Τετάρτη 18 Νοεμβρίου 2020

[Drug approval : entrectinib and larotrectinib - cancers with NTRK fusion].

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[Drug approval : entrectinib and larotrectinib - cancers with NTRK fusion].

Bull Cancer. 2020 Nov;107(11):1085-1086

Authors: Delaye M, Rodrigues M

PMID: 33169692 [PubMed - in process]

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Lessons learned from Chernobyl and Fukushima on thyroid cancer screening and recommendations in case of a future nuclear accident.

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Lessons learned from Chernobyl and Fukushima on thyroid cancer screening and recommendations in case of a future nuclear accident.

Environ Int. 2020 Nov 07;146:106230

Authors: Cléro E, Ostroumova E, Demoury C, Grosche B, Kesminiene A, Liutsko L, Motreff Y, Oughton D, Pirard P, Rogel A, Van Nieuwenhuyse A, Laurier D, Cardis E

Abstract
Exposure of the thyroid gland to ionizing radiation at a young age is the main recognized risk factor for differentiated thyroid cancer. After the Chernobyl and Fukushima nuclear accidents, thyroid cancer screening was implemented mainly for children, leading to case over-diagnosis as seen in South Korea after the implementation of opportunistic screening (where subjects are recruited at healthcare sites). The aim of cancer screening is to reduce morbidity and mortality, but screening can also cause negative effects on health (with unnecessary treatment if over-diagnosis) and on quality of life. This paper from the SHAMISEN special issue (Nuclear Emergency Situations - Improvement of Medical And Health Surveillance) presents the principles of cancer screening, the lessons learned from thyroid cancer screening, as well as the knowledge on thyroid cancer incidence after exposure to iodine-131. The SHAMISEN Consortium recommends to envisage systematic health screening after a nu clear accident, only when appropriately justified, i.e. ensuring that screening will do more good than harm. Based on the experience of the Fukushima screening, the consortium does not recommend mass or population-based thyroid cancer screening, as the negative psychological and physical effects are likely to outweigh any possible benefit in affected populations; thyroid health monitoring should however be made available to persons who request it (regardless of whether they are at increased risk or not), accompanied with appropriate information and support.

PMID: 33171378 [PubMed - as supplied by publisher]

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Integrity of dural closure after autologous platelet rich fibrin augmentation: an in vitro study.

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Integrity of dural closure after autologous platelet rich fibrin augmentation: an in vitro study.

Acta Neurochir (Wien). 2020 04;162(4):737-743

Authors: Vasilikos I, Beck J, Ghanaati S, Grauvogel J, Nisyrios T, Grapatsas K, Hubbe U

Abstract
BACKGROUND: Watertight closure of the dura mater is fundamental in neurosurgery. Besides the classical suturing techniques, a variety of biomaterials have been proposed as sealants. Platelet rich fibrin (PRF) is an autologous biomaterial which can readily be obtained through low-speed centrifugation of patient's own blood. It is rich in fibrin, growth factors, leucocytes and cytokines and has shown adhesive properties while promoting the physiological wound healing process. In this study, we investigated the effect of applying PRF in reinforcing the watertight dura mater closure.
METHODS: We created an in vitro testing device, where the watertight dura mater closure could be hydrostatically assessed. On 26 fresh harvested bovine dura maters, a standardised 20-mm incision was closed with a running suture, and the leak pressure was measured first without (primary leak pressure) and then with PRF augmentation (secondary leak pressure). The two groups of measurements have been statistically analysed with the Student's paired t test.
RESULTS: The "running suture only group" had a leak pressure of 10.5 ± 1.2 cmH2O (mean ± SD) while the "PRF-augmented group" had a leak pressure of 47.2 ± 2.6 cm H2O. This difference was statistically significant (p < 0.001; paired t test).
CONCLUSIONS: Autologous platelet rich fibrin augmentation reliably reinforced watertight closure of the dura mater to a > 4-fold increased leak pressure after failure of the initial standard running suture technique.

