Chitooligosaccharide: An evaluation of physicochemical and biological properties with the proposition for determination of thermal degradation products

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): Lucas Phil, Muhammad Naveed, Imran Shair Mohammad, Li Bo, Di Bin
Being the most versatile biopolymer, chitooligosaccharide/chitosan oligosaccharide (COS) has been extensively studied for a range of exceptional biological activities and potential developments of novel medical devices and systems in biomedical and pharmaceutical fields. While possessing intrinsic biocompatibility, mucoadhesiveness, and non-toxicity it gained more interests in the biomedical development of novel systems, devices, and pharmaceutical formulations. The bioactive relativity of chitosan and COS are of highly significant and thus explored in this paper while highlighting its multiple biological activities and promising biomedical applications. More emphasis is on the molecular weight, degree of acetylation/deacetylation, degree of polymerization and reactive groups in relation to chitin and chitosan. Despite COS wide acceptance and utilization, the associated viscosity and instability are crucial factors that posed a great challenge to researchers. The apparent reason attributed to instability and viscosity could be the presence intrinsic variable oligomers within COS. Due to lack of data on safety and impurity analysis of thermal exposure of COS, we hypothesized that different molecules could be generated with thermal treatment of COS, thus finally suggested a prospective determination of thermal degradation product(s)in COS. Hence the aim of this paper is to highlight COS physicochemical and biological significance with reference to its recent developments and propose a further chemical analysis thermal treated COS. This could trigger future researchers for possible isolation and characterization of distinct biomolecules from COS.



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A review on phytochemistry and therapeutic uses of Hibiscus sabdariffa L.

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): Ghazala Riaz, Rajni Chopra
Hibiscus sabdariffa L. (roselle) belonging to the Malvaceae family is widely grown in many countries. This plant is often used in the traditional medicine being rich in phytochemicals like polyphenols especially anthocyanins, polysaccharides and organic acids thus having enormous prospective in modern therapeutic uses.The study aimed to review and document all the available evidence and information about the calyces of Hibiscus sabdariffa (roselle) with the special focus on their nutritional composition, bioactive constituents and therapeutic uses. The electronic database was searched up to 2017, using keywords Hibiscus sabdariffa, chemical constituents of roselle, therapeutic uses of roselle. Journals, books and conference proceedings were also searched.The review provides valuable information about the nutraceutical component of Hibiscus sabdariffa L. and their utilization for curing various degenerative diseases like hypertension, hyperlipidemia, cancer and other inflammatory diseases of liver and kidney. Their toxicological effects have also been discussed from a safety point of view.Most studies supported and provided the scientific basis for the statement that Hibiscus sabdariffa and their active constituents play an important role in the prevention of chronic and degenerative diseases that are associated with oxidative stress. Our study suggests, that good research is needed, to establish a potential strategy that can balance the pharmacological and toxic effects of roselle and standardized fingerprint of Hibiscus sabdariffa is required internationally for quality control.

Graphical abstract

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Arginine: Challenges and opportunities of this two-faced molecule in cancer therapy

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): Mozhgan Jahani, Fatemeh Noroznezhad, Kamran Mansouri
Numerous antitumor therapies have been developed based on the differences in cells' metabolisms. Regarding the important role of arginine (Arg) in the regulation of multiple metabolic and signaling pathways, its deprivation has been proposed as a good strategy for tumor regression in tumors with defected Arg metabolic enzymes like argininosuccinate synthase 1 (ASS1). However, modulatory effect of Arg on various cancers is also a controversial issue. Therefore, this review article intends to address some of the challenges faced by Arg deprivation method as well as Arg administration for cancer therapy.



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Targeted cancer therapy through 17-DMAG as an Hsp90 inhibitor: Overview and current state of the art

