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Santa Maria Nuova, Italy
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Sung Y.-H.,Head | Liu C.-H.,National Tsing Hua University | Huang S.-D.,National Tsing Hua University
Analytical Letters | Year: 2014

Dispersive liquid–liquid microextraction based on solid formation without a disperser combined with high-performance liquid chromatography has been developed for the determination of 4-tert-butylphenol, 4-n-nonylphenol, and 4-tert-octylphenol. This method is rapid, easy, and uses only 10 µL of a low toxicity organic solvent (1-hexadecanethiol) for the extraction solvent and no disperser solvent. The extraction time and centrifugation time require less than 10 min. The linear range was 1–500 ng mL−1 for 4-tert-butylphenol, 2–1000 ng mL−1 for 4-tert-octylphenol, and 5–500 ng mL−1 for 4-n-nonylphenol with r2 ≥ 0.9986. The detection limits were between 0.2 and 1.5 ng mL−1. The recoveries of lake and river water samples were in the range of 79% to 108%, and the relative standard deviations were 5% to 10%. © 2014, Copyright Taylor & Francis Group, LLC.


PubMed | Novartis, Chang Gung University, Head, Szent Imre University Teaching Hospital and 16 more.
Type: | Journal: The Lancet. Oncology | Year: 2017

Phosphatidylinositol 3-kinase (PI3K) pathway activation in squamous cell carcinoma of the head and neck contributes to treatment resistance and disease progression. Buparlisib, a pan-PI3K inhibitor, has shown preclinical antitumour activity and objective responses in patients with epithelial malignancies. We assessed whether the addition of buparlisib to paclitaxel improves clinical outcomes compared with paclitaxel and placebo in patients with recurrent or metastatic squamous cell carcinoma of the head and neck.In this multicentre, randomised, double-blind, placebo-controlled phase 2 study (BERIL-1), we recruited patients aged 18 years and older with histologically or cytologically confirmed recurrent and metastatic squamous cell carcinoma of the head and neck after disease progression on or after one previous platinum-based chemotherapy regimen in the metastatic setting. Eligible patients were enrolled from 58 centres across 18 countries and randomly assigned (1:1) to receive second-line oral buparlisib (100 mg once daily) or placebo, plus intravenous paclitaxel (80 mg/mBetween Nov 5, 2013, and May 5, 2015, 158 patients were enrolled and randomly assigned to receive either buparlisib plus paclitaxel (n=79) or placebo plus paclitaxel (n=79). Median progression-free survival was 46 months (95% CI 35-53) in the buparlisib group and 35 months (22-37) in the placebo group (hazard ratio 065 [95% CI 045-095], nominal one-sided p=0011). Grade 3-4 adverse events were reported in 62 (82%) of 76 patients in the buparlisib group and 56 (72%) of 78 patients in the placebo group. The most common grade 3-4 adverse events (occurring in 10% of patients in the buparlisib group vs the placebo group) were hyperglycaemia (17 [22%] of 76 vs two [3%] of 78), anaemia (14 [18%] vs nine [12%]), neutropenia (13 [17%] vs four [5%]), and fatigue (six [8%] vs eight [10%]). Serious adverse events (regardless of relation to study treatment) were reported for 43 (57%) of 76 patients in the buparlisib group and 37 (47%) of 78 in the placebo group. On-treatment deaths occurred in 15 (20%) of 76 patients in the buparlisib group and 17 (22%) of 78 patients in the placebo group; most were caused by disease progression and none were judged to be related to study treatment.On the basis of the improved clinical efficacy with a manageable safety profile, the results of this randomised phase 2 study suggest that buparlisib in combination with paclitaxel could be an effective second-line treatment for patients with platinum-pretreated recurrent or metastatic squamous cell carcinoma of the head and neck. Further phase 3 studies are warranted to confirm this phase 2 finding.Novartis Pharmaceuticals Corporation.


