133 results on '"Hadar, T."'
Search Results
2. Epidemiological Aspects of Idiopathic Peripheral Facial Palsy
- Author
-
Tovi, F., Hadar, T., Sidi, J., Sarov, I., and Sarov, B.
- Published
- 1986
3. EZH2 promotes a bi-lineage identity in basal-like breast cancer cells
- Author
-
Granit, R Z, Gabai, Y, Hadar, T, Karamansha, Y, Liberman, L, Waldhorn, I, Gat-Viks, I, Regev, A, Maly, B, Darash-Yahana, M, Peretz, T, and Ben-Porath, I
- Published
- 2013
- Full Text
- View/download PDF
4. Marking of Target Lymph Nodes with carbon suspension in breast cancer patients undergoing neoadjuvant chemotherapy – first results from the AXSANA study (NCT04373655).
- Author
-
Rief, A., Hartmann, S., Banys-Paluchowski, M., de Boniface, J., Gentlini, O. D., Stickeler, E., Karadeniz Cakmak, G., Hauptmann, M., Basali, T., Berger, T., Fröhlich, S., Ruf, F., Schmidt, E., Wihlfahrt, K., Aktas Sezen, B., Porpiglia, M., Zetterlund, L., Natsiopoulos, I., Sackey, H., and Hadar, T.
- Published
- 2024
- Full Text
- View/download PDF
5. The impact of positive resection margins in partial laryngectomy for advanced laryngeal carcinomas and radiation failures
- Author
-
Soudry, E, Hadar, T, Shvero, J, Segal, K, Shpitzer, T, Nageris, B I, and Feinmesser, R
- Published
- 2010
- Full Text
- View/download PDF
6. Squamous cell carcinoma of the oral tongue in patients younger than 30 years: clinicopathologic features and outcome
- Author
-
Soudry, E., Preis, M., Hod, R., Hamzany, Y., Hadar, T., Bahar, G., Strenov, Y., and Shpitzer, T.
- Published
- 2010
- Full Text
- View/download PDF
7. The Significance of Specific IgA Antibodies in the Serum in the Early Diagnosis of Zoster
- Author
-
Tovi, F., Hadar, T., Sidi, J., Sarov, B., and Sarov, I.
- Published
- 1985
8. 16S rRNA amplicon sequencing identifies microbiota associated with oral cancer, Human Papilloma Virus infection and surgical treatment
- Author
-
Guerrero-Preston, R., Godoy-Vitorino, F., Jedlicka, A., Rodriguez, A., González, H., Bondy, J., Lawson, F., Folawiyo, O., Michailidi, M., Dziedzic, A., Thangavel, R., Hadar, T., Noordhuis, M.G., Westra, W., Koch, W., and Sidransky, D.
- Published
- 2016
- Full Text
- View/download PDF
9. Analysis of the prognostic significance of lymph node related characteristics in papillary thyroid carcinoma patients presenting with pre- or intra-operative evidence of cervical lymph node metastases.
- Author
-
Soudry, E, Hilly, O, Preis, M, Hadar, T, Segal, K, Bachar, G, and Feinmesser, R
- Subjects
LYMPH nodes ,THYROID cancer patients ,MULTIVARIATE analysis ,INTRAOPERATIVE awareness ,IODINE isotopes ,ACADEMIC medical centers ,CANCER relapse ,CHI-squared test ,CONFIDENCE intervals ,LYMPH node surgery ,METASTASIS ,STATISTICAL hypothesis testing ,T-test (Statistics) ,THYROID gland tumors ,THYROIDECTOMY ,LOGISTIC regression analysis ,DATA analysis software ,PAPILLARY carcinoma ,DESCRIPTIVE statistics ,TERTIARY care ,PROGNOSIS - Abstract
Objective:To identify the prognostic significance of specific lymph node related characteristics for disease persistence and recurrence in patients with pre- or intra-operative evidence of neck metastases and no other risk factors.Method and resultsSixty-eight patients were identified; 50 per cent had persistent or recurrent disease. All underwent the same treatment strategy. There were no statistically significant differences in any of the patient- or tumour-related parameters when patients with and without persistence or recurrence were compared. Patients with recurrent or persistent disease had significantly larger (>3 cm) metastatic lymph nodes, but there were no differences regarding other lymph node related parameters (i.e. number, extracapsular extension, number of lymph nodes with extracapsular extension, and central vs lateral neck location). On multivariate analysis, however, none of the parameters were predictive of persistent or recurrent disease.Conclusion:In papillary thyroid carcinoma patients with no other risk factors, pre- or intra-operative evidence of cervical metastases was associated with a very high rate of disease persistence or recurrence. Specific lymph node characteristics were not shown to have prognostic significance. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
- Full Text
- View/download PDF
10. Early death from papillary thyroid carcinoma.
- Author
-
Hamzany Y, Soudry E, Strenov Y, Lipschitz N, Segal K, Hadar T, Hilly O, and Feinmesser R
- Published
- 2012
11. 191 EZH2 and GATA3 Play Opposing Roles in Controlling the Differentiation State of Basal-like Breast Cancer Cells
- Author
-
Granit, R.Z., Hadar, T., Karamansha, Y., Waldhorn, I., Gat-Viks, I., Liberman, L., Maly, B., Peretz, T., Regev, A., and Ben-Porath, I.
- Published
- 2012
- Full Text
- View/download PDF
12. Anaplastic thyroid carcinoma. A clinical, histologic, and immunohistochemical study.
- Author
-
Shvero, J., Hadar, T., Gal, R., Kessler, E., and Avidor, I.
- Published
- 1988
- Full Text
- View/download PDF
13. Laryngeal carcinoma in patients 40 years of age and younger.
- Author
-
Shvero, Jacob, Hadar, Tuvia, Segal, Karl, Abraham, Aristide, Sidi, Jack, Shvero, J, Hadar, T, Segal, K, Abraham, A, and Sidi, J
- Published
- 1987
- Full Text
- View/download PDF
14. Hurthle cell carcinoma of the thyroid gland. A tumor of moderate malignancy.
- Author
-
Har-el, Gady, Hadar, Tuvia, Segal, Karl, Levy, Rudy, Sidi, Jack, Har-El, G, Hadar, T, Segal, K, Levy, R, and Sidi, J
- Published
- 1986
- Full Text
- View/download PDF
15. Novobiocin-induced anti-proliferative and differentiating effects in melanoma B16.
- Author
-
Nordenberg, J, Albukrek, D, Hadar, T, Fux, A, Wasserman, L, Novogrodsky, A, and Sidi, Y
- Published
- 1992
- Full Text
- View/download PDF
16. Endoscopic transnasal transsphenoidal microsurgery versus the sublabial approach for the treatment of pituitary tumors: endonasal complications.
- Author
-
Koren I, Hadar T, Rappaport ZH, and Yaniv E
- Published
- 1999
17. Supraglottic carcinoma: a retrospective study of 114 patients
- Author
-
Shvero, J., Hadar, T., Yaniv, E., Marshak, G., Feinmesser, R., and Segal, K.
- Published
- 1997
- Full Text
- View/download PDF
18. The varying social dynamics in orally transmitted and notated vs. improvised musical performance.
- Author
-
Hadar T and Rabinowitch TC
- Abstract
Musical performance can be viewed as an intricate form of social behavior. Accordingly, the rich diversity of existing musical styles and traditions may reflect distinct modes of social interaction. To gain a better understanding of the relations between musical style and social dynamics, we have formulated a framework for dissecting different genres of musical performance according to key social criteria. In particular, we contemplate on the continuum ranging from strictly orally transmitted and notated to fully improvised music, and its relation to general compliance with social norms and structure, borrowing key concepts from tight-loose theory, a powerful paradigm for studying societal behaviors and tendencies. We apply this approach to analyze four distinct prominent musical genres, providing a detailed mapping between musical style and social dynamics. This work highlights important factors that link between musical performance and social interaction, and will enable future experimental unraveling of social aspects of musical performance as expressed by different musical styles and practices., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hadar and Rabinowitch.)
- Published
- 2023
- Full Text
- View/download PDF
19. Oncoplastic breast consortium recommendations for mastectomy and whole breast reconstruction in the setting of post-mastectomy radiation therapy.
