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This study examines the impact of chainsaw chain type and tree species on the concentration of inhalable wood dust generated during motor-manual harvesting in forested areas. The effects of conducting real-world measurements of inhalable dust within the operator's breathing zone during forestry work are investigated. Two different chain types were evaluated: the commonly used 3/8" pitch chain (conventional chain) and the 0.325" pitch chain. Additionally, measurements were taken for three tree species: beech, oak, and pine (including both live and standing dead trees after a fire). Results showed that, overall, using the conventional 3/8" chain type yielded the highest concentration of wood dust for all three tree species. Notably, the highest wood dust concentration was observed in the burned Pinus brutia cluster, also with the 3/8" chain pitch. These findings emphasize the importance of understanding how chain type and tree species contribute to wood dust levels.
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BACKGROUND: Brain metastases from sarcomatous lesions pose a management challenge owing to their rarity and the histopathological heterogeneity. Prognostic indices such as the Graded Prognostic Assessment (GPA) index have been developed for several primary tumour types presenting with brain metastases (e.g. lung, breast, melanoma), tailored to the specifics of different primary histologies and molecular profiles. Thus far, a prognostic index to direct treatment decisions is lacking for adult sarcoma patients with brain metastases. METHODS: We performed a multicentre analysis of a national group of expert sarcoma tertiary centres (French Sarcoma Group, GSF-GETO) with the participation of one Canadian and one Swiss centre. The study cohort included adult patients with a diagnosis of a bone or soft tissue sarcoma presenting parenchymal or meningeal brain metastases, managed between January 1992 and March 2012. We assessed the validity of the original GPA index in this patient population and developed a disease-specific Sarcoma-GPA index. RESULTS: The original GPA index is not prognostic for sarcoma brain metastasis patients. We have developed a dedicated Sarcoma-GPA index that identifies a sub-group of patients with particularly favourable prognosis based on histology, number of brain lesions and performance status. CONCLUSIONS: The Sarcoma-GPA index provides a novel tool for sarcoma oncologists to guide clinical decision-making and outcomes research.
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Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundario , Sarcoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Encefálicas/mortalidad , Neoplasias Encefálicas/terapia , Toma de Decisiones Clínicas , Terapia Combinada , Manejo de la Enfermedad , Femenino , Humanos , Estado de Ejecución de Karnofsky , Masculino , Persona de Mediana Edad , Clasificación del Tumor/métodos , Pronóstico , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto JovenRESUMEN
[This corrects the article DOI: 10.1016/j.mex.2022.101919.].
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Interleukin (IL)-8 promotes cellular proliferation and angiogenesis in patients with non-small-cell lung cancer (NSCLC) and may be related to cachexia. Our aim was to investigate the relationship of IL-8 levels with nutritional status, and clinical outcome of patients with NSCLC. Patients with metastatic NSCLC referred for first-line therapy were eligible. Baseline IL-8 levels were measured in plasma. The Mini Nutritional Assessment (MNA) was used for the evaluation of the nutritional status, and patients were classified into 3 groups: A (score 24-30) "well nourished," B (score 17-23.5) "risk of malnutrition," and C (0-16.5) "malnourishment." Response to first-line chemotherapy, time-to-tumor progression (TTP), and overall survival (OS) were also recorded. In total, 114 patients (101 males, 88.5%; mean age = 67.5 yr) were evaluated. Performance status was 0-1 in 62% of the patients. According to the MNA, the majority of patients (71%) was either at nutritional risk or malnourished. IL-8 levels were significantly different between MNA groups (P = 0.023) and correlated with TTP (P = 0.013) and OS (P = 0.001) in univariate analysis. Baseline IL-8 levels correlate with the nutritional status of patients with metastatic NSCLC, suggesting that this cytokine may be related with cachexia.
