These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the

/pdf/clinical-practice-guidelines-for-antimicrobial-prophylaxis-1gq1adk8ux.pdf

Clinical practice guidelines for antimicrobial prophylaxis in surgery

Current medical imaging technologies allow visualization of tissue anatomy in the human body at resolutions ranging from 100 micrometers to 1 millimeter. These technologies are generally not sensitive enough to detect early-stage tissue abnormalities associated with diseases such as cancer and atherosclerosis, which require micrometer-scale resolution. Here, optical coherence tomography was adapted to allow high-speed visualization of tissue in a living animal with a catheter-endoscope 1 millimeter in diameter. This method, referred to as "optical biopsy," was used to obtain cross-sectional images of the rabbit gastrointestinal and respiratory tracts at 10-micrometer resolution.

In Vivo Endoscopic Optical Biopsy with Optical Coherence Tomography

Far from being simple degradative enzymes, proteases are now seen as key signalling molecules and desirable drug targets in several diseases. Turk discusses our success so far at targeting proteases and how these enzymes might be exploited therapeutically in the future. Until fairly recently, proteases were considered primarily to be protein-degrading enzymes. However, this view has dramatically changed and proteases are now seen as extremely important signalling molecules that are involved in numerous vital processes. Protease signalling pathways are strictly regulated, and the dysregulation of protease activity can lead to pathologies such as cardiovascular and inflammatory diseases, cancer, osteoporosis and neurological disorders. Several small-molecule drugs targeting proteases are already on the market and many more are in development. The status of human protease research and prospects for future protease-targeted drugs are reviewed here, with reference to some key examples where protease drugs have succeeded or failed.

Targeting proteases: successes, failures and future prospects.

/pdf/clinical-practice-guidelines-for-antimicrobial-prophylaxis-yxd0y9e4ks.pdf

Clinical practice guidelines for antimicrobial prophylaxis in surgery.

Carotenoids constitute a ubiquitous group of isoprenoid pigments. They are very efficient physical quenchers of singlet oxygen and scavengers of other reactive oxygen species. Carotenoids can also act as chemical quenchers undergoing irreversible oxygenation. The molecular mechanisms underlying these reactions are still not fully understood, especially in the context of the anti- and pro-oxidant activity of carotenoids, which, although not synthesized by humans and animals, are also present in their blood and tissues, contributing to a number of biochemical processes. The antioxidant potential of carotenoids is of particular significance to human health, due to the fact that losing antioxidant-reactive oxygen species balance results in “oxidative stress”, a critical factor of the pathogenic processes of various chronic disorders. Data coming from epidemiological studies and clinical trials strongly support the observation that adequate carotenoid supplementation may significantly reduce the risk of several disorders mediated by reactive oxygen species. Here, we would like to highlight the beneficial (protective) effects of dietary carotenoid intake in exemplary widespread modern civilization diseases, i.e., cancer, cardiovascular or photosensitivity disorders, in the context of carotenoids’ unique antioxidative properties.

https://www.mdpi.com/2072-6643/6/2/466/pdf

Potential role of carotenoids as antioxidants in human health and disease.

The goal of this study was to develop a deep neural network (DNN) for predicting surgical/medical complications and unplanned reoperations following thyroidectomy.

Artificial neural network prediction of post‐thyroidectomy outcome

OBJECTIVES
To analyze the variant-specific survival benefits and usage patterns of standardized treatment combinations of surgery (S), radioactive iodine ablation (RAI), and thyroid-stimulating hormone suppression therapy (THST) for high-risk differentiated thyroid cancer.


STUDY DESIGN
Retrospective cohort study.


SETTING
National Cancer Database.


METHODS
The 2004-2017 National Cancer Database was queried for patients receiving definitive surgery for high-risk papillary, follicular, or Hurthle cell thyroid cancer. Cox proportional hazards and Kaplan-Meier analyses assessed for treatment-associated survival.


RESULTS
Of 21,076 cases, 18,214 underwent survival analysis with a mean ± SD age of 50.6 ± 17.1 years (71.3% female). When compared with surgery alone, S + RAI was associated with reduced mortality in papillary (hazard ratio [HR], 0.574; P < .001) and follicular (HR, 0.489; P = .004) thyroid cancer. S + RAI + THST was associated with reduced mortality in papillary (HR, 0.514; P < .001), follicular (HR, 0.602; P = .016), and Hurthle cell (HR, 0.504; P = .021) thyroid cancer. In papillary thyroid cancer, S + RAI (91.3%), S + THST (89.2%), and S + RAI + THST (92.7%) were associated with higher 5-year overall survival rates than surgery (85.4%, all P < .001). Papillary thyroid cancer treatments involving THST were associated with higher 5-year overall survival rates than corresponding regimens without THST (all P < .001). In follicular thyroid cancer, S + RAI (73.9%) and S + RAI + THST (78.7%) were associated with higher 5-year overall survival rates than surgery (65.6%, all P < .05). In Hurthle cell thyroid cancer, S + RAI (66.5%) and S + RAI + THST (73.4%) were associated with higher 5-year overall survival rates than surgery (53.7%, all P < .05). On linear regression, THST usage increased by 77.5% (R2 = 0.944, P < .001), while RAI usage declined by 11.3% (R2 = 0.320, P = .035).


CONCLUSIONS
High-risk differentiated thyroid cancer exhibited varying susceptibilities to different treatment combinations depending on histology, with greatest responses to regimens that included RAI. Physician practices have trended toward decreased RAI and increased THST usage.

Outcomes and Trends of Treatments in High-Risk Differentiated Thyroid Cancer.