- Author
-
Weber WP, Shaw J, Pusic A, Wyld L, Morrow M, King T, Mátrai Z, Heil J, Fitzal F, Potter S, Rubio IT, Cardoso MJ, Gentilini OD, Galimberti V, Sacchini V, Rutgers EJT, Benson J, Allweis TM, Haug M, Paulinelli RR, Kovacs T, Harder Y, Gulluoglu BM, Gonzalez E, Faridi A, Elder E, Dubsky P, Blohmer JU, Bjelic-Radisic V, Barry M, Hay SD, Bowles K, French J, Reitsamer R, Koller R, Schrenk P, Kauer-Dorner D, Biazus J, Brenelli F, Letzkus J, Saccilotto R, Joukainen S, Kauhanen S, Karhunen-Enckell U, Hoffmann J, Kneser U, Kühn T, Kontos M, Tampaki EC, Carmon M, Hadar T, Catanuto G, Garcia-Etienne CA, Koppert L, Gouveia PF, Lagergren J, Svensjö T, Maggi N, Kappos EA, Schwab FD, Castrezana L, Steffens D, Krol J, Tausch C, Günthert A, Knauer M, Katapodi MC, Bucher S, Hauser N, Kurzeder C, Mucklow R, Tsoutsou PG, Sezer A, Çakmak GK, Karanlik H, Fairbrother P, Romics L, Montagna G, Urban C, Walker M, Formenti SC, Gruber G, Zimmermann F, Zwahlen DR, Kuemmel S, El-Tamer M, Vrancken Peeters MJ, Kaidar-Person O, Gnant M, Poortmans P, and de Boniface J
- Subjects
- Female, Humans, Mastectomy methods, Nipples, Prospective Studies, Breast Neoplasms radiotherapy, Breast Neoplasms surgery, Mammaplasty methods
- Abstract
Aim: Demand for nipple- and skin- sparing mastectomy (NSM/SSM) with immediate breast reconstruction (BR) has increased at the same time as indications for post-mastectomy radiation therapy (PMRT) have broadened. The aim of the Oncoplastic Breast Consortium initiative was to address relevant questions arising with this clinically challenging scenario., Methods: A large global panel of oncologic, oncoplastic and reconstructive breast surgeons, patient advocates and radiation oncologists developed recommendations for clinical practice in an iterative process based on the principles of Delphi methodology., Results: The panel agreed that surgical technique for NSM/SSM should not be formally modified when PMRT is planned with preference for autologous over implant-based BR due to lower risk of long-term complications and support for immediate and delayed-immediate reconstructive approaches. Nevertheless, it was strongly believed that PMRT is not an absolute contraindication for implant-based or other types of BR, but no specific recommendations regarding implant positioning, use of mesh or timing were made due to absence of high-quality evidence. The panel endorsed use of patient-reported outcomes in clinical practice. It was acknowledged that the shape and size of reconstructed breasts can hinder radiotherapy planning and attention to details of PMRT techniques is important in determining aesthetic outcomes after immediate BR., Conclusions: The panel endorsed the need for prospective, ideally randomised phase III studies and for surgical and radiation oncology teams to work together for determination of optimal sequencing and techniques for PMRT for each patient in the context of BR., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
20. Hybrid Prepectoral Direct-to-Implant and Autologous Fat Graft Simultaneously in Immediate Breast Reconstruction: A Single Surgeon's Experience with 25 Breasts in 15 Consecutive Cases.
- Author
-
Gronovich Y, Winder G, Maisel-Lotan A, Lysy I, Sela E, Spiegel G, Carmon M, Hadar T, Elami A, Eizenman N, and Binenboym R
- Subjects
- Adult, Aged, Esthetics, Female, Follow-Up Studies, Humans, Middle Aged, Outcome Assessment, Health Care, Prospective Studies, Transplantation, Autologous methods, Breast Implantation methods, Pectoralis Muscles surgery, Subcutaneous Fat transplantation
- Abstract
Background: The direct-to-implant method depends on the quality of the mastectomy flaps and can be used only when the flaps are adequately perfused. Even though the method was designed to be a definitive reconstruction procedure, it has been associated with an increased likelihood that additional operative revision will be required in order to achieve the expected final cosmetic outcome. The authors describe a hybrid prepectoral direct-to-implant method that combines autologous fat grafting in the superior medial pole with immediate reconstruction., Methods: In this prospective study, 15 patients (25 reconstructed breasts) underwent simultaneous hybrid prepectoral direct-to-implant reconstruction together with autologous fat grafting performed by a single senior plastic surgeon (Y.G)., Results: The mean quantity of autologous fat grafted in the superior medial aspect of the breast was 59.4 ± 12.8 cc. The mean total volume of the hybrid reconstructed breast, including implant and autologous fat graft, was 497.2 ± 89.1 cc. Satisfying final outcomes were achieved in all cases. There were no major complications, although minor complications were observed., Conclusions: The authors' hybrid approach allows the surgeon to achieve a more satisfying outcome with regard to the cleavage area. It results in a better natural appearance, an improved contour, and reduced upper pole rippling and deflation, with a lower likelihood that an additional operative revision will be required to achieve the desired final aesthetic outcome. The authors believe that their hybrid approach should be implemented as an integral part of the direct-to-implant prepectoral reconstruction procedure., Clinical Question/level of Evidence: Therapeutic, IV., (Copyright © 2022 by the American Society of Plastic Surgeons.)
- Published
- 2022
- Full Text
- View/download PDF
21. Innovative Standards in Surgery of the Breast after Neoadjuvant Systemic Therapy.
- Author
-
Hadar T, Koretz M, Nawass M, and Allweis TM
- Abstract
Background: The goal of neoadjuvant systemic therapy (NST) in breast cancer is to downstage tumors and downgrade treatment. Indications are constantly evolving. These changes raise practical questions for planning of surgery after NST., Summary: In this review we discuss current evolving aspects of surgery of the breast after NST. Breast-conserving surgery (BCS) eligibility increases after NST - both neoadjuvant chemotherapy (NAC) and neoadjuvant endocrine therapy. Adequate margin width in NST and upfront surgery are similar - "no tumor on ink" for invasive cancer. Oncoplastic breast surgery after NST is feasible - both for BCS and mastectomy with reconstruction. There is increasing interest in the possibility of omitting surgery in patients with a complete response to NAC. Several trials are being conducted in aim of achieving acceptable prediction of pathological complete response, by combination of imaging and percutaneous biopsy of the tumor bed, as well as assessing the safety of such an approach., Key Messages: Surgery of the breast after NST should be determined not only according to biologic and anatomic parameters at diagnosis, but is dynamic, and must be tailored according to the response to therapy. The omission of surgery in exceptional responders after NAC is being explored., Competing Interests: All authors have no conflicts of interest to declare., (Copyright © 2021 by S. Karger AG, Basel.)
- Published
- 2021
- Full Text
- View/download PDF
22. The Soundscape of Neonatal Intensive Care: A Mixed-Methods Study of the Parents' Experience.
- Author
-
Chifa M, Hadar T, Politimou N, Reynolds G, and Franco F
- Abstract
Parents who have infants hospitalised in neonatal intensive care units (NICUs) experience high levels of stress, including post-traumatic stress disorder (PTSD) symptoms. However, whether sounds contribute to parents' stress remains largely unknown. Critically, researchers lack a comprehensive instrument to investigate the relationship between sounds in NICUs and parental stress. To address this gap, this report presents the "Soundscape of NICU Questionnaire" (SON-Q), which was developed specifically to capture parents' perceptions and beliefs about the impact that sound had on them and their infants, from pre-birth throughout the NICU stay and in the first postdischarge period. Parents of children born preterm ( n = 386) completed the SON-Q and the Perinatal PTSD Questionnaire (PPQ). Principal Component Analysis identifying underlying dimensions comprising the parental experience of the NICU soundscape was followed by an exploration of the relationships between subscales of the SON-Q and the PPQ. Moderation analysis was carried out to further elucidate relationships between variables. Finally, thematic analysis was employed to analyse one memory of sounds in NICU open question. The results highlight systematic associations between aspects of the NICU soundscape and parental stress/trauma. The findings underscore the importance of developing specific studies in this area and devising interventions to best support parents' mental health, which could in turn support infants' developmental outcomes.
- Published
- 2021
- Full Text
- View/download PDF
23. Presymptomatic Awareness of Germline Pathogenic BRCA Variants and Associated Outcomes in Women With Breast Cancer.
- Author
-
Hadar T, Mor P, Amit G, Lieberman S, Gekhtman D, Rabinovitch R, and Levy-Lahad E
- Subjects
- Breast Neoplasms epidemiology, Breast Neoplasms pathology, Disease-Free Survival, Female, Genetic Variation genetics, Germ-Line Mutation genetics, Humans, Kaplan-Meier Estimate, Middle Aged, BRCA1 Protein genetics, BRCA2 Protein genetics, Breast Neoplasms genetics, Genetic Predisposition to Disease
- Published
- 2020
- Full Text
- View/download PDF
24. JAK3 Variant, Immune Signatures, DNA Methylation, and Social Determinants Linked to Survival Racial Disparities in Head and Neck Cancer Patients.
