Estimating survival after salvage surgery for recurrent salivary gland cancers: Systematic review.

Recurrent salivary gland carcinomas (RSCs) are poorly characterized and their clinical features and treatment options have not yet been fully described. The goal of this study was to analyze the therapeutic strategies and oncological outcomes of RSC patients through a literature review analysis. This systematic review was performed according to the PRISMA statements. Inclusion criteria for the systematic review were based on the population, intervention, comparison, and outcomes according to (PICO) framework. Two thousand seven hundred and four records were selected and 1817 recurrences were studied. Three hundred and sixty-five patients underwent salvage surgery (20.1%) and their 5-year mortality rate, overall survival and disease-free survival were 35%, 70%, and 42%, respectively. RSCs are aggressive neoplasms with a high rate of distant metastases (28.9%). Salvage surgery can be considered in patients with limited local and/or regional recurrences, even in case of single distant relapse, appearing within the first 3 years of follow-up.

Employment Instability and Fertility in Europe: A Meta-Analysis.

The relationship between employment instability and fertility is a major topic in demographic research, with a proliferation of published papers on this matter, especially since the Great Recession. Employment instability, which most often manifests in unemployment or time-limited employment, is usually deemed to have a negative effect on fertility, although different fertility reactions are hypothesized by sociological theories, and micro-level evidence is fragmented and contradictory. We used meta-analytic techniques to synthesize European research findings, offer general conclusions about the effects of employment instability on fertility (in terms of direction and size), and rank different sources of employment instability. Our results suggest that employment instability has a nonnegligible negative effect on fertility. Men's unemployment is more detrimental for fertility than men's time-limited employment; conversely, a woman having a fixed-term contract is least likely to have a child. Next, the negative effect of employment instability on fertility has become stronger over time, and is more severe in Southern European countries, where social protection for families and the unemployed is least generous. Finally, meta-regression estimates demonstrate that failing to account for income and partner characteristics leads to an overestimation of the negative effect of employment instability on fertility. We advance the role of these two factors as potential mechanisms by which employment instability affects fertility. Overall, this meta-analysis provides the empirical foundation for new studies on the topic.

Is the effect of job uncertainty on fertility intentions channeled by subjective well-being?

This article combines two apparently distinct strands of contemporary research on fertility: the literature on economic uncertainty and fertility; and the literature on subjective well-being and fertility. We advance the hypothesis that the impact of jobs with uncertain conditions on fertility intentions is channeled by an individual's level of subjective well-being, which captures also unmeasured amenities of the job, including prestige, work-life balance, or welfare provision. To offer evidence for this hypothesis, we apply techniques of mediation analysis to data from two rounds of the European Social Survey (ESS 2004 and 2010). Our analysis suggested that the effect of jobs with uncertain conditions on fertility intentions depends on the level of subjective well-being: the negative effect is found only when subjective well-being is relatively low (i.e. life satisfaction levels equal or below six). Detailed results show that parents and older individuals have lower fertility intentions than childless and younger individuals when they have a job with uncertain conditions and a consequent low subjective well-being. We also found that - while the economic crisis was underway in 2010 - it was especially the deterioration in men's position in the labor market that was associated with lower fertility plans.

The surgical treatment of cerebrospinal fistula: Qualitative and quantitative analysis of indications and results.

Cerebrospinal fistula might occur in different ways. CSF closure techniques have undergone significant evolution that has led to the consolidation of the transnasal endoscopic approach. Despite the existence of multiple publications, meaningful information is still lacking in clinical practice and the literature about the ideal method, material, and timing for repair of CSF. The purpose of this review was to summarize the success rate of endoscopic CSF leak repair as well as whether specific techniques or materials influence the primary success rate through a review of the latest advancements in endoscopic CSF management published in the past 10 years. The principles of multilayer reconstructions and the routine use of vascularized flaps in expanded endonasal surgery have reduced postoperative CSF leaks' failure rates between 5% and 10% (4% in this meta-analysis). Effective endoscopic anterior skull base (ASB) closure may be achieved by multiple reconstructive techniques, which should be tailored case by case according to the patient and defect conditions.