similarly excised. Frozen sections were sent of the surrounding periosteum, orbital fat, nasal and sinus mucosa, and soft tissues, and all were negative. Reconstruction of the lacrimal system was performed with silicone tube intubation and the defect was closed with large glabellar and mid-facial flaps. One year post-operatively she maintained a normal ocular examination, and her eyelids and silicone tubes were well positioned. Systemic evaluation remained unrevealing. Basaloid adenocarcinoma of the lacrimal sac is relatively rare, and we highlight the role of a more conservative surgical intervention given the high rates of survival and low incidence of progression to metastatic disease when treating this rare malignancy.

PMID: 28837389 [PubMed - as supplied by publisher]

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Core Outcome Domains for early phase clinical trials of sound-, psychology-, and pharmacology-based interventions to manage chronic subjective tinnitus in adults: the COMIT'ID study protocol for using a Delphi process and face-to-face meetings to establish consensus.

Core Outcome Domains for early phase clinical trials of sound-, psychology-, and pharmacology-based interventions to manage chronic subjective tinnitus in adults: the COMIT'ID study protocol for using a Delphi process and face-to-face meetings to establish consensus.

Trials. 2017 Aug 23;18(1):388

Authors: Fackrell K, Smith H, Colley V, Thacker B, Horobin A, Haider HF, Londero A, Mazurek B, Hall DA

Abstract
BACKGROUND: The reporting of outcomes in clinical trials of subjective tinnitus indicates that many different tinnitus-related complaints are of interest to investigators, from perceptual attributes of the sound (e.g. loudness) to psychosocial impacts (e.g. quality of life). Even when considering one type of intervention strategy for subjective tinnitus, there is no agreement about what is critically important for deciding whether a treatment is effective. The main purpose of this observational study is, therefore to, develop Core Outcome Domain Sets for the three different intervention strategies (sound, psychological, and pharmacological) for adults with chronic subjective tinnitus that should be measured and reported in every clinical trial of these interventions. Secondary objectives are to identify the strengths and limitations of our study design for recruiting and reducing attrition of participants, and to explore uptake of the core outcomes.
METHODS: The 'Core Outcome Measures in Tinnitus: International Delphi' (COMIT'ID) study will use a mixed-methods approach that incorporates input from health care users at the pre-Delphi stage, a modified three-round Delphi survey and final consensus meetings (one for each intervention). The meetings will generate recommendations by stakeholder representatives on agreed Core Outcome Domain Sets specific to each intervention. A subsequent step will establish a common cross-cutting Core Outcome Domain Set by identifying the common outcome domains included in all three intervention-specific Core Outcome Domain Sets. To address the secondary objectives, we will gather feedback from participants about their experience of taking part in the Delphi process. We aspire to conduct an observational cohort study to evaluate uptake of the core outcomes in published studies at 7 years following Core Outcome Set publication.
DISCUSSION: The COMIT'ID study aims to develop a Core Outcome Domain Set that is agreed as critically important for deciding whether a treatment for subjective tinnitus is effective. Such a recommendation would help to standardise future clinical trials worldwide and so we will determine if participation increases use of the Core Outcome Set in the long term.
TRIAL REGISTRATION: This project has been registered (November 2014) in the database of the Core Outcome Measures in Effectiveness Trials (COMET) initiative.

PMID: 28835261 [PubMed - in process]

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Can grip strength and/or walking speed be simple indicators of the deterioration in tongue pressure and jaw opening force in older individuals?

Can grip strength and/or walking speed be simple indicators of the deterioration in tongue pressure and jaw opening force in older individuals?

Gerodontology. 2017 Aug 23;:

Authors: Wakasugi Y, Tohara H, Machida N, Nakane A, Minakuchi S

Abstract
OBJECTIVES: Swallowing-related muscle strength decreases due to sarcopenia, and older people are at risk for sarcopenia and the resultant dysphagia. However, no studies have assessed the direct relationships between whole-body strength and swallowing-related muscles. Therefore, this study investigates the relationships between decreased whole-body strength, which is easily evaluated, and swallowing-related muscle strength.
MATERIALS AND METHODS: A total of 197 elderly individuals (97 men aged 78.5 ± 6.6 years and 100 women aged 77.8 ± 6.2 years) were enrolled. Grip strength, walking speed, tongue pressure and jaw opening force were measured, and the effects of age and the relationships between whole-body strength and swallowing-related muscle strength were investigated.
RESULTS: With respect to age-related changes, tongue pressure, jaw opening force, grip strength and walking speed decreased with age in men and women. The relationships between whole-body strength and swallowing-related muscle strength were analysed, with age used as the control variable. Among men, tongue pressure was correlated with grip strength and walking speed, whereas jaw opening force was correlated with grip strength. Among women, neither tongue pressure nor jaw opening force was correlated with grip strength or walking speed.
CONCLUSIONS: There was a sex-based difference in the correlations between whole-body strength and swallowing-related muscle strength. Among men, swallowing-related muscle strength was correlated with whole-body strength, and grip strength could thus serve as a simple indicator for swallowing-related muscle strength.
CLINICAL RELEVANCE: Decreased swallowing-related muscle strength can be inferred in cases involving male patients for whom decreased grip strength is measured during physical examination or is otherwise suggested (eg, by an inability to open plastic bottles).

PMID: 28836306 [PubMed - as supplied by publisher]

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Tolerable delay for speech production and perception: effects of hearing ability and experience with hearing aids

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Can grip strength and/or walking speed be simple indicators of the deterioration in tongue pressure and jaw opening force in older individuals?

Can grip strength and/or walking speed be simple indicators of the deterioration in tongue pressure and jaw opening force in older individuals?

Gerodontology. 2017 Aug 23;:

Authors: Wakasugi Y, Tohara H, Machida N, Nakane A, Minakuchi S

PMID: 28836306 [PubMed - as supplied by publisher]

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Mechanisms and risk factors of thrombosis in cancer

Publication date: Available online 25 August 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Anna Falanga, Laura Russo, Viola Milesi, Alfonso Vignoli
The close relationship between cancer and thrombosis is known since more than a century. Venous thromboembolism (VTE) may be the first manifestation of an occult malignancy in an otherwise healthy individual. Cancer patients commonly present with abnormalities of laboratory coagulation tests, indicating an ongoing subclinical hypercoagulable condition. The results of laboratory tests demonstrate that a process of fibrin formation and removal parallels the development of malignancy, which is of particular interest since fibrin and other clotting products are important for both thrombogenesis and tumor progression. Besides general clinical risk factors (i.e. age, previous VTE, immobility, etc), other factors typical of cancer can increase the thrombotic risk in these patients, including the type of cancer, advanced disease stage, and cancer therapies. In addition, biological factors, including tumor cell-specific prothrombotic properties and the host cell inflammatory response to the tumor, play a central role in the pathogenesis of cancer-associated thrombosis. Cancer cells produce and release procoagulant and fibrinolytic proteins, as well as inflammatory cytokines. In addition, they are capable of directly adhering to host cells (i.e. endothelial cells, monocytes, platelets, and neutrophils), thereby stimulating additional prothrombotic properties of the host effector cells. Tumor-shed procoagulant microparticles also contribute to the patient hypercoagulable state. Finally, the changes of stromal cells of the tumor 'niche' induced by tissue factor (TF) highlight new interactions between hemostasis and cancer. Of interest, most of these mechanisms, besides activating the hemostatic system, also promote tumor growth and metastasis, and are regulated by oncogenic events. Indeed, molecular studies demonstrate that oncogenes responsible for the cellular neoplastic transformation drive the programs of hemostatic protein expression and microparticle liberation by cancer tissues. Human and animal experimental models demonstrate that activation of cancer-associated prothrombotic mechanisms parallels the development of overt thrombotic syndromes in vivo.

