Primary Synovial Sarcoma of Kidney-a Report of 2 Cases and Review of Literature

Journal of the Egyptian National Cancer Institute. Sep, 2010  |  Pubmed ID: 21863065

Primary kidney sarcomas are rare neoplasms. Pre-operative signs and symptoms are non-specific, thus making early diagnosis of this condition difficult. The presenting features are similar to other common renal tumors.

Modified Loose-seton Technique for the Treatment of Complex Anal Fistulas

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland. Oct, 2010  |  Pubmed ID: 20070336

The aim of treatment of anal fistula is to remove the track avoiding while ensuring faecal continence. We report the results of a technique that preserves the external anal sphincter in patients with complex anal fistulas.

Effects of Betahistine on Patient-reported Outcomes in Routine Practice in Patients with Vestibular Vertigo and Appraisal of Tolerability: Experience in the OSVaLD Study

The International Tinnitus Journal. 2010  |  Pubmed ID: 21609908

This was a 3-month multicentre, open-label post-marketing surveillance study of betahistine (24 mg b.i.d. or 16 mg t.i.d.) in patients with vertigo of peripheral vestibular origin. Study endpoints comprised on-treatment changes in the Dizziness Handicap Index (DHI), Hospital Anxiety and Depression Score (HADS) and the Short-Form (SF)-36v2. Total DHI score improved 37.2 points (of a 100-point scale) following betahistine treatment. Corresponding improvements occurred in all three DHI scale domains (all p < 0.001 vs baseline). Betahistine therapy was also accompanied by progressive, significant improvements in both HADS-A and HADS-D scores (p < 0.001), and improvements in the distribution profiles of anxiety and depression scores. Significant improvements in the Physical Component Summary and Mental Component Summary scores of the SF-36v2 were recorded during betahistine treatment. Betahistine was generally well tolerated. A total of 76 adverse drug reactions (ADRs) were recorded in 49 patients (2.4%), of which 75 were classified as mild or moderate and 54 were possibly related to betahistine. ADRs led to study drug discontinuation in 17 patients. These data illustrate that treatment with betahistine 48 mg/day in patients with recurrent peripheral vestibular vertigo is associated with improvements in objective measures of health-related quality of life and satisfactory tolerability.

Tinnitus Treatment with Sound Stimulation During Sleep

The International Tinnitus Journal. 2010  |  Pubmed ID: 21609912

A new strategy for idiopathic subjective tinnitus treatment - sound stimulation during sleep - has been applied. It was based on the acknowledgement that the auditory system also works during sleep, processing the incoming information. Eleven patients were stimulated every night during 6 months. The stimulus was a sound that mimetized the tinnitus and was fixed at the same tinnitus intensity, applied through an iPod. All patients decreased their tinnitus intensity in the first month of treatment (statistically significant), most of them in the first week. Tinnitus intensity continued decreasing in the following weeks; three patients presented periods of total silence.

[Lumbar Transforaminal Epidural Injections: Evaluation of Potential Risks and Complications]

Journal De Radiologie. Sep, 2010  |  Pubmed ID: 20814399

[Echo Time Optimization at T2W MR Imaging of the Liver]

Journal De Radiologie. Jan, 2011  |  Pubmed ID: 21352731

Clinical and Radiological Profile of Neurocysticercosis in South Indian Children

Indian Journal of Pediatrics. Aug, 2011  |  Pubmed ID: 21399954

Prevalence of Orthostatic Hypotension in a Series of Elderly Mexican Institutionalized Patients

Cardiology Journal. 2011  |  Pubmed ID: 21660918

Orthostatic hypotension (OH) is a common problem among the elderly. It is associated with an increase in morbidity and mortality, but its prevalence in Mexico is unknown.

