Spiritual peace and life meaning

Spiritual peace and life meaning may buffer the effect of anxiety on physical well‐being in newly diagnosed cancer survivors:

Abstract

Objective

To assess the extent to which spiritual well‐being moderates the relationship between anxiety and physical well‐being in a diverse, community‐based cohort of newly diagnosed cancer survivors.

Methods

Data originated from the Measuring Your Health (MY‐Health) study cohort (n=5506), comprised of people assessed within 6‐13 months of cancer diagnosis. Life meaning/peace was assessed using the 8‐item subscale of the Spiritual Well‐Being Scale (FACIT‐Sp‐12). Anxiety was measured with an 11‐item PROMIS® Anxiety short form, and physical well‐being was assessed using the 7‐item FACT‐G subscale. Multiple linear regression models were used to assess relationships among variables.

Results

Life meaning and peace was negatively associated with anxiety, b = ‐0.56 (p < 0.001) and positively associated with physical well‐being, b = 0.43 (p = < 0.001) after adjusting for race, education, income, and age. A significant interaction between life meaning/piece and anxiety emerged (p < .001) indicating that spiritual well‐being moderates the relationship between anxiety and physical well‐being. Specifically, for cancer survivors high in anxiety, physical well‐being was dependent on levels of life meaning/peace, b = 0.19, p < .001. For those low in anxiety, physical well‐being was not associated with levels of life meaning/peace, b = 0.01, p = .541. Differences in cancer clinical factors (cancer stage at diagnosis, cancer type) did not significantly impact results.

Conclusions

Further research is needed to assess how spiritual well‐being may buffer the negative effect of anxiety on physical well‐being. A clinical focus on spiritual well‐being topics such as peace and life meaning, may help cancer survivors of all types as they transition into follow‐up care.

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Video cognitive‐behavioral therapy for insomnia in cancer patients

Video cognitive‐behavioral therapy for insomnia in cancer patients: A cost‐effective alternative:

Abstract

Objective

Despite its high prevalence, cancer‐related insomnia typically remains untreated because of a lack of access to cognitive‐behavioral therapy for insomnia (CBT‐I), the treatment of choice for this condition. While face‐to‐face CBT‐I appears to be optimal in terms of efficacy, self‐administered formats may be more cost‐effective. The goal of this secondary analysis of a randomized clinical trial was to compare the cost‐effectiveness of a professionally‐based CBT‐I (PCBT‐I) to that of a video‐based CBT‐I (VCBT‐I).

Methods

A total of 161 women with breast cancer received six weekly, individual CBT‐I sessions (PCBT‐I; n = 81) or a 60‐minutes animated video +6 short booklets (VCBT‐I; n = 80). Participants completed the Insomnia Severity Index (ISI) and provided information to calculate treatment costs.

Results

Total per patient treatment costs were 5.5 times greater for PCBT‐I ($1298.90) than VCBT‐I ($234.36; P < .0001). Both at posttreatment and 3‐month follow‐up, the ISI reduction was greater in PCBT‐I than VCBT‐I, but these differences were not significant (P = .09 and P = .24, respectively). In contrast, the cost‐effectiveness ratio was significantly more advantageous for VCBT‐I than PCBT‐I. Compared to VCBT‐I, each reduction of 1 unit on the ISI produced by PCBT‐I was associated with a treatment cost that was significantly greater at posttreatment ($186.95 CAD vs $44.87 CAD; P = .001) and follow‐up ($154.76 vs $24.97, P = .005).

Conclusions

Although CBT‐I is slightly less efficacious when self‐administered, it constitutes a much more cost‐effective alternative than face‐to‐face CBT‐I and represents an extremely valuable option in settings where monetary and human resources required to administer CBT‐I are not available or sufficient.

assessing focal renal lesions in pediatric patients with tuberous sclerosis complex

Performance of simultaneous multi-slice accelerated diffusion-weighted imaging for assessing focal renal lesions in pediatric patients with tuberous sclerosis complex:

Abstract

Background

Diffusion-weighted imaging (DWI) is a useful MRI technique to characterize abdominal lesions in children, but long acquisition times can lead to image degradation. Simultaneous multi-slice accelerated DWI is a promising technique to shorten DWI scan times.

Objective

To test the feasibility of simultaneous multi-slice DWI of the kidneys in pediatric patients with tuberous sclerosis complex (TSC) and to evaluate the accelerated protocol regarding image quality and quantitative apparent diffusion coefficient (ADC) values compared to standard echoplanar DWI sequence.

Materials and methods

We included 33 children and adolescents (12 female, 21 male; mean age 10±5 years) with TSC and renal cyst or angiomyolipoma on 3-tesla (T) MRI from 2017 to 2019. All studies included both free-breathing standard echoplanar DWI and simultaneous multi-slice DWI sequences. Subjective and quantitative image quality was evaluated using a predefined 5-point scale. ADC values were obtained for all renal cysts and angiomyolipomas ≥5 mm. All statistical analysis was performed using Stata/SE v15.1.

Results

Simultaneous multi-slice DWI ADC values were slightly lower compared to standard echoplanar DWI for both renal cysts and angiomyolipomas (mean difference 0.05×10⁻³ mm²/s, 95% confidence interval [CI] 0.40–0.50 and 0.024×10⁻³ mm²/s, 95% CI 0.17–0.21, respectively, with P>0.1). Our results showed that renal lesions with ADC values >1.69×10⁻³ mm²/s were all cysts, whereas lesions with values <1.16×10⁻³ mm²/s were all angiomyolipomas. However, ADC values could not discriminate between lipid-rich and lipid-poor angiomyolipomas (P>0.1, for both sequences).

