OtoRhinoLaryngology by Alexandros G.Sfakianakis

Πέμπτη 3 Αυγούστου 2017

Selective cytotoxicity of vanadium complexes on human pancreatic ductal adenocarcinoma cell line by inducing necroptosis, apoptosis and mitotic catastrophe process.

Selective cytotoxicity of vanadium complexes on human pancreatic ductal adenocarcinoma cell line by inducing necroptosis, apoptosis and mitotic catastrophe process.

Oncotarget. 2017 Jul 22;:

Authors: Kowalski S, Hać S, Wyrzykowski D, Zauszkiewicz-Pawlak A, Inkielewicz-Stępniak I

Abstract
The pancreatic cancer is the fourth leading cause of cancer-related death and characterized by one of the lowest five-year survival rate. The current therapeutic options are demonstrating minimal effectiveness, therefore studies on new potential anticancer compounds, with non-significant side effects are highly desirable. Recently, it was demonstrated that vanadium compounds, in particular organic derivatives, exhibit anticancer properties against different type of tumor as well as favorable biodistribution from a pancreatic cancer treatment perspective.In this research, we showed selective cytotoxic effect of vanadium complexes, containing phenanthroline and quinoline as an organic ligands, against human pancreatic ductal adenocarcinoma cell line (PANC-1), compared to non-tumor human immortalized pancreas duct epithelial cells (hTERT-HPNE). Results exhibited that vanadium complexes inhibited autophagy process in selective cytotoxic concentration as well as caused the cell cycle arrest in G2/M phase associated with mitotic catastrophe and increased level of reactive oxygen species (ROS). Moreover, in higher concentration, vanadium derivatives induced a mix type of cell death in PANC-1 cells, including apoptotic and necroptotic process.Our investigation emphasizes the anticancer potential of vanadium complexes by indicating their selective cytotoxic activity, through different process posed by alternative type of cell deaths to apoptosis-resistant cancer cells. Further studies supporting the therapeutic potential of vanadium in pancreatic cancer treatment is highly recommended.

PMID: 28767448 [PubMed - as supplied by publisher]

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Prevalence and survival prognosis of prostate cancer in patients with end-stage renal disease: a retrospective study based on the Korea national database (2003-2010).

Prevalence and survival prognosis of prostate cancer in patients with end-stage renal disease: a retrospective study based on the Korea national database (2003-2010).

Oncotarget. 2017 Jul 22;:

Authors: Kim SH, Joung JY, Suh YS, Kim YA, Hong JH, Kuark TS, Lee ES, Lee KH

Abstract
OBJECTIVE: The study was aimed to evaluate the prevalence and prognosis of prostate cancer (PC) and end-stage renal disease (ESRD), determine the risk factors for overall survival (OS) and PC-specific survival (CSS), and evaluate differences in PC-related clinical therapeutic patterns between patients with and without PC-ESRD.
METHODS: This observational population study, performed at the National Cancer Center and Cancer Research Institute in Korea, included patients with PC and ESRD from the nationwide Korean Health Insurance System and Korean Central Cancer Registry data. Five-year overall and cancer-specific survival. A joinpoint regression analysis was performed to predict incidence and mortality of PC. Survival was analyzed using Kaplan-Meir curves with log rank tests of patients with dialysis or transplantation.
RESULTS: Of 3945 patients with PC-ESRD, 3.9% were on dialysis (N=152), 0.2% had kidney transplantation (N=10, D-TPL group); 3783 (95.9%) had neither dialysis nor transplantation (non-D-TPL ESRD group). There were 697 PC-specific deaths. The median respective OS, PC-specific survival, and 5-year survival rates in the non-ESRD, non-D-TPL ESRD, dialysis ESRD, and transplantation ESRD groups were significantly different (p<0.001). Presence of ESRD, age, body mass index, SEER stage, no treatment within 6 months after diagnosis, no surgery, chemotherapy, radiotherapy or hormonal therapy, non-adenocarcinoma pathology, and Charlson comorbidity index were independent risk factors for OS and CSS.
CONCLUSIONS: With a 10.1% nationwide prevalence of PC-ESRD, the presence of ESRD was a significant survival factor along with other significant clinicopathological factors.

PMID: 28767447 [PubMed - as supplied by publisher]

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Optimizing molecular weight of octyl chitosan as drug carrier for improving tumor therapeutic efficacy.

Optimizing molecular weight of octyl chitosan as drug carrier for improving tumor therapeutic efficacy.

Oncotarget. 2017 Jul 22;:

Authors: Zhang M, Ma Y, Wang Z, Han Z, Gao W, Gu Y

Abstract
Macromolecular drug carriers have attracted much attention taking advantage of passive tumor targeting property and excellent biocompatibility. For many biomedical applications, however, the effectiveness of the carriers is insufficient, which complicate further development into clinical use. Here, we systematically investigated the effects of molecular weight (from 1KDa to 300KDa) of macromolecular drug carrier, octyl chitosan, on tumor accumulation and penetration, as well as drug loading and releasing profiles. It was found that the molecular weight of chitosan influenced the cellular uptake and pharmacokinetic behavior of the nanocarriers, which ultimately determined their drug delivery efficiency. Interestingly, increased molecular weight of chitosan decreased its cellular uptake but increased its resident time in blood, which provided ample time for tumor accumulation. Moreover, the molecular weight altered the drug loading capability and release profile. Our results demonstrated that 10KDa octyl chitosan was an ideal candidate for anticancer drug delivery, which could deliver anticancer agent to tumor tissues and release drugs in tumor cells more effectively than those of other molecular weights, and finally result in better therapeutic effect.

PMID: 28767446 [PubMed - as supplied by publisher]

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Interim PET-CT may predict PFS and OS in T-ALL/LBL adult patients.

Interim PET-CT may predict PFS and OS in T-ALL/LBL adult patients.

Oncotarget. 2017 Jul 26;:

Authors: Wang L, Wang JH, Bi XW, Chen XQ, Lu Y, Xia ZJ

Abstract
T lymphoblastic leukemia/lymphoma (T-ALL/LBL) is highly aggressive. Although intensive chemotherapies such as ALL-type regimens are commonly used, about half adult patients eventually relapse and die of T-ALL/LBL. Overwhelming evidences have confirmed that interim PET can predict survival outcomes and guide subsequent treatments in Hodgkin lymphoma. However, whether interim PET-CT can predict survival outcomes or not in T-ALL/LBL patients remains unclear. 47 adult patients of T-ALL/LBL were retrospectively reviewed. Interim PET-CT was done after induction therapy and evaluated according to the International Harmonization Project criteria. After induction therapy, interim PET-CT was positive in 19 patients (40.4%). After a median follow up time of 34 months, the 2-year and 3-year progression free survival (PFS) rate were 39% and 30%, respectively, and the 2-year and 3-year overall survival (OS) rate were 54% and 45%, respectively. Using Kaplan-Meier survival analysis, it was found that interim PET-CT positivity correlated with significantly inferior PFS and OS (2-year PFS rate for patients with positive or negative interim PET were 21.1% or 56.0%, respectively, p = 0.002; 2-year OS rate for patients with positive or negative interim PET were 31.6% or 63.7%, respectively, p = 0.010). However, there was no significant relationship between PFS, OS and bone marrow infiltration, lactate dehydrogenase level, and stages (p > 0.05). Interim PET-CT may predict PFS and OS in adult patients of T-ALL/LBL, which needs to be validated in prospective clinical trials. The optimal criteria for interim PET-CT evaluation and risk-adapted treatment strategy determined by interim PET-CT should be investigated in future clinical practice.

PMID: 28768246 [PubMed - as supplied by publisher]

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Over forty years of bladder cancer glycobiology: Where do glycans stand facing precision oncology?

Over forty years of bladder cancer glycobiology: Where do glycans stand facing precision oncology?

Oncotarget. 2017 Jul 21;:

Authors: Azevedo R, Peixoto A, Gaiteiro C, Fernandes E, Neves M, Lima L, Santos LL, Ferreira JA

Abstract
The high molecular heterogeneity of bladder tumours is responsible for significant variations in disease course, as well as elevated recurrence and progression rates, thereby hampering the introduction of more effective targeted therapeutics. The implementation of precision oncology settings supported by robust molecular models for individualization of patient management is warranted. This effort requires a comprehensive integration of large sets of panomics data that is yet to be fully achieved. Contributing to this goal, over 40 years of bladder cancer glycobiology have disclosed a plethora of cancer-specific glycans and glycoconjugates (glycoproteins, glycolipids, proteoglycans) accompanying disease progressions and dissemination. This review comprehensively addresses the main structural findings in the field and consequent biological and clinical implications. Given the cell surface and secreted nature of these molecules, we further discuss their potential for non-invasive detection and therapeutic development. Moreover, we highlight novel mass-spectrometry-based high-throughput analytical and bioinformatics tools to interrogate the glycome in the postgenomic era. Ultimately, we outline a roadmap to guide future developments in glycomics envisaging clinical implementation.

PMID: 28767404 [PubMed - as supplied by publisher]

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Meta-analysis of clinical significance of p53 protein expression in patients with osteosarcoma.

Meta-analysis of clinical significance of p53 protein expression in patients with osteosarcoma.

Future Oncol. 2017 Aug 02;:

Authors: Wu J, Guo A, Li Q, Wang D

Abstract
AIM: The prognostic role of p53 protein expression in osteosarcoma has been reported, but the results remain conflicting.
MATERIALS & METHODS: The relevant literature databases were searched to get eligible articles published in English. The overall ORs or HRs and their corresponding 95% CIs were calculated.
RESULTS: The results indicated that p53 protein expression was not linked to age factor, gender, tumor grade, cancer metastasis and response to chemotherapy. p53 expression was significantly lower in osteogenic osteosarcoma than in nonosteogenic osteosarcoma (OR = 0.40; p = 0.006). p53 expression was associated with a poor prognosis of patients in overall survival (univariate analysis: HR: 2.49; p < 0.001 and multivariate analysis: HR: 2.92; p < 0.001).
CONCLUSION: p53 expression was correlated with pathological type and may become a useful prognostic biomarker in overall survival in osteosarcoma.

PMID: 28766969 [PubMed - as supplied by publisher]

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Regorafenib as treatment for patients with advanced hepatocellular cancer.

Regorafenib as treatment for patients with advanced hepatocellular cancer.

