Gender difference in the neuroimmunomodulation of obesity: A mini review

Venugopal Lalitha, Gopal Krushna Pal

International Journal of Clinical and Experimental Physiology 2016 3(3):109-112

Obesity along with its comorbidities is escalating rapidly in epidemic fashion worldwide. Sex differences exist in the etiopathogenesis of obesity-mediated diseases, which is primarily mediated by the distribution of adipose tissue and alterations in the neural regulation. In this review, we have emphasized the role of gender in the development of obesity, and its alterations in the neural and its associated inflammatory pathways.

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Effective strategies should be at place to prevent chikungunya

GK Pal

International Journal of Clinical and Experimental Physiology 2016 3(3):107-108



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Polyphenolic extract from coconut kernel modulates apoptotic genes, reactive oxygen species production, and prevents proliferation of human colon cancer cell line

Dhanya Krishnan Radhakrishnan, Sunitha Mary Chacko, Prakash Kumar Bhaskara, Sukumaran Sandya, Nevin Kottayath Govindan

International Journal of Clinical and Experimental Physiology 2016 3(3):113-121

Background and Aim: The modern diet along with sedentary lifestyle has led to an increasing mortality rate for colon cancer. Several dietary phytochemicals have been investigated for colon cancer therapy, so as to replace the synthetic drugs having adverse health side effects. The aim of the study was to evaluate the antiproliferative effect of polyphenol-rich fraction from coconut kernel (CKf) on human colon cancer cell lines (HT-29). Methods: The total flavonoids and polyphenols present in CKfwere determined colorimetrically. The cytotoxic and apoptotic effect of CKfwas determined using 3-(4,5-dimethyl thiazol-2yl)-2,5-diphenyl tetrazolium bromide assay, acridine orange/ethidium bromide staining, and 4',6-diamidino-2-phenylindole-2 staining. Levels of caspase-3 activity were measured colorimetrically. The expression levels of apoptotic genes BAK, BAX, BID and p53 were measured using real-time polymerase chain reaction. The effect of CKfin inducing reactive oxygen species (ROS) was studied using 2′,7′-dichlorofluorescein diacetate staining. Mitochondrial potential of HT-29 cells treated with CKfwas determined by Rhodamine 123 staining. Results: Experimental results showed that CKfcontains significant amount of polyphenols. CKfshowed cytotoxicity against HT-29 cells (Lethal Dose 50% of 8 μg/ml) by increasing the free radical concentration, caspase 3 enzyme levels, and decreasing the mitochondrial membrane potential in dose-dependent manner. The levels of p53 and BAX showed a major increase in a dose-dependent manner, while BAK gene levels showed a slight but significant increase. Conclusion: These results clearly indicate that coconut kernel which contains cytotoxic phenols affect the growth of colon cancer cells by modulating the apoptotic machinery mediated through mitochondrial ROS production.

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Breakfast: Biochemical prospectives

Nivedita Nanda

International Journal of Clinical and Experimental Physiology 2016 3(3):149-149



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Learning style preference for basic medical science: A key to instructional design

Himel Mondal, Shaikat Mondal, Debasish Das

International Journal of Clinical and Experimental Physiology 2016 3(3):122-126

Background and Aim: Students have specific learning style preference, and it is important for designing classroom instruction to make a better learning environment. There are mainly four sensory modalities for learning (V = visual, A = aural, R = read/write, and K = kinesthetic) and these can be assessed. Methods: A cross-sectional study of the 1st-year medical students (n = 146) was carried out. VARK® questionnaire version 7.8, a set of 16 multiple-choice questions with a pretested additional questionnaire, was used to assess the preferred learning mode. Results: Kinesthetic mode is most preferred (total score = 1146), followed by aural (total score = 808), visual (total score = 624), and read/write (total score = 584). Mean value: V = 4.27 ± 2.87, A = 5.53 ± 2.95, R = 4 ± 2.21, K = 7.85 ± 2.72. Preference for practical class is 52%, discussion with teacher is 39%, 1-h lecture is 5%, and tutorial is least preferred (4%). For lecture, chalk and talk gets 76% preference with the second choice as PowerPoint™ (PPT) presentation (13%). For PPT slides, “salient points and diagram” in the slide are most preferred (58%), followed by “diagram only” in the slide (30%). Animated image or video is preferred by majority (52%) of students. Moreover, learners enjoy a class with some breaks and humor (48%) while 31% like interaction with teachers. During lecture, 82% students like to take notes whereas 18% do not like to take notes. Conclusion: This study has revealed that most students learn best by kinesthetic method and practical classes. Still, students prefer blackboard/whiteboard teaching with some humor. For PPT presentation, they prefer salient points and diagram with a preference of animation or video. Majority take notes from class. These findings would help a teacher to design their instructional material for effective teaching.

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Effect of petroleum ether extract of Cedrus deodara on body weight in diabetic rats

Ganesh Pradhan, Suparna Podder, Sushil Charndra Mahapatra

International Journal of Clinical and Experimental Physiology 2016 3(3):140-143

Background and Aim: Overweight and obesity are the strong risk factors for diabetes. The present study aims to find out whether petroleum ether extract of Cedrus deodara (PEECD) reduces body weight in alloxan-induced diabetic rats. Materials and Methods: A total of 36 rats (6 normal rats and 30 alloxan-induced diabetic rats) were included in the study and they were divided into six groups of six animals each. PEECD at three different doses of 100 mg/kg, 200 mg/kg, and 400 mg/kg was administered on 0th, 7th, 14th, and 21st days and then the body weight was estimated using a weighing machine. Statistical analysis was performed by one-way ANOVA. Results: On the 14th and 21st days of PEECD administration at doses of both 200 mg/kg and 400 mg/kg, the body weight decreased significantly (P < 0.05) in alloxan-induced diabetic rats when compared with the control group. However, this decrease in body weight was also statistically significant (P < 0.05) when compared with the standard on the 21st day of PEECD administration at a dose of 400 mg/kg. There was a statistically significant decrease (P < 0.05) in body weight when compared with the control group on the 21st day of administration of PEECD at a dose of 100 mg/kg. Conclusion: From the above findings, we conclude that PEECD is capable of reducing body weight in alloxan-induced diabetic rats. Hence, further studies should be done to confirm the weight-reducing property of PEECD extract on diabetic rats so that it could be added to the list of traditional plants which are effective in reducing the body weight.