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Carcinoma de Pulmón de Células no Pequeñas/sangre , Interleucina-8/sangre , Neoplasias Pulmonares/sangre , Estado Nutricional , Anciano , Caquexia/sangre , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/patología , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/patología , Masculino , Desnutrición/sangre , Persona de Mediana Edad , Análisis Multivariante , Evaluación Nutricional , Valor Predictivo de las Pruebas , PronósticoRESUMEN
BACKGROUND: The development of musculoskeletal disorders (MSDs) associated with forestry operations is an alarming issue. OBJECTIVE: In the present paper, an attempt was made to assess the location and the prevalence of the MSDs in timber harvesting tasks. METHODS: The analysis of logging-related risk factors was carried out by observing working postures with the use of the assessment tool RULA (Rapid Upper Limb Assessment) during harvesting jobs. In addition, the standardised Nordic Musculoskeletal Questionnaire (NMQ) was used in order to record self-reported MSDs symptoms. RESULTS: Results revealed that, in all work stages, risk levels were extremely high. According to the results of the RULA analysis, 77.5% of the working postures adopted by the left side of the body and 61.25% of postures involving the right side belong to the very high-risk level. According to the results of the questionnaire, a high percentage of loggers (34%) reported that they were facing problems in their backs and knees. CONCLUSIONS: Training and informing operators about the correct positions and the manual movement techniques, as well as increasing the mechanisation level of harvesting operations could reduce physiological work hardship.
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Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Ergonomía , Agricultura Forestal , Humanos , Enfermedades Musculoesqueléticas/complicaciones , Enfermedades Musculoesqueléticas/etiología , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Postura , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
The idea of entropy, which has its roots in information theory and proposes that one may measure the degree of uncertainty associated with the prediction of bits and pieces of information, has been widely used by biologists and ecologists for decades to define biological diversity. For ecologists, the core of the issue is whether or not two species' distribution taken from the same habitat are the same or distinct. The Shannon index and Simpson diversity are well-known in ecology; however, the non-linearity of these indices may cause a misinterpretation of the underlying diversity, as shown by Lou Jost (2006) and others. Applying the proposed template, one can:â¢calculate several biodiversity indices,â¢compare two different forest stands (or formations, or plots), or two different profiles in two different times, for the same forest stand (or formation, or plot), in terms of biodiversity.
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BACKGROUND: Frey's syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. METHODS: We conducted a 20-year retrospective study including the patients who had undergone "formal" (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. RESULTS: We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey's syndrome was found after the use of dermal collagen interpositional barrier (P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor's test was positive at an incidence of 59.09% in Group A and 21.87% in Group B (P = .004, 95% CI). Severe Frey's syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B (P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey's syndrome in the compared groups. CONCLUSION: Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey's syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.
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Colágeno/uso terapéutico , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Enfermedades de las Parótidas/cirugía , Complicaciones Posoperatorias/prevención & control , Sudoración Gustativa/prevención & control , Adenolinfoma/cirugía , Adenoma/cirugía , Adenoma Pleomórfico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Parótida/cirugía , Parotiditis/cirugía , Estudios Retrospectivos , Sialadenitis/cirugía , Teratoma/cirugía , Adulto JovenRESUMEN
Basal cell carcinoma (BCC) accounts for nearly 25% of all cancers in the human body and for almost 75% of skin malignancies; approximately 85% of basal cell carcinomas develop in the head and neck region. Limited demographic, clinical and histological predictors for second primary and/or recurrent BCC have been identified to date. Our objective was to identify predictors of recurrence and second primary tumour development of BCC in the head and neck region. We included 1062 patients with a histologically confirmed diagnosis of BCC. Multivariate and Cox regression analysis were used to access demographic, clinical and histological predictors. Study follow up included 4,302 patient-years, each patient was followed-up for an average 4.0 +/- 1.8 years (range 1-12). Overall recurrence rate was 4%. High-risk histology type was associated with an increased risk for recurrence (odds ratio (OR) = 3.47, 95%CI: 1.07-11.25). We calculated a 4-fold increased risk for recurrence with positive excision margins (OR = 4.31, 95%CI: 1.82-10.22), a 21% increased risk for recurrence (OR = 1.21, 95%CI: 1.06-1.37) and a 25% increased risk for second primary BCC development (OR = 1.25, 95%CI: 1.17-1.34) per year of follow-up. The median time free of second primary tumour was 7 years, while the median time free of recurrence was 12 years. The strongest predictors for recurrence are positive excision margins and high-risk histology type, indicating the need for additional patient care in such cases.
