Journals

Sensitisation to milk, egg and peanut from birth to 18 years: a longitudinal study of a cohort at risk of allergic disease.

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Sensitisation to milk, egg and peanut from birth to 18 years: a longitudinal study of a cohort at risk of allergic disease.

Pediatr Allergy Immunol. 2015 Aug 27;

Authors: Alduraywish SA, Lodge CJ, Vicendese D, Lowe AJ, Erbas B, Matheson MC, Hopper J, Hill DJ, Axelrad C, Abramson MJ, Allen KJ, Dharmage SC

Abstract

BACKGROUND: Longitudinal data on the natural history of food sensitisation beyond early childhood are scarce. We aimed to investigate the natural history of milk, egg and peanut sensitisation from infancy to18 years and assess whether early food sensitisation predicted adolescent food allergy.

METHODS: Sensitisation to cow’s milk, hen’s egg and peanut was measured by skin prick testing at ages 6 months, 1, 2, 12 and 18 years in a high risk allergy birth cohort (n=620). Generalized additive models investigated interactions with sex, eczema and aeroallergen sensitisation in infancy. Logistic regression assessed the relationships between early food sensitisation and adolescent sensitisation and probable food allergy up to 18 years.

RESULTS: The prevalence of egg and peanut sensitisation peaked at 12 months, while milk sensitisation peaked at both 1 and 12 years. Boys with early eczema had the highest prevalences of milk and egg sensitisation throughout follow-ups. However, neither sex nor eczema influenced the prevalence of peanut sensitisation over time. New onset food sensitisation beyond the age of 2 was observed in 7% of participants. Food sensitisation at 12 months was associated with increased risk of adolescent food sensitisation and adolescent probable food allergy, with sensitisation to more than one food allergen had the strongest predictor.

CONCLUSIONS: Food sensitisation prevalence is highest in infancy and declines after 12 months of age. Boys with early life eczema have the highest prevalence of milk and egg sensitisation. Food sensitisation at 12 months can predict children at greater risk of adolescent sensitisation and probable food allergy at 12 and 18 years. This article is protected by copyright. All rights reserved.

PMID: 26311279 [PubMed - as supplied by publisher]

A Population-Based Examination of the Surgical Outcomes for Patients with Esophageal Sarcoma.

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A Population-Based Examination of the Surgical Outcomes for Patients with Esophageal Sarcoma.

Ann Surg Oncol. 2015 Aug 27;

Authors: Wu GX, Ituarte PH, Paz IB, Kim J, Raz DJ, Kim JY

Abstract

BACKGROUND: Esophageal sarcoma (ES) is a rare malignancy. The literature is limited to small case series and reports. This study used a population data set to study the characteristics, treatments, surgical outcomes, and prognostic factors for survival among ES patients.

METHODS: The study identified 178 ES cases (0.3 %) and 63,548 esophageal carcinoma (EC) cases (99.7 %) including adenocarcinoma and squamous cell carcinoma using the Surveillance, Epidemiology, and End Results (SEER) Registry (1973-2011). Characteristics and therapeutics were compared between ES and EC. Survival data were analyzed using Kaplan-Meier estimation. Uni- and multivariate Cox proportional hazard models determined predictors of 5-year overall survival (OS).

RESULTS: Compared with the EC patients, the ES patients were more likely to be women, to have localized tumors, and to undergo surgery but less likely to receive radiation (p < 0.001). The most common histologies were carcinosarcoma, leiomyosarcoma, and gastrointestinal stromal tumor (GIST). The 5-year OS for the ES patients was 38 % compared with 17 % for the EC patients (p < 0.001). The median survival period for the ES and EC surgical patients with locoregional disease was respectively 50 and 24 months. The ES patients with nonmetastatic disease who received surgery had better OS than those who did not (37 vs. 14 %; p < 0.0001). In the multivariate analysis, age and advanced stage conferred worse OS, whereas GIST histology and surgery were favorable predictors for OS.

CONCLUSION: The ES patients were more likely to have localized disease, to be treated with surgery, and to have better OS than the EC patients. The survival benefit of surgery suggests that surgery should be the primary treatment for ES patients with resectable disease, particularly those with GIST.

PMID: 26310279 [PubMed - as supplied by publisher]

Impact of Consensus Guidelines by the Society of Surgical Oncology and the American Society for Radiation Oncology on Margins for Breast-Conserving Surgery in Stages 1 and 2 Invasive Breast Cancer.

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Impact of Consensus Guidelines by the Society of Surgical Oncology and the American Society for Radiation Oncology on Margins for Breast-Conserving Surgery in Stages 1 and 2 Invasive Breast Cancer.

