Δευτέρα 7 Μαρτίου 2022

Current management and perspectives for locally advanced nasopharyngeal carcinoma

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Cancer Radiother. 2022 Mar 3:S1278-3218(22)00030-0. doi: 10.1016/j.canrad.2021.11.026. Online ahead of print.

ABSTRACT

Nasopharyngeal carcinoma diagnosis is often made at a locally advanced stage (75 to 90% of cases) due to its deep localization. Concomitant radio-chemotherapy is the cornerstone of the treatment of locally advanced forms. The advent of intensity-modulated radiotherapy has improved oncological outcomes and reduced toxicity and is currently the gold standard for irradiation technique. For the locally advanced stage, the addition of induction chemotherapy has become the new standard care according to the latest international recommendations to reduce tumor volumes and act early on micro-metastases. Despite these therapeutic advances, the local and especially distant failure rate remains high. This article reviews current treatment strategies and discuss new approaches and perspectives of locoregional and systemic treatment to re duce treatment failures.

PMID:35249815 | DOI:10.1016/j.canrad.2021.11.026

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Neural Contributions to the Cochlear Summating Potential: Spiking and Dendritic Components

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Abstract

Using electrocochleography, the summating potential (SP) is a deflection from baseline to tones and an early rise in the response to clicks. Here, we use normal hearing gerbils and gerbils with outer hair cells removed with a combination of furosemide and kanamycin to investigate cellular origins of the SP. Round window electrocochleography to tones and clicks was performed before and after application of tetrodotoxin to prevent action potentials, and then again after kainic acid to prevent generation of an EPSP. With appropriate subtractions of the response curves from the different conditions, the contributions to the SP from outer hair cells, inner hair cell, and neural "spiking" and "dendritic" responses were isolated. Like hair cells, the spiking and dendritic components had opposite polarities to tones — the dendritic component had negative polarity and the spiking component had positive polarity. The magnitude of the spiking component was larger than the dendritic across frequencies and intensities. The onset to tones and to clicks followed a similar sequence; the outer hair cells responded first, then inner hair cells, then the dendritic component, and then the compound action potential of the spiking response. These results show the sources of the SP include at least the four components studied, and that these have a mixture of polarities and magnitudes that vary across frequency and intensity. Thus, multiple possible interactions must be considered when interpreting the SP for clinical uses.

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Bioinspired Super-Strong Aqueous Synthetic Tissue Adhesives

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Matter. 2022 Mar 2;5(3):933-956. doi: 10.1016/j.matt.2021.12.018. Epub 2022 Jan 25.

ABSTRACT

Existing tissue adhesives and sealants are far from satisfactory when applied on wet and dynamic tissues. Herein, we report a strategy for designing biodegradable super-strong aqueous glue (B-Seal) for surgical uses inspired by an English ivy adhesion strategy and a cement particle packing theory. B-Seal is a fast-gelling, super-strong, and elastic adhesive sealant composed of injectable water-borne biodegradable polyurethane (WPU) nanodispersions with mismatched particle sizes and counterions in its A-B formulation. B-Seal showed 24-fold greater burst pressure than DuraSeal®, 138-fold greater T-pull adhesive strength than fibrin glue, and 16-fold greater lap shear strength than fibrin glue. In vivo evaluation on a rat cerebrospinal fluid (CSF) rhinorrhea model and a porcine craniotomy model validated the safety and efficacy of B-Seal for effective C SF leak prevention and dura repair. The plant-inspired adhesion strategy combined with particle packing theory represents a new direction of designing the next-generation wet tissue adhesives for surgeries.

PMID:35252844 | PMC:PMC8896806 | DOI:10.1016/j.matt.2021.12.018

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Paget's disease of bone and megaloblastic anemia in a 72-year-old patient: A case report and systematic literature review

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Exp Ther Med. 2022 Apr;23(4):269. doi: 10.3892/etm.2022.11195. Epub 2022 Feb 8.

ABSTRACT

Paget's disease of bone (PDB) is characterized by abnormal osteoclastic bone resorption with disorganized bone neo-formation, primarily affecting elderly (>55 years) patients. Although the majority of patients are asymptomatic, some patients may experience bone pain due to local periosteal involvement or osteoarthritic lesions in the spine; in addition, limb deformities may lead to secondary gait problems or degenerative joint changes. Anemia has an overall prevalence of 12-17% in elderly adults (>65 years old), with macrocytic anemia being the less common type. Megaloblastic anemia is a macrocytic anemia characterized by the presence of large, immature, nucleated cells (megaloblasts) in the blood, with the most common cause being a deficiency of folate and/or vitamin B12. We herein report the rare case of a 72-year-old male patient exhibitin g both these conditions, with the aim of discussing the possible association between the two and, most importantly, the clinical management of the patient in a real-life setting over a period of 10 years. The patient was diagnosed based on clinical symptoms (bone pain), radiological imaging and specific laboratory tests, and received discontinuous courses of bisphosphonates and cyanocobalamin supplementation therapy, based mainly on aggravated symptomatology. A systematic literature review was also performed and revealed not only the scarcity of reports on similar cases, but also the mechanisms that may underlie the possible association of PDB with macrocytic anemia due to vitamin B12 deficiency in elderly patients.

PMID:35251335 | PMC:PMC8892619 | DOI:10.3892/etm.2022.11195

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