This chapter will cover the fundamentals of endoscopy in otolaryngology, beginning with a history of the substantial progress that has been made since endoscopy was first developed in the 1800s, followed by a brief overview of the anatomy of the upper aerodigestive tract, and concluding with a discussion of contemporary office-based and surgical endoscopic practices. Knowledge of the fundamentals of endoscopy both in the office and the operating room is critical to understanding our current capabilities for visualizing and manipulating structures within the upper aerodigestive tract.

Practical Endoscopy for Laser Interventions of the Upper Aerodigestive Tract

PurposeFor patients without pathological evidence of cervical disease after neck dissection for cutaneous squamous cell carcinoma involving the parotid region, inclusion of the ipsilateral cervical neck in the post-parotidectomy radiation volume is routinely performed. We report our experience with selective avoidance of the ipsilateral neck for patients undergoing postoperative radiation to the parotid bed.Methods and MaterialsFrom January 2014 to December 2023, a total of 30 consecutive patients underwent postoperative radiation after parotidectomy for cutaneous squamous cell carcinoma involving the parotid area. All patients had previously had a neck dissection confirming pathological N0 disease. Treatment was delivered using intensity-modulated radiotherapy to a median dose of 60 Gy (range, 56 to 66 Gy). The radiation target volumes included the parotid bed only, with deliberate avoidance of the ipsilateral cervical neck. The median pathologic tumor size of the parotid tumor was 3.3 cm (range, 0.2 to 9.4 cm). Final pathologic evaluation showed positive microscopic margins in 8 patients (27%), perineural invasion in 17 patients (57%), and facial nerve involvement in 6 patients (20%).ResultsThere were no isolated nodal failures. One patient developed an ipsilateral neck recurrence at approximately 8 months after completion of radiation therapy. This occurred 2 months subsequent to the development of local recurrence. The 5-year actuarial rates of local (parotid) control, neck control, and overall survival were 87%, 97%, and 76%, respectively.ConclusionOmission of the ipsilateral neck from the parotid volume does not compromise disease control for pathologically N0 patients undergoing postoperative radiation for cutaneous squamous cell carcinoma involving the parotid region. Practical implications are discussed. 

http://www.advancesradonc.org/article/S2452109423001343/pdf

Refining Target Volume Coverage after Parotidectomy for Cutaneous Squamous Cell Carcinoma: Omission of the Cervical Neck from the Radiation Field

Practical Radiation Oncology (2017) 7, 100-102 www.practicalradonc.org Teaching Case Recurrent squamous cell carcinoma involving cranial nerves in a patient with left glottic carcinoma treated with definitive radiation therapy: A case report Kunal Sindhu BA a , William Armstrong MD b , Anton Hasso MD c , Ted Farzaneh MD d , Parima Daroui MD, PhD e, ⁎ a Warren Alpert School of Medicine, Brown University, Providence, Rhode Island Department of Otolaryngology, Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, California c Department of Radiology, Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, California d Department of Pathology, Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, California e Department of Radiation Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, California b Received 19 September 2016; revised 4 November 2016; accepted 10 November 2016 Introduction Side effects from definitive radiation therapy in patients with cancers of the head and neck are not uncommon. Controlling the acute side effects of treatment, including mucositis, xerostomia, dysphagia, and dysphonia, is of the utmost necessity because these symptoms are potentially debilitating and may jeopardize patients’ adherence to treatment regimens. In the longer term, persistent xeros- tomia, difficulties with speech and swallowing, and fibrosis have been noted in patients who have received radiation therapy. 1 Radiation-induced cranial neuritis, although rare, has also been observed and most often affects the sixth and twelfth cranial nerves. 2 When patients with a history of head or neck radiation treatment develop these symptoms, however, clinicians must maintain a wide differential diagnosis because each of these symptoms has a vast array of potential etiologies. In this report, we present a patient whose symptoms, although mirroring Conflicts of interest: None. ⁎ Corresponding author. Department of Radiation Oncology, University of California Irvine, 101 The City Drive South, Building 23, Orange, CA 92868. E-mail address: pdaroui@uci.edu (P. Daroui). some of those known to be long-term consequences of radiation therapy, were instead found to be a manifestation of a recurrence of squamous cell carcinoma (SCC) limited to the cranial nerve tract. Case report A 53-year-old man with a 50 pack-year smoking history initially presented to his primary care physician with nasal congestion and otalgia. Two months later, after antibiotics failed to ameliorate these symptoms, he developed progressive hoarseness and throat discomfort. Flexible fiberoptic laryngoscopy (FFL) performed by a specialist revealed an exophytic, left true vocal cord lesion. The patient was then referred to our institution, where a repeat FFL showed mucosal irregularity of the left true vocal cord in the context of otherwise symmetrically mobile vocal cords. Computed tomography scans of the neck demonstrated irregularity and thickening of the left true vocal cord with obscuration of the laryngeal ventricle. Microdirect laryngoscopy with partial excision of the left true vocal cord mass was performed to acquire tissue. A 10-mm mass along the superior surface of the left true http://dx.doi.org/10.1016/j.prro.2016.11.004 1879-8500/© 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

https://escholarship.org/content/qt36c3n14r/qt36c3n14r.pdf?t=oubarb

Recurrent squamous cell carcinoma involving cranial nerves in a patient with left glottic carcinoma treated with definitive radiation therapy: A case report.

William B. Armstrong

Papers

Artificial neural network prediction of post‐thyroidectomy outcome

Outcomes and Trends of Treatments in High-Risk Differentiated Thyroid Cancer.

Practical Endoscopy for Laser Interventions of the Upper Aerodigestive Tract

Refining Target Volume Coverage after Parotidectomy for Cutaneous Squamous Cell Carcinoma: Omission of the Cervical Neck from the Radiation Field

Recurrent squamous cell carcinoma involving cranial nerves in a patient with left glottic carcinoma treated with definitive radiation therapy: A case report.