Dystrophin expression in the mdx mouse restored by stem cell transplantation

The development of cell or gene therapies for diseases involving cells that are widely distributed throughout the body has been severely hampered by the inability to achieve the disseminated delivery of cells or genes to the affected tissues or organ. Here we report the results of bone marrow transplantation studies in the mdx mouse, an animal model of Duchenne's muscular dystrophy, which indicate that the intravenous injection of either normal haematopoietic stem cells or a novel population of muscle-derived stem cells into irradiated animals results in the reconstitution of the haematopoietic compartment of the transplanted recipients, the incorporation of donor-derived nuclei into muscle, and the partial restoration of dystrophin expression in the affected muscle. These results suggest that the transplantation of different stem cell populations, using the procedures of bone marrow transplantation, might provide an unanticipated avenue for treating muscular dystrophy as well as other diseases where the systemic delivery of therapeutic cells to sites throughout the body is critical. Our studies also suggest that the inherent developmental potential of stem cells isolated from diverse tissues or organs may be more similar than previously anticipated.

Engineering and characterization of functional human microvessels in immunodeficient mice

SUMMARY

Current model systems used to investigate angiogenesis in vivo rely on the interpretation of results obtained with nonhuman endothelial cells. Recent advances in tissue engineering and molecular biology suggest the possibility of engineering human microvessels in vivo. Here we show that human dermal microvascular endothelial cells (HDMEC) transplanted into severe combined immunodeficient (SCID) mice on biodegradable polymer matrices differentiate into functional human microvessels that anastomose with the mouse vasculature. HDMEC were stably transduced with Flag epitope or alkaline phosphatase to confirm the human origin of the microvessels. Endothelial cells appeared dispersed throughout the sponge 1 day after transplantation, became organized into empty tubular structures by Day 5, and differentiated into functional microvessels within 7 to 10 days. Human microvessels in SCID mice expressed the physiological markers of angiogenesis: CD31, CD34, vascular cellular adhesion molecule 1 (VCAM-1), and intercellular adhesion molecule 1 (ICAM-1). Human endothelial cells became invested by perivascular smooth muscle alpha-actin-expressing mouse cells 21 days after implantation. This model was used previously to demonstrate that overexpression of the antiapoptotic protein Bcl-2 in HDMEC enhances neovascularization, and that apoptotic disruption of tumor microvessels is associated with apoptosis of surrounding tumor cells. The proposed SCID mouse model of human angiogenesis is ideally suited for the study of the physiology of microvessel development, pathologic neovascular responses such as tumor angiogenesis, and for the development and investigation of strategies designed to enhance the neovascularization of engineered human tissues and organs.

Diagnostic value of HLA-B27 testing ankylosing spondylitis and Reiter's syndrome

Typing for histocompatibility antigen (HLA)-B27 has been suggested as a clinically valuable diagnostic test for ankylosing spondylitis and Reiter's syndrome, although some decry its use for this purpose. Diagnoses can be made in most patients with these diseases on the basis of the history, physical examination, and roentgenographic findings. The B27 test cannot be used to screen an asymptomatic population to detect these diseases and should not be thought of as a routine diagnostic test. We present probability graphs derived from Bayes' theorem, which show that for certain patients the B27 test, when used properly, is of clinical value as an aid to diagnosis. Proper application of the B27 test in clinical medicine is discussed. The test result does not absolutely confirm or exclude the presence of these diseases; it merely provides a probability statement on their existence in the patient. The test is therefore most useful to physicians who understand the use of probability reasoning in clinical decision making.

Interferon-dependent activation of the serine kinase PI 3'-kinase requires engagement of the IRS pathway but not the Stat pathway