- Author
-
Guerrero-Preston R, Lawson F, Rodriguez-Torres S, Noordhuis MG, Pirini F, Manuel L, Valle BL, Hadar T, Rivera B, Folawiyo O, Baez A, Marchionni L, Koch WM, Westra WH, Kim YJ, Eshleman JR, and Sidransky D
- Subjects
- Adult, Black or African American statistics & numerical data, Biomarkers, Tumor analysis, Case-Control Studies, Female, Follow-Up Studies, Gene Expression Regulation, Neoplastic, Head and Neck Neoplasms ethnology, Head and Neck Neoplasms genetics, Head and Neck Neoplasms immunology, Humans, Male, Middle Aged, Prognosis, Squamous Cell Carcinoma of Head and Neck ethnology, Squamous Cell Carcinoma of Head and Neck genetics, Squamous Cell Carcinoma of Head and Neck immunology, Squamous Cell Carcinoma of Head and Neck mortality, Survival Rate, Tumor Suppressor Protein p53 genetics, White People statistics & numerical data, DNA Methylation, Germ-Line Mutation, Head and Neck Neoplasms mortality, Health Status Disparities, Janus Kinase 3 genetics, Lymphocytes, Tumor-Infiltrating immunology, Social Determinants of Health
- Abstract
To inform novel personalized medicine approaches for race and socioeconomic disparities in head and neck cancer, we examined germline and somatic mutations, immune signatures, and epigenetic alterations linked to neighborhood determinants of health in Black and non-Latino White (NLW) patients with head and neck cancer. Cox proportional hazards revealed that Black patients with squamous cell carcinoma of head and neck (HNSCC) with PAX5 ( P = 0.06) and PAX1 ( P = 0.017) promoter methylation had worse survival than NLW patients, after controlling for education, zipcode, and tumor-node-metastasis stage ( n = 118). We also found that promoter methylation of PAX1 and P AX5 ( n = 78), was correlated with neighborhood characteristics at the zip-code level ( P < 0.05). Analyses also showed differences in the frequency of TP53 mutations ( n = 32) and tumor-infiltrating lymphocyte (TIL) counts ( n = 24), and the presence of a specific C → A germline mutation in JAK3 , chr19:17954215 (protein P132T), in Black patients with HNSCC ( n = 73; P < 0.05), when compared with NLW ( n = 37) patients. TIL counts are associated ( P = 0.035) with long-term (>5 years), when compared with short-term survival (<2 years). We show bio-social determinants of health associated with survival in Black patients with HNSCC, which together with racial differences shown in germline mutations, somatic mutations, and TIL counts, suggests that contextual factors may significantly inform precision oncology services for diverse populations., (©2019 American Association for Cancer Research.)
- Published
- 2019
- Full Text
- View/download PDF
25. Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy.
- Author
-
Weber WP, Haug M, Kurzeder C, Bjelic-Radisic V, Koller R, Reitsamer R, Fitzal F, Biazus J, Brenelli F, Urban C, Paulinelli RR, Blohmer JU, Heil J, Hoffmann J, Matrai Z, Catanuto G, Galimberti V, Gentilini O, Barry M, Hadar T, Allweis TM, Olsha O, Cardoso MJ, Gouveia PF, Rubio IT, de Boniface J, Svensjö T, Bucher S, Dubsky P, Farhadi J, Fehr MK, Fulco I, Ganz-Blättler U, Günthert A, Harder Y, Hauser N, Kappos EA, Knauer M, Landin J, Mechera R, Meani F, Montagna G, Ritter M, Saccilotto R, Schwab FD, Steffens D, Tausch C, Zeindler J, Soysal SD, Lohsiriwat V, Kovacs T, Tansley A, Wyld L, Romics L, El-Tamer M, Pusic AL, Sacchini V, and Gnant M
- Subjects
- Consensus, Female, Humans, Mastectomy, Subcutaneous adverse effects, Necrosis, Nipples pathology, Surgical Flaps pathology, Breast Neoplasms surgery, Mammaplasty methods, Mastectomy, Subcutaneous methods
- Abstract
Purpose: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion., Methods: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology., Results: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference., Conclusions: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.
- Published
- 2018
- Full Text
- View/download PDF
26. Hygroscopic sonographically detectable clips form characteristic breast and lymph node pseudocysts.
- Author
-
Carmon M, Zilber S, Gekhtman D, Olsha O, Hadar T, and Golomb E
- Subjects
- Adult, Aged, Breast pathology, Breast Neoplasms diagnostic imaging, Breast Neoplasms pathology, Cysts etiology, Cysts pathology, Female, Humans, Lymph Nodes pathology, Middle Aged, Breast diagnostic imaging, Cysts diagnostic imaging, Lymph Nodes diagnostic imaging, Surgical Instruments
- Abstract
The use of hygroscopic sonographically detectable clips (HSDCs) has dramatically increased during the last years, especially in breast cancer patients who undergo neoadjuvant chemotherapy. The aims of this study are to define the appearance of HSDC sites in histopathological specimens, and to enable pathologists to recognize these sites and differentiate them from other lesions. We examined 124 breast cancer specimens in which the application of HSDCs was documented, 88 breast tissues and 36 lymph nodes, and analyzed the appearance of the clip site in these tissues. The clip site was clearly detected histologically in 79/88 (90%) of the breast specimens and in 29/36 (81%) of lymph node specimens. In most of the specimens, the HSDC site had a specific characteristic appearance of a pseudocyst, lined by layers of epithelioid histiocytes, sometimes with pseudopapillary formation, and with minimal or no fibrosis. This was the appearance in 69 of the breast specimens and in 23 of the lymph node specimens. In other specimens, scarring, scattered foamy macrophages and abundant siderophages were the predominant findings, as usually found in sites of other clips. As non-palpable breast lesions become more frequent, clips play a major role in the treatment of breast cancer, making them an important component of the communication among radiologists, surgeons, pathologists, and oncologists. HSDCs in tissues have a characteristic appearance with an epithelioid component. Pathologists should be able to recognize this finding, differentiate it from other breast lesions and include it in the pathology report.
- Published
- 2018
- Full Text
- View/download PDF
27. Can molecular profiling enhance radiotherapy? Impact of personalized targeted gold nanoparticles on radiosensitivity and imaging of adenoid cystic carcinoma.
- Author
-
Hazkani I, Motiei M, Betzer O, Sadan T, Bragilovski D, Lubimov L, Mizrachi A, Hadar T, Levi M, Ben-Aharon I, Haviv I, Popovtzer R, and Popovtzer A
- Subjects
- Anaplastic Lymphoma Kinase, Carcinoma, Adenoid Cystic drug therapy, Carcinoma, Adenoid Cystic metabolism, Crizotinib, Humans, Mutation genetics, Pyrazoles therapeutic use, Pyridines therapeutic use, Receptor Protein-Tyrosine Kinases metabolism, Carcinoma, Adenoid Cystic diagnostic imaging, Gold chemistry, Metal Nanoparticles chemistry
- Abstract
Personalized molecular profiling has an established role in selection of treatment for metastatic disease; however, its role in improving radiosensitivity and functional imaging has not been evaluated. In the current study, we examined molecular profiling as a tool for designing personalized targeted gold nanoparticles (GNP) to serve as dual-modal tumor radiosensitizers and functional imaging enhancers. To this end, molecular profiling of a patient's salivary gland adenoid cystic carcinoma (ACC) was performed, and anaplastic lymphoma kinase (ALK) mutation was detected. The extracted tumor was subcutaneously injected into mice, which were then treated either with radiation, the specific ALK inhibitor crizotinib, or a combination of therapies. One of these combinations, namely, ALK-targeted GNP (via crizotinib coating), was found to enhance radiation treatment, as demonstrated by a significant decrease in tumor volume over 24 days. In parallel, ALK-targeted GNP substantially augmented tumor visualization via computed tomography. The mechanism of radiosensitivity enhancement was mostly related to a diminished cell repair mechanism in tumors, as demonstrated by proliferating cell nuclear antigen staining. These findings indicate that personalized molecular profiling is an effective technique for enhancing cancer theranostics., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.