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Quality of life and Indian Diabetes Risk Score are linked to heart rate variability in young individuals with prediabetes and diabetes in India

Gorantla Shravya Keerthi, Pravati Pal, Gopal Krushna Pal, Jaya Prakash Sahoo, Magadi Gopalakrishna Sridhar, Jayaraman Balachander

International Journal of Clinical and Experimental Physiology 2016 3(3):127-133

Background and Aim: Although diabetes is known to be associated with cardiac autonomic neuropathy and depressed quality of life (QoL) in terms of physical and psychological domains due to the disease duration and complications, till date no reports are available to show the link between QoL and Indian Diabetes Risk Score (IDRS) with cardiac autonomic neuropathy assessed with heart rate variability (HRV) in newly diagnosed type 2 diabetes mellitus and prediabetes without comorbidities. IDRS is known to predict cardiometabolic risks, neuropathy and future diabetes risk even in normoglycemic subjects. Hence, in this study, we have planned to assess the plausible link between QoL scale and IDRS with HRV in young Indian individuals with newly diagnosed diabetes and prediabetes. Methods: Among 328 (18–45 years) age-matched individuals, 78 were included as controls, 126 in prediabetes group, and 124 in newly diagnosed diabetes group. Subject's QoL and IDRS were assessed by questionnaires, and resting HRV were recorded. Fasting blood glucose (FBG) and fasting insulin was estimated, and homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. Independent association of ratio of low-frequency to high-frequency power (LF: HF ratio) with other variables was analyzed by multiple regression analysis. Results: HRV and QoL were significantly decreased; IDRS, FBG, fasting insulin, and HOMA-IR were significantly increased in prediabetes and diabetes group compared to controls with an equal level of significance. Furthermore, these parameters showed significant difference that was more intense in diabetes group compared with prediabetes group. Conclusion: The association of sympathovagal imbalance in terms of LF: HF ratio with QoL and IDRS was found in Indian adults with prediabetes and diabetes even in the younger age without having any disease complications.

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Spinal muscular atrophy

Farah Mushtaq, Sheikh Mushtaq Ahmad, Surinder Kaur, Surjit Singh, LS Dashora

International Journal of Clinical and Experimental Physiology 2016 3(3):147-148

Spinal muscular atrophy (SMA) is a genetic motor neuron disease characterized by progressive degeneration of motor neurons. Herein, a 12-year-old female child, born to healthy nonconsanguineous parents, was brought with the chief complaints of wasting and weakness of both lower limbs for 3 years. There was no family history of neurological illness. On examination, higher mental functions and cranial nerve examinations were normal. Typical worm-like fasciculations were seen in tongue and both lower limbs. Upper extremities were less affected. The child was able to feed herself. Respiratory muscles were not affected. A diagnosis of SMA-Type 3 (Kugelberg–Welander disease) was made on the basis of clinical presentation and subsequently, the diagnosis was genetically confirmed by molecular analysis of SMN gene. Electromyography showed spontaneous fibrillation at rest. Nerve conduction study was normal. No medical treatment was able to delay the progression. Supportive therapy includes orthopedic care and mild physiotherapy.

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The interrelationship of personality with stress in medical students

Pallavi Panchu, Syed Liyakath Ali, Tom Thomas

International Journal of Clinical and Experimental Physiology 2016 3(3):134-139

Background and Aim: Medicine, as we know, is a demanding career and students of medicine are prone to various forms of stress. Medical curriculum is stressful and requires the right type of personality to cope with the vast curriculum and study schedule. Stress adversely affects the students' academic performance and clinical skills. The sources of stress if studied along with the physiology of the learners' personality will help the students make the right career choice, thereby minimizing stress. Hence, if a student's personality is analyzed, a right career option may be made and stress may be reduced, to produce competent doctors. Therefore, the present study looks into the relationship of personality with the types of stresses faced by medical students. Methods: This cross-sectional study was conducted in a medical college in East India. Students were given two validated questionnaires. Medical student stress questionnaire assesses the sources of stresses in medical students and classifies it into six types. The big-five personality questionnaire classifies students as having five major personality traits. The data were analyzed by Student's t-test and Chi-square test using SPSS version 22. Results: Most of the medical students have academic stressors and agreeable personality traits with uniform gender distribution. Agreeable females have more academic stress. Overall, agreeable students have more statistically significant academic stress (P < 0.01). Conclusion: An ideal doctor has an agreeable personality which most of our students have. The right blend of personality traits helps in alleviating stress, improving the academic outcome. The type of stress faced by the students and his/her personality should be kept in mind while helping students make a career choice and in curriculum designing.

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News and Views

M Sathish Babu

International Journal of Clinical and Experimental Physiology 2016 3(3):150-151



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Table of Contents

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Value-added reporting of specific IgE

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Editorial Board

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Corrigendum to “The transport mechanism of the mitochondrial ADP/ATP carrier” [Biochim. Biophys. Acta 1863/10 (2016) 2379–2393]

Publication date: Available online 6 October 2016
Source:Biochimica et Biophysica Acta (BBA) - Molecular Cell Research
Author(s): Edmund R.S. Kunji, Antoniya Aleksandrova, Martin S. King, Homa Majd, Valerie L. Ashton, Elizabeth Cerson, Roger Springett, Mikhail Kibalchenko, Sotiria Tavoulari, Paul G. Crichton, Jonathan J. Ruprecht




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Synergism between RIZ1 gene therapy and paclitaxel in SiHa cervical cancer cells

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Gamma Knife Radiosurgery in Recurrent Glioblastoma

Background: We evaluated Gamma Knife radiosurgery (GKRS) as a treatment option for patients with recurrent glioblastoma. Patients and Methods: 42 patients with histopathologically diagnosed recurrent grade IV tumor were treated with GKRS. All patients had undergone standard multimodal first-line treatment. The average time from diagnosis to GKRS was 17.0 months. The median target volume was 5.1 cm³. The median margin dose was 10 Gy and the median central dose 20 Gy. In a subset of patients, O⁶-methylguanine methyltransferase (MGMT) promoter methylation analysis by pyrosequencing was performed. Results: Most patients did not develop complications after GKRS. Time to radiological progression after initial GKRS was 4.4 months (95% CI: 3.1-5.7 months). Radiological progression mainly occurred beyond the GKRS-irradiated area. The median survival time after initial GKRS was 9.6 months (95% CI: 7.7-11.5 months). The median overall survival time from diagnosis was 25.6 months (95% CI: 21.8-29.3 months). Patients with MGMT promoter methylation survived significantly longer (33.4 months; 95% CI: 21.2-45.5 months) compared to patients without MGMT promoter methylation (16.0 months; 95% CI: 8.0-23.9 months). Conclusion: GKRS seems to be a relatively safe salvage treatment option for recurrent glioblastoma for highly selected patients but must be seen as part of a multimodal treatment algorithm.
Stereotact Funct Neurosurg 2016;94:265-272

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Gamma Knife Surgery for Recurrent or Residual Supratentorial Primitive Neuroectodermal Tumors

Background: Supratentorial primitive neuroectodermal tumors (PNETs) are highly malignant and rare tumors of the central nervous system. Objectives: The aim of this study was to determine the role of Gamma Knife surgery (GKS) as a salvage treatment option for patients with recurrent or residual supratentorial PNETs. Methods: Between 1998 and 2014, 11 patients with supratentorial PNETs were retrospectively analyzed. This series consisted of 7 male and 4 female patients. The median age was 17 years. All patients received surgical resection followed by adjuvant therapy. The median time from operation to the first GKS treatment was 72.5 months. The median tumor volume was 17.5 cm³, and the median marginal dose was 11.5 Gy. Results: 15 (65%) of the 23 tumors had been controlled. The actuarial local tumor control rate was 91% at 3 months, 73% at 6 months, and 44% at 12 months. At the time of analysis, 9 (82%) of the patients had died. The median survival time after the first GKS session was 17 months. The median survival time from the initial diagnosis was 65 months. No adverse radiation effect after GKS treatment occurred in any patient. Conclusions: GKS treatment might be an effective salvage treatment option for recurrent or residual supratentorial PNETs after multimodal treatment.
Stereotact Funct Neurosurg 2016;94:273-278

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Yield Strength Testing in Human Cadaver Nasal Septal Cartilage and L-Strut Constructs.

