Predicting cisplatin tolerability in older adults with head and neck cancer - Insights for improved chemoradiation outcomes.

Purpose: Cumulative cisplatin doses of ≥ 200 mg/m improve survival in adults with head-and-neck squamous cell carcinoma (HNSCC) undergoing chemoradiation, but many older adults with HNSCC cannot receive this prognostically relevant dose due to toxicities. This study aims to develop predictive models to assess the likelihood of older adults with HNSCC receiving ≥ 200 mg/m cisplatin during chemoradiation.

Methods: 366 patients from the SENIOR database, an international cohort of adults ≥ 65 years with HNSCC, received definitive chemoradiation with single-agent cisplatin and were analyzed.

Ventilation-Perfusion Mismatch in a Patient With an Arteriovenous Fistula and Underlying Pulmonary Parenchymal Disease.

Many causes can result in hypoxia. We describe an interesting case of a patient with an arteriovenous fistula who had worsening hypoxia initially attributed to progression of chronic obstructive pulmonary disease and heart failure. However, after a meticulous workup, we found an interplay of complex yet common factors contributing to hypoxia.

Paraspinal ultrasonography: lack of accuracy in evaluating patients with cervical or lumbar back pain.

This study evaluates the ability of paraspinal ultrasonography to identify abnormal echogenicity in patients with cervical or lumbar back pain, or both. Paraspinal ultrasonography was performed on 82 subjects, including 23 asymptomatic controls. Echogenicity in the region of nerve roots and facets was assessed.

Brainstem auditory evoked potentials: intraoperative monitoring technique in surgery of posterior fossa tumors.

Brainstem auditory evoked potentials (BAEPs) were used to monitor eight neurosurgical procedures involving posterior fossa tumors to assist the neurosurgeon in preservation of hearing postoperatively. The technique included placement of recording electrodes over the Cz (vertex) and both earlobes. Stimulation was accomplished intraoperatively with a specifically designed intraauricular click stimulator that did not interfere with surgical access to the suboccipital region.