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European Archives of... Apr 2012Some laryngeal epithelial precursor lesions progress to invasive carcinoma and others do not. Routine light microscopic classification has limited value in predicting... (Review)
Review
Some laryngeal epithelial precursor lesions progress to invasive carcinoma and others do not. Routine light microscopic classification has limited value in predicting the evolution of these lesions. This article reviews the experience to date with the use of molecular markers for the prognostic evaluation of laryngeal epithelial precursor lesions. We conducted a thorough review of the published literature to identify those studies using biomarkers to predict malignant progression of laryngeal epithelial precursor lesions. Of the 336 studies identified in this systematic search, 15 met the inclusion criteria and form the basis of this review. Limited studies suggest that certain biomarkers are potentially reliable predictors of malignant progression including various regulators of cell adhesion and invasion (e.g. FAK, cortactin, osteopontin, and CD44v6) and proliferation-associated markers such as TGF-βRII and Kv3.4. The predictive value of these markers, however, has yet to be confirmed in large-scale prospective studies. Although the cell cycle-related proteins are the most frequently studied markers, none have been consistently reliable across multiple studies. The absence of standardization in methodologies, test interpretation, and other parameters may contribute to study inconsistencies. Various biomarkers have proved to have potential prognostic value and could be clinically relevant. The utility and prognostic power of these biomarkers should be confirmed in large, well-designed, standardized prospective studies.
Topics: Biomarkers, Tumor; Cell Transformation, Neoplastic; Disease Progression; Humans; Laryngeal Mucosa; Larynx; Pharyngeal Neoplasms; Precancerous Conditions; Predictive Value of Tests; Prognosis
PubMed: 22081098
DOI: 10.1007/s00405-011-1831-4 -
Archives of Disease in Childhood Feb 2009To determine the effect of adenoidectomy and/or tonsillectomy ("adenotonsillectomy") upon growth and growth biomarkers, in the context of sleep disordered breathing... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine the effect of adenoidectomy and/or tonsillectomy ("adenotonsillectomy") upon growth and growth biomarkers, in the context of sleep disordered breathing (SDB). SDB in children, primarily due to adenotonsillar hypertrophy, increases the risk of growth failure.
DESIGN
Systematic review and meta-analysis. PubMed, ERIC and Cochrane Reviews databases from January 1980 to November 2007 were searched for studies reporting: pre/post-adenotonsillectomy height and weight changes as percentage increased or decreased, raw data, z scores or centiles, or: IGF-1 and/or IGFBP-3 serum-level changes as z scores or raw data. For anthropometrics, the meta-analysis included studies presenting z scores or centiles.
SETTING
Observational studies.
PATIENTS
Otherwise healthy children, not selected for obesity.
MAIN OUTCOME MEASURES
Pre/post-surgery changes in standardised height and weight, and IGF-1 and IGFBP-3.
RESULTS
Of 211 citations identified, 20 met systematic review criteria. SDB was an enrolment criterion in 13 of the studies, and one of several enrolment criteria in three. Meta-analysis findings for pre/post-surgery changes were: standardised height: 10 studies, 363 total children, pooled standardised mean differences (SMD) = 0.34 (95% CI 0.20 to 0.47); standardised weight: 11 studies, 390 total children, pooled SMD = 0.57 (95% CI 0.44 to 0.70); IGF-1: 7 studies, 177 total children, pooled SMD = 0.53 (95% CI 0.33 to 0.73); IGFBP-3: 7 studies, 177 total children, pooled SMD = 0.59 (95% CI 0.34 to 0.83).
CONCLUSIONS
Standardised height and weight, and IGF-1 and IGFBP-3 increased significantly after adenotonsillectomy. Findings suggest that primary care providers and specialists consider SDB secondary to adenotonsillar hypertrophy when screening, treating and referring children with growth failure.
Topics: Adenoidectomy; Adenoids; Adolescent; Anthropometry; Body Height; Child; Child, Preschool; Female; Growth; Growth Disorders; Humans; Hyperplasia; Infant; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor Binding Proteins; Insulin-Like Growth Factor I; Male; Palatine Tonsil; Sleep Apnea, Obstructive; Tonsillectomy; Weight Gain
PubMed: 18684748
DOI: 10.1136/adc.2008.141192 -
Archives of Otolaryngology--head & Neck... Jul 2007To systematically review and quantify complication rates and to identify preoperative factors among patients who underwent platysma myocutaneous flap reconstruction for... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To systematically review and quantify complication rates and to identify preoperative factors among patients who underwent platysma myocutaneous flap reconstruction for head and neck cancer.
