Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial

Objective To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections

Recurrence up to 3.5 years after antibiotic treatment of acute otitis media in very young Dutch children: survey of trial participants

Objective To determine the long term effects of antibiotic treatment for acute otitis media in young children

Optimising pain management in children with acute otitis media through a primary care-based multifaceted educational intervention: study protocol for a cluster randomised controlled trial.

Whilst current guidelines highlight the importance of pain management for children with acute otitis media (AOM), there is evidence to suggest that this is not implemented in everyday practice. We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness

Larotrectinib efficacy and safety in TRK fusion cancer: An expanded clinical dataset showing consistency in an age and tumor agnostic approach

Background: TRK fusion cancer results from gene fusions involving NTRK1, NTRK2 or NTRK3. Larotrectinib, the first selective TRK inhibitor, has demonstrated an overall response rate (ORR) of 75% with a favorable safety profile in the first 55 consecutively enrolled adult and pediatric patients with TRK fusion cancer (Drilon et al.,NEJM2018). Here, we report the clinical activity of larotrectinib in an additional 35 TRK fusion cancer patients and provide updated follow-up of the primary analysis set (PAS) of 55 patients as of 19thFeb 2018. Methods: Patients with TRK fusion cancer detected by molecular profiling from 3 larotrectinib clinical trials (NCT02122913, NCT02637687, and NCT02576431) were eligible.Larotrectinib was administered until disease progression, withdrawal, or unacceptable toxicity. Disease status was assessed using RECIST version 1.1. Results: As of Feb 2018, by independent review, 6 PRs in the PAS deepened to CRs. The median duration of response (DoR) and progression-free survival in the PAS had still not been reached, with 12.9 months median follow-up. At 1 year, 69% of responses were ongoing, 58% of patients remained progression-free and 90% of patients were alive. An additional 19 children and 25 adults (age range, 0.1-78 years) with TRK fusion cancer were enrolled after the PAS, and included cancers of the salivary gland, thyroid, lung, colon, melanoma, sarcoma, GIST and congenital mesoblastic nephroma. In 35 evaluable patients, the ORR by investigator assessment was 74% (5 CR, 21 PR, 6 SD, 2 PD, 1 not determined). In these patients, with median follow-up of 5.5 months, median DoR had not yet been reached, and 88% of responses were ongoing at 6 months, consistent with the PAS. Adverse events (AEs) were predominantly grade 1, with dizziness, increased AST/ALT, fatigue, nausea and constipation the most common AEs reported in ≥ 10% of patients. No AE of grade 3 or 4 related to larotrectinib occurred in more than 5% of patients. Conclusions: TRK fusions are detected in a broad range of tumor types. Larotrectinib is an effective age- and tumor-agnostic treatment for TRK fusion cancer with a positive safety profile. Screening patients for NTRK gene fusions in solid- and brain tumors should be actively considered

Pneumococcal conjugate vaccines for preventing otitis media

BACKGROUND: Acute otitis media (AOM) is a very common early infancy and childhood disease. The marginal benefits of antibiotics on AOM, the increasing problem of bacterial resistance to antibiotics, and the huge estimated direct and indirect annual costs associated with otitis media (OM) have prompted a search for effective vaccines to prevent AOM. OBJECTIVES: To assess the effect of pneumococcal conjugate vaccines (PCVs) in preventing AOM in children up to 12 years of age. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, issue 2), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (January 1995 to November 2007); and EMBASE (January 1995 to November 2007). SELECTION CRITERIA: Randomised controlled trials of PCVs to prevent AOM in children aged 12 years or younger, with a follow up of at least six months after vaccination. DATA COLLECTION AND ANALYSIS: Three review authors independently assessed trial quality and two review authors extracted data. MAIN RESULTS: We included seven trials on 7- to 11-valent PCV (with different carrier proteins). There was large heterogeneity regarding study population, type of conjugate vaccine, and outcome measures between trials, therefore, results were not pooled. The only currently licensed 7-valent PCV Prevenar with CRM197 as carrier protein (CRM197-PCV7) administered during infancy was in two studies associated with a 6% (95% confidence interval (CI) -4% to 16%) and 7% (95% CI 4% to 9%) relative reduction in risk of AOM episodes. Another 7-valent PCV with the outer membrane protein complex of Neisseria meningitidis (N. meningitidis) serogroup B as carrier protein, administered in infancy, did not reduce overall AOM episodes, while an 11-valent PCV with Haemophilus influenzae (H. influenzae) protein D as carrier protein was associated with a relative reduction in risk of AOM episodes of 34% (95% CI 21% to 44%). 9-valent PCV (with CRM197 carrier protein) administered in healthy toddlers was associated with a 17% (95% CI -2% to 33%) relative reduction in risk of OM episodes. CRM197-PCV7 followed by 23-valent pneumococcal polysaccharide vaccination administered after infancy in older children with a history of AOM showed no beneficial effect on further AOM episodes. AUTHORS' CONCLUSIONS: Based on current evidence of the effectiveness of PCVs for the prevention of AOM, the currently licensed 7-valent PCV administered during infancy has marginal beneficial effects. Discrete reductions of 6% to 7% may mean substantial reductions from a public health perspective. Administering PCV7 in older children with a history of AOM appears to have no benefit in preventing further episodes

