Source:Practical Radiation Oncology
Author(s): Daniel G Petereit
http://ift.tt/2xotuQD
Πέμπτη 14 Σεπτεμβρίου 2017
Walking Forward: A Narrative from South Dakota
Source:Practical Radiation Oncology
Author(s): Daniel G Petereit
http://ift.tt/2xotuQD
Acid–base safety during the course of a very low-calorie-ketogenic diet
Abstract
Background and Aims
Very low-calorie ketogenic (VLCK) diets have been consistently shown to be an effective obesity treatment, but the current evidence for its acid-base safety is limited. The aim of the current work was to evaluate the acid-base status of obese patients during the course of a VLCK diet.
Method
Twenty obese participants undertook a VLCK diet for 4 months. Anthropometric and biochemical parameters, and venous blood gases were obtained on four subsequent visits: visit C-1 (baseline); visit C-2, (1-2 months); maximum ketosis; visit C-3 (2-3 months), ketosis declining; and visit C-4 at 4 months, no ketosis. Results were compared with 51 patients that had an episode of diabetic ketoacidosis as well as with a group that underwent a similar VLCK diet in real life conditions of treatment.
Results
Visit C1 blood pH (7.37 ± 0.03); plasma bicarbonate (24.7 ± 2.5 mmol/l); plasma glucose (96.0 ± 11.7 mg/l) as well as anion gap or osmolarity were not statistically modified at four months after a total weight reduction of 20.7 kg in average and were within the normal range throughout the study. Even at the point of maximum ketosis all variables measured were always far from the cut-off points established to diabetic ketoacidosis.
Conclusion
During the course of a VLCK diet there were no clinically or statistically significant changes in glucose, blood pH, anion gap and plasma bicarbonate. Hence the VLCK diet can be considered as a safe nutritional intervention for the treatment of obesity in terms of acid-base equilibrium.
http://ift.tt/2x5XfF3
Acid–base safety during the course of a very low-calorie-ketogenic diet
Abstract
Background and Aims
Very low-calorie ketogenic (VLCK) diets have been consistently shown to be an effective obesity treatment, but the current evidence for its acid-base safety is limited. The aim of the current work was to evaluate the acid-base status of obese patients during the course of a VLCK diet.
Method
Twenty obese participants undertook a VLCK diet for 4 months. Anthropometric and biochemical parameters, and venous blood gases were obtained on four subsequent visits: visit C-1 (baseline); visit C-2, (1-2 months); maximum ketosis; visit C-3 (2-3 months), ketosis declining; and visit C-4 at 4 months, no ketosis. Results were compared with 51 patients that had an episode of diabetic ketoacidosis as well as with a group that underwent a similar VLCK diet in real life conditions of treatment.
Results
Visit C1 blood pH (7.37 ± 0.03); plasma bicarbonate (24.7 ± 2.5 mmol/l); plasma glucose (96.0 ± 11.7 mg/l) as well as anion gap or osmolarity were not statistically modified at four months after a total weight reduction of 20.7 kg in average and were within the normal range throughout the study. Even at the point of maximum ketosis all variables measured were always far from the cut-off points established to diabetic ketoacidosis.
Conclusion
During the course of a VLCK diet there were no clinically or statistically significant changes in glucose, blood pH, anion gap and plasma bicarbonate. Hence the VLCK diet can be considered as a safe nutritional intervention for the treatment of obesity in terms of acid-base equilibrium.
http://ift.tt/2x5XfF3
The efficacy and safety of a monophasic hyaluronic acid filler in the correction of nasolabial folds: A randomized, multicenter, single blinded, split-face study
Summary
Background
The different rheological properties of hyaluronic acid (HA) filler reflect their specific manufacturing processes and resultant physicochemical characteristics. However, there are few researches about the relationship between product differences and clinical outcome when HA fillers are used for nasolabial folds (NLFs).
Aims
This study sought to compare the rheological properties, efficacy and safety of a monophasic HA filler, and a well-studied biphasic HA filler, in the treatment of NLFs.
Patients/methods
A total of 72 Korean subjects with moderate to severe NLFs were randomized to receive injections with monophasic HA or biphasic HA on the left or right side of the face. Efficacy was evaluated by the change in the Wrinkle Severity Rating Scale (WSRS) at 2, 10, 18, 26, and 52 weeks. Safety was assessed on the basis of all abnormal reactions during the clinical test period. To compare the rheological characteristics of two cross-linked HA fillers, viscoelastic analysis was performed.
Results
At week 26, the mean WSRS was 2.26±0.56 for the monophasic HA side and 2.24±0.54 for the biphasic HA side. Both treatments were well tolerated. The adverse reactions were mild and transient. Monophasic HA filler had lower elasticity and higher viscosity than biphasic HA filler.
Conclusion
Despite a number of different rheological properties, monophasic HA is noninferior to biphasic HA in the treatment of moderate to severe NLFs for 52 weeks. Therefore, monophasic HA provides an alternative option for NLFs correction.
http://ift.tt/2yaxfal
Study of the mechanism of remediation of Cd-contaminated soil by novel biochars
Abstract
This article used novel non-magnetized and magnetized biochars prepared under a CO2 atmosphere returned to Cd-contaminated soil and compared these to the effects of conventional biochars prepared under a N2 atmosphere with regard to Cd-contaminated soil remediation. A pot experiment with lettuce (Lactuca sativa) was conducted to investigate the relative soil remediation effects of these biochars. The soil used for the pot experiment was spiked with 20 mg kg−1 Cd and amended with 5% of a biochar before sowing. Through these research works, some important results were obtained as follows: (1) applying biochar treated by pyrolysis under a CO2 atmosphere can obtain the best remediation effect of Cd-contaminated soil that the content of cadmium in the lettuce roots, stems, and leaves was reduced 67, 62, and 63%, respectively; (2) the magnetic biochar aggregation for the soil is weak, so the heavy metal cadmium in the soil could not be immobilized well by the magnetic biochar; (3) The remediation mechanism of novel biochars is that biochar includes a large number of organic functional groups (−C–OH, −C=O, COO−) that can act in a complexing reaction with heavy metal Cd(II) and the inorganic salt ions (Si, S, Cl, etc.) that can combine with cadmium and generate a stable combination.
http://ift.tt/2weeTHO
Experiences of two different modalities in the management of choroidal melanoma in the Asian Indian population
Prajna Meeralakshmi, Parag K Shah, Venkatapathy Narendran
South Asian Journal of Cancer 2017 6(3):134-136
Background: Choroidal malignant melanoma is a rare intraocular cancer in Asian Indian population. There is a paucity of data from our population comparing iodine 125 (I-125) brachytherapy and enucleation. Aim: This study aims to compare two groups of choroidal melanoma patients treated with either I-125 brachytherapy or enucleation in the Asian Indian population. Objectives: To evaluate the long-term morbidity and mortality rates in choroidal melanoma patients treated with either I-125 brachytherapy or enucleation. Methods: It is a retrospective study involving forty four eyes, diagnosed with choroidal melanoma from May 2008 to February 2015. All were evaluated preoperatively for metastasis. Twenty-two underwent globe salvaging I-125 brachytherapy surgery whereas remaining 22 underwent globe destructive primary enucleation procedure. Results: At a mean follow-up 39 months, 2 of 22 cases (9%) died in the brachytherapy group. One was secondary to metastasis in the liver while the other case died of a natural cause. In the enucleation group also, there were two deaths (9%) secondary to metastasis. The metastasis free survival was 95% in the brachytherapy group and 91% in the enucleation group, which was not statistically significant (P = 0.3577). Kaplan–Meier survival at 3 years and 5 years was 95% and 89% for brachytherapy group and 94% and 89% for enucleation group. Conclusion: This study found no difference in the long-term survival of choroidal melanoma patients treated with either brachytherapy or enucleation in the Asian Indian eyes.
http://ift.tt/2x4CNTC
South Asian Journal of Cancer 2017 6(3):134-136
Background: Choroidal malignant melanoma is a rare intraocular cancer in Asian Indian population. There is a paucity of data from our population comparing iodine 125 (I-125) brachytherapy and enucleation. Aim: This study aims to compare two groups of choroidal melanoma patients treated with either I-125 brachytherapy or enucleation in the Asian Indian population. Objectives: To evaluate the long-term morbidity and mortality rates in choroidal melanoma patients treated with either I-125 brachytherapy or enucleation. Methods: It is a retrospective study involving forty four eyes, diagnosed with choroidal melanoma from May 2008 to February 2015. All were evaluated preoperatively for metastasis. Twenty-two underwent globe salvaging I-125 brachytherapy surgery whereas remaining 22 underwent globe destructive primary enucleation procedure. Results: At a mean follow-up 39 months, 2 of 22 cases (9%) died in the brachytherapy group. One was secondary to metastasis in the liver while the other case died of a natural cause. In the enucleation group also, there were two deaths (9%) secondary to metastasis. The metastasis free survival was 95% in the brachytherapy group and 91% in the enucleation group, which was not statistically significant (P = 0.3577). Kaplan–Meier survival at 3 years and 5 years was 95% and 89% for brachytherapy group and 94% and 89% for enucleation group. Conclusion: This study found no difference in the long-term survival of choroidal melanoma patients treated with either brachytherapy or enucleation in the Asian Indian eyes.
http://ift.tt/2x4CNTC
Epidemiology and outcomes of nasopharyngeal carcinoma: Experience from a regional cancer center in Southern India
Rudresha Antapura Haleshappa, Aditi Harsh Thanky, Lakshmaiah Kuntegowdanahalli, Govind Babu Kanakasetty, Lokanatha Dasappa, Linu Jacob
South Asian Journal of Cancer 2017 6(3):122-124
Context: Nasopharyngeal carcinoma (NPC) is a rare head and neck cancer with significant geographical variation. There are limited data on epidemiology and outcomes of NPC reported from Southern India. Settings and Design: Retrospective analysis. Materials and Methods: We analyzed our hospital data between January 2005 and December 2011 with NPC and analyzed their demographic parameters and outcomes with therapy. Results: A total 143 cases of NPC were identified. Median age at presentation was 35 years with male predominance. Majority (84%) of the cases had the WHO Type 3 histology. Nodal metastasis at presentation was seen in 90% of the cases, majority being bilateral. Distant metastasis was seen in 16% of the cases, most commonly at bone, lung, and liver. Concurrent chemoradiation with weekly cisplatin was offered to 84.7% of localized disease while 80% of these also received adjuvant chemotherapy. Complete remission and partial remission were achieved in 66.1% and 15.2% of the cases, respectively. Weekly cisplatin was well tolerated with Grade 3–4 toxicity seen in 22% of cases. At a median follow-up of 20 months, 2-year progression-free survival and overall survival were 67.2% and 79.5%, respectively. Statistical Analysis Used: SPSS software version 20. Conclusion: NPC is a rare head and neck malignancy in Southern India, presenting with advanced stage and more propensity to distant metastasis. It has good outcomes to concurrent chemoradiation with weekly schedule of cisplatin being well-tolerated regime. Further prospective studies to test this schedule and other novel agents in this potentially curable malignancy are warranted.
http://ift.tt/2wdH8GD
South Asian Journal of Cancer 2017 6(3):122-124
Context: Nasopharyngeal carcinoma (NPC) is a rare head and neck cancer with significant geographical variation. There are limited data on epidemiology and outcomes of NPC reported from Southern India. Settings and Design: Retrospective analysis. Materials and Methods: We analyzed our hospital data between January 2005 and December 2011 with NPC and analyzed their demographic parameters and outcomes with therapy. Results: A total 143 cases of NPC were identified. Median age at presentation was 35 years with male predominance. Majority (84%) of the cases had the WHO Type 3 histology. Nodal metastasis at presentation was seen in 90% of the cases, majority being bilateral. Distant metastasis was seen in 16% of the cases, most commonly at bone, lung, and liver. Concurrent chemoradiation with weekly cisplatin was offered to 84.7% of localized disease while 80% of these also received adjuvant chemotherapy. Complete remission and partial remission were achieved in 66.1% and 15.2% of the cases, respectively. Weekly cisplatin was well tolerated with Grade 3–4 toxicity seen in 22% of cases. At a median follow-up of 20 months, 2-year progression-free survival and overall survival were 67.2% and 79.5%, respectively. Statistical Analysis Used: SPSS software version 20. Conclusion: NPC is a rare head and neck malignancy in Southern India, presenting with advanced stage and more propensity to distant metastasis. It has good outcomes to concurrent chemoradiation with weekly schedule of cisplatin being well-tolerated regime. Further prospective studies to test this schedule and other novel agents in this potentially curable malignancy are warranted.
http://ift.tt/2wdH8GD
Topical vancomycin: Does it reduce surgical site infection in bone tumors?
