Improved survival following surgery and radiation therapy for olfactory neuroblastoma: analysis of the SEER database

<p>Abstract</p> <p>Background</p> <p>Olfactory Neuroblastoma is a rare malignant tumor of the olfactory tract. Reports in the literature comparing treatment modalities for this tumor are limited.</p> <p>Methods</p> <p>The SEER database (1973-2006) was queried by diagnosis code to identify patients with Olfactory Neuroblastoma. Kaplan-Meier was used to estimate survival distributions based on treatment modality. Differences in survival distributions were determined by the log-rank test. A Cox multiple regression analysis was then performed using treatment, race, SEER historic stage, sex, age at diagnosis, year at diagnosis and SEER geographic registry.</p> <p>Results</p> <p>A total of 511 Olfactory Neuroblastoma cases were reported. Five year overall survival, stratified by treatment modality was: 73% for surgery with radiotherapy, 68% for surgery only, 35% for radiotherapy only, and 26% for neither surgery nor radiotherapy. There was a significant difference in overall survival between the four treatment groups (p < 0.01). At ten years, overall survival stratified by treatment modality and stage, there was no significant improvement in survival with the addition of radiation to surgery.</p> <p>Conclusions</p> <p>Best survival results were obtained for surgery with radiotherapy.</p

Management of Comorbidities in Diabetics With Renal Cell Carcinoma Past Utilization and Current Outcomes

Objectives: This study evaluated whether particular diabetes mellitus (DM), hyperlipidemia, or hypertension pharmacotherapy was associated with improved renal cell carcinoma (RCC) outcomes in diabetics with emergent RCC. Methods: All DM cases newly diagnosed with RCC at Roswell Park Cancer Institute (January 01, 2003-December 31, 2010) were included (n = 95). Baseline demographic information, clinical history, and cancer outcomes were documented after chart review. Fisher’s test was used for the analysis of categorical outcomes across different treatment groups. Univariate and multivariate analyses for the comparisons of the overall survival and progression-free survival across treatment groups were assessed using Kaplan-Meier log-rank test and Cox proportional hazards models. Results: We found that DM pharmacotherapy users, which may represent a more advanced disease as compared to those controlled by diet alone, displayed significantly greater mortality (P = .01). Additionally, we found that cholesterol-lowering pharmacotherapy use was associated with decreased RCC mortality (hazard ratio = 0.54, P = .06). Individuals receiving combined hypertension regimens had a lower chance to present with baseline metastasis; however, hypertension pharmacotherapy use added no survival benefit. Conclusion: Reinforcing guidelines compliance for hyperlipidemia management in patients with DM may provide a considerable cancer benefit if diagnosed with RCC. Studies evaluating the need for cholesterol-lowering pharmacotherapy in guidelines-noncompliant DM cases upon RCC diagnosis are currently needed

Usability Evaluation of Access Ramps in Transit Buses: Preliminary Findings

The research literature on access ramps used in transit vehicles is undermined by inconsistent methodologies used across studies, thus providing an inconclusive evidence base for proposed Federal guidelines that would impose a maximum 1:6 slope for all deployment situations. The current study assessed the usability of ramp slope for mobility aid users. Four access ramp slopes were evaluated, with 27 adults representing three populations: manual wheelchair users, power wheelchair users, and people with vision impairment who use a cane or service animal. The dependent variables included five usability measures. The 1:8 and 1:12 slopes were usable and acceptable for most participants. The data indicate that the 1:4 slope is too steep for safe unassisted boarding and disembarking. Many manual wheelchair users lacked the strength needed for unassisted ascent. Power wheelchair users and people with vision impairment expressed safety concerns about descent of steeper slopes. Conclusive interpretations should be cautiously drawn because the sample size was relatively small and did not include users of scooters or ambulation aids

Efficacy Of 4 Irrigation Protocols In Killing Bacteria Colonized In Dentinal Tubules Examined By A Novel Confocal Laser Scanning Microscope Analysis

Introduction: The aim of this study was to determine the efficiency of 4 irrigation systems in eliminating bacteria in root canals, particularly in dentinal tubules. Methods: Roots of human teeth were prepared to 25/04, autoclaved, and inoculated with Enterococcus faecalis for 3 weeks. Canals were then disinfected by (1) standard needle irrigation, (2) sonically agitating with EndoActivator, (3) XP Endo finisher, or (4) erbium:yttrium aluminum garnet laser (PIPS) (15 roots/group). The bacterial reduction in the canal was determined by MTT assays. For measuring live versus dead bacteria in the dentinal tubules (4 teeth/group), teeth were split open and stained with LIVE/DEAD BackLight. Coronal, middle, and apical thirds of the canal dentin were scanned by using a confocal laser scanning microscope (CLSM) to determine the ratio of dead/total bacteria in the dentinal tubules at various depths. Results: All 4 irrigation protocols significantly eliminated bacteria in the canal, ranging from 89.6% to 98.2% reduction (P < .001). XP Endo had the greatest bacterial reduction compared with other 3 techniques (P < .05). CLSM analysis showed that XP Endo had the highest level of dead bacteria in the Coronal, middle, and apical segments at 50-mu m depth. On the other hand, PIPS had the greatest bacterial killing efficiency at the 150-mu m depth in all 3 root segments. Conclusions: XP Endo appears to be more efficient than other 3 techniques in disinfecting the main canal space and up to 50 Am deep into the dentinal tubules. PIPS appears to be most effective in killing the bacteria deep in the dentinal tubules.Wo