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Carcinoma Basocelular/patología , Neoplasias de Cabeza y Cuello/patología , Hospitales Especializados , Recurrencia Local de Neoplasia/patología , Neoplasias Primarias Secundarias/patología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/epidemiología , Femenino , Estudios de Seguimiento , Grecia/epidemiología , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/epidemiología , Neoplasias Primarias Secundarias/epidemiología , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Distribución por Sexo , Factores de Tiempo , Adulto JovenRESUMEN
Non-melanoma skin cancer (NMSC) is the commonest malignancy worldwide (>80% located in the head and neck area). The aim of this study was to assess risk factors predisposing to local recurrence of NMSC of the middle third of the face (MTF). This was a single-centre retrospective analysis of patients with NMSC of the MTF treated during 1995-2010. Data on epidemiological and tumour characteristics were collected. Survival analysis was performed and log-rank tests were used to compare differences in survival for each variable. A total of 531 patients with basal cell carcinoma (BCC) of the MTF were identified. Most tumours were nodular type (28.4%), located on the nose (34.3%), and confined to the dermis (75.5%). Negative margins were achieved in 91% of cases. Median follow-up time was 35 months and 15.2% of patients developed local recurrence. Incomplete excision was the only variable predisposing to local recurrence. The cohort also included 114 patients with squamous cell carcinoma (SCC). Most tumours were well differentiated (43.9%), located at the zygomatic area (49.1%), excised with negative margins (93%), and confined to the dermis (67.8%). At a median follow-up time of 42 months, local recurrence occurred in 15.7% of patients. Tumour size, depth of invasion, and prior history of head and neck SCC were risk factors for local recurrence. The variables predictive of recurrence of BCC were incomplete excision and for SCC tumour size, depth of invasion, and a prior history of head and neck SCC.
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Carcinoma Basocelular/patología , Carcinoma de Células Escamosas/patología , Neoplasias Faciales/patología , Recurrencia Local de Neoplasia/patología , Neoplasias Cutáneas/patología , Anciano , Carcinoma Basocelular/radioterapia , Carcinoma Basocelular/cirugía , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirugía , Supervivencia sin Enfermedad , Neoplasias Faciales/radioterapia , Neoplasias Faciales/cirugía , Femenino , Estudios de Seguimiento , Humanos , Metástasis Linfática , Masculino , Márgenes de Escisión , Persona de Mediana Edad , Invasividad Neoplásica , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Cutáneas/radioterapia , Neoplasias Cutáneas/cirugía , Carga TumoralRESUMEN
In Mediterranean ecosystems an increasing demand for in situ trace gas exchange data is emerging to enhance the adaptation and mitigation strategies under forest degradation. Field-chamber green-house gas fluxes and site characteristics were analysed in two Mediterranean peri-urban pine forests showing degradation symptoms. We examined the effect of different thinning interventions on soil CO2, CH4 and N2O fluxes, addressing the relationships with the environmental variables and C and N contents along forest floor-soil layers. Soil temperature resulted as the main driving variable for CO2 efflux and CH4 uptake. Soil moisture content and organic matter availability affected CO2 emission patterns in the two sites. N2O fluxes showed a positive correlation with soil moisture under wetter climatic conditions only. GHG fluxes showed significant correlations with C and N content of both forest floor and mineral soil, especially in the deepest layers, suggesting that it should be considered, together with environmental variables when accounting GHG fluxes in degraded forests. Short-term effects of thinning on CO2 emissions were dependent on disturbance induced by logging operations and organic matter inputs. After thinning CH4 uptake increased significantly under selective treatment, independently from specific site-induced effects. N2O fluxes were characterized by low emissions in both sites and were not affected by treatments. Soil CO2 efflux was the largest component of global warming potential (GWP) from both sites (11,553â¯kgâ¯ha-1â¯y-1 on average). Although it has a large global warming potential, N2O contribution to GWP was about 131â¯kgâ¯CO2eqâ¯ha-1â¯y-1. The contribution of CH4-CO2 equivalent to total GWP showed a clear and significant CH4 sink behaviour under selective treatment (36â¯kgâ¯ha-1â¯y-1 on average). However, in the short-term both thinning approaches produced a weak effect on total GWP.
