JAMA ORL Online First

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Read the latest research from JAMA Otolaryngology—Head & Neck Surgery, which publishes clinical and basic articles from around the world on diseases of the head and neck.

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Online First September 08, 2016 Original Investigation Prevalence and Incidence of Diagnosed Chronic Rhinosinusitis in Alberta, Canada   Yuan Xu, MD, MSc; Hude Quan, MD, PhD; Peter Faris, PhD; et al JAMA Otolaryngol Head Neck Surg. Published online September 08, 2016. doi:10.1001/jamaoto.2016.2227 Chronic Sinusitis and Risk of Head and Neck Cancer in the US Elderly Population   Daniel C. Beachler, PhD, MHS; Eric A. Engels, MD, MPH JAMA Otolaryngol Head Neck Surg. Published online September 08, 2016. doi:10.1001/jamaoto.2016.2624 Survival and Surgical Outcomes for Pediatric Head and Neck Melanoma   Morgan K. Richards, MD, MPH; Josephine Czechowicz, MD; Adam B. Goldin, MD, MPH; et al JAMA Otolaryngol Head Neck Surg. Published online September 08, 2016. doi:10.1001/jamaoto.2016.2630 Invited Commentary Can Chronic Sinusitis Cause Cancer?   Elisabeth H. Ference, MD, MPH; Jeffrey D. Suh, MD JAMA Otolaryngol Head Neck Surg. Published online September 08, 2016. doi:10.1001/jamaoto.2016.2649 Clinical Challenge A Young Man With Enlarging Unilateral Tonsil Mass   Casey Hay, MD; Rafal Kozielski, MD; Philomena Behar, MD JAMA Otolaryngol Head Neck Surg. Published online September 08, 2016. doi:10.1001/jamaoto.2016.2472 You Also May Like Effect of Topical Intranasal Therapy on Epistaxis Frequency in Patients With Hereditary Hemorrhagic Telangiectasia: A Randomized Clinical Trial This message was sent to alsfakia@gmail.com by updates@jamanetwork.org. Thank you for subscribing to JAMA Network email alerts. To sign up for additional alerts, or to unsubscribe, click here.  To ensure you always receive JAMA Network emails, add the email address updates@jamanetwork.org to your address book. To unsubscribe by mail, contact: The JAMA Network AMA Plaza 330 N Wabash Ave Chicago, IL 60611 ©2016 American Medical Association. All rights reserved.

Hydrogel injection reduces rectal toxicity after radiotherapy for localized prostate cancer

Abstract

Purpose

Injection of a hydrogel spacer before prostate cancer radiotherapy (RT) is known to reduce the dose to the rectal wall. Clinical results from the patient's perspective are needed to better assess a possible benefit.

Methods

A group of 167 consecutive patients who received prostate RT during the years 2010 to 2013 with 2‑Gy fractions up to 76 Gy (without hydrogel, n = 66) or 76–80 Gy (with hydrogel, n = 101) were included. The numbers of interventions resulting from bowel problems during the first 2 years after RT were compared. Patients were surveyed prospectively before RT, at the last day of RT, and at a median of 2 and 17 months after RT using a validated questionnaire (Expanded Prostate Cancer Index Composite).

Results

Baseline patient characteristics were well balanced. Treatment for bowel symptoms (0 vs. 11 %; p < 0.01) and endoscopic examinations (3 vs. 19 %; p < 0.01) were performed less frequently with a spacer. Mean bowel function scores did not change for patients with a spacer in contrast to patients without a spacer (mean decrease of 5 points) >1 year after RT in comparison to baseline, with 0 vs. 12 % reporting a new moderate/big problem with passing stools (p < 0.01). Statistically significant differences were found for the items "loose stools", "bloody stools", "painful bowel movements" and "frequency of bowel movements".

Conclusion

Spacer injection is associated with a significant benefit for patients after prostate cancer RT.

http://ift.tt/2c3PqIj

Oral Oncology Articles in Press E

Letter to the editor referring to the publication entitled "The role of antagonists of the PD-1:PD-L1/PD-L2 axis in head and neck cancer treatment" by Pai et al.

Published online: August 28, 2016

P. Szturz, S. Faivre

Oral Oncology

http://www.oraloncology.com/article/S1368-8375(16)30135-X/fulltext



m-TOR inhibitor as potential radiosensitizer for head and neck squamous cell carcinoma: A case report of an organ transplant patient and review of the literature

Published online: August 30, 2016

Amaury Daste, Erwan de Mones, Charles Dupin, Louis François, Alain Ravaud, Laurence Digue

Oral Oncology

http://www.oraloncology.com/article/S1368-8375(16)30136-1/fulltext



Prognostic role of negative plasma EBV DNA level in patients with NPC

Published online: August 30, 2016

Enis Ozyar

Oral Oncology

http://www.oraloncology.com/article/S1368-8375(16)30139-7/fulltext




View all Articles in Press at www.oraloncology.com/inpress

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Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

A pill at bedtime, and your heart is fine? Bedtime hypertension chronotherapy: an opportune and advantageous inexpensive treatment strategy

