Sentinel node biopsy versus elective neck dissection in early-stage oral cancer: a systematic review.

PURPOSE: To provide a summary of the evidence on the comparative effectiveness of two surgical treatment strategies, sentinel node biopsy (SNB) and elective neck dissection (END), in patients with T1-T2 oral cancer and clinically negative (cN0) neck, in terms of overall survival (OS), disease-free survival (DFS) and neck recurrence rates (NRRs). METHODS: A systematic review was performed by including studies published up to April 2019. Meta-analysis was performed to compare NRRs between SNB and END. A narrative summary of the results was generated for OS, DFS and morbidity outcomes. The certainty of evidence was assessed according to the GRADE methodology. RESULTS: No randomized studies were retrieved. Five observational studies were included in the comparative effectiveness analysis and four observational studies were included in the comparative morbidity analysis. The pooled risk ratio showed no differences in NRRs between SNB and END (10.5% vs 11.6%; pooled RR 1.09; 95% CI 0.67-1.76). No differences in OS or DFS between the two treatments were found. SNB appears to be associated with a lower rate of postoperative complications and lower shoulder dysfunction than END. Conversely, the results of the quality of life (QoL) questionnaires are not sufficient to advocate a particular strategy. CONCLUSION: Our review highlights the lack of well conducted and randomized studies comparing SNB to END, leading to poor clinical evidence. Although our findings suggest no significant differences in OS, DFS and NRR between the two strategies, the certainty of our evidence is too low to make it useful for clinical decision making.

Results of Early Versus Intermediate or Delayed Voice Therapy in Patients With Unilateral Vocal Fold Paralysis: Our Experience in 171 Patients.

OBJECTIVES: Vocal fold paralysis can have an important impact on a patient's quality of life. The goal of this study was to compare, in terms of vocal improvement and motility recovery, the post-vocal treatment results of our patients with unilateral vocal fold paralysis (UVFP) when treatment was started early (within 4 weeks from injury) versus intermediate (from 4 to 8 weeks) or delayed (at least 8 weeks after injury) treatment. STUDY DESIGN: An 11-year retrospective study of patients with UVFP who underwent multidimensional diagnostic-therapeutic assessment. METHODS: In total, 171 patients with UVFP were included in our study, divided into three groups who underwent early (first group), intermediate (second group), or delayed (third group) voice treatment. All patients underwent voice therapy based on forcible exercises supplemented by manipulations and maneuvers. RESULTS: Of the 171 patients with UVFP, 106 (62%) recovered vocal fold motility. Of these 106 patients, 51/78 (65%) were in the first group, 30/49 (61%) in the second group, and 25/44 (56%) in the third group. A significant (P < 0.0001) reduction in fundamental frequency (Fo) was present in the first group with a manifest improvement in the mean values of Jitter (Jitt%; P = 0.001), Shimmer (Shim%; P < 0.0001), and noise-to-harmonic ratio (NHR; P < 0.0001). A significant (P < 0.0001) reduction in Fo was found in the second group with a manifest improvement in Jitt% (P < 0.001), Shim% (P < 0.0001), and NHR (P < 0.0001). For the third group, no values were statistically significant apart from the improvement in NHR (P < 0.001). CONCLUSIONS: This study confirms the importance of early rehabilitation underlining the non-functional vocal recovery in patients who started treatment later than 8 weeks after injury.

Raman and micro-thermometric investigation of the fluid inclusions in quartz in a gold-rich formation from Lepaguare mining district (Honduras, Central America).

Fluid inclusions in the quartz crystals present in gold-rich veins from central Honduras have been studied by means of micro-thermometry and micro-Raman spectroscopy in order to provide information on the physico-chemical conditions and chemical composition of the mineralizing fluids. The use of a confocal micro-Raman apparatus allowed to obtain information on the fluid composition, in particular on the gas phase, minimizing the contributions of the host matrix to the Raman signal. The samples studied were collected from an area (Lepaguare mining district, Northern-Central Honduras) rich in ore deposits due to the Cenozoic magmatic activity, where the gold and sulphide mineralization is connected with a system of quartz veins (few decimetres thick) occurring in low-grade metamorphic rocks and produced by hydrothermal fluids. The quartz crystals present in the gold-rich veins often contain fluid inclusions. Four types of fluid inclusions have been observed, but their assemblage in the same clusters and fracture systems, as well as their comparable salinity and homogenization data, suggest that they have the same origin. Micro-thermometry and Raman spectroscopy provide a composition of the mineralizing fluids attributable to the system H(2)O-NaCl-KCl-CO(2)-CH(4), with temperature and pressure intervals of 210-413 degrees C and 1050-3850 bar, respectively. These data agree with an epigenetic origin of the gold deposit (depth < 6 km) related to granitoid or granodiorite intrusions associated to orogenic environments.

[Use of topical methisoprinol (Viruxan) in female genital condylomatosis]. / Utilizzazione del metisoprinolo (Viruxan) per via topica nella condilomatosi genitale femminile.

Medical therapy of genital condylomatosis seems to be the most rational strategy, since this pathology is characterised by highly frequent recurrences after destructive physical therapy alone. Successful therapy of female genital condylomatosis with methisoprinol (Viruxan), administered as ointment and/or vaginal ovules is reported. The drug proved to be efficient both in curing this viral infection and preventing its recurrences.

[Histo-radiological and histo-bronchoscopic correlates in neoplastic pathology of the lung. Personal case series]. / Correlazioni isto-radiologiche e isto-broncoscopiche nella patologia neoplastica del polmone. Casistica personale.

Data are presented on a series of 100 lung cancer patients, diagnosed histologically and encountered in 1984-87. The percentage distribution of the various histotypes and their relationship with radiological and endoscopic aspects were examined. The data obtained are then compared with those reported in the literature.