The effects of poetry-writing SANTEL on erotic body image in remission of cancer in women: a pilot study

International audienceAbstract Aim: Our pilot study aims to describe the effects ofa new specific and structured protocol focused on poetic/erotic writing (named SANTEL) on the (re)sexualization ofbody image in women, who have experienced cancer.Procedure: The protocol consists of four steps: to choose alist of erotic verses focused on the body parts, to fill a semistructuredpoetic text, to write sentences after target phraseson the body; and in the end, to write a free poem. Mrs V.suffered from breast cancer, and one breast was removed.She and her husband participated in this poetic writing protocol,separately. We analyzed the linguistic metaphors ofthe body by QSR Nvivo10 software.Results: Using this protocol, we showed discourse variationsof metaphors before and after the experience of writing.Patient V used “I feel like an alien” as a starting metaphorto describe her cancer experience and after poetic writingsessions, she used other bodily metaphors like “My body isa flower” and “My sensual and white flesh”.Conclusion: This poetic perspective promises a type of“perceptive-literary surgery”, characterized by a sensualinvestment process after remission: a poetic reconstructionof erotic body image.Les effets d'un protocole d'écriture poétique SANTEL sur l'image érotique du corps dans le traitement du cancer féminin : étude pilote The effects of poetry-writing SANTEL on erotic body image in remission of cancer in women: a pilot study A. Santarpia · J. Tellène · M. Carrier Résumé Objectif : Cette étude pilote de type qualitative et exploratoire vise à décrire les effets d'un nouveau protocole d'écriture poético-érotique (nommée SANTEL) sur la rééro-tisation de l'image du corps chez une femme, ayant vécu un cancer. Matériel et méthodes : Il s'agit d'un protocole composé de quatre étapes : une liste des phrases à caractères poétiques et érotiques à choisir, un texte à trous à remplir, des amorces de phrases ciblées sur le corps et en fin un poème libre. Madame V. a subi un cancer du sein nécessitant une ablation complète. Madame V. et son conjoint exécutent le protocole d'écriture séparément. Nous montrons les variations discursives des métaphores utilisées avant et après l'expérience de l'écriture, à travers le logiciel d'analyse qualitative QSR NVivo10. Résultats : Madame V. passera de la métaphore initiale « je me sens une extraterrestre » vers la plus atténuée « Non. Je me dis qu'extraterrestre c'était peut-être un peu énorme ». En plus, elle utilisera de nouvelles métaphores linguistiques du corps pour raconter son image du corps telles que « ce corps de chair blanche » et « une fleur qui s'ouvre délicatement ». Conclusion : Cet exercice spécifique d'écriture promet un type de « chirurgie perceptive-littéraire » dans le processus d'investissement sensuel et affectif après la rémission, une reconstruction perceptive et poétique de l'image érotique du corps. Mots clés Métaphores perceptives · Image du corps · Cancer féminin · Corps érotique · Écriture poétique · Chirurgie perceptive-littéraire · Logiciel QSR NVivo10. Abstract Aim: Our pilot study aims to describe the effects of a new specific and structured protocol focused on poetic/ erotic writing (named SANTEL) on the (re)sexualization of body image in women, who have experienced cancer. Procedure: The protocol consists of four steps: to choose a list of erotic verses focused on the body parts, to fill a semi-structured poetic text, to write sentences after target phrases on the body; and in the end, to write a free poem. Mrs V. suffered from breast cancer, and one breast was removed. She and her husband participated in this poetic writing protocol , separately. We analyzed the linguistic metaphors of the body by QSR Nvivo10 software. Results: Using this protocol, we showed discourse variations of metaphors before and after the experience of writing. Patient V used " I feel like an alien " as a starting metaphor to describe her cancer experience and after poetic writing sessions, she used other bodily metaphors like " My body is a flower " and " My sensual and white flesh ". Conclusion: This poetic perspective promises a type of " perceptive-literary surgery " , characterized by a sensual investment process after remission: a poetic reconstruction of erotic body image. Keywords Bodily metaphors · Body image · Feminine cancer · Erotic body · Poetry writing · Perceptive-literary surgery · QSR Nvivo10 software