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Cancer-related Fatigue in Adolescents and Young Adults: A Systematic Review of the Literature

Publication date: Available online 24 August 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): E. Nowe, Y. Stöbel-Richter, A. Sender, K. Leuteritz, M. Friedrich, K. Geue
Adolescents and young adults with cancer (AYA) represent a specific age cohort dealing with the disease in a stage of life characterized by development, upheavals, and establishment. The aim of this study was to point out the state of research on how AYA are affected by cancer-related fatigue (CRF).ResultsTwelve articles were included. CRF was found to be higher in AYA than in either of the comparison groups, healthy peers and older cancer patients. Most included studies did not measure CRF with multidimensional, fatigue-specific instruments.ConclusionWe found a gap in research concerning CRF in AYA. The existing findings suggest that CRF is a significant issue for AYA cancer patients. However, less is known about the prevalence, severity, and impact of CRF in AYA, and their treatment. This should be considered in future research, and risk and prevention factors should be ascertained. Multidimensional and fatigue-specific measuring tools should be used to do this.

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Book review.

Book review.

Int J Audiol. 2017 Aug 24;:1

Authors: Thunder T

PMID: 28835149 [PubMed - as supplied by publisher]

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Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Int J Audiol. 2017 Aug 24;:1-11

Authors: Mattsson TS, Follestad T, Andersson S, Lind O, Øygarden J, Nordgård S

Abstract
OBJECTIVE: The main purpose of this research was to obtain normative data for auditory processing tests for Norwegian speaking children.
DESIGN: Participants were administered routine audiological tests and an auditory processing test-battery consisting of Filtered Words, Competing Words, Dichotic Digits, Gaps In Noise, Duration- and Frequency Pattern, Binaural Masking Level Difference and HIST Speech in Noise test. A group of 10-year-old children were retested after two weeks. The effects ear, age and gender and the test-retest reliability were investigated.
STUDY SAMPLE: There were 268 normal hearing children aged 7-12 years who participated in the study.
RESULTS: Results revealed no differences between genders. The children showed improving performance by age on all tests, except from the Gaps In Noise and Binaural Masking Level Difference. As expected, the children showed a right ear advantage on dichotic speech tests that decreased with age. The test-retest reliability for the tests was good, with a small learning effect on the Filtered Words test.
CONCLUSION: Normative data were established and the preferred tests for diagnosing Auditory Processing Disorder were suggested for Norwegian children aged 7-12 years.

PMID: 28835140 [PubMed - as supplied by publisher]

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Book review.

Book review.

Int J Audiol. 2017 Aug 24;:1

Authors: Thunder T

PMID: 28835149 [PubMed - as supplied by publisher]

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Relational quality, illness interference, and partner support in Ménière's disease.

Relational quality, illness interference, and partner support in Ménière's disease.

Int J Audiol. 2017 Aug 24;:1-7

Authors: Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E

PMID: 28835146 [PubMed - as supplied by publisher]

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Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Int J Audiol. 2017 Aug 24;:1-11

Authors: Mattsson TS, Follestad T, Andersson S, Lind O, Øygarden J, Nordgård S

PMID: 28835140 [PubMed - as supplied by publisher]

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Hearing-related quality of life outcomes for Singaporean children using hearing aids or cochlear implants.

Hearing-related quality of life outcomes for Singaporean children using hearing aids or cochlear implants.

Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Jun;133 Suppl 1:S25-30

Authors: Looi V, Lee ZZ, Loo JH

Abstract
OBJECTIVES: The Children Using Hearing Devices Quality of Life Questionnaire (CuHDQOL) is a new parent-administered hearing-specific questionnaire for children fitted with hearing devices. The aim of this study was to assess outcomes for hearing-impaired children in Singapore using this measure, as well as to examine its applicability for use in a clinical setting.
MATERIALS AND METHODS: The CuHDQOL has 26 items, uses a recall period of 1 month, and is divided into three sections: parental perspectives and expectations (eight items), impact on the family (eight items) and hearing-related quality of life (QOL) of the child (10 items). Responses are made on a 5-point Likert scale, and transformed to a score from 0-100. Twenty-two parents of children with hearing aids and 14 parents of children with cochlear implants completed the CuHDQOL.
RESULTS: The mean total CuHDQOL scores was 62/100 for the children using hearing aids and 53/100 for children with cochlear implants. Scores for the children using hearing aids were higher across all subscales, with a linear regression showing this to be significant for the parental perspectives and expectations subscale (B=-10.58, P=0.041). Analyses of Variance showed that both the 'Parent Perspective and Expectations' and the 'Hearing-related QOL' subscales were significantly higher than the 'Impact on Family' subscale for both groups (P≤0.003).
CONCLUSIONS: The CuHDQOL was found to be a simple, efficient questionnaire that could easily be incorporated into clinical practice to provide a more holistic evaluation of a child's outcomes post intervention, and/or to monitor their progress over time.

PMID: 27267231 [PubMed - indexed for MEDLINE]

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Transalar transsphenoidal meningoencephalocele presenting in the form of recurrent meningitis: Report of two cases and discussion of the diagnosis and treatment.

Transalar transsphenoidal meningoencephalocele presenting in the form of recurrent meningitis: Report of two cases and discussion of the diagnosis and treatment.

Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Dec;133(6):423-427

Authors: Zoghlami A, Bon Mardion N, Callonnec F, Dehesdin D, Proust F, Marie JP

Abstract
INTRODUCTION: Skull base meningoencephaloceles are rare congenital malformations. The two cases of transalar transsphenoidal malformation reported here differ from the classical transsphenoidal meningoencephalocele.
CASE REPORTS: Case 1 was a three-and-a-half-year-old boy and case 2 was a 36-year-old man. Both cases presented with clinical features of recurrent meningitis. Surgical management of case 1 was performed via an intradural infratemporal fossa craniotomy with reoperation 2years later. In the second case, surgery was initially performed via an endonasal approach and then via pterional craniotomy. Reoperation via Sekhar's transpetrosal approach was also a failure. Only closure of the trigeminal-pontine angle via a suboccipital retrosigmoid approach allowed repair of the defect.
DISCUSSION: Surgical access to the pterygopalatine fossa is complex due to its anatomical position and its anatomical relations with nerves and vessels. An endoscopic approach appears to be a valuable alternative to classical craniotomy.
CONCLUSION: In the two cases reported here, neurosurgery allowed lasting closure of the defect.