It is commonly assumed that cardiovascular (CV) system rests during the nighttime, the sleep span being a restorative time for the CV system. However, the biology of the CV system is much more complicated than assumed. Convincing evidence now demonstrates the critical importance of the sleep-time blood pressure (BP) level and 24-hour (h) pattern in affecting CV risk. BP is not constant but exhibits distinct temporal patterning during the 24-h, with a circadian (from the Latin 'circa diem', near 24-h) organization.

http://ift.tt/2cdXwbV

Reduction of cardiac and coronary artery doses in irradiation of left-sided breast cancer during inspiration breath hold

Abstract

Background and purpose

The radiation dose received by the heart during adjuvant left-sided breast irradiation plays a crucial role in development of late toxicity. Although the absolute risk of cardiotoxicity can be reduced with modern irradiation techniques, cardiotoxic chemotherapy increases the risk of late damage. Thus, the radiation dose to the heart should be minimized. This study evaluated the influence of different amplitudes of inspiration breath hold (IBH) during simulated left-sided breast irradiation on cardiac doses compared to free breathing (FB).

Patients and methods

CT data of 11 lung cancer patients were retrospectively used as left-sided pseudo-breast cancer cases. Two CT scans were used, one during IBH and one during FB, and two treatment plans were generated. Relevant heart, lung, and left anterior descending artery (LAD) parameters were derived from dose–volume histograms. The normal tissue complication probabilities (NTCPs) for the heart were calculated based on the relative seriality model. Inspiration depth was quantified using chest volume and diameter, and correlated thereafter to a possible sparing of heart tissue.

Results

Mean reduction of heart dose for IBH compared to FB was 40 % (1.65 vs. 0.99 Gy; p = 0.007). Maximum dose to the heart and LAD could be decreased by 33 % (p = 0.011) and 43 % (p = 0.024), respectively. The mean anteroposterior shift was 5 mm (range 0.9–9.5 mm). Significant negative correlations between the relative change in LAD mean dose and the mean thoracic diameter and volume change, as well as with the absolute change in thoracic diameter were seen. The NTCP for cardiac mortality could be decreased by about 78 % (p = 0.017).

Conclusion

For left-sided breast cancer patients, cardiac doses can be significantly decreased with tangential irradiation and IBH.

http://ift.tt/2bWn4Pe

Review of quantitative outcome analysis of cranial morphology in craniosynostosis

Outcome measures in craniosynostosis surgery have progressed from those based on the need for surgical revision to linear anthropometric measurements, 2D CT vector analysis and 3D CT vector analysis. However, finding an objective means to assess postoperative cranial morphological improvement remains challenging.A critical review of previous studies used to measure craniosynostosis surgery outcomes is presented. The introduction of novel techniques currently being used in our unit which is described.

http://ift.tt/2chdIfT

Robotic-assisted Nipple Sparing Mastectomy: A feasibility study on cadaveric models

Nipple-sparing mastectomy (NSM) is increasingly popular for the treatment of selected breast cancers and prophylactic mastectomy. Surgical scarring and aesthetic outcomes are important patient related cosmetic considerations.1,2 Today, the concept of minimal invasive surgery has become popular, especially with the use of robotic surgery.

http://ift.tt/2cG0B5K

The learning rate in three dimensional high definition video assisted microvascular anastomosis in a rat model

Three-dimensional (3D)-high definition (HD) video systems are changing microsurgical practice by providing stereoscopic imaging not only for the surgeon and first assistant using the binocular microscope, but also for others involved in the surgery. The purpose of this study was to evaluate the potential to replace the binocular microscope for microarterial anastomoses and assess the rate of learning based on surgeons' experience.Two experienced and two novice microsurgeons performed a total of 88 rat femoral arterial anastomoses: 44 using a 3D HD video device ('Trenion', Carl Zeiss Meditech) and 44, a binocular microscope.

http://ift.tt/2checm7

The Role of Face Transplantation in the Self-Inflicted Gunshot Wound

Facial self-inflicted gunshot wounds (SIGSWs) cause a devastating midfacial defect, and pose a challenging problem to the reconstructive surgeon. Face transplantation (FT) has the potential for near-normal restoration in otherwise non-reconstructable defects. Two out of 7 FT recipients at Brigham and Women's Hospital (BWH) were individuals who sustained SIGSWs. Here, we illustrate the role of FT in the management of SIGSWs through an aesthetic, functional and psychosocial examination of outcomes.

http://ift.tt/2cFYTle

Drug Synergism of Proteasome Inhibitors and Mitotane by Complementary Activation of ER Stress in Adrenocortical Carcinoma Cells