- Published
- 2017
- Full Text
- View/download PDF
28. Acute Rhinosinusitis in Immunosuppressed Children: Diagnostic and Therapeutic Management.
- Author
-
Ritter A, Fischer S, Yaniv E, Hadar T, Soudry E, Shai D, Gilony D, and Bachar G
- Subjects
- Acute Disease, Adolescent, Child, Child, Preschool, Endoscopy, Female, Humans, Male, Mycoses, Neoplasms complications, Retrospective Studies, Immunocompromised Host, Rhinitis complications, Rhinitis diagnosis, Rhinitis microbiology, Rhinitis therapy, Sinusitis complications, Sinusitis diagnosis, Sinusitis microbiology, Sinusitis therapy
- Abstract
Background: Immunosuppressive therapy places pediatric patients at risk of developing life-threatening sinonasal infections. Diagnosis and treatment are challenging owing to nonspecific signs and symptoms. The aim of this study was to present our department's experience with the surgical management of acute rhinosinusitis in immunosuppressed children., Methods: The records of all children with a hematologic or oncologic disease who underwent endoscopic sinus surgery (ESS) for acute rhinosinusitis from January 2005 to May 2014 were reviewed. Data were retrospectively collected on demographics, clinical and imaging characteristics, microbiology, pathology, treatment and outcome., Results: Thirty-four-immunosuppressed children underwent ESS for acute rhinosinusitis. Most patients had a fungal infection. Nineteen patients died at the end of follow-up; 10 deaths were infection-related. Facial swelling was the only symptom that correlated with death of infection. Relapse of the underlying disease, bone marrow transplantation, and long duration of neutropenia correlated with infection-related mortality. Fungal infection, and specifically Aspergillus, correlated with death from infection., Conclusions: ESS is a safe and efficient procedure for diagnosing and treating immunosuppressed pediatric patients with acute rhinosinusitis. Early detection and aggressive medical and surgical treatment, with control of underlying risk factors, are crucial to improve outcome.
- Published
- 2017
- Full Text
- View/download PDF
29. Detectability of Hygroscopic Clips Used in Breast Cancer Surgery.
- Author
-
Carmon M, Olsha O, Gekhtman D, Nikitin I, Cohen Y, Messing M, Lioubashevsky N, Abu Dalo R, Hadar T, and Golomb E
- Subjects
- Adult, Aged, Aged, 80 and over, Breast diagnostic imaging, Breast surgery, Female, Humans, Middle Aged, Retrospective Studies, Breast Neoplasms surgery, Surgical Instruments, Ultrasonography, Mammary methods
- Abstract
Sonographically detectable clips were introduced over the last decade. We retrospectively studied the rate and duration of sonographically detectable clip detectability in patients with breast cancer who had sonographically detectable clips inserted over a 2-year period. Nine of 26 patients had neoadjuvant chemotherapy, with all clips remaining detectable 140 to 187 days after insertion. Six of the 9 had intraoperative sonographic localization, with 1 reoperation (17%). Eleven additional patients with nonpalpable tumors and sonographically detectable clips had intraoperative sonographic localization with 1 reoperation (9%). In 1 patient, a sonographically detectable clip enabled intraoperative identification of a suspicious lymph node. There were no complications or clip migration. Sonographically detectable clips are helpful in breast cancer surgery with and without neoadjuvant chemotherapy, remaining detectable for many months and often averting preoperative localization and scheduling difficulties., (© 2016 by the American Institute of Ultrasound in Medicine.)
- Published
- 2017
- Full Text
- View/download PDF
30. Repair of caudal septal deviation: the fishing line technique.
- Author
-
Yaniv D, Hadar T, Hod R, Lansberg R, Koren I, and Yaniv E
- Subjects
- Adolescent, Adult, Female, Humans, Male, Middle Aged, Nose Diseases surgery, Surgical Flaps, Young Adult, Nasal Septum surgery, Otorhinolaryngologic Surgical Procedures, Plastic Surgery Procedures
- Abstract
Background: Repair of caudal septal deviation using currently described methods is challenging technically. The aim of this work is to describe a novel and simple technique for the treatment of caudal septal deviations that protects the nasal tip, by fixating of cartilage to the columella., Methods: All patients with caudal septal deviation operated on between June 2008 to November 2013 in 2 major medical centers were operated using the "fishing line technique." Patient satisfaction was recorded by a standard questionnaire (16-item Sino-Nasal Outcome Test [SNOT-16]), before and after surgery. The fishing line technique was performed in 63 patients with a severe caudal septal deviation of which 14 also had rhinoplasty. A mucoperichondrial flap was elevated on either side of the damaged septal cartilage. The cartilage was excised and remodeled into a straight sheet, and then repositioned between the mucoperichondrial flaps, and fixed to the septal columella., Results: Mean age of the study group was 36 years. Follow-up ranged from 24 to 70 months. At the last follow-up, the septum was straight in all cases, with no deviation from the nostrils to the choana. Good airway was found in 53 patients. Eight patients had partial turbinate hypertrophy with an impaired airway, and 2 had severe turbinate hypertrophy. SNOT-16 mean score improved from 27 to 10 (p < 0.001). All patients were satisfied with the aesthetic outcome., Conclusion: The fishing-line technique for severe caudal septum deviations is easy to perform and yields satisfactory anatomic and aesthetic results., (© 2016 ARS-AAOA, LLC.)
- Published
- 2017
- Full Text
- View/download PDF
31. Heat shock proteins HSP90, HSP70 and GRP78 expression in medullary thyroid carcinoma.
- Author
-
Soudry E, Stern Shavit S, Hardy B, Morgenstern S, Hadar T, and Feinmesser R
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Carcinoma, Neuroendocrine diagnosis, Carcinoma, Neuroendocrine pathology, Child, Endoplasmic Reticulum Chaperone BiP, Female, Humans, Immunohistochemistry methods, Male, Middle Aged, Thyroid Neoplasms diagnosis, Thyroid Neoplasms pathology, Young Adult, Carcinoma, Neuroendocrine metabolism, HSP70 Heat-Shock Proteins metabolism, HSP90 Heat-Shock Proteins metabolism, Heat-Shock Proteins metabolism, Thyroid Neoplasms metabolism
- Abstract
Background: Medullary thyroid carcinoma management consists mainly of surgical resection and is largely chemoresistant. There is ongoing effort to discover novel therapies for medullary thyroid carcinoma. Increased levels of heat shock proteins have been associated with multiple cancers and are being studied as potential therapeutic targets. The purpose of this study was to determine the expression levels of heat shock proteins 90 and 70 and of glucose related protein 78 in medullary thyroid carcinoma tissues compared with normal thyroid tissues., Methods: 20 tissue specimens of medullary thyroid carcinoma and 10 specimens of thyroids without malignancy were analyzed by immunohistochemistry., Results: Medullary thyroid carcinoma specimens showed 27% higher expression level of heat shock protein 90 immunostaining, and a 43% higher expression level of heat shock protein 70 immunostaining versus normal controls. These differences, however, were not statistically significant. A significantly higher expression level was noted for glucose related protein 78 in the medullary thyroid carcinoma specimens than in the controls., Conclusion: This study indicates increased expression levels of heat shock proteins 90 and 70 and glucose related protein 78 levels in medullary thyroid carcinoma. These findings, though preliminary imply that these proteins may have a role in medullary thyroid carcinoma's tumor biology and may have and future therapeutic options. Larger cohorts are needed to corroborate these results., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
32. Prognostic factors in metastatic cutaneous squamous cell carcinoma of the head and neck.
- Author
-
Bachar G, Mizrachi A, Rabinovics N, Guttman D, Shpitzer T, Ad-El D, and Hadar T
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Carcinoma, Squamous Cell mortality, Disease-Free Survival, Female, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Skin Neoplasms mortality, Carcinoma, Squamous Cell secondary, Head and Neck Neoplasms pathology, Skin Neoplasms pathology
- Abstract
Metastatic cutaneous squamous cell carcinoma (SCC) of the head and neck poses a significant therapeutic challenge due to its aggressive biologic behavior. We conducted a retrospective study of 71 patients-58 men and 13 women, aged 28 to 88 years (mean: 71)-who had been treated at our university-affiliated tertiary care medical center for metastatic cutaneous SCC over a 15-year period. In addition to demographic data, we compiled and analyzed information on tumor characteristics, the site and extent of metastasis, treatment, follow-up, and outcome. Among the tumor factors, poorly differentiated carcinoma was an independent predictor of poorer disease-free survival, and older age was found to be an independent predictor of poorer overall survival. We found no significant difference in disease-free or disease-specific survival among patients with parotid involvement, neck involvement, or both. In our series, the site of nodal involvement appeared to have no prognostic significance in patients with metastatic cutaneous SCC of the head and neck.