Future Oncol. 2017 Aug 02;:

Authors: Thillai K, Srikandarajah K, Ross P

Abstract
Hepatocellular carcinoma is one of the fastest growing causes of cancer-related mortality worldwide. Sorafenib was the first and only drug to improve survival for patients with advanced disease, and has been the cornerstone of treatment for nearly a decade. Regorafenib is a multikinase inhibitor that has recently been shown to significantly improve survival in patients who have progressed on first-line sorafenib. In this review, we discuss the pharmacokinetic and pharmacodynamics properties of regorafenib and its efficacy and tolerability in patients with advanced hepatocellular carcinoma.

PMID: 28766967 [PubMed - as supplied by publisher]

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Boosting anti-HER2 CD4 T-helper responses in HER2 expressing ductal carcinoma in situ.

Boosting anti-HER2 CD4 T-helper responses in HER2 expressing ductal carcinoma in situ.

Future Oncol. 2017 Aug 02;:

Authors: Nocera NF, Lee MC, Czerniecki BJ

PMID: 28766964 [PubMed - as supplied by publisher]

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HOXA13 is associated with unfavorable survival and acts as a novel oncogene in prostate carcinoma.

HOXA13 is associated with unfavorable survival and acts as a novel oncogene in prostate carcinoma.

Future Oncol. 2017 Aug 02;:

Authors: Dong Y, Cai Y, Liu B, Jiao X, Li ZT, Guo DY, Li XW, Wang YJ, Yang DK

Abstract
AIM: To investigate the clinical relevance and functional role of HOXA13 in prostate cancer Methods: PCR, western blot and immunohistochemistry were performed to determine the expression. Kaplan-Meier and Cox regression survival analyses investigated the clinical relevance. Cell viability, flow cytometry and transwell assays were used to determine the functional roles.
RESULTS: HOXA13 expression is sharply increased in carcinoma tissues and is significantly associated with poor prognosis of prostate cancer patients. Interestingly, nucleus not cytoplasm HOXA13 expression is associated with unfavorable survival of the patients. Furthermore, nucleus HOXA13 expression represents an unfavorable and independent prognosis factor of histological grade 2 or Gleason grade <8 patients. Functionally, forced expression of HOXA13 obviously promotes tumor cell proliferation, migration and invasion, whereas inhibits tumor cell apoptosis.
CONCLUSION: HOXA13 is an unfavorable prognostic factor and a novel oncogene for prostate cancer.

PMID: 28766961 [PubMed - as supplied by publisher]

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Considerations for Clinicians in the Diagnosis, Prevention, and Treatment of Breast Cancer-Related Lymphedema: Recommendations from a Multidisciplinary Expert ASBrS Panel : Part 1: Definitions, Assessments, Education, and Future Directions.

Considerations for Clinicians in the Diagnosis, Prevention, and Treatment of Breast Cancer-Related Lymphedema: Recommendations from a Multidisciplinary Expert ASBrS Panel : Part 1: Definitions, Assessments, Education, and Future Directions.

Ann Surg Oncol. 2017 Aug 01;:

Authors: McLaughlin SA, Staley AC, Vicini F, Thiruchelvam P, Hutchison NA, Mendez J, MacNeill F, Rockson SG, DeSnyder SM, Klimberg S, Alatriste M, Boccardo F, Smith ML, Feldman SM

PMID: 28766232 [PubMed - as supplied by publisher]

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Evaluating the Risk of Upstaging HER2-Positive DCIS to Invasive Breast Cancer.

Evaluating the Risk of Upstaging HER2-Positive DCIS to Invasive Breast Cancer.

Ann Surg Oncol. 2017 Aug 01;:

Authors: Mustafa RE, DeStefano LM, Bahng J, Yoon-Flannery K, Fisher CS, Zhang PJ, Tchou J, Czerniecki BJ, De La Cruz LM

Abstract
BACKGROUND: Overexpression of human epidermal growth factor 2 (HER2) in invasive breast cancer (IBC) is an independent poor prognostic factor. However, the significance of HER2 overexpression in ductal carcinoma in situ (DCIS) is not well defined. The current study assessed the correlation of HER2(+) DCIS with the rate of upstaging to IBC on the final pathology.
METHODS: The study retrospectively analyzed patients with the diagnosis of DCIS on core needle biopsy (CNB) at the authors' institution from 2009 to 2016. Data were analyzed using two-sample t tests. Multivariate analysis was performed using logistic regression.
RESULTS: The study found that HER2(+) DCIS had significantly higher rates of upstaging to IBC than HER2(-) DCIS (odds ratio [OR] 1.89; p = 0.012). In addition, triple-positive disease was more than two times more likely to be upstaged (OR 2.5; p = 0.01), whereas patients with estrogen (ER)-positive, progesterone (PR)-positive, and HER2(-) diseases were half as likely to be upstaged (OR 0.5; p = 0.04). Upstaging did not differ for patients with triple-negative disease (OR 0.89; p = 0.8). Additionally, patients with HER2(+) DCIS were significantly younger regardless of ER/PR status (p = 0.03). The overexpression of HER2 in patients with an initial diagnosis of DCIS on CNB were twice as likely to have IBC on the final pathology as those who did not.
CONCLUSION: The results suggest that overexpression of HER2 may serve as a biomarker for risk stratification of patients with DCIS and may help to guide treatment strategies in the future. For institutions in which HER2 testing may be performed on DCIS, patients should be counseled appropriately about the risk of upgrade to IBC.

PMID: 28766212 [PubMed - as supplied by publisher]

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Keynote Address at the American Society of Breast Surgeons 18th Annual Meeting : Current and Future Application of Intraoperative Radiotherapy (IORT) in the Curative and Palliative Treatment of Breast Cancer.

Keynote Address at the American Society of Breast Surgeons 18th Annual Meeting : Current and Future Application of Intraoperative Radiotherapy (IORT) in the Curative and Palliative Treatment of Breast Cancer.

Ann Surg Oncol. 2017 Aug 01;:

Authors: Wenz F

Abstract
Intraoperative radiotherapy (IORT) is increasingly used worldwide. Breast cancer is the most rapidly growing indication for IORT, approaching 70-80% of cases in most centers. This report reviews the theoretical background and clinical use of IORT for primary and metastasized breast cancer. There are established applications such as tumor bed boost during breast-conserving surgery followed by whole breast radiotherapy or IORT as a form of accelerated partial-breast irradiation (APBI) for selected patients. Novel applications such as IORT for vertebral or brain metastases are presented as well as technological developments, widening the spectrum of potential clinical applications for IORT.

PMID: 28766200 [PubMed - as supplied by publisher]

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Present and future of metastatic colorectal cancer treatment: A review of new candidate targets.

Present and future of metastatic colorectal cancer treatment: A review of new candidate targets.

World J Gastroenterol. 2017 Jul 14;23(26):4675-4688

Authors: Martini G, Troiani T, Cardone C, Vitiello P, Sforza V, Ciardiello D, Napolitano S, Della Corte CM, Morgillo F, Raucci A, Cuomo A, Selvaggi F, Ciardiello F, Martinelli E

Abstract
In the last two decades, great efforts have been made in the treatment of metastatic colorectal cancer (mCRC) due to the approval of new target agents for cytotoxic drugs. Unfortunately, a large percentage of patients present with metastasis at the time of diagnosis or relapse after a few months. The complex molecular heterogeneity of this disease is not completely understood; to date, there is a lack of predictive biomarkers that can be used to select subsets of patients who may respond to target drugs. Only the RAS-mutation status is used to predict resistance to anti-epidermal growth factor receptor agents in patients with mCRC. In this review, we describe approved targeted therapies for the management of metastatic mCRC and discuss new candidate targets on the horizon.

PMID: 28765689 [PubMed - in process]

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Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry.

Lauren subtypes of advanced gastric cancer influence survival and response to chemotherapy: real-world data from the AGAMENON National Cancer Registry.

Br J Cancer. 2017 Aug 01;:

Authors: Jiménez Fonseca P, Carmona-Bayonas A, Hernández R, Custodio A, Cano JM, Lacalle A, Echavarria I, Macias I, Mangas M, Visa L, Buxo E, Álvarez Manceñido F, Viudez A, Pericay C, Azkarate A, Ramchandani A, López C, Martinez de Castro E, Fernández Montes A, Longo F, Sánchez Bayona R, Limón ML, Diaz-Serrano A, Martin Carnicero A, Arias D, Cerdà P, Rivera F, Vieitez JM, Sánchez Cánovas M, Garrido M, Gallego J

Abstract
BACKGROUND: The choice of chemotherapy in HER2-negative gastric cancer is based on centre's preferences and adverse effects profile. No schedule is currently accepted as standard, nor are there any factors to predict response, other than HER2 status. We seek to evaluate whether Lauren type influences the efficacy of various chemotherapies and on patient overall survival (OS).
METHODS: We have conducted a multicenter study in 31 hospitals. The eligibility criteria include diagnosis of stomach or gastroesophageal junction adenocarcinoma, HER2 negativity, and chemotherapy containing 2-3 drugs. Cox proportional hazards regression adjusted for confounding factors, with tests of 'treatment-by-histology' interaction, was used to estimate treatment effect.
RESULTS: Our registry contains 1303 tumours analysable for OS end points and 730 evaluable for overall response rate (ORR). A decrease in ORR was detected in the presence of a diffuse component: odds ratio 0.719 (95% confidence interval (CI), 0.525-0.987), P=0.039. Anthracycline- or docetaxel-containing schedules increased ORR only in the intestinal type. The diffuse type displayed increased mortality with hazard ratio (HR) of 1.201 (95% CI, 1.054-1.368), P=0.0056. Patients receiving chemotherapy with docetaxel exhibited increased OS limited to the intestinal type: HR 0.65 (95% CI, 0.49-0.87), P=0.024, with no increment in OS for the subset having a diffuse component. With respect to progression-free survival (PFS), a significant interaction was seen in the effect of docetaxel-containing schedules, with better PFS limited to the intestinal type subgroup, in the comparison against any other schedule: HR 0.65 (95% CI, 0.50-0.85), P=0.015, and against anthracycline-based regimens: HR 0.64 (95% CI, 0.46-0.88), P=0.046.
CONCLUSIONS: As a conclusion, in this registry, Lauren classification tumour subtypes predicted survival and responded differently to chemotherapy. Future clinical trials should stratify effect estimations based on histology.British Journal of Cancer advance online publication: 1 August 2017; doi:10.1038/bjc.2017.245 www.bjcancer.com.