PMID: 27431342 [PubMed - indexed for MEDLINE]

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Viruses in cancers among the immunosuppressed

Abstract

Most cancer forms known to be caused by viruses are increased among the immunosuppressed, but several cancer forms without established viral etiology are also increased, notably non-melanoma skin carcinoma (NMSC). We followed all 13429 solid organ transplantation patients in Sweden for cancer occurrence after transplantation. We requested these tumor specimens and sequenced the first 89 specimens received (62 NMSCs, 27 other cancers). The sequences were analyzed for viruses based on two bioinformatics algorithms (paracel-blast (sensitive for detection of known viruses) and hidden Markov model (HMM; sensitive for distantly related viruses)). Among the 62 NMSCs, the virus family detected in the largest proportion of specimens was Mimiviridae (9/62 NMSCs). The majority of the virus-related reads belonged to Papillomaviridae. The HMM analysis identified 86 additional previously not described viral contigs related to 11 virus families, with reads related to Mimiviridae being the most common (detected in 28/62 NMSCs) with the most prevalent contig (Mimivirus SE906, 1937 bp) detected in 17/62 NMSCs. Among the 27 other cancers, viral sequences were detected in only 5 specimens by blast analysis, compared to in all 27 specimens by HMM (Mimiviridae, Poxviridae, Phycodnaviridae and virus-related sequences yet unclassified to any family). 99% of the virus reads belonged to a single previously not described sequence (Mimivirus SE996, 911 bp). A multitude of viruses is readily detectable in specimens with cancers occurring among the immunosuppressed, with sequences related to Mimiviridae being the most prevalent. Further research would be needed to elucidate the biological significance of the viruses. This article is protected by copyright. All rights reserved.

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Laryngeal trauma with and without tracheal separation

Publication date: Available online 24 August 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): Charissa N. Kahue, Alexander Gelbard
External laryngotracheal trauma is a rare occurrence and requires specialized evaluation and management. Airway compromise from laryngotracheal injury can be catastrophic. The stability of an airway must be ensured with rapid and repeated clinical evaluation. Additionally, bedside and operative endoscopy combined with radiographic studies should guide treatment planning. Repair may include open reduction and internal fixation of laryngeal fractures, endolaryngeal mucosal repair (via either endoscopic or open approaches), endoluminal stenting or open repair of laryngotracheal separation.

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Introduction

Publication date: Available online 24 August 2017
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s): William Yao

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Book review.

Book review.

Int J Audiol. 2017 Aug 24;:1

Authors: Thunder T

PMID: 28835149 [PubMed - as supplied by publisher]

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Relational quality, illness interference, and partner support in Ménière's disease.

Relational quality, illness interference, and partner support in Ménière's disease.

Int J Audiol. 2017 Aug 24;:1-7

Authors: Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E

PMID: 28835146 [PubMed - as supplied by publisher]

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Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Int J Audiol. 2017 Aug 24;:1-11

Authors: Mattsson TS, Follestad T, Andersson S, Lind O, Øygarden J, Nordgård S

PMID: 28835140 [PubMed - as supplied by publisher]

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Book review.

Book review.

Int J Audiol. 2017 Aug 24;:1

Authors: Thunder T

PMID: 28835149 [PubMed - as supplied by publisher]

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Relational quality, illness interference, and partner support in Ménière's disease.

Relational quality, illness interference, and partner support in Ménière's disease.

Int J Audiol. 2017 Aug 24;:1-7

Authors: Pyykkö I, Manchaiah V, Zou J, Levo H, Kentala E

PMID: 28835146 [PubMed - as supplied by publisher]

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Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Normative data for diagnosing auditory processing disorder in Norwegian children aged 7-12 years.

Int J Audiol. 2017 Aug 24;:1-11

Authors: Mattsson TS, Follestad T, Andersson S, Lind O, Øygarden J, Nordgård S

PMID: 28835140 [PubMed - as supplied by publisher]

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Influence of electrode array stiffness and diameter on hearing in cochlear implanted guinea pig.

Influence of electrode array stiffness and diameter on hearing in cochlear implanted guinea pig.

PLoS One. 2017;12(8):e0183674

Authors: Drouillard M, Torres R, Mamelle E, De Seta D, Sterkers O, Ferrary E, Nguyen Y

Abstract
During cochlear implantation, electrode array translocation and trauma should be avoided to preserve residual hearing. The aim of our study was to evaluate the effect of physical parameters of the array on residual hearing and cochlear structures during insertion. Three array prototypes with different stiffnesses or external diameters were implanted in normal hearing guinea pigs via a motorized insertion tool carried on a robot-based arm, and insertion forces were recorded. Array prototypes 0.4 and 0.4R had 0.4 mm external diameter and prototype 0.3 had 0.3 mm external diameter. The axial stiffness was set to 1 for the 0.4 prototype and the stiffnesses of the 0.4R and 0.3 prototypes were calculated from this as 6.8 and 0.8 (relative units), respectively. Hearing was assessed preoperatively by the auditory brainstem response (ABR), and then at day 7 and day 30 post-implantation. A study of the macroscopic anatomy was performed on cochleae harvested at day 30 to examine the scala location of the array. At day 7, guinea pigs implanted with the 0.4R array had significantly poorer hearing results than those implanted with the 0.3 array (26±17.7, 44±23.4, 33±20.5 dB, n = 7, vs 5±8.7, 1±11.6, 12±11.5 dB, n = 6, mean±SEM, respectively, at 8, 16 and 24 kHz, p<0.01) or those implanted with the 0.4 array (44±23.4 dB, n = 7, vs 28±21.7 dB, n = 7, at 16 kHz, p<0.05). Hearing remained stable from day 7 to day 30. The maximal peak of insertion force was higher with the 0.4R array than with the 0.3 array (56±23.8 mN, n = 7, vs 26±8.7 mN, n = 6). Observation of the cochleae showed that an incorrectly positioned electrode array or fibrosis were associated with hearing loss ≥40 dB (at 16 kHz). An optimal position in the scala tympani with a flexible and thin array and prevention of fibrosis should be the primary objectives to preserve hearing during cochlear implantation.

