Samhandling i praksis

U radu su opisani problemi profesionalnih glazbenika. Tema prvog poglavlja su mišićno-koštani i ţivĉano mišićni poremećaji kao najĉešći oblici poremećaja. U središnjem dijelu rada fokalna distonija kao najteţi oblik poremećaja detaljno je opisana kroz neposredno iskustvo gitarista Juraja Majstorovića. U zakljuĉku su izdvojeni savjeti i preporuke medicinskih struĉnjaka te glazbenika koji su se suoĉavali s ozljedama, odnosno s oboljenjima svojstvenim profesionalnim glazbenicima.This paper is dealing with medical problems in musicians. The first chapter describes musculosceletal disorders and sensory motor disorders as the most common forms of disorder. In central part of this paper, focal dystonia as the most difficult form of movement disorder is described through the direct case of guitarist Juraj Majstorović. In the end, there are some recommendation and helpful solutions given by medical experts and musicians who faced professional disorders

Induction chemotherapy in the treatment of nasopharyngeal carcinoma: Clinical outcomes and patterns of care

Abstract The role of induction chemotherapy in nasopharyngeal carcinoma (NPC) remains controversial. The primary aim of this study was to use the National Cancer Database to evaluate the patterns of care of induction chemotherapy in NPC and its impact on overall survival (OS). Patients with NPC from 2004 to 2014 were obtained from the NCDB. Patients were considered to have received induction chemotherapy if it was started ≥43 days before the start of RT and concurrent CRT if chemotherapy started within 21 days after the start of RT. Propensity score matching was used to control for selection bias. Cox proportional hazards model was used to determine significant predictors of OS. Logistic regression model was used to determine predictors of the use of induction chemotherapy. Significance was defined as a P value <.05. A total of 4857 patients were identified: 4041 patients (87.2%) received concurrent CRT and 816 patients (16.8%) received induction chemotherapy. The use of induction therapy remained stable between 2004 and 2014. Younger patients and those with higher T‐ and N‐stage had a higher likelihood of being treated with induction chemotherapy. The 5‐year OS in patients treated with induction chemotherapy and CRT was 66.3% vs 69.1%, respectively (P = .25). There was no difference in OS when these two groups were analyzed after propensity score matching. No differences in OS existed between these treatment groups in patients with T3‐T4N1 or TanyN2‐3 disease (P = .76). Propensity score matching also did not reveal any difference in OS in patients with T3‐T4N1 or TanyN2‐3 disease. The use of induction chemotherapy has remained stable in the last decade. In this study of patients with NPC, induction chemotherapy was not associated with improved OS compared to CRT alone

Development and testing of attachment methods for pop-up satellite archival transmitters in European eel

Background: Four methods for attaching pop-up satellite transmitters to European eel were tested in the laboratory by recording long-term tag retention, growth and survival; short-term behavioral responses; and physical damage from attachments. Results: All eels survived until they lost their tag, or until end of the six-month study. Specific growth rate did not differ between tagged fish and controls. Tag retention varied from 0% to 100% among attachment methods. A tagging method that uses the strength of the eel skin by attaching the tag to the skin at three points is recommended for ocean migration studies based on a long tag retention time, minimal behavioral reactions, negligible damage to the swimming muscle, and minimal physical damage both for fish retaining and losing the tag. Although tag retention was 50% over six months, those losing their tags still retained them for 114 to 134 days. Another method had higher tag retention (100%), but required the use of steel wires that moved upwards through the muscle over time. This method was regarded as less suitable because of a strong behavioral reaction in the first two days after tagging and damage to the swimming muscle. Results from 275 silver eels released on European coasts equipped with pop-up satellite transmitters or similarly sized pop-up data storage tags to study the ocean spawning migration indicated a large premature tag release. This was partly related to mechanical tag loss, but probably mainly to a high predation rate (>20% confirmed predations of eels with pop-up satellite transmitters). Mean time to premature tag release was 14 to 21 days (maximum nine months). Conclusions: Laboratory and field data showed that pop-up satellite transmitters attached to eels can remain attached for six to nine months, but that tag retention is a challenge. Hiding behavior in a structured habitat increased the risk of entanglement and tag loss. In ocean migration studies, consideration should be given to transportation and release off shore instead of in shallower areas where they are more likely to seek the seabed and hide in structured habitats. Behavioral reactions indicate that data recorded during the first two to three days after tagging may not reflect natural behavior.Development and testing of attachment methods for pop-up satellite archival transmitters in European eelpublishedVersio