PMID: 32034495 [PubMed - indexed for MEDLINE]

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MR Myelography for the Detection of CSF-Venous Fistulas.

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MR Myelography for the Detection of CSF-Venous Fistulas.

AJNR Am J Neuroradiol. 2020 05;41(5):938-940

Authors: Chazen JL, Robbins MS, Strauss SB, Schweitzer AD, Greenfield JP

Abstract
CSF-venous fistula is an important treatable cause of spontaneous intracranial hypotension that is often difficult to detect using traditional imaging techniques. Herein, we describe the technical aspects and diagnostic performance of MR myelography when used for identifying CSF-venous fistulas. We report 3 cases in which the CSF-venous fistula was occult on CT myelography but readily detected using MR myelography.

PMID: 32354709 [PubMed - indexed for MEDLINE]

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Histopathological prognostic factors for colorectal liver metastases: A systematic review and meta-analysis of observational studies.

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Histopathological prognostic factors for colorectal liver metastases: A systematic review and meta-analysis of observational studies.

Histol Histopathol. 2020 Nov 09;:18274

Authors: de Oliveira CVC, Fonseca GM, Kruger JAP, de Mello ES, Coelho FF, Herman P

Abstract
INTRODUCTION: Resection is the mainstay of treatment for colorectal liver metastases (CRLMs). Many different histopathological factors related to the primary colorectal tumour have been well studied; however, histopathological prognostic factors related to CRLMs are still under evaluation.
OBJECTIVE: To identify histopathological factors related to overall survival (OS) and disease-free survival (DFS) in patients with resected CRLMs.
METHODS: A systematic review was performed with the following databases up to August 2020: PubMed, EMBASE, Web of Science, SciELO, and LILACS. The GRADE approach was used to rate the overall certainty of evidence by outcome.
RESULTS: Thirty-three studies including 4,641 patients were eligible. We found very low certainty evidence that the following histopathological prognostic factors are associated with a statistically significant decrease in OS: presence of portal vein invasion (HR, 0,50 [95% CI, 0,37 to 0,68]; I²=0%), presence of perineural invasion (HR, 0,55 [95% CI, 0,36 to 0,83]; I²=0%), absence of pseudocapsule (HR, 0,41 [CI 95%, 0,29 to 0,57], p<0,00001; I²=0%), presence of satellite nodules (OR, 0,45 [95% CI, 0,26 to 0,80]; I²=0%), and the absence of peritumoural inflammatory infiltrate (OR, 0,20 [95% CI, 0,08 to 0,54]; I²=0%). Outcome data on DFS were scarce, except for tumour borders, which did not present a significant impact, precluding the meta-analysis.
CONCLUSION: Of the histopathological prognostic factors studied, low- to moderate-certainty evidence shows that vascular invasion, perineural invasion, absence of pseudocapsule, presence of satellite nodules, and absence of peritumoral inflammatory infiltrate are associated with shorter overall survival in CRLMs.

PMID: 33165892 [PubMed - as supplied by publisher]

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Anaplastic thyroid carcinoma: Updates on WHO classification, clinicopathological features and staging.

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Anaplastic thyroid carcinoma: Updates on WHO classification, clinicopathological features and staging.

Histol Histopathol. 2020 Nov 10;:18277

Authors: Abe I, Lam AK

Abstract
Anaplastic thyroid carcinoma is an uncommon carcinoma representing 1 to 4 % of all thyroid cancers. The carcinoma is most common in females of the eight decades. It is a locally advanced cancer with frequent infiltration of surrounding organs, blood vessels and skin of neck. Paraneoplastic manifestations could occur. Approximately half of the patients with anaplastic thyroid carcinoma had distant metastasis with lung and brain as the most frequent sites of metastasis. The median survival of patients with anaplastic thyroid carcinoma reported was from 1 to 6 months. The current terminology of the cancer in World Health Organization is "anaplastic thyroid carcinoma" rather than "undifferentiated thyroid carcinoma". In the latest American Joint Committee on Cancer (AJCC) TNM staging system for anaplastic thyroid carcinoma, there are updates on T and N categories. To conclude, updated knowledge of clinicopathological features, classification, pathological staging will improve our understanding of the cancer and will help in the management of the patients with this aggressive cancer.

