Two- vs three-drug combination chemotherapy in advanced or recurrent head and neck cancer: a single institution experience of 361 patients.

Head and neck squamous cancer is a major concern in India. The proportion of advanced cases is significantly high, and these patients have dismal survival prospects despite aggressive therapy. Often surgical resection and/or radiotherapy are not feasible in these patients.

Measuring medical burden using CIRS in older veterans enrolled in UPBEAT, a psychogeriatric treatment program: a pilot study.

Background: A quantitative measure of medical burden is needed to assess medical comorbidities in psychogeriatric patients. The Cumulative Illness Rating Scale (CIRS) is the most widely used instrument for measuring medical burden in psychogeriatric research. Many clinicians, however, are discouraged by the requirement to project the persistence of acute conditions and therefore do not use the scale.

Symptoms of depression and anxiety (MHI) following acute medical/surgical hospitalization and post-discharge psychiatric diagnoses (DSM) in 839 geriatric US veterans.

Objective: We addressed the relatively unexplored use of screening scores measuring symptoms of depression and/or anxiety to aid in identifying patients at increased risk for post-discharge DSM-IV Axis I diagnoses. We were unable to find such studies in the literature.

Method: Elderly veterans without recent psychiatric diagnoses were screened for depression and anxiety symptoms upon admission to acute medical/surgical units using the Mental Health Inventory (MHI).

Prevalence and awareness of risk factors and behaviours of coronary heart disease in an urban population of Karachi, the largest city of Pakistan: a community survey.

Objectives: To estimate the prevalence and awareness of risk factors and risk behaviours of coronary heart disease (CHD) in the lower middle class residing in urban localities of Karachi, a mega city of Pakistan.

Methods: The design consisted of a cross-sectional community based survey in the lower middle class urban localities of Karimabad, Garden and Kharardar in Karachi, Pakistan. One thousand four hundred adults (18 years and above) registered with the Aga Khan Development Network (AKDN) participated in the survey.

Upfront submandibular salivary gland transfer in pharyngeal cancers.

Head and neck irradiation results in salivary dysfunction and subsequent xerostomia. Twenty two patients with squamous cancer of oropharynx or hypopharynx underwent contralateral submandibular salivary gland transfer (SMSGT) to submental triangle to shield it from subsequent radiotherapy. Resting salivary outputs of transferred and untransferred gland (control) were measured before and after SMSGT and following radiotherapy, by cannulating individual submandibular duct.

Family income and its relation to preschool children's adjustment for families in the NICHD Study of Early Child Care.

The current study examines relations of mean-level estimates, linear changes, and instability in income and family processes to child outcomes and addresses whether income, through its impact on family functioning, matters more for children living in poverty. Temporal changes and instability in family processes, but not income, predicted children's adjustment. Cross-sectional mediational analyses indicated that for families living at the poverty threshold, family processes fully mediated the effect of average income over the study period on social behavior but only partially mediated its effect on cognitive-linguistic development.

Angiosarcoma of the pleura.

Angiosarcoma is a rare, highly malignant tumor arising from endothelial cells of small blood vessels. They usually occur in the skin, deep soft tissues, breast and liver. Pleural angiosarcomas are extremely rare and are restricted to case reports in medical literature.

Children referred to an emergency department by an after-hours call center: complaint-specific analysis.

Background And Objectives: Approximately 20% of phone calls to after-hours call centers result in referrals to the emergency department (ED), but data regarding ED management and disposition are lacking. We sought to determine the acuity of illness of referred children as reflected by triage classifications and need for therapeutic interventions, diagnostic testing, and hospitalization, and to stratify the analysis of ED management and dispositions by chief complaints.

Design And Methods: Patients referred to the ED by the after-hours call centers, without physician consultation, were identified.

Trappin ovine molecule (TOM), the ovine ortholog of elafin, is an acute phase reactant in the lung.

As large animal models continue to play an important role in translating lung-directed therapeutic strategies from laboratory animals to humans, there is an increasing interest in the analysis of endogenous regulators of inflammation at both a genomic and a therapeutic level. To this end, we have sought to characterize the ovine ortholog of elafin, an important regulator of inflammation in humans. We have isolated both the elafin cDNA and gene, which have a similar structure to other species' orthologs.

Differential gene expression identifies novel markers of CD4+ and CD8+ T cell activation following stimulation by Mycobacterium tuberculosis.

T cell activation in response to antigenic stimulation is a complex process, involving changes in the expression level of a large number of genes. We have used cDNA array technology to characterize the differences in gene expression between human CD4+ and CD8+ T cells. PBMC from six healthy donors were stimulated with live Mycobacterium tuberculosis, and the gene expression profiles of each donor's CD4+ and CD8+ T cells were analyzed separately.

Outcomes of children referred to an emergency department by an after-hours call center.

Background And Objectives: After-hours call centers are increasingly prevalent, yet there is little patient outcomes data. We sought to determine compliance with referral to an emergency department (ED) and describe outcomes and clinical characteristics of referred patients including triage classifications, therapeutic interventions, diagnostic testing, diagnoses, and hospitalization rates.

Design And Participants: A retrospective cohort design.

Postoperative cerebellar herniation in a large intrapetrous aneurysmal bone cyst.

An 18-year old boy presented with a tumour involving a large part of the petrous bone. A radical resection of a petrous bone 'aneurysmal bone cyst' was achieved. A large defect in the dura adjoining the posterior surface of the petrous bone was made during surgery.

Satisfaction with health care for young children.

Objectives: The aims of this study are to 1) assess parent satisfaction with well-child care for their young child and 2) identify how global satisfaction ratings and parent reports on the processes of care vary with child and family characteristics, health care received, and health system factors.

Methods: The National Survey of Early Childhood Health is a telephone survey that used a stratified random-digit-dial sampling design to achieve a nationally representative sample of 2068 children and 4 to 35 months. Parents provided global ratings of satisfaction with their child's well-child visits (range 0-100) and reported their satisfaction with information provided and the time spent with the provider.

Overview of the content of health supervision for young children: reports from parents and pediatricians.

Objective: To describe the content of anticipatory guidance provided to parents of infants and toddlers and to identify primary areas of unmet need as reported by both parents and pediatricians.

Methods: Parent data were obtained from the National Survey of Early Childhood Health, a nationally representative sample of parents of 2068 US children aged 4 to 35 months. Pediatrician data were obtained from the Periodic Survey of Fellows, a national survey of members of the American Academy of Pediatrics.

Two unusual lesions in the nasal cavity of infants--a nasal chondromesenchymal hamartoma and an aneurysmal bone cyst like lesion. More closely related than we think?

Benign reparative lesions in the head and neck region in infants are rare and often difficult to classify on histology. Discussed herein are two rare lesions in infants occurring at identical locations in the nasal cavity with striking histologic similarity but different histologic labels. One was a case of nasal chondromesenchymal hamartoma (NCMH) occurring in a 1-year-old child and the other an aneurysmal bone cyst (ABC) like lesion affecting a 4-month infant.

Masquerade syndrome: sebaceous carcinoma presenting as an unknown primary with pagetoid spread to the nasal cavity.

Sebaceous carcinoma of the eyelid is an uncommon tumour with unusual modes of presentation. It can remain occult at the primary site, without producing any mass, masquerading as chronic blepharoconjunctivitis, while setting up metastases in the regional lymph nodes especially in the pre-auricular group. We report here a case that not only masqueraded as chronic blepharoconjunctivitis with nodal metastases from an 'unknown primary' in the neck, but whose tumour spread in a pagetoid manner along the nasolacrimal duct producing a nasal tumour that was believed to be the 'unknown primary'.