Angiolymphoid hyperplasia with eosbvophilia-case report

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign condition characterized by subcutaneous lesions in the head-neck region. It is frequently misdiagnosed as a malignant lesion. Knowledge of the existence of the disease and pathological interpretation are requisites for early diagnosis. We present a case report and review of the literature.     

Tonsillar carcinoma — a review

Tonsillar carcinoma which is a not uncommon form of head-neck malignancy is reviewed.     

Adjuvant/Perioperative Therapy in Pancreatic and Periampullary Cancer

The delivery of postoperative combined modality adjuvant therapy for completely resected pancreatic adenocarcinoma was initially shown to be beneficial based on a prospective, randomized trial published 30 years ago. Since then, oncologists have debated whether chemotherapy alone, chemoradiation, or both are optimal adjuvant therapies following pancreatectomy for pancreatic ductal adenocarcinomas (PDAC). No global consensus has emerged, and there is no one superior modality despite randomized trials in part, to poor trial design, poor patient selection, and poor therapy options itself. We need to have a disciplined approach to the selection of patients for pancreatectomy, pathologic assessment of surgical resection margins, and postoperative (pre-treatment) imaging. In the era of the multidetector CT optimized for pancreatic imaging, tumors of “borderline resectability” have emerged as a distinct subset of PDAC. The attempt to standardize the definition of borderline resectable is a work in progress and modified with time. This distinction (between resectable and borderline resectable) is essential to minimize potentially confounding results of clinical trials. Additionally, preoperative therapy is not only preferred but mandatory in a large population of borderline resectable patients. Ultimately, as we develop more effective systemic therapies for PDAC, proceeding with surgery after a period of induction therapy will be even more compelling especially if there is a clear positive impact on overall survival.     

Mortality risk factors for listeriosis – A 10 year review of non-pregnancy associated cases in England 2006–2015

Listeriosis

is a foodborne illness that can result in septicaemia, Central Nervous System (CNS) disease, foetal loss and death in high risk patients.

An evaluation of wear of human enamel opposed by ceramics of different surface finishes

Statement of Problem:

Surface of porcelain restoration is a matter of clinical concern because of its abrasive action on the opposing enamel.

Purpose:

This study comparatively evaluated wear of enamel when opposed by three different surface finishes of ceramic.

Materials and Methods:

A total of 60 metal-ceramic discs (10 mm × 2 mm) with different surface finishes were fabricated. They were divided into four groups of autoglazed ceramic surface, over glazed ceramic surface, ceramic surface polished with Shofu polishing kit and ceramic surface polished with DFS polishing wheels and paste. Each group comprised of 15 discs. Sixty human teeth samples were prepared from freshly extracted, unrestored, caries free, nonattrited maxillary first premolars. Each tooth sample was weighed before wear testing using AT200 Mettler Toledo electronic analytical balance of 0.0001 g accuracy. Occlusal surfaces of these teeth were then abraded against the substrates in a wear machine for a total of 10,000 cycles. Each tooth sample was weighed after 5000 cycles and after the total of 10,000 cycles, respectively, using the same balance. Differences in weight of tooth samples before and after wear testing were evaluated statistically using one-way analysis of variance and Bonferroni''s correction for multiple group comparisons.

Results:

The values obtained for percentage weight loss after 10,000 cycles for over glazed ceramic surface were marginally higher than values obtained for autoglazed surface. It was observed that values obtained for percentage weight loss by polished ceramic after 10,000 cycles were statistically less as compared to the values obtained with autoglazed and over glazed ceramic surface (P < 0.001). There was no statistically significant difference between the values obtained by polished ceramic surfaces of two different groups.

Conclusion:

Enamel wear produced by polished porcelain is substantially less than autoglazed and over glazed porcelain. No significant difference was found in enamel wear when opposed by ceramic surfaces polished by two different methods. This study indicates the potential damage porcelain can inflict upon enamel and suggests that porcelain should be polished instead of over glazed.     

Frequency and Intensity of Postoperative Surveillance After Curative Treatment of Pancreatic Cancer: A Cost-Effectiveness Analysis

Background

Few data exist to guide oncologic surveillance following curative treatment of pancreatic cancer. We sought to identify a rational, cost-effective postoperative surveillance strategy.

Methods

We constructed a Markov model to compare the cost-effectiveness of 5 postoperative surveillance strategies. No scheduled surveillance served as the baseline strategy. Clinical evaluation and carbohydrate antigen (CA) 19-9 testing without/with routine computed tomography and chest X-ray at either 6- or 3-month intervals served as the 4 comparison strategies of increasing intensity. We populated the model with symptom, recurrence, treatment, and survival data from patients who had received intensive surveillance after multimodality treatment at our institution between 1998 and 2008. Costs were based on Medicare payments (2011 US dollars).

Results

The baseline strategy of no scheduled surveillance was associated with a postoperative overall survival (OS) of 24.6 months and a cost of $3837/patient. Clinical evaluation and CA 19-9 assay every 6 months until recurrence was associated with a 32.8-month OS and a cost of $7496/patient, with an incremental cost-effectiveness ratio (ICER) of $5364/life-year (LY). Additional routine imaging every 6 months incrementally increased total cost by $3465 without increasing OS. ICERs associated with clinic visits every 3 months without/with routine imaging were $127,680 and $294,696/LY, respectively. Sensitivity analyses changed the strategies’ absolute costs but not the relative ranks of their ICERs.

Conclusions

Increasing the frequency and intensity of postoperative surveillance of patients after curative therapy for pancreatic cancer beyond clinical evaluation and CA 19-9 testing every 6 months increases cost but confers no clinically significant survival benefit.