Tuesday, January 26, 2021

Chrysophanol protects human bronchial epithelial cells from cigarette smoke extract (CSE)-induced apoptosis.

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Chrysophanol protects human bronchial epithelial cells from cigarette smoke extract (CSE)-induced apoptosis.

Int J Mol Epidemiol Genet. 2020;11(3):39-45

Authors: Wu G, Yuan T, Zhu H, Zhang H, Su J, Guo L, Zhou Q, Xiong F, Yu Q, Yang P, Zhang S, Mo B, Zhao J, Cai J, Wang CY

Abstract
OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is a common respiratory disease characterized by the persistent airflow obstruction. Chrysophanol, an anthraquinone derivative isolated from the rhizomes of Rheum palmatum, has been reported to be protective for some inflammatory diseases. The present report aimed to dissect its effect on cigarette smoke extract (CSE)-induced apoptosis in 16HBECs, a human bronchial epithelial cell line.
METHODS: CCK8 cell viability assay was conducted to evaluate the protective effect of chrysophanol on 16HBECs after CSE induction. Western blot analysis, Annexin V/PI staining and TUNEL assay were conducted to test the effect of chrysophanol on 16HBECs apoptosis induced by CSE. Then the western blot assay measured associated molecular pathways to dissect the mechanisms underlying protective effect of chrysophanol on 16HBECs.
RESULTS: Chrysophanol protects 16HBECs against CSE-induced apoptosis in a dose dependent manner. Specifically, pre-treatment of 16HBECs with 20 mmol/l of chrysophanol, reduced CSE-induced apoptosis by almost 10%. Mechanistically, chrysophanol manifested high potency to attenuate CSE-induced expression of apoptotic markers, Bax and cleaved caspase 3. In particular, chrysophanol not only represses CSE-induced oxidative stress by inhibiting CYP1A1 expression, but also suppresses CSE-induced ER stress by inhibiting pPERK, ATF4 and ATF6 expression.
CONCLUSION: Chrysophanol showed protective effect on CSE-induced epithelial injuries in cell line 16HBECs. And our data support that chrysophanol could be employed to reduce the toxicity of cigarette smoke in bronchial epithelial cells, which may have the potential to decrease the risk for developing COPD in smoking subjects.

PMID: 33488953 [PubMed]

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Chronic opioid use after laryngeal cancer treatment

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Abstract

Background

Survivors of head and neck cancer may be at increased risk for chronic opioid use and questions remain about risk factors.

Methods

Retrospective study of patients with laryngeal cancer prescribed opioids utilizing the Truven Health Marketscan database. Patients had laryngeal cancer, underwent treatment, filled an opioid prescription, and were enrolled in this private insurance plan 1 year prior to and after treatment.

Results

In this study, 7484 patients were included; 17.2% developed chronic opioid use, defined as consecutive opioid fills at least 90 days after treatment cessation. Early opioid use (OR = 3.607, 95% CI [3.125–4.163]), tobacco use (OR = 1.28, 95% CI [1.117–1.467]), median morphine milligram equivalent (MME; OR = 1.001, 95% CI [1.000–1.0001]), and radiation alone (OR = 1.435, 95% CI [1.199–1.717]) were predictive of chronic opioid use.

Conclusions

Nearly one in five patients prescribed opioids during treatment developed chronic use. Providers should discuss the risk of chronic opioid use, set expectations for opioid weaning, and consider adjunct pain regimens to develop effective pain management strategies.

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Evaluating the impact of metabolic syndrome on postoperative thyroidectomy outcomes

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Abstract

Objective

Metabolic syndrome (MetS) has previously been linked to increased risk of postoperative morbidity and mortality in other surgical undertakings. Because MetS is a consequence of endocrine dysfunction, and given the thyroid's crucial role in endocrine homeostasis, we sought to evaluate the association between MetS and postoperative outcomes of thyroidectomy.

Methods

Data were acquired from the ACS‐NSQIP database from years 2005 to 2017. Patients with obesity, diabetes, and hypertension were defined as having MetS. Odds ratios (OR) were obtained for outcomes to quantify risk with multivariate logistic regression.

Results

Outcomes significantly affected by MetS included overall complication (OR: 2.00), extended postoperative stay (OR: 1.52), medical complication (OR: 1.48), surgical complication (OR: 1.62), and mortality (OR: 2.33).

Conclusions

Patients with MetS undergoing thyroidectomy are at increased risk of an increased length of stay, overall complications, and mortality.