Yield Strength Testing in Human Cadaver Nasal Septal Cartilage and L-Strut Constructs.

JAMA Facial Plast Surg. 2016 Oct 6;:

Authors: Liu YF, Messinger K, Inman JC

Abstract
Importance: To our knowledge, yield strength testing in human nasal septal cartilage has not been reported to date. An understanding of the basic mechanics of the nasal septum may help surgeons decide how much of an L-strut to preserve and how much grafting is needed.
Objectives: To determine the factors correlated with yield strength of the cartilaginous nasal septum and to explore the association between L-strut width and thickness in determining yield strength.
Design, Setting, and Participants: In an anatomy laboratory, yield strength of rectangular pieces of fresh cadaver nasal septal cartilage was measured, and regression was performed to identify the factors correlated with yield strength. To measure yield strength in L-shaped models, 4 bonded paper L-struts models were constructed for every possible combination of the width and thickness, for a total of 240 models. Mathematical modeling using the resultant data with trend lines and surface fitting was performed to quantify the associations among L-strut width, thickness, and yield strength. The study dates were November 1, 2015, to April 1, 2016.
Main Outcomes and Measures: The factors correlated with nasal cartilage yield strength and the associations among L-strut width, thickness, and yield strength in L-shaped models.
Results: Among 95 cartilage pieces from 12 human cadavers (mean [SD] age, 67.7 [12.6] years) and 240 constructed L-strut models, L-strut thickness was the only factor correlated with nasal septal cartilage yield strength (coefficient for thickness, 5.54; 95% CI, 4.08-7.00; P < .001), with an adjusted R2 correlation coefficient of 0.37. The mean (SD) yield strength R2 varied with L-strut thickness exponentially (0.93 [0.06]) for set widths, and it varied with L-strut width linearly (0.82 [0.11]) or logarithmically (0.85 [0.17]) for set thicknesses. A 3-dimensional surface model of yield strength with L-strut width and thickness as variables was created using a 2-dimensional gaussian function (adjusted R2 = 0.94). Estimated yield strengths were generated from the model to allow determination of the desired yield strength with different permutations of L-strut width and thickness.
Conclusions and Relevance: In this study of human cadaver nasal septal cartilage, L-strut thickness was significantly associated with yield strength. In a bonded paper L-strut model, L-strut thickness had a more important role in determining yield strength than L-strut width. Surgeons should consider the thickness of potential L-struts when determining the amount of cartilaginous septum to harvest and graft.
Level of Evidence: NA.

PMID: 27711923 [PubMed - as supplied by publisher]

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Sociodemographic Factors Associated With Knowledge and Risk Perception of Human Papillomavirus and Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma Among a Predominantly Black Population.

Sociodemographic Factors Associated With Knowledge and Risk Perception of Human Papillomavirus and Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma Among a Predominantly Black Population.

JAMA Otolaryngol Head Neck Surg. 2016 Oct 6;:

Authors: Osazuwa-Peters N, Adjei Boakye E, Chen BY, Clancy J, Vallot PL, Su JL, Beck GE, Varvares MA

Abstract
Importance: The incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasing in the United States and may be underestimated among black individuals. Characterizing the current knowledge level among black individuals is critical to developing interventions to increase awareness.
Objective: To describe the sociodemographic correlates of knowledge and risk perception of HPV and HPV-associated OPSCC among a predominantly black population.
Design, Setting, and Participants: A cross-sectional survey was conducted at a drag racing event on September 12 and 13, 2015, in Madison, Illinois. The setting was a community-based oral head and neck cancer screening and education initiative. Participants were 301 drag race attendees 18 years or older who were conveniently sampled from attendees at an annual drag racing event predominantly patronized by black individuals.
Main Outcomes and Measures: The primary outcome was knowledge and risk perception of HPV and HPV-associated OPSCC. An electronic-based questionnaire elicited sociodemographic information and contained oral cancer knowledge and risk perception items, which were combined to form knowledge and risk perception scores. Multivariable linear regression analysis assessed estimates of knowledge and risk perception of HPV and HPV-associated OPSCC.
Results: Of the 301 participants (111 female and 190 male) completing the questionnaire, 194 (64.5%) were black. Overall, respondents ranged in age from 18 to 78 years, with a mean (SD) age of 48.0 (13.0) years. The mean (SD) knowledge score was 5.7 (4.6) of 15, and the mean (SD) risk perception score was 2.2 (1.4) of 6. Using multivariable linear regression, we found that, for every 1-year increase in age, knowledge of HPV-associated OPSCC decreased by 5.0% and was worse in men (β = -1.26; 95% CI, -2.33 to -0.18), black vs white individuals (β = -1.29; 95% CI, -2.35 to -0.23), and those with a high school diploma or less vs college graduates (β = -3.23; 95% CI, -4.67 to -1.80). Black individuals also had lower perceived risk of developing HPV-associated OPSCC (β = -0.36; 95% CI, -0.69 to -0.02) compared with white individuals, and participants with a high school diploma or less had lower perceived risk of developing HPV-associated OPSCC compared with those with a college degree or higher (β = -0.59; 95% CI, -1.04 to -0.14).
Conclusions and Relevance: Age and sex were independent correlates of knowledge of HPV-associated OPSCC, while race and education level were correlates of both knowledge and risk perception of HPV-associated OPSCC. These findings should inform future interventions targeted at increasing knowledge of HPV-associated OPSCC in black communities.

PMID: 27711922 [PubMed - as supplied by publisher]

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Advances in 3-Dimensional Printing in Otolaryngology: A Review.

Advances in 3-Dimensional Printing in Otolaryngology: A Review.