PMID: 28765618 [PubMed - as supplied by publisher]

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Structural and functional identification of vasculogenic mimicry in vitro.

Structural and functional identification of vasculogenic mimicry in vitro.

Sci Rep. 2017 Aug 01;7(1):6985

Authors: Racordon D, Valdivia A, Mingo G, Erices R, Aravena R, Santoro F, Bravo ML, Ramirez C, Gonzalez P, Sandoval A, González A, Retamal C, Kogan MJ, Kato S, Cuello MA, Osorio G, Nualart F, Alvares P, Gago-Arias A, Fabri D, Espinoza I, Sanchez B, Corvalán AH, Pinto MP, Owen GI

Abstract
Vasculogenic mimicry (VM) describes a process by which cancer cells establish an alternative perfusion pathway in an endothelial cell-free manner. Despite its strong correlation with reduced patient survival, controversy still surrounds the existence of an in vitro model of VM. Furthermore, many studies that claim to demonstrate VM fail to provide solid evidence of true hollow channels, raising concerns as to whether actual VM is actually being examined. Herein, we provide a standardized in vitro assay that recreates the formation of functional hollow channels using ovarian cancer cell lines, cancer spheres and primary cultures derived from ovarian cancer ascites. X-ray microtomography 3D-reconstruction, fluorescence confocal microscopy and dye microinjection conclusively confirm the existence of functional glycoprotein-rich lined tubular structures in vitro and demonstrate that many of structures reported in the literature may not represent VM. This assay may be useful to design and test future VM-blocking anticancer therapies.

PMID: 28765613 [PubMed - in process]

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Characterization of infiltrating lymphocytes in human benign and malignant prostate tissue.

Characterization of infiltrating lymphocytes in human benign and malignant prostate tissue.

Oncotarget. 2017 Jul 24;:

Authors: Rådestad E, Egevad L, Jorns C, Mattsson J, Sundberg B, Nava S, Ericzon BG, Henningsohn L, Levitsky V, Uhlin M

Abstract
Immune checkpoint blockade has shown promising results in numerous cancer types. However, in prostate cancer (PC), absent or limited responses have been reported. To investigate further, we compared the phenotype of infiltrating T-cells isolated from prostate tissue from patients with PC (n = 5), benign prostatic hyperplasia (BPH) (n = 27), BPH with concurrent PC (n = 4) and controls (n = 7). The majority of T-cells were CD8+ and had a CCR7-CD45RO+ effector memory phenotype. However, the yield of T-cells isolated from PC lesions was on average 20-fold higher than that obtained from control prostates. Furthermore, there were differences between the prostate conditions regarding the percentage of T-cells expressing several activation markers and co-inhibitory receptors. In conclusion, many prostate-infiltrating T-cells express co-inhibitory receptors PD-1 and LAG-3, regardless of prostate condition. Despite the observed increase in counts and percentages of PD-1+ T-cells in PC, the concomitant demonstration of high percentage of PD-1+ T-cells in control prostates suggests that PD-1 may play a role in controlling the homeostasis of the prostate rather than in contributing to PC-associated immune-suppression. Thus, PD-1 may not be a good candidate for checkpoint blockade in PC and these data are relevant for evaluation of clinical trials and in designing future immunotherapeutic approaches of PC.

PMID: 28765518 [PubMed - as supplied by publisher]

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Next-generation sequencing in chronic lymphocytic leukemia: recent findings and new horizons.

Next-generation sequencing in chronic lymphocytic leukemia: recent findings and new horizons.

Oncotarget. 2017 Jul 24;:

Authors: Rodríguez-Vicente AE, Bikos V, Hernández-Sánchez M, Malcikova J, Hernández-Rivas JM, Pospisilova S

Abstract
The rapid progress in next-generation sequencing technologies has significantly contributed to our knowledge of the genetic events associated with the development, progression and treatment resistance of chronic lymphocytic leukemia patients. Together with the discovery of new driver mutations, next-generation sequencing has revealed an immense degree of both intra- and inter-tumor heterogeneity and enabled us to describe marked clonal evolution. Advances in immunogenetics may be implemented to detect minimal residual disease more sensitively and to track clonal B cell populations, their dynamics and molecular characteristics. The interpretation of these aspects is indispensable to thoroughly examine the genetic background of chronic lymphocytic leukemia. We review and discuss the recent results provided by the different next-generation sequencing techniques used in studying the chronic lymphocytic leukemia genome, as well as future perspectives in the methodologies and applications.

PMID: 28765516 [PubMed - as supplied by publisher]

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Disease-free survival is not a surrogate endpoint for overall survival in adjuvant trials of pancreatic cancer: a systematic review of randomized trials.

Disease-free survival is not a surrogate endpoint for overall survival in adjuvant trials of pancreatic cancer: a systematic review of randomized trials.

HPB (Oxford). 2017 Jul 29;:

Authors: Petrelli F, Tomasello G, Ghidini M, Lonati V, Passalacqua R, Barni S

Abstract
BACKGROUND: Adjuvant chemotherapy (CT) is the standard of care for patients with resected pancreatic cancer (PC). Overall survival (OS) has traditionally represented the primary endpoint in randomized trials assessing adjuvant therapies for PC. The aim of this study was to assess if disease-free survival (DFS) was an adequate surrogate endpoint for OS in randomized trials of adjuvant therapy in PC.
METHODS: A systematic literature search was conducted in PubMed, Web of Science, SCOPUS and Embase, Cochrane Library and the World Health Organization International Clinical Trials Registry Platform up to February 2nd, 2017. Surrogacy of DFS with OS was assessed between endpoints and OS through the Spearman rank correlation coefficient, and between the treatment effects on the endpoints using the squared correlation R(2).
RESULTS: A total of 12 eligible randomized trials that enrolled 4,888 patients where identified for the final analysis. Correlation of DFS with OS was weak at the individual level (Spearman rank correlation coefficient = 0.31) and moderate at the trial level (R(2) = 0.44).
CONCLUSIONS: DFS does not represent an appropriate surrogate for OS in randomized trials of adjuvant therapy for resected PC. Hence, OS should remain the primary endpoint of future trials evaluating new agents in postsurgical setting.

PMID: 28764887 [PubMed - as supplied by publisher]

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Heterogeneity in high-risk prostate cancer treated with high-dose radiation therapy and androgen deprivation therapy.

Heterogeneity in high-risk prostate cancer treated with high-dose radiation therapy and androgen deprivation therapy.

BMC Urol. 2017 Aug 01;17(1):60

Authors: Cagney DN, Dunne M, O'Shea C, Finn M, Noone E, Sheehan M, McDonagh L, O'Sullivan L, Thirion P, Armstrong J

Abstract
BACKGROUND: Our aim was to assess the heterogeneity of high-risk (HR) prostate cancer managed with high-dose external beam radiotherapy (EBRT) with androgen deprivation therapy (ADT).
METHODS: We identified 547 patients who were treated with modern EBRT from 1997 to 2013, of whom 98% received ADT. We analyzed biochemical relapse-free survival (bRFS) and distant metastases-free survival (DMFS).
RESULTS: Median EBRT dose was 74 Gy, and median ADT duration was 8 months. At 5 years, the DMFS was 85%. On multivariate analysis, significant predictors of shorter bRFS were biopsy Gleason score (bGS) of 8 to 10, higher prostate-specific antigen (PSA) level, shorter duration of ADT and lower radiation dose while predictors of shorter DMFS were bGS of 8 to 10, higher PSA level, and lower radiation dose. We identified an unfavorable high-risk (UHR) group of with 2-3 HR factors based on 2015 National Comprehensive Cancer Network (NCCN) criteria and a favorable high-risk (FHR) group, with 1 HR feature. Comparing very-HR prostate cancer, UHR & FHR, 5 year bRFS rates were 58.2%, 66.2%, and 69.2%, and 5 year DMFS rates were 78.4%, 81.2%, and 88.0%.
CONCLUSION: Patients with multiple HR factors have worse outcome than patients with 1 HR factor. Future studies should account for this heterogeneity in HR prostate cancer.

PMID: 28764689 [PubMed - in process]

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Impact of oestrogen and progesterone receptor expression in the cancer cells and myometrium on survival of patients with endometrial cancer.

Impact of oestrogen and progesterone receptor expression in the cancer cells and myometrium on survival of patients with endometrial cancer.

J Obstet Gynaecol. 2017 Aug 01;:1-7

Authors: Tomica D, Ramić S, Danolić D, Šušnjar L, Perić-Balja M, Puljiz M

Abstract
Loss of oestrogen receptor (ER) and progesterone receptor (PR) expression in endometrial cancer cells indicates poor prognosis. The aim of this study was to determine the correlation of ER and PR expression in cancer cells and the surrounding myometrium with the disease progression. Immunohistochemical expression of ER and PR was detected in cancer and myometrial cells of patients with EC. ER was detected in 65.2% of cancer cells and in 88.4% of myometrial cells. PR was detected in 59.4% of cancer cells and in 84.1% of myometrial cells. The 5-year overall survival (OS) was 76.8%. Patients with ER and PR negative EC had a shorter period until recurrence (p = .013 and .043) and shorter OS (p = .011 and .066) than those with ER and PR positive cancer. Negative ER and PR status in EC has an impact on recurrence and poor OS. The status of hormone receptors in myometrium may be useful in disease prognosis. Impact Statement The status of hormone receptors in endometrial cancer has been the subject of numerous studies and loss of hormone receptors indicates higher tumor grade and higher clinical stage, lympho-vascular space invasion and deeper myometrial invasion. Although, the communication between the endometrium and myometrium is crucial under physiological conditions, the status of hormone receptors in the myometrium and its significance in cancer progression is poorly studied. Our results showed that loss of ER in the myometrium indicate poor prognosis. The assessment of hormone receptor status in myometrium might be useful in predicting the course of the disease. Results of our research support the theory that stromal and myometrial cells may contribute to tumorigenesis in endometrial cancer. Better understanding of ER/PR expression in myometrial cells is needed, and our research opens new possibilities for identification of key pathways and new potential target molecules in EC prognosis and treatment. It is probable that future classification of endometrial cancer will rely on molecular sub-typing, where the status of hormone receptors in the myometrium might play an important role.

