SEOM clinical guideline in nasopharynx cancer (2017)

Nasopharyngeal carcinoma (NPC) is distinct from other cancers of the head and neck in biology, epidemiology, histology, natural history, and response to treatment. Radiation therapy is an essential component of curative-intent of non-disseminated disease and the association of chemotherapy improves the rates of survival. In the case of metastatic disease stages, treatment requires platinum/gemcitabine-based chemotherapy and patients may achieve a long survival time.     

Whole-Brain Propagation Delays in Multiple Sclerosis,a Combined Tractography-Magnetoencephalography Study

Two structurally connected brain regions are more likely to interact, with the lengths of the structural bundles, their widths, myelination, and the topology of the structural connectome influencing the timing of the interactions. We introduce an in vivo approach for measuring functional delays across the whole brain in humans (of either sex) using magneto/electroencephalography (MEG/EEG) and integrating them with the structural bundles. The resulting topochronic map of the functional delays/velocities shows that larger bundles have faster velocities. We estimated the topochronic map in multiple sclerosis patients, who have damaged myelin sheaths, and controls, demonstrating greater delays in patients across the network and that structurally lesioned tracts were slowed down more than unaffected ones. We provide a novel framework for estimating functional transmission delays in vivo at the single-subject and single-tract level.SIGNIFICANCE STATEMENT This article provides a straightforward way to estimate patient-specific delays and conduction velocities in the CNS, at the individual level, in healthy and diseased subjects. To do so, it uses a principled way to merge magnetoencephalography (MEG)/electroencephalography (EEG) and tractography.     

Superficial Venous-Associated Inflammation from Direct IV Administration of RRx-001 in Rats

RRx-001 is a small molecule NLRP3 inflammasome inhibitor with anti-CD47 and antiangiogenic/vascular normalization properties in a Phase 3 clinical trial that has been designated as a drug-device combination by the FDA. In the Phase 1 first-in-man dose escalation clinical trial, where RRx-001 was given by direct intravenous (IV) infusion, the main adverse event was a sterile painful infusion phlebitis (IP). Less pain was experienced when RRx-001 was infused at a slower rate over multiple hours which was impractical on an outpatient basis. In Phase 2, for reasons of convenience and safety, RRx-001 was co-administered with an aliquot of autologous blood from an ex-vivo device called the eLOOP on the premise that RRx-001 binds to hemoglobin on red blood cells (RBCs), making it unavailable to directly interact with venous nociceptors. Phlebitis has the potential to progress to deep venous thrombosis or septic thrombophlebitis or post-thrombotic syndrome in hypercoagulable and immunosuppressed cancer patients. In this 13-week toxicology study of once weekly IV RRx-001 administration to Wistar Han rats followed by a recovery period of 28 days. The main observed toxicity was a significant inflammatory response in the vein wall, consistent with superficial venous thrombosis observed in man. Due to this development, direct IV infusion of RRx-001 is relatively contraindicated in favor of co-administration with autologous blood.     

Dosage effects of X and Y chromosomes on language and social functioning in children with supernumerary sex chromosome aneuploidies: implications for idiopathic language impairment and autism spectrum disorders

Background: Supernumerary sex chromosome aneuploidies (X/Y‐aneuploidies), the presence of extra X and/or Y chromosomes, are associated with heightened rates of language impairments and social difficulties. However, no single study has examined different language domains and social functioning in the same sample of children with tri‐, tetra‐, and pentasomy X/Y‐aneuploidy. The current research sought to fill this gap in the literature and to examine dosage effects of X and Y chromosomes on language and social functioning. Methods: Participants included 110 youth with X/Y‐aneuploidies (32 female) and 52 with typical development (25 female) matched on age (mean ～12 years; range 4–22) and maternal education. Participants completed the Wechsler intelligence scales, and parents completed the Children’s Communication Checklist‐2 and the Social Responsiveness Scale to assess language skills and autistic traits, respectively. Results: Both supernumerary X and Y chromosomes were related to depressed structural and pragmatic language skills and increased autistic traits. The addition of a Y chromosome had a disproportionately greater impact on pragmatic language; the addition of one or more X chromosomes had a disproportionately greater impact on structural language. Conclusions: Given that we link extra X chromosomes with structural language impairments and an extra Y chromosome with pragmatic language impairments, X/Y‐aneuploidies may provide clues to genetic mechanisms contributing to idiopathic language impairment and autism spectrum disorders.     

Zur Frage nach der Genese der Piqûre-Glykosurie

Zusammenfassung Es wurden die Sera von 13 Kaninchen vor und nach einer erfolgreichen Piqûre auf ihre vasokonstriktorische Wirkung untersucht. Als Reagens dienten die Gefässe der hinteren Extremitäten des Frosches nach der von P. Trendelenburg auch für den qualitativen Adrenalinnachweis ausgearbeiteten Läwen'schen Methode.Eine erhöhte vasokonstriktorische Wirkung des nach der Piqûre gewonnenen Serums war nur ein einziges Mal nachzuweisen, sie war aber auch in diesem Falle nur eben merklich. In drei anderen Fällen war eher das vor der Piqûre gewonnene Serum stärker vasokonstriktorisch wirksam, in neun Fällen war zwischen den Seris vor und nach der Piqûre mit der Läwen-Trendelenburg'schen Methode überhaupt kein Unterschied nachweisbar.Wenn nicht irgendwelche uns bisher unbekannte Momente den Nachweis der Vermehrung des Blutadrenalins und der hier verwendeten Methodik verhindern, so müssen wir annehmen, dass die — anscheinend einwandfrei erwiesene — Bedeutung der Nebennieren für das Zustandekommen des Piqûre-Diabetes nicht in einer gesteigerten Adrenalinabgabe an das Blut zu suchen ist.     

Nuchal cord and neurodevelopmental performance at 1 year.

OBJECTIVE: To test the null hypothesis that the presence of a nuchal cord at delivery has no effect on neurodevelopmental performance at 1 year of age. METHODS: The offspring of 190 women with clinically normal antenatal courses were evaluated within 1 month of their first birthday by a blinded observer using the Bayley Scales of Infant Development. The cases were grouped based on the presence of a symptomatic nuchal cord during labor (abnormal fetal heart rate patterns or meconium), and significant differences were detected using analysis of variance. RESULTS: A symptomatic nuchal cord was present during labor and delivery in 24% of the 190 cases. At 1 year of age scores on both Bayley scales were slightly but significantly (P < .01) lower in the offspring delivered with a symptomatic nuchal cord. The mental index was 116 +/- 9 versus 120 +/- 7, and the psychomotor index was 101 +/- 11 versus 107 +/- 9. These differences were accentuated (P = .09) when the symptomatic cases complicated by extreme tightness, multiple loops, or antenatal detection were compared to symptomatic cases without these additional complications (overall index 110 +/- 8 versus 105 +/- 10). There were no between group differences in multiple potential confounding obstetric or demographic variables. CONCLUSIONS: These data do not support the null hypothesis and suggest that symptomatic nuchal cords, which are identified before labor as being extremely tight or having multiple loops, may be associated with a subclinical deficit in neurodevelopmental performance at 1 year of age.