Relevance of level I and IIB neck dissection in laryngeal cancer.

OBJECTIVES: Dissection of neck levels I and IIB is time-consuming and can cause comorbidity. This study aimed to determine whether level I and IIB neck dissection was necessary in patients with laryngeal cancer and clinically detectable or nondetectable neck nodes. PATIENTS AND METHODS: This was a retrospective review of 73 patients with laryngeal cancer. Essential clinical data were obtained and analysed to determine the incidence of neck node metastasis in levels I and IIB. RESULTS: Of the 48 patients with no clinically apparent neck nodes, none had level I metastases and only one had level IIB metastases. Of the patients with clinically detectable neck nodes, three of 21 patients had level I metastases and three of 25 patients had level IIB metastases; these six patients also had additional metastases in level IIA. CONCLUSION: Dissection of neck levels I and IIB is justifiable in laryngeal cancer patients with clinically detectable neck nodes and suspicious lymph nodes in the respective level or level IIA. However, in patients without clinically detectable neck nodes, preservation of levels I and IIB is oncologically safe, economical and reduces the risk of comorbidity.

Evaluation of the revised physical activity readiness questionnaire in older adults.

Physical Activity Readiness Questionnaire (PARQ) clearance has been recommended prior to low-to-moderate exercise involvement. The measure, however, appears to exclude a high proportion of older adults due to false positive responses. To improve this situation, a revised PARQ was developed (rPARQ). The purpose of this study was to compare the number exclusions resulting from the PARQ and rPARQ in 60- to 69-yr-old adults. Participants were recruited from Community Nutrition Centers (97 males, 96 females; mean age = 64.82 yr, SD +/- 2.85). At random, half completed the PARQ or rPARQ on day 1 and the respective opposite instrument on day 2. There was a significant decrease in the number of exclusions resulting from the PARQ as compared to the rPARQ (146 to 128, P < 0.001). Percentage of agreement regarding exclusion/inclusion status between the two measures was 87.6% (kappa = 0.71). Responses for the six matched questions were significantly (P < 0.0001) related with contingency and phi coefficients ranging from 0.40 to 0.58 and 0.43 to 0.71, respectively. These results support the concurrent validity of the rPARQ and suggest the revisions have had their intended effect.

Levobunolol vs timolol for open-angle glaucoma and ocular hypertension.

A group of 162 patients with chronic open-angle glaucoma or ocular hypertension were treated twice daily for up to 15 months with one of the following topical ophthalmic solutions: 0.5% levobunolol, 1% levobunolol, or 0.5% timolol. Overall mean reductions in intraocular pressure were 8 mm Hg for patients receiving 0.5% levobunolol or timolol and 8.2 mm Hg for patients receiving 1% levobunolol. There were no significant differences between levobunolol and timolol in mean reductions in intraocular pressure, percent of patients with adequately controlled intraocular pressure, or life-table estimates of the probability of successful treatment.