PMID: 28837630 [PubMed - in process]

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Erratum to: Nd:YAG laser irradiation associated with fluoridated gels containing photo absorbers in the prevention of enamel erosion

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Implementation of a perioperative surgical home protocol for pediatric patients presenting for adenoidectomy

Publication date: October 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 101
Author(s): Vidya T. Raman, Dmitry Tumin, Joshua Uffman, Arlyne K. Thung, Candice Burrier, Kris R. Jatana, Charles Elmaraghy, Joseph D. Tobias
IntroductionThe perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction.MethodsEligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history. Participation in Pediatric PSH (PPSH) was introduced to the families by the pediatric otolaryngologists. Either the patient's family or physician team could elect to decline participation in the PPSH model. On the day of surgery, the PPSH protocol included a paper checklist to ensure that all patients met eligibility standards. A standardized order-set was implemented in the electronic medical record (EMR) for pre-operative and post-operative nursing instructions and eligible medications. Patients received at least 3 hours of postoperative monitoring prior to discharge home to address postoperative issues. Prior to discharge, caregivers watched a standard teaching video, available on YouTube, which was developed in conjunction with the hospital educational and technical support staff. An attending anesthesiologist made a postoperative followup phone call on the evening of surgery to ensure no untoward events were experienced by the patient as well as elicit caregiver feedback concerning the discharge process. The protocol was discontinued if at any time family members, physicians, or nurses were uncomfortable with completing the protocol or felt that the patient did not meet discharge criteria.ResultsOne hundred sixty-six patients were evaluated for PPSH inclusion. Forty patients were excluded (23 did not meet inclusion criteria, 5 had viral upper respiratory infections, and 10 for other non specified reasons such as tonsillectomy added, sibling with surgery, and incorrect documentation). Therefore, a total of 126 were eligible for PPSH (male/female = 69/57; age 22 ± 4 months). The comparison group included 1,029 children (male/female = 645/384; age 22 ± 7 months of age) undergoing adenoidectomy who were not evaluated for PPSH inclusion. Of the 126 PPSH participants included in the analysis, 27 were excluded at some point during the pathway. Nine cases experienced oxygen desaturation, laryngospasm, or required supplemental oxygen. Noncompliance with the protocol was noted in 5 cases, parental concerns were noted in 17 cases, and there were concerns from the pediatric anesthesiologist or otolaryngologist in 5 cases. In the comparison group, hospital length of stay was significantly longer than in the PSH group (p<0.001), with 524 (51%) patients discharged on the day of service compared to 99 (79%) in the PSH group. No major morbidity or mortality occurred. There was no difference between the two groups in return to the emergency department (ED) visits within 30 days (PSH: 7/126, 6%; control: 59/1,029, 6%; p=0.935). Within 14 days of the procedure, 4 PPSH patients visited urgent care or a primary care physician; 4 visited the ED; and 1 was readmitted to the hospital. Twenty families contacted the otorhinolaryngology triage phone line primarily related to pain and fever.ConclusionWe present our experience and success in developing a PPSH for patients, ranging in age from 16 to 35 months of age, undergoing adenoidectomy either alone or with tympanostomy tube insertion by protocolizing care, collaborating among care providers, and educating families. With this process in place, a significant percentage of these patients who were previously admitted were discharged home the same day of surgery.

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Nephronectin is Decreased in Metastatic Breast Carcinoma and Related to Metastatic Organs

Abstract

Breast cancer causes death mostly due to distant metastasis. During metastasis, cancer cells create new conditions in which normal tissue structure can be disturbed. Nephronectin, which is the primary ligand for α8β1 integrin, plays an important role in kidney development. There are conflicting findings regarding its role in cancer progression and metastasis, especially in breast carcinoma. The aim of this study was to determine changes in nephronectin expression in primary tumor tissues and metastatic visceral organs, using metastatic and non-metastatic cell lines in a mouse model of breast cancer. In our study, 4T1-Liver Metastatic and 4T1-Heart Metastatic cells, originally derived from 4T1-murine breast carcinoma, and non-metastatic 67NR carcinoma cells were used. Cancer cells were injected orthotopically into the mammary gland of 8–10 week-old Balb-c mice. Primary tumors, lung, liver tissues were collected on 12th and 25th days after the tumor injection. Immunohistochemistry was used to determine expression of nephronectin in tissues. We also investigated the expression levels of the protein by using western blot technique. We found that lung and liver tissue of control animals (not-injected with tumor cells) expressed nephronectin which was lost in animals bearing metastatic tumor for 25 days. In accordance, nephronectin staining of lung and liver was preserved in animals injected with non-metastatic 67NR tumors. These results demonstrate that loss of nephronectin may play an important role in formation metastatic milieu for cancer cells. This is the first study demonstrating that tumor-induced loss of nephronectin expression in visceral organs in which metastatic growth takes place.

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Washout of Fine Sand Particles From a Ceramic Tile Roof: Laboratory Experiments Under Simulated Rainfall

Abstract

Roof runoff is an important source of urban stormwater and a main source of rainwater harvesting. Deposition of pollutants on rooftops can have a negative impact on runoff quality and, therefore, on harvested rainwater. Laboratory experiments with simulated rainfall were performed in order to study the washout of fine sand particles deposited on a ceramic tile roof, by runoff, considering the effect of the particle position, particle areal load, particle connectivity and roof slope. Results indicated that particle washout was influenced by the particle position on the roof; particle transport peak and transported mass was higher for the particle mass positions closer to the outlet. Increase in particle areal load decreased particle transport whereas particle connectivity had no effect on particle transport. However, roof slope was a dominant aspect in the particle washout; increase in roof slope greatly increased particle transport peak and transported mass. It also remarkably increased the first flush effect.

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Risk of cause-specific death in individuals with cancer – modifying role diabetes, statins, and metformin

Abstract

Both diabetes mellitus (DM) and cancer are common diseases and they frequently occur in the same patients. We investigated the all-cause and cause-specific mortality dynamics in relation to baseline DM, statin use, and metformin use. The study population consisted of 39,900 incident cancer cases from Finland, 19,822 patients were free of DM at the start of follow-up, and 20,078 had DM. Mortality from all causes, and cancer, cardiovascular (CVD) and other causes was analysed using Poisson regression model with the following variables: sex, age, DM, statin and metformin usage in baseline, cancer type and stage, and calendar period. Statin usage was associated with a reduced cancer-specific mortality with incidence rate ratio (IRR) 0.72 (95% confidence interval 0.69-0.74), IRR for CVD mortality was 0.95 (0.88-1.02), and for other causes 0.64 (0.56-0.74). In a sub-population of DM patients, IRR for metformin in all-cause mortality was 0.74 (0.71-0.78), in cancer mortality 0.75 (0.72-0.79), in CVD mortality 0.75 (0.68-0.83), and other causes 0.68 (0.60-0.78). In conclusion, our register-based study of survival after cancer diagnosis showed that patients with diabetes had substantially poorer outcome in all measures. An association between baseline statin usage and lower all-cause, cancer, and cardiovascular mortality was modified by cancer type. The effect of statin use was largest for breast and colorectal cancer. Metformin usage in a subpopulation of oral antidiabetic users was in general associated with lower mortality, but this association was modified by cancer type. The association was strongest for liver, colorectal, and breast cancer. This article is protected by copyright. All rights reserved.