Conclusion

A 55% reduction in scan time was achieved using simultaneous multi-slice DWI for abdominal imaging in children with TSC, with near identical image quality as standard DWI. These results suggest that multi-slice techniques should be considered more broadly as an MRI acceleration technique in children.

behavioural sex differences

A systematic review and meta‐analysis of behavioural sex differences in executive control:


Due to inconsistencies within the literature, we conducted a meta‐analysis on sex differences in executive control. Here, we show that males and females do not differ in the executive control domains of performance monitoring, response inhibition, and cognitive set‐shifting. However, there are task‐specific differences observed on the CANTAB spatial working memory task and the delay discounting task. Our results indicate a need for more well‐controlled studies to understand how sex differences may influence task performance.

Abstract

Literature investigating whether an individuals' sex affects their executive control abilities and performance on cognitive tasks in a normative population has been contradictory and inconclusive. Using meta‐analytic procedures (abiding by PRISMA guidelines), this study attempts to identify the magnitude of behavioural sex differences in three prominent executive control domains of cognitive set‐shifting, performance monitoring, and response inhibition. PubMed, Web of Science, and Scopus were systematically searched. Across 46 included studies, a total of 1988 females and 1884 males were included in the analysis. Overall, males and females did not differ on performance in any of the three domains of performance monitoring, response inhibition, or cognitive set‐shifting. Task‐specific sex differences were observed in the domains of performance monitoring, in the CANTAB Spatial Working Memory task—males scored statistically higher than females (Hedges' g = −0.60), and response inhibition, in the Delay Discounting task—females scored statistically higher than males (Hedges' g = 0.64). While the meta‐analysis did not detect overall behavioural sex differences in executive control, significant heterogeneity and task‐specific sex differences were found. To further understand sex differences within these specific tasks and domains, future research must better control for age and sex hormone levels.

Fine needle aspiration cytology of cervical lymph nodes: Comparison of liquid based cytology (SurePath) and conventional preparation

Fine needle aspiration cytology of cervical lymph nodes: Comparison of liquid based cytology (SurePath) and conventional preparation:

Abstract

Background

Fine needle aspiration cytology (FNAC) is the first diagnostic step in patient with cervical lymphadenopathy because of its simplicity, safety and early availability of the results. Liquid‐based cytology (LBC) is an alternative processing method which is used for both gynecological and nongynecological samples. Literature reviewed show few studies comparing LBC with conventional preparation (CP).

Aim

The present study was undertaken to evaluate the efficacy of LBC and comparison of LBC and CP in cervical lymphadenopathy.

Materials and Methods

In this prospective study, a total of 75 cases of FNAC with cervical lymphadenopathy were included. The first pass was used for CP followed by LBC with the use of SurePath (SP) technique. Both the smears were compared for cellularity, background containing blood, cell debris, lymphoglandular bodies, stromal fragments, cytoarchitectural pattern, etc., by semiquantitative scoring system.

Results

There was no statistical difference in the cellularity, cell architecture, and monolayer cells (P > .05). On the basis of background containing blood, cell debris, lympho‐glandular bodies, stromal fragments (P < .001), nuclear, and cytoplasmic details (P < .05), LBC was found to be superior to CP.

Conclusion

LBC is a relatively simple technique and superior to CP in respect of better nuclear and cytoplasmic details with loss of background blood and debris. It has a diagnostic accuracy equivalent to that of CP. However, use of both LBC and CP can result in better diagnostic accuracy.

Ameloblastoma diagnosis by fine‐needle aspiration cytology supplemented by cell block samples

Ameloblastoma diagnosis by fine‐needle aspiration cytology supplemented by cell block samples:

Abstract

Ameloblastomas are rarely encountered in clinical practice, accounting for only 1% of tumors and cysts of the jaw although they are one of the most common odontogenic neoplasms. The cytological features are described in a few case reports only. The aim of this study was to describe the morphological features of ameloblastoma in fine‐needle aspiration cytology (FNAC) and highlight the contribution of cell blocks in their diagnosis. Three cases of ameloblastoma diagnosed on FNAC (FNAC) with cell block samples were retrieved and evaluated in detail. Radiological correlation was performed in three cases. Follow‐up histopathology of the resected specimen was available in two cases. Cytology smears showed clusters of basaloid cells with high nucleocytoplasmic(N/C) ratio and dense chromatin. Focal squamoid differentiation was present in one case and cystic change predominated in one case. The characteristic morphology of the tumor was better appreciated on cell block section with cribriform and trabecular arrangement of tumor cells with peripheral nuclear palisading with foci of squamoid differentiation and cystic change. Cell blocks from aspirates act as mini‐biopsies and contribute to accurate diagnoses of ameloblastomas of the mandible, thereby emphasizing their contribution to the proper management of these uncommon neoplasms.

Complications of Fluoroscopically Guided Cervical Interlaminar Epidural Steroid Injections

Complications of Fluoroscopically Guided Cervical Interlaminar Epidural Steroid Injections:

Abstract

Purpose of Review

Cervical interlaminar epidural steroid injection is a common intervention in the management of cervical radiculitis. Given the large number of injections done annually, it is important to assess the potential complications associated with this procedure.

Recent Findings

Based on current published studies, the overall complication rate varies. The vast majority are minor complications. However, this review also identified potentially catastrophic complications following cervical interlaminar epidural steroid injections.

Summary

Based upon our review, cervical epidural steroid injection is considered a safe intervention. Nevertheless, catastrophic complications such as spinal cord injuries from needle placement, infections, and epidural hematoma can occur. It is prudent to take appropriate measures to minimize these complications.

Low-Dose Naltrexone for Chronic Pain

Low-Dose Naltrexone for Chronic Pain: Update and Systemic Review:

Abstract

Purpose of Review

The purpose of this review is to evaluate and explain our current understanding of the clinical use of low-dose naltrexone in the treatment of chronic pain.

