Long-term control of melanoma adrenal metastasis treated with radiotherapy

xlomafota13 shared this article with you from Inoreader Long-term control of melanoma adrenal metastasis treated with radiotherapy Via Melanoma Research - Published Ahead-of-Print Introduction Melanoma remains a large global burden with a significant proportion of patients succumbing to metastatic disease. The adrenal gland is a common area for metastasis with surgical treatment as the main modality. Radiotherapy is less utilised in this setting with uncertainty over deliverability and efficacy. Here, we present the details and outcomes of 20 patients treated with radiotherapy, with or without systemic therapy, for melanoma adrenal metastasis in a single institute. Methods Twenty patients were identified from radiation treatment and medical records from between 2015 and 2019 at our institution. Three patients had bilateral radiotherapy treatments and therefore 23 adrenal lesions were analysed. Demographics, indications for treatment, radiotherapy methodology and outcomes were recorded. Outcomes were based on serial 18F FDG PET/computerized tomography scans reporting using the PERCIST criteria. Results The most common indication for radiotherapy was oligo-progressive disease (70%) followed by symptom palliation. Eight (35%) of the treatments were delivered by stereotactic ablative body radiotherapy. Twelve (60%) patients had concurrent immunotherapy. Twenty of twenty-three (87%) adrenal lesions had an initial response to treatment with 12 (60%) maintaining local control until death or end of follow-up. Median adrenal-specific progression-free survival was 13 months. Four patients (17%) required salvage adrenalectomy. Symptom palliation was achieved in the majority of patients for which it was indicated and there were no grade three toxicities. The median time from radiotherapy to change of immunotherapy treatment was 4 months. Conclusions Radiotherapy for melanoma adrenal metastasis is effective and deliverable. With the majority of patients achieving a palliative and clinically relevant durable response, adrenalectomy can be reserved as a salvage option. Received 2 August 2021 Accepted 13 February 2022 Correspondence to Brendan McCann, MbChB, Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia, Tel: +44 7505398515; e-mail: brendanmccann85@gmail.comBrendan.mccann@ggc.scot.nhs.uk Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of lateral neck nodes in common and aggressive variants of thyroid cancer

xlomafota13 shared this article with you from Inoreader Management of lateral neck nodes in common and aggressive variants of thyroid cancer Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review Although nodal metastasis in thyroid cancer does not have a major impact on outcome, it does have some prognostic implication in adverse metastasis and aggressive histology. The purpose of this review is to discuss evaluation and management of lateral neck nodes in thyroid cancer. Recent findings There is a high incidence of central and lateral neck node metastasis in thyroid cancer. Appropriate preoperative evaluation is key prior to first surgical procedure. The distribution of nodal metastasis is well recognized and so generally a modified neck dissection is recommended from levels II through V. The risk of nodal metastasis at level IIb is rare. The complications of lateral neck dissection, though rare, are of significant importance to the quality of life. Summary Appropriate preoperative evaluation, including good ultrasound and CT scan with contrast, is recommended. Preoperative FNA of the lateral neck node will be helpful, along with thyroglobulin management if indicated. The neck dissection should include significant levels of neck, avoiding neural injury. Nonsurgical therapies may be recommended in selected patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pathogenic DST sequence variants result in either epidermolysis bullosa simplex (EBS) or hereditary sensory and autonomic neuropathy type 6 (HSAN‐VI)

xlomafota13 shared this article with you from Inoreader Pathogenic DST sequence variants result in either epidermolysis bullosa simplex (EBS) or hereditary sensory and autonomic neuropathy type 6 (HSAN‐VI) Via Experimental Dermatology Abstract DST encodes bullous pemphigoid antigen-1 (BPAG1), a protein with eight tissue-specific isoforms expressed in the skin, muscle, brain, and nerves. Accordingly, mutations in this gene are associated with epidermolysis bullosa simplex (EBS) and hereditary sensory and autonomic neuropathy type 6 (HSAN-VI). The genotypic spectrum is attested to by 19 distinct mutations but genotype-phenotype correlation for both disorders is not well established. In this study, we performed next-generation sequencing (NGS) on two families with different phenotypic presentations, one fetus (P1) with musculoskeletal and neurological malformations established by prenatal ultrasound and family history, and a 15-year-old female (P2) with skin blistering. P1 had a novel homozygous nonsense mutation, DST: NM_001144769, c.3805C>T, p.R1269* within a region of homozygosity (ROH). This mutation resides within the plakin domain of BPAG1 and ablates all isoforms of this protein, leading to novel ex tracutaneous phenotypes consistent with HSAN-VI in P1. P2 had a recurrent homozygous mutation DST: NM_001723.7, c.3370C>T, p.Gln1124* that presented with giant, trauma-induced skin blisters without extracutaneous involvement. This mutation is located within the coiled-coil domain present on the skin isoform of DST, BPGA1-e, associated with EBS. In summary, we report two families with pathogenic DST variants and expand the spectrum of DST genotype and phenotypes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The perfusion index as a noninvasive method for continuous monitoring of peripheral perfusion: A baseline study to assess the perfusion index in healthy adult volunteers

xlomafota13 shared this article with you from Inoreader The perfusion index as a noninvasive method for continuous monitoring of peripheral perfusion: A baseline study to assess the perfusion index in healthy adult volunteers Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 26:S1748-6815(22)00117-6. doi: 10.1016/j.bjps.2022.02.031. Online ahead of print. NO ABSTRACT PMID:35277365 | DOI:10.1016/j.bjps.2022.02.031 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does the Perception of Own Voice Affect Our Behavior?

xlomafota13 shared this article with you from Inoreader Does the Perception of Own Voice Affect Our Behavior? Via Journal of Voice This study aimed to investigate what are the factors that influence the perception of one's own voice, and if there are any differences using voice between speaking and singing. Further the study purported to examine how these attitudes affect individuals' vocal behavior in personal and social contexts. A total of 100 participants completed the survey which comprised 23 questions about demographics, music experience, speaking voice, and singing voice. The quantitative data were analyzed by correlations and paired t test. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.