- Published
- 2016
33. Brachytherapy for radiotherapy-resistant head and neck cancer: A review of a single center experience.
- Author
-
Hazkani I, Rabinovics N, Limon D, Silvern D, Koren S, Hadar T, Bachar G, Shpitzer T, and Popovtzer A
- Subjects
- Adult, Aged, Aged, 80 and over, Eccrine Glands radiation effects, Feasibility Studies, Female, Humans, Male, Middle Aged, Mouth radiation effects, Nasal Mucosa radiation effects, Neoplasm Recurrence, Local radiotherapy, Radiation Tolerance, Radiotherapy Dosage, Squamous Cell Carcinoma of Head and Neck, Treatment Outcome, Young Adult, Brachytherapy methods, Carcinoma, Squamous Cell radiotherapy, Head and Neck Neoplasms radiotherapy
- Abstract
Objectives/hypothesis: Despite advances in radiotherapy and chemotherapy treatments for head and neck cancers, the local failure rate is high. In most radiotherapy-resistant cases, surgery is performed; however, some cases are considered unresectable. No standard treatment for these situations has been established. In this study, we review our experience with brachytherapy (BT), which has a different biological mechanism than standard radiotherapy., Methods: All patients received prior radiation to the recurrence area. Median high-dose radiation BT dose was 50 Gy, administered in 5 to 10 Gy fractions twice daily for 5 days. High-dose radiation was given via four to 10 catheters inserted under local anesthesia (3 patients) or general anesthesia with preventive tracheostomy (10 patients)., Results: Thirteen patients received BT from 2010 to 2014. Male:female ratio was 1.6:1, and median age was 66 years (range 23-89). Of those 13 patients, 10 patients were diagnosed with squamous cell carcinoma (SCC) of the oral cavity, two patients with SCC of the nasal mucosa, and one patient with eccrine duct carcinoma. Prior radiation dose ranged from 60 to 70 Gy. Local control was achieved in 11 of 13 patients; only 15.3% (2 of 13) had in-field recurrence. Five patients developed local out-of-field recurrence, and two developed distant metastases. Five patients are alive with no evidence of disease. No major toxicities were encountered. Two patients had severe mucositis and recovered within several weeks., Conclusion: Brachytherapy for radiotherapy-resistant head and neck cancers is feasible with minor adverse events, which enables good local control. However, many advanced head and neck cancers develop regional or distant metastases; therefore, additional treatment should be suggested., Level of Evidence: 4. Laryngoscope, 126:2246-2251, 2016., (© 2016 The American Laryngological, Rhinological and Otological Society, Inc.)
- Published
- 2016
- Full Text
- View/download PDF
34. 16S rRNA amplicon sequencing identifies microbiota associated with oral cancer, human papilloma virus infection and surgical treatment.
- Author
-
Guerrero-Preston R, Godoy-Vitorino F, Jedlicka A, Rodríguez-Hilario A, González H, Bondy J, Lawson F, Folawiyo O, Michailidi C, Dziedzic A, Thangavel R, Hadar T, Noordhuis MG, Westra W, Koch W, and Sidransky D
- Subjects
- Aged, Cohort Studies, Female, Gene Amplification, Head and Neck Neoplasms genetics, Head and Neck Neoplasms microbiology, Head and Neck Neoplasms surgery, Head and Neck Neoplasms virology, Humans, Longitudinal Studies, Male, Middle Aged, Papillomaviridae genetics, Papillomavirus Infections microbiology, Papillomavirus Infections pathology, Papillomavirus Infections surgery, Prognosis, Risk Factors, Squamous Cell Carcinoma of Head and Neck, Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell microbiology, Carcinoma, Squamous Cell surgery, Carcinoma, Squamous Cell virology, Microbiota genetics, Mouth Neoplasms genetics, Mouth Neoplasms microbiology, Mouth Neoplasms surgery, Mouth Neoplasms virology, Oral Surgical Procedures, Papillomavirus Infections genetics, RNA, Ribosomal, 16S genetics
- Abstract
Systemic inflammatory events and localized disease, mediated by the microbiome, may be measured in saliva as head and neck squamous cell carcinoma (HNSCC) diagnostic and prognostic biomonitors. We used a 16S rRNA V3-V5 marker gene approach to compare the saliva microbiome in DNA isolated from Oropharyngeal (OPSCC), Oral Cavity Squamous Cell Carcinoma (OCSCC) patients and normal epithelium controls, to characterize the HNSCC saliva microbiota and examine their abundance before and after surgical resection.The analyses identified a predominance of Firmicutes, Proteobacteria and Bacteroidetes, with less frequent presence of Actinobacteria and Fusobacteria before surgery. At lower taxonomic levels, the most abundant genera were Streptococcus, Prevotella, Haemophilus, Lactobacillus and Veillonella, with lower numbers of Citrobacter and Neisseraceae genus Kingella. HNSCC patients had a significant loss in richness and diversity of microbiota species (p<0.05) compared to the controls. Overall, the Operational Taxonomic Units network shows that the relative abundance of OTU's within genus Streptococcus, Dialister, and Veillonella can be used to discriminate tumor from control samples (p<0.05). Tumor samples lost Neisseria, Aggregatibacter (Proteobacteria), Haemophillus (Firmicutes) and Leptotrichia (Fusobacteria). Paired taxa within family Enterobacteriaceae, together with genus Oribacterium, distinguish OCSCC samples from OPSCC and normal samples (p<0.05). Similarly, only HPV positive samples have an abundance of genus Gemellaceae and Leuconostoc (p<0.05). Longitudinal analyses of samples taken before and after surgery, revealed a reduction in the alpha diversity measure after surgery, together with an increase of this measure in patients that recurred (p<0.05). These results suggest that microbiota may be used as HNSCC diagnostic and prognostic biomonitors., Competing Interests: The authors have no conflicts of interest with the subject matter or materials discussed in this manuscript.
- Published
- 2016
- Full Text
- View/download PDF
35. Bacteriology of the Middle Meatus in Chronic Rhinosinusitis with and without Polyposis.
- Author
-
Stern S, Hadar T, Nachalon Y, Ben-Zvi H, Soudry E, and Yaniv E
- Subjects
- Academic Medical Centers, Adult, Bacteria classification, Case-Control Studies, Chronic Disease, Female, Follow-Up Studies, Humans, Incidence, Israel, Male, Middle Aged, Nasal Cavity surgery, Nasal Polyps physiopathology, Nasal Polyps surgery, Nasal Surgical Procedures methods, Preoperative Care methods, Retrospective Studies, Rhinitis epidemiology, Rhinitis surgery, Risk Assessment, Sinusitis epidemiology, Sinusitis surgery, Tertiary Care Centers, Bacteria isolation & purification, Nasal Cavity microbiology, Nasal Polyps microbiology, Rhinitis microbiology, Sinusitis microbiology
- Abstract
There are only limited data in the literature, and none specifically from the Middle East, on the pathogenic bacteria in chronic rhinosinusitis (CRS) as opposed to healthy nasal cavities and their association with disease severity. The present study was conducted in the department of head and neck surgery of a tertiary medical center. Middle meatal swabs were taken preoperatively from patients with CRS with nasal polyposis (CRSwNP) (n = 60), CRS without nasal polyposis (CRSsNP) (n = 50), and control patients with septal deviation (n = 26) or no nasal abnormalities (n = 27). Culture findings were compared among the groups and correlated with CRS severity. Positive pathogenic culture rates were 78% in the CRSwNP group and 64% in the CRSsNP group. Twenty pathogenic bacterial species were identified; the most common was Staphylococcus aureus (27%). The most common Gram-negative isolate was Citrobacter spp. (17%). Gram-negative species were significantly more prevalent in the CRSwNP group than the others. Mean Lund-Mackay scores were 12.8 in the CRSwNP group and 6.9 in the CRSsNP group, and were unrelated to the culture findings. Positive culture rates were significantly higher in the septal deviation (54%) than the nasal healthy group (26%), although both values were significantly lower than in the CRS groups. In conclusion, patients with CRS have higher rates of bacterial isolates than patients without CRS. CRSwNP is associated with more Gram-negative bacteria than CRSsNP, regardless of disease severity. The relatively high positive culture rate in patients with septal deviation merits investigation., (© 2016 S. Karger AG, Basel.)
- Published
- 2016
- Full Text
- View/download PDF
36. Adjuvant treatment for head and neck cancer in solid organ transplant recipients.
- Author
-
Rabinovics N, Hadar T, Mizrachi A, Bachar G, Purim O, and Popovtzer A
- Subjects
- Adult, Aged, Chemotherapy, Adjuvant, Female, Humans, Male, Middle Aged, Young Adult, Carcinoma, Squamous Cell drug therapy, Head and Neck Neoplasms drug therapy, Organ Transplantation
- Published
- 2015
- Full Text
- View/download PDF
37. Differential promoter methylation of kinesin family member 1a in plasma is associated with breast cancer and DNA repair capacity.