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Lifelong occupational exposure to wood dust and risk of nasal and nasopharyngeal cancer: A case-control study among men in four Nordic countries – with an emphasis on nasal adenocarcinoma

Abstract

The current study aims to provide stronger evidence to aid in our understanding of the role of lifelong occupational exposure to (softwood-dominated) mixed wood dust in aetiology of nasal cancer. We included broad exposure occurred in a range of wood-processing occupation across varied industries in four Nordic countries. A population-based case-control study was conducted on all male cases with nasal adenocarcinoma (393 cases), other types of nasal cancer (2446), and nasopharyngeal cancer (1747) diagnosed in Finland, Sweden, Norway, and Iceland between1961 and 2005. For each case, five male controls, who were alive at the time of diagnosis of the case (index date), were randomly selected, matched by birth-year and country. Cumulative exposures (CE)s to wood dust and formaldehyde before the index date were quantified based on a job-exposure matrix linked to occupational titles derived from population censuses. Hazard ratios (HRs) for the CE of wood dust were estimated by conditional logistic regression, adjusted for CE to formaldehyde and 95% confidence intervals (CIs) were calculated. There was an increasing risk of nasal adenocarcinoma related to wood dust exposure. The HR in the highest CE category of wood dust (≥ 28.82 mg/m³-years) was 16.5 (95% CI 5.05-54.1). Neither non-adenocarcinoma of the nose nor nasopharyngeal cancer could be linked to wood dust exposure. Lifelong CE to softwood-dominated mixed wood dusts is strongly linked with elevated risk in nasal adenocarcinoma but not with other types of nasal or nasopharyngeal cancer. This article is protected by copyright. All rights reserved.

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Temporomandibular joint reconstruction after condylar fracture complication related to osteosynthesis material

Publication date: Available online 24 August 2017
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): J.F.C. Dantas, J.N. Nogueira Neto, V.A. Sarmento, P.S.F. Campos
Total condylar resorption and the failure of bone synthesis material as postoperative complications of condyle fracture are seldom reported in the literature. When these occur, they may severely limit temporomandibular joint (TMJ) function. In such cases, a reconstruction of the joint is indicated, which can be achieved by means of an alloplastic prosthesis. This article reports a rare case of impaction of osteosynthesis material in the region of the base of the skull associated with a mandibular condyle fracture treated with rigid internal fixation, which resulted in complications. There was progression to condylar resorption, requiring an alloplastic TMJ reconstruction, which was performed in a single surgical session.

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The impact of treatment for head and neck cancer on positive psychological change within a year of completing treatment

Publication date: Available online 24 August 2017
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): S. Harding, T.P. Moss
Head and neck cancer carries a high level of morbidity and mortality. So why could anyone find having such a disease a positive event? The adversity hypothesis of "what doesn't kill you makes you stronger" suggests that people can use adversity to develop as human beings. This positive psychological change has received little attention in relation to head and neck cancer. Responses to the Silver Lining Questionnaire, University of Washington Quality of Life Questionnaire, and Short-Form 12 were collected from a postal survey, 3 to 12 months after the completion of treatment for head and neck cancer. Fifty-two (63%) people returned the survey and were included in the analysis. Time since completion of therapy did not show any relationship with positive psychological change. Tumour stage and treatment regimen both had a relationship with positive change. Participants with lower stage tumours had higher levels of positive change than those with tumours of higher stages. Participants who had surgery alone reported more positive change than those who had surgery with radiotherapy. A social factor related to greater change was being married or living with a partner when compared to living alone. Further research would aid the identification of bio-psychosocial factors that influence the development of positive psychological change and inform the development of rehabilitation interventions.

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Coping and resiliency enhancement program (CARE): a pilot study for interpreters in cancer care

Abstract

Objective

There is a growing demand for interpreters in the cancer setting. Interpreters, the link to quality care for limited English proficiency patients, face many psychosocial stressors in their work. This project assessed interpreters' experiences of stress and piloted a resiliency program to help interpreters cope with stressors.

Methods

From 2013 to 2014, we pilot tested a targeted resiliency program with interpreters from three Boston-based hospitals. In Phase 1, we conducted five focus groups (n = 31) to identify interpreters' psychosocial needs. In Phase 2, we developed and tested a 4-h group program with 29 interpreters (response rate = 90%; 69% female, 54% Hispanic, 85% born outside of the U.S.).

Results

Phase 1. Stressors were patient-based (seeing young patients decline), interactions with medical team (unsure of role), and systems-based (appointment unpredictability). Phase 2. At baseline interpreters reported low abilities to cope with stress (measured by the Measure of Current Status (MOCS-A)). At 4-week follow-up we found improvements in job satisfaction (p = .02; Cohen's d = .41) and declines in sick days (p = .08; Cohen's d = .38). Stress reactivity (MOCS-A) improved; specifically participants reported feeling more assertive about their needs (p = .10; Cohen's d = .30) and more able to relax at will (p = .10; Cohen's d = .35)—important mechanisms to lower distress.

Conclusions

We piloted a resiliency program for medical interpreters in cancer care. We found that interpreters experience distress and have low coping skills. This program resulted in improved work factors and stress reactivity. Future research should include further implementation and testing in a larger, randomized trial.Copyright © 2016 John Wiley & Sons, Ltd.

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Ceramide and Its Related Neurochemical Networks as Targets for Some Brain Disorder Therapies

Abstract

Correlational and causal comparative research link ceramide (Cer), the precursor of complex sphingolipids, to some psychiatric (e.g., depression, schizophrenia (SZ), alcohol use disorder, and morphine antinociceptive tolerance) and neurological (e.g., Alzheimer's disease (AD), Parkinson disease (PD)) disorders. Cer generation can occur through the de novo synthesis pathway, the sphingomyelinase pathways, and the salvage pathway. The discoveries that plasma Cer concentration increase during depressive episodes in patients and that tricyclic and tetracyclic antidepressants functionally inhibit acid sphingomyelinase (ASM), the enzyme that catalyzes the degradation of sphingomyelin to Cer, have initiated a series of studies on the role of the ASM-Cer system in depressive disorder. Disturbances in the metabolism of Cer or SM are associated with the occurrence of SZ and PD. In both PD and SZ patients, the elevated levels of Cer or SM in the brain regions were associated with the disease. AD patients showed also an abnormal metabolism of brain Cer at early stages of the disease which may suggest Cer as an AD biomarker. In plasma of AD patients and in AD transgenic mice, ASM activity was increased. In contrast, partial ASM inhibition of Aβ deposition improved memory deficits. Furthermore, in clinical and preclinical research, ethanol enhanced activation of ASM followed by Cer production. Limited data have shown that Cer plays an important role in the development of morphine antinociceptive tolerance. In summary, clinical and preclinical findings provide evidence that targeting the Cer system should be considered as an innovative translational strategy for some brain disorders.