PMID: 28764605 [PubMed - as supplied by publisher]

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Optimization of cGMP purification and expansion of umbilical cord blood-derived T-regulatory cells in support of first-in-human clinical trials.

http:--linkinghub.elsevier.com-ihub-imag

Optimization of cGMP purification and expansion of umbilical cord blood-derived T-regulatory cells in support of first-in-human clinical trials.

Cytotherapy. 2017 Feb;19(2):250-262

Authors: McKenna DH, Sumstad D, Kadidlo DM, Batdorf B, Lord CJ, Merkel SC, Koellner CM, Curtsinger JM, June CH, Riley JL, Levine BL, Miller JS, Brunstein CG, Wagner JE, Blazar BR, Hippen KL

Abstract
BACKGROUND AIMS: Thymic-derived regulatory T cells (tTreg) are critical regulators of the immune system. Adoptive tTreg transfer is a curative therapy for murine models of autoimmunity, graft rejection, and graft-versus-host disease (GVHD). We previously completed a "first-in-human" clinical trial using in vitro expanded umbilical cord blood (UCB)-derived tTreg to prevent GVHD in patients undergoing UCB hematopoietic stem cell transplantation (HSCT). tTreg were safe and demonstrated clinical efficacy, but low yield prevented further dose escalation.
METHODS: To optimize yield, we investigated the use of KT64/86 artificial antigen presenting cells (aAPCs) to expand tTreg and incorporated a single re-stimulation after day 12 in expansion culture.
RESULTS: aAPCs increased UCB tTreg expansion greater than eightfold over CD3/28 stimulation. Re-stimulation with aAPCs increased UCB tTreg expansion an additional 20- to 30-fold. Re-stimulated human UCB tTreg ameliorated GVHD disease in a xenogeneic model. Following current Good Manufacturing Practice (cGMP) validation, a trial was conducted with tTreg. tTreg doses up to >30-fold higher compared with that obtained with anti-CD3/28 mAb coated-bead expansion and Foxp3 expression was stable during in vitro expansion and following transfer to patients. Increased expansion did not result in a senescent phenotype and GVHD was significantly reduced.
DISCUSSION: Expansion culture with cGMP aAPCs and re-stimulation reproducibly generates sufficient numbers of UCB tTreg that exceeds the numbers of T effector cells in an UCB graft. The methodology supports future tTreg banking and is adaptable to tTreg expansion from HSC sources. Furthermore, because human leukocyte antigen matching is not required, allogeneic UCB tTreg may be a useful strategy for prevention of organ rejection and autoimmune disease.

PMID: 27887864 [PubMed - indexed for MEDLINE]

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Learning management system and e-learning tools: an experience of medical students' usage and expectations.

Learning management system and e-learning tools: an experience of medical students' usage and expectations.

Int J Med Educ. 2016 Aug 20;7:267-73

Authors: Back DA, Behringer F, Haberstroh N, Ehlers JP, Sostmann K, Peters H

Abstract
OBJECTIVES: To investigate medical students´ utilization of and problems with a learning management system and its e-learning tools as well as their expectations on future developments.
METHODS: A single-center online survey has been carried out to investigate medical students´ (n = 505) usage and perception concerning the learning management system Blackboard, and provided e-learning tools. Data were collected with a standardized questionnaire consisting of 70 items and analyzed by quantitative and qualitative methods.
RESULTS: The participants valued lecture notes (73.7%) and Wikipedia (74%) as their most important online sources for knowledge acquisition. Missing integration of e-learning into teaching was seen as the major pitfall (58.7%). The learning management system was mostly used for study information (68.3%), preparation of exams (63.3%) and lessons (54.5%). Clarity (98.3%), teaching-related contexts (92.5%) and easy use of e-learning offers (92.5%) were rated highest. Interactivity was most important in free-text comments (n = 123).
CONCLUSIONS: It is desired that contents of a learning management system support an efficient learning. Interactivity of tools and their conceptual integration into face-to-face teaching are important for students. The learning management system was especially important for organizational purposes and the provision of learning materials. Teachers should be aware that free online sources such as Wikipedia enjoy a high approval as source of knowledge acquisition. This study provides an empirical basis for medical schools and teachers to improve their offerings in the field of digital learning for their students.

PMID: 27544782 [PubMed - indexed for MEDLINE]

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Regorafenib as treatment for patients with advanced hepatocellular cancer.

Regorafenib as treatment for patients with advanced hepatocellular cancer.

Future Oncol. 2017 Aug 02;:

Authors: Thillai K, Srikandarajah K, Ross P

PMID: 28766967 [PubMed - as supplied by publisher]

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Τετάρτη 2 Αυγούστου 2017

"Ann Rehabil Med"[jour]; +23 new citations

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GI Value Solution

The post GI Value Solution appeared first on Sword Medical.

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NaviAid™ AB Advancing Balloon

The post NaviAid™ AB Advancing Balloon appeared first on Sword Medical.

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BlueNight® Trainer

The post BlueNight® Trainer appeared first on Sword Medical.

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Inhibition of NLRP3 inflammasome: a new protective mechanism of cinnamaldehyde in endotoxin poisoning of mice.

Inhibition of NLRP3 inflammasome: a new protective mechanism of cinnamaldehyde in endotoxin poisoning of mice.

Immunopharmacol Immunotoxicol. 2017 Aug 01;:1-9

Authors: Xu F, Wang F, Wen T, Sang W, Wang D, Zeng N

Abstract
CONTEXT: Cinnamaldehyde (CA) has a protective effect in endotoxin poisoning of mice, but there is no direct evidence for the protective effect of CA through inhibition of NLRP3 inflammasome activation in endotoxin poisoning of mice.
OBJECTIVE: We aimed to investigate the protective mechanism of CA in endotoxin poisoned mice through NLRP3 inflammasome.
MATERIALS AND METHODS: First, we evaluated the anti-inflammatory effect of CA in phorbol-12-myristate acetate-differentiated THP-1 cells through the NLRP3 inflammasome. Second, in a mouse model of lipopolysaccharide (LPS)-induced endotoxin poisoning, CA was administrated for 5 d (once a day) before the 15 mg/kg LPS challenge. Then, the levels of IL-1β in serum were measured, and the effect of CA on the NLRP3 inflammasome activation and the expression of cathepsin B and P2X7R proteins in lung were explored.
RESULTS: In vitro, CA decreased the levels of p20, pro-IL-1β and IL-1β in cell culture supernatants, as well as the expression of NLRP3 and IL-1β mRNA in cells. In vivo, CA decreased IL-1β production in serum. Furthermore, CA suppressed LPS-induced NLRP3, p20, Pro-IL-1β, P2X7 receptor (P2X7R) and cathepsin B protein expression in lung, as well as the expression of NLRP3 and IL-1β mRNA.
CONCLUSIONS: CA has a protective effect in the endotoxin poisoned mice through the inhibition of NLRP3 inflammasome activation. Furthermore, CA suppresses the NLRP3 inflammasome activation by inhibiting the expression of cathepsin B and P2X7R protein expression. CA can be considered as a potential therapeutic candidate for diseases involved in endotoxin poisoning such as sepsis.

PMID: 28762847 [PubMed - as supplied by publisher]

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Incidence and 5-year survival rate for head and neck cancers in Grenada compared to the African American population over the period 1991-2010.

Incidence and 5-year survival rate for head and neck cancers in Grenada compared to the African American population over the period 1991-2010.

Cancer Causes Control. 2017 Jul 31;:

Authors: du Plessis M, Hage R

Abstract
Very little data exist on the incidence and burden of cancer in the individual Caribbean countries. Some data are available for larger areas, reported under a bigger geographical region; Latin America and the Caribbean, but many of the individual countries are not included. One of the main reasons is a lack of official cancer registries. Data are usually collected from hospital records or private physician records, and since it is not in an official registry, these data are not always accessible for inclusion in databases such as SEER and GLOBOCAN. Grenada is one of the countries that currently does not have a registry. Our aim is to report on the incidence for head and neck cancer with subcategories; hypopharynx, oropharynx, oral cavity, salivary glands, and larynx from data collected by the sole ear nose and throat specialist over a 20-year period. The age adjusted incidence per 100,000 for these cancers, whether combined or individually, is lower than that of similar populations. The incidence in males is only slightly higher than those reported in some parts of Africa. In females, only Eastern Africa is reported to have a lower incidence than that found in our study. While the incidence of oral cancers is lower than that of African Americans, the survival rate is comparable. Socioeconomic status, lack of infrastructure, and advanced stage at diagnosis appear to be closely related to the survival rate. Incidence reports suggest that incidence of head and neck cancers in individuals of African descent is lower than other populations. It is therefore not surprising that the incidence in Grenada is relatively low, although the incidence may be underestimated.

PMID: 28762075 [PubMed - as supplied by publisher]

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[Feeding, eating, and swallowing disorders in infants and children : An overview].

[Feeding, eating, and swallowing disorders in infants and children : An overview].

HNO. 2017 Jul 31;:

Authors: Schwemmle C, Arens C

Abstract
Swallowing is a dynamic process that requires more than 30 muscles in the recruitment/coordination of the lips, tongue, palate, pharynx, larynx and esophagus. The eating and swallowing procedure is learned in sensitive or critical periods: when a certain degree of maturation has been achieved, the appropriate stimulus permits a certain milestone of development to occur. The swallowing procedure occurs in three main stages oral, pharyngeal, and esophageal. Therefore, swallowing disorders may present in any, some, or all of these stages in addition to feeding problems. Adult dysphagia, or difficulty swallowing, has long been reported in the literature. Infants and children also experience feeding disorders and swallowing problems, either because of developmental disorders, syndromes, behavioral or neurological conditions, respiratory problems, and/or gastroesophageal reflux, eosinophilic esophagitis or anatomical deficits. Feeding problems or dysphagia are seen in up to 25% of all children; approximately 40% of prematurely born infants have swallowing disorders, up to 64-78% with developmental disorders and up to 99% with cerebral palsy. Diagnostic options include health status, broad social environment, parent-child interactions, and parental concerns. Evaluation of dysphagia and feeding disorders involves a multifactorial approach. Imaging studies may include videofluoroscopy and/or fiberoptic evaluation of swallowing (FEES). Successful oral feeding must be measured in quality of meal time experiences with best possible oral sensorimotor skills and safe swallowing while not jeopardizing a child's functional health status or the parent-child relationship. An interdisciplinary team approach enables coordinated global assessment and therapy planning.