JAMA Otolaryngol Head Neck Surg. 2016 Oct 6;:

Authors: VanKoevering KK, Hollister SJ, Green GE

Abstract
Importance: Three-dimensional (3-D) printing is an exponentially growing technology that enables the use of a patient's image data to create patient-specific models, devices, and implants. Three-dimensional printing, developed in the 1980s, has emerged in the past decade with the potential to create new paradigms in personalized medicine.
Observations: The field of otolaryngology has advanced many current and evolving future medical applications of 3-D printing. The predominant uses of 3-D printing have rapidly progressed from patient-specific models and simulators to intraoperative guides. Continued advancements now include 3-D-printed implants and future tissue-engineered constructs, which bring new regulatory challenges. This review summarizes the literature and provides a comprehensive guide to the background, applications, and current limitations of 3-D printing across the head and neck.
Conclusions and Relevance: Three-dimensional printing enables the rapid production of patient-specific devices for personalized medicine. The field of otolaryngology has pioneered many of the underlying advancements in medical 3-D printing and will continue to remain at the forefront of 3-D printing technology.

PMID: 27711917 [PubMed - as supplied by publisher]

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Palatal Motion After Primary and Secondary Furlow Palatoplasty.

Palatal Motion After Primary and Secondary Furlow Palatoplasty.

JAMA Otolaryngol Head Neck Surg. 2016 Oct 6;:

Authors: Rudnicki PA, Tsang C, Vecchiotti MA, Scott AR

Abstract
Importance: Indications for Furlow palatoplasty include primary repair of cleft palate as well as secondary repair, or secondary palatoplasty for treatment of velopharyngeal insufficiency. Speculation exists surrounding the benefit of secondary Furlow palatoplasty in cases of a previously well-reconstructed palate or a short but otherwise anatomically normal soft palate because it has been theorized that reorientation of a previously reconstructed or normal muscular levator sling should in fact worsen palatal motion.
Objective: To compare palatal motion following primary and secondary Furlow palatoplasty using footage from postoperative nasopharyngoscopy videos.
Design, Setting, and Participants: In this retrospective case series, medical records in a database of an urban academic pediatric otolaryngology practice was used to identify patients who had undergone either primary or secondary Furlow palatoplasty. Subjects with adequate postoperative nasopharyngoscopy footage were randomized, and 2 blinded reviewers assessed soft palate motion in each video using an abbreviated version of the Golding-Kushner scale.
Main Outcomes and Measures: Reviewers' blinded ratings of soft palate motion were quantified using a modified Golding-Kushner scale to generate a mean palatal motion score for each subject (range, 0.0-2.0). Scores of primary and secondary Furlow palatoplasty patients were compared.
Results: Over a 4-year period, 20 patients with adequate postoperative nasopharyngoscopy footage were identified (12 primary Furlow palatoplasty patients and 8 secondary Furlow palatoplasty patients). Patients consisted of 8 males and 12 females and ranged in age from 12 months to 22 years at the time of postoperative nasopharyngoscopy. Modified Golding-Kushner scores were similar between groups: mean primary group, 1.61 (range, 0.5-2.0); mean secondary group, 1.53 (range, 0.75-2.0); absolute difference in mean, 0.08 (95% CI, 0.00-0.43); effect size, Hedges g, 0.18. There was fair interrater reliability (interclass coefficient, R = 0.45), consistent with prior reports using this scale. No significant difference in postoperative palatal motion scores was identified between primary and secondary palatoplasty groups in this study.
Conclusions and Relevance: When examined in isolation, postoperative motion of the soft palate appears similar following both primary and secondary Furlow palatoplasty procedures, suggesting that there are no major deleterious effects on palatal motion following secondary Furlow palatoplasty.

PMID: 27711915 [PubMed - as supplied by publisher]

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Full-Thickness Scalp Defects Reconstructed With Outer Table Calvarial Decortication and Surface Grafting.

Full-Thickness Scalp Defects Reconstructed With Outer Table Calvarial Decortication and Surface Grafting.

JAMA Facial Plast Surg. 2016 Oct 6;:

Authors: Sand JP, Diaz JA, Nussenbaum B, Rich JT

PMID: 27711911 [PubMed - as supplied by publisher]

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Morphological Variation of Subarcuate Artery and Canal in Atresia.

Morphological Variation of Subarcuate Artery and Canal in Atresia.

ORL J Otorhinolaryngol Relat Spec. 2016 Oct 7;78(5):276-280

Authors: Chen K, Lyu H, Yang L, Zhang T, Dai P

Abstract
OBJECTIVES: An aberrant subarcuate artery (SAA) and its related canal are infrequent and asymptomatic. The presence of this variation may cause untoward hemorrhages, if accidentally nicked. Therefore, it is important for otologists to be aware of this entity, and its relative anatomy, to avoid any unexpected complication. We present a case of a 7-year-old girl who presented with right-sided microtia with membranous atresia.
METHODS: High-resolution computed tomographic scan and three-dimensional reconstruction of the temporal bone showed bilateral enlarged SAA.
RESULTS: The width of the right-sided bone canal was between 0.76 and 1.33 mm. The left temporal bone showed the same variation, with the width of the canal consistently greater than 1.0 mm, ranging from 1.07 to 1.23 mm in greatest transverse dimension.
CONCLUSIONS: The variation proposed in microtia was not previously reported in the literature, which may have important implications for the canal reconstruction.

PMID: 27710955 [PubMed - as supplied by publisher]

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CT-based follow-up following radiotherapy or radiochemotherapy for locally advanced head and neck cancer; outcome and development of a prognostic model for regional control.

CT-based follow-up following radiotherapy or radiochemotherapy for locally advanced head and neck cancer; outcome and development of a prognostic model for regional control.

Br J Radiol. 2016 Oct 6;:20160492

Authors: Nevens D, Vantomme O, Laenen A, Hermans R, Nuyts S

Abstract
OBJECTIVES: The purpose of this study is to make a prognostic model for regional relapse in head and neck cancer using clinical and Computed Tomography (CT) parameters.
METHODS: 183 patients with lymph node-positive head and neck cancer were treated between 2002 and 2012 with radiotherapy or concurrent chemoradiotherapy. CT studies pre- and post-treatment were reviewed for lymph node size and presence of necrosis, extracapsular spread and calcifications. For every patient, correlations with 3 year regional control (RC), metastasis free survival (MFS), disease free survival (DFS) and overall survival (OS) were made.
RESULTS: 3-year outcome rates were as follows: LC of 84%, RC of 80%, MFS of 74%, DFS of 61%, OS of 63%. Pre-treatment nodal size and presence of necrosis were associated with a poorer outcome. This was also the case for post-treatment lymph node size, the presence of necrosis and extracapsular spread. We developed a CT-based prognostic model for regional control with an area under the curve of 0.78 (95% Confidence Interval 0.63;0.85).
CONCLUSIONS: We reached a good outcome in our patient cohort using a CT-based follow-up approach. A CT-based model was developed which can aid in predicting regional control. Advances in knowledge: A prognostic model is proposed which can aid to predict regional control and the necessity of post-radiotherapy neck dissection using clinical parameters and parameters derived from the post-treatment CT study. This is the first paper to propose a prognostic model for regional relapse in head and neck cancer based on these parameters.