Recent Findings

Recent pre-clinical uses and clinical studies further elucidate the use of low-dose naltrexone in the treatment of chronic pain.

Summary

Low-dose naltrexone (LDN) has shown promise to reduce symptoms related to chronic pain conditions such as fibromyalgia, inflammatory bowel conditions, and multiple sclerosis. The mechanism of LDN appears to be modulation of neuro-inflammation, specifically, the modulation of the glial cells and release of inflammatory chemicals in the central nervous system. These effects appear to unique at low dosage compared to dosage for food and drug administration approved use for alcohol and opioid dependence. We review the evidence that LDN has shown more than promise and should be further investigated in clinical practice.

staging for head and neck cutaneous squamous cell carcinoma (HNcSCC)

The American Joint Committee on Cancer staging for metastatic head and neck cutaneous squamous cell carcinoma: A multi‐institutional study of within‐stage heterogeneity and impact on prognostic performance:

Abstract

Background

The American Joint Committee on Cancer (AJCC) staging for head and neck cutaneous squamous cell carcinoma (HNcSCC) stratifies risk poorly. We hypothesized that this results from prognostic heterogeneity within N and TNM groups.

Methods

Retrospective analysis of disease‐specific survival (DSS) in a multicenter study of 1146 patients with nodal metastases from HNcSCC.

Results

The majority of patients were classified as pN2a or pN3b (83.1%) and TNM stage IV (90.6%). On multivariate analysis, there was statistically significant prognostic heterogeneity within these groups based on the number and size of nodal metastases, immunosuppression, and perineural invasion. When stage IV patients were categorized into low, moderate, and high‐risk groups based on adverse features, there was wide variation in prognosis with 5‐year DSS ranging from 90% to 60% (P < .001).

Conclusions

The AJCC staging system stratifies risk poorly in HNcSCC due to significant prognostic heterogeneity within pN2a, pN3b, and stage IV groups.

Endoscopic transoral approach for resection of retrostyloid parapharyngeal space tumors

Endoscopic transoral approach for resection of retrostyloid parapharyngeal space tumors: Retrospective analysis of 16 patients:

Abstract

Background

The purpose of this study was to assess the feasibility of the endoscopic transoral approach for resection of retrostyloid benign tumors.

Methods

We retrospectively reviewed 16 patients with retrostyloid parapharyngeal space (PPS) tumors resected via an endoscopic transoral approach. After separation and control of the internal carotid artery (ICA), tumors in the retrostyloid PPS were then removed under the guidance of angled endoscope (45°).

Results

All 16 patients with retrostyloid PPS tumors were successfully removed via an endoscopic transoral approach. There were 15 schwannomas and 1 paraganglioma. Two tumors were removed en bloc, and the other 14 tumors were removed by piecemeal. In five patients, the tumor extended into the jugular foramen, and was completely removed via the transoral corridor, without cerebrospinal fluid leak. No ICA injury was encountered in any of the 16 patients.

Conclusion

The endoscopic transoral approach is suitable for the resection of retrostyloid PPS tumors and is associated with low morbidity.

Determining the number and distribution of intraparotid lymph nodes

Determining the number and distribution of intraparotid lymph nodes according to parotidectomy classification of European Salivary Gland Society: Cadaveric study:

Abstract

Background

To investigate the distribution of the parotid gland's intraglandular lymph nodes using the parotidectomy zones determined by the parotidectomy classification of the European Salivary Gland Society (ESGS).

Materials and Methods

A total of 128 parotid glands were dissected from 64 fresh cadavers, by bilateral parotidectomy without additional incision within the standard autopsy procedure, and categorized.

Results

Eighty‐six percent of the IGLNs were located in the superficial lobe and 14% in the deep lobe. An average of 7.09 ± 3.55 IGLNs were found for each of the gland; there were 6.11 ± 3.28 in the superficial lobe and 0.98 ± 1.46 in the deep lobe. While the most common lymph nodes were found in level 2 with 47.7%, only 5% of IGLNs were at level 4. According to the proposed modification, the most common lymph nodes (35.24%) were located at level 2B.

Conclusion

Level 2B was found to contain significantly more lymph nodes than other levels, which has not been evaluated before in literature.

Transbronchial Needle Aspiration Cytology and Purulent Pericarditis

Transbronchial Needle Aspiration Cytology and Purulent Pericarditis: Journal of Investigative Medicine High Impact Case Reports, Volume 8, Issue , January-December 2020.

Endobronchial ultrasound with transbronchial needle aspiration (TBNA) is commonly performed for the evaluation of mediastinal lymphadenopathy. Purulent pericarditis is a rare, yet potentially fatal complication of TBNA. It commonly presents with nonspecific symptoms such as chest pain, shortness of breath, palpitations, or vague abdominal discomfort. Additionally, more severe symptoms such as cardiac tamponade and even death have been reported. In this article, we present the case of a 58-year-old male who developed purulent pericardial effusion with tamponade thought to be caused by TBNA cytology. This case raises an important question regarding the current guidelines for prophylactic antibiotic treatment for patients at high risk of developing purulent pericarditis as a complication of TBNA.

Giant sublingual hamartoma with medial cleft tongue

Giant sublingual hamartoma with medial cleft tongue: a case report and literature review: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

Hamartomas commonly occur in respiratory and digestive organs, such as the lungs, pancreas, and liver; they rarely occur in the oral cavity, especially in the sublingual region. This report describes a 5-month-old boy who presented with a giant sublingual hamartoma and medial cleft tongue. He underwent corrective operations at 5 months, 11 months, and 31 months of age. Histopathological analysis revealed features suggestive of hamartoma. There have been no signs of recurrence. The boy exhibited normal speech development at 3 years of age; all other oral functions were unaffected at that time. This report includes a review of relevant literature. The findings in this report and previous literature suggest that a multidisciplinary approach, carefully planned staged surgery, and rehabilitation are needed to achieve favorable outcomes in patients with hamartoma in the oral cavity.