- Author
-
Guerrero-Preston R, Hadar T, Ostrow KL, Soudry E, Echenique M, Ili-Gangas C, Pérez G, Perez J, Brebi-Mieville P, Deschamps J, Morales L, Bayona M, Sidransky D, and Matta J
- Subjects
- Adult, Aged, Aged, 80 and over, Breast Neoplasms pathology, Case-Control Studies, Epigenesis, Genetic, Female, Humans, Middle Aged, Myelin and Lymphocyte-Associated Proteolipid Proteins genetics, Nerve Growth Factors genetics, Promoter Regions, Genetic, Tacrolimus Binding Proteins genetics, Breast Neoplasms blood, Breast Neoplasms genetics, DNA Methylation, DNA Repair, Kinesins genetics
- Abstract
Methylation alterations of CpG islands, CpG island shores and first exons are key events in the formation and progression of human cancer, and an increasing number of differentially methylated regions and genes have been identified in breast cancer. Recent studies of the breast cancer methylome using deep sequencing and microarray platforms are providing a novel insight on the different roles aberrant methylation plays in molecular subtypes of breast cancer. Accumulating evidence from a subset of studies suggests that promoter methylation of tumor-suppressor genes associated with breast cancer can be quantified in circulating DNA. However, there is a paucity of studies that examine the combined presence of genetic and epigenetic alterations associated with breast cancer using blood-based assays. Dysregulation of DNA repair capacity (DRC) is a genetic risk factor for breast cancer that has been measured in lymphocytes. We isolated plasma DNA from 340 participants in a breast cancer case control project to study promoter methylation levels of five genes previously shown to be associated with breast cancer in frozen tissue and in cell line DNA: MAL, KIF1A, FKBP4, VGF and OGDHL. Methylation of at least one gene was found in 49% of the cases compared to 20% of the controls. Three of the four genes had receiver characteristic operator curve values of ≥ 0.50: MAL (0.64), KIF1A (0.51) and OGDHL (0.53). KIF1A promoter methylation was associated with breast cancer and inversely associated with DRC. This is the first evidence of a significant association between genetic and epigenetic alterations in breast cancer using blood-based tests. The potential diagnostic utility of these biomarkers and their relevance for breast cancer risk prediction should be examined in larger cohorts.
- Published
- 2014
- Full Text
- View/download PDF
38. Key tumor suppressor genes inactivated by "greater promoter" methylation and somatic mutations in head and neck cancer.
- Author
-
Guerrero-Preston R, Michailidi C, Marchionni L, Pickering CR, Frederick MJ, Myers JN, Yegnasubramanian S, Hadar T, Noordhuis MG, Zizkova V, Fertig E, Agrawal N, Westra W, Koch W, Califano J, Velculescu VE, and Sidransky D
- Subjects
- Carcinoma, Squamous Cell metabolism, Cell Line, Tumor, Cohort Studies, CpG Islands, Female, Head and Neck Neoplasms metabolism, Humans, Male, Mutation, PAX5 Transcription Factor genetics, PAX5 Transcription Factor metabolism, Paired Box Transcription Factors genetics, Paired Box Transcription Factors metabolism, Receptor, Notch1 genetics, Receptor, Notch1 metabolism, Tumor Suppressor Protein p53 genetics, Tumor Suppressor Protein p53 metabolism, Carcinoma, Squamous Cell genetics, DNA Methylation, Gene Silencing, Genes, Tumor Suppressor, Head and Neck Neoplasms genetics, Promoter Regions, Genetic
- Abstract
Tumor suppressor genes (TSGs) are commonly inactivated by somatic mutation and/or promoter methylation; yet, recent high-throughput genomic studies have not identified key TSGs inactivated by both mechanisms. We pursued an integrated molecular analysis based on methylation binding domain sequencing (MBD-seq), 450K Methylation arrays, whole exome sequencing, and whole genome gene expression arrays in primary head and neck squamous cell carcinoma (HNSCC) tumors and matched uvulopalatopharyngoplasty tissue samples (UPPPs). We uncovered 186 downregulated genes harboring cancer specific promoter methylation including PAX1 and PAX5 and we identified 10 key tumor suppressor genes (GABRB3, HOXC12, PARP15, SLCO4C1, CDKN2A, PAX1, PIK3AP1, HOXC6, PLCB1, and ZIC4) inactivated by both promoter methylation and/or somatic mutation. Among the novel tumor suppressor genes discovered with dual mechanisms of inactivation, we found a high frequency of genomic and epigenomic alterations in the PAX gene family of transcription factors, which selectively impact canonical NOTCH and TP53 pathways to determine cell fate, cell survival, and genome maintenance. Our results highlight the importance of assessing TSGs at the genomic and epigenomic level to identify key pathways in HNSCC, deregulated by simultaneous promoter methylation and somatic mutations.
- Published
- 2014
- Full Text
- View/download PDF
39. Cancer of the head and neck region in solid organ transplant recipients.
- Author
-
Rabinovics N, Mizrachi A, Hadar T, Ad-El D, Feinmesser R, Guttman D, Shpitzer T, and Bachar G
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Basal Cell diagnosis, Carcinoma, Basal Cell mortality, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell mortality, Female, Follow-Up Studies, Head and Neck Neoplasms diagnosis, Head and Neck Neoplasms mortality, Humans, Incidence, Kaplan-Meier Estimate, Male, Middle Aged, Retrospective Studies, Skin Neoplasms diagnosis, Skin Neoplasms mortality, United States epidemiology, Carcinoma, Basal Cell etiology, Carcinoma, Squamous Cell etiology, Head and Neck Neoplasms etiology, Organ Transplantation adverse effects, Skin Neoplasms etiology
- Abstract
Background: Solid organ recipients are at an increased risk of developing various malignancies. We investigated the incidence, clinical features, and outcome of patients diagnosed with head and neck cancer after organ transplantation., Methods: A retrospective analysis was undertaken of patients who underwent solid organ transplantation (kidney, liver, lung, heart) treated at our institution from 1992 to 2010., Results: Of 2817 organ recipients, 175 patients (6.1%) developed 391 head and neck malignancies. Cutaneous malignancies were the most common (93%): squamous cell carcinoma (SCC; 51%) and basal cell carcinoma (BCC; 42%). The average interval from transplantation to diagnosis of head and neck malignancy was 7.3 years, with liver recipients diagnosed earlier. Eighteen percent of patients presented with an aggressive pattern of head and neck cancer, including 24% of patients with cutaneous SCC., Conclusion: Organ transplantation recipients are at a higher risk to develop head and neck cancer with an aggressive behavior characterized by multiple recurrences and decreased survival., (Copyright © 2013 Wiley Periodicals, Inc.)
- Published
- 2014
- Full Text
- View/download PDF
40. Size discrepancy between sonographic and pathological evaluation of solitary papillary thyroid carcinoma.
- Author
-
Bachar G, Buda I, Cohen M, Hadar T, Hilly O, Schwartz N, Shpitzer T, and Segal K
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Carcinoma, Papillary, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Thyroid Cancer, Papillary, Treatment Outcome, Tumor Burden, Young Adult, Artifacts, Carcinoma diagnosis, Carcinoma surgery, Microscopy methods, Thyroid Neoplasms diagnosis, Thyroid Neoplasms surgery, Ultrasonography methods
- Abstract
Background: Sonographic size of suspicious thyroid lesions is an essential parameter in the evaluation of thyroid nodules, determining the need for needle biopsy and has impact on the extent of surgery. Limited data is available on the correlation between the size of the thyroid nodule on sonography and the actual size measured during histological examination. The aim of the present study was to compare these two modalities and to discuss the potential clinical implications of the findings in the study population., Methods: The database of Rabin Medical Center was reviewed for all patients with histologically proven papillary carcinoma of the thyroid treated by thyroid surgery between 2005 and 2010., Results: 292 patients with papillary thyroid carcinoma were included. The mean sonographic size of the nodule was 2.19 ± 1.15 cm. The mean pathological diameter was 1.69 ± 1.09 cm. Discrepancies between tumor histological diameter and the sonographically measurement were more prominent in tumors larger than 1.5 cm. Nonetheless, 18.8% of thyroid nodules that were measured by US as larger than 1cm, were found to be smaller than 1cm on final pathology. Similarly, 7.2% of nodules evaluated by sonography were determined as being larger than 4 cm, while their definitive size was smaller than 4 cm., Conclusions: We noted a significant discrepancy between the preoperative sonographic and the pathologic size measurements for papillary thyroid carcinoma. The sonographic evaluation misclassifies both patients with small and large thyroid tumors, and consequently exposes them to unnecessary workup and more extensive operation. This discrepancy between the ultrasound findings and actual tumor size should be taken into account in clinical practice and help guide the evaluation and treatment of patients with thyroid nodules., (Copyright © 2013. Published by Elsevier Ireland Ltd.)