Derivatization Ion Chromatography for the Determination of Monoethanolamine in Presence of Hydrazine in PHWR Steam-Water Circuits

International Journal of Analytical Chemistry. 2011  |  Pubmed ID: 21785596

A simple, rapid and accurate method for the determination of monoethanolamine (MEA) in PHWR steam-water circuits has been developed. MEA is added in the feed water to provide protection against corrosion while hydrazine is added to scavenge dissolved oxygen. The quantitative determination of MEA in presence of hydrazine was accomplished using derivatization ion chromatography with conductometric detection in nonsuppressed mode. A Metrosep cation 1-2 analytical column and a Metrosep cartridge were used for cation separation. A mixture of 4 mM tartaric acid, 20% acetone and 0.05 mM HNO(3) was used as eluent. Acetone in the mobile phase leads to the formation of different derivatives with MEA and hydrazine. The interferences due Na(+) and NH(4) (+) were eliminated by adopting a simple pretreatment procedure employing OnGuard-H cartridge. The limit of detection limit of MEA was 0.1 μg mL(-1) and the relative standard deviation was 2% for the overall method. The recovery of MEA added was in the range 95%-102%. The method was applied to the determination of MEA in steam generator water samples.

The Effect of HLA Disparity on Clinical Outcome After HLA-haploidentical Blood and Marrow Transplantation

Clinical Transplantation. Sep, 2011  |  Pubmed ID: 21919963

Huo M-R, Xu L-P, Li D, Liu D-H, Liu K-Y, Chen H, Han W, Chen Y-H, Wang Y, Wang J-Z, Zhang X-H, Zhao X-Y, Huang X-J. The effect of HLA disparity on clinical outcome after HLA-haploidentical blood and marrow transplantation. Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01499.x. © 2011 John Wiley & Sons A/S. Abstract:  The relative importance of various human leukocyte antigen (HLA) loci has not been established for unmanipulated HLA-mismatched/haploidentical transplantation. To address this question, we analyzed the impact of HLA-A, HLA-B, HLA-DRB1, HLA-DRB3, HLA-DRB4, and HLA-DRB5 on the outcome of HLA-haploidentical transplantation. Four hundred and eighty-one donor-recipient pairs were fully typed before transplantation. In univariate analysis, HLA-B mismatch not only demonstrated significant adverse effects on acute graft-versus-host disease (GVHD) and transplant-related mortality but also was associated with reduced overall survival and leukemia-free survival (LFS). In multivariate analysis, HLA-B mismatch remained the independent risk factor for acute GVHD and transplant-related mortality. The high risk of disease and the female donor were found to be significant factors for reduced overall survival and LFS. Furthermore, multiple mismatch of the HLA locus was found to have no synergistic adverse effect on outcomes. Our results suggest that prospective matching of patients and donors for HLA-B antigen in the unshared HLA haplotype is warranted for HLA-mismatched/haploidentical transplantation.

Assessing Candidacy for Bilateral Cochlear Implants: A Survey of Practices in the United States and Canada

Cochlear Implants International. May, 2011  |  Pubmed ID: 22333494

OBJECTIVES: There are currently no agreed-upon criteria to establish candidacy for bilateral cochlear implants (CIs). This study categorized practice patterns for establishing bilateral CI candidacy. METHODS: A postal survey was sent to all practices performing CIs in the United States and Canada. The survey queried centers regarding candidacy criteria for bilateral implantation, testing parameters, definition of ????best aided condition????, use of testing in noise, localization, and quality-of-life questionnaires. The survey was resent to non-responding centers 4 weeks after the initial mailing. RESULTS: The overall response rate was 40%. ????Best aided condition???? (70%) and hearing in noise (52%) were used to establish bilateral candidacy, while 45% of centers offered bilateral implants to all candidates. The majority of respondents defined ????best aided???? as hearing aids only (57% non-exclusive) or CI and hearing aid together (57%). Only 25% considered a CI alone as best aided. Nearly 5% considered no aiding to be the best aided. Sound localization was used by 8% of respondents for candidacy assessment. Reimbursement affected candidacy decision for 45%. There was variability in stimulus levels (60, 50, 45, and 55????dB), signal-to-noise ratios, and speaker orientations used. DISCUSSION: There are no consistent criteria to assess patients for bilateral CIs. This practice variation makes comparing outcomes across centers challenging and leaves open the possibility of having external standards imposed by regulators or payors. Standardization of candidacy assessment is necessary to develop best practices for bilateral cochlear implantation both to optimize patient outcomes and to ensure the continuity of coverage for these services.