Several signaling pathways are activated by interferon alpha (IFNalpha) in hematopoietic cells, including the Jak-Stat and the insulin receptor substrate (IRS) pathways. It has been previously shown that IFNalpha activates the phosphatidylinositol (PI) 3'-kinase via an interaction of the p85 subunit of PI 3'-kinase with IRS proteins. Other studies have proposed that Stat-3 also functions as an adapter for p85. We sought to identify the major pathway that regulates IFNalpha activation of the PI3'-kinase in hematopoietic cells. Our data demonstrate that IFNalpha induces the interaction of p85 with IRS-1 or IRS-2, but not Stat-3, in various hematopoietic cell lines in which IRS-1 and/or IRS-2 and Stat-3 are activated by IFNalpha. In addition, inhibition of PI 3'-kinase activity by preincubation of cells with the PI 3'-kinase inhibitor LY294002 does not affect IFN-dependent formation of SIF complexes that contain Stat-3. To determine whether phosphorylation of tyrosine residues in the IFN receptor is required for activation of the PI 3'-kinase, we performed studies using mouse L929 fibroblasts transfected with mutated human IFNAR1 and/or IFNAR2 subunits of the Type I IFN receptor, lacking tyrosine phosphorylation sites. The serine kinase activity of the PI-3K was activated by human IFNalpha in these cells, suggesting that phosphorylation of the Type I IFN receptor is not essential for PI3K activation. We then determined whether IFNalpha activates the Akt kinase, a known downstream target for PI 3'-kinase that mediates anti-apoptotic signals. Akt was activated by insulin or IGF-1, but not IFNalpha, in the IFNalpha-sensitive U-266 myeloma cell line. Altogether, our data establish that the IRS pathway and not the Stat pathway, is the major pathway regulating engagement of PI 3'-kinase in hematopoietic cells. Furthermore, the selective activation of Akt by insulin/IGF-1 suggests the existence of distinct regulatory activities of PI3'-kinase in growth factor versus interferon signaling.

Amazonian palm Oenocarpus bataua ("patawa"): chemical and biological antioxidant activity--phytochemical composition

In French Guiana, "diversity" within the Palm family is obvious since more than 75 species have been identified. Oenocarpus bataua Mart., called "patawa" is well known for its culinary uses whereas literature on its phytochemical composition and biological properties remains poor. This work deals with determining the antioxidant activity of this palm fruit and its polyphenol composition; Euterpe oleracea (açai) used as a reference. It turned out that patawa had a stronger antioxidant activity than açai in TEAC and FRAP tests. A similar activity was observed by DPPH assay whereas in ORAC and KRL tests, that açai showed an antioxidant activity respectively 2.6 and 1.5 fold higher than patawa. Polyphenolic composition, determined by UPLC/MS(n), would imply the presence of anthocyanins, condensed tannins, stilbenes and phenolic acids, well known for their biological activities. These results present patawa fruit as a new amazonian resource for cosmetics, food and pharmaceuticals purposes.

Risk of transmission of bovine spongiform encephalopathy to humans in the United States: report of the Council on Scientific Affairs. American Medical Association

CONTEXT

The risk of possible transmission of bovine spongiform encephalopathy (BSE) in the United States is a substantial public health concern.

OBJECTIVE

To systematically review the current scientific literature and discuss legislation and regulations that have been implemented to prevent the disease.

METHODS

Literature review using the MEDLINE, EMBASE, and Lexis/Nexis databases for 1975 through 1997 on the terms bovine spongiform encephalopathy, prion diseases, prions, and Creutzfeldt-Jakob syndrome. The Internet was used to identify regulatory actions and health surveillance.

DATA EXTRACTION

MEDLINE, EMBASE, and Lexis/Nexis databases were searched from 1975 through 1997 for English-language articles that provided information on assessment of transmission risk.

RESULTS

Unique circumstances in the United Kingdom caused the emergence and propagation of BSE in cattle, including widespread use of meat and bonemeal cattle feed derived from scrapie-infected sheep and the adoption of a new type of processing that did not reduce the amount of infectious prions prior to feeding. Many of these circumstances do not exist in the United States. In the United Kingdom, new variant Creutzfeldt-Jakob disease probably resulted from the ingestion of BSE-contaminated processed beef. The United Kingdom and the European Union now have strong regulations in place to stop the spread of BSE. While BSE has not been observed in the United States, the US government has surveillance and response plans in effect.

CONCLUSIONS

Current risk of transmission of BSE in the United States is minimal because (1) BSE has not been shown to exist in this country; (2) adequate regulations exist to prevent entry of foreign sources of BSE into the United States; (3) adequate regulations exist to prevent undetected cases of BSE from uncontrolled amplification within the US cattle population; and (4) adequate preventive guidelines exist to prevent high-risk bovine materials from contaminating products intended for human consumption.

Accuracy of touch imprint cytology in diagnosing lung cancer

A 3-year study assessed the diagnostic accuracy of touch imprint smears in the diagnosis of lung cancer. Touch imprint smears were prepared from 90 computerized tomographic-guided core needle lung biopsies. Cytological diagnosis of touch imprint smears were correlated with the histological diagnosis of the corresponding core needle biopsy specimen, which was taken as the gold standard. The sensitivity, specificity, positive predictive value and negative predictive value of imprint smear results were 89%, 100%, 100% and 68%, respectively. There were no false positives, and all patients with small cell lung cancer were correctly diagnosed with this technique. Imprint cytology can be used to provide a rapid, preliminary diagnosis of lung cancer.