PMID: 33170501 [PubMed - as supplied by publisher]

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Preoperative coronavirus testing

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[Preoperative coronavirus testing in Germany : Experiences with applying the recommendations of the German Society of Otorhinolaryngology, Head and Neck Surgery].

HNO. 2020 Nov 10;:

Authors: Stuck BA, Demmler U, Hoffmann TK

PMID: 33170313 [PubMed - as supplied by publisher]

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Prevalence of anomalous or ectopic insertion of pectoralis minor: a systematic review and meta-analysis of 4146 shoulders.

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Prevalence of anomalous or ectopic insertion of pectoralis minor: a systematic review and meta-analysis of 4146 shoulders.

Surg Radiol Anat. 2020 Nov 09;:

Authors: Asghar A, Narayan RK, Satyam A, Naaz S

Abstract
INTRODUCTION: The proximal insertion beyond coracoid process of pectoralis minor is considered as hidden culprit of rotator cuff disorders. The ectopic insertion is also associated with thoracic outlet syndrome. The current review was conducted to provide a comprehensive evidence-based assessment of the anatomical characteristics of ectopic insertion of pectoralis minor.
MATERIALS AND METHODS: A through systematic search was conducted on the major electronic database, PubMed, EMBASE, Google Scholar and Journals of Anatomy, orthopedics, plastic surgery, sports medicine. The primary outcome was to measure the prevalence of ectopic insertion of pectoralis minor tendons. The data extraction was conducted for pooled estimation and metanalysis.
RESULTS: A total of 25 studies were included for systematic review. The overall pooled estimate of ectopic insertion of Pectoralis Minor was 19.27% (95% CI 15-24%). The prevalence rate in dissected specimen was 21% (CI 15-28%) and in arthroscopic evaluation was 22% (95% CI 5-59%) which was marginally higher with wide confidence interval due small sample size. The prevalence rate in MRI and USG were 15 and 12%, because MRI and USG have almost similar sensitivity in the detection of anomalous insertion of Pectoralis Minor. The distribution of subtypes of anomalous or ectopic insertion based on Le Double classification was 34% for type I, 42 and 9% for Type III. The incidence of ectopic insertion of pectoralis minor was highest in Japanese population. The female and left side have slightly higher incidence at insignificant level.
CONCLUSION: The preoperative MRI or at least USG evaluation of shoulder joint must be conducted for appropriate surgical planning, because the prevalence of ectopic insertion is around 20%. The preoperative detection of anomalous insertion of pectoralis minor can be crucial in minimizing the incidences of iatrogenic injuries of tendon or post-operative complications.

PMID: 33165647 [PubMed - as supplied by publisher]

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Anatomical variations of the extensor tendons of the fetal thumb.

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Anatomical variations of the extensor tendons of the fetal thumb.

Surg Radiol Anat. 2020 Nov 10;:

Authors: Öztürk K, Dursun A, Kastamoni Y, Albay S

Abstract
PURPOSE: The extensor pollicis longus (EPL) and brevis (EPB) and abductor pollicis longus (APL) are muscles located in the posterior compartment of the forearm. These muscles allow the thumb to move independently from the other four fingers by attaching to the thumb separately. This study's goal was to investigate the tendon variations and insertions of these muscles.
METHODS: Our study was conducted on 43 fetal cadavers (86 upper extremities) aged between 17 and 40 weeks of gestation. This study investigated the tendon numbers and insertions of the EPL, EPB, and APL.
RESULTS: The tendon numbers of the EPL and EPB were observed to range between 1 and 2, and the tendon numbers of the APL ranged between 1 and 5. The EPL was found to insert into the distal phalanx via the dorsal aponeurosis in all extremities. It was observed that the EPB tendons inserted into the proximal phalanx, distal phalanx, and dorsal aponeurosis. It was determined that the APL tendons inserted into the basis of the first metacarpal, abductor pollicis brevis, opponens pollicis, and trapezium bone.
CONCLUSION: Knowing the tendon variations and insertions of the EPL, EPB, and APL muscles during the fetal period will be useful in planning treatments to correct the congenital thumb anomalies and the loss of function after injury.