PMID: 28761970 [PubMed - as supplied by publisher]

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Survival of head and neck cancer cells relies upon LZK kinase-mediated stabilization of mutant p53.

Survival of head and neck cancer cells relies upon LZK kinase-mediated stabilization of mutant p53.

Cancer Res. 2017 Jul 31;:

Authors: Edwards ZC, Trotter EW, Torres-Ayuso P, Chapman P, Wood HM, Nyswaner K, Brognard J

Abstract
Head and neck squamous cell carcinoma (HNSCC) includes epithelial cancers of the oral and nasal cavity, larynx, and pharynx and accounts for ~350,000 deaths/year worldwide. Smoking-related HNSCC is associated with few targetable mutations but is defined by frequent copy number alteration, the most common of which is gain at 3q. Critical 3q target genes have not been conclusively determined for HNSCC. Here we present data indicating that MAP3K13 (encoding LZK) is an amplified driver gene in HNSCC. Copy number gain at 3q resulted in increased MAP3K13 mRNA in HNSCC tumor samples and cell lines. Silencing LZK reduced cell viability and proliferation of HNSCC cells with 3q gain but not control cell lines. Inducible silencing of LZK caused near complete loss of colony-forming ability in cells harboring 3q gain. These results were validated in vivo by evidence that LZK silencing was sufficient to reduce tumor growth in a xenograft model of HNSCC. Our results establish LZK as critical for maintaining expression of mutant stabilized p53.

PMID: 28760853 [PubMed - as supplied by publisher]

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Evidence of surgical treatments for intractable Meniere's disease.

Evidence of surgical treatments for intractable Meniere's disease.

Auris Nasus Larynx. 2017 Jul 28;:

Authors: Kitahara T

Abstract
Meniere's disease is an inner ear disease, characterized by recurrent rotatory vertigo, sensorineural hearing loss and tinnitus. There are some with frequent vertigo attacks, progressive hearing loss and persistent annoying tinnitus even through the continuous standard medical treatments. These cases are thought to account for 10%-20% of all cases of Meniere's disease. In this review article, we would like to demonstrate the evidences for surgical treatments according to the previous papers, and consider the next therapeutic strategies including surgical options according to the international guidelines.

PMID: 28760332 [PubMed - as supplied by publisher]

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The applicability of new TNM classification for humanpapilloma virus-related oropharyngeal cancer in the 8th edition of the AJCC/UICC TNM staging system in Japan: A single-centre study.

The applicability of new TNM classification for humanpapilloma virus-related oropharyngeal cancer in the 8th edition of the AJCC/UICC TNM staging system in Japan: A single-centre study.

Auris Nasus Larynx. 2017 Jul 28;:

Authors: Sano D, Yabuki K, Arai Y, Tanabe T, Chiba Y, Nishimura G, Takahashi H, Yamanaka S, Oridate N

Abstract
OBJECTIVE: The purpose of this study is to validate the applicability of new TNM classification for human papillomavirus (HPV)-related oropharyngeal cancer (OPC) in the 8th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM staging system in Japan.
METHODS: A total of 91 OPC patients treated with radiation-based therapy between January 2011 and December 2016 were analyzed retrospectively in this study. HPV infection status was evaluated using tumor p16 expression.
RESULTS: 40 OPC patients (44.0%) had HPV-positive disease in this study. The distribution of disease stage of HPV-positive OPC patients dramatically changed from the 7th edition to the 8th edition of AJCC/UICC TNM classification. However, neither the 8th edition nor the 7th edition of the AJCC/UICC TNM staging system could adequately predict outcomes of HPV-positive OPC patients in our patient series. On the other hand, our multivariate analysis indicated that matted nodes and age ≥63 were independent prognostic factors for progression-free survival. In addition, HPV-positive OPC patients with stage I without matted nodes showed significantly better OS and PFS compared with those with stage I with matted nodes and stages II and III in the 8th edition of the AJCC/UICC TNM staging system (P=0.008, and P=0.043, respectively).
CONCLUSION: Our results suggested that matted nodes of HPV-positive OPC patients might be additionally examined to apply the 8th edition of AJCC/UICC TNM classification for more adequate predicting outcomes of HPV-positive OPC patients.

PMID: 28760331 [PubMed - as supplied by publisher]

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Reversing Age Related Changes of the Laryngeal Muscles by Chronic Electrostimulation of the Recurrent Laryngeal Nerve.

http:--journals.plos.org-plosone-resourc

Reversing Age Related Changes of the Laryngeal Muscles by Chronic Electrostimulation of the Recurrent Laryngeal Nerve.

PLoS One. 2016;11(11):e0167367

Authors: Karbiener M, Jarvis JC, Perkins JD, Lanmüller H, Schmoll M, Rode HS, Gerstenberger C, Gugatschka M

Abstract
Age related atrophy of the laryngeal muscles -mainly the thyroarytenoid muscle (TAM)- leads to a glottal gap and consequently to a hoarse and dysphonic voice that significantly affects quality of life. The aim of our study was to reverse this atrophy by inducing muscular hypertrophy by unilateral functional electrical stimulation (FES) of the recurrent laryngeal nerve (RLN) in a large animal model using aged sheep (n = 5). Suitable stimulation parameters were determined by fatiguing experiments of the thyroarytenoid muscle in an acute trial. For the chronic trial an electrode was placed around the right RLN and stimulation was delivered once daily for 29 days. We chose a very conservative stimulation pattern, total stimulation time was two minutes per day, or 0.14% of total time. Overall, the mean muscle fiber diameter of the stimulated right TAM was significantly larger than the non-stimulated left TAM (30μm±1.1μm vs. 28μm±1.1 μm, p<0.001). There was no significant shift in fiber type distribution as judged by immunohistochemistry. The changes of fiber diameter could not be observed in the posterior cricoarytenoid muscle (PCAM). FES is a possible new treatment option for reversing the effects of age related laryngeal muscle atrophy.

PMID: 27893858 [PubMed - indexed for MEDLINE]

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Surgical outcome of thoracic myelopathy caused by ossification of ligamentum flavum.

Surgical outcome of thoracic myelopathy caused by ossification of ligamentum flavum.

J Clin Neurosci. 2017 Jul 28;:

Authors: Wang H, Wei F, Long H, Han G, Sribastav SS, Li Z, Huang Y, Zhu R, Liang C

Abstract
Ossification of the ligamentum flavum (OLF) may result in thoracic myelopathy (TM) because of the spinal canal narrowing. The aim of this study was to investigate clinical outcomes of symptomatic thoracic OLF treated using posterior decompressive laminectomy. We made a retrospective review of patients who underwent posterior decompressive laminectomy from 2007 through 2016 for symptomatic TM caused by OLF. Thirty-three patients who had surgery for TM caused by OLF that was diagnosed based on clinical, radiologic, and pathologic evaluations. All patients had undergone decompressive laminectomy and excision of the OLF. The clinical course was evaluated according to modified JOA scores. Magnetic resonance imaging was used to determine the number of vertebral segments demonstrating OLF, the level of thoracic cord involvement, and spine lesions coexisting with OLF. Results showed the neurological status improved at follow up (70.82±32.22months) from a preoperative mean Japanese Orthopaedic Association score of 7.03±1.29 points to 9.52±0.83 points at the last follow up (p<0.01). Recovery outcomes were excellent in 8 patients, good in 22 patients, fair in 2 patients and poor in 1 patient. Surgical complications, which resolved after appropriate and prompt treatment, including cerebrospinal fluid leakage in 4 patient, immediate postoperative neurologic deterioration in 2 patient, and wound infection in 4 patient. Our findings suggest that posterior decompressive laminectomy with or without instrumented fusion is an effective treatment for symptomatic thoracic OLF, which provides satisfactory clinical improvement.

PMID: 28760654 [PubMed - as supplied by publisher]

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Successful treatment of pituitary sella Aspergillus abscess in a renal transplant recipient.

Successful treatment of pituitary sella Aspergillus abscess in a renal transplant recipient.

J Clin Neurosci. 2017 Jul 28;:

Authors: Lim JC, Rogers TW, King J, Gaillard F

PMID: 28760653 [PubMed - as supplied by publisher]

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Effect of practicing yoga on cervical vestibular evoked myogenic potential.

Effect of practicing yoga on cervical vestibular evoked myogenic potential.

Eur Arch Otorhinolaryngol. 2017 Jul 31;:

Authors: Shambhu T, Kumar SD, Prabhu P

Abstract
The present study attempted to determine the effect of practicing yoga on functioning of sacculo-collic pathway using cervical vestibular evoked myogenic potential (cVEMP). cVEMP was recorded from 40 participants (20 who practice yoga regularly and 20 who do not practice yoga regularly). The differences in amplitude of P1, N1, P1-N1 complex, asymmetry ratio and latencies of P1 and N1 of cVEMP were compared between both the groups. The results of the study showed that there was a significant increase (p < 0.05) in the amplitude of P1, N1 and P1-N1 complex and a significant reduction in latency (p < 0.05) for experimental group. The asymmetry ratio in individuals who practice yoga was significantly lower (Mean = 6.73) compared to the control group (Mean = 19.13). Multivariate regression analyses suggested that the number of years of yoga practice significantly predicted the amplitude of P1-N1 complex (β = 0.70, p < 0.01) and amplitude ratio (β = 0.72, p < 0.01). Thus, practicing yoga improves postural control and strengthens the muscles and vestibular system leading to enhanced cVEMP responses. The plastic changes in the vestibular system and increased muscular strength because of constant practicing of yoga could have led to changes in cVEMP responses. However, further studies on a larger group of individuals are essential for better clinical applicability of the results.

PMID: 28762044 [PubMed - as supplied by publisher]

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Medication-related osteonecrosis of the jaw in oncological patients with skeletal metastases: conservative treatment is effective up to stage 2.

Medication-related osteonecrosis of the jaw in oncological patients with skeletal metastases: conservative treatment is effective up to stage 2.