Checklist of the dragonflies and damselflies (Insecta: Odonata) of Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka

A checklist of the dragonflies and damselflies occurring in Bangladesh, Bhutan, India (including Andaman and Nicobar Islands), Nepal, Pakistan and Sri Lanka is presented. In total 588 (including 559 full species) taxa are known to occur in the region of which 251 taxa (species subspecies) are single country endemics. Recent taxonomic changes relevant to the area are summarized. Sixteen taxa are synonymized and a checklist of all synonyms established since 1950 is provided. Information is given on available larval descriptions including a list of genera present in the region for which no larvae have yet been described. Numerous species occurring in the area are still poorly known and a list of genera for which a revision is urgently needed is provided.                The following new synonyms are established: Calicnemia sudhaae Mitra, 1994 = Calicnemia imitans Lieftinck, 1948 syn. nov.; Ceriagrion fallax cerinomelas Lieftinck, 1927 = Ceriagrion fallax Ris, 1914 syn. nov.; Ceriagrion fallax pendleburyi Laidlaw, 1931 = Ceriagrion fallax Ris, 1914 syn. nov.; Coenagrion kashmirus Chowdhary Das, 1975 = Ischnura forcipata Morton, 1907 syn. nov.; Enallagma insula Fraser, 1920 = Aciagrion occidentale Laidlaw, 1919 syn. nov.; Himalagrion pithoragarhicum Sahni, 1964 = Ceriagrion fallax Ris, 1914 syn. nov.; Ischnura bhimtalensis Sahni, 1965 = Ischnura rubilio Selys, 1876 syn. nov.; Onychargia indica Sahni, 1964 = Paracercion calamorum (Ris, 1916) syn. nov.; Anaciaeschna kashmirense Singh Baijal, 1954 = Anaciaeschna martini (Selys, 1897) syn. nov.; Cyclogomphus vesiculosus Selys, 1854 = Cyclogomphus ypsilon Selys, 1954 syn. nov.; Chlorogomphus brittoi Navás, 1934 = Chlorogomphus xanthoptera (Fraser, 1919) syn. nov.; Hylaeothemis indica Fraser, 1946 = Hylaeothemis apicalis Fraser, 1924 syn. nov.; Sympetrum durum Bartenef, 1916 = Sympetrum striolatum commixtum Selys, 1884 syn. nov.; Sympetrum himalayanum Navás, 1934 = Sympetrum hypomelas (Selys, 1884) syn. nov.; Sympetrum haematoneura Fraser, 1924 = Sympetrum speciosum Oguma, 1915 syn. nov.; Sympetrum speciosum taiwanum Asahina, 1951 = Sympetrum speciosum Oguma, 1915 syn. nov.                In addition, Periaeschna lebasi Navás, 1930 is regarded a nomen nudum. The following new combinations are proposed: Onychogomphus acinaces Laidlaw, 1922 is transferred to the genus Melligomphus Chao, 1990 resulting in Melligomphus acinaces (Laidlaw, 1922) comb. nov. Onychogomphus saundersii Selys, 1854 is transferred to the genus Nychogomphus Carle, 1986 resulting in Nychogomphus saundersii (Selys, 1854) comb. nov..

Peliosis of the spleen with rupture

A case of peliosis of the spleen without apparent involvement of the liver or other organs is presented. The peliosis was discovered following rupture of the spleen after minimal trauma and was successfully treated by surgery. None of the common associations of peliosis was present (i.e., tuberculosis or intake of steroid compounds). Drugs addiction and chronic alcoholism were the only coexisting debilitating conditions exhibited by this patient.

Botulinum toxin injection in the pediatric population with medically refractory neuropathic bladder

INTRODUCTION

Botulinum toxin injection (BTI) has been advocated as a second line therapy in management of neuropathic bladder in pediatric population for refractory patients to conventional medical management such as anticholinergics. The purpose was to review the safety and efficacy of BTI in children with neuropathic bladder refractory to conservative non-surgical measures. We hypothesized that BTI would be an effective alternative to bladder augmentation in certain patients but not all.

