Non-melanoma skin cancer of the external auditory canal: long-term outcomes of a tertiary head and neck unit.

Purpose: External auditory canal (EAC) skin cancer is often diagnosed at advanced stages, leading to poor survival outcomes. Our study aims to describe disease characteristics, treatments and outcomes of patients with EAC cancer, increasing understanding of the management of this rare disease.

Methods: Retrospective, observational study including patients with non-melanoma EAC skin cancer treated at Guy's and St Thomas' Head and Neck Unit from 2012 to 2021, with follow-up until October 2023.

Dissociation Without Detonation: A DFT Analysis of the Thermally Induced Fragmentation of Binary Sulfur-Nitrogen Rings and Cages.

Potential thermal dissociation pathways available to binary sulfur nitrides have been explored by density functional theory methods, and the results interpreted in terms of their known thermochemical behavior. The cyclic cation/anion pair SN both undergo concerted (4 + 2) cycloreversions to afford the 3-membered thiadiazirine ring -NSN and, respectively, the SNS cation/anions. A similar pathway has been identified for SN, leading to S and -NSN.

Correction of the Manubriosternal Angle: The Missing Link in the Diagnosis and Management of Anterior Chest Wall "Pectus" Deformities.

A normal manubriosternal angle (MSA) varies between 157 and 161 degrees, and it is either increased (in pectus carinatum) or decreased (in pectus excavatum). Measurements of the MSA can accurately define the severity of both deformities and gauge the degree of response to therapeutic intervention(s). Correction of the MSA during repair of pectus deformity by complete upper transverse sternotomy seems necessary.

Seroprevalence and risk factors for Q fever and Rift Valley fever in pastoralists and their livestock in Afar, Ethiopia: A One Health approach.

Background: Coxiella burnetii, the causative agent of Q fever, and Rift Valley fever virus are two under-researched zoonotic pathogens in Ethiopia. Potential outbreaks of these diseases, in light of the high dependency of nomadic pastoralists on their livestock, poses a risk to both human and animal health in addition to risking the pastoralists livelihoods. Our study aimed to determine the seroprevalence and associated risk factors for Q fever and Rift Valley fever in pastoral communities in the Afar region of north-eastern Ethiopia.

Setting up a nurse-led 2-week-wait head and neck cancer diagnostic service.

The number of urgent '2-week-wait' referrals to hospital for people with suspected head and neck cancer being sent by primary care is constantly growing and it is becoming increasingly difficult for head and neck cancer services to meet this demand. In order for trusts to meet their Faster Diagnosis Standards, there needs to be an effective and efficient way to ensure there is capacity for patients to receive the appropriate assessments and diagnostic investigations without compromising the quality of care delivered. This article presents the proposal of introducing a nurse-led 2-week-wait clinic to meet the ever-growing demands on the service.

Status of zoonotic disease research in refugees, asylum seekers and internally displaced people, globally: A scoping review of forty clinically important zoonotic pathogens.

Background: At the end of 2022, there were over 108 million forcibly displaced people globally, including refugees, asylum seekers (AS) and internally displaced people (IDPs). Forced migration increases the risk of infectious disease transmission, and zoonotic pathogens account for 61% of emerging and re-emerging infectious diseases. Zoonoses create a high burden of disease and have the potential to cause large-scale outbreaks.

Cardiac GR Mediates the Diurnal Rhythm in Ventricular Arrhythmia Susceptibility.

Background: Ventricular arrhythmias (VAs) demonstrate a prominent day-night rhythm, commonly presenting in the morning. Transcriptional rhythms in cardiac ion channels accompany this phenomenon, but their role in the morning vulnerability to VAs and the underlying mechanisms are not understood. We investigated the recruitment of transcription factors that underpins transcriptional rhythms in ion channels and assessed whether this mechanism was pertinent to the heart's intrinsic diurnal susceptibility to VA.

Outlier detection of vital sign trajectories from COVID-19 patients.

In this work, we present a novel trajectory comparison algorithm to identify abnormal vital sign trends, with the aim of improving recognition of deteriorating health.There is growing interest in continuous wearable vital sign sensors for monitoring patients remotely at home. These monitors are usually coupled to an alerting system, which is triggered when vital sign measurements fall outside a predefined normal range.

Seroprevalence of Coxiella burnetii in an Indigenous Population from the Sierra Nevada De Santa Marta, Colombia.

Coxiella burnetii is an underreported zoonotic pathogen in many rural regions globally. We investigated C. burnetii exposure in a remote indigenous tribe residing in the Sierra Nevada de Santa Marta, Colombia.