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Neurotoxicity of the Cyanotoxin BMAA Through Axonal Degeneration and Intercellular Spreading

Abstract

β-Methylamino-l-alanine (BMAA) is implicated in neurodegeneration and neurotoxicity, particularly in ALS-Parkinson Dementia Complex. Neurotoxic properties of BMAA have been partly elucidated, while its transcellular spreading capacity has not been examined. Using reconstructed neuronal networks in microfluidic chips, separating neuronal cells into two subcompartments—(1) the proximal, containing first-order neuronal soma and dendrites, and (2) a distal compartment, containing either only axons originating from first-order neurons or second-order striatal neurons—creates a cortico-striatal network. Using this system, we investigated the toxicity and spreading of BMAA in murine primary neurons. We used a newly developed antibody to detect BMAA in cells. After treatment with 10 μM BMAA, the cyanotoxin was incorporated in first-degree neurons. We also observed a rapid trans-neuronal spread of BMAA to unexposed second-degree neurons in 48 h, followed by axonal degeneration, with limited somatic death. This in vitro study demonstrates BMAA axonal toxicity at sublethal concentrations and, for the first time, the transcellular spreading abilities of BMAA. This neuronal dying forward spread that could possibly be associated with progression of some neurodegenerative diseases especially amyotrophic lateral sclerosis.

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Identification of patients with localized Ewing sarcoma at higher risk for local failure: A report from the Children’s Oncology Group

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Safia K. Ahmed, R. Lor Randall, Steven G. DuBois, William S. Harmsen, Mark Krailo, Karen J. Marcus, Katherine A. Janeway, David S. Geller, Joel I. Sorger, Richard B. Womer, Linda Granowetter, Holcombe E. Grier, Richard G. Gorlick, Nadia N.I. Laack
PurposeTo identify clinical and treatment variables associated with a higher risk of local failure in Ewing sarcoma patients treated on recent Children's Oncology Group protocols.Methods and MaterialsData for 956 patients treated with ifosfamide and etoposide based chemotherapy on INT-0091, INT-0154, and AEWS0031 were analyzed. Local treatment modalities were defined as surgery, definitive radiotherapy (RT), or surgery+radiation (S+RT). Five-year cumulative incidence of local failure was determined.ResultsThe local failure rate for the entire cohort was 7.3%, with a 3.9% rate for surgery, 15.3% for RT (p<0.01), and 6.7% for S+RT (p=0.12). The local failure incidence was 5.4% for extremity tumors, 13.2% for pelvis tumors (p<0.01), 5.3% for axial non-spine tumors (p=0.90), 9.1% for extraskeletal tumors (p=0.08), and 3.6% for spine tumors (p=0.49). The incidence of local failure was 14.8% for extremity tumors and 22.4% for pelvis tumors treated with RT, compared to 3.7% for extremity tumors and 3.9% for pelvis tumors treated with surgery (p≤0.01). There was no difference in local failure incidence by local treatment modality for axial non-spine, spine, and extraskeletal tumors. The local failure incidence was 11.9% in patients ≥18 years versus 6.7% in patients <18 years (p=0.02). Age ≥18 years (Hazard ratio 1.9, p=0.04) and treatment with RT (Hazard ratio 2.40, p<0.01) remained independent prognostic factors for higher local failure incidence on multivariate analysis. Tumor size (</≥ 8 centimeters) was available in 40% of patients and did not correlate with local failure incidence.ConclusionsLocal tumor control is excellent and similar between surgery and RT for axial non-spine, spine, and extraskeletal tumors. Age ≥18 years and use of RT, primarily for pelvis and extremity tumors, are associated with the highest risk of local failure. Further efforts should focus on improving outcomes for these patients.

Teaser

Our analysis of local tumor control outcomes in 956 Ewing sarcoma patients demonstrates age ≥18 years and use of definitive radiotherapy, primarily for pelvis and extremity tumors, are associated with the highest risk of local failure. Local tumor control is excellent and similar between surgery and definitive radiotherapy for axial non-spine, spine, and soft tissue extraskeletal tumors.

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Radiotherapy deficiencies identified during on-site dosimetry visits by the IROC Houston QA Center

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Stephen F. Kry, Lainy Dromgoole, Paola Alvarez, Jessica Leif, Andrea Molineu, Paige Taylor, David S. Followill
PurposeTo review the dosimetric, mechanical, and programmatic deficiencies most frequently observed during on-site visits of radiotherapy facilities by the Imaging and Radiation Oncology Core Houston office (IROC Houston).MethodsIROC Houston's findings between 2000 and 2014, including 409 institutions and 1020 linacs, were compiled. IROC Houston's on-site evaluation includes verification of absolute calibration (tolerance of ±3%), relative dosimetric review (tolerances of ±2% between TPS calculation and measurement), mechanical evaluation (including MLC and kV-MV evaluation against TG-142 tolerances), and general programmatic review (including institutional QA program versus TG-40 and TG-142).ResultsAn average of 3.1 deficiencies was identified at each institution visited, a number that has decreased slightly with time. The most common errors are tabulated, and include TG-40/TG-142 compliance (82% of institutions were deficient), small field size output factors (59% of institutions had errors ≥3%), and wedge factors (33% of institutions had errors ≥3%). Dosimetric errors of ≥10%, including in beam calibration, were seen at many institutions.ConclusionsThere is substantial room for improvement of both dosimetric and programmatic issues in radiotherapy, which should be a high priority for the medical physics community. Particularly relevant was suboptimal beam modeling in the treatment planning system and a corresponding failure to detect these errors by not including TPS data in the linac QA process.

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IROC Houston on-site visits of radiotherapy facilities includes an evaluation of beam calibration, relative dosimetry, mechanical checks, and other programmatic issues. The deficiencies identified over the past 15 years are compiled in this study, highlighting areas where problems are most often found (e.g., small field output factors, wedge factors, calibration, etc.). These areas should receive particular attention during beam modeling and machine QA by medical physicists to ensure optimal accuracy is achieved.

