Follow-up after treatment for head and neck cancer: United Kingdom National Multidisciplinary Guidelines

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. In the absence of high-level evidence base for follow-up practices, the duration and frequency are often at the discretion of local centres. By reviewing the existing literature and collating experience from varying practices across the UK, this paper provides recommendations on the work up and management of lateral skull base cancer based on the existing evidence base for this rare condition

APLIKASI SENSOR LOAD CELL YZC-133 SEBAGAI PENDETEKSI BERAT SANTAN PADA COCONUT MILK AUTO MACHINE

The machine that produces coconut milk or coconut milk auto machine is a machine assemblied so that can produce a coconut milk without using the water. The working principle of coconut milk auto machine is, when the cover cup is covered then photodiode sensor will transmitt a voltage signal to microcontroller ATMEGA 8535 for activating driver relay. It’s caused the motor will be active and process the coconut to be coconut milk. Coconut milk that produces will be detected by load cell YZC-133 and when coconut milk has been 150 mL then the machine will be nonactive automatic. According to the explaining above, then designed an engine coconut milk auto machine using microcontroller ATMEGA 8535 as a controller. This machine also assemblied to weigh the coconut milk weight automatic. This machine uses load cell YZC-133 sensor as a weight coconut milk detector. Load cell sensor will detect the weight that is burdened on longitudinal section and transmits a signal to microcontroller then the coconut milk weigt will be displayed by LCD. According to the data that is got, when there is no output voltage load cell YZC-133 at amplifier signal is 162,7 mV as offset voltage and on the 150 grams output voltage at amplifier signal is 476 mV. Keyword : coconut milk auto machine, sensor photodioda, mikrokontroler ATMEGA 8535, driver relay, loadcell YZC-13

Letter to the editor in reference to : "A web-based prediction score for head and neck cancer referrals"

Sir, We read with interest the article by Lau et al (2018) on the design of a web‐based prediction score for head and neck cancer (HNC) referrals. The authors state that there are no similar scoring systems available in the literature that are web‐based and applicable to the two‐week‐wait referrals. Over the last years, risk calculators for common cancer have been extensively explored and are available online, aiming to improve cancer referral pathways and detection.1, 2 A HNC risk calculator (HNC‐RC) based on symptoms and demographics has also been developed and is available online (Sensitivity: 74.8%; specificity: 65.9%; and overall predictive power (AUC): 0.77).3 It has also been externally validated maintaining its discriminatory ability (sensitivity: 79.3%; specificity: 68.6%; and AUC: 0.81). In their abstract, Lau et al have stated that logistic regression and artificial network machine approached have been used. Despite this, only the former was employed, as mentioned in their methodology section, due to time‐related restrictions and effort required to ensure an error‐free algorithm

Provision of physiotherapy rehabilitation following neck dissection in the UK

Background Neck dissection is associated with post-operative shoulder dysfunction in a substantial number of patients, affecting quality of life and return to work. There is no current UK national practice regarding physiotherapy after neck dissection. Method Nine regional centres were surveyed to determine their standard physiotherapy practice pre- and post-neck dissection, and to determine pre-emptive physiotherapy for any patients. Results Eighty-nine per cent of centres never arranged any pre-emptive physiotherapy for any patients. Thirty-three per cent of centres offered routine in-patient physiotherapy after surgery. No centres offered out-patient physiotherapy for all patients regardless of symptoms. Seventy-eight per cent offered physiotherapy for patients with any symptoms, with 11 per cent offering physiotherapy for those with severe dysfunction only. Eleven per cent of centres never offered physiotherapy for any dysfunction. Conclusion The provision of physiotherapy is most commonly reactive rather than proactive, and usually driven by patient request. There is little evidence of pre-arranged physiotherapy for patients to treat or prevent shoulder dysfunction in the UK

KONDISI FISIK RUMAH DAN PERILAKU MASYARAKAT TERHADAP KEBERADAAN VEKTOR TIKUS DI KELURAHAN KAMPUNG BARU KECAMATAN SENAPELAN KOTA PEKANBARU TAHUN 2017