Do environmental factors influence the movement of estuarine fish? A case study using acoustic telemetry

Telemetry methods were used to investigate the influence of selected environmental variables on the position and movement of an estuarine-dependent haemulid, the spotted grunter Pomadasys commersonnii (Lacepède 1801), in the Great Fish Estuary, South Africa. Forty individuals (263–698 mm TL) were surgically implanted with acoustic coded transmitters and manually tracked during two periods (7 February to 24 March 2003; n = 20 and 29 September to 15 November 2003; n = 20). Real-time data revealed that spotted grunter are euryhaline (0–37) and are able to tolerate large variations in turbidity (4–356 FTU) and temperature (16–30 °C). However, the fish altered their position in response to large fluctuations in salinity, temperature and turbidity, which are characteristic of tidal estuarine environments. Furthermore, tidal phase had a strong influence on the position of spotted grunter in the estuary

Do environmental factors influence the movement of estuarine fish? A case study using acoustic telemetry

Telemetry methods were used to investigate the influence of selected environmental variables on the position and movement of an estuarine-dependent haemulid, the spotted grunter Pomadasys commersonnii (Lacepède 1801), in the Great Fish Estuary, South Africa. Forty individuals (263–698 mm TL) were surgically implanted with acoustic coded transmitters and manually tracked during two periods (7 February to 24 March 2003; n = 20 and 29 September to 15 November 2003; n = 20). Real-time data revealed that spotted grunter are euryhaline (0–37) and are able to tolerate large variations in turbidity (4–356 FTU) and temperature (16–30 °C). However, the fish altered their position in response to large fluctuations in salinity, temperature and turbidity, which are characteristic of tidal estuarine environments. Furthermore, tidal phase had a strong influence on the position of spotted grunter in the estuary

Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients

BACKGROUND: This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. METHODS: From 1997–2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). RESULTS: Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. CONCLUSION: Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis

Prognostic microRNA signatures derived from The Cancer Genome Atlas for head and neck squamous cell carcinomas

Identification of novel prognostic biomarkers typically requires a large dataset which provides sufficient statistical power for discovery research. To this end, we took advantage of the high‐throughput data from The Cancer Genome Atlas (TCGA) to identify a set of prognostic biomarkers in head and neck squamous cell carcinomas (HNSCC) including oropharyngeal squamous cell carcinoma (OPSCC) and other subtypes. In this study, we analyzed miRNA‐seq data obtained from TCGA patients to identify prognostic biomarkers for OPSCC. The identified miRNAs were further tested with an independent cohort. miRNA‐seq data from TCGA was also analyzed to identify prognostic miRNAs in oral cavity squamous cell carcinoma (OSCC) and laryngeal squamous cell carcinoma (LSCC). Our study identified that miR‐193b‐3p and miR‐455‐5p were positively associated with survival, and miR‐92a‐3p and miR‐497‐5p were negatively associated with survival in OPSCC. A combined expression signature of these four miRNAs was prognostic of overall survival in OPSCC, and more importantly, this signature was validated in an independent OPSCC cohort. Furthermore, we identified four miRNAs each in OSCC and LSCC that were prognostic of survival, and combined signatures were specific for subtypes of HNSCC. A robust 4‐miRNA prognostic signature in OPSCC, as well as prognostic signatures in other subtypes of HNSCC, was developed using sequencing data from TCGA as the primary source. This demonstrates the power of using TCGA as a potential resource to develop prognostic tools for improving individualized patient care