Defining the Tipping Point. A Complex Cellular Life/death Balance in Corals in Response to Stress

Scientific Reports. 2011  |  Pubmed ID: 22355675

Apoptotic cell death has been implicated in coral bleaching but the molecules involved and the mechanisms by which apoptosis is regulated are only now being identified. In contrast the mechanisms underlying apoptosis in higher animals are relatively well understood. To better understand the response of corals to thermal stress, the expression of coral homologs of six key regulators of apoptosis was studied in Acropora aspera under conditions simulating those of a mass bleaching event. Significant changes in expression were detected between the daily minimum and maximum temperatures. Maximum daily temperatures from as low as 3°C below the bleaching threshold resulted in significant changes in both pro- and anti-apoptotic gene expression. The results suggest that the control of apoptosis is highly complex in this eukaryote-eukaryote endosymbiosis and that apoptotic cell death cascades potentially play key roles tipping the cellular life/death balance during environmental stress prior to the onset of coral bleaching.

Tobacco Addiction and The Risk of Upper Aerodigestive Tract Cancer in A Multicenter Case-Control Study

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337537

BACKGROUND: While previous studies on tobacco and alcohol and the risk of upper aerodigestive tract (UADT) cancers have clearly shown dose-response relations with the frequency and duration of tobacco and/or alcohol, studies on addiction to tobacco itself as a risk factor for UADT cancer have not been published, to our knowledge. The aim of this report is to assess whether smoking addiction is a risk factor for UADT SCC risk in the multicenter case-control study (ARCAGE) in Western Europe independent of tobacco smoking or alcohol drinking intensity or duration.METHODS: The analyses included 1,905 ever smoking UADT SCC cases (871 oral cavity/oropharynx, 814 hypopharynx/larynx, 127 esophagus, and 93 overlapping oral cavity/pharynx) and 1,489 ever smoking controls. The addiction variables included first cigarette after waking up, difficulty refraining from smoking in places where it is forbidden, and cigarettes per day. Odds ratios (OR) and 95% confidence intervals (95% CI) for UADT cancers with addiction variables were estimated with unconditional logistic regression, adjusting for center, age, sex, education level, alcohol consumption, and tobacco smoking.RESULTS: Among current smokers, 76.47% of cases were categorized in the highest addiction level, whereas 54.69% of controls were in that category. The participants who smoked their first cigarette within 5 minutes of waking up were two times more likely to develop UADT SCC (OR = 2.22, 95% CI 1.57-3.15) than those who smoked 60 minutes after waking up. A higher modified Fagerstram score, reflecting greater tobacco addiction, was associated with an increased risk of UADT SCC among current smokers, but not among former smokers.CONCLUSION: We observed that time to first cigarette after waking up was associated with UADT SCC risk, regardless of heavy smoking or alcohol drinking behaviors. These results are consistent with residual effect of smoking that was not captured by the questionnaire responses alone. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.

Benefits and Harms of Screening Mammography Frequency by Age and Comorbidity Score

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337538

BACKGROUND: There is uncertainty about the appropriate use of screening mammography in older women. We compared the benefits and harms of screening mammography frequency according to age and comorbidity scores. METHODS: We conducted analyses within a prospective cohort study of four mammography registries in the Breast Cancer Surveillance Consortium that had mammography data linked to Medicare claims information. Participants included 137,949 women aged 66-89 years without breast cancer and 2,993 women with breast cancer. We estimated odds of advanced (IIb, III, IV) stage, large tumor size (>20 millimeters), and estrogen receptor (ER) negative tumors and cumulative probability of false-positive mammography after 10 years of screening by mammography frequency, age and comorbidity score as determined by the Charlson Comorbidity Index. RESULTS: Mammography biennially vs. annually for women aged 66-89 years does not increase risk of tumors with unfavorable characteristics regardless of women's comorbidity score. Cumulative probability of a false-positive result for annual and biennial screening of women aged 66-89 years with a comorbidity score of ≥1 was 48 (46.1, 49.9) and 29 (28.1, 29.9) respectively. False-positives were more common among annual screeners than among those screened biennially irrespective of women's comorbidity score. CONCLUSION: Mammography annually vs. biennially does not have added benefit for women aged 66-89 years, even among those in good overall health as reflected by the lack of comorbidity. Risk of false-positive mammography is much higher with annual mammography.