- Published
- 2013
- Full Text
- View/download PDF
41. Post-laryngectomy voice rehabilitation: comparison of primary and secondary tracheoesophageal puncture.
- Author
-
Guttman D, Mizrachi A, Hadar T, Bachar G, Hamzani Y, Marx S, and Shvero J
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Chemoradiotherapy adverse effects, Chemoradiotherapy methods, Female, Humans, Male, Middle Aged, Punctures, Retrospective Studies, Time Factors, Treatment Outcome, Voice Quality, Young Adult, Hypopharyngeal Neoplasms surgery, Laryngeal Neoplasms surgery, Laryngectomy methods, Larynx, Artificial, Voice Disorders rehabilitation
- Abstract
Background: Voice restoration following total laryngectomy is an important part of patients' rehabilitation and long-term quality of life., Objectives: To evaluate the long-term outcome of indwelling voice prostheses inserted during (primary procedure) or after (secondary procedure) total laryngectomy., Methods: The study group included 90 patients who underwent total laryngectomy and tracheoesophageal puncture (TEP) with placement of voice prosthesis at a tertiary medical center during the period 1990-2008. Background, clinical and outcome data were collected by medical file review. Findings were compared between patients in whom TEP was performed as a primary or a secondary procedure., Results: TEP was performed as a primary procedure in 64 patients and a secondary procedure in 26. Corresponding rates of satisfactory voice rehabilitation were 84.4% and 88.5% respectively. There was no association of voice quality with either receipt of adjuvant radiation/chemoradiation or patient age. The average lifetime of the voice prosthesis was 4.2 months for primary TEP and 9.06 months for secondary TEP (P= 0.025)., Conclusions: Primary TEP provides almost immediate and satisfactory voice rehabilitation. However, it is associated with a significantly shorter average prosthesis lifetime than secondary TEP. Chemoradiotherapy and patient age do not affect voice quality with either procedure.
- Published
- 2013
42. Prognostic significance of nodal ratio in cutaneous squamous cell carcinoma of the head and neck.
- Author
-
Mizrachi A, Hadar T, Rabinovics N, Shpitzer T, Guttman D, Feinmesser R, and Bachar G
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell mortality, Disease-Free Survival, Female, Head and Neck Neoplasms mortality, Humans, Lymphatic Metastasis, Male, Middle Aged, Prognosis, Skin Neoplasms mortality, Squamous Cell Carcinoma of Head and Neck, Survival Rate, Carcinoma, Squamous Cell pathology, Head and Neck Neoplasms pathology, Lymph Nodes pathology, Skin Neoplasms pathology
- Abstract
The TNM classification is not specific for head and neck skin cancer and makes no allowance for disease extent. Studies have shown that the relative number of metastatic-to-examined lymph nodes, termed the Nodal ratio, is a reliable independent prognosticator in several types of cancer. The study was designed as a retrospective analysis in a university affiliated tertiary care center setting. The files of all patients (n = 71) with cutaneous head and neck squamous cell carcinoma and regional lymph node metastasis who attended a tertiary medical center between 1990 and 2008 were reviewed for clinical variables and outcome, and Nodal ratio was calculated. Data were analyzed for impact on survival. On multivariate analysis Nodal ratio and age were found to be significant predictors of overall survival. The N-ratio was the only significant predictor of disease-specific survival. Age, type of treatment (selective/modified neck dissection), pathologic N stage, and radiotherapy had no effect. The Nodal ratio is a potentially valuable prognostic index in cutaneous squamous cell carcinoma. The minimal number of nodes that need to be excised has to be determined.
- Published
- 2013
- Full Text
- View/download PDF
43. Effect of intranasal steroids on glucose and hemoglobin A1c levels in diabetic patients.
- Author
-
Mizrachi A, Bachar G, Yaniv E, Hadar T, and Vinker S
- Subjects
- Administration, Intranasal, Aged, Aged, 80 and over, Anti-Inflammatory Agents adverse effects, Female, Glucocorticoids adverse effects, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Triamcinolone Acetonide adverse effects, Anti-Inflammatory Agents administration & dosage, Blood Glucose analysis, Diabetes Mellitus, Type 2 blood, Glucocorticoids administration & dosage, Glycated Hemoglobin analysis, Triamcinolone Acetonide administration & dosage
- Abstract
Background: Intranasal steroids are widely used for the treatment of inflammatory diseases of the nose and sinuses such as rhinosinusitis, allergic rhinitis, and nonallergic rhinitis. Along with the general otherwise healthy population, many diabetic patients use intranasal steroids as well. This study was designed to evaluate the adverse effects of long-term treatment with intranasal corticosteroid preparations in diabetic patients., Methods: The study group included all diabetic patients treated with intranasal steroids for at least 3 months at primary care clinics in Clalit Health Services Central District in Israel in 2002-2007. The central database had been reviewed for demographic data, medical history, medications, and laboratory test results., Results: A total of 1768 diabetic patients were treated with topical nasal steroid sprays during the study period. Data on hemoglobin A1c (HbA1c) levels both before and during steroid treatment was available for 245 patients, and data on fasting serum glucose levels at both time points was available for 163 patients. On statistical analysis, there was no change in either measure from baseline to 3 months after starting treatment (p = 0.104 and p = 0.101, respectively). Treatment with triamcinolone acetonide was associated with a significantly greater increase in fasting serum glucose levels than other preparations (p = 0.006)., Conclusion: Intranasal corticosteroids seem to have no adverse effects on HbA1c and serum glucose levels in diabetic patients. Their long-term use appears to be safe, provided that the patients are carefully monitored, especially those receiving triamcinolone acetonide.
- Published
- 2012
- Full Text
- View/download PDF
44. Novel grading system for quantifying upper-airway obstruction on sleep endoscopy.
- Author
-
Bachar G, Nageris B, Feinmesser R, Hadar T, Yaniv E, Shpitzer T, and Eidelman L
- Subjects
- Adult, Body Mass Index, Chi-Square Distribution, Female, Humans, Hypopharynx pathology, Larynx pathology, Male, Middle Aged, Nasopharynx pathology, Palatine Tonsil pathology, Severity of Illness Index, Tongue pathology, Uvula pathology, Airway Obstruction pathology, Endoscopy, Sleep Apnea, Obstructive pathology
- Abstract
Background: The aim of this study was to present a novel anatomically comprehensive and clinically applicable system for the quantification of sleep endoscopy findings in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS)., Methods: Fifty-five adult patients with a polysomnographic diagnosis of OSAHS were referred for midazolam-induced sleep endoscopy following failure of continuous positive airway pressure. Five anatomical sites of possible obstruction along the upper airway were documented: nose/nasopharynx (N), uvulopalatine plane (P), tongue base (T), larynx (L), and hypopharynx (H). Each involved site was assigned a severity grade of 1 (partial obstruction) or 2 (complete obstruction). The digits representing the obstruction pattern at each level were then added to yield a severity index (SI). The SI for each patient was determined by two independent observers. Findings were correlated with the respiratory disturbance index (RDI) and body mass index (BMI)., Results: The SI was significantly correlated with the RDI (R=0.746, Pearson; P<0.0001) and predicted disease severity with 65% accuracy. There was no association with BMI. By site, the tongue base and hypopharynx were significantly correlated with obstruction severity; obstruction in the tongue base predicted disease severity with a sensitivity of 68.8 and sensitivity of 81.1., Conclusion: Our easy-to-use endoscopic grading system provides physicians with an accurate picture of the pattern of the upper-airway system obstruction in patients with obstructive sleep apnea/hypopnea syndrome. It is a promising tool for estimating the location and severity of upper airway disease and may have implications for treatment planning.
- Published
- 2012
- Full Text
- View/download PDF
45. Early tongue carcinoma: analysis of failure.
- Author
-
Preis M, Hadar T, Soudry E, Shpitzer T, Strenov Y, Hod R, Nageris BI, and Feinmesser R
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell mortality, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Risk Factors, Tongue Neoplasms mortality, Treatment Failure, Young Adult, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Glossectomy, Neck Dissection, Tongue Neoplasms pathology, Tongue Neoplasms surgery
- Abstract
Background: Failure rate of surgery for early tongue carcinoma remains high. We sought to identify patterns of failure and recurrence risk factors., Methods: Data review was carried out on 50 patients treated for early tongue carcinoma (T1/2N0M0); surgery was unsuccessful in 11 of these patients. All patients underwent transoral resection of the tongue tumor and prophylactic neck dissection (supraomohyoid)., Results: Tumor recurred within 3 to 18 months. Nine died of disease. Four had failure in neck level 4, 6 in level 1, and 1 simultaneously in level 1 and locally. Most tumors were moderately differentiated. Average depth was 6.64 mm., Conclusions: We report 11 patients with early tongue carcinoma who failed local excision with neck dissection. Failures occurred in level 4 (4 patients) and level 1 (7 patients). This group may benefit from extended neck surgery. Sex, age, stage, and depth of tumor were not significantly different in the group with treatment failure. Tumors in the group with treatment failure were more poorly differentiated., (Copyright © 2011 Wiley Periodicals, Inc.)
