Τετάρτη 7 Ιουνίου 2017
Within-Bolus Variability of the Penetration-Aspiration Scale Across Two Subsequent Swallows in Patients with Head and Neck Cancer
Abstract
To compare two consecutive swallowing attempts to study if there is a difference in Rosenbek’s penetration-aspiration scale (PAS) scores between the first and second swallowing attempt of the same bolus type in videofluoroscopic examination of swallowing (VFS). Additional aims include reflecting on which bolus sizes and consistencies are the most relevant to include in further studies for head and neck cancer (HNC) patients. The VFS for 38 patients curatively treated for HNC was studied. All included patients showed swallowing difficulties (PAS ≥ 2). The examination protocol included two swallows each of six different boluses: 3, 5, 10, 20 ml thin, 5 ml mildly thick, and 3 ml of extremely thick liquid. All boluses were compared between the first and second swallowing attempt with regard to PAS scores. No statistically significant differences in PAS were found between the first and second swallow for any of the boluses in this study on group level. For 20 ml thin and 3 ml extremely thick liquid, there were low Intra-Class Correlations, indicating a low within-bolus agreement. The greatest within-bolus differences were found for 20 ml thin, 5 ml mildly thick and 3 ml extremely thick liquid, which demonstrated high intra-individual coefficient of variation (0.458–0.759). The data of this study show a high within-bolus variability of the PAS score between two subsequent swallows for all different consistencies. In order to assess swallowing safety, the highest PAS score for each bolus type is suggested for use in studies of HNC patients.
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An international survey about nail histology processing techniques
Abstract
Background
There is limited data on nail histopathology techniques. The objective of this study was to examine nail histopathology techniques currently in use internationally.
Methods
An online survey was sent to the European Nail Society and Council for Nail Disorders during 2015–16.
Results
There were fifty seven respondents, from twenty countries comprising dermatologists, podiatrists and pathologists.
Specimens were unmarked or marked using ink or a suture and fixed in 10% formalin, from 6 to 48 hours before embedding in paraffin wax (90% (17/19), liquid nitrogen (frozen section, 1/19) and 2-hydroxyethylmethacrylate (plastic, 1/19).
Nail softening was undertaken by 71% (17/24) of respondents for 6 to 48 hours using Mollifex Gurr (12.5%, 3/24), 10% potassium hydroxide solution (12.5%, 3/24) or 10% potassium thioglycolate cream (12.5%, 3/24).
Sections thickness was 4-9 µm (62.5%), using a steel microtome (92%,12/13) on glass slides (91.6%, 11/12).
Hematoxylin and eosin (H&E) was routine for all biopsies and Periodic acid Schiff (PAS) (100%,15/15) for fungus The favored stain for differentiating melanin and hemoglobin was Fontana-Masson (60%, 6/10). For pigmented lesions, Melan-A was always employed by all respondents (9/9).
Conclusion
Nail histopathology processing has some small variations from normal skin processing.
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Cutaneous Malignancies Simulating Seborrheic Keratoses: An Underappreciated Phenomenon?
ABSTRACT
Background
Seborrheic keratosis (SK), a common and benign entity, is generally diagnosed clinically without the need for a biopsy. Given their variable appearance, SK may mimic cancer clinically and require biopsy for clinically equivocal cases. A clinician may also choose to perform biopsies on SK based on other circumstances, such as cosmetic reasons, or SK being in an inconvenient and irritative location.
Methods
Dermatopathology samples from 2015 obtained from private and university locations were retrospectively assessed. Cases included in the study were those with “SK” or “ISK” (irritated seborrheic keratosis) and no other diagnosis in the clinical data. Cases with modifiers suggestive of malignancy such as “SK rule out others,” changing, growing, etc. were excluded. A total of 4361 eligible cases were identified and used for analysis.
Results
Of the 4361 cases identified as only “SK” or “ISK” in the clinical data, 3759 (86.2%) were, in fact, SK or ISK. 466 (10.7%) were an assortment of non-malignancy diagnoses such as dermatofibroma. There were 136 (3.1%) cases histologically diagnosed as malignancies. The majority (9/136 cases; 67%) were in situ or invasive squamous cell carcinoma; 24.3% (33/136) were basal cell carcinoma, and 8.8% (12/136) were melanoma.
Conclusions
SK may mimic cancer even in clinically unsuspicious cases.
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