The Role of Polymorphisms in DNA Repair Genes and HPV 18 Integration Status in Cervical Dysplasia

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337542

Despite the fact that cervical cancer is one of the leading causes of death in women worldwide, research has yet to elucidate why some HPV-infected women develop cancerous lesions while others are able to clear the infection. Previous studies have shown that HPV integration status may be associated with cervical cancer development, and yet, host genetic factors that may be involved in the viral integration process have not yet been identified. The purpose of this study was to examine the association between both HPV 18 viral integration status and single nucleotide polymorphisms (SNPs) in non-homologous end-joining (NHEJ) DNA repair pathway genes on cervical dysplasia. Specifically, we sought to compare women with no dysplasia to those with low-grade or high-grade squamous intraepithelial lesions.METHODS: A total of 765 women were selected from two large trials designed to evaluate optical technologies for cervical cancer. Genotyping was performed using the Illumina Golden Gate platform. HPV 18 integration status was determined using a previously established protocol. Chi-square tests were conducted to determine which SNPs were associated with normal cytology, low-grade, or high-grade lesions. Among participants with cervical dysplasia, polytomous logistic regression models were used to evaluate the effect of each polymorphism on viral integration status. An additive genetic model was used for all tests. P-values were adjusted using the false discovery rate method.RESULTS: Women with high-grade lesions were significantly younger than women with low-grade or no lesions. Tag-SNPs in 13 DNA repair genes, including MRE11A, ATM, and XRCC4, were significantly associated with cervical dysplasia. Most participants had a mix of both episomal and integrated HPV 18. Tag-SNPs in the XRCC4, PRKCH, and MRE11A genes were found to be significantly associated with HPV 18 integration status.CONCLUSION: Our study indicates that host genetic variation in NHEJ DNA repair pathway genes, including MRE11A and XRCC4, are significantly associated with HPV 18 integration, and that these genes may play a key role in determining cervical cancer development and progression. This is the first study to examine host genetic variation in association with the viral integration event. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.

Deficits in Health-Promoting Behaviors Among Veteran and Non-Veteran Male Cancer Survivors in Texas

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337548

OBJECTIVES: Cancer survivors may have increased risk for additional malignancies and illnesses. Veterans comprise a significant proportion of Texas male cancer survivors and may differ in their health status and needs from non-veterans. It is unknown whether they differ in general health-promotion strategies. This study sought to identify deficits in health-promoting behaviors among Texas male cancer survivors and to determine whether veteran-status predicts differences along these behaviors.METHODS: Using the Behavioral Risk Factor Surveillance System 2009 survey, we conducted secondary analysis of 280 veteran and 250 non-veteran Texas male cancer survivors. Data were analyzed using Fisher's exact test and logistic-regression models.RESULTS: Survivors averaged 68 years (SD = 11.4) and were primarily white (93%), married (71.5%), college graduates (51%), and non-smokers (91%). Respondents reported several different cancer diagnoses; most commonly prostate (28%). More non-veterans than veterans were obese (31.6% vs. 22.5%; p = 0.03). Veteran-status was not associated with other co-morbidities, current smoking, binge drinking, or fruit/vegetable consumption. However, only 22% met recommendations for daily fruits/vegetables. In multivariate regression, veterans were less likely to meet moderate (OR = 0.54, 95% CI = 0.30-0.95) and vigorous (OR = 0.67, 95% CI = 0.45-0.99) physical-activity recommendations, but were more likely to have had health examinations within the previous year (OR = 1.77, 95% CI = 1.11-2.83).CONCLUSION: Texas male cancer survivors reported deficits across important health behaviors, including dietary and physical-activity recommendations. Veterans reported low compliance with physical-activity guidelines, in spite of evidence-based veterans health-promotion programs, e.g., MOVE! ®. Our results suggest veterans' adherence to routine care may offer a point of intervention to implement health-promotion guidelines among cancer survivors. Further research is needed to understand how to use the growing focus on cancer survivorship within the VA healthcare system to encourage greater adoption of health promotion practices among veteran cancer survivors. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.