Suman Byregowda, Ajay Puri, Ashish Gulia
South Asian Journal of Cancer 2017 6(3):99-101
Introduction: We retrospectively analyzed a consecutive group of patients operated for bone tumors of extremity and pelvis who received only perioperative antibiotics (Group A) against a similar group that had additional 1 g topical vancomycin sprinkled in the wound before closure (Group B). The aim was to determine if the addition of topical vancomycin decreases the incidence of deep surgical site infection (SSI). Materials and Methods: A total of 221 patients operated between January 2011 and December 2011 were analyzed in Group A and 254 patients operated between April 2012 and March 2013 were analyzed in Group B. Any patient who required operative intervention for wound discharge was considered to be infected. All patients had a 1 year follow-up to determine the incidence of SSI. Results: The overall rate of SSI was 7% (31 of 475 patients). Seventeen (8%) of Group A patients had SSI as against 14 (6 %) of Group B patients (P = 0.337). A subgroup analysis of endoprosthetic reconstructions, internal fixation implants (plates/intramedullary nails), extracorporeal radiation treated bones and strut allografts showed no difference between the two groups of patients. Conclusion: Our data suggest that the addition of topical vancomycin before wound closure in patients operated for bone tumors does not decrease the incidence of SSI. Further investigation of this technique using a case–controlled methodology with an increase in the dose of vancomycin may be warranted.
http://ift.tt/2x3jzNV
South Asian Journal of Cancer 2017 6(3):99-101
Introduction: We retrospectively analyzed a consecutive group of patients operated for bone tumors of extremity and pelvis who received only perioperative antibiotics (Group A) against a similar group that had additional 1 g topical vancomycin sprinkled in the wound before closure (Group B). The aim was to determine if the addition of topical vancomycin decreases the incidence of deep surgical site infection (SSI). Materials and Methods: A total of 221 patients operated between January 2011 and December 2011 were analyzed in Group A and 254 patients operated between April 2012 and March 2013 were analyzed in Group B. Any patient who required operative intervention for wound discharge was considered to be infected. All patients had a 1 year follow-up to determine the incidence of SSI. Results: The overall rate of SSI was 7% (31 of 475 patients). Seventeen (8%) of Group A patients had SSI as against 14 (6 %) of Group B patients (P = 0.337). A subgroup analysis of endoprosthetic reconstructions, internal fixation implants (plates/intramedullary nails), extracorporeal radiation treated bones and strut allografts showed no difference between the two groups of patients. Conclusion: Our data suggest that the addition of topical vancomycin before wound closure in patients operated for bone tumors does not decrease the incidence of SSI. Further investigation of this technique using a case–controlled methodology with an increase in the dose of vancomycin may be warranted.
http://ift.tt/2x3jzNV
Comparison of the applicability of Hasford score and European Treatment and Outcome Study score in Indian patients with chronic phase chronic myeloid leukemia on imatinib therapy
Neha Chopra Narang, Mrinalini Kotru, Meera Sikka, Usha Rusia
South Asian Journal of Cancer 2017 6(3):117-138
http://ift.tt/2wfDSec
South Asian Journal of Cancer 2017 6(3):117-138
http://ift.tt/2wfDSec
Testicular metastasis in Wilms' tumor
Shikha Dhal, Maitrik J Mehta, Ankita Parikh, Maitri Bhagat, Aryakumar Banidutta
South Asian Journal of Cancer 2017 6(3):101-101
http://ift.tt/2x3ZcQU
South Asian Journal of Cancer 2017 6(3):101-101
http://ift.tt/2x3ZcQU
Human papillomavirus in head and neck cancer in India: Current status and consensus recommendations
Vedang Murthy, Adnan Calcuttawala, Kirti Chadha, Anil d'Cruz, Arvind Krishnamurthy, Indranil Mallick, Sudhir Nair, Tanuja Teni, Sagar Pawar, Kaustav Talapatra, Asawari Patil, Amit Bhatt, Sanjoy Chatterjee, Monali Swain, Prasad Narayanan, Nikhil Ghadyalpatil, Manish Singhal, Moni Kuriakose, Kumar Prabhash, Jaiprakash Agarwal, Purvish Parikh
South Asian Journal of Cancer 2017 6(3):93-98
Human papillomavirus (HPV) associated head and neck squamous cell cancers (HNSCC) have become increasingly common in the West, but the same cannot be said about India. These cancers have a different biology and confer a better prognosis, however, its current role in the management of patients in India is not clearly defined. At the 35th Indian Cooperative Oncology Network conference held in September 2016, a panel of radiation, surgical and medical oncologists, pathologists, and basic scientists from across the country having experience in clinical research with respect to HPV in HNSCC reviewed the available literature from India. All the ideas and facts were thereafter collated in this report. Various topics of controversy in dealing with the diagnosis and management of HPV-associated HNSCC have been highlighted in this report in context to the Indian scenario. Furthermore, the prevalence of the same and its association with tobacco and high-risk sexual behavior has been touched on. Conclusively, a set of recommendations has been proposed by the panel to guide the practicing oncologists of the country while dealing with HPV-associated HNSCC.
http://ift.tt/2wdHtJp
South Asian Journal of Cancer 2017 6(3):93-98
Human papillomavirus (HPV) associated head and neck squamous cell cancers (HNSCC) have become increasingly common in the West, but the same cannot be said about India. These cancers have a different biology and confer a better prognosis, however, its current role in the management of patients in India is not clearly defined. At the 35th Indian Cooperative Oncology Network conference held in September 2016, a panel of radiation, surgical and medical oncologists, pathologists, and basic scientists from across the country having experience in clinical research with respect to HPV in HNSCC reviewed the available literature from India. All the ideas and facts were thereafter collated in this report. Various topics of controversy in dealing with the diagnosis and management of HPV-associated HNSCC have been highlighted in this report in context to the Indian scenario. Furthermore, the prevalence of the same and its association with tobacco and high-risk sexual behavior has been touched on. Conclusively, a set of recommendations has been proposed by the panel to guide the practicing oncologists of the country while dealing with HPV-associated HNSCC.
http://ift.tt/2wdHtJp
Primary intraosseous squamous cell carcinoma in a dentigerous cyst
Karthika Panneerselvam, Anantanarayanan Parameswaran, B Kavitha, Elavenil Panneerselvam
South Asian Journal of Cancer 2017 6(3):105-117
http://ift.tt/2wtHwfD
South Asian Journal of Cancer 2017 6(3):105-117
http://ift.tt/2wtHwfD
Metastatic gastrointestinal stromal tumor: A regional cancer center experience of 44 cases
MC Suresh Babu, Tamojit Chaudhuri, K Govind Babu, KC Lakshmaiah, D Lokanatha, Linu Abraham Jacob, AH Rudresha, KN Lokesh, LK Rajeev
South Asian Journal of Cancer 2017 6(3):118-121
Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Historically, a poor prognosis for metastatic disease has been reported with systemic chemotherapy. Significant advances have been made in the last decade, since the introduction of different tyrosine kinase inhibitors (TKIs). Unfortunately, even though the TKIs have been used for a long time, there are very few published data of the experience of TKI therapy in metastatic GIST from India. Materials and Methods: Patients diagnosed with metastatic GIST from January 2005 to October 2016 at our center, who received first-line therapy with imatinib 400 mg/day, were reviewed retrospectively. Patients' profile, response to treatment, toxicity of TKI therapy, time to progression, and survival were evaluated. Results: Of the 44 metastatic GIST patients, 23 (52.2%) were males. Median age at diagnosis was 48 years. The most common presenting symptom was an abdominal pain (52%), followed by weight loss (23%). Most frequently affected metastatic site was liver (57%), followed by peritoneum (16%), and lungs (4.5%). Metastases to both liver and peritoneum were found in 10 patients (22.5%). All patients were initially treated with imatinib at a dose of 400 mg/day. Disease stabilization was documented in 21 cases (48%), and 13 patients (29%) achieved a partial response. TKI therapy was well-tolerated in most cases. Median progression-free survival (PFS) was 26 months, and estimated median survival was 48 months. Patients with lung metastases have a significantly inferior median PFS and overall survival, in comparison to patients with other metastatic sites (P < 0.05). Conclusions: Imatinib therapy was well tolerated and induced a sustained clinical benefit in more than half of the patients with metastatic GIST. Lung metastases seemed to be a poor prognostic factor in this patient population.
http://ift.tt/2x30awB
South Asian Journal of Cancer 2017 6(3):118-121
Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Historically, a poor prognosis for metastatic disease has been reported with systemic chemotherapy. Significant advances have been made in the last decade, since the introduction of different tyrosine kinase inhibitors (TKIs). Unfortunately, even though the TKIs have been used for a long time, there are very few published data of the experience of TKI therapy in metastatic GIST from India. Materials and Methods: Patients diagnosed with metastatic GIST from January 2005 to October 2016 at our center, who received first-line therapy with imatinib 400 mg/day, were reviewed retrospectively. Patients' profile, response to treatment, toxicity of TKI therapy, time to progression, and survival were evaluated. Results: Of the 44 metastatic GIST patients, 23 (52.2%) were males. Median age at diagnosis was 48 years. The most common presenting symptom was an abdominal pain (52%), followed by weight loss (23%). Most frequently affected metastatic site was liver (57%), followed by peritoneum (16%), and lungs (4.5%). Metastases to both liver and peritoneum were found in 10 patients (22.5%). All patients were initially treated with imatinib at a dose of 400 mg/day. Disease stabilization was documented in 21 cases (48%), and 13 patients (29%) achieved a partial response. TKI therapy was well-tolerated in most cases. Median progression-free survival (PFS) was 26 months, and estimated median survival was 48 months. Patients with lung metastases have a significantly inferior median PFS and overall survival, in comparison to patients with other metastatic sites (P < 0.05). Conclusions: Imatinib therapy was well tolerated and induced a sustained clinical benefit in more than half of the patients with metastatic GIST. Lung metastases seemed to be a poor prognostic factor in this patient population.
http://ift.tt/2x30awB
Breast cancer risk factor evaluation in a Western Himalayan state: A case–control study and comparison with the Western World
Purnima Thakur, Rajeev Kumar Seam, Manoj K Gupta, Manish Gupta, Mukesh Sharma, Vikas Fotedar
South Asian Journal of Cancer 2017 6(3):106-109
Context: Breast cancer incidence is increasing rapidly in India. The lifestyle, built, genetic makeup, reproductive and breastfeeding patterns are quite different in Indian females when compared to the Western population. Generalizing the Western data to the population residing in the Himalayan region would breed inaccuracies. Aim: The aim of our study was to identify risk factors in our own population in a Western Himalayan state of Himachal Pradesh, India. Subjects and Methods: A case–control study with 377 cases of invasive breast cancer and 346 hospital-based controls was conducted for 1 year. The data were collected by interviewing the individuals during their visit to hospital using a questionnaire. The data were analyzed using standard statistical techniques using SPSS version 17 software. Results: Factors found to have strong association with invasive breast cancer on multivariate analysis are late age at first childbirth >30 years, which is the strongest risk factor associated, late age of menopause > 50 years, high socioeconomic class, and age of female above 50 years. Conclusion: In our females, age >50 years, late age of menopause (>50 years), late age at first childbirth (>30 years), and high socioeconomic status were found to be major risk factors associated with breast cancer. Several factors implicated in the Western data were not found to be significant in our study. We need to identify such aspects in reproductive and breastfeeding patterns of women and spread awareness regarding the same.
http://ift.tt/2wek7n6
South Asian Journal of Cancer 2017 6(3):106-109
Context: Breast cancer incidence is increasing rapidly in India. The lifestyle, built, genetic makeup, reproductive and breastfeeding patterns are quite different in Indian females when compared to the Western population. Generalizing the Western data to the population residing in the Himalayan region would breed inaccuracies. Aim: The aim of our study was to identify risk factors in our own population in a Western Himalayan state of Himachal Pradesh, India. Subjects and Methods: A case–control study with 377 cases of invasive breast cancer and 346 hospital-based controls was conducted for 1 year. The data were collected by interviewing the individuals during their visit to hospital using a questionnaire. The data were analyzed using standard statistical techniques using SPSS version 17 software. Results: Factors found to have strong association with invasive breast cancer on multivariate analysis are late age at first childbirth >30 years, which is the strongest risk factor associated, late age of menopause > 50 years, high socioeconomic class, and age of female above 50 years. Conclusion: In our females, age >50 years, late age of menopause (>50 years), late age at first childbirth (>30 years), and high socioeconomic status were found to be major risk factors associated with breast cancer. Several factors implicated in the Western data were not found to be significant in our study. We need to identify such aspects in reproductive and breastfeeding patterns of women and spread awareness regarding the same.
http://ift.tt/2wek7n6
Serum alkaline phosphatase in oral squamous cell carcinoma and its association with clinicopathological characteristics
Swetha Acharya, Jyoti Kale, Pragati Rai, Venkatesh Anehosur, Kaveri Hallikeri
South Asian Journal of Cancer 2017 6(3):125-128
Context: Biochemical changes occur in biological fluids and tissues of different types of malignancies. Tumor markers in serum, tissue, and other body fluids during neoplastic process are of clinical value in the management of patients with cancers. Serum alkaline phosphatase (ALP) activity is potentially a useful indicator for detection of malignancies, but its status in oral squamous cell carcinoma (OSCC) is less explored. Aims: The aim of this study is to evaluate the serum level of ALP in OSCC patients and assess its relation with the clinicopathological features. Settings and Design: A total of 175 participants (145 OSCC patients and 30 healthy controls) were included in the study. One hundred and forty-five patients with OSCC who underwent treatment at our institution were included to obtain the clinicopathological data. Materials and Methods: Fasting blood ALP activity was evaluated using ALP assessment kit and biochemistry analyzer. Statistical Analysis Used: The data were analyzed by SPSS-21 software (SPSS Statistics for Windows, Version 21.0, Armonk, NY, USA), using t-test, Mann–Whitney U, and Kruskal–Wallis tests. Results: Raised ALP was seen in 24% of OSCC patients. The mean ALP in OSCC was significantly higher than the control. ALP level in patients with advanced stage was significantly higher than with early stage. The serum ALP level in OSCC patients with bone involvement (BI) by local extension of tumor was significantly higher than without BI. Conclusion: ALP showed statistically significant differences in relation to tumor stages and BI. Hence, ALP could be useful in advanced stage disease for expressing the endurance of patient and tumor expansion. Elevated ALP in OSCC patients may indicate BI.
http://ift.tt/2x6gzSy
South Asian Journal of Cancer 2017 6(3):125-128
Context: Biochemical changes occur in biological fluids and tissues of different types of malignancies. Tumor markers in serum, tissue, and other body fluids during neoplastic process are of clinical value in the management of patients with cancers. Serum alkaline phosphatase (ALP) activity is potentially a useful indicator for detection of malignancies, but its status in oral squamous cell carcinoma (OSCC) is less explored. Aims: The aim of this study is to evaluate the serum level of ALP in OSCC patients and assess its relation with the clinicopathological features. Settings and Design: A total of 175 participants (145 OSCC patients and 30 healthy controls) were included in the study. One hundred and forty-five patients with OSCC who underwent treatment at our institution were included to obtain the clinicopathological data. Materials and Methods: Fasting blood ALP activity was evaluated using ALP assessment kit and biochemistry analyzer. Statistical Analysis Used: The data were analyzed by SPSS-21 software (SPSS Statistics for Windows, Version 21.0, Armonk, NY, USA), using t-test, Mann–Whitney U, and Kruskal–Wallis tests. Results: Raised ALP was seen in 24% of OSCC patients. The mean ALP in OSCC was significantly higher than the control. ALP level in patients with advanced stage was significantly higher than with early stage. The serum ALP level in OSCC patients with bone involvement (BI) by local extension of tumor was significantly higher than without BI. Conclusion: ALP showed statistically significant differences in relation to tumor stages and BI. Hence, ALP could be useful in advanced stage disease for expressing the endurance of patient and tumor expansion. Elevated ALP in OSCC patients may indicate BI.