Impaired glucocorticoid receptor function attenuates herpes simplex virus 1 production during explant-induced reactivation from latency in female mice.

A correlation exists between stress and increased episodes of human alpha-herpes virus 1 reactivation from latency. Stress increases corticosteroid levels; consequently, the glucocorticoid receptor (GR) is activated. Recent studies concluded that a GR agonist, but not an antagonist, accelerates productive infection and reactivation from latency.

Structures and Spectroscopic Properties of Polysulfide Radical Anions: A Theoretical Perspective.

The potential involvement of polysulfide radical anions S is a recurring theme in discussions of the basic and applied chemistry of elemental sulfur. However, while the spectroscopic features for = 2 and 3 are well-established, information on the structures and optical characteristics of the larger congeners ( = 4-8) is sparse. To aid identification of these ephemeral species we have performed PCM-corrected DFT calculations to establish the preferred geometries for S ( = 4-8) in the polar media in which they are typically generated.

The impact of 2 weeks wait referral on survival of head and neck cancer patients.

Purpose: This study aims to evaluate the association between 2 weeks wait referral and survival in the head and neck cancer.

Methods: Retrospective cohort study of consecutively discussed new head and neck cancer patients at large United Kingdom Cancer Alliance including two tertiary referral hospitals and two district general hospital.

Results: A total of 276 cancer patients were included for analysis.

Glucocorticoid Receptors Drive Breast Cancer Cell Migration and Metabolic Reprogramming via PDK4.

Corticosteroids act on the glucocorticoid receptor (GR; NR3C1) to resolve inflammation and are routinely prescribed to breast cancer patients undergoing chemotherapy treatment to alleviate side effects. Triple-negative breast cancers (TNBCs) account for 15% to 20% of diagnoses and lack expression of estrogen and progesterone receptors as well as amplified HER2, but they often express high GR levels. GR is a mediator of TNBC progression to advanced metastatic disease; however, the mechanisms underpinning this transition to more aggressive behavior remain elusive.

Water soluble swallow for leak detection after total laryngectomy post radiotherapy.

Aim: Pharyngeal leak (PL) and pharyngocutaneous fistula (PCF) are serious complications following total laryngectomy and their incidence is higher in the salvage setting. The aim of this study is to describe the accuracy of water soluble swallow (WSS) to rule out salivary postoperative leak after salvage total laryngectomy (STL) to expedite start of oral intake.

Material And Methods: Retrospective study including patients undergoing STL between 2008 and 2021 at Guy's Hospital.

Respiratory strategy at birth initiates distinct lung injury phenotypes in the preterm lamb lung.

Background: A lack of clear trial evidence often hampers clinical decision-making during support of the preterm lung at birth. Protein biomarkers have been used to define acute lung injury phenotypes and improve patient selection for specific interventions in adult respiratory distress syndrome. The objective of the study was to use proteomics to provide a deeper biological understanding of acute lung injury phenotypes resulting from different aeration strategies at birth in the preterm lung.

Vancomycin-resistant Enterococcus outbreak in a pre- and post-cardiothoracic transplant population: Impact of discontinuing multidrug-resistant organism surveillance during the coronavirus disease 2019 pandemic.

Introduction: Many institutions suspended surveillance and contact precautions for multidrug-resistant organisms (MDROs) at the outset of the coronavirus disease 2019 (COVID-19) pandemic due to a lack of resources. Once our institution reinstated surveillance in September 2020, a vancomycin-resistant Enterococcus (VRE) faecium outbreak was detected in the cardiothoracic transplant units, a population in which we had not previously detected outbreaks.

Methods: An outbreak investigation was conducted using pulsed-field gel electrophoresis for strain typing and electronic medical record review to determine the clinical characteristics of involved patients.

Case report: Changes in the levels of stress hormones during Takotsubo syndrome.

Background: Takotsubo syndrome is an acute cardiac condition usually involving abnormal regional left ventricular wall motion and impaired left ventricular contractility. It is due mainly to hyper-stimulation of the sympathetic nerve system, inducing an excess of catecholamines, usually triggered by intense psychological or physiological stress. The relationship between Takotsubo syndrome and the circulating stress hormones cortisol and copeptin (a surrogate marker of arginine vasopressin) has not been well documented.

Patterns of neck metastasis and occult neck disease during recurrent laryngeal cancer.

Objective: Numerous factors are considered to impact on the rate of complications during salvage total laryngectomy procedures. Neck dissection could be one of these factors. This study analysed the pattern of lymph node metastasis and rate of occult neck disease during salvage total laryngectomy as well as the impact of neck dissection on survival and complication rates.