Evaluation of the utility of localized adjuvant radiation for node-negative primary cutaneous squamous cell carcinoma with clear histologic margins

Background Though NCCN recommends consideration of localized adjuvant radiation following clear-margin surgery for cutaneous squamous cell carcinoma (CSCC) with large caliber (≥0.1mm) nerve invasion (LCNI) and other high-risk features, only a single small study has compared surgery plus adjuvant radiation (S+ART) to surgical monotherapy (SM) for CSCC. Objectives Compare surgery plus adjuvant radiation (S+ART) to surgical monotherapy (SM) for primary CSCCs with LCNI and other risk factors. Methods Matched retrospective cohort study of primary CSCCs (matched on gender, age, immune status, type of surgery, diameter, differentiation, depth and LCNI) treated with S+ART versus SM. Subgroup analysis of CSCCs with LCNI was performed. Results 62 CSCCs were included in matched analysis (S + ART: 31, SM: 31) and 33 in LCNI analysis (S+ART: 16, SM: 17). There was no significant difference in local recurrence (LR), metastasis, or death from disease in either analysis. Risk of LR was low (7, 8%) with 3 of the LRs being effectively treated upon recurrence. Limitations Single academic center, non-randomized design. Conclusion Adjuvant radiation did not improve outcomes compared to SM due to a low baseline risk of recurrence; although ART for named nerve invasion and LCNI of 3 or more nerves has been shown to improve outcomes in a prior study. Randomized studies are needed to define the subset of CSCC for whom adjuvant radiation has utility

Autoantibody Production in Cancer—The Humoral Immune Response toward Autologous Antigens in Cancer Patients

A link between autoimmune responses and cancer via autoantibodies was first described in the 1950s. Since, autoantibodies have been studied for their potential use as cancer biomarkers, however the exact causes of their production remain to be elucidated. This review summarizes current theories of the causes of autoantibody production in cancer, namely: 1) defects in tolerance and inflammation, 2) changes in protein expression levels, 3) altered protein structure, and 4) cellular death mechanisms. We also highlight the need for further research into this field to improve our understanding of autoantibodies as biomarkers for cancer development and progression

Rhoda Stamell, 26th Annual Literary Festival

Rhoda Stamell had been a teacher for over 30 years when she won the Frances Shaw Older Woman\u27s Writing Award, sponsored by Ragdale Foundation in 1996. The next year she retired from teaching English in urban high schools and community colleges. Stamell has attended Ragdale Colony, Virginia Center for the Creative Arts, MacDowell Colony, Blue Mountain Colony, Byrdcliffe and Vermont Studio Center. She has written three novels and several novellas. Her short stories have appeared in The Boston Review, The Kenyon Review, and the upcoming anthology What Are You Looking At? (Harcourt Brace 2003). Currently, she is an adjunct professor of literature, composition and creative writing at Lawrence Technological University in Southfield, Mich

Are tertiary care paediatricians prepared for disaster situations?

Introduction: Children, with their specific vulnerabilities and needs, make up to more than 20% of society, so they are at risk of getting involved in disasters. Are the specialists treating them for medical problems in daily life also capable to deal with them in disaster situations? Hypothesis/Problem: The goals of this study were to evaluate perceived knowledge and capability of tertiary pediatricians to deal with disasters, to identify promoting factors, and to evaluate education need and willingness to work. Methods: A survey looking for demographics, hospital disaster planning, estimated risk and capability for disasters, training, and willingness to work, and a set of six content assessment questions to evaluate knowledge, were presented to emergency pediatricians and pediatric emergency physicians in specialized tertiary centers. Results: The response rate was 51%. Thirty-five percent had disaster training and 53% felt that disaster education should be obligatory in their curriculum. Risk for disasters was estimated from 2.4/10 for nuclear incidents to 7.6/10 for major trauma. Self-estimated capability for these situations ranged from 1.8/10 in nuclear incidents to 7.6/10 in major trauma. Unconditional willingness to work ranged from 37% in nuclear situations to 68% in pandemics. Mean score on the questions was 2.06/6. Training, knowledge of antidote and personal protective equipment (PPE) use, self-estimated capability, and exposure were significant predictors for higher scores. Willingness to work correlated significantly with age, self-estimated capability, and risk estimation. In case of chemical and nuclear incidents, there was correlation with knowledge on the use of decontamination, PPE, and radio-detection devices. Conclusion: Despite a clear perception of the risks and a high willingness to work, preparedness is limited. The major conclusion is that basics of disaster management should be included in pediatric training