- Published
- 2012
- Full Text
- View/download PDF
46. Role of parathyroid hormone monitoring during parathyroidectomy.
- Author
-
Bachar G, Mizrachi A, Hadar T, Feinmesser R, and Shpitzer T
- Subjects
- Adenoma blood, Adenoma diagnosis, Female, Humans, Hyperparathyroidism, Primary diagnosis, Hyperparathyroidism, Primary surgery, Male, Middle Aged, Parathyroid Neoplasms blood, Parathyroid Neoplasms diagnosis, Adenoma surgery, Monitoring, Intraoperative, Parathyroid Hormone blood, Parathyroid Neoplasms surgery, Parathyroidectomy
- Abstract
Background: The value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy has been previously debated., Methods: This retrospective analysis was of 240 patients, operated on for primary hyperparathyroidism (PHPT) between January 2002 and January 2006 and categorized into 3 groups by preoperative and intraoperative modalities: group 1 (n = 109), technetium 99m sestamibi (MIBI), ultrasonography, and IOPTH; group 2 (n = 102), ultrasonography and MIBI; and group 3 (n = 29), ultrasonography and IOPTH. Sensitivity and specificity were calculated., Results: In group 1, IOPTH increased the success rate from 97% to 99%. In group 2, ultrasonography and MIBI were concordant in 95% of cases. In group 3, IOPTH increased the sensitivity from 89% to 96%. The duration of surgery was longer (p < .0001) when IOPTH was applied., Conclusions: When ultrasonography and MIBI are used, the additional benefit of IOPTH is marginal, especially given the longer duration of surgery. Ultrasonography and additional IOPTH yield good success rates when MIBI is not available., (Copyright © 2011 Wiley Periodicals, Inc.)
- Published
- 2011
- Full Text
- View/download PDF
47. Squamous cell carcinoma of the oral tongue in patients over 75 years old.
- Author
-
Soudry E, Preis M, Hod R, Hamzany Y, Hadar T, Bahar G, Sternov Y, and Shpitzer T
- Subjects
- Aged, Aged, 80 and over, Cohort Studies, Combined Modality Therapy, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Rate, Treatment Outcome, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Tongue Neoplasms pathology, Tongue Neoplasms therapy
- Abstract
Background and Aims: Squamous cell carcinoma (SCC) of the oral tongue is one of the most frequent head and neck cancers. The over-70-year age group is the fastest growing segment of the population. Age, however, is not considered a prognostic factor in oral tongue SCC. This study investigated the clinical and histopathological characteristics, disease course, and outcome of SCC of the oral tongue in patients over 75 years old compared with younger patients., Methods: We reviewed the files of 85 patients with histologically proven SCC of the oral tongue who were treated in our department in 1992-2007 and followed for a minimum of 2 years. Findings were compared between those aged 75 years or more and younger patients., Results: Twenty-eight patients (33%) were aged 75 to 94 years (average 80.5±4.5 yrs), including 14 who were over 80 years old, and 57 patients were aged 15-74 years (average 51.1±18.2 yrs). No statistically significant differences were found between the groups in clinical or histopathological characteristics or patient outcome. The 5-year disease-free survival rate was 65% for patients over 75 and 58% for younger patients. Corresponding rates for 5-year disease-specific survival were 69% and 70%. These differences were not statistically significant., Conclusions: Patients over 75 with oral tongue SCC should be managed like younger patients in terms of clinical staging and co-morbidities. They should be given a chance for treatment, as their prognosis is no different from that of younger patients.
- Published
- 2011
- Full Text
- View/download PDF
48. Anti-estrogen therapy for hereditary hemorrhagic telangiectasia - a long-term clinical trial.
- Author
-
Yaniv E, Preis M, Shevro J, Nageris B, and Hadar T
- Subjects
- Adult, Epistaxis etiology, Estrogen Antagonists therapeutic use, Female, Humans, Male, Middle Aged, Quality of Life, Tamoxifen therapeutic use, Telangiectasia, Hereditary Hemorrhagic complications, Epistaxis drug therapy, Telangiectasia, Hereditary Hemorrhagic drug therapy
- Abstract
Statement of Problem: Hereditary hemorrhagic telangiectasia (HHT) is associated with recurrent epistaxis in 90% of the cases. Good response to hormone treatment has been documented, although its use remains controversial. The aim of this study was to examine the efficacy of an anti-estrogenic agent, tamoxifen, in the treatment of HHT-associated epistaxis., Method of Study: Out of 46 patients with diagnosis of epistaxis due to HHT who started treatment with tamoxifen 20 mg/d, 38 patients completed a mean of 23.4 months of treatment. All patients filled out a self-assessment questionnaire of rhinologic Quality of Life and epistaxis grading scale., Main Results: The bleeding score and the Quality of Life score improved. Hemoglobin concentration also improved. None of the patients needed blood transfusions during the treatment period. Only one patient had minor side effects of the drug., Principal Conclusions: Tamoxifen appears to be an effective agent for the treatment of epistaxis due to HHT.
- Published
- 2011
- Full Text
- View/download PDF
49. Malignant external otitis: analysis of severe cases.
- Author
-
Soudry E, Hamzany Y, Preis M, Joshua B, Hadar T, and Nageris BI
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Otitis Externa classification, Otitis Externa mortality, Severity of Illness Index, Survival Rate, Otitis Externa diagnosis
- Abstract
Objective: To study the effect of specific clinical, laboratory, and imaging parameters on the course of severe (type 1) malignant external otitis (MEO)., Study Design: Case series with chart review., Setting: Tertiary, university-affiliated medical center., Subjects and Methods: Fifty-seven patients hospitalized with severe MEO were followed for disease course and survival in a tertiary center between 1990 and 2008., Results: In 20% of patients, disease was persistent and/or aggressive despite prolonged and extensive treatment. Of this subgroup, 45% died of the disease. Prognostic factors of persistent/aggressive disease were facial nerve paralysis, bilateral disease, and significant major computed tomography findings (temporomandibular joint destruction, infratemporal fossa or nasopharyngeal soft tissue involvement). Cultures grew fungi in 5 patients, and follow-up imaging revealed disease progression. The overall 5-year survival was 55% for patients with short-term disease and 40% for patients with persistent/ aggressive disease (P = .086). By age, 5-year survival was 75% in patients younger than 70 years old and 44% in older patients (P = .029)., Conclusions: A significant subset of patients with MEO has a prolonged, aggressive, and highly fatal disease that needs to be identified early. These patients more frequently have bilateral disease, cranial nerve paralysis, and positive computed tomography findings. Their follow-up should routinely include imaging studies to evaluate disease progression, and every effort should be made to identify and treat underlying fungal infection.
- Published
- 2011
- Full Text
- View/download PDF
50. Fungal malignant external otitis.
- Author
-
Hamzany Y, Soudry E, Preis M, Hadar T, Hilly O, Bishara J, and Nageris BI
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Fungi classification, Fungi isolation & purification, Humans, Hyperbaric Oxygenation, Male, Middle Aged, Mycoses microbiology, Mycoses therapy, Otitis Externa microbiology, Otitis Externa therapy, Treatment Outcome, Mycoses mortality, Mycoses pathology, Otitis Externa mortality, Otitis Externa pathology
- Abstract
Objective: To investigate the clinical characteristics and outcome of fungal malignant external otitis (MEO)., Methods: The files of 60 patients treated for MEO in 1990-2008 at a tertiary medical center were reviewed for clinical characteristics and outcome, and findings were compared between patients with fungal and nonfungal infection., Results: Mean duration of follow-up was 4 years. Nine patients (15%) had fungal disease; the main pathogen was Candida spp. Compared with the nonfungal MEO group, patients with a fungal infection were younger at diagnosis (average 68 vs. 74 years, p = 0.01) and had more facial nerve palsies (55% vs. 14%, p = 0.01), fewer positive bacterial cultures at presentation (33% vs. 75%, p = 0.02), and higher rates of surgery (78% vs. 18%, p = 0.0008) and hyperbaric treatment (78% vs. 4%, p = 0.0001). Eighty-nine percent had persistent infection (>2 courses of systemic antibiotics before antifungal treatment) compared with 12% in the nonfungal group (p = 0.0001). Fungal disease was associated with more persistently positive imaging findings (87.5% vs. 25%, p = 0.0001). There was no significant between-group difference in survival., Conclusion: Fungal MEO probably occurs secondary to prolonged antibiotic treatment for bacterial MEO. The fungal disease is more invasive than the bacterial disease, although survival is the same. Treatment should be aggressive and hyperbaric oxygen therapy should be considered., (Copyright © 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.