Lacroixbynum1977

The incidence of and mortality from anal cancer, predominantly squamous cell carcinoma (SCC), have been increasing since the 1980s, during an era when many common malignancies have seen decreases in mortality. Dermatologists may be more likely to see patients at an increased risk for anal SCC, such as those living with HIV, MSM and those presenting for management of anogenital warts, yet there is little guidance in the field on how to manage these patients. We underwent a project to review the evidence surrounding screening and prevention of anal SCC. HPV vaccination, the main preventative measure for anal SCC, is often underutilized and may not be effective for those most at risk. Screening methods currently include high-risk HPV and anal cytology testing, with high-resolution anoscopy (HRA) reserved for biopsy and confirmatory testing. High-risk HPV testing has been associated with high sensitivity for intraepithelial neoplasia, but low specificity in high-risk groups. Recent meta-analyses examining AIN detection using anal cytology estimate a similarly high sensitivity of 74-87%, with a relatively higher specificity (44-66%) for identifying high-grade AIN. Selleck ABT-199 HRA is the gold standard for diagnosis, but its accessibility and cost are deterrents from its use as a screening tool. Cervical cancer screening, initially adopted without significant evidence of its impact, has significantly decreased cervical cancer rates. The argument can be made that rates of anal SCC may also benefit from appropriate screening methods, particularly anal cytology. It is prudent for dermatologists to be aware of the methods available to them in the management of at-risk patients, the data supporting them, and the potential benefits of screening in order to counsel patients appropriately and address the increasing burden of disease.

In this systematic review, we aim to identify prognostic imaging variables of recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy.

A systematic search was performed in PubMed and EMBASE (1990-2020). The crude data and effect estimates were extracted for each imaging variable. The level of evidence of each variable was assessed and pooled risk ratios (RRs) were calculated.

Twenty-two articles were included in this review, 17 on computed tomography (CT) and 5 on magnetic resonance imaging (MRI) variables. We found strong evidence for the prognostic value of tumor volume at various cut-off points (pooled RRs ranging from 2.09 to 3.03). Anterior commissure involvement (pooled RR 2.19), posterior commissure involvement (pooled RR 2.44), subglottic extension (pooled RR 2.25), and arytenoid cartilage extension (pooled RR 2.10) were also strong prognostic factors.

Pretreatment tumor volume and involvement of several subsites are prognostic factors for recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy.

Pretreatment tumor volume and involvement of several subsites are prognostic factors for recurrent laryngeal or hypopharyngeal carcinoma after chemoradiotherapy.

Emotional problem-related distress is a common issue faced by patients with cancer. However, patients suffering with this emotional burden do not typically seek assistance. This study sought to determine the prevalence of emotional problem-related distress by cancer type, and identify factors correlated with the level of assistance requested.

Using the SupportScreen®, patients were screened for emotional problem-related distress at their first or second visit to an NCI designated Comprehensive Cancer Center. General Linear Model was used to test the association between emotional problem-related distress and type of cancer, and the relationship between level of assistance requested and patients' characteristics.

A total of 2,421 patients were included in this analysis. Patients were mostly female (62%), diagnosed with breast (24%), gynecological (16%) or gastrointestinal (15%) cancers. Highest levels of emotional problem-related distress were reported by patients diagnosed with lung, gynecological, breast and gastrointestinal cancers. Level of assistance requested were significantly associated with problem-related distress scores (p<0.001), which were higher among patients with lower household incomes (p<0.001) and Spanish as primary language (p=0.001).

Our study found an association between Level of assistance requested and emotional problem-related distress, which were heightened by lower income and Spanish-speaking. Intervention strategies should be considered to increase access to psychosocial support services.

Our study found an association between Level of assistance requested and emotional problem-related distress, which were heightened by lower income and Spanish-speaking. Intervention strategies should be considered to increase access to psychosocial support services.Cognitive control is built upon the interactions of multiple brain regions. It is currently unclear whether the involved regions are temporally separable in relation to different cognitive processes and how these regions are temporally associated in relation to different task performances. Here, using stop-signal task data acquired from 119 healthy participants, we showed that concurrent and poststop cognitive controls were associated with temporally distinct but interrelated neural mechanisms. Specifically, concurrent cognitive control activated regions in the cingulo-opercular network (including the dorsal anterior cingulate cortex [dACC], insula, and thalamus), together with superior temporal gyrus, secondary motor areas, and visual cortex; while regions in the fronto-parietal network (including the lateral prefrontal cortex [lPFC] and inferior parietal lobule) and cerebellum were only activated during poststop cognitive control. The associations of activities between concurrent and poststop regions were dependent on task performance, with the most notable difference in the cerebellum. Importantly, while concurrent and poststop signals were significantly correlated during successful cognitive control, concurrent activations during erroneous trials were only correlated with posterror activations in the fronto-parietal network but not cerebellum. Instead, the cerebellar activation during posterror cognitive control was likely to be driven secondarily by posterror activation in the lPFC. Further, a dynamic causal modeling analysis demonstrated that postsuccess cognitive control was associated with inhibitory connectivity from the lPFC to cerebellum, while excitatory connectivity from the lPFC to cerebellum was present during posterror cognitive control. Overall, these findings suggest dissociable but temporally related neural mechanisms underlying concurrent, postsuccess, and posterror cognitive control processes in healthy individuals.