Functional Imaging to Predict Treatment Response in Head and Neck Cancer: How Close are We to Biologically Adaptive Radiotherapy?

gnorimies20.15 shared this article with you from Inoreader Functional Imaging to Predict Treatment Response in Head and Neck Cancer: How Close are We to Biologically Adaptive Radiotherapy? Via Head and Neck Related Articles Functional Imaging to Predict Treatment Response in Head and Neck Cancer: How Close are We to Biologically Adaptive Radiotherapy? Clin Oncol (R Coll Radiol). 2020 Oct 27;: Authors: Paterson C, Hargreaves S, Rumley CN Abstract It is increasingly recognised that head and neck cancer represents a spectrum of disease with a differential response to standard treatments. Although prognostic factors are well established, they do not reliably predict response. The ability to predict response early during radiotherapy would allow adaptation of treatment: intensifying treatment for those not responding adequately or de-intensifying remaining therapy for those likely to achieve a complete response. Functional imaging offers such an opportunity. Changes in parameters obtained with functional magnetic resonance imaging or positron emission tomography-computed tomography during treatment have been found to be predictive of disease control in head and neck cancer. Although many questions remain unanswered regarding the optimal implementation of these techniques, current, maturing and future studies may provide the much-needed homogeneous cohorts with larger sample sizes and external validation of parameters. Wit h a stepwise and collaborative approach, we may be able to develop imaging biomarkers that allow us to deliver personalised, biologically adaptive radiotherapy for head and neck cancer. PMID: 33127234 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of intracellular zinc in molecular and cellular function in allergic inflammatory diseases.

gnorimies20.15 shared this article with you from Inoreader Role of intracellular zinc in molecular and cellular function in allergic inflammatory diseases. Via Head and Neck Related Articles Role of intracellular zinc in molecular and cellular function in allergic inflammatory diseases. Allergol Int. 2020 Oct 27;: Authors: Suzuki M, Suzuki T, Watanabe M, Hatakeyama S, Kimura S, Nakazono A, Honma A, Nakamaru Y, Vreugde S, Homma A Abstract Zinc is an essential micronutrient in human body and a vital cofactor for the function of numerous proteins encoded by the human genome. Zinc has a critical role in maintaining many biochemical and physiological processes at the molecular, cellular, and multiple organ and systemic levels. The alteration of zinc homeostasis causes dysfunction of many organs and systems. In the immune system, zinc regulates the differentiation, proliferation and function of inflammatory cells, including T cells, eosinophils, and B cells, by modifying several signaling pathways such as NFκB signaling pathways and TCR signals. An adequate zinc level is essential for proper immune responses and decreased zinc levels were reported in many allergic inflammatory diseases, including atopic dermatitis, bronchial asthma, and chronic rhinosinusitis. Decreased zinc levels often enhance inflammatory activation. On the other hand, the inflammatory conditions alter the intracellular homeostasis of zinc, oft en decreasing zinc levels. These findings implied that there could be a vicious cycle between zinc deficiency and inflammatory conditions. In this review, we present recent evidence on the involvement of zinc in atopic dermatitis, bronchial asthma, and chronic rhinosinusitis, with insights into the involvement of zinc in the underlying molecular and cellular mechanisms related to these allergic inflammatory diseases. PMID: 33127267 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Respiratory muscle training in late-onset Pompe disease: Results of a sham-controlled clinical trial.

gnorimies20.15 shared this article with you from Inoreader Respiratory muscle training in late-onset Pompe disease: Results of a sham-controlled clinical trial. Via Head and Neck Related Articles Respiratory muscle training in late-onset Pompe disease: Results of a sham-controlled clinical trial. Neuromuscul Disord. 2020 Sep 28;: Authors: Jones HN, Kuchibhatla M, Crisp KD, Hobson-Webb LD, Case L, Batten MT, Marcus JA, Kravitz RM, Kishnani PS Abstract To address progressive respiratory muscle weakness in late-onset Pompe disease (LOPD), we developed a 12-week respiratory muscle training (RMT) program. In this exploratory, double-blind, randomized control trial, 22 adults with LOPD were randomized to RMT or sham-RMT. The primary outcome was maximum inspiratory pressure (MIP). Secondary and exploratory outcomes included maximum expiratory pressure (MEP), peak cough flow, diaphragm ultrasound, polysomnography, patient-reported outcomes, and measures of gross motor function. MIP increased 7.6 cmH2O (15.9) in the treatment group and 2.7 cmH2O (7.6) in the control group (P = 0.4670). MEP increased 14.0 cmH2O (25.9) in the treatment group and 0.0 cmH2O (12.0) in the control group (P = 0.1854). The only statistically significant differences in secondary/exploratory outcomes were improvements in time to climb 4 steps (P = 0.0346) and daytime sleepiness (P = 0.0160). The magnitude of changes in MIP and MEP in the tre atment group were consistent with our pilot findings but did not achieve statistical significance in comparison to controls. Explanations for this include inadequate power and baseline differences in subject characteristics between groups. Additionally, control group subjects appeared to exhibit an active response to sham-RMT and therefore sham-RMT may not be an optimal control condition for RMT in LOPD. PMID: 33127291 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mucinous cystadenocarcinoma of the oral tongue: malignant transformation from a mucinous cystadenoma?