http://ift.tt/2x6gzSy
Clinical practice and outcomes in advanced gastrointestinal stromal tumor: Experience from an Indian tertiary care center
Subhadeep Bose, Anant Ramaswamy, Arvind Sahu, Omshree Shetty, Saurabh S Zanwar, Jimmy Mirani, Chaitali Nashikkar, Vikas Ostwal
South Asian Journal of Cancer 2017 6(3):110-112
Background: Management of advanced Gastrointestinal stromal tumors (GIST) has been revolutionized with the use of Imatinib guided by mutation analysis. Data from India remains scarce. Materials and Methods: Patients with metastatic GIST who were treated at Department of Gastro-intestinal & Hepaticopancreaticobiliary Oncology Unit at Tata Memorial Hospital, Mumbai between December, 2004 and December 2015 were included in the analysis. Clinical and radiological data was retrieved from stored medical records and charts. Results: A total of 83 patients with metastatic GIST were available for analysis. Median age was 54 years with a 3:1 male predominance. Stomach was the most common site of primary with liver being the most common site of metastasis. c-Kit mutation analysis results were available for 44 patients with exon 11 mutant being the most common mutation. With a median follow up of 33 months, the 10 years estimated progression free and overall survival (OS) was 18% and 51% respectively. Overall response rate to first line imatinib was 37.6% and estimated 3 years OS to first line therapy was significantly better for Exon 11 mutated patients (p=0.016). 34 patients received second line therapy in the form of either sunitinib, pazopanib or increased dose imatinib with a clinical benefit rate of 73.5%. C-Kit mutated patients had a better median OS compared to non mutated patients. Conclusions: GIST diagnosed and treated in the Indian subcontinent appears to show improved outcomes. The importance of c-Kit mutation analysis in determining the prognosis and outcomes of patients with advanced GIST is emphasized.
http://ift.tt/2x3ozlR
South Asian Journal of Cancer 2017 6(3):110-112
Background: Management of advanced Gastrointestinal stromal tumors (GIST) has been revolutionized with the use of Imatinib guided by mutation analysis. Data from India remains scarce. Materials and Methods: Patients with metastatic GIST who were treated at Department of Gastro-intestinal & Hepaticopancreaticobiliary Oncology Unit at Tata Memorial Hospital, Mumbai between December, 2004 and December 2015 were included in the analysis. Clinical and radiological data was retrieved from stored medical records and charts. Results: A total of 83 patients with metastatic GIST were available for analysis. Median age was 54 years with a 3:1 male predominance. Stomach was the most common site of primary with liver being the most common site of metastasis. c-Kit mutation analysis results were available for 44 patients with exon 11 mutant being the most common mutation. With a median follow up of 33 months, the 10 years estimated progression free and overall survival (OS) was 18% and 51% respectively. Overall response rate to first line imatinib was 37.6% and estimated 3 years OS to first line therapy was significantly better for Exon 11 mutated patients (p=0.016). 34 patients received second line therapy in the form of either sunitinib, pazopanib or increased dose imatinib with a clinical benefit rate of 73.5%. C-Kit mutated patients had a better median OS compared to non mutated patients. Conclusions: GIST diagnosed and treated in the Indian subcontinent appears to show improved outcomes. The importance of c-Kit mutation analysis in determining the prognosis and outcomes of patients with advanced GIST is emphasized.
http://ift.tt/2x3ozlR
A comparative study of bloodstream infections in acute myeloid leukemia according to different phases of treatment: Can we predict the organism?
Preetam Kalaskar, Asha Anand, Harsha Panchal, Apurva Patel, Sonia Parikh, Sandip Shah
South Asian Journal of Cancer 2017 6(3):132-133
Introduction: The treatment of acute myeloid leukemia (AML) consists of induction therapy with anthracyclines and cytarabine followed by two to four cycles of consolidation therapy with high-dose cytarabine after achieving remission. There have been very few studies comparing infections during induction and consolidation. We have analyzed blood cultures of patients with AML during episodes of fever occurring during induction and consolidation, for comparing the bloodstream infections in both the phases. Materials and Methods: Blood cultures of patients during febrile episodes were collected from central venous catheters and peripheral blood, both during induction and consolidation therapy of AML. Results: The study population included 52 AML patients. During induction, there were 52 episodes of fever and 25 (48%) blood cultures were positive, 15 of these blood cultures reported Gram-negative organisms, 9 reported Gram-positive organisms and 1 as yeast. During consolidation, 47 episodes of fever were recorded and blood cultures were positive in 12, of which 7 were Gram-negative, 5 were Gram-positive. Conclusion: The incidence of blood culture positive infections during therapy of AML at our center was higher. The predominant organism isolated was Gram-negative both during induction and consolidation. The incidence of blood culture positive infections had decreased by 50% during consolidation.
http://ift.tt/2wdCbOh
South Asian Journal of Cancer 2017 6(3):132-133
Introduction: The treatment of acute myeloid leukemia (AML) consists of induction therapy with anthracyclines and cytarabine followed by two to four cycles of consolidation therapy with high-dose cytarabine after achieving remission. There have been very few studies comparing infections during induction and consolidation. We have analyzed blood cultures of patients with AML during episodes of fever occurring during induction and consolidation, for comparing the bloodstream infections in both the phases. Materials and Methods: Blood cultures of patients during febrile episodes were collected from central venous catheters and peripheral blood, both during induction and consolidation therapy of AML. Results: The study population included 52 AML patients. During induction, there were 52 episodes of fever and 25 (48%) blood cultures were positive, 15 of these blood cultures reported Gram-negative organisms, 9 reported Gram-positive organisms and 1 as yeast. During consolidation, 47 episodes of fever were recorded and blood cultures were positive in 12, of which 7 were Gram-negative, 5 were Gram-positive. Conclusion: The incidence of blood culture positive infections during therapy of AML at our center was higher. The predominant organism isolated was Gram-negative both during induction and consolidation. The incidence of blood culture positive infections had decreased by 50% during consolidation.
http://ift.tt/2wdCbOh
Unraveling the spectrum of KIT mutations in gastrointestinal stromal tumors: An Indian Tertiary Cancer Center Experience
Trupti Pai, Munita Bal, Omshree Shetty, Mamta Gurav, Vikas Ostwal, Anant Ramaswamy, Mukta Ramadwar, Sangeeta Desai
South Asian Journal of Cancer 2017 6(3):113-117
Background: Primary mutations in the KIT gene are the driving force for gastrointestinal stromal tumors (GIST) tumorigenesis. Predictive role of KIT mutation status aids oncologists in patient management. There is a paucity of comprehensive data on the frequency of mutations in the KIT gene in GIST affecting Indian patients. The aims of this study were to determine the frequency and spectrum of molecular alterations affecting the KIT gene and assess their association with clinicopathologic features in a cohort of patients of GIST. Materials and Methods: Morphological and immunohistochemically confirmed GIST cases (n = 114) accessioned from August 2014-June 2015 were analyzed for mutations in KIT exons 9, 11, 13, and 17 and subjected to Sanger sequencing onto the ABI 3500 Genetic Analyzer. The sequences were analyzed using sequence analysis software: SeqScape® and Chromas Lite. Results: KIT mutations were seen in 70% of cases and the majority of KIT mutations involved exon 11 (57%), followed by exon 9 (10%), exon 13 (3%), and exon 17 (1%). Most common exon 11 mutations were in-frame deletions (61.4%) followed by substitution mutations (19.3%). Exon 9 mutations showed identical duplication of Ala-Tyr at codons 502–503. Simultaneous mutations affecting exon 11 and 13 were discovered. Novel variations, namely, p.Q556E (c.1666C>G), p.Q556dup (c.1666_1668dupCAG), p.K558_V559delinsS (c.1672_1677delAAGGTTinsAGT), p.Y503_F504insTY (c.1509_1510insACCTAT), and p.K642R (c.1925A>G) involving exons 11, 9, and 13, respectively, were observed. Interpretation and Conclusions: First study with complete analysis of all 4 exons of KIT (exons 9, 11, 13, and 17) in Indian GIST patients. Along with well-described KIT mutations, several rare double mutations as well as novel alterations were reported in this series.
http://ift.tt/2x4CMPy
South Asian Journal of Cancer 2017 6(3):113-117
Background: Primary mutations in the KIT gene are the driving force for gastrointestinal stromal tumors (GIST) tumorigenesis. Predictive role of KIT mutation status aids oncologists in patient management. There is a paucity of comprehensive data on the frequency of mutations in the KIT gene in GIST affecting Indian patients. The aims of this study were to determine the frequency and spectrum of molecular alterations affecting the KIT gene and assess their association with clinicopathologic features in a cohort of patients of GIST. Materials and Methods: Morphological and immunohistochemically confirmed GIST cases (n = 114) accessioned from August 2014-June 2015 were analyzed for mutations in KIT exons 9, 11, 13, and 17 and subjected to Sanger sequencing onto the ABI 3500 Genetic Analyzer. The sequences were analyzed using sequence analysis software: SeqScape® and Chromas Lite. Results: KIT mutations were seen in 70% of cases and the majority of KIT mutations involved exon 11 (57%), followed by exon 9 (10%), exon 13 (3%), and exon 17 (1%). Most common exon 11 mutations were in-frame deletions (61.4%) followed by substitution mutations (19.3%). Exon 9 mutations showed identical duplication of Ala-Tyr at codons 502–503. Simultaneous mutations affecting exon 11 and 13 were discovered. Novel variations, namely, p.Q556E (c.1666C>G), p.Q556dup (c.1666_1668dupCAG), p.K558_V559delinsS (c.1672_1677delAAGGTTinsAGT), p.Y503_F504insTY (c.1509_1510insACCTAT), and p.K642R (c.1925A>G) involving exons 11, 9, and 13, respectively, were observed. Interpretation and Conclusions: First study with complete analysis of all 4 exons of KIT (exons 9, 11, 13, and 17) in Indian GIST patients. Along with well-described KIT mutations, several rare double mutations as well as novel alterations were reported in this series.
http://ift.tt/2x4CMPy
Pattern of occurrence and treatment outcome of second primary malignancies: A single center experience
Prekshi Chaudhary, Sweety Gupta, Nitin Leekha, Ruchir Tandon, Malay Nandy, Sudarsan De
South Asian Journal of Cancer 2017 6(3):137-138
Background: The incidence of cancer survivors is increasing, but these individuals, unfortunately, face the risk of second primary malignancies (SPMs). This increasing incidence can be credited to increased survival rates of cancer patients, environmental factors, host factors, and genetic predispositions. Hence, vigilance on the part of the patient as well as clinician for the development of new signs and symptoms is mandatory. Aims: Retrospective analysis of the pattern of incidence and clinical outcome of patients diagnosed with SPM and to review the literature. Settings and Design: A hospital-based retrospective collection of prospective data of patients diagnosed with SPM. Materials and Methods: Thirty-six patients with histopathologically proven SPM from January 2009 to July 2015 were included in this study. Factors such as age, sex, site, stage, histology, treatment received, and outcome were recorded. Statistical Analysis Used: Basic statistical tools have been used for analyzing the data. Results and Conclusions: The likelihood of occurrence of second malignancy, either synchronous or metachronous, should always be kept in mind while evaluating a cancer patient. Appearance of new signs and symptoms during the initial evaluation as well as during follow-up should raise a suspicion, and both patient and oncologist should have a low threshold for further assessment. Early diagnosis and treatment will reduce morbidity and mortality and lead to better survival outcome.
http://ift.tt/2wej4nh
South Asian Journal of Cancer 2017 6(3):137-138
Background: The incidence of cancer survivors is increasing, but these individuals, unfortunately, face the risk of second primary malignancies (SPMs). This increasing incidence can be credited to increased survival rates of cancer patients, environmental factors, host factors, and genetic predispositions. Hence, vigilance on the part of the patient as well as clinician for the development of new signs and symptoms is mandatory. Aims: Retrospective analysis of the pattern of incidence and clinical outcome of patients diagnosed with SPM and to review the literature. Settings and Design: A hospital-based retrospective collection of prospective data of patients diagnosed with SPM. Materials and Methods: Thirty-six patients with histopathologically proven SPM from January 2009 to July 2015 were included in this study. Factors such as age, sex, site, stage, histology, treatment received, and outcome were recorded. Statistical Analysis Used: Basic statistical tools have been used for analyzing the data. Results and Conclusions: The likelihood of occurrence of second malignancy, either synchronous or metachronous, should always be kept in mind while evaluating a cancer patient. Appearance of new signs and symptoms during the initial evaluation as well as during follow-up should raise a suspicion, and both patient and oncologist should have a low threshold for further assessment. Early diagnosis and treatment will reduce morbidity and mortality and lead to better survival outcome.
http://ift.tt/2wej4nh
Feasibility and Efficacy of Mat Pilates on People with Mild-to-Moderate Parkinson's Disease: A Preliminary Study
Rejuvenation Research , Vol. 0, No. 0.
http://ift.tt/2faqQqG
The Minimal Clinically Important Difference for the Rasch Neuropsychiatric Inventory Irritability and Aggression Scale for Traumatic Brain Injury
Source:Archives of Physical Medicine and Rehabilitation
Author(s): James F. Malec, Flora M. Hammond
ObjectiveTo determine the Minimal Clinically Important Difference (MCID) for a Rasch measure derived from the Irritability/Lability and Agitation/Aggression subscales of the Neuropsychiatric Inventory (NPI-TBI-IA).DesignDistribution-based statistical methods were applied to retrospective data to determine candidates for the MCID. These candidates were evaluated by anchoring the NPI-TBI-IA to Global Impression of Change (GIC) ratings by participants, significant others, and a supervising physician.Main Outcome MeasureNPI-TBI-IA.SettingPostacute rehabilitation outpatient clinic.Participants274 cases with observer ratings; 232 cases with self-ratings by participants with moderate-severe TBI at least 6 months post-injury.ResultsFor observer ratings on the NPI-TBI-IA, anchored comparisons found an improvement of ½ SD was associated with at least minimal general improvement on GIC by a significant majority (69-80%); ½ SD improvement on participant NPI-TBI-IA self-ratings was also associated with at least minimal improvement on the GIC by a substantial majority (77-83%). The percent indicating significant global improvement did not increase markedly on most ratings at higher levels of improvement on the NPI-TBI-IA.ConclusionsA ½ SD improvement on the NPI-TBI-IA indicates the MCID for both observer and participant ratings on this measure.
http://ift.tt/2x6mPdk
Benefits of the Restorative Exercise and Strength Training for Operational Resilience and Excellence Yoga Program for Chronic Lower Back Pain in Service Members: A Pilot Randomized Control Trial
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Krista Beth Highland, Audrey Schoomaker, Winifred Rojas, Josh Suen, Ambareen Ahmed, Zhiwei Zhang, Sarah Fink Carlin, Christian Calilung, Michael Kent, Chester Buckenmaier
ObjectiveTo examine the feasibility and preliminary effectiveness of an individualized yoga program.DesignPilot randomized control trial.SettingMilitary medical center.ParticipantsPatients (N=68) with chronic LBP.InterventionsRestorative Exercise and Strength Training for Operational Resilience and Excellence (RESTORE) program (9-12 individual yoga sessions) or treatment-as-usual (control) for 8-week period.Main Outcome MeasuresThe primary outcome was past 24-hour pain scores (Defense and Veterans Pain Rating Scale). Secondary outcomes included disability (Roland-Morris Disability Questionnaire), physical functioning, and symptom burden (Patient Reported Outcomes Measurement Information System-29 subscales). Assessment occurred at baseline, Week 4, Week 8, 3-month follow-up, and 6-month follow-up. Exploratory outcomes included the proportion of participants in each group reporting clinically meaningful changes at 3-month and 6-month follow-ups.ResultsGeneralized linear mixed models with sequential Bonferroni-corrected pairwise significance tests and chi-square analyses examined longitudinal outcomes. Secondary outcome significance tests were Bonferroni-adjusted for multiple outcome tests. The RESTORE group reported improved pain, compared to the control group. Secondary outcomes did not retain significance after Bonferroni-adjustments for multiple outcomes. Though, a greater proportion RESTORE participants reported clinically-meaningfully changes in all outcome at 3-month follow-up and symptom burden at 6-month follow-up.ConclusionRESTORE may be a viable non-pharmacologic approach to LBP with minimal side effects and research efforts are needed to compare effectiveness of RESTORE delivery formats (e.g., group versus individual) or to other treatment modalities.