Br J Oral Maxillofac Surg. 2017 Jul 28;:

Authors: Coropciuc RG, Grisar K, Aerden T, Schol M, Schoenaers J, Politis C

Abstract
There is currently no widespread strategy for treating medication-related osteonecrosis of the jaw (MRONJ), so our aim was to evaluate retrospectively the outcome of a minimally invasive treatment protocol for patients with both MRONJ and cancer. We designed a retrospective cohort study of patients with cancer who had been diagnosed with MRONJ after treatment with denosumab or bisphosphonates given intravenously. Primary outcome measures were improvement in the clinical stage of MRONJ and the time course to its resolution. Secondary outcome measures included the incidence of risk factors and patterns of treatment. Seventy-nine patients with 109 lesions were enrolled, and their characteristics, presentation of the lesions, complications, and relations to previous oral interventions were recorded. Treatment depended on the stage of disease, and included conservative medical, and minimally-invasive surgical, procedures. There was complete healing and resolution of disease in 38/57 stage 1 lesions, 30/47 stage 2 lesions, and 3/5 stage 3 lesions. The symptoms improved in 16/47 stage 2 lesions, and 2/5 stage 3 lesions. Fifteen of the stage 1 lesions, and one of the stage 2 lesions, failed to respond. Despite the possibility of an aggressive approach to the treatment of MRONJ, conservative treatment remains the first line of defence as regression is obvious, with evidence of no evolution to a higher stage. In our experience surgical intervention is recommended in persistent stage 3 MRONJ that has failed to respond to conservative treatment.

PMID: 28760314 [PubMed - as supplied by publisher]

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Influence of polyvinylpyrrolidone, microcrystalline cellulose and colloidal silicon dioxide on technological characteristics of a high-dose Petiveria alliacea tablet.

Influence of polyvinylpyrrolidone, microcrystalline cellulose and colloidal silicon dioxide on technological characteristics of a high-dose Petiveria alliacea tablet.

Drug Dev Ind Pharm. 2017 Aug 01;:1-21

Authors: García-Pérez ME, Lemus-Rodríguez Z, Hung-Arbelo M, Vistel-Vigo M

Abstract
PURPOSE: Petiveria alliacea L. (Phytolaccaceae) is a perennial shrub used by its immunomodulatory, anticancerogenic and anti-inflammatory properties. This study determined the influence of polyvinylpyrrolidone (PVP), colloidal silicon dioxide (CSD) and microcrystalline cellulose (MC) on the technological characteristic of a high-dose P.alliacea tablet prepared by the wet granulation method.
METHODOLOGY: The botanical and pharmacognostic analysis of the plant material was firstly performed, followed by a 2(3) factorial design considering three factors at two levels: a) the binder (PVP) incorporated in formulation at 10 and 15% (w/w); b) the compacting agent (CSD) added at 10 and 15% (w/w) and; c) the diluent (MC) included at 7.33 and 12.46% (w/w). The analysis of pharmaceutical performance and the accelerated and long-term stability of the best prototype was also completed.
RESULT AND DISCUSSION: The binder, compacting agent and the interaction Binder/Diluent had a significant impact on breaking force of high-dose P.alliacea tablet. The optimum formula was found to contain 15% (w/w) of CSD, 7.33% (w/w) of MC and 10% (w/w) of PVP. At these conditions, the tablet shows a breaking force of 77.96 N, a friability of 0.39%, a total phenol content of 1.30 mg/tablet and a maximum disintegration time of 6 min.
CONCLUSIONS: The use of adequate amounts of PVP, MC and CSD as per the factorial design allowed the preparation of a tablet suitable for administration, despite the inappropriate flow and compressibility properties of the P.alliacea powder.

PMID: 28762858 [PubMed - as supplied by publisher]

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Cholesterol Derivative-Based Liposomes for Gemcitabine Delivery: Preparation, In Vitro, and In Vivo Characterization.

Cholesterol Derivative-Based Liposomes for Gemcitabine Delivery: Preparation, In Vitro, and In Vivo Characterization.

Drug Dev Ind Pharm. 2017 Aug 01;:1-34

Authors: Li T, Chen L, Deng Y, Liu X, Zhao X, Cui Y, Shi J, Feng R, Song Y

Abstract
As an anti-tumor drug, gemcitabine (Gem) is commonly used for the treatment of non-small cell lung cancer and pancreatic cancer. However, there are several clinical drawbacks to using Gem, including its extremely short plasma half-life and side effects. To prolong its half-life and reduce its side effects, we synthesized a derivative of Gem using cholesterol (Chol). This derivative, called gemcitabine-cholesterol (Gem-Chol) was entrapped into liposomes by a thin-film dispersion method. The particle size of the Gem-Chol liposomes was 112.57 ± 1.25 nm, encapsulation efficiency was above 99%, and drug loading efficiency was about 50%. In vitro studies revealed that the Gem-Chol liposomes showed delayed drug release and long-term stability at 4°C for up to two months. In vivo studies also showed the superiority of the Gem-Chol liposomes, and compared with free Gem, the Gem-Chol liposomes had longer circulation time. Moreover, an anti-tumor study in H22 and S180 tumor models showed that liposomal entrapment of Gem-Chol improved the anti-tumor effect of Gem. This study reports a potential formulation of Gem for clinical application.

PMID: 28760000 [PubMed - as supplied by publisher]

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Veliparib Monotherapy to Patients With BRCA Germ Line Mutation and Platinum-Resistant or Partially Platinum-Sensitive Relapse of Epithelial Ovarian Cancer: A Phase I/II Study.

Veliparib Monotherapy to Patients With BRCA Germ Line Mutation and Platinum-Resistant or Partially Platinum-Sensitive Relapse of Epithelial Ovarian Cancer: A Phase I/II Study.

Int J Gynecol Cancer. 2017 Aug 01;:

Authors: Steffensen KD, Adimi P, Jakobsen A

Abstract
OBJECTIVE: A new treatment principle, which seems to radically change the treatment approach in ovarian cancer (OC), has developed over the past few years. Poly(ADP-ribose) polymerase inhibitors work by interfering with mechanisms important to DNA damage repair. Cancer cells that already have defects in the BRCA genes are particularly sensitive to treatment with poly(ADP-ribose) polymerase inhibitors. The main purpose of this study was to investigate the effect of veliparib in patients with known BRCA1/2 mutations and with a platinum-resistant or intermediate sensitive relapse of OC.
METHODS: Major eligibility criteria were primary epithelial ovarian/fallopian/peritoneal cancer patients with a platinum-resistant or intermediate sensitive relapse of OC and with evaluable disease by either Response Evaluation Criteria In Solid Tumors or Gynecological Cancer Intergroup CA-125 criteria. Patients were treated with oral veliparib twice daily on days 1 to 28.
RESULTS: Sixteen patients were enrolled in the phase I part, and a maximum tolerable dose of 300 mg twice daily was established. The phase II part enrolled 32 patients with a median of 4 previous treatment regimens. The overall response rate combining Response Evaluation Criteria In Solid Tumors and CA-125 response was 65% (6% complete response and 59% partial response). Progression-free and overall survival rates of the intention-to-treat population were 5.6 months (95% confidence interval, 5.2-7.3 months) and 13.7 months (95% confidence interval, 10.2-17.3 months), respectively. The most common phase II treatment-related grade 2 toxicities included fatigue (22%), nausea (22%), and vomiting (9%).
CONCLUSIONS: Treatment with veliparib in heavily pretreated patients with relapse of OC demonstrates a considerable efficacy with an acceptable toxicity profile.

PMID: 28763368 [PubMed - as supplied by publisher]

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Addition of an antiangiogenic therapy, bevacizumab, to gemcitabine plus oxaliplatin improves survival in advanced biliary tract cancers.

Addition of an antiangiogenic therapy, bevacizumab, to gemcitabine plus oxaliplatin improves survival in advanced biliary tract cancers.

Invest New Drugs. 2017 Aug 01;:

Authors: Bréchon M, Dior M, Dréanic J, Brieau B, Guillaumot MA, Brezault C, Mir O, Goldwasser F, Coriat R

Abstract
Background The prognosis of patients with metastatic carcinoma of the biliary tract (mBTC) is poor and a systemic therapy with gemcitabine and platinum-based is the gold standard. The addition of bevacizumab to the chemotherapy might increase patients' survival. Our aim was to assess and compare the efficacy of GEMOX (gemcitabine and oxaliplatin regimen) plus bevacizumab to GEMOX alone in mBTC. Methods Patients with mBTC who received the GEMOX-bevacizumab (n = 32; Group A) or GEMOX (n = 25; Group B) regimen as first-line treatment were compared. Treatment was repeated every two weeks until disease progression or unacceptable adverse effects occurred. The primary evaluation criterion was the progression-free survival (PFS). Results A quarter of patients (8/32) from Group A and a fifth of patients (13/25) from Group B had an objective response. The median PFS was 6.48 months and 3.72 months in Group A and B, respectively (p = 0.049). The median OS was 11.31 months and 10.34 months in Group A and B, respectively. Grade 3/4 sepsis was identified in 9.4% and 12% in Group A and B, respectively, (p = 0.64). Conclusion In mBTC, the addition of bevacizumab to GEMOX increased the progression-free survival and was associated with manageable toxicity. These data pave the way for further evaluation of antiangiogenic agents in mBTC.

PMID: 28762171 [PubMed - as supplied by publisher]

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Effect of acute treadmill exercise on cisplatin-induced muscle atrophy in the mouse.

Effect of acute treadmill exercise on cisplatin-induced muscle atrophy in the mouse.

Pflugers Arch. 2017 Jul 31;:

Authors: Sakai H, Kimura M, Isa Y, Yabe S, Maruyama A, Tsuruno Y, Kai Y, Sato F, Yumoto T, Chiba Y, Narita M

Abstract
Cisplatin, a platinum-based anti-cancer drug, is one of the most effective broad-spectrum anti-cancer agents used against various cancers. It has been recently suggested that low skeletal muscle mass is predictive of mortality in patients with cancer. Although several molecules produced by the actual tumor itself contribute to skeletal muscle impairment, we recently suggested that the administration of cisplatin could increase levels of muscle RING finger-1 (MuRF1) and atrogin-1, possibly leading to muscle atrophy in the mouse. Exercise is an important factor that induces muscle protein synthesis and muscle hypertrophy by enhancing the positive effects of the Akt/mTOR/p70S6 kinase pathway. In the present study, we therefore investigated the effect of treadmill exercise on cisplatin-induced muscle atrophy. C57BL/6J mice were treated with cisplatin (3 mg/kg, i.p.) or saline for four consecutive days. On day 4, the quadriceps and gastrocnemius muscles were isolated from the mice. The animals in the treadmill exercise groups were forced to run on a motorized treadmill for 20 min once a day for 9 days. In addition to muscle mass, the decrease in myofiber diameter associated with cisplatin administration was significantly restored by treadmill exercise. This exercise also significantly attenuated cisplatin-induced upregulation of MuRF1 and atrogin-1 in quadriceps and gastrocnemius muscle. The decreased Akt, p70S6 kinase, and Foxo3a phosphorylation observed with cisplatin treatment was significantly recovered by treadmill exercise in both the muscles. In the present study, myostatin (Mstn) gene expression, upregulated by cisplatin administration, was also attenuated by treadmill exercise. These findings suggest that treadmill exercise could attenuate cisplatin-induced muscle atrophy, at least partially, and could improve prognosis.