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Contaminantes Atmosféricos/análisis , Dióxido de Carbono/análisis , Monitoreo del Ambiente , Bosques , Metano/análisis , Óxido Nitroso/análisis , Suelo/química , Calentamiento GlobalRESUMEN
BACKGROUND: Triflusal has demonstrated an efficacy similar to aspirin in the prevention of vascular events in patients with acute myocardial infarction (ΜΙ) and ischaemic stroke but with less bleeding events. OBJECTIVE: We performed a randomised, multicentre, phase 4 clinical trial to compare the clinical efficacy and safety of triflusal versus aspirin, administered for 12 months in patients eligible to receive a cyclooxygenase-1 (COX-1) inhibitor. METHODS: Patients with stable coronary artery disease or with a history of non-cardioembolic ischaemic stroke were randomly assigned to receive either triflusal 300 mg twice or 600 mg once daily or aspirin 100 mg once daily for 12 months. The primary efficacy endpoint was the composite of: (a) ΜΙ, (b) stroke (ischaemic or haemorrhagic), or, (c) death from vascular causes for the entire follow-up period. The primary safety endpoints were the rate of bleeding events as defined by Bleeding Academic Research Consortium (BARC) criteria. RESULTS: At 12-month follow-up, an equivalent result was revealed between the triflusal (n=559) and aspirin (n=560) in primary efficacy endpoint. Specifically, the combined efficacy outcome rate (i.e. MI, stroke or death from vascular causes) difference was equal to -1.3% (95% confidence interval -1.1 to 3.5) and lied within the a-priori defined equivalence interval (p<0.001). Regarding the primary safety endpoints, patients on triflusal treatment were 50% less likely to develop bleeding events according to the BARC criteria, and especially any clinically overt sign of haemorrhage that requires diagnostic studies, hospitalisation or special treatment (BARC type 2). CONCLUSION: The efficacy of triflusal in the secondary prevention of vascular events is similar to aspirin when administered for 12 months. Importantly, triflusal significantly reduced the incidence of ΜΙ and showed a better safety profile compared with aspirin. (ASpirin versus Triflusal for Event Reduction In Atherothrombosis Secondary prevention, ASTERIAS trial; Clinical Trials.gov Identifier: NCT02616497).
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Aspirina/uso terapéutico , Isquemia Encefálica/prevención & control , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Inhibidores de la Ciclooxigenasa/uso terapéutico , Embolia Intracraneal/prevención & control , Infarto del Miocardio/prevención & control , Inhibidores de Agregación Plaquetaria/uso terapéutico , Salicilatos/uso terapéutico , Prevención Secundaria , Accidente Cerebrovascular/prevención & control , Anciano , Aspirina/efectos adversos , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/mortalidad , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/mortalidad , Inhibidores de la Ciclooxigenasa/efectos adversos , Femenino , Grecia , Hemorragia/inducido químicamente , Humanos , Embolia Intracraneal/diagnóstico , Embolia Intracraneal/mortalidad , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/mortalidad , Inhibidores de Agregación Plaquetaria/efectos adversos , Recurrencia , Factores de Riesgo , Salicilatos/efectos adversos , Accidente Cerebrovascular/diagnóstico , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: Arbutus unedo is a valuable Mediterranean shrub as an ornamental plant as well as fruit tree. Fresh fruits of A. unedo are a good source of antioxidants, of vitamins C, E and carotenoids and also are characterized by the high content of mineral elements. MATERIALS AND METHODS: The effects of gibberellic acid (GA3) and cold stratification (CS) on seed germination performance were investigated in A. unedo seeds collected from three provenances in the Northern part of Greece. Seeds of each provenance were soaked in solutions of GA3 (500, 1000 or 2000 ppm) for 24 h and subsequently were subjected to CS at 3 - 5°C for 0, 1, 2, and 3 months. RESULTS: Non-stratified seeds of the three A. unedo provenances which were not treated with GA3 solutions exhibited very low germination. However, seed germination was significantly improved after a one-month period of CS. Similarly, the non-stratified seeds of all three provenances became non-dormant after the treatment with 2000 ppm GA3 and they germinated at high percentages. However, in untreated seeds with GA3, after a one-month CS period the seeds of the Pieria provenance exhibited higher germination percentage than that of Rodopi provenance seeds. Furthermore, in non-stratified seeds, the Pieria provenance seeds treated with GA3 germinated at higher percentages and more rapidly than those of the other two provenances. CONCLUSION: The results indicated that untreated seeds exhibited very low germination at 20/25°C. However, in all three provenances seed germinability was significantly improved by a one-month period of CS or treatment of seeds with 2000 ppm GA3. Furthermore, there was a considerable variability among seed provenances in response to the treatments which were applied.