http://ift.tt/2y2AWxY
Rasch Analysis, Dimensionality, and Scoring of the Neuropsychiatric Inventory (NPI) Irritability and Aggression Subscales in Individuals with Traumatic Brain Injury
Source:Archives of Physical Medicine and Rehabilitation
Author(s): James F. Malec, Timothy E. Stump, Patrick O. Monahan, Jacob Kean, Dawn Neumann, Flora M. Hammond
ObjectiveTo develop, for versions completed by individuals with traumatic brain injury (TBI) and an observer, a more precise metric for the Neuropsychiatric Inventory (NPI) Irritability and Aggression scales using all behavioral item ratings for use with individuals with TBI and address the dimensionality of the represented behavioral domains.DesignRasch and confirmatory factor analyses of retrospective baseline NPI data from three treatment studies.SettingPostacute rehabilitation clinic.Participants287 cases with observer ratings; 238 cases with self-ratings by participants with complicated mild, moderate or severe TBI at least 6 months post-injury.Main Outcome MeasureFrequency and severity ratings from NPI Irritability/Lability and Agitation/Aggression subscales.ResultsConfirmatory factor analyses of both observer and participant ratings showed good fit for either a one-factor or two-factor solution. Consistent with this, the Rasch model also fit the data well with aggression items indicating the more severe end of the construct and irritability items populating the milder end.ConclusionsIrritability and aggression appear to represent different levels of severity of a single construct. The derived Rasch metric offers a measure of this construct based on responses to all specific items that is appropriate for parametric statistical analysis and may be useful in research and clinical assessments of individuals with TBI.
http://ift.tt/2jwlB6r
Evaluation of delivery costs for external beam radiation therapy and brachytherapy for locally advanced cervical cancer using time-driven activity-based costing
Publication date: Available online 14 September 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Kristine Bauer-Nilsen, Colin Hill, Daniel M. Trifiletti, Bruce Libby, Donna H. Lash, Melody Lain, Deborah Christodoulou, Constance Hodge, Timothy N. Showalter
PurposeThis study aims to evaluate the delivery costs, using time-driven activity-based costing (TDABC), and reimbursement for definitive radiation therapy for locally advanced cervical cancer.Methods and MaterialsProcess maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource, and then calculated the total cost of patient care based upon CCR and time for each resource. Costs were compared to 2016 Medicare reimbursement and relative value units (RVUs).ResultsThe total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs comprising 49.8%. Brachytherapy cost $8,610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). EBRT cost $4,055.01 in costs (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and EBRT delivery ($4,798.73 vs. $1,404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with IMRT or 135.90 RVUs with 3DCRT, with total reimbursement of $23,321.71 and $16,071.90 respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3DCRT (1.63 minutes) or IMRT (1.32 minutes).ConclusionTDABC was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources comprised the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We hypothesize that the significant discrepancy between treatment costs and physician effort versus reimbursement may be a potential driver of reported national trends towards poor compliance with brachytherapy and suggest re-evaluation of payment policies to incentivize quality care.
Teaser
Time-driven activity-based costing methodology was applied to calculate the delivery costs of definitive radiation therapy for locally advanced cervical cancer. Brachytherapy was more costly and consumed more attending radiation oncologist time than external beam radiation therapy. Comparison of the delivery costs and physician time requirements to current reimbursement revealed a financial disincentive against brachytherapy, which should be studied as a potential contributor to the reported national poor compliance rates for cervical cancer brachytherapy.http://ift.tt/2fni2eh
Stereotactic Body Radiotherapy as an Alternative to Transarterial Chemoembolization for Hepatocellular Carcinoma
Publication date: Available online 14 September 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Eli Sapir, Yebin Tao, Matthew J. Schipper, Latifa Bazzi, Paula M. Novelli, Paulina Devlin, Dawn Owen, Kyle C. Cuneo, Theodore S. Lawrence, Neehar D. Parikh, Mary Feng
BackgroundThere is little data to guide non-surgical treatment selection for patients with HCC. Therefore, we conducted a large, single institutional comparison of transarterial chemoembolization (TACE) and SBRT outcomes in similar groups of patients.MethodsFrom 2006 to 2014, 209 patients with 1-2 tumors underwent TACE (n=84) to 114 tumors or image-guided SBRT (n=125) to 173 tumors. Propensity score analysis with inverse probability of treatment weighting was used to compare outcomes between treatments while adjusting for imbalances in treatment assignment. Local control (LC), toxicity, and overall survival (OS) were retrospectively analyzed.ResultsTACE and SBRT groups were similar with respect to the number of tumors treated per patient, underlying liver disease and baseline liver function. Patients treated with SBRT were older (65 vs 61 yrs, p=0.01) and had smaller tumors (2.3 vs 2.9 cm, p < 0.001), and less frequently underwent liver transplantation (8% vs. 18%, p = 0.01). 1- and 2-yr LC favored SBRT: 97% and 91% for SBRT and 47% and 23%, for TACE (HR 66.5, p < 0.001). For patients treated with TACE, higher AFP (HR 1.11 per doubling, p =0.008) and segmental portal vein thrombosis (HR 9.9, p < 0.001) were associated with worse LC. Predictors associated with LC after SBRT were not identified. Grade 3+ toxicity occurred after 13% and 8% of TACE and SBRT treatments, respectively (p = 0.05). There was no difference in OS between patients treated with TACE or SBRT.ConclusionSBRT is a safe alternative to TACE for 1-2 tumors, and provides better LC, with no observed difference in OS. Prospective comparative trials of TACE and SBRT are warranted.
http://ift.tt/2xozloN
Salvage brachytherapy for radiorecurrent prostate cancer: Searching for safety and success
Source:Brachytherapy
Author(s): Max Peters, Marinus A. Moerland, Jochem R.N. van der Voort van Zyp
http://ift.tt/2eZA858
The effects of needle damage on annulus fibrosus micromechanics
Publication date: Available online 14 September 2017
Source:Acta Biomaterialia
Author(s): Claudio Vergari, Jessica C. Mansfield, Daniel Chan, Andrew Clarke, Judith R. Meakin, Peter C. Winlove
Needle puncture of the intervertebral disc can initiate a mechanical and biochemical cascade leading to disc degeneration. Puncture's mechanical effects have been shown near the puncture site, mechanical effects should be observed far, relative to needle size, from the puncture site, given the disc-wide damage induced by the stab. The aim of this work was to quantify these far-field effects, and to observe the local structural damage provoked by the needle.Strips of cow tail annulus fibrosus underwent two consecutive mechanical loadings to 5% tensile strain; fifteen samples were punctured in a radial direction with a randomly assigned needle between the two loadings (needle gauges between 19 and 23). Ten samples (control group) were not punctured. During loading, the tissue strains were imaged using second harmonic generation microscopy in a <600x800µm region about 4.4mm from the puncture site. After mechanical testing, the puncture site was imaged in 3D.Puncture had no significant effect on annulus elastic modulus. Imaging showed a modest change in the shearing between fibre bundles however, the linear strain between bundles, intra-bundle shear and linear strain were not significantly affected. At the puncture site, detached lumps of tissue were present.These results suggest that the mechanical effects observed in intact discs are due to the depressurization of the disc, rather than the local damage to the annulus. Needle profiles could be designed, aiming at separating fibre bundles rather than cutting through them, to avoid leaving dying tissue behind.Statement of significanceNeedle puncture of the intervertebral disc can initiate a mechanical and biochemical cascade leading to disc degeneration, but the link between the local damage of the puncture and the disc-wide effects is not well understood. This work aimed at determining the micro–mechanical effects of the puncture far from its site, and to observe the damage induced by the puncture with high resolution imaging. Results show that the puncture had modest effect far from the puncture, but lumps of tissue were left by the needle, detached from the disc; these could cause further damage through friction and inflammation of the surrounding tissues. This suggests that the cascade leading to degeneration is probably driven by a biochemical response rather than disc-wide mechanical effects.
Graphical abstract
http://ift.tt/2eZrYKb
Material process development for the fabrication of heterogeneous titanium structures with selective pore morphology by a hybrid additive manufacturing process
Publication date: 5 December 2017
Source:Materials & Design, Volume 135
Author(s): Esmat Sheydaeian, Kaveh Sarikhani, Pu Chen, Ehsan Toyserkani
This paper addresses a new methodology to fabricate cellular structures with embedded close pores distributed in controlled fashion. A hybrid additive manufacturing system integrating binder jetting and material extrusion was employed to selectively incorporate a sacrificial polymer into the structures followed by a post-processing step to decompose the polymer. Four different polymer compositions mixture of bisphenol-A ethoxylated diacrylate and cellulose acetate butyrate (CAB) were prepared. From determining the rheological and interfacial properties of the polymers, the composition with the highest CAB concentration (20wt%) demonstrated lowest permeation inside powder porous media (0.03m2/s). The significance of the results is in retaining the quality of green substrate via a decrease in influence of the polymer shrinkage stress due to a reduction in the polymer - powders interface. The effect of binder jetting and design parameters on the quality of green samples manufactured by embedding the optimized composition revealed the direct influence of binder saturation level, layer thickness, and the number of powder layers covering encapsulated polymers. In the heat treatment of the samples (up to 1400°C), a high level of accuracy (1% error margin) in morphology of cavities, resulted from the decomposition of polymers (400°C), was achieved.
Graphical abstract
http://ift.tt/2fasvNf
A study of parametric calibration for low cost 3D printing: Seeking improvement in dimensional quality
Publication date: 5 December 2017
Source:Materials & Design, Volume 135
Author(s): Leonardo Santana, Jorge Lino Alves, Aurélio da Costa Sabino Netto
Open source projects have helped extrusion-based Additive Manufacturing processes gain popularity in recent years. While they allow the design and development of low cost machines, one of the main difficulties users have found is the parametric calibration. A study was proposed to understand the best practices for the setup of "input parameters", since in the open software chain there are many available for setup. Through experimental design methods, the dimensional accuracy of a cubic structure was analysed by varying factors such as: slicing software, layer thickness, infill density, first layer, infill and perimeter speeds, as well as extrusion temperature and multiplier. A Prusa I3 Hephestos printer and a Polylactic Acid (PLA) filament were used, and the parts were evaluated with contact measurement, 3D scanning and mass measurement procedures. Statistical analysis showed that the dimensional accuracy of the components was mostly affected by the infill density and the extrusion multiplier. Both parameters highlight the influence of the slicing software on the planning and quality of the models. Instabilities in the amount and flow of material, characterized by excess deposition, were responsible for the distortions along the three fundamental directions of the cubes.
Graphical abstract
http://ift.tt/2fatj4G
Hyperbranched alkyd/magnetite-silica nanocomposite as a coating material
Publication date: 5 December 2017
Source:Materials & Design, Volume 135
Author(s): Mohamed S. Selim, Feng Q. Wang, Hui Yang, Yong Huang, Shigenori Kuga
Engineering innovative nanomaterials with low volatile organic content (VOC) has awarded great interest to control air pollutant emissions. We designed a highly branched alkyd matrix suitable for surface coating from castor oil via polyesterification. A simple A2+B3 (di- and tri-functional monomers) methodology was used to prepare the hyperbranched polyester from natural multifunctional monomers. Magnetite-coated silica (Fe3O4@SiO2) particles with 60–70nm average diameter were prepared by in situ method that binds magnetite nanoparticles to silica nanospheres. The magnetite size and attaching efficiency were controlled by the concentration of chemicals and reflux duration. The nanocomposite coating was prepared by solution casting. The structure-property relationship was studied for different concentrations of nanofiller in the alkyd matrix. The surface and anticorrosive properties were studied via contact angle and salt spray tests. Mechanical performance and thermal stability were assessed by various methods. The highest improvement was achieved with nanofiller insertion up to 0.5% Fe3O4@SiO2 nanospheres.