METHODS

We retrospectively identified 22 patients with neuropathic bladder due to any condition who underwent urologic BTI at our hospital since 2010. Multiple clinicopathologic variables were examined including the following: demographics, use of anticholinergics, the presence of anticholinergic refractoriness or intolerance, dosage of BTI, urodynamic variables, and continence status.

RESULTS

The mean patient age at time of BTI was 10 years with a follow up of 12 months. Indications for BTI were anti-cholinergic refractory (AR) urodynamic parameters and/or incontinence and anticholinergic intolerance (AI). Nearly all patients received 300 Units at BTI into detrusor. No complications occurred from BTI. Overall 54% had improved continence after the initial BTI whereas 45% had achieved complete continence between catheterizations. Cystometric capacity increased by 46% and maximum detrusor pressure decreased by 43% following initial BTI (See Table). 75% of AI patients were continent between CIC after BTI compared to 50% of AR patients (P = 0.002). The observed mean duration of clinical improvement after initial BTI was 4.6 months and four patients underwent repeat BTI. Pre BTI % of age expected bladder capacity Post BTI % of age expected bladder capacity % Improvement in Urodynamic Parameter P value Cystometric Capacity (mL) 227 60 331 87 46 0.008 Maximum Detrusor Pressure (cm H2O) 63 44 43 0.002 Compliance (mL/cm H2O) 4.3 8.8 104 0.001.

DISCUSSION

Our results are comparable to existing literature with respect to urodynamic parameters. The observed differences may be due to heterogenous patient population of various etiologies of neuropathic bladder and no uniform criteria to proceed with bladder augmentation. The AR patients in our cohort may have had a higher degree of bladder fibrosis which BTI would be less likely to impact and explain the differences in clinical response between AR and AI patients.

CONCLUSIONS

BTI is a safe and effective treatment option for pediatric patients with neuropathic bladder refractory to standard therapy. The degree of continence observed after BTI in our series was higher for AI rather than AR patients.

Experience with pion radiotherapy

Forty-one patients with a total of 86 tumors were treated with negative pimesons (pions) at the Los Alamos Meson Physics Facility (LAMPF) through December 31, 1977. An additional 30 tumors in the total patient population were treated with 100 kVp x-rays to assess comparative effects on skin nodules and 8 patients received additive photon or electron radiation to pion-treated portals. Of 52 evaluable tumors in 20 patients treated with pions only and followed for 3 to 22 months, 81% (42 tumors) completely regressed; 6% (3 tumors) partially regressed; and 13% (7 tumors) did not respond, although 5 of the 7 have shown no growth for 10 months. Of eight tumors in seven patients treated with a combination of pions and conventional radiation, three tumors showed complete response and five tumors showed partial response, though the resected specimens in two (one with complete and one with partial response) revealed no tumor microscopically. Reactions in normal tissues have been mild, with some patients exhibiting no normal tissue reaction, as compared with relatively marked tumor response.

Investigation by immunofluorescence of arterial lesions in rabbits on two different lipid supplements and treated with pyridinol carbamate

Rabbits maintained on a pellet diet supplemented with cholesterol, or on a semi-synthetic diet containing beef fat but no added cholesterol, have been studied in relation to their development of hyperlipidaemia and of lipid-filled arterial lesions. The influence of pyridinol carbamate on animals on both diets was also examined but found to produce no significant effect. Animals on both diets developed a hyperlipoproteinaemia. In cholesterol-fed animals this developed quickly, became gross, and was characterized by the presence of an anomalous lipoprotein of very low density, large molecular size and abnormally high cholesterol content. Beef fat fed animals showed a more moderate hyperlipidaemia which developed more slowly and the lipoproteins qualitatively resembled those in normal rabbits. Differences in the rate and severity of development of aortic lesions between the two different dietary supplements were found to reflect differences in the duration and intensity of hyperlipoproteinaemia between the groups. Arterial lesions in cholesterol-fed animals were more extensive and contained larger numbers of fat-filled cells than those in beef fat-fed animals. Comparisons were made (in many cases on the identical section) between lesions treated with a fluorescein labelled antiserum to total rabbit serum low density lipoproteins (TLDL) and with a conventional lipid stain. Precise agreement was found between the distribution of lipid reacting with Oil red 0 and specific fluorescence for TLDL in endothelial cells, in extracellular deposits in the intimal ground-substance and in medial smooth muscle cells. But fat-filled cells in the intima and in reticulo-endothelial tissue showed variable immunofluorescent reactivity. The reason for this discrepancy is discussed. Agreement between the distribution of conventional lipid staining and specific immunofluorescence for TLDL was also found in extracellularly distributed material in arterioles and smaller vessels at certain sites. It is suggested that these results establish that rabbit TLDL serve as the vehicles transporting lipid into the experimental lesions, just as the homologous human lipoproteins do in human atherosclerosis.