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Hospital quality factors influencing the mobility of patients for radical prostate cancer radiotherapy: a national population based study

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Ajay Aggarwal, Daniel Lewis, Arunan Sujenthiran, Susan C. Charman, Richard Sullivan, Heather Payne, Malcolm Mason, Jan van der Meulen
IntroductionPatient choice policies have been introduced across publicly funded health systems to give patients more control over their care, and to encourage quality improvement amongst providers. To date we have no empirical evidence that patients requiring radiation treatment are prepared to travel to alternative more distant centres or the factors that influence this.Materials and MethodsWe present the results of a national cohort study using administrative hospital data for all 44,363 men who were diagnosed with prostate cancer and underwent radical radiotherapy in the English National Health Service between 2010 and 2014. Using geographic information systems we investigated the extent to which men choose to travel beyond ("bypass") their nearest radiotherapy centre and conditional logistic regression to estimate the effect of hospital and patient characteristics on this mobility.Results20.7% (n= 9,161) of men bypassed their nearest radiotherapy centre. Travel time had a very strong impact on where patients moved to for their treatment, but its effect was smaller for men who were younger, more affluent, and from rural areas (p for interaction always <0·001). Men were prepared to travel further to hospitals that offered hypofractionated prostate radiotherapy as their standard schedule (odds ratio 3.19, p<0.001), to large-scale radiotherapy units (odds ratio 1.56 P<0.001) and to hospitals that were early adopters of intensity modulated radiotherapy (odds ratio 1.37, p<0.001).ConclusionMen with prostate cancer are prepared to bypass their nearest radiotherapy centres. They are more likely to travel to larger established centres and those that offer innovative technology and more convenient radiotherapy schedules. Indicators, which accurately reflect the quality of radiotherapy delivered are needed to guide patients' choices for radiotherapy treatment. In their absence, patient mobility may negatively affect the efficiency and capacity of a regional or national radiotherapy service and offer perverse incentives for technology adoption.

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Using geographic information systems and econometric modelling we present the first national study evaluating the hospital quality factors that attract patients for radiotherapy treatment in health-care markets. We found that one in five men bypassed their nearest radiotherapy centre for treatment, especially those who were younger, and more affluent. In the absence of indicators reflecting treatment quality, centres that were early adopters of intensity modulated radiotherapy or that offered shorter hypofractionated treatment schedules were more attractive to patients.

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Feasibility of pencil beam scanned Intensity Modulated Proton Therapy in breath-hold for locally-advanced non-small cell lung cancer

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Jenny Gorgisyan, Per Munck af Rosenschold, Rosalind Perrin, Gitte F. Persson, Mirjana Josipovic, Maria Francesca Belosi, Svend Aage Engelholm, Damien C. Weber, Antony J. Lomax
PurposeThe feasibility of treating patients with locally-advanced non-small cell lung cancer (NSCLC) with pencil beam scanned intensity modulated proton therapy (IMPT) in breath-hold has been evaluated.Methods and MaterialsFifteen NSCLC patients previously treated to 66 Gy in 33 fractions with image-guided photon radiation therapy were included in this simulation study. In addition to a planning breath-hold CT scan prior to treatment start, six (median, range: 3-9) breath-hold CT scans per patient were acquired prospectively, throughout the course of the radiation therapy. Three field IMPT treatment plans were constructed based on the planning breath-hold CT scan and the 4D dose distributions were simulated, taking both the intra- and inter-fractional motion of the patient into account, in addition to the dynamic treatment delivery.ResultsThe median clinical target volume (CTV) V95% (the volume receiving 95% of the prescribed dose) was 99.8% and 99.7% for the planned and simulated dose distributions, respectively. For three patients (20%), the dose degradation was more than 5% and plan adjustment was needed. Dose degradation was significantly correlated to the change in water-equivalent path lengths (WEPL) (p<0.01) in terms of percentage of voxels with 3 mm undershoot on repeat CTs. The dose to the organs at risk was similar for planned and simulated dose distributions. Three or less breath-holds per field would be required for 12/15 patients, which is clinically feasible.ConclusionsFor 9/15 NSCLC patients, IMPT in breath-hold was both dosimetrically robust and feasible to deliver regarding the treatment time. Three patients would require plan adaption to meet the dosimetric criteria. WEPL is an indicator of plan robustness and should be considered for selection of patients for which the plan would require adaptation.

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Recommendations for the optimal radiation dose in patients with primary cutaneous anaplastic large cell lymphoma: A report of the Dutch Cutaneous Lymphoma Group

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Rutger C. Melchers, Rein Willemze, Laurien A. Daniëls, Karen J. Neelis, Marcel W. Bekkenk, Ellen R.M. de Haas, Barbara Horvath, Michelle M. van Rossum, Cornelus J.G. Sanders, Berit Velstra, Joep C.J.M. Veraart, Rachel E.J. Roach, Maarten H. Vermeer, Koen D. Quint
ObjectiveTo determine the optimal radiation dose for treatment of primary cutaneous anaplastic large cell lymphoma (C-ALCL) with solitary or localized, multifocal or recurrent skin lesions.Materials and MethodsIn this multicenter study, patients with C-ALCL, who had been treated with radiotherapy (RT) between 1984 and 2016, were retrieved from the Dutch registry of cutaneous lymphomas. Distinction was made between patients first presenting with solitary or localized (n=63), with multifocal skin lesions (n=6), and patients with a skin relapse (n=22). Radiation doses, treatment response and follow-up were evaluated. Radiation doses were categorized in low-dose (≤20 Gy), intermediate dose (21-39 Gy) and high-dose (≥40 Gy).Results61/63 (97%) patients presenting with solitary or localized skin lesions showed a complete response (CR). There were no differences in CR between low-dose (16/17), intermediate dose (15/15) and high-dose RT (30/31). After a median follow-up of 46 months, 30 of 63 (48%) patients had a relapse, but infield relapses were never observed. Six out of 6 (100%) patients initially presenting with multifocal skin lesions showed a CR (3/3 low-dose, 2/2 intermediate dose, 1/1 high-dose). After a median follow-up of 27 months, 3 of 6 patients had a relapse. Treatment of 33 skin relapses in 22 patients showed no differences in CR between low-dose (18/19), intermediate dose (6/6) and high-dose radiotherapy (8/8).In the last ten years there has been a decrease in radiation dose used in the treatment of C-ALCL. Treatment of multifocal and recurrent lesions with a dose of 8 Gy (2x4 Gy) resulted in CR of 17/18 lesions.ConclusionOur results show that a radiation dose of 20 Gy (8x2.5 Gy) is effective in patients presenting with solitary or localized skin lesions. For patients with multifocal skin lesions and patients with a skin relapse, a dose of 8 Gy (2x4 Gy) may be sufficient.

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Radiotherapy is the first choice of treatment in primary cutaneous anaplastic large cell lymphoma (C-ALCL), but the optimal dose has yet to be defined. Based on the evaluation of 114 radiation fields in 78 C-ALCL patients, we recommend a dose of 20 Gy for the initial treatment of solitary or localized skin lesions and a dose of 8 Gy for initial treatment of multifocal lesions and for recurrent lesions.