PMID: 28762162 [PubMed - as supplied by publisher]

from #PM All via ola Kala on Inoreader http://ift.tt/2u453HL

Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy.

Indolent peritoneal mesothelioma: PI3K-mTOR inhibitors as a novel therapeutic strategy.

ESMO Open. 2017;2(1):e000101

Authors: Dolly SO, Migali C, Tunariu N, Della-Pepa C, Khakoo S, Hazell S, de Bono JS, Kaye SB, Banerjee S

Abstract
Peritoneal mesothelioma (MPeM) is a scarce abdominal-pelvic malignancy that presents with non-specific features and exhibits a wide clinical spectrum from indolent to aggressive disease. Due to it being a rare entity, there is a lack of understanding of its molecular drivers. Most treatment data are from limited small studies or extrapolated from pleural mesothelioma. Standard treatment includes curative surgery or pemetrexed-platinum palliative chemotherapy. To date, the use of novel targeted agents has been disappointing. Described is the management of two young women with papillary peritoneal mesothelioma with widespread recurrence having received platinum-pemetrexed chemotherapy. Both patients obtained symptomatic and disease benefit with apitolisib, a dual phosphoinositide 3-kinase-mammalian target of rapamycin (PI3K-mTOR) inhibitor for subsequent relapses, with one patient having a partial response for almost 3 years. Both are alive and well 10-13 years from diagnosis.
CONCLUSION: These case presentations highlight a subgroup of rare MPeM that behave indolently that is compatible with long-term survival. This series identifies the use of targeted therapies with PI3K-mTOR-based inhibitors as a novel approach, warranting further clinical assessment. Development of prognostic biomarkers is essential to aid identify tumour aggressiveness, help stratify patients and facilitate treatment decisions.

PMID: 28761723 [PubMed]

from #PM All via ola Kala on Inoreader http://ift.tt/2hnnLnK

Transferrin-functionalized nanographene oxide for delivery of platinum complexes to enhance cancer-cell selectivity and apoptosis-inducing efficacy.

Transferrin-functionalized nanographene oxide for delivery of platinum complexes to enhance cancer-cell selectivity and apoptosis-inducing efficacy.

Int J Nanomedicine. 2017;12:5023-5038

Authors: Zhu H, Zhou B, Chan L, Du Y, Chen T

Abstract
Rational design and construction of delivery nanosystems for anticancer metal complexes is a crucial strategy to improve solubility under physiological conditions and permeability and retention behavior in tumor cells. Therefore, in this study, we designed and synthesize a transferrin (Tf)-conjugated nanographene oxide (NGO) nanosystem as a cancer-targeted nanocarrier of Pt complexes (Tf-NGO@Pt). This nanodelivery system exhibited good solubility under physiological conditions. Moreover, Tf-NGO@Pt showed higher anticancer efficacy against MCF human breast cancer cells than the free Pt complex, and effectively inhibited cancer-cell migration and invasion, with involvement of reactive oxygen species overproduction. In addition, nanolization also enhanced the penetration ability and inhibitory effect of the Pt complex toward MCF7 breast cancer-cell tumor spheroids. The enhancement of anticancer efficacy was positively correlated with increased cellular uptake and cellular drug retention. This study provides a new strategy to facilitate the future application of metal complexes in cancer therapy.

PMID: 28761342 [PubMed - in process]

from #PM All via ola Kala on Inoreader http://ift.tt/2u3Lwa4

The Microbiology of Ruthenium Complexes.

The Microbiology of Ruthenium Complexes.

Adv Microb Physiol. 2017;71:1-96

Authors: Southam HM, Butler JA, Chapman JA, Poole RK

Abstract
Ruthenium is seldom mentioned in microbiology texts, due to the fact that this metal has no known, essential roles in biological systems, nor is it generally considered toxic. Since the fortuitous discovery of cisplatin, first as an antimicrobial agent and then later employed widely as an anticancer agent, complexes of other platinum group metals, such as ruthenium, have attracted interest for their medicinal properties. Here, we review at length how ruthenium complexes have been investigated as potential antimicrobial, antiparasitic and chemotherapeutic agents, in addition to their long and well-established roles as biological stains and inhibitors of calcium channels. Ruthenium complexes are also employed in a surprising number of biotechnological roles. It is in the employment of ruthenium complexes as antimicrobial agents and alternatives or adjuvants to more traditional antibiotics, that we expect to see the most striking developments in the future. Such novel contributions from organometallic chemistry are undoubtedly sorely needed to address the antimicrobial resistance crisis and the slow appearance on the market of new antibiotics.

PMID: 28760320 [PubMed - in process]

from #PM All via ola Kala on Inoreader http://ift.tt/2u3kfEY

Randomized controlled trial of S-1 maintenance therapy in metastatic esophagogastric cancer - the multinational MATEO study.

Randomized controlled trial of S-1 maintenance therapy in metastatic esophagogastric cancer - the multinational MATEO study.

BMC Cancer. 2017 Jul 31;17(1):509

Authors: Haag GM, Stocker G, Quidde J, Jaeger D, Lordick F

Abstract
BACKGROUND: The optimal duration of firstline chemotherapy in metastatic esophagogastric cancer is unknown. In most clinical trials therapy was given until tumour progression or limiting toxicity. Maintenance concepts aiming to prolong the duration of response and maintain quality of life have been established in other tumour types but not in esophagogastric cancer. S-1 is an oral fluoropyrimidine with proven efficacy in metastatic esophagogastric cancer.
METHODS: The Maintenance Teysuno® (S-1) in esophagogastric cancer (MATEO) trial is a multinational, randomized phase II study that explores the role of S-1 maintenance therapy in Her-2 negative, advanced esophagogastric adenocarcinoma. After a 12-week firstline platinum-fluoropyrimidine-based chemotherapy patients without tumour progression are randomized in a 2:1 allocation to receive S-1 alone or continue with the same regimen as during the primary period. The primary endpoint is overall survival. Secondary endpoints include safety and toxicity, progression-free survival and quality of life. Correlative biomarker analyses focus on the identification of a subgroup of patients with a prolonged benefit from S-1 based maintenance therapy.
DISCUSSION: MATEO will be the first trial to define the role of a S-1 based maintenance therapy in patients having received a platinum-based firstline chemotherapy.
TRIAL REGISTRATION: NCT02128243 (date of registration: 29-04-2014).

PMID: 28760152 [PubMed - in process]

from #PM All via ola Kala on Inoreader http://ift.tt/2u3M3ZN

Haematological cancer: After ibrutinib, CAR T cells induce responses.

Haematological cancer: After ibrutinib, CAR T cells induce responses.

Nat Rev Clin Oncol. 2017 Aug 01;:

Authors: Romero D

PMID: 28762387 [PubMed - as supplied by publisher]

from #PM All via ola Kala on Inoreader http://ift.tt/2ujz5SN

Genetics: Taking single-cell transcriptomics to the bedside.

Genetics: Taking single-cell transcriptomics to the bedside.

Nat Rev Clin Oncol. 2017 Aug 01;:

Authors: Behjati S, Haniffa M

PMID: 28762386 [PubMed - as supplied by publisher]

from #PM All via ola Kala on Inoreader http://ift.tt/2f7DrL9

CNS cancer: Glioblastoma subtypes revisited.

CNS cancer: Glioblastoma subtypes revisited.

Nat Rev Clin Oncol. 2017 Aug 01;:

Authors: Sidaway P

PMID: 28762385 [PubMed - as supplied by publisher]

from #PM All via ola Kala on Inoreader http://ift.tt/2u33bPw

HER2-positive breast cancer is lost in translation: time for patient-centered research.

HER2-positive breast cancer is lost in translation: time for patient-centered research.

Nat Rev Clin Oncol. 2017 Aug 01;:

Authors: Gingras I, Gebhart G, de Azambuja E, Piccart-Gebhart M

Abstract
No biomarker beyond HER2 itself, which suffers from a low positive predictive value, has demonstrated clinical utility in breast cancer, despite numerous attempts to improve treatment tailoring for the growing number of anti-HER2 targeted therapies. This prompted us to examine the body of evidence, using a systematic approach, to identify putative predictive biomarkers in HER2-positive breast cancer, and discuss the hitherto failure to address the needs of patients. In the future, it is hoped immune-based biomarkers will predict benefit from anti-HER2 treatments in the neoadjuvant and adjuvant settings. In advanced-stage disease, the quantification of tumour heterogeneity using molecular-imaging technology has generated informative data on the success or failure of the antibody-drug conjugate T-DM1. Treatment tailoring remains a high priority, in cost-constrained health-care systems, but such tailoring will require a dramatic shift in the way translational research is being conducted, with the establishment of large, easily accessible, and well-annotated databases of candidate predictive biomarkers. Single-centre biomarker research should become a thing of the past.

PMID: 28762384 [PubMed - as supplied by publisher]

from #PM All via ola Kala on Inoreader http://ift.tt/2f7VVep

The third ventricle roof: an anatomical study using constructive interference in steady-state magnetic resonance imaging.

The third ventricle roof: an anatomical study using constructive interference in steady-state magnetic resonance imaging.