Inflammatory cytokine expression in the skin of patients with postherpetic neuralgia

Inflammatory cytokine expression in the skin of patients with postherpetic neuralgia: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

ObjectiveTo assess the expression of inflammatory cytokines in the affected and normal skin of postherpetic neuralgia (PHN) patients.MethodsAffected skin and normal skin samples were collected from PHN patients. Inflammatory cell infiltration in the dermis were evaluated by hematoxylin-eosin (HE) staining. A human inflammatory protein array containing 40 cytokines was used to assess expression differences between PHN and control skin. Enzyme linked immunosorbent assay (ELISA) kits were used to confirm cytokine expression in 10 PHN patients.ResultsHE staining showed that the epidermis of PHN skin was thicker than that of contralateral normal skin. Compared with normal skin, there was more infiltration of inflammatory cells into the dermis of PHN skin. The cytokine array detected the presence of 21/40 cytokines; however, only interleukin (IL)-1α showed differential expression between PHN skin and normal skin. ELISA results for IL-1α, IL-16, intercellular adhesion molecule-1, and monocyte chemoattractant protein-1 were consistent with those of cytokine arrays.ConclusionsExpression of inflammatory cytokines in PHN skin was not significantly altered compared with normal skin. Chronic refractory pain in PHN is not necessarily associated with increased inflammation in the affected skin.

The real cause of right lower abdominal pain: an analysis of ultrasonographic findings............................ the ureteral calculus might have played a much more important role in causing acute right lower abdominal pain than the accessory spleen

The real cause of right lower abdominal pain: an analysis of ultrasonographic findings: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

A pelvic accessory spleen is uncommon and most patients with this condition are asymptomatic. Ureteral calculus is a common disease and can cause acute abdominal pain. We report a 51‐year‐old male patient who presented at our hospital with acute right lower abdominal pain and gross hematuria. A large mass on the right side of the pelvis was detected on an ultrasound examination, as well as a calculus in the lower segment of the right ureter. Computed tomography angiography showed the presence of a long vascular pedicle with an artery originating from the splenic artery and a vein that joined with the splenic vein. Laparoscopy was carried out and it showed a solid mass covered with omentum on the right lower abdomen. The mass was then removed surgically. Histopathological examination of the resected specimens confirmed splenic tissue. We speculate that the accessory spleen and ureteral calculus caused right lower abdominal pain in our case. However, the ureteral calculus might have played a much more important role in causing acute right lower abdominal pain than the accessory spleen.

The regulatory role of exosomes in leukemia and their clinical significance

The regulatory role of exosomes in leukemia and their clinical significance: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

Recurrence is a primary cause of death in patients with leukemia. The interactions of tumor cells with the microenvironment and tumor stem cells hidden in bone marrow promote the recurrence and metastasis of leukemia to lymphoid tissue. Exosomes, membrane-coated nanovesicles secreted by living cells, perform biomaterial transfer and information exchange between cells. Exosomes contain various other biological components derived from parental cells, and they remotely regulate the function of target cells through body fluid flow. Recent studies revealed that exosomes participate in the development of leukemia and play important roles in its diagnosis and treatment by influencing cell proliferation and apoptosis, regulating bone marrow microenvironment, promoting angiogenesis, and inhibiting hematopoiesis. Exosomes are potential biomarkers and therapeutic targets for leukemia, and they can influence drug resistance. Leukemia-derived exosomes present leukemia-related antigens to target cells, promote the proliferation of leukemic cells, help these cells escape immunity, protect them from the cytotoxic effects of chemotherapeutics, and promote angiogenesis and tumor migration. Therefore, exosomes are closely related to the metastasis, treatment, and prognosis of leukemia, and they can be used to detect and monitor the progression of leukemia. This paper reviews the regulatory roles of exosomes in leukemia and their clinical significance.

Predictive value of cardiopulmonary fitness parameters in the prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

Predictive value of cardiopulmonary fitness parameters in the prognosis of patients with acute coronary syndrome after percutaneous coronary intervention: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

ObjectivesWe aimed to determine the predictive value of cardiopulmonary exercise testing (CPX) in the prognosis of patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention (PCI).MethodsWe conducted a retrospective study including patients who underwent CPX within 1 year of PCI between September 2012 and October 2017. Patients were followed-up until the occurrence of a major adverse cardiac event (MACE) or administrative censoring (September 2019). A Cox regression model was used to identify significant predictors of a MACE. Model performance was evaluated in terms of discrimination (C-statistic) and calibration (calibration-in-the-large).ResultsIn total, 184 patients were included and followed-up for a median 51 months (interquartile range: 36–67 months) and 32 events occurred. Multivariable analysis revealed that body mass index and Gensini score were significant predictors of a MACE. Four CPX-related variables were found to be predictive of a MACE: premature CPX termination, peak oxygen uptake, heart rate reserve, and ventilatory equivalent for carbon dioxide slope. The final prediction model had a C-statistic of 0.92 and calibration-in-the-large 0.58%.ConclusionCPX-related parameters may have high predictive value for poor outcomes in patients with ACS who undergo PCI, indicating a need for appropriate treatment and timely management.