PMID: 33170332 [PubMed - as supplied by publisher]

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Role of specific IgE on staphylococcal enterotoxin B in chronic rhinosinusitis severity

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Abstract

Objective

To investigate the clinical significance of specific IgE‐staphylococcal enterotoxin B (IgE‐SEB) in CRS (chronic rhinosinusitis).

Design

Retrospective analysis of patients who were positive for specific IgE‐staphylococcal enterotoxin B.

Setting

Tertiary rhinology clinic.

Participants

A total of 965 patients who were tested for specific IgE‐staphylococcal enterotoxin B from December 2016 to December 2017

Main outcome measures

We retrospectively reviewed the records of 965 patients who were tested for specific IgE‐staphylococcal enterotoxin B from December 2016 to December 2017. Patient demographics, titre specific IgE to staphylococcal enterotoxin B levels, MAST, serologic test, and medical records were reviewed.

Results

IgE‐SEB (KU/L) was higher in CRS patients than Non‐CRS patients (0.13±0.37 vs 0.08±0.22, respectively; p‐value: 0.044), and the IgE‐SEB (+, ≥0.35) rate was also higher (10.06% vs 4.46%, respectively; p‐value: 0.030). IgE‐SEB (KU/L) was higher in the CRS group than in the fungal sinusitis group (0.13±0.37 vs 0.03±0.05, respectively; p‐value: <0.001), and the IgE‐SEB (+, ≥0.35) rate was also higher (10.06% vs 0 %, respectively; p‐value: 0.015). Between the CRSsNP (chronic rhinosinusitis without nasal polyps) and CRSwNP (chronic rhinosinusitis with nasal polyps) groups, there were no differences in IgE‐SEB (KU/L) or IgE‐SEB (+) rates. IgE‐SEB positivity was not associated with the presence of polyps, concomitant asthma, or postoperative recurrence. As the values of IgE‐SEB(KU/L) and the IgE‐SEB (+,>0.1) rate increased, the CRS severity also increased.

Conclusions

IgE‐SEB showed a positive correlation with Lund‐Mackay CT severity score, but not with postoperative recurrence or nasal polyps. Further studies are needed to obtain clear evidence that IgE‐SEB can be considered as an independent CRS endotype.

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The implications of variations in nasal irrigation recipes in the United Kingdom

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Abstract

Objective

This study aims to investigate the variations in publicly available nasal irrigation recipes published in the United Kingdom (UK).

Design

Internet searches used to identify eligible nasal irrigation recipes. These were then examined for their physical and biochemical properties, through theoretical calculations and experimental measurement.

Setting

Recipes produced by healthcare providers or official national bodies in the UK.

Participants

No human participants.

Main outcome measures

Solution osmolality (classified into hypo‐, iso‐ and hyper‐tonic), acidity (pH) and specific gravity.

Results

13 unique recipes were identified from 17 sources. Osmolality ranged from 166.2 to 1492.2 mosmol/kg in volumes ranging from 142 to 1136 mls (isotonic range 275‐295 mosmol/kg). Specific gravity ranged from 1.006 to 1.034. pH ranged from 7.74 to 8.11. No recipe produced a solution with isotonic properties. The majority produced hypertonic irrigations.

Conclusions

Most publicly available nasal irrigation recipes produce hypertonic solutions but there is great variability in the osmolality and volume. UK organisations should take action to review published recipes to bring these into alignment with latest guidelines (recommending against hypertonic saline use) and reduce variability in patient interpretations.

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