PMID: 27710014 [PubMed - as supplied by publisher]

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64Cu2+ Ions as PET Probe: An Emerging Paradigm in Molecular Imaging of Cancer.

64Cu2+ Ions as PET Probe: An Emerging Paradigm in Molecular Imaging of Cancer.

Mol Pharm. 2016 Oct 6;:

Authors: Chakravarty R, Chakraborty S, Dash A

Abstract
Positron emission tomography (PET) imaging has transformed diagnostic nuclear medicine and become an essential strategy in cancer management. With the expected growth of this molecular imaging modality, there is a recognized need for new PET probes to address the clinical challenges in the early diagnosis and staging of various types of cancers. In this endeavor, the prospect of using 64Cu in the form of simple Cu2+ ions as PET probe is not only a cost-effective proposition, but also seems poised to broaden the palette of molecular imaging probes in the foreseeable future. The usefulness of 64Cu2+ ions as PET probe is based on the fact that Cu is an essential element which plays an important role in cell proliferation and angiogenesis. Over the last few years, there has been continuous flow of evidences based on studies in animal models on the uptake of 64Cu2+ ions in different types of tumors, including, hepatoma, colorectal cancer, prostate cancer, lung cancer, breast cancer, head and neck cancer, fibrosarcoma, melanoma, glioblastoma and ovarian cancer. The widespread preclinical success of 64Cu2+ ions as PET probe has recently resulted in translation of this radiotracer to clinical settings for non-invasive imaging and staging of prostate cancer in human patients. In this concise review, we have focused on the latest developments in PET imaging of cancer in preclinical and clinical settings using 64Cu2+ ion as a probe and discussed the challenges and opportunities for future development.

PMID: 27709959 [PubMed - as supplied by publisher]

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'Compromise position' image alignment to accommodate independent motion of multiple clinical target volumes during radiotherapy: A high risk prostate cancer example.

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'Compromise position' image alignment to accommodate independent motion of multiple clinical target volumes during radiotherapy: A high risk prostate cancer example.

J Med Imaging Radiat Oncol. 2016 Oct 5;:

Authors: Rosewall T, Yan J, Alasti H, Cerase C, Bayley A

Abstract
INTRODUCTION: Inclusion of multiple independently moving clinical target volumes (CTVs) in the irradiated volume causes an image guidance conundrum. The purpose of this research was to use high risk prostate cancer as a clinical example to evaluate a 'compromise' image alignment strategy.
METHODS: The daily pre-treatment orthogonal EPI for 14 consecutive patients were included in this analysis. Image matching was performed by aligning to the prostate only, the bony pelvis only and using the 'compromise' strategy. Residual CTV surrogate displacements were quantified for each of the alignment strategies.
RESULTS: Analysis of the 388 daily fractions indicated surrogate displacements were well-correlated in all directions (r(2)  = 0.95 (LR), 0.67 (AP) and 0.59 (SI). Differences between the surrogates displacements (95% range) were -0.4 to 1.8 mm (LR), -1.2 to 5.2 mm (SI) and -1.2 to 5.2 mm (AP). The distribution of the residual displacements was significantly smaller using the 'compromise' strategy, compared to the other strategies (p 0.005). The 'compromise' strategy ensured the CTV was encompassed by the PTV in all fractions, compared to 47 PTV violations when aligned to prostate only.
CONCLUSIONS: This study demonstrated the feasibility of a compromise position image guidance strategy to accommodate simultaneous displacements of two independently moving CTVs. Application of this strategy was facilitated by correlation between the CTV displacements and resulted in no geometric excursions of the CTVs beyond standard sized PTVs. This simple image guidance strategy may also be applicable to other disease sites that concurrently irradiate multiple CTVs, such as head and neck, lung and cervix cancer.

PMID: 27709834 [PubMed - as supplied by publisher]

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Circulating Epstein-Barr virus-encoded micro-RNAs as potential biomarkers for nasal natural killer/T-cell lymphoma.

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Circulating Epstein-Barr virus-encoded micro-RNAs as potential biomarkers for nasal natural killer/T-cell lymphoma.

Hematol Oncol. 2016 Oct 6;:

Authors: Komabayashi Y, Kishibe K, Nagato T, Ueda S, Takahara M, Harabuchi Y

Abstract
Nasal natural killer/T-cell lymphoma (NNKTL) is an Epstein-Barr virus (EBV)-associated malignancy and is characterized by local invasion and widespread dissemination, with a consequent poor prognosis. Micro-RNAs (miRNAs) play roles in the pathogenesis of several malignancies by regulating gene expression and have been recently identified as stable entities in serum. Here, we investigated the value of circulating EBV-miRNAs as biomarkers for NNKTL. Sera of patients with NNKTL were subjected to miRNA polymerase chain reaction (PCR)-array analysis, after which serum EBV-miRNA levels were verified using quantitative PCR. The latter analysis revealed high miR-BART2-5p, miR-BART7-3p, miR-BART13-3p, and miR-BART1-5p expression levels in sera of patients with NNKTL and indicated accurate values for discriminating patients with NNKTL from healthy controls. Levels of these 4 EBV-miRNAs, which were secreted from NNKTL cells, significantly decreased after treatment compared with those before treatment. Furthermore, a high circulating miR-BART2-5p level was associated with disease progression and poor prognosis in patients with NNKTL. Our findings demonstrate that circulating EBV-miRNAs, particularly miR-BART2-5p, may serve as potential diagnostic and prognostic biomarkers in patients with NNKTL.

PMID: 27709652 [PubMed - as supplied by publisher]

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Long-term quality of life after transoral laser microsurgery for laryngeal carcinoma.

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Long-term quality of life after transoral laser microsurgery for laryngeal carcinoma.

J Surg Oncol. 2016 Oct 6;:

Authors: Valls-Mateus M, Ortega A, Blanch JL, Sabater F, Bernal-Sprekelsen M, Vilaseca I

Abstract
BACKGROUND AND OBJECTIVES: Previous studies showed good short-term Quality of life (QOL) after Transoral Laser Microsurgery (TLM) for laryngeal cancer. Here, we aimed to evaluate QOL after TLM in the long-term.
METHODS: Prospective longitudinal study. Sixty-two consecutive disease-free patients were evaluated using UW-QOL v4 and SF-12 questionnaires, 1 and 5 years after TLM. Changes over time were assessed according to age, location, and tumor size. Long-term VHI-10 was also evaluated.
RESULTS: The mean follow-up time was 5.41 ± 2.02 years. No differences in the global UW-QOL score were observed between 1 and 5 years after TLM (1135.00 vs. 1127.20; P = 0.4). Activity worsened slightly in the long-term (93.03 vs. 87.70; P = 0.02). Forty-two and 58% of the patients reported that their health 1 and 5 years after treatment was much better than prior to diagnosis. Initially, 3.3% considered their health much worse, which was reduced to 1.7% at 5 years. SF-12 scores remained unchanged for both physical and mental aspects (P > 0.05). The VHI-10 was 3.81 ± 5.7 for supraglottic and 7.2 ± 9.6 for glottic tumors.
CONCLUSION: Patients treated with TLM present a very good long-term QOL. Only activity deteriorates over time, while voice and swallowing remain satisfactory in the majority of patients. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc.