DESIGN
This study analyzed 190 patients in 16 case series published between 1982 and 2002. Funnel plots, contingency tables, and chi(2) analyses were used to minimize bias and heterogeneity among the studies. Logistic regression models were used to quantify the associations between preoperative factors (age, sex, T stage, prior radiation therapy, and recipient site) and complications (skin loss or necrosis, fistula, dehiscence, hematoma, and infection) at different recipient sites (floor of mouth, alveolar ridge, pharyngeal wall, buccal mucosa, tongue or tongue base, and tonsil).
SETTING
Academic research.
PATIENTS
Patients described in the literature with head and neck surgery who underwent platysma flap reconstruction.
MAIN OUTCOME MEASURES
Results of logistic regression analyses.
RESULTS
Seventy-one patients (37%) developed a complication, ranging from 20% at the buccal mucosa to 55% at the tonsil and at the alveolar ridge. Major complications (ie, those requiring further surgery) occurred in 5% of patients. The most common complication was skin loss or necrosis, occurring in 25% of patients. Postoperative complications were not associated with age or sex but were associated with recipient site and tumor stage. Overall, complications were 0.3 (95% confidence interval [CI], 0.1-1.1) times less common at the buccal mucosa than at other recipient sites. Hematomas were 18.8 (95% CI, 1.6-217) times more common at the buccal mucosa. Infections were 20.0 (95% CI, 1.1-350) times more common at the pharyngeal wall. Major complications were 4.6 (95% CI, 0.9-23.5) times more likely, and fistulas were 9.2 (95% CI, 2.0-43.1) times more likely in patients with stage T3 or T4 oral cancer than in patients with lesser grades.
CONCLUSIONS
Postoperative complications were not associated with age, sex, or preoperative radiation therapy, but they were associated with recipient site and tumor stage. These results may guide surgeons considering the platysma flap to reconstruct head and neck cancer.
Topics: Fistula; Head and Neck Neoplasms; Hematoma; Humans; Logistic Models; Mouth; Necrosis; Postoperative Complications; Reoperation; Skin; Surgical Flaps
PubMed: 17638777
DOI: 10.1001/archotol.133.7.655 -
Preventive Medicine Jul 2004The objective of this study is to weigh the risks of moderate alcohol consumption against its benefits and, as a result, to derive tolerable upper alcohol intake levels... (Review)
Review
BACKGROUND
The objective of this study is to weigh the risks of moderate alcohol consumption against its benefits and, as a result, to derive tolerable upper alcohol intake levels (TUALs) for the German adult population.
METHODS
Human studies assessing the effects of moderate alcohol consumption (< or = 40 g/day) on coronary heart disease, stroke, blood pressure, diseases of the liver, gallbladder, bile duct, and pancreas, cancer of the mouth/pharynx/larynx/oesophagus, stomach, colon/rectum, and breast, foetal alcohol syndrome/foetal alcohol effects, as well as all-cause mortality, published in the 10-15 years before 1999, have been systematically reviewed. The quality of studies has been evaluated using a self-constructed evaluation scheme. As a result of comparing the critical endpoints of alcohol intake related to morbidity and mortality, the TUALs have been derived.
RESULTS
The TUALs have been set at 10-12 g/day for healthy women and 20-24 g/day for healthy men of the adult population (18 years and older). Additional guidelines on alcohol use have been defined, taking into account further important aspects like alcohol consumption patterns and high-risk groups.
CONCLUSIONS
The TUALs are not intended to be recommended intake levels. However, if the TUALs and the additional guidelines are followed, a relation of alcohol consumption to an increased risk of alcohol-associated diseases is unlikely for the majority of the population.
Topics: Adult; Alcohol Drinking; Data Collection; Dose-Response Relationship, Drug; Ethanol; Female; Germany; Humans; Male; Risk Assessment
PubMed: 15207992
DOI: 10.1016/j.ypmed.2003.11.011