Identification of differentially expressed genes between mucinous adenocarcinoma and other adenocarcinoma of colorectal cancer using bioinformatics analysis

Identification of differentially expressed genes between mucinous adenocarcinoma and other adenocarcinoma of colorectal cancer using bioinformatics analysis: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

ObjectiveAs a unique histological subtype of colorectal cancer (CRC), mucinous adenocarcinoma (MC) has a poor prognosis and responds poorly to treatment. Genes and markers related to MC have not been reported.MethodsTo identify biomarkers involved in development of MC compared with other common adenocarcinoma (AC) subtypes, four datasets were obtained from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified using GEO2R. A protein–protein interaction network was constructed. Functional annotation for DEGs was performed via DAVID, Metascape, and BiNGO. Significant modules and hub genes were identified using Cytoscape, and expression of hub genes and relationships between hub genes and MC were analyzed.ResultsThe DEGs were mainly enriched in negative regulation of cell proliferation, bicarbonate transport, response to peptide hormone, cell–cell signaling, cell proliferation, and positive regulation of the canonical Wnt signaling pathway. The Venn diagram revealed eight significant hub genes: CXCL9, IDO1, MET, SNAI2, and ZEB2 were highly expressed in MC compared with AC, whereas AREG, TWIST1, and ZEB1 were expressed at a low level. AREG and MET might be significant biomarkers for MC.ConclusionThe identified DEGs might help elucidate the pathogenesis of MC, identify potential targets, and improve treatment for CRC.

Risk factors for surgical site infection after major oral oncological surgery

Risk factors for surgical site infection after major oral oncological surgery: the experience of a tertiary referral hospital in China: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

ObjectiveTo identify risk factors associated with surgical site infection (SSI) after major oral oncological surgery.MethodsThis retrospective study reviewed data from patients that underwent major surgery for oral cancer at a tertiary referral hospital in China between January 2005 and July 2016. SSI was diagnosed within 30 days. Demographic, cancer-related, preoperative, perioperative and postoperative data were analysed using descriptive statistics and univariate and multivariate analyses of the risk factors for SSI.ResultsA total of 786 patients were enrolled, of whom 125 had SSI (15.9%), which were all incisional. Independent risk factors for SSI, identified by multivariate analysis, were diabetes mellitus (odds ratio [OR] 2.147, 95% confidence interval [CI] 1.240, 3.642), prior radiotherapy (OR 4.595, 95% CI 1.293, 17.317) and oral–neck communication (OR 2.838, 95% CI 1.263, 7.604); and factors reflecting large extent resections were tracheostomy (OR 2.235, 95% CI 1.435, 3.525), anterolateral thigh flap (OR 1.971, 95% CI 1.103, 3.448) and latissimus dorsi flap (OR 4.178, 95% CI 1.325, 13.189).ConclusionsMultiple risk factors were associated with SSI after major oral oncological surgery. To minimize SSI risk, surgeons managing oral cancer patients should have a better understanding of the risk factors, including diabetes mellitus, prior radiotherapy, tracheostomy, oral–neck communication and flap reconstruction.

Evaluation of stability of deep venous thrombosis of the lower extremities using Doppler ultrasound

Evaluation of stability of deep venous thrombosis of the lower extremities using Doppler ultrasound: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

ObjectiveThis study aimed to assess using Doppler ultrasound for analyzing stability of deep venous thrombosis (DVT) of the lower extremities.MethodsPatients with DVT of the lower extremities who were treated from August 2017 to December 2019 were selected. The patients were divided into stable and unstable groups according to whether thrombus was collected in a filter. Related ultrasound and blood test results were analyzed and compared.ResultsA total of 126 patients with DVT of the lower extremities were included, of whom 74 were in the stable group and 52 were in the unstable group. There were significant differences in the prothrombin time (PT), and lipoprotein alpha, D-dimer, and triglyceride levels between the groups. D-dimer levels >2800 ug/L, smoking, history of venous thrombosis, PT >13.15 s, and body mass index >24.45 kg/m2 were independent risk factors for stability of DVT of the lower extremities. The area under the curve with combined detection of DVT was significantly higher than that for body mass index, PT, and D-dimer alone.ConclusionDoppler ultrasound may be reliable for analyzing the stability of DVT of the lower extremities. Related strategies targeting risk factors are required for reducing DVT of the lower extremities.

Seasonal variation in notified tuberculosis cases

Seasonal variation in notified tuberculosis cases from 2014 to 2018 in eastern China: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

ObjectiveTuberculosis (TB) incidence shows a seasonal trend. The purpose of this study was to explore seasonal trends in TB cases in Jiangsu Province.MethodsTB case data were collected from the TB registration system from 2014 to 2018. The X12-ARIMA model was used to adjust the Jiangsu TB time series. Analysis of variance was used to compare TB seasonal amplitude (SA) between subgroups and identify factors responsible for seasonal variation.ResultsThe TB incidence in Jiangsu showed a seasonal trend. Confirmed active TB peaked in March and reached a minimum in February. The amplitude of the peak-to-bottom difference was 38.15%. The SAs in individuals 7 to 17 years old (80.00%) and students (71.80%) were significantly different than those in other subgroups. Among bacterial culture positive individuals, the SAs among female patients, individuals aged 7 to 17 years and students were significantly different from those in the reference group. Among culture-negative patients, the SA among individuals aged 7 to 17 years was significantly different those in other subgroups.ConclusionsThe TB incidence in Jiangsu Province displayed a seasonal trend. Factors related to seasonal variation were age and occupation. Our results highlight the importance of controlling Mycobacterium tuberculosis transmission during winter.

Association between fish intake and glioma risk................Dietary intake of fresh fish may reduce the risk of glioma, but consumption of processed fish may increase the risk of glioma

Association between fish intake and glioma risk: a systematic review and meta-analysis: Journal of International Medical Research, Volume 48, Issue 8, August 2020.