Abstract

Mitotane is the only drug approved for treatment of the orphan disease adrenocortical carcinoma (ACC) and was recently shown to be the first clinically used drug acting through endoplasmic reticulum (ER)-stress induced by toxic lipids. Since mitotane has limited clinical activity as monotherapy, we here study the potential of activating ER-stress through alternative pathways. The single reliable NCI-H295 cell culture model for ACC was used to study the impact MG132, bortezomib (BTZ) and carfilzomib (CFZ) on mRNA and protein expression of ER-stress markers, cell viability and steroid hormone secretion. We found all proteasome inhibitors alone to trigger expression of mRNA (spliced X-box protein 1, XBP1) and protein markers indicative of the inositol-requiring enzyme 1 (IRE1) dependent pathway of ER-stress but not phosphorylation of eukaryotic initiation factor 2α (eIF2α), a marker of the PRKR-like endoplasmic reticulum kinase (PERK)-dependent pathway. Whereas mitotane alone activated both pathways, combination of BTZ and CFZ with low-dose mitotane blocked mitotane-induced eIF2α phosphorylation but increased XBP1-mRNA splicing indicating that proteasome inhibitors can commit signalling towards a single ER-stress pathway in ACC cells. By applying the median effect model of drug combinations using cell viability as a read out, we determined significant drug synergism between mitotane and both BTZ and CFZ. In conclusion, combination of mitotane with activators of ER-stress through the unfolded protein response is synergistic in an ACC cell culture model. Since proteasome inhibitors are readily available clinically, they are attractive candidates to study for ACC treatment in clinical trials in combination with mitotane.

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Female specific glucose-sensitivity of GnRH1 neurons leads to sexually dimorphic inhibition of reproduction in medaka

Endocrinology, Early Release.


http://ift.tt/2csweAz

Recent Findings on Quality-of-Life Management in Patients With Cancer

This Viewpoint highlights recent findings on quality-of-life management for patients with cancer and their survivors.

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Implications of Moonshot in Hereditary Cancer Syndromes

This Viewpoint discusses the significance of investing billions of dollars in genomic sequencing and the implications of finding a hereditary mutation in patients with metastatic cancer using next-generation sequencing.

http://ift.tt/2c8Hxxw

Prognostic Factors for Local Control in Breast Cancer With Boost vs No Boost

This reanalysis of the EORTC "boost vs no boost" trial examines the long-term impact of prognostic factors on ipsilateral breast tumor recurrence in patients treated with breast-conserving therapy.

http://ift.tt/2c8Hfqb

Breast Cancer Risk Following Diagnosis of Atypical Ductal Hyperplasia

This cohort study uses data from the Breast Cancer Surveillance Consortium to evaluate the 10-year cumulative risk of breast cancer in women with atypical ductal hyperplasia that was diagnosed on needle biopsy vs excisional biopsy.

http://ift.tt/2csleDg

Human Papillomavirus Types Conferring Poor Cancer Prognosis

In Reply Human papillomavirus (HPV)-related oropharynx cancer (OPC) is well known to have a favorable outcome compared with HPV-unrelated OPC. The use of immunohistochemical analysis to detect tumor overexpression of p16 is regarded as a reliable surrogate marker for HPV-driven OPC and is presently used to define this disease for inclusion within clinical trials, including those studying treatment deescalation. Appropriately, these trials also incorporate additional criteria such as tumor extent to define risk groups. For some patients, however, p16 status and tumor extent have limitations in predicting outcome. It is therefore imperative in the era of deescalation to identify additional potential prognostic factors in HPV-related OPC. We recently reported that HPV-16 was associated with favorable survival compared with other HPV types (HPV-other) (HR, 4.8; P = .003), a finding that could not be readily explained by differences in clinical, demographic, or genomic features. Psyrri et al have highlighted several aspects of our analysis, and we appreciate the opportunity to reply.

http://ift.tt/2ccXCTA

Human Papillomavirus Types Conferring Poor Cancer Prognosis

To the Editor In their interesting research letter, Bratman and colleagues report that patients with head and neck squamous cell carcinoma associated with human papillomavirus (HPV) genotypes other than HPV-16 have inferior survival. They propose that this finding will affect patient selection in trials of treatment deintensification, which seek to minimize long-term toxic effects in patients with highly curable HPV-initiated oropharyngeal cancer. Data respecting the relative importance of p16 and HPV status in predicting outcome after chemoradiotherapy, as well as experience in cervical cancer, may be helpful in interpreting these results.

http://ift.tt/2c1XdGB

Atypical Ductal Hyperplasia

Since the 1985 report by Dupont and Page, women with atypical hyperplasia have been found to have an increased risk for developing breast cancer. Recent reports with long-term follow-up have shown the absolute risk for developing breast cancer to be within the range of 1% to 2% per year. Most of these studies were performed in cohorts starting in the 1960s, before the widespread use of screening mammograms and core biopsies. In the modern era, are we overestimating the risk of women with atypical hyperplasia for developing breast cancer?

http://ift.tt/2ccX4Nh

Benefits of Tumor Bed Boost After Whole-Breast Radiotherapy

Beginning in the late 1970s, multiple randomized trials established the equivalence of breast-conserving surgery plus radiotherapy to mastectomy. Uncertainty existed with regard to the required radiation dose, as some of the early trials delivered an additional boost of radiation to the tumor bed after whole-breast radiotherapy while others did not.

http://ift.tt/2c1WEwp

Mucositis (or Stomatitis)

Mucositis (sometimes called stomatitis) is inflammation and damage of the mucous membranes lining the mouth and other parts of the gastrointestinal (GI) tract.

http://ift.tt/2ccXkfw