Ann Surg Oncol. 2015 Aug 27;

Authors: Chung A, Gangi A, Amersi F, Bose S, Zhang X, Giuliano A

Abstract

BACKGROUND: This study aimed to evaluate the impact that the release of consensus guidelines for margins in breast-conserving surgery (BCS) had on re-excision rates.

METHODS: A retrospective review examined a prospectively maintained database of patients who had operable invasive breast cancer treated with BCS at the authors’ institution. The patients were divided into two groups: (1) those with a diagnosis determined from 1 July 2011 to 31 July 2013 (before release of the guidelines) and (2) those with a diagnosis determined from 1 February 2014 to 31 July 2014 (after release of the guidelines). The groups were evaluated with respect to patient and tumor characteristics, re-excision rates, and reasons for re-excision.

RESULTS: A total of 846 cases of BCS were managed: 597 in group 1 and 249 in group 2. Re-excision rates were significantly reduced after release of the consensus guidelines (p = 0.03). Re-excisions were performed for 115 (19 %) of 597 patients in group 1 and 32 (13 %) of 249 patients in group 2. After release of the guidelines, re-excisions were performed for positive margins, as defined by the consensus statement, in 25 (78 %) of 32 cases. The two groups did not differ significantly in terms of age, tumor size, grade, nodal status, estrogen receptor status, progesterone receptor status, or human epidermal growth factor receptor 2 status. Group 1 had more tumors of mixed ductal and lobular histology than group 2, and group 2 had more lobular tumors than group 1 (p = 0.02).

CONCLUSIONS: The consensus guidelines on margins for BCS were applied for 78 % of the patients who underwent re-excision and resulted in a significant reduction in re-excision rates.

PMID: 26310280 [PubMed - as supplied by publisher]

Nuclear PROX1 is Associated with Hypoxia-Inducible Factor 1α Expression and Cancer Progression in Esophageal Squamous Cell Carcinoma.

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Nuclear PROX1 is Associated with Hypoxia-Inducible Factor 1α Expression and Cancer Progression in Esophageal Squamous Cell Carcinoma.

Ann Surg Oncol. 2015 Aug 27;

Authors: Yokobori T, Bao P, Fukuchi M, Altan B, Ozawa D, Rokudai S, Bai T, Kumakura Y, Honjo H, Hara K, Sakai M, Sohda M, Miyazaki T, Ide M, Nishiyama M, Oyama T, Kuwano H

Abstract

BACKGROUND: Transcription factor prospero homeobox 1 (PROX1) has been identified as a master regulator of lymphangiogenesis associated with metastasis. Although PROX1 expression has been investigated in several cancers, its clinical significance remains controversial and needs further validation. In this study, we investigated the clinical and functional significance of PROX1 and PROX1 regulator hypoxia-inducible factor 1α (HIF1α) in esophageal squamous cell carcinoma (ESCC).

METHODS: A total of 117 samples from ESCC patients were analyzed for PROX1, HIF1α, and E-cadherin expression by immunohistochemistry; correlation with clinicopathological characteristics was determined. PROX1 function was evaluated in PROX1 small interfering RNA (siRNA)-transfected human ESCC cells in vitro by assessing cell proliferation and migration.

RESULTS: PROX1 expression was higher in ESCC than in normal tissues. Patients with higher PROX1 expression (n = 26) had increased nuclear accumulation of HIF1α (p = 0.004) and more advanced metastasis, both lymph node (N factor; p = 0.09) and hematogenous (M factor; p = 0.04), than those with lower PROX1 expression (n = 91). In addition, high PROX1 and HIF1α expression correlated with low levels of E-cadherin, an epithelial cell marker. Analysis of overall and cancer-specific survival indicated that elevated PROX1 expression was significantly correlated with poor prognosis (p = 0.0064). PROX1 downregulation in ESCC cells inhibited cellular proliferation and migration (p < 0.05). Hypoxia restored PROX1 levels that were reduced by PROX1-specific siRNA.

CONCLUSION: Our data suggest that high expression of PROX1 in ESCC could be used as an indicator of poor prognosis, and that PROX1 is a promising candidate molecular target for ESCC treatment.

PMID: 26310281 [PubMed - as supplied by publisher]

Local Anti-miR Delivery: The Latest in the Arsenal of Drug-Eluting Stents.

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Local Anti-miR Delivery: The Latest in the Arsenal of Drug-Eluting Stents.