Langerhans cell histiocytosis in sequential discordant lymphoma

B cell non-Hodgkin lymphoma of the follicular subtype (grade 3/3) affecting the nasopharynx and breast, and containing foci of Langerhans cell histiocytosis, was diagnosed in a 56 year old white woman who was a longstanding heavy smoker. Four years before this she had developed stage 1a mixed cellularity Hodgkin lymphoma affecting the right inguinal region, which was treated by irradiation and chemotherapy without recurrence. Review of the original Hodgkin lymphoma histology demonstrated a small focus of Langerhans cell histiocytosis. This is thought to be the first recorded case of Langerhans cell histiocytosis occurring in a sequential discordant lymphoma. Its importance is discussed.

Manganese in gasoline. Council on Scientific Affairs, American Medical Association

This report responds to a resolution that asked the American Medical Association (AMA) to take action to reduce potential health risks from the use of methylcyclopentadienyl manganese tricarbonyl (MMT) in gasoline. Information for this report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with medical and public health experts. Based on this information, the AMA Council on Scientific Affairs determined that there is insufficient scientific evidence to assess the public health impact of MMT use. While limited evidence indicates that general-population exposures to manganese from the use of MMT in gasoline are low, more research is needed to determine possible health effects from long-term, low-dose exposures to MMT and its combustion products. Until such data are available, educational and informational strategies should be developed to improve public awareness of the health and environmental issues surrounding MMT use.

Digestive tract schwannoma

BACKGROUND

Digestive tract schwannomas (DTS) are rare benign mesenchymal tumours usually affecting females between 30 and 60 years old.

METHODS

We retrospectively reviewed 2 cases of DTS treated at our hospital. The first case is a 38-year-old female with gastric schwannoma presenting with acute upper gastro-intestinal bleeding. The second case is a 36-year-old female with mesenteric schwannoma presenting with chronic right iliac fossa pain. Both patients underwent surgical resection of the tumour.

RESULTS

Histology and immunohistochemistry revealed the typical appearance of a DTS.

CONCLUSION

DTS is most commonly found in the stomach. It is usually asymptomatic but can present with variable symptoms. Definitive diagnosis can only be made on the basis of immunohistochemistry. Surgical resection is the treatment of choice.

Phyllodes tumour and stromal sarcoma of the breast: an ultrastructural comparison

The ultrastructure of the stromal cells of three benign and one malignant phyllodes tumours and three stromal sarcomas has been studied and compared with the stromal cells of two fibroadenomas and four normal lobules. One stromal sarcoma was possibly of nerve sheath origin, but the other two showed features in common with the phyllodes tumours and the fibroadenomas. Prominent electron dense cytoplasmic bodies with distinctive morphological features are described and a correlation with the degree of malignancy is postulated.

A controlled pore glass bead assay for the measurement of cytoplasmic and nuclear glucocorticoid receptors

An assay for the quantitation of cytoplasmic and nuclear glucocorticoid receptors in lymphoid tissue has been developed using controlled pore glass (CPG) beads. Soluble receptor--3H-steroid complex (cytosol or nuclear extract) is adsorbed quantitatively within the crevasses of porous glass beads. Excess labeled steroid as well as most non-specifically bound steroid is easily washed away, leaving the hormone-receptor complex retained by the beads. Bound 3H-steroid is eluted with ethanol and measured for radioactivity. This procedure which is simple, rapid, and highly reproducible is carried out using frozen samples (stable for many months) containing as few as 1 X 10(7) cells. A comparison of the CPG assay to dextran coated charcoal and a whole cell assay demonstrates that CPG and dextran coated charcoal give equivalent measurements of cytosolic receptor concentration, while the CPG and whole cell assays provide equivalent values for total receptor content.

