[Infrasound - implications for human medicine]. / Infraschall ­ humanmedizinische Implikationen.

Infrasound describes ubiquitous, low-frequency sound (< 20 Hz) in the environment with a long wavelength below the median hearing threshold, which can nevertheless be heard and tactilely perceived, depending on the sound pressure level and frequency spectrum. In nature, infrasound emissions usually occur only in the low-threshold range. Nevertheless, after strong and chronic exposure to usually artificially generated infrasound emissions, various effects on the ear and the body, sometimes questionably critical to health, can be observed. Correct measurement and assessment of infrasound sources is complex and controversial. Established guidelines are scarce. Innovative research areas include infrasound monitoring for evaluation of natural events and infrasound applications in medicine. In the future, it is hoped that new insights will be gained from infrasound research and that a more extensive classification in occupational medicine will be possible.

Infrasound a new weapon in cancer therapy?

BACKGROUND: Researchers take different positions when describing the effects of infrasound on the human body. Although several studies investigated the likely harmful effects of infrasound exposure from wind turbines a significant connection has not been found yet. There is evidence that infrasound interacts with cell metabolism and may disrupt cell membrane integrity. OBJECTIVES: The suggested impairment of the cells' ultrastructure by infrasound leads to the question of whether infrasound can be therapeutically used, for instance in cancer therapy. This review provides the current state of the literature. METHOD: Current literature on infrasound in cancer therapy including all studies with the search terms 'cancer' and 'infrasound' were identified and reviewed until the year 2020. RESULTS: The present state of research reveals promising effects of targeted infrasound in cancer therapy. Infrasound directly affects the tumor cells' ultrastructure and seems to sensitize several types of cancer to chemotherapy, presumably due to membrane permeabilization. The application of infrasound on tumor cells without other therapeutic agents demonstrates different effects that probably depend on the type of cells, the applied frequency and sound pressure level as well as the time of exposure. CONCLUSIONS: The mechanism of infrasound on cancer cells is not completely understood yet, hence, further studies have to be conducted to clarify the ultrastructural and metabolic changes inside the tumor cells. The development of suitable infrasound generators for the application in a clinical setting would be an important course of action.

Influence of travel burden on tumor classification and survival of head and neck cancer patients.

PURPOSE: Cancer patients have to overcome various barriers to obtain diagnostics and treatment at head and neck cancer centers. Travel distance to a specialized hospital may result in psychosocial and financial distress, thus interfering with diagnostics, treatment, and follow-up care. In this study, we have aimed to analyze the association of travel distance with cTNM status, UICC stage at primary diagnosis, and survival outcomes of head and neck cancer (HNC) patients. METHODS: We have analyzed data of 1921 consecutive HNC patients diagnosed between 2014 and 2019 at the head and neck cancer center of the Comprehensive Cancer Center Ulm (CCCU), Germany. Postal code-based travel distance calculation in kilometers, TNM status, and UICC stage were recorded at initial diagnosis. The assembly of travel distance-related groups (short, intermediate, long-distance) has been investigated. Moreover, group-related survival and recurrence analysis have been performed. RESULTS: In contrast to observations from overseas, no association of travel distance and higher cTNM status or UICC stage at primary diagnosis has been observed. Furthermore, no significant differences for recurrence-free survival and overall survival by travel distance were detected. CONCLUSION: In southern Germany, travel distance to head and neck cancer centers seems to be tolerable. Travel burden is not synonymous with travel distance alone but also involves sociodemographic, monetary, and disease-specific aspects as well as accessibility to proper infrastructure of transport and health care system.

[Hormonal influence on hearing]. / Hormonelle Beeinflussung des Hörvermögens.