PMID: 27709626 [PubMed - as supplied by publisher]

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Assessment of treatment options for rectosigmoid cancer: single-incision plus one port laparoscopic surgery, single-incision laparoscopic surgery, and conventional laparoscopic surgery.

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Assessment of treatment options for rectosigmoid cancer: single-incision plus one port laparoscopic surgery, single-incision laparoscopic surgery, and conventional laparoscopic surgery.

Surg Endosc. 2016 Oct 5;:

Authors: Liu R, Wang Y, Zhang Z, Li T, Liu H, Zhao L, Deng H, Li G

Abstract
BACKGROUND: The advantages of reduced-port laparoscopic surgery (RPLS) for rectosigmoid cancer treatment have been disputed. This study evaluated the outcomes of RPLS compared to conventional laparoscopic surgery (CLS) for rectosigmoid cancer.
METHODS: Data from 211 patients who underwent a selective sigmoidectomy or anterior resection from August 2011 to June 2014 at a single institution were collected and analyzed via propensity score matching. Operative outcomes, inflammatory responses, pain intensity, oncologic outcomes, quality of life, and cosmetic results were compared between groups.
RESULTS: After matching, 96 patients (48 CLS and 48 RPLS) were evaluated. Sixteen RPLS cases underwent single-incision laparoscopic surgery (SILS), and 32 underwent single-incision plus one port laparoscopic surgery (SILS + 1). Baseline clinical characteristics were comparable between the RPLS and the CLS groups. Morbidity, pathologic outcomes, and 3-year disease-free survival and overall survival rates were also comparable between the 2 groups. Compared with the CLS group, the RPLS group had a shorter total incision length (p < 0.001); shorter time to liquid diet (p = 0.027), ambulation (p = 0.026), and discharge (p < 0.001); and lower visual analogue scale scores during mobilization at postoperative days 3-5 (p < 0.05). The total operation times, C-reactive protein levels at 24 h and 96 h, and interleukin-6 levels at 24 h postoperatively were significantly lower in the SILS + 1 group than those in the CLS and SILS groups (p < 0.05). Compared with the CLS group, the RPLS group showed better social functioning at 6 months postoperatively (p = 0.011). The SILS and SILS + 1 groups showed similar cosmetic results, and both groups showed better results than the CLS group (p < 0.001).
CONCLUSIONS: RPLS for rectosigmoid cancer is feasible, with short-term safety and long-term oncological safety comparable to that of CLS. Better cosmesis and accelerated recovery can be expected. SILS + 1 is a better choice than CLS or SILS for rectosigmoid cancer because it minimizes invasiveness and reduces technical difficulties.

PMID: 27709329 [PubMed - as supplied by publisher]

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Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

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Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

Eur Arch Otorhinolaryngol. 2016 Oct 5;:

Authors: Koo SK, Kwon SB, Kim YJ, Moon JI, Kim YJ, Jung SH

Abstract
Snoring is a sign of increased upper airway resistance and is the most common symptom suggestive of obstructive sleep apnea. Acoustic analysis of snoring sounds is a non-invasive diagnostic technique and may provide a screening test that can determine the location of obstruction sites. We recorded snoring sounds according to obstruction level, measured by DISE, using a smartphone and focused on the analysis of formant frequencies. The study group comprised 32 male patients (mean age 42.9 years). The spectrogram pattern, intensity (dB), fundamental frequencies (F 0), and formant frequencies (F 1, F 2, and F 3) of the snoring sounds were analyzed for each subject. On spectrographic analysis, retropalatal level obstruction tended to produce sharp and regular peaks, while retrolingual level obstruction tended to show peaks with a gradual onset and decay. On formant frequency analysis, F 1 (retropalatal level vs. retrolingual level: 488.1 ± 125.8 vs. 634.7 ± 196.6 Hz) and F 2 (retropalatal level vs. retrolingual level: 1267.3 ± 306.6 vs. 1723.7 ± 550.0 Hz) of retrolingual level obstructions showed significantly higher values than retropalatal level obstruction (p < 0.05). This suggests that the upper airway is more severely obstructed with retrolingual level obstruction and that there is a greater change in tongue position. Acoustic analysis of snoring is a non-invasive diagnostic technique that can be easily applied at a relatively low cost. The analysis of formant frequencies will be a useful screening test for the prediction of occlusion sites. Moreover, smartphone can be effective for recording snoring sounds.

PMID: 27709292 [PubMed - as supplied by publisher]

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Trends and patterns of computed tomography scan use among children in The Netherlands: 1990-2012.

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Trends and patterns of computed tomography scan use among children in The Netherlands: 1990-2012.

Eur Radiol. 2016 Oct 5;:

Authors: Meulepas JM, Smets AM, Nievelstein RA, Gradowska P, Verbeke J, Holscher HC, Rutten MJ, Kieft M, Ronckers CM, Hauptmann M

Abstract
OBJECTIVE: To evaluate trends and patterns in CT usage among children (aged 0-17 years) in The Netherlands during the period 1990-2012.
METHODS: Lists of electronically archived paediatric CT scans were requested from the Radiology Information Systems (RIS) of Dutch hospitals which reported >10 paediatric CT scans annually in a survey conducted in 2010. Data included patient identification, birth date, gender, scan date and body part scanned. For non-participating hospitals and for years prior to electronic archiving in some participating hospitals, data were imputed by calendar year and hospital type (academic, general with <500 beds, general with ≥ 500 beds).
RESULTS: Based on 236,066 CT scans among 146,368 patients performed between 1990 and 2012, estimated annual numbers of paediatric CT scans in The Netherlands increased from 7,731 in 1990 to 26,023 in 2012. More than 70 % of all scans were of the head and neck. During the last decade, substantial increases of more than 5 % per year were observed in general hospitals with fewer than 500 beds and among children aged 10 years or older.
CONCLUSION: The estimated number of paediatric CT scans has more than tripled in The Netherlands during the last two decades.
KEY POINTS: • Paediatric CT in The Netherlands has tripled during the last two decades. • The number of paediatric CTs increased through 2012 in general hospitals. • Paediatric CTs continued to increase among children aged 10 years or older.

PMID: 27709278 [PubMed - as supplied by publisher]

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Metabolic Syndrome Is not an Independent Risk Factor for Hearing Impairment.

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Metabolic Syndrome Is not an Independent Risk Factor for Hearing Impairment.