Surg Radiol Anat. 2017 Jul 31;:

Authors: Tsutsumi S, Ishii H, Ono H, Yasumoto Y

Abstract
PURPOSE: The third ventricle roof in vivo has been infrequently explored. The aim of the present study was to delineate the neurovascular structures relevant to the third ventricle roof using magnetic resonance (MR) imaging.
METHODS: A total of 78 patients were enrolled in the study. Following initial examinations with conventional MR sequences, the constructive interference in steady-state (CISS) sequence was performed in coronal sections on 67 patients and in sagittal sections on 11 patients.
RESULTS: In the coronal sections, the fornices and internal cerebral veins were delineated in all 67 patients. The cross-sectional appearance and size of the fornices were variable, and the relationship between fornices presented as five different types. In 82% of patients, dominance of one relationship type was not found. The diameter of the internal cerebral veins (ICVs) was also variable, and the relationship between ICVs presented as four different types. In 70% of patients, dominance of one relationship type was not found. In 52% of patients, the lower layer of the third ventricle roof was identified as an inhomogeneous membranous structure. In the sagittal sections, the lower layer of the third ventricle roof was delineated as an inhomogeneous linear structure with variable slopes.
CONCLUSIONS: The third ventricle roof appears highly variable in morphology. Visualization of the third ventricle roof using the CISS sequence may be useful for planning safe and effective surgical maneuvers around the region.

PMID: 28762085 [PubMed - as supplied by publisher]

from #PM All via ola Kala on Inoreader http://ift.tt/2vsMJIi

Anatomy and histology of the scrotal ligament in adults: inconsistency and variability of the gubernaculum testis.

Anatomy and histology of the scrotal ligament in adults: inconsistency and variability of the gubernaculum testis.

Surg Radiol Anat. 2017 Jul 31;:

Authors: Cavalie G, Bellier A, Marnas G, Boisson B, Robert Y, Rabattu PY, Chaffanjon P

Abstract
PURPOSE: The anatomy of gubernaculum testis (GT) is often discussed; however, the postnatal anatomy of the GT or scrotal ligament (SL) is rarely described. Hence, we performed an anatomical and histological study to analyze histologically the structures between testis and scrotum.
METHODS: We performed anatomical dissections on 25 human fresh cadavers' testes. Each testis was removed with its envelopes and macroscopically analyzed. Then samples were included for histological study. Finally, they were analyzed under microscope, looking for attachments between testis, epididymis and scrotal envelopes.
RESULTS: The absence of proximal and distal attachment was found in 56.0% of cases. Looking at the proximal attachment of the SL, the main one found is the epididymal attachment (28.0%), whereas no cases of testis attachment was found. Distally, there are more variations with scrotal attachment (12%) and cremaster attachment (12.0%). We found a significant prevalence of multiple adherences in 16.0% of cases too. Finally, in 15 cases (57.7%) an attachment is present between testis and epididymis, as it is commonly described.
CONCLUSIONS: In the majority of cases there is no attachment of the lower pole of the testis and epididymis and these structures remain free. So it seems that the SL disappears with aging. Moreover, there is not only one kind of ligamentous attachment, but a high variability of attachments at the lower pole of the testiculo-epididymal structure. When it exists, this structure is never a real ligament and it seems more appropriate to use the term "attachments".

PMID: 28762084 [PubMed - as supplied by publisher]

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Healthcare Acquired Infections

Health Watch USA Logo Health Watch USA^sm Newsletter
www.healthwatchusa.org Aug. 1, 2017
Member of the National Quality Forum and a designated "Community Leader"
for Value-Driven Healthcare by the U.S. Dept. of Health and Human Services

Healthcare Acquired Infections

The Research Evidence Behind Chlorhexidine Recommendations

Dr. Maiwald Matthias discusses research integrity concerns regarding the antiseptic chlorhexidine. Specific topics relate to incomplete reporting of methodology, errors in data interpretation, clinical equipoise and bias in meta-analyses. Specific attention is given on how these problems impact the WHO indications for surgical antisepsis. (July 19th HW USA meeting. )
View YouTube Video:  https://youtu.be/8YDMQjjnn7g

Shoddy research, deadly results - OpEd Lexington Herald Leader
"(The problem of Conflicts of interest) is of paramount importance. Research is the foundation for treatment protocols and health policy. A murky fog has descended over what works and what does not. The U.S. private health-care system is following the path of least resistance, hoping the emphasis on inexpensive hand hygiene programs will be enough to reverse this epidemic, rather than making the hard and expensive investment needed in infection control."
http://www.kentucky.com/opinion/op-ed/article163753803.html

National Trends in the Frequency of Bladder Catheterization and Physician-diagnosed Catheter-associated Urinary Tract Infections
Noel Eldridge, (Senior Advisor AHRQ) presents on national trends of CAUTI infections in the United States during the July 2017 HW USA meeting.    "There were statistically significant declines in observed bladder catheterization frequency and adjusted CAUTI frequency in some patient populations between 2009 and 2014."
View YouTube Video: https://youtu.be/olZGy1jJ3_Y

CDC Consumer Advocates Submit Comment Regarding MRSA Testing of Healthcare Workers.
"Unlike the general population, healthcare workers are in frequent contact with patients with fresh surgical wounds and in immunocompromised states.   This makes control of MRSA carriage in this population of greater concern. At least one study has found a significant decrease in MRSA associated with screening and decolonization of healthcare workers."
http://www.healthwatchusa.org/HWUSA-Initiatives/PDF-Downloads/MRSA-Hospital-Worker-Screening-Comment.pdf

Second Study Confirms HW USA's Analysis that MRSA Bloodstream Infection Rates Did Not Decline Between 2014 to 2015
Clinical Infectious Disease: "Serious MRSA-related infections not declining, despite overall MRSA decline. A new study from CDDEP researchers and collaborators finds that rates of the most serious methicillin-resistant Staphylococcus aureus (MRSA) infections—blood infections and pneumonias—did not decline from 2010 to 2014, despite a decline in all MRSA infections"
https://academic.oup.com/cid/article-abstract/doi/10.1093/cid/cix640/4036368/Trends-in-Methicillin-Resistant-Staphylococcus

HW USA's Article: The incidence of MRSA infections in the United States: is a more comprehensive tracking system needed? https://aricjournal.biomedcentral.com/articles/10.1186/s13756-017-0193-0

A Belfast Hospital's Response to an Outbreak of Clostridium difficile
BBC: "The Belfast Trust confirmed that a ward was closed briefly and two patients were affected in Musgrave Park Hospital in Belfast." It is significant to note that an "outbreak" was defined as only 2 cases and the institutional response was resolute.
http://www.bbc.com/news/uk-northern-ireland-40614788

CDC Report: Antibiotic Use in the United States, 2017: Progress and Opportunities  https://www.cdc.gov/getsmart/stewardship-report/

Healthcare Quality

Death Rates May Even Go Down With hospital Readmission Reductions
JAMA: "Among Medicare fee-for-service beneficiaries hospitalized for heart failure, acute myocardial infarction, or pneumonia, reductions in hospital 30-day readmission rates were weakly but significantly correlated with reductions in hospital 30-day mortality rates after discharge."
JAMA:  http://jamanetwork.com/journals/jama/article-abstract/2643762

FierceHealthcare : http://www.fiercehealthcare.com/healthcare/death-rates-don-t-go-up-when-hospitals-reduce-readmissions?

Myth of Drug Expiration Dates
NPR: "Though the government requires pharmacies to throw away expired drugs, it doesn't always follow these instructions itself. Instead, for more than 30 years, it has pulled some medicines and tested their quality."
http://www.npr.org/sections/health-shots/2017/07/18/537257884/that-drug-expiration-date-may-be-more-myth-than-fact

Editorial: Patients have a right to know when a doctor is on probation for a serious violation
http://www.latimes.com/opinion/editorials/la-ed-docs-probation-patient-notification-20170727-story.html


Medical Devices

The Battle Over Essure
Washington Post: "The warning — coming 14 years after Essure went on the market and two years after Keisha had it implanted — was a major victory for anti-Essure activists. But it also left a number of unresolved questions: How did this device come to market? What made it so popular? And should women continue to use it?"
http://www.washingtonpost.com/sf/style/2017/07/26/essure/

Two More Duodenoscopes Are Recalled

Fujifilm Duodenoscope Model ED-530XT
http://www.fujifilmusa.com/products/medical/endoscopy/pdf/
UrgentFieldCorrectionAndRemoval_ED530XT_072117.pdf
Pentax Duodenoscope Models Ed-3490TK and ED-3270K
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm?id=155670

===========================================================

Health Watch USA's 2017 Healthcare Quality & Patient Safety Conference

The Setting Of Strong Quality Standards
& Research Integrity

Nov. 3rd, 2017 at the Four Points Sheraton, Lexington, KY

Speakers to Include:

Joycelyn Elders, MD – Past U.S. Surgeon General
Deborah Nelson: Pulitzer prize winning investigative reporter presenting on conflicts-of-interest and infectious disease policy. Associate Professor Investigative Journalism. University of Maryland.
Resume: https://merrill.umd.edu/about-merrill/staff-faculty/deborah-nelson/
Ivan Oransky, MD -- Distinguished Writer in Residence, New York University & Co-Founder of "Retraction Watch" presenting on Characteristics and Findings of Retracted Peer-Reviewed Scientific Manuscripts.
Resume: https://journalism.nyu.edu/about-us/profile/ivan-oransky-md/
Lisa McGiffert, Consumer Union's Safe Patient Project, presenting on Patient Safety and Healthcare Accountability.
Resume: http://consumersunion.org/experts/lisa-mcgiffert/

Presentation videos for the 2016 Conference are now online.
To view the conference presentations: Go To:
https://www.youtube.com/playlist?list=PLKKV6p_etRmPhxndxzrvt7yeE-ICUmqzK

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Τρίτη 18 Απριλίου 2017

Percutaneous Aponeurotomy and Lipofilling (PALF) versus Limited Fasciectomy; a response on the Prospective Randomized Controlled Trial.

No abstract available

http://ift.tt/2oSwHnh

Hemodynamic Study of Three Patterns of Flaps on Rats with a Novel Panoramic Photographing Technique Involved.

No abstract available

http://ift.tt/2okWscu

"Reply to: Effectiveness of autologous fat grafting in adherent scars: results obtained by a comprehensive scar evaluation protocol".

No abstract available

http://ift.tt/2okLFPG

Effectiveness of Autologous Fat Grafting in Adherent Scars: Results Obtained by a Comprehensive Scar Evaluation Protocol.

No abstract available

http://ift.tt/2oSpTG4

Comment on: Percutaneous Aponeurotomy and Lipofilling (PALF) versus Limited Fasciectomy in Patients with Primary Dupuytren's Contracture: A Prospective, Randomized, Controlled Trial.

No abstract available

http://ift.tt/2okD5Aj