Search

Simple Summary: This study investigates the prognostic value of C-reactive protein (CRP) kinetics in patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M-HNSCC) treated with checkpoint inhibitors (CPI). We analyzed data from 44 patients treated between 2018 and 2023, applying two existing CRP classifications and developing a new one. While the existing classifications did not correlate with overall survival (OS), our novel CRP kinetic classification showed a significant association with OS (p = 0.05). Multivariate analysis identified our CRP classification (p = 0.007) and the outcome of the first re-staging (p = 0.002) as independent prognostic factors. These findings suggest that our new CRP kinetic classification could serve as a valuable prognostic marker for R/M-HNSCC patients undergoing CPI therapy, though further validation with larger patient cohorts is needed. Introduction The kinetic of C-reactive protein (CRP) in the early phase of therapy with checkpoint inhibitors (CPI) and its prognostic value has already been investigated in several tumor entities. In particular, flare dynamics have been described as a positive prognostic parameter. The aim of this retrospective study is to examine the extent to which such an application can also be transferred to patients with recurrent or metastatic squamous cell carcinoma of the head and neck region (R/M-HNSCC). Material and Methods All patients treated with CPI for R/M-HNSCC at our clinic between 2018 and 2023 were included (n = 44). Demographic, clinical, histopathologic and laboratory data were extracted from the digital patient records and statistically analyzed. We then examined the CRP kinetic using two previously published classifications and proposed a new classification ourselves. Subsequently, correlation analyses were performed with the overall survival (OS) of the patients. Results Of the two CRP kinetic classifications previously published, only one showed a correlation with the result of the first re-staging, and neither showed a correlation with the OS of R/M-HNSCC patients. Our new CRP kinetic classification showed a significant association with OS in R/M-HNSCC patients (p = 0.05). In a multivariate analysis, our CRP kinetic classification (p = 0.007) and the outcome of the first re-staging (p = 0.002) were significant independent factors for OS. Discussion Our novel CRP kinetic classification significantly correlates with OS in R/M-HNSCC patients, indicating a potential prognostic marker. Existing classifications from other cancer entities showed limited prognostic significance, emphasizing the need for tailored markers. For validation, however, testing on larger R/M-HNSCC patient collectives is necessary. [ABSTRACT FROM AUTHOR]

We combine the recent literature on issue competition with work on intra‐party heterogeneity to advance a novel theoretical argument. Starting from the premise that party leaders and non‐leaders have different motivations and incentives, we conjecture that issue strategies should vary across the party hierarchy. We, therefore, expect systematic intra‐party differences in the use of riding the wave and issue ownership strategies. We test this claim by linking public opinion data to manually coded information on over 3600 press releases issued by over 500 party actors across five election campaigns in Austria between 2006 and 2019. We account for self‐selection into leadership roles by exploiting transitions into and out of leadership status over time. The results show that party leaders are more likely than non‐leaders to respond to the public's issue priorities, but not more or less likely to pursue issue‐ownership strategies. [ABSTRACT FROM AUTHOR]

Extant research points to the importance of social identity and group attitudes for political behavior. Even though this should have important consequences for political communication, few scholars have investigated how parties use appeals to social groups to capitalize on these predispositions. This study introduces the concept of social group yield as a new theoretical framework to explain how parties strategically emphasize groups to mobilize their core voters and broaden their support base among the general electorate. Empirically, I examine the case of Austria based on a content analysis of electoral manifestos for the national elections in 2013, 2017, and 2019 to measure parties' group emphasis, combined with cross-sectional survey data measuring voters' group attitudes. The results confirm that group attitudes of party supporters and the wider electorate direct parties' emphasis of different groups. These findings have important implications for the representation of social groups, political polarization, and party competition. [ABSTRACT FROM AUTHOR]

While a rich literature addresses legislative agenda-setting in multiparty democracies, relatively little is known how members of parliament disseminate the legislative agenda beyond the parliamentary floor. Drawing on content analyses of 110 legislative debates and 5,847 press releases from Austrian MPs (2013–2017), we test whether legislators are more likely to send press releases on issues that are salient to their party (party agenda-setting) and to other parties in the party system (systemic salience). MPs should also communicate more on issues that fall within their area of expertise (issue specialization) and when they have given a speech on that issue during the legislative debate (intra-party delegation). While we find empirical support for all these expectations, communication of the legislative agenda largely rests on each parties' issue specialists and their speakers in plenary debates. Importantly, there is no significant discrepancy overall between the actual parliamentary issue agenda and the agenda communicated by party MPs. [ABSTRACT FROM AUTHOR]