ObjectivesWe investigated the association between the consumption of fresh and processed fish and glioma risk using a meta-analysis approach.MethodsWe selected and analyzed observational studies that discussed the relationships between fresh and processed fish intake on glioma risk from PubMed, Web of Science, Embase, and the SinoMed and Wanfang databases from inception to 31 March 2020. Studies were selected according to pre-established eligibility criteria and data were extracted separately by two researchers. A meta-analysis was conducted based on a random-effects model to provide pooled odds ratios (OR) and 95% confidence intervals (CIs).ResultsEight studies considered the relationship between fish intake (seven fresh and seven processed fish) and glioma risk and were included in this meta-analysis. The OR effect size for fresh fish intake and glioma risk was 0.72 (95%CI 0.53–0.97) and the overall OR effect size for processed fish intake and glioma risk was 1.88 (95%CI 1.06–3.34).ConclusionDietary intake of fresh fish may reduce the risk of glioma, but consumption of processed fish may increase the risk of glioma. This study had some limitations, and further studies are therefore required to clarify the associations between fish intake and glioma risk.

Medical Oncology

 

Running an oncology day-care with guts and glory

Medical Oncology

Wed Aug 26, 2020 03:00

MYH9 suppresses melanoma tumorigenesis, metastasis and regulates tumor microenvironment

Abstract Non-muscle myosin IIA heavy chain (MYH9) has been implicated in many physiological and pathological functions including cell adhesion, polarity, motility to cancer. However, its role in melanoma remains unexplored. The aim of our study was to evaluate the role of MYH9 in melanoma tumor development and metastasis and further to find out the potential underlying mechanisms. In this study, we evaluated the in vitro migratory and invasive properties and in vivo tumor development...

Medical Oncology

Wed Sep 09, 2020 03:00

Prospective evaluation of 68 Ga-PSMA-11 PET/CT in Chinese men with biochemical recurrence after radical prostatectomy for prostate cancer: relationships between location of recurrence, time after prostatectomy, and serum PSA level

Abstract The purpose of this study was to prospectively evaluate the distribution of PSMA-targeted, PET-avid lesions in prostate cancer (PCa) patients with biochemical recurrence in a Chinese cohort. The relationships between PSA levels, disease-free time after prostatectomy, and 68Ga-PSMA-11 PET/computed tomography (CT) findings were investigated. Inclusion criteria included histopathologically proven prostate adenocarcinoma, two consecutive PSA levels > 0.20 ng/mL, and...

Medical Oncology

Sat Sep 12, 2020 03:00

Associated analysis of PER1/TUBB2B with endometrial cancer development caused by circadian rhythm disorders

Abstract Endometrial cancer (EC) is one of the most common gynecologic malignancies, and the incidence rate of night shift among women workers is higher than that in the general population. Circadian rhythm disorder, mainly rhythm gene, is related to various tumor onset, including EC. This study described the sleep/night-shift features of EC patients, explored the mechanism of the circadian clock gene PER and investigated prognostic and functional values of Per1 caused by night...

Medical Oncology

Mon Sep 14, 2020 03:00

Cinnamaldehyde induces endogenous apoptosis of the prostate cancer-associated fibroblasts via interfering the Glutathione-associated mitochondria function

Abstract Cinnamaldehyde (CA) is an essential component of cinnamon that has been shown to exhibit anti-tumor effects through growth inhibition and induction of apoptosis in cancer cells. We have previously shown that CA could interfere with myeloid-derived suppressor cells (MDSCs), leading to cancer growth inhibition. In addition, recent studies have demonstrated that cancer-associated fibroblasts (CAFs) promote cancer development in different ways. However, the effect of CA...

Medical Oncology

Tue Sep 22, 2020 03:00

Letter to the editor regarding “A randomized controlled trial: comparing extracorporeal shock wave therapy versus local corticosteroid injection for the treatment of carpal tunnel syndrome”

Medical Oncology

Tue Sep 22, 2020 03:00

Transcription factor YY1 mediates epithelial–mesenchymal transition through the TGFβ signaling pathway in bladder cancer

Abstract Bladder cancer is one of the most aggressive urothelial tumors. Previous studies have suggested that epithelial–mesenchymal transition (EMT) contributes to bladder cancer progression. However, the regulatory network of EMT in bladder cancer remains elusive. In this study, we found Yin Yang 1 (YY1) is a critical regulator of EMT in bladder cancer. First, we showed that YY1 was upregulated in bladder cancer tissues than that in adjacent normal tissues. Then, we proved...

Medical Oncology

Thu Sep 24, 2020 03:00

Extracranial Meningioma in the Scalp with Concurrent Steatocystoma.

Extracranial Meningioma in the Scalp with Concurrent Steatocystoma.:

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Extracranial Meningioma in the Scalp with Concurrent Steatocystoma.

Case Rep Pathol. 2020;2020:6539064

Authors: Tong J, Aksenov SA, Chorost MI, Rodgers WH

Abstract

This report documents a rare case of an extracranial meningioma on the posterior scalp without apparent dural connection. Additionally, a sebaceous steatocystoma of the anterior scalp presented alongside the meningioma. A steatocystoma localized to the scalp is also remarkably rare. To our knowledge, this is the first report documenting both an extracranial meningioma and a steatocystoma presenting concurrently on the scalp. A male patient in his thirties presented with a mass lesion on the scalp. A CT scan revealed one posterior scalp mass with no intracranial abnormalities. Post excision histologic examination confirmed an extracranial meningioma (meningothelial variant, WHO Grade I). A second anterior scalp mass, not revealed by CT scan, was discovered during surgery. It was excised and diagnosed as a steatocystoma. Meningiomas predominantly occur intracranially but, in some instances, may present as a standalone extracranial tumor without intracranial abnormalities. Because extracranial meningioma is uncommon, it may be overlooked during clinical diagnosis of scalp masses. We recommend that this neoplasm be routinely considered in the differential diagnosis of extracranial tumors. The discovery of another rare tumor-a steatocystoma located in immediate proximity on the scalp-is further remarkable. We briefly review relevant case reports and etiologies and consider a potential relationship between the two neoplasms. However, it remains more likely that the concurrence of these tumors in our patient was simply coincidental.