Teudt I.U.,Head and Neck Surgery | Meyer J.E.,Head | Ritter M.,University of Lübeck | Wollenberg B.,University of Lübeck | And 3 more authors.
Brachytherapy | Year: 2014

Purpose: Sinonasal malignancies are a rare group of cancers often associated with late presentation and poor prognosis. In the past, there was little progress regarding survival rate, and often, multimodal treatment regimens are required. The aim of this study was to evaluate the clinical outcome of perioperative image-adapted brachytherapy (IABT) as part of a multidisciplinary treatment regimen for the therapy of sinonasal cancer. Methods and Materials: Since 2006, patients with sinonasal cancer at the University Hospital of Schleswig-Holstein Campus Luebeck, Germany, were offered a multimodal treatment concept including head and neck surgery, perioperative IABT with or without external beam radiation therapy, and chemotherapy. In a retrospective study, such patients were analyzed for survival rate, tumor control, and toxicity of the interdisciplinary treatment. Results: Thirty-five consecutive patients were analyzed. The majority of patients (63%) were treated for a primary tumor and 62% presented with tumor Stages III-IV. The mean follow-up time with IABT was 28months. Overall survival estimate was 72% after 3years. Disease-specific survival, disease-free survival, and local control rates were 83%, 63%, and 67%, respectively. On univariate analysis, a significant better disease-free survival rate was found in patients treated for primary, but not recurrent, sinonasal cancer (p=0.006). The overall treatment toxicities were mainly classified Grade I. Conclusions: Interdisciplinary perioperative IABT is associated with excellent locoregional control and survival rates. IABT is well tolerated and shows low toxicity. Furthermore, visual acuity can be preserved in advanced cases. The implementation of perioperative IABT into multimodal treatment regimens improves the oncologic outcome. © 2014 American Brachytherapy Society.


Wilhelm T.,Head | Harlaar J.J.,Rotterdam University | Kerver A.,Rotterdam University | Kleinrensink G.-J.,Rotterdam University | Benhidjeb T.,Charité - Medical University of Berlin
European Archives of Oto-Rhino-Laryngology | Year: 2010

Over the past 10 years, several minimally invasive procedures for thyroid surgery have been developed. Because of extensive dissection in the thoracic and neck region, the name "minimal-invasive" is misleading. The aim of this study was to define a new trans-oral access to the cervical spaces especially to the thyroid on the basis of natural orifice surgery. Three embalmed human specimens were dissected for complete review of the anatomical situation in the cervical region. In additional five fresh frozen human specimens after an experimental trans-oral endoscopic minimally invasive thyroidectomy the anatomical structures of the floor of the oral cavity as well as the anterior neck region were evaluated. It was possible to create a working space under the platysma muscle with respect to the surgical planes of the neck and fascial layers. Within this area, the pretracheal region can be reached and the thyroid gland can be visualized and resected. To access the working space, a trocar for endoscopic view is placed medially in the floor of the oral cavity sublingually. The trocar passes the muscles of the floor of the oral cavity easily without relation to relevant anatomical structures. A first exclusively sublingual approach had to be abandoned because triangulation of the instruments could not be reached. Therefore, the approach was modified by positioning the working trocars in the oral vestibule bilaterally. By this way, a road map for accessing all anterior cervical regions directly under the platysma muscle could be established and anatomical landmarks and areas of possible collateral damage could have been defined. This combined sublingual and bi-vestibular trans-oral endoscopic approach enables an easy access to all structures and spaces of the anterior neck region with respect to anatomical preformed layers neck, even to the thyroid as one of the more distant structures. © 2010 Springer-Verlag.


PubMed | Surgeon, University of the Incarnate Word, Head and BlackRock
Type: Journal Article | Journal: Journal of current glaucoma practice | Year: 2017

Sub-Saharan Africa has a population of 1 billion, with one ophthalmologist per million people. Basic ophthalmic support services are virtually absent for all but a few urban populations. Minimally invasive laser treatment may help. This study reports our initial experience using selective laser trabeculoplasty (SLT) in a mixed-racial population of adult glaucoma patients in Durban, South Africa.Institution Review Board approved the 5-year chart review.Consecutive glaucomatous adults underwent SLT (Lumenis Selecta) on one or both eyes applying 360 treatment of 120 to 140 closely spaced burns (400 urn spot size for 3 ns; range 1.1-1.4 mJ). Significance of change in intraocuar pressure (IOP) from baseline at 1, 3, 6, and 12 months was assessed by two-tailed paired t-test.Among 148 eyes of 84 patients (60 African, 21 Indian, 3 Caucasian), 69 had already undergone glaucoma therapy, and 15 untreated Selective laser trabeculoplasty was effective in producing clinically significant IOP reduction among South African adults with or without prior medical or surgical anti-glaucoma therapy. Socioeconomically comparable individuals of Indian ancestry showed good therapeutic responses, but significantly less efficacious than those observed among Black subjects. Programs to provide first-line SLT management of glaucoma in Africa, where 90% of patients are unable to sustain prescribed medical therapy, appear to be a very appropriate option.Goosen E, Coleman K, Visser L, Sponsel WE. Racial Differences in Selective Laser Trabeculoplasty Efficacy. J Curr Glaucoma Pract 2017;11(1):22-27.