BACKGROUND: Hearing loss leads to impairments in communication, social interactions, and cognitive functions. This renders early treatment particularly important. A causal therapy is not yet available. Human and animal studies have shown that certain hormones can have a positive effect on hearing. OBJECTIVE: This review provides an overview of the effects of various hormones on hearing and describes the potential benefit for future therapeutic approaches. MATERIALS AND METHODS: A systematic literature review of reviews dealing with the effects of various hormones on hearing in humans and animals published in PubMed between 2015 and 2020 was conducted. RESULTS: Hormones may mediate antiapoptotic effects on structure-relevant cells of the cochlea and auditory pathway, and may influence hair cell functionality or the electrolyte balance of the endo- and perilymph. Current research focuses on glucocorticoids; the mineral corticoid aldosterone; the sex hormones estrogen, progesterone, and testosterone; the growth hormones GH (growth hormone) and IGF­1 (insulin-like growth factor 1); thyroid hormones; and insulin. Study results are still inconsistent at this time, but various hormones appear to represent a possible future treatment option for acute hearing loss. Long-term hormone treatment, which would be necessary particularly in the case of age-related hearing loss, does not currently represent a sensible course of action due to the side effect profile of the systemic treatment/lack of practicable topical application options. CONCLUSION: The mode of action of hormones is complex. Whether they can be used in the future for individualized treatment of patients with acute hearing impairment requires further investigation.

[Laryngectomy-still state of the art?] / Die Laryngektomie ­ noch zeitgemäß?

Total laryngectomy provides a curative approach for patients with advanced laryngeal and hypopharyngeal cancer without distant metastasis. Especially in stage cT4a disease, laryngectomy is superior to primary radio(chemo)therapy in retrospective studies. Further relevant indications for the procedure are tumor-related laryngeal dysfunction such as dysphagia and aspiration, as well as cancer recurrence after primary radio(chemo)therapy. The surgical procedure is highly standardized, with an appropriate safety profile. The subsequent loss of voice must be compensated by voice rehabilitation (voice prosthesis, ructus). The current overview provides information about indications for laryngectomy, preoperative clinical diagnostics, the surgical procedure, complications, alternative treatment, rehabilitation, and prognosis. Total laryngectomy remains a standard procedure in modern head and neck oncology.

[Neck dissection-Surgical treatment of cervical lymphatic drainage pathways]. / Neck-Dissection ­ Die operative Behandlung der zervikalen Lymphabflusswege.

Neck dissection (ND) is an essential component of treatment in head and neck squamous cell carcinoma (HNSCC). The extent of ND depends on primary tumor location and T and N stage. Trials have demonstrated improved survival for cN+ status with therapeutic ND as well as for cN0 status with selective ND if the primary has a high incidence of occult metastasis. The accuracy of the procedure is of prognostic relevance. In the prognostic model of the TNM classification, the parameter "N" does not only reflect the number of affected lymph nodes, but also their size and extranodal tumor extension. Due to its better prognosis, a positive human papillomavirus (HPV) status is also incorporated in the present TNM classification. In order to minimize morbidity after ND, one seeks to limit its extent without reducing survival time. To this aim, sentinel node biopsy or surveillance with positron-emission computed tomography (PET-CT) in cN0 necks or after primary radio(chemo)therapy are being investigated.

[HPV-positive oropharyngeal cancer-risk for the partner?] / HPV-positives Oropharynxkarzinom ­ eine Gefahr für den Partner?

A case of HPV-positive, metachronous oropharyngeal cancer in a married couple has been reported in the context of other studies, thus raising the question of whether it is necessary to screen or intensively monitor the partners of patients with HPV-positive oropharyngeal cancer, or whether preventive methods are required. Current data suggests that there is a potential risk for the partner to develop a concordant disease, but because of the lack of consolidated data, no statement on the frequency of this event can presently be made. Further epidemiological trials might be useful.

Ripper procedure for determining sulfur dioxide in wine: collaborative study.

Twenty-three laboratories analyzed 5 replicate wine samples according to a specified version of the Ripper direct iodometric titration for sulfur dioxide. Each sample was analyzed for (A) free SO2, (B) total SO2, and (C) iodine-reactive substances other than SO2. Although variation of A with temperature and of A and B with time of analysis were anticipated, analysis of covariance showed no significant reduction in error when these variables were taken into account. Error did vary with SO2 level and wine type, red vs white. Pooled estimates of precision (within-laboratory error) in mg SO2/L wine were, for white wine: (A) 3.3, (B) 10.4, (C) 1.9; for red wine: (A) 3.8, (B) 7.3, (C) 1.9. Pooled estimates of systematic (between-laboratory) error in mgSO2/L wine were, for white wine: (A) 2.7, (B) 16.6, (C) 2.1; for red wine: (A) 4.3, (B) 15.1, (C) 3.0. Although rapid and convenient, the Ripper method is severely limited by poor precision and large systematic error. The Ripper method is not recommended for adoption by the AOAC.