Arterioscler Thromb Vasc Biol. 2015 Sep;35(9):1905-6

Authors: Moore KJ, Rayner KJ

PMID: 26310808 [PubMed - in process]

Relax: It’s Not All About Degradation.

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Relax: It’s Not All About Degradation.

Arterioscler Thromb Vasc Biol. 2015 Sep;35(9):1907-9

Authors: Stangherlin A, Zoccarato A

PMID: 26310809 [PubMed - in process]

Carotid Ultrasound Phenotypes Are Biologically Distinct.

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Carotid Ultrasound Phenotypes Are Biologically Distinct.

Arterioscler Thromb Vasc Biol. 2015 Sep;35(9):1910-3

Authors: Spence JD

PMID: 26310810 [PubMed - in process]

Metabolic Flexibility and Dysfunction in Cardiovascular Cells.

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Metabolic Flexibility and Dysfunction in Cardiovascular Cells.

Arterioscler Thromb Vasc Biol. 2015 Sep;35(9):e37-42

Authors: Vallerie SN, Bornfeldt KE

PMID: 26310811 [PubMed - in process]

Quantitative CT analysis of pure ground-glass opacity nodule (GGN) predicts further CT change.

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Quantitative CT analysis of pure ground-glass opacity nodule (GGN) predicts further CT change.

Chest. 2015 Aug 27;

Authors: Bak SH, Lee HY, Kim JH, Um SW, Kwon OJ, Han J, Kim HK, Kim J, Lee KS

Abstract

Background: We sought to determine if quantitative analysis of lung adenocarcinoma manifesting as a ground-glass opacity (GGO) nodule (GGN) on initial computed tomography (CT) can predict further CT change or rate of growth.

Methods: This retrospective study included patients with lung adenocarcinoma manifesting as pure GGN on initial CT, who were followed up with interval CT until resection. All pure GGNs were classified based on CT interval change in three subgroups as follows: group A (development of solid component), group B (growth of GGO component), and group C (no change in size). Nodule size, volume, density, mass, and CT attenuation values were assessed from initial CT datasets.

Results: Fifty-four pure GGNs were enrolled and classified into group A (n=9), group B (n=25), and group C (n=20). Nodule size, volume, mass, and density of the GGNs in each subgroup were not significantly different. The 97.5th percentile CT attenuation value and slope of CT attenuation values from 2.5th to 97.5th percentile were significantly different among the three subgroups (P = 0.02, P < 0.00). Three of nine (33%) pure GGNs showing a new solid component developed solid component within 6 months.

Conclusions: The 97.5th percentile CT attenuation value and slope of CT attenuation values from 2.5th to 97.5th percentile could be helpful in predicting future CT change and rate of growth of pure GGNs. Pure GGNs showing higher 97.5th percentile CT attenuation values and steeper slopes of CT attenuation values may need more frequent follow-up than the usual interval of 6 months.

PMID: 26313232 [PubMed - as supplied by publisher]

Who Gets Early Tracheostomy?: Evidence of Unequal Treatment at 185 Academic Medical Centers.

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Who Gets Early Tracheostomy?: Evidence of Unequal Treatment at 185 Academic Medical Centers.

Chest. 2015 Aug 27;

Authors: Shaw JJ, Santry HP

Abstract

Introduction: While the benefits of early tracheostomy in ventilator dependent patients are well established, the reasons for variation in time from intubation to tracheostomy remain unclear. We identified clinical and demographic disparities in time-to-tracheostomy.

Methods: We performed a level III retrospective prognostic study by querying the University HealthSystem Consortium (2007-2010) for adult patients receiving a tracheostomy after initial intubation. Time-to-tracheostomy was designated ‘EARLY’ <7 days or ‘LATE’ >10 days. Cohorts were stratified by time-to-tracheostomy and compared using univariate tests of association and multivariable adjusted models.

Results: 49,191 patients underwent tracheostomy after initial intubation: 42% EARLY (N= 21,029) and 58% LATE (N=28,162). On both univariate and multivariable analyses, females, blacks, Hispanics and Medicaid patients were less likely to receive an early tracheostomy. EARLY patients also experienced lower rates of mortality (OR 0.84; 95%CI 0.79-0.88).

Conclusions: Early tracheostomy was associated with increased survival. Yet there were still significant disparities in time to tracheostomy according to sex, race and type of insurance. Application of evidence based algorithms for tracheostomy may reduce unequal treatment and improve overall mortality rates. Additional research into this apparent bias in referral/rendering of tracheostomy is needed.

PMID: 26313324 [PubMed - as supplied by publisher]