Graphical abstract
http://ift.tt/2fatiOa
Distinct Effects of Body Mass Index and Waist/Hip Ratio on Risk of Breast Cancer by Joint Estrogen and Progestogen Receptor Status: Results from a Case‐Control Study in Northern and Eastern China and Implications for Chemoprevention
AbstractBackground.Obesity is a consideration in the pharmacologic intervention for estrogen receptor (ER) positive (ER+) breast cancer risk. Body mass index (BMI) and waist/hip ratio (WHR) have demonstrated different effects on breast cancer risk in relation to estrogen receptor (ER) status, but the results have been inconsistent. Furthermore, the situation in Chinese women remains unclear.Materials and Methods.We conducted a case‐control study including 1,439 breast cancer cases in Northern and Eastern China. Both ER and progesterone receptor (PR) statuses were available for 1,316 cases. Associations between body size‐related factors and breast cancer risk defined by receptor status were assessed by multiple polytomous unconditional logistic regression analysis.Results.Body mass index and WHR were positively associated with overall breast cancer risk. Body mass index was positively associated with both ER+/PR positive (PR+) and ER negative (ER−)/PR negative(PR−) subtype risks, although only significantly for ER+/PR+ subtype. Waist–hip ratio was only positively correlated with ER−/PR− subtype risk, although independent of BMI. Body mass index was positively associated with risk of ER+/PR+ and ER−/PR− subtypes in premenopausal women, whereas WHR was inversely correlated with ER+/PR− and positively with ER−/PR− subtype risks. Among postmenopausal women, WHR >0.85 was associated with increased risk of ER−/PR− subtype.Conclusions.Both general and central obesity contribute to breast cancer risk, with different effects on specific subtypes. General obesity, indicated by BMI, is more strongly associated with ER+/PR+ subtype, especially among premenopausal women, whereas central obesity, indicated by WHR, is more specific for ER−/PR− subtype, independent of menopausal status. These results suggest that different chemoprevention strategies may be appropriate in selected individuals.Implications for Practice.The results of this study suggest that general and central obesity may play different roles in different breast cancer subtypes, supporting the hypothesis that obesity affects breast carcinogenesis via complex molecular interconnections, beyond the impact of estrogens. The results also imply that different chemoprevention strategies may be appropriate for selected individuals, highlighting the need to be particularly aware of women with a high waist/hip ratio but normal body mass index. Given the lack of any proven pharmacologic intervention for estrogen receptor negative breast cancer, stricter weight‐control measures may be advised in these individuals.
http://ift.tt/2wei6aA
Comprehensive Genomic Profiling of 282 Pediatric Low‐ and High‐Grade Gliomas Reveals Genomic Drivers, Tumor Mutational Burden, and Hypermutation Signatures
AbstractBackground.Pediatric brain tumors are the leading cause of death for children with cancer in the U.S. Incorporating next‐generation sequencing data for both pediatric low‐grade (pLGGs) and high‐grade gliomas (pHGGs) can inform diagnostic, prognostic, and therapeutic decision‐making.Materials and Methods.We performed comprehensive genomic profiling on 282 pediatric gliomas (157 pHGGs, 125 pLGGs), sequencing 315 cancer‐related genes and calculating the tumor mutational burden (TMB; mutations per megabase [Mb]).Results.In pLGGs, we detected genomic alterations (GA) in 95.2% (119/125) of tumors. BRAF was most frequently altered (48%; 60/125), and FGFR1 missense (17.6%; 22/125), NF1 loss of function (8.8%; 11/125), and TP53 (5.6%; 7/125) mutations were also detected. Rearrangements were identified in 35% of pLGGs, including KIAA1549‐BRAF, QKI‐RAF1, FGFR3‐TACC3, CEP85L‐ROS1, and GOPC‐ROS1 fusions. Among pHGGs, GA were identified in 96.8% (152/157). The genes most frequently mutated were TP53 (49%; 77/157), H3F3A (37.6%; 59/157), ATRX (24.2%; 38/157), NF1 (22.2%; 35/157), and PDGFRA (21.7%; 34/157). Interestingly, most H3F3A mutations (81.4%; 35/43) were the variant K28M. Midline tumor analysis revealed H3F3A mutations (40%; 40/100) consisted solely of the K28M variant. Pediatric high‐grade gliomas harbored oncogenic EML4‐ALK, DGKB‐ETV1, ATG7‐RAF1, and EWSR1‐PATZ1 fusions. Six percent (9/157) of pHGGs were hypermutated (TMB >20 mutations per Mb; range 43–581 mutations per Mb), harboring mutations deleterious for DNA repair in MSH6, MSH2, MLH1, PMS2, POLE, and POLD1 genes (78% of cases).Conclusion.Comprehensive genomic profiling of pediatric gliomas provides objective data that promote diagnostic accuracy and enhance clinical decision‐making. Additionally, TMB could be a biomarker to identify pediatric glioblastoma (GBM) patients who may benefit from immunotherapy.Implications for Practice.By providing objective data to support diagnostic, prognostic, and therapeutic decision‐making, comprehensive genomic profiling is necessary for advancing care for pediatric neuro‐oncology patients. We present the largest cohort of pediatric low‐ and high‐grade gliomas profiled by next‐generation sequencing. We detected reportable alterations in 95% of patients, including diagnostically relevant lesions as well as novel oncogenic fusions and mutations. Additionally, we report tumor mutational burden (TMB), which identifies a subpopulation of hypermutated glioblastomas that harbor deleterious mutations in DNA repair genes. This provides support for TMB as a potential biomarker to identify patients who may preferentially benefit from immune checkpoint inhibitors.
http://ift.tt/2ya9peB
Histology of non-small cell lung cancer predicts the response to stereotactic body radiotherapy
Source:Radiotherapy and Oncology
Author(s): Juliane Hörner-Rieber, Denise Bernhardt, Julian Dern, Laila König, Sebastian Adeberg, Angela Paul, Claus Peter Heussel, Jutta Kappes, Hans Hoffmann, Felix J.P. Herth, Jürgen Debus, Arne Warth, Stefan Rieken
Background and purposeTo investigate the prognostic impact of different histological subtypes of non-small cell lung cancer (NSCLC) on outcome following stereotactic body radiotherapy (SBRT) for NSCLC patients.Materials and methodsWe analyzed 126 consecutive patients with early-stage adenocarcinoma or squamous cell carcinoma treated with SBRT from 2004 to 2016. Adenocarcinoma patients were further sub-classified as high-risk or low-risk tumors.ResultsWith a median follow-up time of 22months, 2-year overall survival (OS), local (LC), and distant control (DC) were 68%, 90% and 79%, respectively. For LC, histologic subtype was identified as major independent prognostic factor (p=0.033): while LC was 81% for squamous cell carcinoma patients, LC was significantly improved for high-risk and even more non-high-risk adenocarcinoma patients with 96% and 100%, respectively (p=0.026). The negative prognostic impact of the histologic subtype "squamous cell carcinoma" was not evident when patients received SBRT with higher total doses in EQD2 (2Gy equivalent dose): if patients were treated with a total dose in EQD2≥150Gy, no significant difference in LC for histologic subtypes was detected anymore (p=0.355).ConclusionIn the current study, histologic subtypes of NSCLC predicted local control probabilities following SBRT. Prospective, multi-center studies are needed to evaluate the prognostic impact of histology and consecutively the need for SBRT dose adaptation.
http://ift.tt/2flyICH
Inter-observer agreement in GTV delineation of bone metastases on CT and impact of MR imaging: A multicenter study
Source:Radiotherapy and Oncology
Author(s): A.S. Gerlich, J.M. van der Velden, A.N.T.J. Kotte, C.L. Tseng, G. Fanetti, W.S.C. Eppinga, N. Kasperts, M.P.W. Intven, F.A. Pameijer, M.E.P. Philippens, H.M. Verkooijen, E. Seravalli
Background and purposeThe use of Stereotactic Body Radiotherapy (SBRT) for bone metastases is increasing rapidly. Therefore, knowledge of the inter-observer differences in tumor volume delineation is essential to guarantee precise dose delivery. The aim of this study is to compare inter-observer agreement in bone metastases delineated on different imaging modalities.Material and methodsTwenty consecutive patients with bone metastases treated with SBRT were selected. All patients received CT and MR imaging in treatment position prior to SBRT. Five observers from three institutions independently delineated gross tumor volume (GTV) on CT alone, CT with co-registered MRI and MRI alone. Four contours per imaging modality per patient were available, as one set of contours was shared by 2 observers. Inter-observer agreement, expressed in generalized conformity index [CIgen], volumes of contours and contours center of mass (COM) were calculated per patient and imaging modality.ResultsMean GTV delineated on MR (45.9±52.0cm3) was significantly larger compared to CT–MR (40.2±49.4cm3) and CT (34.8±41.8cm3). A considerable variation in CIgen was found on CT (mean 0.46, range 0.15–0.75) and CT–MRI (mean 0.54, range 0.17–0.71). The highest agreement was found on MRI (mean 0.56, range 0.20–0.77). The largest variations of COM were found in anterior–posterior direction for all imaging modalities.ConclusionsLarge inter-observer variation in GTV delineation exists for CT, CT–MRI and MRI. MRI-based GTV delineation resulted in larger volumes and highest consistency between observers.
http://ift.tt/2xo8glV
Ex vivo γH2AX radiation sensitivity assay in prostate cancer: Inter-patient and intra-patient heterogeneity
Source:Radiotherapy and Oncology
Author(s): Chiara De-Colle, Ala Yaromina, Joerg Hennenlotter, Howard Thames, Arndt-Christian Mueller, Tim Neumann, Arnulf Stenzl, Marcus Scharpf, Falko Fend, Umberto Ricardi, Michael Baumann, Daniel Zips, Apostolos Menegakis
IntroductionThe aim of the study is to assess inter-patient and intra-patient heterogeneity in tumour cell radiosensitivity using the ex vivo γH2AX assay in prostate cancer specimens.MethodsExcised specimens from untreated prostate cancer patients were cultivated 24h in media, irradiated ex vivo and fixed after 24h. Residual γH2AX foci were counted and the slope of the dose response was calculated. Intra-patient heterogeneity was studied from three to seven different biopsies.ResultsIn pathology-confirmed tumour samples from 21 patients the slope of residual γH2AX foci and radiation dose showed a substantial heterogeneity ranging from 0.82 to 3.17 foci/Gy. No correlation was observed between the slope values and the Gleason score (p=0.37), prostate specific antigen (p=0.48) and tumour stage (p=0.89). ANOVA indicated that only in 1 out of 9 patients, biopsies from different tumour locations yielded statistically significant differences. Variance component analysis indicated higher inter-patient than intra-patient variability. Bootstrap simulation study demonstrated that one biopsy is sufficient to estimate the mean value of residual γH2AX per dose level and account for intra-patient heterogeneity.ConclusionsIn prostate cancer inter-patient heterogeneity in tumour cell radiation sensitivity is pronounced and higher than intra-patient heterogeneity supporting the further development of the γH2AX ex vivo assay as a biomarker for individualized treatment.
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Stereotactic body radiotherapy for lung cancer patients with idiopathic interstitial pneumonias
Source:Radiotherapy and Oncology
Author(s): Yuichiro Tsurugai, Atsuya Takeda, Naoko Sanuki, Tatsuji Enomoto, Takeshi Kaneko, Yu Hara, Tomikazu Mizuno, Noriyuki Saeki, Yousuke Aoki, Yohei Oku, Takeshi Akiba, Etsuo Kunieda
PurposeTo compare toxicity and survival after stereotactic body radiotherapy (SBRT) between lung cancer patients with or without idiopathic interstitial pneumonias (IIPs), and to investigate the potential value of SBRT for the patients.MethodsAmong lung cancer patients receiving SBRT between 2005 and 2016, we evaluated those treated with a total dose of 40–60Gy in five fractions with curative intent who either were staged as cT1-4N0M0 or experienced postoperative isolated local recurrence. We analyzed the incidence of radiation pneumonitis (RP) in all patients and local recurrence and overall survival (OS) in T1a-2a patients.ResultsA total of 508 patients were eligible, including 42 with IIPs. The median follow-up was 32.3 (6.0–120.9) months. Significantly more patients with IIPs had grade ≥3RP than did those without IIPs (12% vs. 3%, p=0.009). The 2-year local recurrence rate was low in both groups (3.4% vs. 5.6%, p=0.38). The 2-year OS rate was significantly lower in the patients with IIPs (42.2% vs. 80.9%, p<0.001), although death from lung cancer was comparable (p=0.74).ConclusionSBRT achieved excellent local control with acceptable pulmonary toxicity in lung cancer patients with IIPs. SBRT can be a reasonable option for early lung cancer patients with IIPs.
http://ift.tt/2xohvlY
Temporal variation in bat-fruit interactions: Foraging strategies influence network structure over time
Source:Acta Oecologica, Volume 85
Author(s): Natalya Zapata-Mesa, Sebastián Montoya-Bustamante, Oscar E. Murillo-García
Mutualistic interactions, such as seed dispersal, are important for the maintenance of structure and stability of tropical communities. However, there is a lack of information about spatial and temporal variation in plant-animal interaction networks. Thus, our goal was to assess the effect of bat's foraging strategies on temporal variation in the structure and robustness of bat-fruit networks in both a dry and a rain tropical forest. We evaluated monthly variation in bat-fruit networks by using seven structure metrics: network size, average path length, nestedness, modularity, complementary specialization, normalized degree and betweenness centrality. Seed dispersal networks showed variations in size, species composition and modularity; did not present nested structures and their complementary specialization was high compared to other studies. Both networks presented short path lengths, and a constantly high robustness, despite their monthly variations. Sedentary bat species were recorded during all the study periods and occupied more central positions than nomadic species. We conclude that foraging strategies are important structuring factors that affect the dynamic of networks by determining the functional roles of frugivorous bats over time; thus sedentary bats are more important than nomadic species for the maintenance of the network structure, and their conservation is a must.
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Development and optimization of dispersible tablet of Bacopa monnieri with improved functionality for memory enhancement
Vaishali Tejas Thakkar, Amol Deshmukh, Lal Hingorani, Payal Juneja, Lalji Baldaniya, Asha Patel, Tosha Pandya, Mukesh Gohel
Journal of Pharmacy And Bioallied Sciences 2017 9(3):208-215
Introduction: The Bacopa monnieri is traditional Ayurvedic medicine, and reported for memory-enhancing effects. The Bacoside is poorly soluble, bitter in taste and responsible for the memory enhancement action. Memory enhancer is commonly prescribed for children or elder people. Objective: Poor solubility, patient compliance and bitterness were a major driving force to develop taste masked β-cyclodextrin complex and dispersible tablets. Materials and Methods: The inclusion complex of Bacopa monnieri and β-cyclodextrin was prepared in different molar ratios of Bacopa monnieri by Co-precipitation method. Phase solubility study was conducted to evaluate the effect of β-cyclodextrin on aqueous solubility of Bacoside A. The characterization was determined by Fourier transformation infrared spectroscopy (FTIR),Differential scanning calorimetry (DSC) and X-ray diffraction study (XRD).Crospovidone and croscarmallose sodium were used as super disintigrant.The 32 full factorial design was adopted to investigate the influence of two superdisintegrants on the wetting time and disntegration time of the tablets. Conclusion: The result revels that molar ratio (1:4) of inclusion complex enhance 3-fold solubility. Full factorial design was successfully employed for the optimization of dispersible tablet of B. monnieri . The short-term accelerated stability study confirmed that high stability of B. monnieri in inclusion complex.
http://ift.tt/2f9ZQIf
Journal of Pharmacy And Bioallied Sciences 2017 9(3):208-215
Introduction: The Bacopa monnieri is traditional Ayurvedic medicine, and reported for memory-enhancing effects. The Bacoside is poorly soluble, bitter in taste and responsible for the memory enhancement action. Memory enhancer is commonly prescribed for children or elder people. Objective: Poor solubility, patient compliance and bitterness were a major driving force to develop taste masked β-cyclodextrin complex and dispersible tablets. Materials and Methods: The inclusion complex of Bacopa monnieri and β-cyclodextrin was prepared in different molar ratios of Bacopa monnieri by Co-precipitation method. Phase solubility study was conducted to evaluate the effect of β-cyclodextrin on aqueous solubility of Bacoside A. The characterization was determined by Fourier transformation infrared spectroscopy (FTIR),Differential scanning calorimetry (DSC) and X-ray diffraction study (XRD).Crospovidone and croscarmallose sodium were used as super disintigrant.The 32 full factorial design was adopted to investigate the influence of two superdisintegrants on the wetting time and disntegration time of the tablets. Conclusion: The result revels that molar ratio (1:4) of inclusion complex enhance 3-fold solubility. Full factorial design was successfully employed for the optimization of dispersible tablet of B. monnieri . The short-term accelerated stability study confirmed that high stability of B. monnieri in inclusion complex.