J Nutr Health Aging. 2016;20(8):816-824

Authors: Lee HY, Choi YJ, Choi HJ, Choi MS, Chang DS, Kim AY, Cho CS

Abstract
OBJECTIVE: We aimed to investigate the association between metabolic syndrome (MS) and hearing impairment (HI) using nationally representative data from Korean adults.
DESIGN, SETTING AND PARTICIPANTS: A total of 16,799 subjects (≥19 years old; 7,170 men and 9,629 women) who underwent pure tone audiometry testing were included in the analysis. Data were obtained from the fifth Korea National Health and Nutrition Examination Survey (2010-2012). Subjects were divided into two groups according to the presence of MS.
RESULTS: Among the subjects with MS, 47% had HI. Logistic regression analysis revealed that MS was not an independent risk factor for HI, although increased fasting plasma glucose (OR 1·4, 95% CI: 1·1-1·8) was independently associated with HI. In addition, older age, male sex, very low body mass index (≤17·5 kg/m2), lower education level, smoking history, and occupational noise exposure were independently associated with HI. For low-frequency HI, independent risk factors included older age, lower educational level, lower economic status, and very low BMI (≤17·5 kg/m2). For high-frequency HI, independent risk factors included older age, male sex, lower educational level, lower economic status, increased blood pressure, lower high-density lipoprotein cholesterol, and smoking history.
CONCLUSIONS: MS itself was not an independent risk factor for HI, and, among the individual metabolic components, only increased fasting plasma glucose was independently associated with HI.

PMID: 27709230 [PubMed - in process]

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Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers.

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Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers.

Quant Imaging Med Surg. 2016 Aug;6(4):430-448

Authors: Yuan J, Lo G, King AD

Abstract
Radiation therapy (RT), in particular intensity-modulated radiation therapy (IMRT), is becoming a more important nonsurgical treatment strategy in head and neck cancer (HNC). The further development of IMRT imposes more critical requirements on clinical imaging, and these requirements cannot be fully fulfilled by the existing radiotherapeutic imaging workhorse of X-ray based imaging methods. Magnetic resonance imaging (MRI) has increasingly gained more interests from radiation oncology community and holds great potential for RT applications, mainly due to its non-ionizing radiation nature and superior soft tissue image contrast. Beyond anatomical imaging, MRI provides a variety of functional imaging techniques to investigate the functionality and metabolism of living tissue. The major purpose of this paper is to give a concise and timely review of some advanced functional MRI techniques that may potentially benefit conformal, tailored and adaptive RT in the HNC. The basic principle of each functional MRI technique is briefly introduced and their use in RT of HNC is described. Limitation and future development of these functional MRI techniques for HNC radiotherapeutic applications are discussed. More rigorous studies are warranted to translate the hypotheses into credible evidences in order to establish the role of functional MRI in the clinical practice of head and neck radiation oncology.

PMID: 27709079 [PubMed - in process]

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PITX3 promoter methylation is a prognostic biomarker for biochemical recurrence-free survival in prostate cancer patients after radical prostatectomy.

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PITX3 promoter methylation is a prognostic biomarker for biochemical recurrence-free survival in prostate cancer patients after radical prostatectomy.

Clin Epigenetics. 2016;8:104

Authors: Holmes EE, Goltz D, Sailer V, Jung M, Meller S, Uhl B, Dietrich J, Röhler M, Ellinger J, Kristiansen G, Dietrich D

Abstract
BACKGROUND: Molecular biomarkers that might help to distinguish between more aggressive and clinically insignificant prostate cancers (PCa) are still urgently needed. Aberrant DNA methylation as a common molecular alteration in PCa seems to be a promising source for such biomarkers. In this study, PITX3 DNA methylation (mPITX3) and its potential role as a prognostic biomarker were investigated. Furthermore, mPITX3 was analyzed in combination with the established PCa methylation biomarker PITX2 (mPITX2).
METHODS: mPITX3 and mPITX2 were assessed by a quantitative real-time PCR and by means of the Infinium HumanMethylation450 BeadChip. BeadChip data were obtained from The Cancer Genome Atlas (TCGA) Research Network. DNA methylation differences between normal adjacent, benign hyperplastic, and carcinomatous prostate tissues were examined in the TCGA dataset as well as in prostatectomy specimens from the University Hospital Bonn. Retrospective analyses of biochemical recurrence (BCR) were conducted in a training cohort (n = 498) from the TCGA and an independent validation cohort (n = 300) from the University Hospital Bonn. All patients received radical prostatectomy.
RESULTS: In PCa tissue, mPITX3 was increased significantly compared to normal and benign hyperplastic tissue. In univariate Cox proportional hazards analyses, mPITX3 showed a significant prognostic value for BCR (training cohort: hazard ratio (HR) = 1.83 (95 % CI 1.07-3.11), p = 0.027; validation cohort: HR = 2.56 (95 % CI 1.44-4.54), p = 0.001). A combined evaluation with PITX2 methylation further revealed that hypermethylation of a single PITX gene member (either PITX2 or PITX3) identifies an intermediate risk group.
CONCLUSIONS: PITX3 DNA methylation alone and in combination with PITX2 is a promising biomarker for the risk stratification of PCa patients and adds relevant prognostic information to common clinically implemented parameters. Further studies are required to determine whether the results are transferable to a biopsy-based patient cohort. Trial registration: Patients for this unregistered study were enrolled retrospectively.

PMID: 27708722 [PubMed - in process]

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Analysis of Direct Simultaneous Measurement of Glottal Airflow Velocity, Subglottal Pressure, and High-Speed Imaging Using Flexible Transnasal Endoscope in a Human Subject.

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Analysis of Direct Simultaneous Measurement of Glottal Airflow Velocity, Subglottal Pressure, and High-Speed Imaging Using Flexible Transnasal Endoscope in a Human Subject.

Yonago Acta Med. 2016 Sep;59(3):241-247

Authors: Kataoka H, Arii S, Fukuhara T, Fujiwara K, Kunimoto Y, Hasegawa K, Takeuchi H

Abstract
It is difficult to directly observe glottal airflow velocity just above the glottis due to sensor size requirements and limited accessibility. We developed a miniature hot-wire probe and flexible fiberscopic high-speed imaging system for human examinations. Simultaneous direct measurement of glottal airflow velocity, subglottal pressure, and vocal fold vibration was achieved in a patient who was treated with a T-tube for tracheal stenosis. Airflow velocity changes at the anterior midline of the vocal folds were synchronized with subglottal pressure changes during each phonation cycle. The velocity at the anterior midline of the vocal folds showed a rhythmic pattern of sharp, high peaks. The result of fast Fourier transform analysis indicated that glottal velocity at the anterior midline of the vocal folds had abundant high-frequency components that were not affected by resonance of the vocal tract. Airflow velocity was variable and diminished except at the anterior midline of the vocal folds.