Ruminant Fatty Acids and Prostate Cancer Risk in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337551

Relationship Between Use of Different Oral Contraceptive Formulations and Breast Cancer Risk Among Young Women

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337552

PURPOSE: Prior studies suggest that recent oral contraceptive (OC) use is associated with a modest increased risk of breast cancer among young women. However, the majority of these reports have relied on self-reported use and have not characterized risks associated with newer OC formulations.METHODS: We conducted a nested case-control study among health plan enrollees at a large health maintenance organization, Group Health Cooperative, which serves the greater Seattle-Puget Sound region. Cases consisted of 1,102 women 20-49 years of age diagnosed with invasive breast cancer from 1990-2009. We randomly selected 21,952 controls matched on age, year, and enrollment length. Detailed information on recent OC use, including formulation, dose, and duration was ascertained from electronic pharmacy records. Multivariate-adjusted conditional logistic regression was used to calculate odds ratios (ORs) as estimates of relative risks and 95% confidence intervals (CIs).RESULTS: Recent OC use (within 1 year of diagnosis) was associated with a 60% (95% CI = 1.3-1.9) increased breast cancer risk. The association was slightly stronger for estrogen receptor (ER) positive compared to ER-negative disease (ER-positive OR = 1.7, 95% CI = 1.3-2.1 and ER-negative OR = 1.2, 95% CI = 0.8-1.8), though this difference was not statistically significant. The ORs varied somewhat by OC formulation, with recent use of OCs containing the progestin ethynodiol diacetate (OR = 2.6, 95% CI = 1.4-4.7) or high dose estrogen (OR = 2.7, 95% CI = 1.2-6.4) associated with particularly elevated risk estimates compared to non-use of OCs in the prior year. In contrast, risk estimates for recent use of OCs with the progestin norgestimate or low dose estrogen suggested either a modest association or no association (OR = 1.2, 95% CI = 0.6-2.2 and OR = 1.0, 95% CI = 0.6-1.7, respectively).CONCLUSIONS: These results suggest that recent use of contemporary OC formulations is associated with an elevated risk of breast cancer among women ages 20-49, with associations varying somewhat by OC formulation. Although breast cancer is rare among young women, the potential risk of breast cancer associated with certain formulations could impact OC recommendations by providers if these findings are confirmed. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.

Race and Risk of Large Bowel Polyps in Younger and Older Patients

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337553

Non-Physician Providers, Cancer Screening and Health Behavior Counseling

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337554

PURPOSE: Patients who receive a physician's recommendation for cancer screening and behavioral modification are most likely to comply with these recommendations. However, physicians face time constraints that make it nearly impossible to provide all recommended preventive services. The 2010 Affordable Care Act will expand health insurance coverage to 42 million Americans by 2014. Non-physician providers may help meet this new demand for primary care and ensure compliance with preventive services recommendations.METHODS: Data from the 2005 National Health Interview Survey were analyzed using multivariate logistic regression to assess the association between provider type seen in the past 12 months and compliance with U.S. Preventive Services Task Force cancer screening recommendations and receipt of behavior counseling among age-eligible adults (n = 23,201). Models were adjusted for age, level of education, and insurance status and stratified by gender.RESULTS: About 15% of NHIS participants (N = 4,652) saw a non-physician provider (nurse practitioner, certified nurse midwife or physician assistant) and a primary care physician. In adjusted analyses, age-eligible women were more likely to be compliant with Pap screening (OR: 5.0; 95% CI: 4.2-5.9), mammography (OR: 6.6; 95% CI: 5.2-8.4) and colorectal screening recommendations (OR: 7.8; 95% CI: 5.3-11.4) if they saw a non-physician provider and a primary care physician compared to not seeing any provider. Similarly, men were more likely to be compliant with colorectal screening recommendations (OR: 9.6; 95% CI: 6.9-13.5) if they saw a non-physician provider and a primary care physician. Women and men were more likely to report a provider asking about smoking status if they saw a non-physician provider and a primary care physician than those who saw other types of healthcare providers ((OR: 2.2; 95% CI: 2.0-2.4) and (OR: 3.0; 95% CI: 2.4-3.7), respectively).CONCLUSIONS: Seeing a non-physician provider and a primary care physician is related to an increased likelihood of compliance with cancer screening recommendations and receipt of health behavior counseling. Opportunities exist for non-physician providers during this era of healthcare reform. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.