Quality compared to quantity of life in laryngeal cancer: A time trade-off study.

BACKGROUND: The purpose of this study was to use time trade-off to assess the factors influencing patients' decisions in advanced laryngeal cancer. Time trade-off is a well-established method of assessing how individuals value a particular health state. METHODS: We developed vignettes depicting life after chemoradiotherapy or laryngectomy. One hundred fourteen participants ranked them, assigned utility values, and rated the importance of survival on treatment choice. RESULTS: Chemoradiotherapy was preferred by 62% and laryngectomy by 38%. Chemoradiotherapy optimal outcome had the highest mean utility value (0.64) followed by total laryngectomy optimal outcome (0.56). Total laryngectomy poor outcome (0.33) was equivalent to chemoradiotherapy poor outcome (0.32).The average survival advantage required for a participant to change their preferred choice was 2.1 years. CONCLUSION: The functional treatment outcome had a greater effect on health state utility values than treatment modality. In many individuals, larynx conservation may not be the primary consideration in treatment preference. © 2015 Wiley Periodicals, Inc. Head Neck 38: E631-E637, 2016.

Synthesis of benzothiophene-based hydroxamic acids as potent and selective HDAC6 inhibitors.

A small library of 3-[(4-hydroxycarbamoylphenyl)aminomethyl]benzothiophenes was prepared and assessed as a novel class of HDAC6 inhibitors, leading to the identification of three representatives as potent and selective HDAC6 inhibitors. Further tests with regard to inflammatory responses indicated that HDAC6 inhibition can be uncoupled from transcriptional inhibition at the level of activated NF-κB, AP-1, and GR.

The use of the Newcastle Control Score in the management of intermittent exotropia.

AIM: To evaluate the use of the Newcastle Control Score (NCS) in the management of intermittent exotropia (X(T)). PARTICIPANTS AND METHODS: Children aged <11 years with X(T) had an assessment of NCS as part of routine management. Other data collected included visual acuity, near and distance alignment with alternating prism cover test and near (Frisby test) and distance stereoacuity (Frisby Davis Distance Stereotest (FD2TM)). Analysis involved correlation between baseline NCS, angle and stereoacuity, examination of change over time and logistic regression to determine predictors of surgery. RESULTS: Baseline data were obtained on 272 children and follow-up data on 157. Mean (SD) age was 4 (1.9) years. Complete NCSs were obtained for all except one child at baseline, and all children at follow-up. At baseline, total NCS and the home control component were correlated with near stereo (r = -0.22, p<0.01 and r = -0.19, p<0.02, respectively), near alignment (r = 0.34, p<0.001 and r = 0.19, p<0.02) and distance alignment (r = 0.30, p<0.001 and r = 0.26, p<0.001). The clinic near control component was correlated with near alignment (r = 0.39, p<0.001), but not near stereoacuity, and the clinic distance control with near alignment (r = 0.16, p<0.02), distance alignment (r = 0.27, p<0.001) and distance stereoacuity (r = -0.25, p<0.03). A high (poor) NCS (> or =4) at the latest follow-up predicted surgery (p<0.001, OR 29.3, 95% CI 6.2 to 138.7). CONCLUSION: The NCS is a useful measure of the clinical severity of X(T), can be used to serially assess improvement or deterioration and is a useful tool for the management of these patients.

Risk factors for first-ever stroke in older people in the north East of England: a population-based study.

BACKGROUND AND PURPOSE: Although older people potentially have most to gain from prevention, they have been excluded from or underrepresented in many stroke incidence studies. We sought to determine the risk factors for stroke in older people. METHODS: A 5-year follow-up study of a population-based cohort of 4440 subjects aged >65 years in northern England. Subjects were recruited from 27 general practices between 1995 and 1997. RESULTS: A total of 329 out of 4351 subjects with follow-up data suffered a first-ever stroke. On multivariate analysis, risk factors for stroke in older people included atrial fibrillation (hazard ratio [HR], 2.03 [95%CI, 1.31 to 3.16]); previous transient ischemic attack (1.87 [95% CI, 1.27 to 2.76]); smoking (1.72 [95% CI,1.28 to 2.32]); and cardiovascular disease (1.55 [95% CI, 1.19 to 2.03]). The HR per 10-mm Hg increase in systolic blood pressure was 1.15 (95% CI, 1.06 to 1.24). Age was associated with a HR of 1.74 (95% CI, 1.42 to 2.12) per 10-year increase. CONCLUSIONS: "Classic risk factors" increase the risk of stroke in older people. Stroke is not an inevitable consequence of aging, so by identifying and modifying risk factors in older people there are opportunities to reduce the incidence and mortality of this devastating condition.