PMID: 32963867 [PubMed - as supplied by publisher]

Multiple endo bronchial lipoma

Multiple endo bronchial lipoma: a rare case report.:

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Multiple endo bronchial lipoma: a rare case report.

BMC Pulm Med. 2020 Sep 22;20(1):251

Authors: Zhao S, Shui Y, Dai Z

Abstract

BACKGROUND: Endobronchial lipoma is an extremely rare benign tumor, which is generally located in the first three subdivisions of the tracheobronchial tree. According to the existing literature, all endobronchial lipomas are single (one per patient). Here, we report a rare case in which the patient presented with two endobronchial lipomas in the same patient, and underwent a bronchoscopic tumor resection in the left main bronchus and the left lower bronchus. Both tumors were pathologically confirmed as endobronchial lipoma.

CASE PRESENTATION: A 52-year-old Chinese man presented at the clinic reporting a mild cough with yellow color sputum and exertional dyspnea for 2 weeks. He was a heavy smoker (45 pack-years). Chest auscultation demonstrated faint wheezing in left lower lobe. Computed tomography (CT) revealed two low-density endobronchial masses located in the middle segment of the left main bronchus and the posterior basilar segmental bronchus of the left lower lobe. The neoplasms measured a CT-attenuation value of -70HU, -98HU in density with air trapping and atelectasis in the segmental bronchus of the left lower lobe. The patient underwent interventional bronchoscopic management to remove the neoplasms by using an electrosurgical snare, cryotherapy, and electrocautery. The locations of the neoplasms were confirmed at the left main bronchus and the superior segment of the left lower lobe during bronchoscopic intervention. Histopathological examination confirmed that both tissues were consistent with lipomas. After 18 months of follow-up, the patient was free of symptoms and CT revealed that bronchiectasia remained in the superior segment of the left lower lobe; however, no mass lesion was present in the left bronchus.

CONCLUSIONS: This case suggests that an endobronchial lipoma can present as multiple lesions, and both proximal and distal types can simultaneously occur in the same patient. Thus, these findings help us further understand the biology of endobronchial lipomas.



PMID: 32962678 [PubMed - as supplied by publisher]

Human Papillomaviruses and Skin Cancer.

Human Papillomaviruses and Skin Cancer.:

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Human Papillomaviruses and Skin Cancer.

Adv Exp Med Biol. 2020;1268:195-209

Authors: Smola S

Abstract

Human papillomaviruses (HPVs) infect squamous epithelia and can induce hyperproliferative lesions. More than 220 different HPV types have been characterized and classified into five different genera. While mucosal high-risk HPVs have a well-established causal role in anogenital carcinogenesis, the biology of cutaneous HPVs is less well understood.From patients with the rare genetic disorder epidermodysplasia verruciformis (EV) and animal models, evidence is accumulating that cutaneous PV of genus β synergize with ultraviolet (UV) radiation in the development of cutaneous squamous cell carcinoma (cSCC). In 2009, the International Agency for Research on Cancer (IARC) classified the genus β-HPV types 5 and 8 as "possible carcinogenic" biological agents (group 2B) in EV disease. Epidemiological and biological studies indicate that genus β-PV infection may also play a role in UV-mediated skin carcinogenesis in non-EV patients. However, they rather act at early stages of carcinogenesis and become dispensable for the maintenance of the malignant phenotype, compatible with a "hit-and-run" mechanism.This chapter will give an overview on genus β-PV infections and discuss similarities and differences of cutaneous and genus α mucosal high-risk HPV in epithelial carcinogenesis.



PMID: 32918220 [PubMed - indexed for MEDLINE]

Recurrent cisplatin-induced bradycardia.

A rare entity: Recurrent cisplatin-induced bradycardia.:

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A rare entity: Recurrent cisplatin-induced bradycardia.

J Cancer Res Ther. 2020 Apr-Jun;16(3):699-700

Authors: Sagcan F, Citak EC, Karpuz D, Alakaya M

PMID: 32719297 [PubMed - indexed for MEDLINE]

Management of recurrent and metastatic oral cavity cancer

Management of recurrent and metastatic oral cavity cancer: Raising the bar a step higher.:

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Management of recurrent and metastatic oral cavity cancer: Raising the bar a step higher.