gnorimies20.15 shared this article with you from Inoreader Mucinous cystadenocarcinoma of the oral tongue: malignant transformation from a mucinous cystadenoma? Via Head and Neck Related Articles Mucinous cystadenocarcinoma of the oral tongue: malignant transformation from a mucinous cystadenoma? BMJ Case Rep. 2020 Oct 30;13(10): Authors: Dutra S, Rito M, Vilares M, Borges A Abstract Mucinous cystadenocarcinoma of minor salivary glands is an extremely rare entity that has only recently been described, with a few published cases in the English literature. A 42-year-old woman with a history of a surgically excised mucinous cystadenoma of the oral tongue, presented with a painful swelling in the oral tongue slowly growing for 1 month. On clinical examination, there was a firm, relatively well-circumscribed mass in the left posterior border of the mobile tongue. Subsequent MRI scan revealed a heterogeneous lesion composed of multiple cysts separated by contrast enhancing septa, in the posterior two-thirds of the left tongue. Imaging findings were similar to those of the previously resected mass, suggesting local relapse of the primary lesion. A complete surgical excision was performed and the histopathological examination revealed typical features of a low-grade mucinous cystadenocarcinoma of minor salivary glands. PMID: 33127690 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lemierre's syndrome: a forgotten life-threatening entity.

gnorimies20.15 shared this article with you from Inoreader Lemierre's syndrome: a forgotten life-threatening entity. Via Head and Neck Related Articles Lemierre's syndrome: a forgotten life-threatening entity. BMJ Case Rep. 2020 Oct 30;13(10): Authors: Gama R, Sousa M, Castro F, Condé A Abstract Lemierre's syndrome is a very rare but potentially fatal condition. It mainly affects adolescents and young adult males, and usually arises as a serious complication of pharyngitis or peritonsillar abscess. It is characterised by the triad of internal jugular vein septic thrombophlebitis, septic emboli (mostly pulmonary) and the isolation of the agent 'Fusobacterium necrophorum' in sterile fluids. In this report, it is described a case in which the nonspecific and subtle clinic made the diagnosis difficult to reach. In fact, only the dissociation between flu-like symptoms and the presence of significant changes in the blood tests (suggestive of acute bacterial infection), led to the request for imaging tests, which proved to be essential for the final diagnosis and subsequent control of the disease. This case report aims to increase the awareness among Ear, Nose and Throat (ENT) residents, paediatricians and family doctors about the existence of this entity and its potential life-threatening nature. PMID: 33127694 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oropharyngeal Kimura's disease: a diagnostic dilemma and therapeutic challenge.

gnorimies20.15 shared this article with you from Inoreader Oropharyngeal Kimura's disease: a diagnostic dilemma and therapeutic challenge. Via Head and Neck Related Articles Oropharyngeal Kimura's disease: a diagnostic dilemma and therapeutic challenge. BMJ Case Rep. 2020 Oct 30;13(10): Authors: Saravanam PK, Gajendran A, Dinakaran N, Jayaraman D Abstract Kimura's disease is a chronic inflammatory disorder involving subcutaneous tissue and locoregional lymph nodes of head and neck region, characterised by angiolymphoid proliferation. It is typically associated with peripheral eosinophilia, increased serum IgE and lymphadenopathy. Diagnosis is usually based on histopathological examination. Though various treatment modalities have been put forward, surgical management remains the first line of treatment, followed by systemic steroids application. This case report discusses the diagnostic dilemma and therapeutic management of a rare clinical presentation and management of oropharyngeal Kimura's disease in a young immunocompetent woman. PMID: 33127696 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transnasal endoscopic resection of Epstein-Barr virus-associated cavernous sinus tumour.