http://ift.tt/2f9ZQIf
α-Glucosidase inhibitory activity of selected Malaysian plants
Dzatil Awanis Mohd Bukhari, Mohammad Jamshed Siddiqui, Siti Hadijah Binti Shamsudin, Md. Mukhlesur Rahman, Siti Zaiton Mat So'ad
Journal of Pharmacy And Bioallied Sciences 2017 9(3):164-170
Diabetes is a common metabolic disease indicated by unusually high plasma glucose level that can lead to major complications such as diabetic neuropathy, retinopathy, and cardiovascular diseases. One of the effective therapeutic managements of the disease is to reduce postprandial hyperglycemia through inhibition of α-glucosidase, a carbohydrate-hydrolyzing enzyme to retard overall glucose absorption. In recent years, a plenty of research works have been conducted looking for novel and effective α-glucosidase inhibitors (AGIs) from natural sources as alternatives for the synthetic AGI due to their unpleasant side effects. Plants and herbs are rich with secondary metabolites that have massive pharmaceutical potential. Besides, studies showed that phytochemicals such as flavonoids, alkaloids, terpenoids, anthocyanins, glycosides, and phenolic compounds possess significant inhibitory activity against α-glucosidase enzyme. Malaysia is a tropical country that is rich with medicinal herbs. In this review, we focus on eight Malaysian plants with the potential as AGI to develop a potential functional food or lead compounds against diabetes.
http://ift.tt/2juEnuy
Journal of Pharmacy And Bioallied Sciences 2017 9(3):164-170
Diabetes is a common metabolic disease indicated by unusually high plasma glucose level that can lead to major complications such as diabetic neuropathy, retinopathy, and cardiovascular diseases. One of the effective therapeutic managements of the disease is to reduce postprandial hyperglycemia through inhibition of α-glucosidase, a carbohydrate-hydrolyzing enzyme to retard overall glucose absorption. In recent years, a plenty of research works have been conducted looking for novel and effective α-glucosidase inhibitors (AGIs) from natural sources as alternatives for the synthetic AGI due to their unpleasant side effects. Plants and herbs are rich with secondary metabolites that have massive pharmaceutical potential. Besides, studies showed that phytochemicals such as flavonoids, alkaloids, terpenoids, anthocyanins, glycosides, and phenolic compounds possess significant inhibitory activity against α-glucosidase enzyme. Malaysia is a tropical country that is rich with medicinal herbs. In this review, we focus on eight Malaysian plants with the potential as AGI to develop a potential functional food or lead compounds against diabetes.
http://ift.tt/2juEnuy
Oral health status and treatment needs of Gunj marketing yard laborers of Raichur City, Karnataka
B Vengal Rao, AM Suresh Babu, SK Kamalsha, M Sirisha Rao, K Karthik
Journal of Pharmacy And Bioallied Sciences 2017 9(3):195-200
Background: Oral health is a vital part of general health and is a valuable asset of every individual. The working population in India usually belong to the lower socioeconomic group. Aim: This study was conducted to assess the oral health status and treatment needs of Gunj marketing yard laborers. Materials and Methods: A descriptive study was conducted among 550 laborers of Gunj marketing yard of Raichur city. A specially designed questionnaire was used to assess the demographic variables and oral hygiene practices. Oral health status was assessed using the WHO assessment form 1997. Simplified oral hygiene index (1964) was used to assess the oral hygiene status. Results: The mean age of the study participants was 35.1 (± 8.02) years and the mean decayed teeth, missing teeth, filled teeth, and decayed, missing, filled teeth was 2.06 (± 1.49), 0.76 (± 2.53), 0.13 (± 0.39), and 2.95 (± 3.02), respectively. The prevalence of dental caries and periodontal disease was 85.7% and 93.5%, respectively. The oral hygiene status was poor in 45.9% of the study participants. Conclusion: This study demonstrates poor oral hygiene and high prevalence of periodontal diseases and dental caries as well as a large proportion of unmet dental needs among these laborers.
http://ift.tt/2f9ZPEb
Journal of Pharmacy And Bioallied Sciences 2017 9(3):195-200
Background: Oral health is a vital part of general health and is a valuable asset of every individual. The working population in India usually belong to the lower socioeconomic group. Aim: This study was conducted to assess the oral health status and treatment needs of Gunj marketing yard laborers. Materials and Methods: A descriptive study was conducted among 550 laborers of Gunj marketing yard of Raichur city. A specially designed questionnaire was used to assess the demographic variables and oral hygiene practices. Oral health status was assessed using the WHO assessment form 1997. Simplified oral hygiene index (1964) was used to assess the oral hygiene status. Results: The mean age of the study participants was 35.1 (± 8.02) years and the mean decayed teeth, missing teeth, filled teeth, and decayed, missing, filled teeth was 2.06 (± 1.49), 0.76 (± 2.53), 0.13 (± 0.39), and 2.95 (± 3.02), respectively. The prevalence of dental caries and periodontal disease was 85.7% and 93.5%, respectively. The oral hygiene status was poor in 45.9% of the study participants. Conclusion: This study demonstrates poor oral hygiene and high prevalence of periodontal diseases and dental caries as well as a large proportion of unmet dental needs among these laborers.
http://ift.tt/2f9ZPEb
Risk versus benefit: Who assesses this in the management of patients on ototoxic drugs?
Katijah Khoza-Shangase
Journal of Pharmacy And Bioallied Sciences 2017 9(3):171-177
The current paper is an attempt at highlighting important strategic indicators, as well as important variables, that the audiology community needs to consider in order to play a more central role in pharmaco-vigilance as part of pharmaco-audiology. Pharmaco-vigilance is an important aspect of pharmacological treatment of disease. In developing countries, where burden of disease is high with resource constraints dictating healthcare priorities; it is important to deliberate on risk/benefit of medications prescribed to treat disease. In the form of a literature review, the author presents current arguments with regards to audiology practice. In audiology, pharmaco-vigilance in the form of ototoxicity monitoring is gaining momentum within the South African research and clinical communities. This ototoxicity monitoring is however non-systematic, non-comprehensive, and does not seem to have a strategic plan behind it. This is fundamentally due to lack of involvement of audiologists in the risk/benefit evaluation of medications during the drug development and monitoring process. The current paper agues for an expanded role of the Audiologist which will ensure collaborative engagement with all relevant stakeholders in order to ensure that both quantity and quality of life are considered during the drug development and monitoring process.
http://ift.tt/2jsVU6y
Journal of Pharmacy And Bioallied Sciences 2017 9(3):171-177
The current paper is an attempt at highlighting important strategic indicators, as well as important variables, that the audiology community needs to consider in order to play a more central role in pharmaco-vigilance as part of pharmaco-audiology. Pharmaco-vigilance is an important aspect of pharmacological treatment of disease. In developing countries, where burden of disease is high with resource constraints dictating healthcare priorities; it is important to deliberate on risk/benefit of medications prescribed to treat disease. In the form of a literature review, the author presents current arguments with regards to audiology practice. In audiology, pharmaco-vigilance in the form of ototoxicity monitoring is gaining momentum within the South African research and clinical communities. This ototoxicity monitoring is however non-systematic, non-comprehensive, and does not seem to have a strategic plan behind it. This is fundamentally due to lack of involvement of audiologists in the risk/benefit evaluation of medications during the drug development and monitoring process. The current paper agues for an expanded role of the Audiologist which will ensure collaborative engagement with all relevant stakeholders in order to ensure that both quantity and quality of life are considered during the drug development and monitoring process.
http://ift.tt/2jsVU6y
Novel pathogens in periodontal microbiology
K Vidya Hiranmayi, K Sirisha, MV Ramoji Rao, P Sudhakar
Journal of Pharmacy And Bioallied Sciences 2017 9(3):155-163
Periodontitis is a polymicrobial disease caused by complex interactions between distinct pathogens in a biofilm resulting in the destruction of periodontal tissues. It seems evident that unknown microorganisms might be involved in onset or progression of periodontitis. For many decades, research in the field of oral microbiology failed to identify certain subgingival microbiota due to technical limitations but, over a period of 12 years using molecular approaches and sequencing techniques, it became feasible to reveal the existence of new periodontal pathogens. Therefore, it is evident that in addition to conventional periodontal pathogens, other microbes might be involved in onset and progression of periodontitis. The novel pathogens enlisted under periodontal phylogeny include Cryptobacterium curtum, Dialister pneumosintes, Filifactor alocis, Mitsuokella dentalis, Slackia exigua, Selenomonas sputigena, Solobacterium moorei, Treponema lecithinolyticum, and Synergistes. The polymicrobial etiology of periodontitis has been elucidated by comprehensive techniques, and studies throwing light on the possible virulence mechanisms possessed by these novel periodontal pathogens are enlisted.
http://ift.tt/2f9ZP79
Journal of Pharmacy And Bioallied Sciences 2017 9(3):155-163
Periodontitis is a polymicrobial disease caused by complex interactions between distinct pathogens in a biofilm resulting in the destruction of periodontal tissues. It seems evident that unknown microorganisms might be involved in onset or progression of periodontitis. For many decades, research in the field of oral microbiology failed to identify certain subgingival microbiota due to technical limitations but, over a period of 12 years using molecular approaches and sequencing techniques, it became feasible to reveal the existence of new periodontal pathogens. Therefore, it is evident that in addition to conventional periodontal pathogens, other microbes might be involved in onset and progression of periodontitis. The novel pathogens enlisted under periodontal phylogeny include Cryptobacterium curtum, Dialister pneumosintes, Filifactor alocis, Mitsuokella dentalis, Slackia exigua, Selenomonas sputigena, Solobacterium moorei, Treponema lecithinolyticum, and Synergistes. The polymicrobial etiology of periodontitis has been elucidated by comprehensive techniques, and studies throwing light on the possible virulence mechanisms possessed by these novel periodontal pathogens are enlisted.
http://ift.tt/2f9ZP79
Increased risk of osteoporosis in depressive patients with erectile dysfunction: A cross-sectional study from Malaysia
Abdul Rahman Fata Nahas, Syed Azhar Syed Sulaiman
Journal of Pharmacy And Bioallied Sciences 2017 9(3):178-184
Background: Depression imposes numerous changes on depressive men, promoting for low bone mineral density (BMD) and erectile dysfunction (ED), yet no published data on exploring the possible association between these two disorders among depressive men. We therefore investigated whether low BMD is associated with ED among depressive men and highlighted the possible mutual underlying factors that might give rise to these two disorders in this specific group of patients. Materials and Methods: In this cross-sectional study, 119 depressive men were recruited and their sociodemographic and clinical characteristics were obtained. Erectile function was evaluated using the 5-item International Index of Erectile Function. All patients received a calcaneal BMD scanning. Chi-square test was conducted to determine if a significant association exists between ED and low BMD. Results: Of the study participants, ninety patients reported ED, while 29 patients reported no ED. Within the ED group, there was a significantly higher proportion of patients with low BMD compared to the non-ED group (85.6% vs. 62.1%, P = 0.006). In addition, among younger participants (i.e., aged
http://ift.tt/2juEmH0
Journal of Pharmacy And Bioallied Sciences 2017 9(3):178-184
Background: Depression imposes numerous changes on depressive men, promoting for low bone mineral density (BMD) and erectile dysfunction (ED), yet no published data on exploring the possible association between these two disorders among depressive men. We therefore investigated whether low BMD is associated with ED among depressive men and highlighted the possible mutual underlying factors that might give rise to these two disorders in this specific group of patients. Materials and Methods: In this cross-sectional study, 119 depressive men were recruited and their sociodemographic and clinical characteristics were obtained. Erectile function was evaluated using the 5-item International Index of Erectile Function. All patients received a calcaneal BMD scanning. Chi-square test was conducted to determine if a significant association exists between ED and low BMD. Results: Of the study participants, ninety patients reported ED, while 29 patients reported no ED. Within the ED group, there was a significantly higher proportion of patients with low BMD compared to the non-ED group (85.6% vs. 62.1%, P = 0.006). In addition, among younger participants (i.e., aged
http://ift.tt/2juEmH0
Effect of the inclusion nanocomplex formed of titanium tetrafluoride and β-Cyclodextrin on enamel remineralization
Thiago Isidro Vieira, Camila Nassur, Adílis Kalina Alexandria, Luciana Pomarico, Valeria Pereira Sousa, Lúcio Mendes Cabral, Ana Maria G Valença, Lucianne Cople Maia
Journal of Pharmacy And Bioallied Sciences 2017 9(3):201-207
Objective: Titanium tetrafluoride (TiF4) is a topical agent used in the control of dental caries; however, it is highly acidic. To minimize this effect, cyclodextrins (CDs) are used. This study evaluated the in vitro potential of TiF4and β-CD on remineralization. Methods: Forty bovine enamel blocks were selected by microhardness and randomly assigned to four groups (n = 10 per group): control (distilled and deionized water), 1% β-CD solution, 1% TiF4solution, and TiF4: β-CD solution. The blocks were subjected to a pH cycling regimen for 8 days. After that, samples were evaluated by cross-sectional microhardness (CSMH), scanning electron microscopy (SEM), and energy dispersive spectrometry (EDS). Data were assessed for normality and analyzed using ANOVA and Tukey's tests (α = 0.05). Results: Regarding CSMH, TiF4: β-CD was statistically superior to the control (P = 0.033), β-CD (P = 0.022), and TiF4(P = 0.006). SEM photomicrography revealed the titanium dioxide coating on slabs treated with TiF4and TiF4: β-CD. EDS assessment demonstrated the presence of titanium on the surface of slabs treated with TiF4and TiF4: β-CD. Conclusion: The solution containing the inclusion nanocomplex formed of TiF4and β-CD was able to reharden the enamel subsurface.
http://ift.tt/2f9ZO35
Journal of Pharmacy And Bioallied Sciences 2017 9(3):201-207
Objective: Titanium tetrafluoride (TiF4) is a topical agent used in the control of dental caries; however, it is highly acidic. To minimize this effect, cyclodextrins (CDs) are used. This study evaluated the in vitro potential of TiF4and β-CD on remineralization. Methods: Forty bovine enamel blocks were selected by microhardness and randomly assigned to four groups (n = 10 per group): control (distilled and deionized water), 1% β-CD solution, 1% TiF4solution, and TiF4: β-CD solution. The blocks were subjected to a pH cycling regimen for 8 days. After that, samples were evaluated by cross-sectional microhardness (CSMH), scanning electron microscopy (SEM), and energy dispersive spectrometry (EDS). Data were assessed for normality and analyzed using ANOVA and Tukey's tests (α = 0.05). Results: Regarding CSMH, TiF4: β-CD was statistically superior to the control (P = 0.033), β-CD (P = 0.022), and TiF4(P = 0.006). SEM photomicrography revealed the titanium dioxide coating on slabs treated with TiF4and TiF4: β-CD. EDS assessment demonstrated the presence of titanium on the surface of slabs treated with TiF4and TiF4: β-CD. Conclusion: The solution containing the inclusion nanocomplex formed of TiF4and β-CD was able to reharden the enamel subsurface.