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Treatment-related non-contiguous radiologic changes in children with diffuse intrinsic pontine glioma treated with expanded irradiation fields and antiangiogenic therapy

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Zoltan Patay, Thomas E. Merchant, Rosa Nguyen, Christopher R. Pierson, Arzu Onar-Thomas, Alberto Broniscer
Among 23 children with diffuse intrinsic pontine glioma who were treated with small-molecule inhibitors and expanded-field local RT, we observed a high incidence of non-contiguous treatment-related abnormalities (NCTRAs) in the brain. On the basis of their imaging features and patterns, we speculate that NCTRA development was secondary to synergistic steno-occlusive vascular effects induced by the combination of expanded clinical target volume RT, potent antiangiogenic therapy, young age, and in one case, possibly a genetic predisposition.

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Unknown Primary Squamous Cell Carcinoma of the Neck

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Kristen J. Otto, Jimmy J. Caudell

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Imaging Findings within the first 12 months of Hepatocellular Carcinoma treated with Stereotactic Body Radiation Therapy (SBRT)

Publication date: Available online 24 August 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Mishal Mendiratta-Lala, Everett Gu, Dawn Owen, Kyle C. Cuneo, Latifa Bazzi, Theodore S. Lawrence, Hero K. Hussain, Matthew S. Davenport
PurposeTo correlate the imaging findings of treated hepatocellular carcinoma (HCC) post stereotactic body radiation therapy (SBRT) with explant pathology and alpha-fetoprotein (AFP) response.MethodsFrom 2007-2015, of 146 patients treated with liver SBRT for Barcelona Clinic Liver Cancer (BCLC) Stage A hepatocellular carcinoma, 10 were identified with inclusion criteria and hadregular interval follow up MRI/triple phase CT and explant pathology or declining AFP values for radiology-pathology response correlation. Reference standards for successful response were: >90% necrosis on explant pathology or pre-treatment AFP >75 ng/mL normalizing to <10 ng/mL within 1 year post-SBRT without other treatment. Subjects were treated with 24-50 Gy in 3-5 fractions. Multiphasic MRI or CT was performed at 3, 6, 9 and 12 months post-SBRT was compared to pre-treatment imaging by two expert radiologists. Descriptive statistics were calculated.ResultsThere were 10 subjects with 10 treated HCCs, classified as 3 OPTN 5a, 4 OPTN 5b, and 3 OPTN 5x. All had successfully treated HCCs, based on explant pathology or declining AFP. Four of 10 HCCs had persistent central arterial hyperenhancement 3-12 months post-SBRT; persistent washout was common up to 12 months (9/10). 9/10 treated HCCs exhibited decreased size at 12 months. Liver parenchyma adjacent to the lesion showed early (3-6 months) hyperemia followed by late (6-12 months) capsular retraction and delayed enhancement. No patient had a significant decline in liver function.ConclusionIn the absence of increasing size, persistent central arterial hyperenhancement and washout can occur within the first 12 months post-SBRT in successfully treated HCCs, and may not represent residual viable tumor. Liver parenchyma adjacent to the treated lesion showed inflammation followed by fibrosis, without significant change in hepatic function. Until a radiological signature of tumor control is determined, freedom from local progression appears to be the best measure of HCC control after SBRT

Teaser

In the absence of increasing size, persistent arterial hyperenhancement with washout can occur within the first 12 months post-SBRT in successfully treated HCCs, and should not be confused with residual tumor. Liver parenchyma adjacent to the treated lesion showed inflammation followed by fibrosis, without significant change in hepatic function. Until a radiological signature of tumor control is determined, freedom from local progression appears to be the best measure of HCC control after SBRT.

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Factorial Validity and Measurement Invariance of the Test of Preschool Early Literacy-Phonological Awareness Test Among Deaf and Hard-of-Hearing Children and Hearing Children.

Objectives: Emerging evidence suggests that early phonological awareness in deaf and hard-of-hearing (DHH) children with functional hearing is significantly related to their reading acquisition, and the assessment of phonological awareness can play a critical role in preventing reading difficulties. Validation of the scores obtained from standardized assessments when used with DHH students is crucial to support the assessments' intended interpretations and implications of test scores. Using archival data sets, the aim of this study was twofold: (a) to establish the factorial validity of the item scores on the Test of Preschool Early Literacy-Phonological Awareness (TOPEL-PA) for DHH children with functional hearing and hearing children and (b) to test measurement invariance across these groups. Our archival data sets included assessments of DHH children, hearing children from low socioeconomic status (SES) backgrounds, and hearing children from a range of SES backgrounds. We hypothesized that a second-order unifying ability, Phonological Awareness, along with four first-order subtest factors would explain inter-item associations among the 27 items on the TOPEL-PA. We further hypothesized that patterns of associations among the item scores would be similar across groups and that the individual items would function similarly across groups. Design: Seven hundred and thirty-three children from three samples participated in the study; 171 were DHH children (Mage = 58.7 months old, SDage = 12.5 months old), 195 were low-SES hearing children (Mage = 55.5 months old, SDage = 3.5 months old), and 367 were diverse-SES hearing children (Mage = 53.4 months old, SDage = 8.9 months old). All DHH children were able to identify the referent of monosyllabic spoken words on the Early Speech Perception Test. Results: Test of confirmatory item factor analyses of the hypothesized second-order factor structure revealed that a second-order unifying ability along with four first-order subtest factors well explained associations among the item scores for all groups. This aligned with the scoring structure of the TOPEL-PA, providing strong evidence for factorial validity of the item scores for DHH children as well as for hearing children groups. The measurement invariance test results provided evidence that the vast majority of TOPEL-PA items functioned similarly for hearing children and DHH children with speech perception abilities, suggesting that the utility of the assessment scores obtained from DHH children is consistent with the scores obtained from hearing children. Conclusion: Results of our study suggest that researchers and practitioners can use the TOPEL-PA to assess DHH children with functional hearing. It also suggests that the two skills measured on the TOPEL-PA (blending and elision) are qualitatively similar for DHH and hearing children, but the latent mean score obtained from the DHH children significantly differed from those of the hearing groups, suggesting a quantitative difference. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Modeling DNA damage-induced pneumopathy in mice: insight from danger signaling cascades

Radiation-induced pneumonitis and fibrosis represent severe and dose-limiting side effects in the radiotherapy of thorax-associated neoplasms leading to decreased quality of life or - as a consequence of treat...

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Πέμπτη 24 Αυγούστου 2017

Long-term Health-Related QoL After Breast Reconstruction

How do these four different methods of breast reconstruction impact health-related quality of life among breast cancer patients?
Plastic Reconstructive Surgery-Global Open (PRS Global Open)

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On assessing neurofeedback effects: should double-blind replace neurophysiological mechanisms?

Sir,

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Αρχειοθήκη ιστολογίου

Παρασκευή 25 Αυγούστου 2017

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Πέμπτη 24 Αυγούστου 2017