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Ericaceae/crecimiento & desarrollo , Germinación/efectos de los fármacos , Giberelinas/farmacología , Reguladores del Crecimiento de las Plantas/farmacología , Semillas/efectos de los fármacos , Frío , Ericaceae/efectos de los fármacos , Ericaceae/genética , Ericaceae/metabolismo , Grecia , Semillas/crecimiento & desarrolloRESUMEN
We aimed to evaluate the feasibility and reliability of brush cytology in the biomarker expression profiling of oral squamous cell carcinomas within the concept of theranostics, and to correlate this biomarker profile with patient measurable outcomes. Markers representative of prognostic gene expression changes in oral squamous cell carcinoma was selected. These markers were also selected to involve pathways for which commercially available or investigational agents exist for clinical application. A set of 7 markers were analysed by immunocytochemistry on the archival primary tumour material of 99 oral squamous cell carcinoma patients. We confirmed the feasibility of the technique for the expression profiling of oral squamous cell carcinomas. Furthermore, our results affirm the prognostic significance of the epidermal growth factor receptor (EGFR) family and the angiogenic pathway in oral squamous cell carcinoma, confirming their interest for targeted therapy. Brush cytology appears feasible and applicable for the expression profiling of oral squamous cell carcinoma within the concept of theranostics, according to sample availability.
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Biomarcadores de Tumor/genética , Carcinoma de Células Escamosas/diagnóstico , Citodiagnóstico/métodos , Perfilación de la Expresión Génica , Neoplasias de la Boca/diagnóstico , Nanomedicina Teranóstica , Anciano , Anciano de 80 o más Años , Biopsia , Carcinoma de Células Escamosas/genética , Femenino , Estudios de Seguimiento , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/genética , Clasificación del Tumor , Estadificación de Neoplasias , Proyectos Piloto , Pronóstico , ARN Mensajero/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tasa de SupervivenciaRESUMEN
BACKGROUND: The paradigm change observed over the last few years in several solid tumors emphasizes the value of locoregional treatment in the presence of metastatic disease, currently ignored in de novo prostate cancer (CaP). We investigated the effect of the primary tumor that is left untreated on prostate cancer-specific morbidity and mortality, time to castration resistance, and overall survival (OS). METHODS: We performed a bicentric cohort study. The overall population included de novo metastatic CaP managed at the Genito-Urinary Oncology Unit of the Gustave Roussy Institute and the Urology Clinic of the University Hospital of Pointe-à-Pitre, France. Descriptive statistical and outcome analyses were performed in the overall cohort and also separately in the N+M0 and M+subgroups. RESULTS: The overall cohort included 263 patients. Approximately two-thirds of patients (64%) presented with locoregional symptoms at diagnosis, and 78% throughout the disease. Of the symptomatic patients, 59% required a locoregional procedure. Median OS of patients with locoregional symptoms at diagnosis was shorter than in those who were asymptomatic (47 vs. 86 mo, P = 0.0007); this difference was maintained in the N+M0 and M+subgroups. Median OS and time to castration resistance showed a nonsignificant trend in favor of patients undergoing a locoregional treatment at diagnosis. CONCLUSION: The presence of symptoms due to locoregional disease in de novo metastatic CaP entails significant morbidity and even mortality and requires active management. Randomized prospective trials are needed to evaluate the role of initial definite locoregional treatment in these patients.
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Neoplasias de la Próstata/patología , Anciano , Estudios de Cohortes , Manejo de la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Neoplasias de la Próstata/mortalidad , Resultado del TratamientoRESUMEN
INTRODUCTION: The aim of this study was to evaluate the sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV) and negative predictive value (NPV) of fine-needle aspiration cytology (FNAC) of salivary gland tumours performed at a tertiary cancer hospital over a time period of 10 years. MATERIALS AND METHODS: A retrospective analysis was carried out between 1995 and 2004 to review the cases of patients with salivary gland tumours who had undergone pre-operative FNA and for whom definite histology was either by tru-cut biopsy or by histopathological examination of the operative specimen. RESULTS: A total of 107 cases of salivary gland tumours were treated during that period, but only 82 cases diagnosed by FNAC could be correlated with histological and clinical data and were considered for this study. The sensitivity, specificity, diagnostic accuracy, PPV and NPV were estimated considering 54 benign and 28 malignant cases. Sensitivity was 90% (28/31), specificity was 98% (54/55), diagnostic accuracy was 95.1% (82/86), PPV was 96% and NPV was 94%. DISCUSSION: This study confirms that FNA cytology is a technique that offers high sensitivity, specificity and diagnostic accuracy in salivary gland tumour diagnosis.