Oral Oncol. 2020 02;101:104492

Authors: Szturz P, Vermorken JB

Abstract

In recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN), the armamentarium of systemic anti-cancer modalities continues to grow in parallel with innovations in and better integration of local approaches. The backbone of cytotoxic chemotherapy remains cisplatin with 5-fluorouracil or a taxane. In contrast to cisplatin, the tumoricidal activity of carboplatin monotherapy is debatable. Adding the epidermal growth factor receptor (EGFR) inhibitor cetuximab to a platinum/5-fluorouracil doublet (the so-called EXTREME regimen) produced a statistically but also clinically significant improvement of survival and became thus the standard first-line palliative treatment in adequately fit patients. Interestingly, three large randomized trials (EXTREME, SPECTRUM, and ZALUTE) evaluating different anti-EGFR monoclonal antibodies (cetuximab, panitumumab, and zalutumumab, respectively) demonstrated preferential anti-tumour efficacy in patients with primary cancer in the oral cavity. Modern immunotherapy with immunomodulating antibodies, dubbed immune checkpoint inhibitors, such as anti-programmed cell death protein-1 (anti-PD-1) inhibitors nivolumab and pembrolizumab, showed unprecedented activity in one first-line (KEYNOTE-048) and several second-line trials (CheckMate-141, KEYNOTE-012, KEYNOTE-055, and KEYNOTE-040). In a minority of also heavily-pretreated patients, these agents generate long-lasting responses without the typical chemotherapy-related toxicity, however, at a price of a low overall response rate, rare but potentially life-threatening immune-related adverse events, the risk of hyperprogression, and high costs. In oligometastatic disease, emerging data indicate long-term benefit with locally ablative techniques including metastasectomy and stereotactic radiotherapy of pulmonary but also hepatic and other distant lesions. In the frame of highly-individualized cancer care, a particularly intriguing approach is a combination of systemic and local therapies.



PMID: 31837576 [PubMed - indexed for MEDLINE]

Neck management in patients with olfactory neuroblastoma.

Neck management in patients with olfactory neuroblastoma.:

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Neck management in patients with olfactory neuroblastoma.

Oral Oncol. 2020 02;101:104505

Authors: Song X, Huang C, Wang S, Yan L, Wang J, Li Y

Abstract

OBJECTIVE: Optimal neck management in patients with olfactory neuroblastoma (ONB), a rare malignancy, remains uncertain. This study aimed to analyse patterns of cervical lymph node metastases and corresponding clinical outcomes and to investigate the value of elective neck irradiation (ENI) in this population.

METHODS AND MATERIALS: This study retrospectively reviewed clinical records, imaging findings, nodal metastasis features and treatment data of 217 patients with ONB treated at our hospital during 1991-2019. Univariate and multivariate analyses were used to assess the influence of cervical lymph node involvement on treatment outcomes. Survival and regional failure rates were compared between patients with or without ENI.

RESULTS: Thirty-two patients (14.7%) presented initially with cervical lymph node metastases, most frequently at levels II (10.6%, 23/217) and VIIa (5.5%, 12/217). Patients with and without cervical node metastasis differed significantly in overall (OS) (41.9% vs. 86.1%, p < 0.001), progression-free (PFS) (41.9% vs. 84.8%, p < 0.001), regional failure-free (45.9% vs. 89%, p < 0.001) and distant metastasis-free survival (41.5% vs. 86.1%, p < 0.001). Cervical lymph involvement was an independent factor affecting poor OS (hazard ratio, 0.184, 95% confidence interval, 0.078-0.436, p < 0.001) and PFS (hazard ratio, 0.198, 95% confidence interval, 0.088-0.445, p < 0.001). Moreover, 43.8% patients (95/217) underwent ENI, which significantly reduced the incidence of regional recurrence from 10.7% to 3.2% (χ2 = 4.396, p = 0.036) but did not significantly affect other survival outcomes. Regional failures could be resolved using salvage treatment.

CONCLUSIONS: Our findings indicate the importance of systematic therapy for patients with initial cervical lymph node metastases. ENI is not recommended for N0 disease.



PMID: 31835073 [PubMed - indexed for MEDLINE]

Seeding of a Tumor in the Gastric Wall after Endoscopic Ultrasound-guided Fine-needle Aspiration of Solid Pseudopapillary Neoplasm of the Pancreas.

Seeding of a Tumor in the Gastric Wall after Endoscopic Ultrasound-guided Fine-needle Aspiration of Solid Pseudopapillary Neoplasm of the Pancreas.:

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Seeding of a Tumor in the Gastric Wall after Endoscopic Ultrasound-guided Fine-needle Aspiration of Solid Pseudopapillary Neoplasm of the Pancreas.

Intern Med. 2020 Mar 15;59(6):779-782

Authors: Yamaguchi H, Morisaka H, Sano K, Nagata K, Ryozawa S, Okamoto K, Ichikawa T

Abstract

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is widely used as a first-line procedure for the definitive diagnosis of pancreatic solid tumor. Adverse events associated with the EUS-FNA procedure include acute pancreatitis, bleeding, infection, and duodenal perforation. Rarely, pancreatic tumors disseminate in the peritoneal cavity or seed in the gastric wall via the biopsy needle tract after EUS-FNA. Such seeding has been noted primarily in cases of adenocarcinomas and has not been associated with solid pseudopapillary neoplasm (SPN), a rare and potentially malignant tumor of the pancreas. This is the first report of a case of tumor seeding in the gastric wall after EUS-FNA of pancreatic SPN.



PMID: 31787691 [PubMed - indexed for MEDLINE]

An Endotracheal Plasmablastic Lymphoma.

An Endotracheal Plasmablastic Lymphoma.:

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An Endotracheal Plasmablastic Lymphoma.

Respiration. 2019;98(6):546-550

Authors: Bots EMT, Opperman J, Bassa F, Koegelenberg CFN

Abstract

We describe an exceptionally rare case of a male patient with newly diagnosed advanced human immunodeficiency virus (HIV) infection, who presented with a plasmablastic lymphoma involving the right maxillary alveolar ridge with associated cervical lymphadenopathy. On a staging positron emission tomography computed tomography (PET-CT) scan, he was incidentally found to have an endotracheal tumour involving the anterolateral aspect of the mid-trachea. The tumour appeared to be well-vascularised at bronchoscopy and was confirmed as well-differentiated plasmablastic lymphoma. Plasmablastic lymphoma is a rare form of non-Hodgkin lymphoma and is associated with HIV. Tracheal involvement to the extent seen in our patient is exceptionally rare, and, to the best of our knowledge, has never been described.



PMID: 31634891 [PubMed - indexed for MEDLINE]