The incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is rising in the West, but little is known in Asia. This study elucidated changes in the incidence ...and HPV-positive portion of OPSCC in Hong Kong. Data from population-based cancer registry were used to analyze the incidence of OPSCC in association with other head and neck cancers. Archived tumor tissues were tested for HPV. From 1986 to 2020, there was a marked decrease in the incidence of nasopharyngeal and laryngeal cancers, but a persistent increase in OPSCC from 36 cases in 1986 to 116 cases in 2020. The average positive rate for high-risk HPV was 36.1% (112/310) among OPSCC diagnosed in 2010-2020. The HPV-positive rate in recent years was significantly higher than earlier cases (tonsil SCC: 64.7% (55/85) in 2016-2020 vs. 40.4% (19/47) in 2010-2015,
= 0.007). Patients with HPV-positive tonsil cancers were significantly younger than those negative (mean SD: 58.9 9.9 vs. 64.3 13.3 years,
= 0.006), but no significant difference was observed between genders. A persistent increase in the incidence of oropharyngeal cancer over the last few decades was observed in Hong Kong, which can be explained by the remarkable increase in HPV-positive tonsil cancers.
In this report, we describe a case of a 5-year-old girl with poor growth and unresolving pneumonia. Bronchoscopy showed numerous endobronchial mucosal nodules, consisting of dense lymphoid ...infiltrates. Bacterial culture of the nodule biopsy suggested endobronchial actinomycosis. Genetic test confirmed the diagnosis of APDS.
The cost of treatment for rare diseases is notoriously high imposing threats to the global healthcare system. Existing market-based tools for orphan drugs are not designed to reduce drug prices and ...could be hampered by adverse selection. We propose an alternative insurance mechanism, Massive Group Insurance (MGI), which aims at reducing the prices of orphan drugs through offering separate Intellectual Property Right (IPR) Fees to the drug company from an MGI Agency, which will collect insurance premiums from each country on each orphan drug that the country wants all its citizens to enjoy access to. The premiums will be calculated so as to ensure that the drug company will collect a profit no smaller than what it enjoys under the traditional model. The plan uses the group insurance concept and will generate a significant increase in drug use. Blockchain technology is used to facilitate authentication and effective IPR payments and ensure data security and low administrative cost. This model can potentially be extended to other categories of expensive drugs and vaccines.
Radiation-induced sarcoma in spine Kam, Lok Sang; Anthony, Marina Portia; Shek, H
Polish journal of radiology
78, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Although radiotherapy is a part of treatment in cancers, it can also induce malignancy as a late complication. The presence of radiation-induced sarcomas in bone, although not very common, is ...acknowledged. The onset of radiation-induced sarcoma in the spine however, is not well recognized. We present here a case of radiation-induced fibrosarcoma in the T1 lamina and spinous process in a patient with a history of breast cancer treated with radiotherapy 30 years prior.
While foot orthoses are commonly used in running, little is known regarding biomechanical risk potentials during uphill running. This study investigated the effects of arch-support orthoses on ...kinetic and kinematic variables when running at different inclinations. Sixteen male participants ran at different inclinations (0°, 3° and 6°) when wearing arch-support and flat orthoses on an instrumented treadmill. Arch-support orthoses induced longer contact time, larger initial ankle dorsiflexion, maximum ankle eversion, and knee sagittal range of motion (RoM) (p < 0.05). As incline slopes increased, vertical impact peak and loading rate, stride length, and ankle coronal RoM decreased, but contact time, stride frequency, initial ankle dorsiflexion and inversion, maximum dorsiflexion, initial knee flexion, and ankle sagittal RoM increased (p < 0.05). Furthermore, knee sagittal RoM was lowest when running at an inclination of 3°. The interaction effect indicated that in arch-support condition, participants running at 6° induced higher maximum ankle eversion than running at 0° (p < 0.05), while no differences were found in flat orthosis condition. These findings suggest that the use of arch-support orthoses would influence running biomechanics that is related to injury risks. Running at higher inclination led to more alterations to biomechanical variables than at lower inclination.
A comprehensive quality assurance (QA) device cum program was developed for the commissioning and routine testing of the 6D IGRT systems. In this article, both the new QA system and the BrainLAB IGRT ...system which was added onto a Varian Clinac were evaluated. A novel compound 6D‐offset simulating phantom was designed and fabricated in the Prince of Wales Hospital (PWH), Hong Kong. The QA program generated random compound 6D‐offset values. The 6D phantom was simply set up and shifted accordingly. The BrainLAB ExacTrac X‐ray IGRT system detected the offsets and then corrected the phantom position automatically through the robotic couch. Routine QA works facilitated data analyses of the detection errors, the correction errors, and the correlations. Fifty sets of data acquired in 2011 in PWH were thoroughly analyzed. The 6D component detection errors and correction errors of the IGRT system were all within ±1mm and ±1° individually. Translational and rotational scalar resultant errors were found to be 0.50±0.27mmand0.54±0.23°, respectively. Most individual component errors were shown to be independent of their original offset values. The system characteristics were locally established. The BrainLAB 6D IGRT system added onto a regular linac is sufficiently precise for stereotactic RT This new QA methodology is competent to assure the IGRT system overall integrity. Annual grand analyses are recommended to check local system consistency and for external cross‐comparison. The target expansion policy of 1.5 mm 3D margin from CTV to PTV is confirmed for this IGRT system currently in PWH.
PACS numbers: 87.53.Ly, 87.55.Gh, 87.55.Qr, 87.56.Fc
BACKGROUNDCetuximab in combination with oral fluoropyrimidine (FP) remains controversial in metastatic colorectal cancer (mCRC). In view of the regional variation in the tolerability of FP, we ...conducted a retrospective analysis to compare oral FP with infusional FP in combination with cetuximab in Chinese population. AIMTo compare the efficacy and safety profile of cetuximab in combination with oral FP and infusional FP in Chinese population in the real-world setting. METHODSA retrospective cohort study was done to analyse consecutive patients with Kras wild-type mCRC who received first-line treatment with cetuximab and FP-based chemotherapy in our unit from January 2010 to December 2015. Ninety-five eligible patients were included. The median follow-up of our cohort was 65.0 mo. RESULTSThe median progression-free survival (mPFS) and median overall survival (mOS) of the entire cohort were 9.66 mo (95%CI: 7.72-12.5) and 25.8 mo (95%CI: 18.7-35.6), respectively. Between oral FP and infusional FP, there was no statistical significant difference in the mPFS 9.79 mo (95%CI: 7.49-12.7) vs 9.63 mo (95%CI: 6.34-13.4); P = 0.72 and mOS 25.8 mo (95%CI: 15.2-35.6) vs 26.3 mo (95%CI: 18.7-41.2); P = 0.63. Grade 3 or above adverse events were reported in 28.4% of patients, being similar with oral and infusional FP, and included 10.5% of neutropenia and 2.1% of diarrhoea events. CONCLUSIONThe current analysis demonstrates comparable efficacy and safety profiles of cetuximab in combination with oral and infusional FP in Chinese population. The results expand treatment options for Chinese patients and invite revision of existing treatment guidelines to incorporate oral FP-based chemotherapy plus cetuximab.
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