Far-infrared study of the Jahn-Teller distorted C60 monoanion in C60 tetraphenylphosphoniumiodide

We report high-resolution far-infrared transmission measurements on C(60)-tetraphenylphosphoniumiodide as a function of temperature. In the spectral region investigated (20-650 cm(-1)), we assign intramolecular modes of the C(60) monoanion and identify low-frequency combination modes. The well-known F(1u)(1) and F(1u)(2) modes are split into doublers at room temperature, indicating a D(5d) or D(3d) distorted ball. This result is consistent with a dynamic Jahn-Teller effect in the strong-coupling limit or with a static distortion stabilized by low-symmetry perturbations. The appearance of silent odd modes is in keeping with symmetry reduction of the hall, while activation of even modes is attributed to interband electron-phonon coupling and orientational disorder in the fulleride salt. Temperature dependences reveal a weak transition in the region 125-150 K in both C(60)(-) and counterion modes, indicating a bulk, rather than solely molecular, effect. Anomalous softening (with decreasing temperature) in several modes may correlate with the radial character of those vibrations. [S0163-1829(98)03245-7]

Citrate anticoagulation versus systemic heparinisation in continuous venovenous hemofiltration in critically ill patients with acute kidney injury: A multi-center randomized clinical trial

Introduction: Because of ongoing controversy, renal and vital outcomes are compared between systemically administered unfractionated heparin and regional anticoagulation with citrate-buffered replacement solution in predilution mode, during continuous venovenous hemofiltration (CVVH) in critically ill patients with acute kidney injury (AKI).Methods: In this multi-center randomized controlled trial, patients admitted to the intensive care unit requiring CVVH and meeting inclusion criteria, were randomly assigned to citrate or heparin. Primary endpoints were mortality and renal outcome in intention-to-treat analysis. Secondary endpoints were safety and efficacy. Safety was defined as absence of any adverse event necessitating discontinuation of the assigned anticoagulant. For efficacy, among other parameters, survival times of the first hemofilter were studied.Results: Of the 139 patients enrolled, 66 were randomized to citrate and 73 to heparin. Mortality rates at 28 and 90 days did not differ between groups: 22/66 (33%) of citrate-treated patients died versus 25/72 (35%) of heparin-treated patients at 28 days, and 27/65 (42%) of citrate-treated patients died versus 29/69 (42%) of heparin-treated patients at 90 days (P = 1.00 for both). Renal outcome, i.e. independency of renal replacement therapy 28 days after initiation of CVVH in surviving patients, did not differ between groups: 29/43 (67%) in the citrate-treated patients versus 33/47 (70%) in heparin-treated patients (P = 0.82). Heparin was discontinued in 24/73 (33%) of patients whereas citrate was discontinued in 5/66 (8%) of patients (P < 0.001). Filter survival times were superior for citrate (median 46 versus 32 hour

International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations

Objective To provide recommendations for the comprehensive management of young infants who present with signs or symptoms concerning for laryngomalacia. Methods Expert opinion by the members of the International Pediatric Otolaryngology Group (IPOG). Results Consensus recommendations include initial care and triage recommendations for health care providers who commonly evaluate young infants with noisy breathing. The consensus statement also provides comprehensive care recommendations for otolaryngologists who manage young infants with laryngomalacia including: evaluation and treatment considerations for commonly debated issues in laryngomalacia, initial work-up of infants presenting with inspiratory stridor, treatment recommendations based on disease severity, management of the infant with feeding difficulties, post-surgical treatment management recommendations, and suggestions for acid suppression therapy. Conclusion Laryngomalacia care consensus recommendations are aimed at improving patient-centered care in infants with laryngomalacia