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Biopsia con Aguja Fina , Neoplasias de las Glándulas Salivales/patología , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Enfermedades de las Glándulas Salivales/patología , Glándulas Salivales/patologíaRESUMEN
BACKGROUND: Head and neck cutaneous squamous cell carcinoma (HNCSCC) although rarely fatal has significant adverse public health effects due to high medical costs, compromised quality of life, functional impairment and other serious consequences. The present longitudinal cohort study of HNCSCC was designed to determine whether certain clinical-pathologic features of HNCSCC are associated with reduced overall and recurrence-free survival, as suggested by previous data. PATIENTS: The cohort sample consisted of 315 consecutive patients presenting with primary HNCSCC of the head and neck. Life-table analysis and Kaplan-Meier survival analysis were performed. Multivariate Cox's proportional hazards regression models were used to assess the effects of covariates on the length of the interval. RESULTS: There were 145 male and 170 female Caucasian patients. At the time of analysis, 222 patients were alive. The mean follow-up time of a patient after enrolment has been 46.7 months (range, 12-124 months). Broder's differentiation grade, perineural involvement, the presence of inflammation and T-stage were independent adjusted predictors for overall survival. pT and N-stage, inflammation and perineural involvement were significant predictors for recurrence-free survival while adjuvant irradiation was associated with a 92% reduced risk for recurrence. Life-table analysis showed that 87% and 69% study patients were free from recurrence at years 3 and 5, respectively. CONCLUSIONS: Certain clinico-pathological predictors can be used to discriminate subsets of high-risk patients that could benefit from long-term follow-up. After excision in negative margins, patients with HNCSCC should be referred to specialised multidisciplinary oncology clinics for counselling on adjuvant radiotherapy and follow-up.
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Carcinoma de Células Escamosas/mortalidad , Neoplasias de Cabeza y Cuello/mortalidad , Recurrencia Local de Neoplasia/mortalidad , Neoplasias Primarias Secundarias/mortalidad , Neoplasias Cutáneas/mortalidad , Adulto , Anciano , Supervivencia sin Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Factores de RiesgoRESUMEN
PURPOSE: The reported incidence of osteonecrosis of the jaw (ONJ) ranges from 0.94% to 18.6%. This cohort study aimed to calculate the incidence of and identify the risk factors for ONJ in patients with cancer treated with intravenous zoledronate, ibandronate, and pamidronate. PATIENTS AND METHODS: Data analyzed included age, sex, smoking status, underlying disease, medical and dental history, bisphosphonates (BP) type, and doses administered. Relative risks, crude and adjusted odds ratios (aORs), and cumulative hazard ratios for ONJ development were calculated. RESULTS: We included 1,621 patients who received 29,006 intravenous doses of BP, given monthly. Crude ONJ incidence was 8.5%, 3.1%, and 4.9% in patients with multiple myeloma, breast cancer, and prostate cancer, respectively. Patients with breast cancer demonstrated a reduced risk for ONJ development, which turned out to be nonsignificant after adjustment for other variables. Multivariate analysis demonstrated that use of dentures (aOR = 2.02; 95% CI, 1.03 to 3.96), history of dental extraction (aOR = 32.97; 95% CI, 18.02 to 60.31), having ever received zoledronate (aOR = 28.09; 95% CI, 5.74 to 137.43), and each zoledronate dose (aOR = 2.02; 95% CI, 1.15 to 3.56) were associated with increased risk for ONJ development. Smoking, periodontitis, and root canal treatment did not increase risk for ONJ in patients receiving BP. CONCLUSION: The conclusions of this study validated dental extractions and use of dentures as risk factors for ONJ development. Ibandronate and pamidronate at the dosages and frequency used in this study seem to exhibit a safer drug profile concerning ONJ complication; however, randomized controlled trials are needed to validate these results. Before initiation of a bisphosphonate, patients should have a comprehensive dental examination. Patients with a challenging dental situation should have dental care attended to before initiation of these drugs.