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Ultrasound‐guided fine‐needle aspiration biopsy of thyroid nodules

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Abstract

Fine needle aspiration biopsy (FNAB) remains crucial in the evaluation of thyroid nodules with suspicious clinical findings or ultrasound (US) features suggestive of malignancy. The use of US‐guidance for FNAB allows real‐time visualization of the needle, but is also highly operator‐dependent. Physicians from many specialties (endocrinologists, otolaryngologists/endocrine surgeons, nuclear medicine physicians, radiologists, and pathologists) are involved in the diagnostic workup of thyroid nodules and a standardized and meticulous technique for US‐FNAB is essential for lowering the yield of nondiagnostic specimens and false‐negative results. This video, therefore, demonstrates a well‐proved technique and technical tips to increase the diagnostic results from US‐FNAB.

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Transoral closure of the supraglottic larynx for intractable aspiration

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Abstract

The aim of this paper is to describe a novel, safe, and effective surgical technique to eliminate aspiration, that is performed entirely by reconstructive transoral laser microsurgery (R‐TLM). Eleven tracheostomy‐dependent patients with recurrent pneumonia secondary to intractable aspiration treated with transoral laryngeal closure were included in our study. In all cases, the supraglottic mucosa is incised in a circumferential manner. The distal tissues are sutured side‐to‐side longitudinally, and the superficial tissues are sutured back‐to‐front transversally. All patients successfully underwent transoral laryngeal closure without significant perioperative complication. Four patients resumed oral feeding for effective nutrition and two patients for pleasure. One patient developed a small fistula with a leak that warranted secondary closure by a follow‐up R‐TLM procedure and subsequently held to protect his airway. Complete supraglottic laryngeal closure can be pe rformed safely and effectively using R‐TLM techniques. They provide a natural‐orifice alternative to open surgery in patients with intractable aspiration.

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The survival benefit of lymph node dissection in resected T1–2, cN0 supraglottic cancer: A population‐based propensity score matching analysis

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Abstract

Background

The survival benefit of clinically negative cervical lymph nodes (cN0) in patients with T1–2 supraglottic cancer (SC) remains unclear. This study aimed to comprehensively evaluate the prognostic value of lymph node dissection (LND) in patients with T1–2, cN0 SC.

Methods

We included 1036 confirmed T1–2, cN0 SC patients with clinicopathological characteristics between 2004 and 2015, based on the Surveillance, Epidemiology, and End Results program (SEER) database. The association between LND and overall survival (OS) was investigated by the Kaplan–Meier method.

Results

Before propensity score matching (PSM), patients selected for LND had better OS, compared to patients did not receive LND (5‐year OS: 62.6% vs 51.2%, respectively; p = 0.011). After PSM, the LND group also present significant improvement in prognosis (5‐year OS: 64.3% vs 51.7%, respectively; p < 0.01).

Conclusions

LND was significantly associated with a more favorable prognosis compared with non‐LND in patients with T1–2, cN0 SC.

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Patterns of blood pressure changes in patients with head and neck cancer receiving radiotherapy or chemo‐radiotherapy at a tertiary cancer centre

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Abstract

Background

To evaluate patterns of blood pressure (BP) changes in patients with head and neck cancer (HNC) receiving radiation (RT)/chemo‐radiation (CRT)

Methods

This study included data collection, compilation, and analysis of 451 consecutive HNC patients who underwent RT/CRT.

Results

Out of 451 patients, 376 (82%) were male and 75 (18%) were female with a median age of 52 years. Patients receiving 3DCRT experienced greater fall in BP, including for SBP and MAP, compared to those receiving IMRT‐IGRT. Female patients experienced greater fall in diastolic BP as compared to male patients (p: 0.03). At the end of treatment, we observed a significant association between a fall in systolic BP (decrease by 10% of baseline) and weight loss of more than 10% of baseline weight (p: 0.03).

Conclusion

Fall in BP during RT/CRT is significantly affected by treatment technique and sex and is strongly associated with significant weight loss.

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A novel voice prosthesis after total laryngectomy with laryngoplasty reconstruction

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Abstract

Background

Although many patients achieve serviceable speech after total laryngectomy (TL), others are limited by un‐naturally low pitch. We describe a cadaveric study to provide proof of concept for a novel voice prosthesis after TL with free tissue laryngoplasty.

Methods

Devices were implanted into fresh frozen cadavers after TL and free tissue laryngoplasty. Phonation pressures were measured using a custom Blom‐Singer Manometer (InHealth Technologies, Carpinteria, CA) and acoustic files were analyzed using Praat, a speech analysis software.

Results

Two fresh frozen cadavers were implanted with the voice prosthesis. Both prostheses demonstrated appropriate stenting of the laryngoplasty. Successful sound production was achieved after airflow generation at the proximal trachea. An average phonation pressure of 3.5 cmH2O (SD 1.7 cmH2O) was necessary to generate a sound intensity of 80.6 dB (SD 0.2 dB) at an average fundamental frequency of 299.5 Hz (SD 112.6 Hz).