gnorimies20.15 shared this article with you from Inoreader Transnasal endoscopic resection of Epstein-Barr virus-associated cavernous sinus tumour. Via Head and Neck Related Articles Transnasal endoscopic resection of Epstein-Barr virus-associated cavernous sinus tumour. BMJ Case Rep. 2020 Oct 30;13(10): Authors: Yokoyama D, Horiguchi K, Higuchi Y, Hashiba J Abstract Epstein-Barr virus-associated smooth muscle tumour (EBV-SMT) is a rare disease occurring in immunosuppressed patients, such as those with AIDS, post-transplantation immunodeficiency and congenital immunodeficiency. Intracranial EBV-SMT after solid organ transplantation has been reported. However, intracranial lesions after bone marrow transplantation are extremely rare. We report the case of a 47-year-old man with a history of acute myeloid leukaemia and bone marrow transplantation. He had symptoms of trigeminal neuralgia, and MRI revealed a left cavernous sinus tumour. He started taking oral gabapentin, but his symptoms did not improve. We performed transnasal endoscopic surgery. Postoperative MRI showed complete removal of the cavernous sinus lesion. Pathological examination showed spindle-shaped cells positive for smooth muscle markers and EBV-encoded small RNA in situ hybridisation. EBV-SMT was pathologically diagnosed. His symptoms improved after surgery. No tumour recur rence was noted on follow-up MRI after 15 months without adjuvant radiation or chemotherapy. PMID: 33127697 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adverse Events Associated With Botox as Reported in a Food and Drug Administration Database.

gnorimies20.15 shared this article with you from Inoreader Adverse Events Associated With Botox as Reported in a Food and Drug Administration Database. Via Head and Neck Related Articles Adverse Events Associated With Botox as Reported in a Food and Drug Administration Database. Aesthetic Plast Surg. 2020 Oct 30;: Authors: Ahsanuddin S, Roy S, Nasser W, Povolotskiy R, Paskhover B Abstract BACKGROUND: Botulinum toxin treatment is the most frequently performed noninvasive cosmetic procedure performed in the USA. Because of its widespread use, an analysis of the adverse event (AE) profile of Botox injections is needed. METHODS: The FDA Adverse Event Report System was queried using an online web-based tool to determine the top 15 adverse events reported for four Botox brand names: Botox/Botox Cosmetic, Dysport, and Xeomin. The proportional reporting ratios (PRR) and relative odds ratios (ROR) were determined. A literature review was performed for eight AEs of clinical significance: eyelid/eyebrow ptosis, asthenia, muscular weakness, facial paresis, dysphagia, botulism, and death. RESULTS: Botox/Botox Cosmetic had 38367 AEs. Dysport had 3582 AEs. Xeomin had 1405 AEs. All drugs with reported cases of eyelid and eyebrow ptosis had significant PRR and ROR values. The PRR and ROR values for asthenia were not significant in any of the drugs and only reached significance for Dysport for muscular weakness and dysphagia. Both Botox/Botox Cosmetic and Dysport had elevated PRRs and RORs for facial paresis and botulism. While all drugs had at least one reported case of death related to Botox injection use, none of the PRR or ROR values were significant. CONCLUSION: Known AEs for Botox injection use include eyelid/brow ptosis and muscular weakness. Feared but rare complications of Botox injection use include dysphagia, botulism, and possibly death, owing to systemic spread of the toxin. This is the first study to analyze the AE data reported to the FDA on Botox injection use. EBM LEVEL: III. PMID: 33128076 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

HFUS Imaging of the Cochlea: A Feasibility Study for Anatomical Identification by Registration with MicroCT.

gnorimies20.15 shared this article with you from Inoreader HFUS Imaging of the Cochlea: A Feasibility Study for Anatomical Identification by Registration with MicroCT. Via Head and Neck Related Articles HFUS Imaging of the Cochlea: A Feasibility Study for Anatomical Identification by Registration with MicroCT. Ann Biomed Eng. 2020 Oct 30;: Authors: Lavenir L, Zemiti N, Akkari M, Subsol G, Venail F, Poignet P Abstract Cochlear implantation consists in electrically stimulating the auditory nerve by inserting an electrode array inside the cochlea, a bony structure of the inner ear. In the absence of any visual feedback, the insertion results in many cases of damages of the internal structures. This paper presents a feasibility study on intraoperative imaging and identification of cochlear structures with high-frequency ultrasound (HFUS). 6 ex-vivo guinea pig cochleae were subjected to both US and microcomputed tomography (µCT) we respectively referred as intraoperative and preoperative modalities. For each sample, registration based on simulating US from the scanner was performed to allow a precise matching between the visible structures. According to two otologists, the procedure led to a target registration error of 0.32 mm ± 0.05. Thanks to referring to a better preoperative anatomical representation, we were able to intraoperatively identify the modiolus, both scalae vestibuli and tympani and deduce the location of the basilar membrane, all of which is of great interest for cochlear implantation. Our main objective is to extend this procedure to the human case and thus provide a new tool for inner ear surgery. PMID: 33128180 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality Assurance in Head and Neck Radiation Therapy.