PMID: 27708541 [PubMed - in process]

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Thousands of melanoma patients in Europe have no access to new drugs

Over 5000 patients with metastatic melanoma in Europe are denied access to new, life saving drugs every year, according to a survey presented at the ESMO 2016 Congress in Copenhagen. Metastatic melanoma is an aggressive and deadly skin cancer. With...

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New device enables rapid identification of brain cancer type and tumour margin

Research team centered at Nagoya University develops a device for quick, accurate identification of a mutation strongly associated with a cancer that affects the central nervous system, potentially enabling accurate removal of the entire tumour during an...

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Breast cancer screening "could be better and less painful"

The breast cancer screening tests offered to women may in many cases be unnecessarily painful. New research from Lund University in Sweden shows that strong compression of the breast during mammography screening does not automatically lead to a better...

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Combination therapy shows higher response and lower toxicity in paediatric brain cancer trial

A high response rate with a single drug in a phase I/II trial of paediatric brain tumour has set the stage for combination therapy with higher response and lower toxicity, researchers reported at the ESMO 2016 Congress in Copenhagen. “The likelihood of...

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Neoadjuvant immunotherapy prior to surgery is safe and feasible in early lung cancer

Neoadjuvant immunotherapy with the PD-1 inhibitor nivolumab is safe and feasible prior to surgery for early lung cancer, researchers reported at the ESMO 2016 Congress in Copenhagen. “Until now nivolumab and the other anti-PD-1 and anti-PD-L1 drug...

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IL-34 as a potential target to tackle drug-resistance

A team of researchers has discovered that chemoresistant lung cancer cells suppress immune functions and strengthen resistance to chemotherapy by producing interleukin-34 (IL-34)—a type of cytokine. The research is published in the latest issue of...

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Immunotherapy for rectal carcinoma: Some stimulating data but still a long way to clinical evidence

Publication date: November 2016
Source:European Journal of Cancer, Volume 68
Author(s): Jean-Pierre Gérard, Jérôme Doyen




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The use of EORTC measures in daily clinical practice—A synopsis of a newly developed manual

Publication date: November 2016
Source:European Journal of Cancer, Volume 68
Author(s): Lisa M. Wintner, Monika Sztankay, Neil Aaronson, Andrew Bottomley, Johannes M. Giesinger, Mogens Groenvold, Morten Aa Petersen, Lonneke van de Poll-Franse, Galina Velikova, Irma Verdonck-de Leeuw, Bernhard Holzner
Cancer has increasingly become a chronic condition and the routine collection of patient-reported outcomes (PROs) like quality of life is widely recommended for clinical practice. Nonetheless, the successful implementation of PROs is still a major challenge, although common barriers to and facilitators of their beneficial use are well known. To support health care professionals and other stakeholders in the implementation of the EORTC PRO measures, the EORTC Quality of Life Group provides guidance on issues considered important for their use in daily clinical practice. Herein, we present an outline of the newly developed “'Manual for the use of EORTC measures in daily clinical practice”, covering the following issues: * a rationale for using EORTC measures in routine care *selection of EORTC measures, timing of assessments, scoring and presentation of results * aspects of a strategic implementation * electronic data assessment and telemonitoring, and * further use of EORTC measures and ethical considerations. Next to an extensive overview of currently available literature, the manual specifically focuses on knowledge about EORTC measures to give evidence-based recommendations whenever possible and to encourage readers and end-users of EORTC measures to contribute to further needed high-quality research. The manual will be accessible on the EORTC Quality of Life Group website's homepage and will be periodically updated to take into account any new knowledge due to medical, technical, regulatory and scientific advances.



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Comments on “Proposal and validation of a new model to estimate survival for hepatocellular carcinoma patients”

Publication date: Available online 6 October 2016
Source:European Journal of Cancer
Author(s): Wei Sang, Stephen L. Chan, Anthony W.H. Chan




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Doctors warn of dangers of complementary medicine for children

Doctors have warned of the dangers associated with complementary therapies after a 4 year old boy with autism was admitted to an emergency department after his parents followed advice to give him...

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Long-term health outcomes after exposure to repeated concussion in elite level: rugby union players

Background

There is continuing concern about effects of concussion in athletes, including risk of the neurodegenerative disease chronic traumatic encephalopathy. However, information on long-term health and wellbeing in former athletes is limited.

Method

Outcome after exposure to repeated brain injury was investigated in 52 retired male Scottish international rugby players (RIRP) and 29 male controls who were similar in age and social deprivation. Assessment included history of playing rugby and traumatic brain injury, general and mental health, life stress, concussion symptoms, cognitive function, disability and markers of chronic stress (allostatic load).

Results

The estimated number of concussions in RIRP averaged 14 (median=7; IQR 5-40). Performance was poorer in RIRP than controls on a test of verbal learning (p=0.022) and of fine co-ordination of the dominant hand (p=0.038) and not significantly different on other cognitive tests (p>0.05). There were no significant associations between number of concussions and performance on cognitive tests. Other than a higher incidence of cardiovascular disease in controls, no group differences were detected in general or mental health or estimates of allostatic load. In RIRP, persisting symptoms attributed to concussion were more common if reporting more than nine concussions (p=0.028), although these symptoms were not perceived to affect social or work functioning.

Conclusions

Despite a high number of concussions in RIRP, differences in mental health, social or work functioning were not found late after injury. Subtle group differences were detected on two cognitive tests, the cause of which is uncertain. Prospective group comparison studies on representative cohorts are required.

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Antimicrobial potential of green synthesized CeO2 nanoparticles from Olea europaea leaf extract

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Split Inteins

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Paravertebral block and persistent postoperative pain after breast surgery: meta-analysis and trial sequential analysis

Summary

We examined whether paravertebral block has an effect on the prevalence of persistent postsurgical pain after breast surgery. Seven randomised, controlled trials (559 patients) which had the outcome assessor blinded were included, comparing patients who received paravertebral blocks after breast surgery with patients who did not. The risk ratio (95% CI) was 0.75 (0.48–1.15) for the incidence of postoperative pain at 3 months (four studies, 317 patients); the risk ratio (95% CI) obtained from three studies including 301 patients reporting on pain after 6 months was 0.57 (0.29–1.72), and the risk ratio (95% CI) for pain after 12 months (three trials, 237 patients) was 0.42 (0.15–1.23). Conventional meta-analysis using the random effects model thus showed no statistically significant risk reduction for persistent postoperative pain at 3 months, 6 months or 12 months. Trial sequential analysis, used to consider the risk of type 1 and type 2 random error, showed that at 3 months, 6 months and 12 months, the number of subjects in the analyses were only 18.3%, 6.8% and 4.2% of the required information sizes at those time points, respectively. Our study is the first to evaluate data on pain 12 months postoperatively. Trial sequential analysis revealed that the current evidence is not sufficient to reach a conclusion. These findings stand in contrast to previous meta-analyses with fewer studies that had concluded that paravertebral block effectively reduces chronic pain.

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