http://ift.tt/2f9ZO35
Glycosides based standardized fenugreek seed extract ameliorates bleomycin-induced liver fibrosis in rats via modulation of endogenous enzymes
Amit D Kandhare, Subhash Laxmanrao Bodhankar, Vishwaraman Mohan, Prasad A Thakurdesai
Journal of Pharmacy And Bioallied Sciences 2017 9(3):185-194
Background: Liver fibrosis a complex process of excess collagen deposition resulted in disturbance of hepatic cellar function. Glycosides based standardized fenugreek seed extract (SFSE-G) has potent anti-inflammatory, antioxidant, and anti-fibrotic properties. Objective: The aim of this study is to evaluate the hepatoprotective potential of SFSE-G against bleomycin (BLM)-induced liver fibrosis in laboratory animals. Materials and Methods: Sprague-Dawley rats (180–220 g) were assigned to various groups, namely, normal, sham, BLM control, SFSE-G (5, 10, 20, and 40 mg/kg, p.o.), methylprednisolone (10 mg/kg, p.o.), and sildenafil (25 mg/kg, p.o.). Liver fibrosis was induced in various groups (except normal and sham) by single intratracheal BLM (6 IU/kg) injection. Various biochemical, molecular (reverse transcription polymerase chain reaction) and histological parameters were evaluated. Results: Intratracheal BLM administration caused significant induction (P < 0.001) of hepatotoxicity and liver fibrosis reflected by elevated levels of serum aspartate transaminase (AST), alanine transaminase (ALT), total as well as direct bilirubin, and gamma-glutamyl transferase (GGT). Administration of SFSE-G (20 and 40 mg/kg, p.o.) significantly reduced (P < 0.001) levels of AST, ALT, and GGT and significantly increased (P < 0.001) the level of serum albumin. BLM-induced elevated liver oxidative stress and decreased total antioxidant capacity was significantly restored (P < 0.001) by SFSE-G (20 and 40 mg/kg) treatment. It also significantly inhibited BLM-induced alteration in liver Farnesoid X receptor (FXR) mRNA expression. SFSE-G treatment reduced histopathological alteration induced by BLM in liver. Conclusion: SFSE-G exerts its hepatoprotective potential via inhibition of oxido-nitrosative stress and modulation of FXR mRNA expression thus ameliorates BLM-induced liver fibrosis.
http://ift.tt/2juEl5U
Journal of Pharmacy And Bioallied Sciences 2017 9(3):185-194
Background: Liver fibrosis a complex process of excess collagen deposition resulted in disturbance of hepatic cellar function. Glycosides based standardized fenugreek seed extract (SFSE-G) has potent anti-inflammatory, antioxidant, and anti-fibrotic properties. Objective: The aim of this study is to evaluate the hepatoprotective potential of SFSE-G against bleomycin (BLM)-induced liver fibrosis in laboratory animals. Materials and Methods: Sprague-Dawley rats (180–220 g) were assigned to various groups, namely, normal, sham, BLM control, SFSE-G (5, 10, 20, and 40 mg/kg, p.o.), methylprednisolone (10 mg/kg, p.o.), and sildenafil (25 mg/kg, p.o.). Liver fibrosis was induced in various groups (except normal and sham) by single intratracheal BLM (6 IU/kg) injection. Various biochemical, molecular (reverse transcription polymerase chain reaction) and histological parameters were evaluated. Results: Intratracheal BLM administration caused significant induction (P < 0.001) of hepatotoxicity and liver fibrosis reflected by elevated levels of serum aspartate transaminase (AST), alanine transaminase (ALT), total as well as direct bilirubin, and gamma-glutamyl transferase (GGT). Administration of SFSE-G (20 and 40 mg/kg, p.o.) significantly reduced (P < 0.001) levels of AST, ALT, and GGT and significantly increased (P < 0.001) the level of serum albumin. BLM-induced elevated liver oxidative stress and decreased total antioxidant capacity was significantly restored (P < 0.001) by SFSE-G (20 and 40 mg/kg) treatment. It also significantly inhibited BLM-induced alteration in liver Farnesoid X receptor (FXR) mRNA expression. SFSE-G treatment reduced histopathological alteration induced by BLM in liver. Conclusion: SFSE-G exerts its hepatoprotective potential via inhibition of oxido-nitrosative stress and modulation of FXR mRNA expression thus ameliorates BLM-induced liver fibrosis.
http://ift.tt/2juEl5U
Developing an integrated treatment pathway for a post-coronary artery bypass grating (CABG) geriatric patient with comorbid hypertension and type 1 diabetes mellitus for treating acute hypoglycemia and electrolyte imbalance
Atta Abbas Naqvi, Amna Shah, Rizwan Ahmad, Niyaz Ahmad
Journal of Pharmacy And Bioallied Sciences 2017 9(3):216-220
Introduction: The ailments afflicting the elderly population is a well-defined specialty of medicine. It calls for an immaculately designed health-care plan to treat diseases in geriatrics. For chronic illnesses such as diabetes mellitus (DM), coronary heart disease, and hypertension (HTN), they require proper management throughout the rest of patient's life. An integrated treatment pathway helps in treatment decision-making and improving standards of health care for the patient. Case Presentation: This case describes an exclusive clinical pharmacist-driven designing of an integrated treatment pathway for a post-coronary artery bypass grafting (CABG) geriatric male patient with DM type I and HTN for the treatment of hypoglycemia and electrolyte imbalance. Intervention: The treatment begins addressing the chief complaints which were vomiting and unconsciousness. Biochemical screening is essential to establish a diagnosis of electrolyte imbalance along with blood glucose level after which the integrated pathway defines the treatment course. Conclusion: This individualized treatment pathway provides an outline of the course of treatment of acute hypoglycemia, electrolyte imbalance as well as some unconfirmed diagnosis, namely, acute coronary syndrome and respiratory tract infection for a post-CABG geriatric patient with HTN and type 1 DM. The eligibility criterion for patients to be treated according to treatment pathway is to fall in the defined category.
http://ift.tt/2f9ZNfx
Journal of Pharmacy And Bioallied Sciences 2017 9(3):216-220
Introduction: The ailments afflicting the elderly population is a well-defined specialty of medicine. It calls for an immaculately designed health-care plan to treat diseases in geriatrics. For chronic illnesses such as diabetes mellitus (DM), coronary heart disease, and hypertension (HTN), they require proper management throughout the rest of patient's life. An integrated treatment pathway helps in treatment decision-making and improving standards of health care for the patient. Case Presentation: This case describes an exclusive clinical pharmacist-driven designing of an integrated treatment pathway for a post-coronary artery bypass grafting (CABG) geriatric male patient with DM type I and HTN for the treatment of hypoglycemia and electrolyte imbalance. Intervention: The treatment begins addressing the chief complaints which were vomiting and unconsciousness. Biochemical screening is essential to establish a diagnosis of electrolyte imbalance along with blood glucose level after which the integrated pathway defines the treatment course. Conclusion: This individualized treatment pathway provides an outline of the course of treatment of acute hypoglycemia, electrolyte imbalance as well as some unconfirmed diagnosis, namely, acute coronary syndrome and respiratory tract infection for a post-CABG geriatric patient with HTN and type 1 DM. The eligibility criterion for patients to be treated according to treatment pathway is to fall in the defined category.
http://ift.tt/2f9ZNfx
Depression, evening salivary cortisol and inflammation in chronic fatigue syndrome: A psychoneuroendocrinological structural regression model
Source:International Journal of Psychophysiology
Author(s): Sara F. Milrad, Daniel L. Hall, Devika R. Jutagir, Emily G. Lattie, Sara J. Czaja, Dolores M. Perdomo, Mary Ann Fletcher, Nancy Klimas, Michael H. Antoni
IntroductionChronic Fatigue Syndrome (CFS) is a poorly understood illness that is characterized by diverse somatic symptoms, hypothalamic pituitary adrenal (HPA) axis dysfunction and heightened inflammatory indicators. These symptoms are often exacerbated and accompanied by psychological distress states and depression. Since depression is known to be associated with HPA axis dysfunction and greater inflammation, a psychoneuroendocrinological (PNE) model of inflammation was examined in persons diagnosed with CFS in order to uncover underlying biopsychosocial mechanisms in this poorly understood chronic illness.MethodsBaseline data were drawn from two randomized controlled trials testing the efficacy of different forms of psychosocial intervention, and included psychological questionnaires, di-urnal salivary cortisol, and blood samples. Data were analyzed with structural equation modeling (SEM).ResultsThe sample (N=242) was mostly middle-aged (Mage=49.36±10.9, range=20–73years), Caucasian (70.1%), female (84.6%), highly educated (88.6% completed some college, college, or graduate program), and depressed (CES-D M=23.87±12.02, range 2–57). The SEM supporting a psychoneuroendocrinological model of immune dysregulation in CFS fit the data χ2 (12)=17.725, p=0.1243, RMSEA=0.043, CFI=0.935, SRMR=0.036. Depression was directly related to evening salivary cortisol and inflammation, such that higher evening cortisol predicted greater depressive symptoms (β=0.215, p<0.01) and higher pro-inflammatory cytokines (interleukin-2 [IL-2], IL-6, and tumor necrosis factor-alpha [TNF-α] levels (β=0.185, p<0.05), when controlling for covariates.DiscussionResults highlight the role of depression, cortisol and inflammation in possible biological mechanisms involved in the pathophysiology of CFS. Time-lagged, longitudinal analyses are needed to fully explore these relationships.
http://ift.tt/2wtyOhl
Xenoestrogen regulation of ERα/ERβ balance in hormone-associated cancers
Source:Molecular and Cellular Endocrinology, Volume 457
Author(s): Filippo Acconcia, Marco Fiocchetti, Maria Marino
The hormone 17β-estradiol (E2) contributes to body homeostasis maintenance by regulating many different physiological functions in both male and female organs. E2 actions in reproductive and non-reproductive tissues rely on a complex net of nuclear and extra-nuclear signal transduction pathways triggered by at least two estrogen receptor subtypes (ERα and ERβ). Consequently, the de-regulation of E2:ER signaling contributes to the pathogenesis of many diseases including cancer. Among other factors, the ERα/ERβ ratio is considered one of the pivotal mechanisms at the root of E2 action in cancer progression. Remarkably, several natural or synthetic exogenous chemicals, collectively called xenoestrogens, bind to ERs and interfere with their signals and intracellular functions. In this review, the molecular mechanism(s) through which xenoestrogens influence ERα and ERβ intracellular concentrations and the consequences of this influence on E2-related cancer will be discussed.
http://ift.tt/2h5ntCd
Hormone-related cancers and endocrine disruptors: New aspects of an old question
Publication date: 5 December 2017
Source:Molecular and Cellular Endocrinology, Volume 457
http://ift.tt/2h860ZF
Recent advances on the stimulatory effects of metals in breast cancer
Source:Molecular and Cellular Endocrinology, Volume 457
Author(s): Rosamaria Lappano, Roberta Malaguarnera, Antonino Belfiore, Marcello Maggiolini
Certain environmental chemicals may accumulate in human serum and tissues eliciting estrogenic and/or carcinogenic effects. Therefore, there is heightened interest in determining whether environmental chemicals may increase the risk for endocrine-related tumors like breast cancer. For instance, metals as cadmium, zinc, copper, iron, nickel and aluminum have been shown to mimic estrogen action. Moreover, the exposure to these chemicals has been reported to stimulate diverse malignancies including breast cancer, which is the most common tumor in women worldwide. In this review, we summarize the epidemiologic and experimental evidence regarding the association between the exposure to some trace elements and breast cancer risk. We also address recent insights on the molecular mechanisms involved by metals in breast tumorigenesis.
http://ift.tt/2y1FxjQ
Recent views of heavy metals as possible risk factors and potential preventive and therapeutic agents in prostate cancer
Source:Molecular and Cellular Endocrinology, Volume 457
Author(s): Veronica Vella, Roberta Malaguarnera, Rosamaria Lappano, Marcello Maggiolini, Antonino Belfiore
Prostate cancer is the most common cancer in men in many industrialized countries. A role for androgens in prostate tumor progression is well recognized, while estrogens may cooperate with androgens in prostate carcinogenesis. The incidence of prostate cancer is highly variable in the different countries, suggesting an important role of environmental factors. Heavy metals are common environmental contaminants and some of them are confirmed or suspected human carcinogens. Some metals are endowed with estrogenic and/or androgenic activities and may play a role as cancer risk factors through this mechanism. Moreover, prostate cancer may present alterations in the intracellular balance of trace metals, such as zinc and copper, which are involved in several regulatory proteins. Herein, we review the possible role of environmental heavy metals and of metal-dyshomeostasis in prostate cancer development and promotion as well as the potential use of some metals in the prevention and therapy of prostate cancer.
http://ift.tt/2h6zHur
Heavy metals in the volcanic environment and thyroid cancer
Publication date: 5 December 2017
Source:Molecular and Cellular Endocrinology, Volume 457
Author(s): R. Vigneri, P. Malandrino, F. Gianì, M. Russo, P. Vigneri
In the last two decades thyroid cancer incidence has increased worldwide more than any other cancer. Overdiagnosis of subclinical microcarcinomas has certainly contributed to this increase but many evidences indicate that a true increase, possibly due to environmental factors, has also occurred.Thyroid cancer incidence is markedly increased in volcanic areas. Thus, the volcanic environment is a good model to investigate the possible factors favoring thyroid cancer.In the volcanic area of Mt. Etna in Sicily, as well as in other volcanic areas, a non-anthropogenic pollution with heavy metals has been documented, a consequence of gas, ash and lava emission. Soil, water and atmosphere contamination, via the food chain, biocontaminate the residents as documented by high levels in the urines and the scalp hair compared to individuals living in adjacent non-volcanic areas.Trace amounts of metals are essential nutrients but, at higher concentrations, can be toxic for living cells. Metals can behave both as endocrine disruptors, perturbing the hormonal system, and as carcinogens, promoting malignant transformation. Similarly to other carcinogens, the transforming effect of heavy metals is higher in developing organisms as the fetus (contaminated via the mother) and individuals in early childhood. In the last decades environment metal pollution has greatly increased in industrialized countries. Although still within the "normal" limits for each single metal the hormesis effect (heavy metal activity at very low concentration because of biphasic, non linear cell response) and the possible potentiation effect resulting from the mixture of different metals acting synergistically can explain cell damage at very low concentrations.The effect of metals on the human thyroid is poorly studied: for some heavy metals no data are available. The scarce studies that have been performed mainly focus on metal effect as thyroid endocrine disruptors. The metal concentration in tissues has been rarely measured in the thyroid. Heavy metal accumulation and metabolism in the thyroid or the carcinogenic activity of different doses and different speciation of metals has not been investigated.These studies are now warranted to better understand thyroid biology and heavy metal role in human thyroid carcinogenesis.
http://ift.tt/2y2fwRc
Acromegaly, genetic variants of the aryl hydrocarbon receptor pathway and environmental burden
Publication date: 5 December 2017
Source:Molecular and Cellular Endocrinology, Volume 457
Author(s): S. Cannavo, F. Trimarchi, F. Ferraù
Increasing evidence suggests that environmental contaminants can exert endocrine disruptors activities and that pollution exposition can have a role in tumorigenic processes. Several environmental pollutants have been shown to affect pituitary cells biology and function. The aryl hydrocarbon receptor (AHR) pathway is involved in xenobiotics' metabolism and in tumorigenesis. A deregulation of the AHR pathway could have a role in pituitary tumours' pathophysiology, especially in the GH secreting ones. AHR-interacting protein (AIP) is one of the key partners of AHR and is implicated in pituitary tumours' pathogenesis. Moreover, an increased prevalence of acromegaly has been reported in a highly polluted area of the province of Messina (Sicily, Italy). Nevertheless, at present, few data are available about the potential role of environmental factors in the pathogenesis and clinical expression of GH secreting pituitary tumours. This review is aimed at discussing the evidences on the potential links among environmental pollutants, the AHR pathway and the pathophysiology of GH-secreting pituitary adenomas.