Evidence-based adjuvant therapy for gliomas: current concepts and newer developments

The incidence of gliomas is increasing worldwide, including India. Of the 18,820 new cases of primary central nervous system (CNS) tumors diagnosed annually in the United States, gliomas account for over 60% with 30-40% of them being glioblastoma multiforme (GBM), 10% being anaplastic astrocytoma (AA), and 10% being low grade gliomas (LGGs). This is in contrast to one study from West Bengal, India, in which only 7.9% of the brain tumors were GBMs, while 46.8% were astrocytomas. Of all adult primary CNS tumors, GBM is the most common and the most malignant with about 7,000 to 8,000 new cases annually in the United States. Given poor outcomes, a number of treatment approaches have been investigated. Common to these approaches is the use of adjuvant radiation therapy, even as surgery alone, with or without chemotherapy, may be the mainstay for some lower grade and low-risk gliomas. Today, treatment typically involves external beam radiation, with concurrent and adjuvant chemotherapy for more aggressive histologies. Although gliomas are relatively uncommon, active research is ongoing. Results of landmark trials along with some of the recently published trials are presented. These trials and management strategies as well as evolving concepts are found by reviewing over 200 articles in the National Library Medical (NLM) database, PubMed, more than 60 of which are refrenced. Specifically, the database is searched using the following keywords, with various combinations: glioma, low-grade, anaplastic, astrocytoma, oligodendroglioma, oligoastrocytoma, glioblastoma multiforme, chemotherapy, radiation, new concepts, phase III, MGMT, CDX-110 (Celldex), temozolomide, 1p/19q deletion, and bevacizumab.

HLA-DR4 genotype frequency and gender effect in familial rheumatoid arthritis

We have studied HLA-A, B, C, and DR antigens in 75 unrelated white families, each with multiple cases of adult-onset definite or classical rheumatoid arthritis (RA) (by ARA criteria). There was no difference in age of onset or serological features of RA between males and females. HLA-DR4 phenotype frequency among female (68%) and male (71%) patients also did not differ significantly. The observed frequencies of HLA-DR4 genotypes (homozygous, heterozygous, and those lacking it) differed significantly (p less than 0.005) between affected and unaffected individuals. However, the observed genotype distribution did not differ from what is expected given the Hardy-Weinburg equilibrium. There is a direct correlation between the number of DR4 allele(s) carried (two, one, or zero) and the percent affected (p less than 0.026 for females and p less than 0.052 for males). These findings highlight the importance of discerning the additional genetic determinants, including those that are gender-associated, which influence susceptibility to RA.

The role of radiotherapy for patients over age 60 with diffuse large B-cell lymphoma in the rituximab era

The role of consolidative radiotherapy (RT) in patients ≥60 years old with DLBCL in the rituximab era is controversial. We examined the impact on disease control and overall survival by the addition of consolidative RT after completion of chemotherapy, while adjusting for known adverse risk factors. Retrospective chart review from 2004 to 2012 of 83 consecutive patients ≥60 years old with DLBCL treated in the rituximab era, 68 of which had a complete response to chemotherapy, was performed. Amongst patients with a complete response, consolidative RT use was associated with 100% 5-year local control, improved progression-free survival (p = 0.047), and a trend for overall survival (p = .098) on multivariate analysis. Amongst all patients, the use of consolidative RT was associated with improved overall survival (p = 0.03). The use of consolidative RT should be considered for patients ≥60 years old independent of stage and response to chemotherapy.

Comparing the Performance Status Scale and MD Anderson Dysphagia Inventory as swallowing outcome measures in head and neck cancer: a prospective cohort study

OBJECTIVES

To examine the relationship between the two disease-specific measures currently in use to assess swallowing outcomes following treatment in patients with head and neck cancer: the Performance Status Scale (PSS) and MD Anderson Dysphagia Inventory (MDADI).

DESIGN

A prospective cohort study.

SETTING

Four head and neck cancer multidisciplinary clinics in the North of England Cancer Network.

PARTICIPANTS

114 patients with cancers of the upper aerodigestive tract.

MAIN OUTCOME MEASURE

Measures of swallowing function administered prospectively across 4 timepoints

RESULTS

Spearman's correlation coefficients were used to measure the relationship between the two scales. There was statistically significant correlation between the two tools at pre-treatment (rs = 0.428, P < 0.000), 3 months post-treatment (rs = 0.454, P < 0.002), 6 months post-treatment (rs = 0.551, P < 0.000) and 12 months post-treatment (rs = 0.680, P < 0.000).

CONCLUSION

This is the first prospective study comparing the MDADI and PSS questionnaires at multiple time points. Our study shows that these different instruments have a good relationship in measuring swallowing function in patients with head and neck cancer in short and medium term after treatment.