Poor Sanitaon, trash management, and the blockage of waterways was a cause of the high populaon of rodents. Rodent were known as vector of infecon diseases such Leptospirosis and Salmonellosis and it very important to protect housing sanitaon in Pekanbaru, especially Kampung Baru. This study aims to determine the relaonship between the physical condion of the house and the behavior of the community to the existence of rat vector in Kampung Baru village, Senapelan sub-district, Pekanbaru City. This study was a quantave analyc with crossseconal design. Populaon was house of cizen in Kampung Baru Sub-District of Senapelan Sub-Province Pekanbaru City. There were 67 households as samples in RW 06 Region. The results showed that there were correlaons on wall variables (p = 0.002), ceiling (p = 0.048), venlaon (p = 0.026), and SPAL (p = 0.020). There was no correlaon on the variable of the goodslayout (p = 0,060), and waste management (p = 0,437) The layout of respondent goods smoothed every 1-2 weeks and daily garbage management always take the household waste and dispose of directly to the disposal place the end of the far away from their community. We recommend that people should pay more aenon to cleanliness in the environment where they lived to avoid the rodent vector that can enter their home. Keywords : Physical House, Community Behavior, RodentTikus merupakan satwa liar yang sangat sering berhubungan dengan kehidupan manusia. Keberadaan tikus dimuka bumi sudah jauh lebih tua dari pada usia peradaban manusia. Tikus hewan mengerat yang sangat merugikan manusia, selain merugikan tikus juga bertindak sebagai sumber/reservoir, penyebar (spreader) dan penular (transmitter) berbagai jenis penyakit. Penelitian ini bertujuan untuk mengetahui hubungan kondisi fisik rumah dan perilaku masyarakat terhadap keberadaan vektor tikus di Kelurahan Kampung Baru Kecamatan Senapelan Kota Pekanbaru tahun 2017. Penelitian ini menggunakan metode kuantitatif dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah rumah warga yang ada di Kelurahan Kampung Baru Kecamatan Senapelan Kota Pekanbaru tahun 2017. Sampel dalam penelitian ini sebanyak 67 KK yang ada di wilayah RW 06. Pengumpulan data menggunakan lembar observasi checklist, analisis data menggunakan chi- square. Hasil penelitian menyimpulkan bahwa terdapat hubungan pada variabel dinding (p=0,002), langit-langit (p=0,048), ventilasi (p=0.026), dan SPAL (p=0,020). Tidak ada hubungan pada variabel tata letak barang (p=0,060), dan pengelolaan sampah (p=0,437) Tata letak barang responden merapikan setiap 1-2 minggu sekali dan pengelolaan sampah setiap hari petugas kebersihan selalu mengambil sampah kerumah masyarakat dan membuang langsung ketempat pembuangan akhir yang jauh dari rumah masyarakat. Sebaiknya masyarakat lebih memperhatikan kebersihan di lingkungan tempat tinggalnya agar dapat menghindari vektor tikus yang dapat masuk ke dalam rumah

Diagnostic accuracy of intraoperative margin assessment techniques in surgery for head and neck squamous cell carcinoma: a meta-analysis

BACKGROUND: Positive margins following head and neck squamous cell carcinoma (HNSCC) surgery lead to significant morbidity and mortality. Existing Intraoperative Margin Assessment (IMA) techniques are not widely used due to limitations in sampling technique, time constraints and resource requirements. We performed a meta-analysis of the diagnostic performance of existing IMA techniques in HNSCC, providing a benchmark against which emerging techniques may be judged. METHODS: The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. Studies were included if they reported diagnostic metrics of techniques used during HNSCC surgery, compared with permanent histopathology. Screening, manuscript review and data extraction was performed by multiple independent observers. Pooled sensitivity and specificity were estimated using the bivariate random effects model. RESULTS: From an initial 2344 references, 35 studies were included for meta-analysis. Sensitivity (Sens), specificity (Spec), diagnostic odds ratio (DOR) and area under the receiver operating characteristic curve (AUROC) were calculated for each group (n, Sens, Spec, DOR, AUROC): frozen section = 13, 0.798, 0.991, 309.8, 0.976; tumour-targeted fluorescence (TTF) = 5, 0.957, 0.827, 66.4, 0.944; optical techniques = 10, 0.919, 0.855, 58.9, 0.925; touch imprint cytology = 3, 0.925, 0.988, 51.1, 0.919; topical staining = 4, 0.918, 0.759, 16.4, 0.833. CONCLUSIONS: Frozen section and TTF had the best diagnostic performance. Frozen section is limited by sampling error. TTF shows promise but involves administration of a systemic agent. Neither is currently in widespread clinical use. Emerging techniques must demonstrate competitive diagnostic accuracy whilst allowing rapid, reliable, cost-effective results