Conclusions

The novel voice prosthesis described herein offers a feasible voice generation mechanism.

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A predictive model of operative time in transoral endoscopic thyroidectomy vestibular approach

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Abstract

Background

Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) has demonstrated excellent safety and is receiving wider use in North America. Understanding which factors lead to operative difficulty, as evaluated by operative time (OT), may help to improve safety and refine indications for this procedure.

Methods

Cases of TOETVA performed at our institution were reviewed. Multivariate linear regression was performed using patient demographics, thyroid characteristics, and operative variables to predict OT.

Results

A total of 207 cases were included for analysis. A multivariate linear regression model, controlling for age, sex, and BMI, was developed from 104 cases with an R 2 of 0.47 (p < 0.001). Cross‐validation on 103 remaining cases showed root‐mean‐square error of 46.37. Total thyroidectomy and lobe size were the only significant predictors (p < 0.001).

Conclusions

We successfully developed a model to predict OT for TOETVA based on preoperative and operative variables. Lobe size, but not BMI, is a significant predictor of OT.

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Exploratory study of functional and psychological factors associated with employment status in patients with head and neck cancer

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Abstract

Background

Compared with other malignancies, head and neck cancer (HNC) increases the risk of not returning to work (RTW).

Methods

Within a cross‐sectional study, patients with HNC filled out the OncoFunction questionnaire, a version of the International Classification of Functioning Core Sets for HNC. In 231 patients below 65 years of age, associations of sociodemographic, clinical, functional, and psychological factors with employment and participation in rehabilitation program were explored.

Results

Unemployed patients reported more swallowing difficulties and speaking problems. Being unemployed was associated with higher levels of depressive and anxiety symptoms, fatigue, and lower global health. Rehabilitation participation was not significantly associated with any of the assessed factors except for smoking.

Conclusions

Unemployed patients with HNC are more burdened than employed patients with HNC regarding clinical, psychological, and functional factors. These differences are more evident later in recovery. Rehabilitation participation was not associated with psychological and functional burden which indicates the need for tailored HNC rehabilitation programs.

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Prognostic value of lymph node ratio versus American Joint Committee on Cancer N classification for surgically resected human papillomavirus‐associated oropharyngeal squamous cell carcinoma

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Abstract

Background

We compared prognostic values of lymph node ratio (LNR) and AJCC 8 N classification in surgically resected human papillomavirus (HPV)‐associated oropharyngeal squamous cell carcinoma (OPSCC).

Methods

Using the National Cancer Database, we identified patients with HPV‐associated OPSCC from 2010 to 2016 who underwent definitive surgical resection. Patients were analyzed by nodal grouping (LNR, N stage) and adjuvant radiation therapy(RT). Primary endpoint was overall survival.

Results

We identified 4166 patients. Survival analysis showed significant improvement for LNR≤6% versus >6% (5 year OS% 92.7% vs. 83.7%, p < 0.001). N classification demonstrated good prognostic ability (5 year OS% for pN0, pN1, pN2 were 91.3%, 90.1%, 78.8%, p < 0.001), but poor separation among stages (compared to pN0: pN1 HR 1.40 [95% CI 0.63, 3.09], p = 0.41; pN2 HR 2.50 [95% CI 1.08, 5.81], p = 0.033). RT improved survival in the LNR > 6% group (5 year OS% 85.4% vs. 74.9%, p < 0.001; HR 0.41 [95% CI 0.28, 0.58], p < 0.001).

Conclusions

LNR should be considered an adjunct category in future staging systems for HPV‐associated OPSCC.

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Inequality in survival of people with head and neck cancer: Head and Neck 5000 cohort study

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Abstract

Background

Explanations for socioeconomic inequalities in survival of head and neck cancer (HNC) patients have had limited attention and are not well understood.

Methods

The UK Head and Neck 5000 prospective clinical cohort study was analyzed. Survival relating to measures of socioeconomic status was explored including area‐based and individual factors. Three‐year overall survival was determined using the Kaplan–Meier method. All‐cause mortality was investigated via adjusted Cox Proportional Hazard models.

Results

A total of 3440 people were included. Three‐year overall survival was 76.3% (95% CI 74.9, 77.7). Inequality in survival by deprivation category, highest education level, and financial concerns was explained by age, sex, health, and behavioral factors. None of the potential explanatory factors fully explained the inequality associated with annual household income or the proportion of income of benefits.

Conclusion

These results support the interventions to address the financial issues within the wider care and support provided to HNC patients.

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