Cervical nodal metastases from head and neck squamous cell carcinoma: MRI criteria for treatment assessment.

BACKGROUND: The purpose of this study was to assess MRI criteria for detecting residual malignant head and neck squamous cell carcinoma (HNSCC) nodes after chemoradiotherapy (CRT). METHODS: One hundred and six metastatic nodes were assessed 6 weeks posttreatment by MRI for necrosis, extranodal neoplastic spread (ENS), size, and percentage of size change. Size measurements were reanalyzed after dividing posttreatment nodes into "discrete solid," "discrete necrotic," and "indiscrete" groups. Results were correlated with nodal response at 2 years. RESULTS: Eighty-three residual nodes were benign and 23 were malignant. Significant predictors of outcome were percentage of change in solid volume (total-necrotic volume; p = .0002) for all posttreatment nodes and percentage of change in total volume for "discrete solid" posttreatment nodes (p = .0003), the latter showing a ≤78% reduction of predicted residual malignant nodes with a negative predictive value (NPV) of 98.2% and positive predictive value (PPV) of 60%. Necrosis, ENS, and size of "discrete necrotic" and "indiscrete" nodes were not significant criteria. CONCLUSION: Necrosis and ENS were inaccurate criteria for residual malignant nodes and hindered the accuracy of size measurements. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1598-E1604, 2016.

Prospective Predictors of Patellofemoral Pain Syndrome: A Systematic Review With Meta-analysis.

CONTEXT: Patellofemoral pain syndrome (PFPS) is one of the most common overuse injuries. OBJECTIVE: To assess the collective evidence of predisposing factors to PFPS. DATA SOURCES: MEDLINE (1960-June 2010), EMBASE (1980-June 2010), and CINAHL (1982-June 2010). STUDY SELECTION: Studies were included if patients were asymptomatic at baseline testing (free of PFPS) and were prospectively followed for the development of the disorder. Only studies that assessed at least 1 variable that can be measured at a typical clinic were included. After duplicates were removed, 973 studies were assessed from their titles or abstracts, 20 from the full text, and from these, 7 met the inclusion criteria. DATA EXTRACTION: Data were extracted for age, weight, height, sample size, patient type (military vs civilian), follow-up periods, diagnostic methods, and diagnostic criteria. Means and standard deviations were extracted for all outcome variables. RESULTS: Meta-analyses were performed for height, weight, leanness, Q angle, number of sit-ups, knee extension strength, and peak knee valgus angle during landing. Lower knee extension strength was the only variable that was predictive of PFPS (P < 0.01). Other variables that were identified as predictive of PFPS by single studies were vertical jump, push-ups, knee flexion and hip abduction strength, thumb-to-forearm flexibility, quadriceps and gastrocnemius flexibility, genu varum, navicular drop, knee valgus moment at initial contact during landing, social support, and palliative reaction. CONCLUSIONS: It appears that anthropometric variables are not associated with PFPS, while knee extension strength deficits appear to be predictors of PFPS.

The synthesis of substituted fluorenes as novel non-imidazole histamine h(3) inhibitors.

A novel non-imidazole fluorene oxime 1a has been identified as a histamine H(3) inhibitor, and its structure-activity relationship has been evaluated.