Prediction of large for gestational age by ultrasound at 35 weeks and impact of ultrasound-delivery interval: Comparison of 6 standards

Objective: The aim of the study was to assess the predictive ability of the ultrasound estimated percentile weight (EPW) at 35 weeks to predict large for gestational age (LGA) at term delivery according to 6 growth standards, including population, population-customized, and international references. The secondary objectives were to determine its predictive ability to detect adverse perinatal outcomes (APOs) and whether the ultrasound-delivery interval influences the detection rate of LGA newborns. Methods: This was a retrospective cohort study of 9, 585 singleton pregnancies. Maternal clinical characteristics, fetal ultrasound data obtained at 35 weeks, and pregnancy and perinatal outcomes were used to calculate EPWs to predict LGAs at delivery according to the customized and the non-customized (NC) Miguel Servet University Hospital (MSUH), the customized Figueras, the NC Fetal Medicine Foundation (FMF), the NC INTERGROWTH-21st, and the NC World Health Organization (WHO) standards. Results: For a 10% false-positive rate, detection rates for total LGAs at delivery ranged from 31.2% with the WHO (area under the curve [AUC] 0.77; 95% confidence interval [CI], 0.76-0.79) to 56.5% with the FMF standard (AUC 0.85; 95% CI, 0.84-0.86). Detection rates and values of AUCs to predict LGAs by ultrasound-delivery interval (range 1-6 weeks) show higher detection rates as the interval decreases. APO detection rates ranged from 2.5% with the WHO to 12.6% with the Figueras standard. Conclusion: The predictive ability of ultrasound estimated fetal weight at 35 weeks to detect LGA infants is significantly greater for FMF and MSUH NC standards. In contrast, the APO detection rate is significantly greater for customized standards. The shorter ultrasound-delivery interval relates to better prediction rates

Cervical lymph node metastasis in adenoid cystic carcinoma of the larynx: a collective international review

Adenoid cystic carcinoma (AdCC) of the head and neck is a well-recognized pathologic entity that rarely occurs in the larynx. Although the 5-year locoregional control rates are high, distant metastasis has a tendency to appear more than 5 years post treatment. Because AdCC of the larynx is uncommon, it is difficult to standardize a treatment protocol. One of the controversial points is the decision whether or not to perform an elective neck dissection on these patients. Because there is contradictory information about this issue, we have critically reviewed the literature from 1912 to 2015 on all reported cases of AdCC of the larynx in order to clarify this issue. During the most recent period of our review (1991-2015) with a more exact diagnosis of the tumor histology, 142 cases were observed of AdCC of the larynx, of which 91 patients had data pertaining to lymph node status. Eleven of the 91 patients (12.1%) had nodal metastasis and, based on this low proportion of patients, routine elective neck dissection is therefore not recommended

Cell-Promoted Nanoparticle Aggregation Decreases Nanoparticle-Induced Hyperthermia under an Alternating Magnetic Field Independently of Nanoparticle Coating, Core Size, and Subcellular Localization

Magnetic hyperthermia has a significant potential to be a new breakthrough for cancer treatment. The simple concept of nanoparticle-induced heating by the application of an alternating magnetic field has attracted much attention, as it allows the local heating of cancer cells, which are considered more susceptible to hyperthermia than healthy cells, while avoiding the side effects of traditional hyperthermia. Despite the potential of this therapeutic approach, the idea that local heating effects due to the application of alternating magnetic fields on magnetic nanoparticle-loaded cancer cells can be used as a treatment is controversial. Several studies indicate that the heating capacity of magnetic nanoparticles is largely reduced in the cellular environment because of increased viscosity, aggregation, and dipolar interactions. However, an increasing number of studies, both in vitro and in vivo, show evidence of successful magnetic hyperthermia treatment on several different types of cancer cells. This apparent contradiction might be due to the use of different experimental conditions. Here, we analyze the effects of several parameters on the cytotoxic efficiency of magnetic nanoparticles as heat inductors under an alternating magnetic field. Our results indicate that the cell-nanoparticle interaction reduces the cytotoxic effects of magnetic hyperthermia, independent of nanoparticle coating and core size, the cell line used, and the subcellular localization of nanoparticles. However, there seems to occur a synergistic effect between the application of an external source of heat and the presence of magnetic nanoparticles, leading to higher toxicities than those induced by heat alone or the accumulation of nanoparticles within cells.This work was partially supported by grants from the MINEICO (SAF2014-54057-R and SAF2017-82223-R to DFB).Peer reviewe