Aim: To investigate the usability of querying subjective impairments of the sense of smell and taste in order to improve pre‐test probability in testing for SARS‐CoV‐2. To achieve this, exploring the prevalence of these restrictions in the COVID‐19‐negative population, as well as nasal co‐symptoms. Design: A cross‐sectional study was carried out as part of the secondary prophylaxis, following the STROBE guidelines of the EQUATOR network. Methods: In total, 1,734 employees of retirement and nursing homes were tested for COVID‐19 and asked for subjective reduction or loss in the sense of smell and taste, furthermore about nasal co‐symptoms such as nasal obstruction and rhinorrhoea. Results: All employees tested negative for COVID‐19. Subjective hyposmia and hypogeusia rarely occurred and were usually accompanied by other nasal symptoms such as nasal obstruction. Querying subjective hyposmia/anosmia or hypogeusia/ageusia appears to be a useful anamnestic instrument for the clinical assessment of the probability of SARS‐CoV‐2 infection. [ABSTRACT FROM AUTHOR]

Background/aim: Transforming growth factor-β (TGF-β) plays a significant role in the formation of different cancer subtypes. There is evidence that TGF-β pathways promote cancerogenic cell characteristics but also have tumor-suppressor capabilities. The tyrosine kinase inhibitors nilotinib, dasatinib, erlotinib, gefitinib, and everolimus are approved as targeted therapies for several tumor entities, including head and neck squamous cell carcinoma (HNSCC). This study aimed to investigate the effects of these substances on the expression levels of TGFβ1 and TGF-β receptor type 2 (TGFβR2) in HPV-negative and HPV-positive SCC cell cultures., Materials and Methods: Expression patterns of TGFβ1 and TGFβR2 were determined using enzyme-linked immunosorbent assay (ELISA) in three HNSCC cell lines (i.e., HNSCC-11A, HNSCC-14C, and CERV196). These cells were incubated with nilotinib, dasatinib, erlotinib, gefitinib, and everolimus (20 μmol/l) and compared to a chemonaive control. An assessment of concentration levels was conducted after 24, 48, 72, and 96 h of treatment., Results: Statistically significant changes in the expression levels of TGFβ1 and TGFβR2 were found in all tested cell cultures (p<0.05) compared to the negative control. An increase in TGFβ-R2 expression was detected after treatment with most of the tested tyrosine kinase inhibitors, whereas a reduction in TGFβ1 was observed. The addition of everolimus had the opposite effect on both TGFβR2 and TGF-B1- expression., Conclusion: Expression of TGFβ1 and TGFβR2 was detected in all cultured HNSCC cell lines. Nilotinib, dasatinib, erlotinib, gefitinib, and everolimus had an impact on the expression levels of TGFβ1 and TGFβR2 in vitro., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

In CUP syndrome (CUP = cancer of unknown primary) there are 1 or more metastases of a primary tumor that cannot be localized despite extensive diagnostics. CUP syndrome accounts for 5% of all human malignancies, making it one of the 10 most common forms of cancer. In addition to inflammatory lymph node enlargement and benign changes such as cervical cysts, lymph node metastases are among the most common cervical masses. Cervical CUP syndrome is a histologically confirmed cervical lymph node metastasis with an unknown primary tumor. In addition to anamnesis, clinical examination and histological confirmation, diagnostics include radiological imaging using PET-CT and panendoscopy with histological primary tumor search. Treatment options include surgical therapy with neck dissection and chemoradiotherapy., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: nein; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: ja, von einer anderen Institution (Pharma- oder Medizintechnikfirma usw.); Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein Erklärung zu nichtfinanziellen Interessen Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Cancer surgery in the head and neck region often results in complex defects. The reconstructive ladder was developed to guide treatment decisions. In the head and neck region the most straightforward reconstructive technique is often not the most suitable, because it is comprised of many functional and aesthetic subregions that lie close together. If primary closure, secondary wound healing or negative wound pressure therapy are not an option, skin grafting is the next step. Larger or aesthetically and functionally challenging defects are often reconstructed with flap surgery. It is distinguished between local or regional flaps that are rotated or transposed into the defect and distant flaps. The blood supply of local/regional flaps is either random pattern or axial pattern, distant flaps are pedicled or free flaps. The vessels of free flaps are connected to the blood supply in the defect by microvascular anastomoses. The radial forearm flap, the pectoralis major flap and the anterolateral thigh flap are the most common distant flaps in the head and neck region. Preoperative planning is the most important step in reconstructive surgery. The method of reconstruction must be suited to the functional and aesthetic requirements of the defect but also to the morbidity and compliance of the patient and the surgical expertise of the clinic. Not only immediate postoperative complications such as insufficient anastomosis, infections or hematoma but also later, mostly functional complications such as dysphagia or dyspnea must be taken into consideration when planning the reconstruction of a defect in the head and neck region., Competing Interests: Erklärung zu finanziellen Interessen Forschungsförderung erhalten: nein; Honorar/geldwerten Vorteil für Referententätigkeit erhalten: nein; Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an im Bereich der Medizin aktiven Firma: nein; Patent/Geschäftsanteile/Aktien (Autor/Partner, Ehepartner, Kinder) an zu Sponsoren dieser Fortbildung bzw. durch die Fortbildung in ihren Geschäftsinteressen berührten Firma: nein Erklärung zu nichtfinanziellen Interessen Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)