gnorimies20.15 shared this article with you from Inoreader Moving Experience from North America to Developing Country to Approach a Desired Level of Quality Assurance in Head and Neck Radiation Therapy. Via Head and Neck Related Articles Moving Experience from North America to Developing Country to Approach a Desired Level of Quality Assurance in Head and Neck Radiation Therapy. J Cancer Educ. 2020 Oct 31;: Authors: Mohamad I, Hosni A, Abu-Hijlih R, Al Mousa A, Al-Rimawi D, Abuhijla F Abstract Evidence is lacking correlation between head and neck (HN) radiation oncology fellowship training and quality assurance (QA) round decision for plan modifications. This study was conducted to identify the association between training and changes in QA decisions. From 2007 to 2018, data on HN cancer cases presented at departmental QA rounds were prospectively collected. Then, we retrospectively analyzed the collected data to determine the impact of fellowship training on QA decisions. Cases were divided into pre-fellowship group (January 2007-September 2014) and post-fellowship group (October 2014-December 2018). Multivariable analysis (MVA) evaluated variables that could be associated with decreased frequencies of QA modification rates. From 2007 to 2018, 1266 HN cancer patients were identified; 728 patients were in the pre-fellowship group and 538 patients in the post-fellowship group. On MVA, fellowship training transformed QA decisions from more to less modifications (modi fied vs. approved; OR, 0.135; 95% CI, 0.076-0.240; p = 0.0001), increased approval rate for advanced T and N categories (T3-4 vs. T0-T2; OR, 0.798; 95% CI, 1.892-4.929; p = 0.0001 and N2-3 vs. N0-1; OR, 0.865; 95% CI, 1.454-3.423; p = 0.0002). By type of modification, fellowship training demonstrated a statistically significant reduction in rates of several types of modification that include target volume definition, target volume delineation, and dose (all p < 0.05). Our study determines the impact of the HN radiation oncology fellowship on decreased QA modification rates. PMID: 33128212 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Calculating and estimating second cancer risk from breast radiotherapy using Monte Carlo code with internal body scatter for each out-of-field organ.

gnorimies20.15 shared this article with you from Inoreader Calculating and estimating second cancer risk from breast radiotherapy using Monte Carlo code with internal body scatter for each out-of-field organ. Via Head and Neck Related Articles Calculating and estimating second cancer risk from breast radiotherapy using Monte Carlo code with internal body scatter for each out-of-field organ. J Appl Clin Med Phys. 2020 Oct 30;: Authors: Takata T, Shiraishi K, Kumagai S, Arai N, Kobayashi T, Oba H, Okamoto T, Kotoku J Abstract Out-of-field organs are not commonly designated as dose calculation targets during radiation therapy treatment planning, but they might entail risks of second cancer. Risk components include specific internal body scatter, which is a dominant source of out-of-field doses, and head leakage, which can be reduced by external shielding. Our simulation study quantifies out-of-field organ doses and estimates second cancer risks attributable to internal body scatter in whole-breast radiotherapy (WBRT) with or without additional regional nodal radiotherapy (RNRT), respectively, for right and left breast cancer using Monte Carlo code PHITS. Simulations were conducted using a complete whole-body female model. Second cancer risk was estimated using the calculated doses with a concept of excess absolute risk. Simulation results revealed marked differences between WBRT alone and WBRT plus RNRT in out-of-field organ doses. The ratios of mean doses between them were as large as 3.5-8.0 for the head and neck region and about 1.5-6.6 for the lower abdominal region. Potentially, most out-of-field organs had excess absolute risks of less than 1 per 10,000 persons-year. Our study surveyed the respective contributions of internal body scatter to out-of-field organ doses and second cancer risks in breast radiotherapy on this intact female model. PMID: 33128332 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.