BACKGROUND: Since Theodor Kocher reduced the mortality rate of thyroidectomy from the 40% reported by Billroth to 0.2% in 1895, a collar incision with open removal of the thyroid gland is the standard procedure. In the past decade, efforts were made to reduce incision size and surgical access trauma by the use of endoscopic techniques. A first attempt was replacement of the central "Kocher incision" with lateral neck incisions and endoscopic removal of a thyroid lobe by Hüscher on 8 July 1996. This lateral access was limited to removing only one lobe of the gland. The most common technique to date is the one developed by Miccoli et al. These authors reduced the incision to a size of 20 to 25 mm and operated on the thyroid by the use of video-endoscopic assistance (MIVAT). Several groups have described an access outside the frontal neck region via a chest, axillary, or combined axillary bilateral breast approach. These accesses only moved the entry point from the frontal neck region to other regions, where they are still visible. The aforementioned minimally invasive approach and the conventional open approach do not respect anatomically given surgical planes and may therefore result in patient complaints, especially swallowing disorders after the scaring of the subcutaneous tissues. These extracervical approaches are associated with an extensive dissection in the access area and thus are maximally invasive.


Miziara I.D.,Head
Indian journal of medical ethics | Year: 2013

Bioethics is a relatively new way of thinking about relationships in medical practice. It enables reflection on ethical conflicts, and opens up management options without dictating rules. Despite this historical context, medical ethics has been sidelined in the course of the development of bioethics. Bioethical reflection does not automatically result in changes to conflict resolution in daily doctor-patient relationships. However, these reflections are important because they promote the search for a "moral consensus" that establishes new ethical rules for day-to-day medical practice. We suggest that there is no conflict between bioethics and medical ethics; rather, these areas interact to establish new standards of behaviour among physicians. The legalisation of orthothanasia in Brazil is one example of how this theory of moral consensus might operate. On the other hand, the legal battle on abortion illustrates how the law cannot change without such a moral consensus.


Kappas C.,Head
Forum of Clinical Oncology | Year: 2013

Once an Oncologist or other Health Care Professional (HCP) agrees to treat a patient, he/she has a professional duty to provide competent care. A patient who believes that he/she has received improper medical treatment may be entited to take legal action against those who administrated that treatment. Typically, all persons, institutions and organizational entities involved with the treatment are named as defendants. This work reviews and comments all types of lawsuits following malpractice (simple negligence, gross negligence and deliberated torts) and product liability; the elements legally required by the plaintiff to prove malpractice and by the defendant to prove innocence and furthermore the profile of the "Reasonable Health Care Professional". Moreover, it presents the potential areas of litigation, characteristic examples of lawsuits, legal defenses to liability and "scientific arms" to avoid litigation for Oncologist Experts.


Joshi M.A.,Head
The journal of contemporary dental practice | Year: 2014

Evaluation of quality and quantity of publications can be done using a set of statistical and mathematical indices called bibliometric indicators. Two major categories of indicators are (1) quantitative indicators that measure the research productivity of a researcher and (2) performance indicators that evaluate the quality of publications. Bibliometric indicators are important for both the individual researcher and organizations. They are widely used to compare the performance of the individual researchers, journals and universities. Many of the appointments, promotions and allocation of research funds are based on these indicators. This review article describes some of the currently used bibliometric indicators such as journal impact factor, crown indicator, h-index and it's variants. It is suggested that for comparison of scientific impact and scientific output of researchers due consideration should be given to various factors affecting theses indicators.


Aslam M.,Head
Journal of Physics: Conference Series | Year: 2013

Progress in the field of engineering is always dependent on new materials. For quite some time, smart and state of the art systems are seen demanding from a modern point of view. The gas sensing devices are turned into an array of sensors than a single sensor to materialize the concept of electronic nose. The metal oxide gas sensors are actively sensitive to gas species at an elevated temperature of more than 250°C. To achieve this minimum temperature requirement, micro-heaters are developed on a certain substrate which ensures the utilization of heat energy for sensing layer of metal oxide such as tin oxide (SnO2). In this paper, a substrate having good thermal insulation has been discussed. © Published under licence by IOP Publishing Ltd.

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