Graphical abstract
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Environmental estrogen-like endocrine disrupting chemicals and breast cancer
Publication date: 5 December 2017
Source:Molecular and Cellular Endocrinology, Volume 457
Author(s): Marisa Morgan, Alok Deoraj, Quentin Felty, Deodutta Roy
BackgroundEstrogen-mimicking endocrine disruptors (EEDs) such as polychlorinated biphenyls (PCBs), bisphenol A (BPA), and phthalates have been found ubiquitously throughout our environment. Although exposure to EEDs has the ability to interfere with endocrine control of reproductive function and development in both humans and wildlife, inconsistent reports have made it difficult to draw conclusions concerning the hypothesized increased risk of breast cancer associated with EEDs.ObjectivesThe purpose of this study was to examine the cross-sectional relationship between exposure to PCBs, BPA or phthalates; and risk of breast cancer in U.S. women using the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey (NHANES) data between 1999 and 2004.MethodsWe analyzed data from female participants (20 years of age and older) collected by NHANES between 1999 and 2004 for exposure assessment based on lipid adjusted serum levels of 6 individual PCB congeners (PCB 074, 099, 118, 138, 153, and 180), the sum of dioxin-like PCBs (074 and 118), and the sum of non-dioxin-like PCBs (099 + 138 + 153 + 187). Levels of urinary BPA and seven phthalate metabolites mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), mono-ethyl phthalate (MEP), mono-(3-caroxypropyl) phthalate (MCPP), mono-benzyl phthalate (MZP), and three metabolites of di (2-ehtylhexyl) phthalate (DEHP): [mono-2-ethylhexyl phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP)] were obtained from the 2003–2010 yearly survey cycles in participants aged 6 years and older. Assessments of EEDs or their metabolites were analyzed in conjunction with medical and reproductive health questionnaire data. Age, race/ethnicity, age at menarche, body mass index (BMI; kg/m2), and lactation were considered as potential confounders in our final models. Geometric means (GM) were calculated to compare PCB, BPA or phthalate concentrations in women who self-reported a breast cancer diagnosis versus women who self-reported never being diagnosed with breast cancer. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for the association between PCB, BPA or phthalate measurements and breast cancer.ResultsIn age, race/ethnicity, and BMI adjusted models, PCB138 was the only congener found to be significantly associated with breast cancer [OR of 3.16; 95% CI: 1.14–8.76]. We also found the sum of non-dioxin-like PCBs to be significantly associated with breast cancer [OR of 1.14; 95% CI: 1.00–1.29]. Risk of breast cancer, however, was not found to be significantly associated with phthalate, phthalate metabolites, and BPA in unadjusted or adjusted logistic regression models.ConclusionsOur results suggest a link between environmental exposures to PCB 138 and breast cancer. There were no significant associations between phthalates or BPA and breast cancers. These findings should be interpreted with caution because of the use of cross-sectional self-reported data and a small sample size of breast cancer subjects. Nonetheless, our finding emphasizes a need of comprehensive environmental molecular epidemiologic study to determine the potential role of environmental exposures to PCBs, phthalates, and BPA in the development of breast cancer.
http://ift.tt/2h4BVug
Diverse pathways of epithelial mesenchymal transition related with cancer progression and metastasis and potential effects of endocrine disrupting chemicals on epithelial mesenchymal transition process
Publication date: 5 December 2017
Source:Molecular and Cellular Endocrinology, Volume 457
Author(s): Hae-Miru Lee, Kyung-A Hwang, Kyung-Chul Choi
Endocrine disrupting chemicals (EDCs) are natural or synthetic compounds that interfere with normal functions of natural hormones in the body, leading to a disruption of the endocrine system. Specifically, EDCs have the potential to cause formation of several hormone-dependent cancers, including breast, ovarian, and prostate cancers. Epithelial mesenchymal transition (EMT) process by which epithelial cells lose their cell polarity and cell-cell adhesion and acquire mesenchymal phenotype is closely associated with malignant transformation and the initiation of cancer metastasis. As a key epithelial marker responsible for adherens junction, E-cadherin enables the cells to maintain epithelial phenotypes. EMT event is induced by E-cadherin loss which can be carried out by many transcription factors (TFs), including Snail, Slug, ZEB1, ZEB2, Kruppel-like factor 8 (KLF8), and Twist. N-cadherin, fibronectin, and vimentin are mesenchymal markers needed for cellular migration. The EMT process is regulated by several signaling pathways mediated by transforming growth factor β (TGF-β), Wnt–β-catenin, Notch, Hedgehog, and receptor tyrosine kinases. In the present article, we reviewed the current understanding of cancer progression effects of synthetic chemical EDCs such as bisphenol A (BPA), phthalates, tetrachlorodibenzo-p-dioxin (TCDD), and triclosan by focusing their roles in the EMT process. Collectively, the majority of previous studies revealed that BPA, phthalates, TCDD, and triclosan have the potential to induce cancer metastasis through regulating EMT markers and migration via several signaling pathways associated with the EMT program. Therefore, it is considered that the exposure to these EDCs can increase the risk aggravating the disease for the patients suffering cancer and that more regulations about the use of these EDCs are needed.
Graphical abstract
http://ift.tt/2y1FggO
Spatial analysis and health risk assessment of heavy metals concentration in drinking water resources
Abstract
The heavy metals available in drinking water can be considered as a threat to human health. Oncogenic risk of such metals is proven in several studies. Present study aimed to investigate concentration of the heavy metals including As, Cd, Cr, Cu, Fe, Hg, Mn, Ni, Pb, and Zn in 39 water supply wells and 5 water reservoirs within the cities Ardakan, Meibod, Abarkouh, Bafgh, and Bahabad. The spatial distribution of the concentration was carried out by the software ArcGIS. Such simulations as non-carcinogenic hazard and lifetime cancer risk were conducted for lead and nickel using Monte Carlo technique. The sensitivity analysis was carried out to find the most important and effective parameters on risk assessment. The results indicated that concentration of all metals in 39 wells (except iron in 3 cases) reached the levels mentioned in EPA, World Health Organization, and Pollution Control Department standards. Based on the spatial distribution results at all studied regions, the highest concentrations of metals were derived, respectively, for iron and zinc. Calculated HQ values for non-carcinogenic hazard indicated a reasonable risk. Average lifetime cancer risks for the lead in Ardakan and nickel in Meibod and Bahabad were shown to be 1.09 × 10−3, 1.67 × 10−1, and 2 × 10−1, respectively, demonstrating high carcinogenic risk compared to similar standards and studies. The sensitivity analysis suggests high impact of concentration and BW in carcinogenic risk.
http://ift.tt/2x5Jk25
Herbivorous snails can increase water clarity by stimulating growth of benthic algae
Abstract
Eutrophication in shallow lakes is characterized by a switch from benthic to pelagic dominance of primary productivity that leads to turbid water, while benthification is characterized by a shift in primary production from the pelagic zone to the benthos associated with clear water. A 12-week mesocosm experiment tested the hypothesis that the herbivorous snail Bellamya aeruginosa stimulates the growth of pelagic algae through grazing on benthic algae and through accelerating nutrient release from sediment. A tube-microcosm experiment using 32P-PO4 as a tracer tested the effects of the snails on the release of sediment phosphorus (P). The mesocosm experiment recorded greater total nitrogen (TN) concentrations and a higher ratio of TN:TP in the overlying water, and a higher light intensity and biomass of benthic algae as measured by chlorophyll a (Chl a) in the snail treatment than in the control. Concentrations of total phosphorus (TP), total suspended solids (TSSs), and inorganic suspended solids (ISSs) in the overlying water were lower in the snail treatment than in the control, though no significant difference in Chl a of pelagic algae between the snail treatment and control was observed. In the microcosm experiment, 32P activity in the overlying water was higher in the snail treatment than in the control, indicating that snails accelerated P release from the sediment. Our interpretation of these results is that snails enhanced growth of benthic algae and thereby improved water clarity despite grazing on the benthic algae and enhancing P release from the sediment. The rehabilitation of native snail populations may therefore enhance the recovery of eutrophic shallow lakes to a clear water state by stimulating growth of benthic algae.
http://ift.tt/2wt73oY
Isotopic effects of PCE induced by organohalide-respiring bacteria
Abstract
Reductive dechlorination performed by organohalide-respiring bacteria (OHRB) enables the complete detoxification of certain emerging groundwater pollutants such as perchloroethene (PCE). Environmental samples from a contaminated site incubated in a lab-scale microcosm (MC) study enable documentation of such reductive dechlorination processes. As compound-specific isotope analysis is used to monitor PCE degradation processes, nucleic acid analysis—like 16S-rDNA analysis—can be used to determine the key OHRB that are present. This study applied both methods to laboratory MCs prepared from environmental samples to investigate OHRB-specific isotope enrichment at PCE dechlorination. This method linkage can enhance the understanding of isotope enrichment patterns of distinct OHRB, which further contribute to more accurate evaluation, characterisation and prospection of natural attenuation processes. Results identified three known OHRB genera (Dehalogenimonas, Desulfuromonas, Geobacter) in diverse abundance within MCs. One species of Dehalogenimonas was potentially involved in complete reductive dechlorination of PCE to ethene. Furthermore, the isotopic effects of PCE degradation were clustered and two isotope enrichment factors (ε) (− 11.6‰, − 1.7‰) were obtained. Notably, ε values were independent of degradation rates and kinetics, but did reflect the genera of the dechlorinating OHRB.
http://ift.tt/2x5Jl69
Comparison of point-source pollutant loadings to soil and groundwater for 72 chemical substances
Abstract
Fate and transport of 72 chemicals in soil and groundwater were assessed by using a multiphase compositional model (CompFlow Bio) because some of the chemicals are non-aqueous phase liquids or solids in the original form. One metric ton of chemicals were assumed to leak in a stylized facility. Scenarios of both surface spills and subsurface leaks were considered. Simulation results showed that the fate and transport of chemicals above the water table affected the fate and transport of chemicals below the water table, and vice versa. Surface spill scenarios caused much less concentrations than subsurface leak scenarios because leaching amounts into the subsurface environment were small (at most 6% of the 1 t spill for methylamine). Then, simulation results were applied to assess point-source pollutant loadings to soil and groundwater above and below the water table, respectively, by multiplying concentrations, impact areas, and durations. These three components correspond to the intensity of contamination, mobility, and persistency in the assessment of pollutant loading, respectively. Assessment results showed that the pollutant loadings in soil and groundwater were linearly related (r 2 = 0.64). The pollutant loadings were negatively related with zero-order and first-order decay rates in both soil (r = − 0.5 and − 0.6, respectively) and groundwater (− 1.0 and − 0.8, respectively). In addition, this study scientifically defended that the soil partitioning coefficient (K d) significantly affected the pollutant loadings in soil (r = 0.6) and the maximum masses in groundwater (r = − 0.9). However, K d was not a representative factor for chemical transportability unlike the expectation in chemical ranking systems of soil and groundwater pollutants. The pollutant loadings estimated using a physics-based hydrogeological model provided a more rational ranking for exposure assessment, compared to the summation of persistency and transportability scores in the chemical ranking systems. In the surface spill scenario, the pollutant loadings were zeros for all chemicals, except methylamine to soil whose pollutant loading was smaller than that in the subsurface leak scenario by 4 orders of magnitude. The maximum mass and the average mass multiplied by duration in soil greatly depended on leaching fluxes (r = 1.0 and 0.9, respectively), while the effect of leaching fluxes diminished below the water table. The contribution of this work is that a physics-based numerical model was used to quantitatively compare the subsurface pollutant loading in a chemical accident for 72 chemical substances, which can scientifically defend a simpler and more qualitative assessment of pollutant loadings. Besides, this study assessed pollutant loadings to soil (unsaturated zone) and groundwater (saturated zone) all together and discussed their interactions.
http://ift.tt/2wt5Jm6
Effects of sublethal Abamectin exposure on some hormonal profiles and testicular histopathology in male albino rats and the possible ameliorative role of Eruca sativa
Abstract
The ameliorative role of Eruca sativa on some hormonal profile and testicular histopathology in male albino rats exposed to a sublethal dose of 1 mg/kg body weight (b.wt). Abamectin (Crater 3.37% EC) was evaluated. Eighteen male albino rats were divided into three groups: control group, Abamectin-treated group, and Abamectin + E. sativa-treated group. Rats of the second group were orally administrated 1 mg/kg b.wt. of Abamectin, the third group received a mixture of sublethal oral dose of Abamectin (1 mg/kg b.wt.) and E. sativa suspension (5 g/kg b.wt.) every 48 h for 28 days. At the end of the study, blood samples were collected from all groups to measure some hormonal parameters; also, rats were dissected and tissue sections from the testes were prepared and stained with hematoxylin and eosin for examination under light microscope. The results of the present study revealed a disturbance in the hormonal parameters and some testicular histopathological changes. In addition, administration of E. sativa might have a promising effect against Abamectin toxicity-induced disorders of thyroid hormones and impaired testicular functions, which were correlated with histopathological changes in the testes of male rats.
http://ift.tt/2x5kf77
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