Inflammatory eruptions associated with immune checkpoint inhibitor therapy: A single-institutional, retrospective analysis with stratification of reactions by toxicity and implications for management

There is increasing recognition of distinct inflammatory eruptions associated with checkpoint inhibitors. A better understanding of their severity, therapeutic response and impact on cancer treatment is needed.

https://ift.tt/2Qnp3ME

Clinical immunotherapeutic approaches for the treatment of head and neck cancer

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide, accounting for more than 550,000 cases and 380,000 deaths annually. The primary risk factors associated with HNSCC are tobacco use and alcohol consumption; nevertheless genetic predisposition and oncogenic viruses also play important roles in the development of these malignancies. The current treatments for HNSCC patients include surgery, chemotherapy, radiotherapy, and cetuximab, and combinations of these.

https://ift.tt/2AKlFpn

Are electronic cigarettes a healthier alternative to conventional tobacco smoking?

Abstract

Electronic cigarettes (EC) with and without nicotine are used by more and more consumers within the last decade. The long-term risks of vapor inhalation are unknown. This study should describe the state of the art of knowledge with respect to the following four items: (1) ingredients of the vapor and their potential risks, the influence of EC on smoking of combustible tobacco to (2) adults and (3) the youth, and (4) the side effects of passive vaping. The vapor of EC contains, in comparison to tobacco smoke, less harmful substances, qualitatively and quantitatively. But, due to failing standardization of EC, this comparison is difficult. Adults are often using both, EC and combustible cigarettes dually. In addition, EC were used for supporting smoke-quitting. Unfortunately, consuming EC with and without nicotine due later to a higher risk of conventional tobacco smoking for the user. In general, the effects of passive vaporing are unknown. Although the vapor of EC is less harmful than tobacco smoke, EC are not hazard-free lifestyle products. Technical standardization should be desirable. Adult smoker's benefit using EC is given by completely change to EC only. The rates of success using EC for smoke quitting are not well evaluated. Children and their parents should be informed on the risks of EC use as a precursor of combustible smoking mandatorily. Internet selling EC to any non-adult should be forbidden by law. EC ought not to be allowed to weaken non-smoker's rights, and third persons should be protected by the potential hazards of EC vaporing.

https://ift.tt/2JDhaQg

The irradiated human mandible: A quantitative study on bone vascularity

Publication date: December 2018

Source: Oral Oncology, Volume 87

Author(s): H. Dekker, N. Bravenboer, D. van Dijk, E. Bloemena, D.H.F. Rietveld, Chr.M. ten Bruggenkate, E.A.J.M. Schulten

Abstract

Objectives

Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow.

Materials and methods

Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm²).

Results

Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels.

Conclusions

Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.

https://ift.tt/2CWJdJn

The diverse cutoff of PD-L1 positivity and negativity in studies regarding head and neck squamous cell carcinoma

Publication date: Available online 3 November 2018

Source: Oral Oncology

Author(s): Wei Liu, Shengkai Chen, Wenbin Yang

https://ift.tt/2P5XFpQ

Delineation of organs at risk in the head and neck region

Publication date: Available online 2 November 2018

Source: Oral Oncology

Author(s): Francesca De Felice, Vincenzo Tombolini

https://ift.tt/2CZlJ6j

Routine admission to step-down unit as an alternative to intensive care unit after pediatric supraglottoplasty

Publication date: Available online 3 November 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Diane W. Chen, Yi-Chun Carol Liu

Abstract

Objective

To evaluate the feasibility and the outcomes for step-down (SD) unit admission as an alternative to intensive care unit (ICU) admission after supraglottoplasty in the pediatric patient. Methods: A review of 98 patients who underwent supraglottoplasty from 2012 to 2017 at a tertiary referral pediatric hospital was performed. An SD unit had 1-to-3 nurse-to-patient ratio with noninvasive positive pressure ventilation capability. Data variables included demographics, comorbidities, preoperative and postoperative respiratory requirements, and length of stay. Results: Routine admission to SD occurred for 85% patients while 15% patients were selectively admitted to ICU due to intubation requirement or perioperative respiratory distress. In SD, noninvasive respiratory support was required for 28 (34%) patients. Three (4%) required re-intubation and ICU transfer without delay in care. Patients at high risk for requiring respiratory support after surgery have a neurologic condition (OR 7.0, 95% 2.4-20.2, p<0.01) or intrinsic pulmonary disease (OR 4.5, 95% CI 1.5-13.3, p<0.01). Median length of stay was shorter for patients in step-down (1 day, IQR 1-2). Conclusion: Patients can be managed safely in a SD unit after supraglottoplasty supporting de-escalation of care. Patients with neurologic and pulmonary comorbidities may have higher respiratory needs postoperatively. Prospective studies are warranted to further optimize resource allocation.

https://ift.tt/2znr5oB