Neoadjuvant treatment response in negative nodes is an important prognosticator after esophagectomy.

Background: The current American Joint Committee on Cancer Seventh Edition (AJCC7) pathologic staging for esophageal adenocarcinoma (EAC) is derived from data assessing the outcomes of patients having undergone esophagectomy without neoadjuvant treatment and has unclear significance in patients who have received multimodality therapy. Lymph nodes with evidence of neoadjuvant treatment effect without residual cancer cells may be observed and are not traditionally considered in pathologic reports, but may have prognostic significance.

Methods: All patients who underwent esophagectomy after completing neoadjuvant therapy for EAC at our institution between 2006 and 2012 were reviewed.

Caffeine reduces cerebral blood flow in patients recovering from an ischaemic stroke.

Background: Caffeine is present in a variety of beverages and food and is widely consumed. In a previous study of patients recovering from an acute ischaemic stroke using transcranial Doppler ultrasound we demonstrated a fall in middle cerebral artery blood velocity of 12% following ingestion of 250 mg caffeine. The aim of this study was to investigate if this velocity change reflected a change in cerebral blood flow.

Assessing dynamic cerebral autoregulation after stroke using a novel technique of combining transcranial Doppler ultrasonography and rhythmic handgrip.

Objectives: Dynamic cerebral autoregulation (CA) is impaired after stroke. Methods employed to assess this phenomenon usually involve deliberate alterations in blood pressure (BP) by physical means. We performed a pilot study to assess dynamic CA in acute stroke patients using a novel technique of combining transcranial Doppler (TCD) ultrasonography with rhythmic handgrip.

Measuring caffeine-induced changes in middle cerebral artery blood velocity using transcranial Doppler in patients recovering from ischaemic stroke.

Acute ingestion of caffeine is known to reduce cerebral blood flow in normal volunteers and in certain patient groups. There is no evidence that this causes problems in the normal population. However, there may be implications if a similar reduction occurs in patients recovering from an ischaemic stroke, in whom local blood flow has already been reduced.