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): Hassan Mellatyar, Sona Talaei, Younes Pilehvar-Soltanahmadi, Abolfazl Barzegar, Abolfazl Akbarzadeh, Arman Shahabi, Mazyar Barekati-Mowahed, Nosratollah Zarghami
Heat shock protein 90 (Hsp90) is an evolutionary preserved molecular chaperone which mediates many cellular processes such as cell transformation, proliferation, and survival in normal and stress conditions. Hsp90 plays an important role in folding, maturation, stabilization and activation of Hsp90 client proteins which all contribute to the development, and proliferation of cancer as well as other inflammatory diseases. Functional inhibition of Hsp90 can have a massive effect on various oncogenic and inflammatory pathways, and will result in the degradation of their client proteins. This turns it into an interesting target in the treatment of different malignancies. 17-dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG) as a semi-synthetic derivative of geldanamycin, has several advantages over 17-Allylamino-17-demethoxygeldanamycin (17-AAG) such as higher water solubility, good bioavailability, reduced metabolism, and greater anti-tumour capability. 17-DMAG binds to the Hsp90, and inhibits its function which eventually results in the degradation of Hsp90 client proteins. Here, we reviewed the pre-clinical data and clinical trial data on 17-DMAG as a single agent, in combination with other agents and loaded on nanomaterials in various cancers and inflammatory diseases.



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Oncogenic long noncoding RNA MALAT1 and HCV-related hepatocellular carcinoma

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): Eman A. Toraih, Alia Ellawindy, Salma Y. Fala, Essam Al Ageeli, Nawal S. Gouda, Manal S. Fawzy, Somaya Hosny
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related mortality worldwide. The oncogenic function of the long non-coding RNA; metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in HCC remains unclear. We aimed to evaluate MALAT1 serum expression profile in HCC and explore its relation to the clinicopathological features. Quantitative Real Time-Polymerase Chain Reaction was applied in 70 cohorts (30 HCC, 20 HCV, 20 controls). Further meta-analysis of clinical studies and in vitro validated experiments was employed. Serum MALAT1 showed area under the curve of 0.79 and 0.70 to distinguish patients with cancer from normal and cirrhotic individuals at fold change of 1.0 and 1.26, respectively. Expression level was significantly higher in males (P <0.001) and patients with massive ascites (P = 0.005). Correlation analysis showed positive correlation of MALAT1 with total bilirubin (r = 0.456, P <0.001) and AST (r = 0.280, P = 0.019), and negative correlation with the hemoglobin level (r = 0.312, P = 0.009). Meta-analysis showed that the over-expressed MALAT1 was linked to tumor number [Cohen's d = 0.450, 95% CI (0.21 to 0.68)], clinical stage [Cohen's d = 0.048, 95% CI (-0.83 to 0.74)], and AFP level [Cohen's d = 0.354, 95% CI (0.1 to 0.57)]. In silico data analysis and systematic review confirmed MALAT1 oncogenic function in cancer development and progression.In conclusion, circulatory MALAT1 might represent a putative non-invasive prognostic biomarker indicating worse liver failure score in HCV-related HCC patients with traditional markers. Large-scale verification is warranted in future studies.



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Antioxidant effects and mechanism of silymarin in oxidative stress induced cardiovascular diseases

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): Abdoh Taleb, Khalil Ali Ahmad, Awais Ullah Ihsan, Jia Qu, Na Lin, Kamal Hezam, Nirmala Koju, Lei Hui, Ding Qilong
Cardiovascular diseases (CVDs) are considered as the major reason for mortality and morbidity worldwide. Substantial evidence suggests that increased oxidative stress plays a significant role in the pathogenesis of CVDs, including atherosclerosis, hypertension, vascular endothelial dysfunction and ischemic heart disease. Cellular oxidative stress results in the release of toxic free radicals by endothelial cells and vascular smooth muscle cells that interact with cell components such as protein, DNA or lipid resulting in cardiovascular pathology. Silymarin has antioxidant activities against CVDs and offers protection against oxidative stress-induced hypertension, atherosclerosis and cardiac toxicity. We present a comprehensive review regarding the oxidative stress and protective effects of silymarin in CVDs management. We also aim to provide mechanistic insight of the mechanisms of silymarin action in oxidative stress-induced CVDs.



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Cancer chemotherapeutics in rheumatoid arthritis: A convoluted connection

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): S. Jayashree, K. Nirekshana, Gunjan Guha, Dipita Bhakta-Guha
Chemotherapy is one of the most popular therapeutic strategies to treat cancer. However, cancer chemotherapeutics have often been associated with impairment of the immune system, which might consequently lead to an augmented risk of autoimmune disorders, such as rheumatoid arthritis. Though the accurate mechanistic facets of rheumatoid arthritis induction have not been interpreted yet, a conglomeration of genetic and environmental factors might promote its etiology. What makes the scenario more challenging is that patients with rheumatoid arthritis are at a significantly elevated risk of developing various types of cancer. It is intriguing to note that diverse cancer chemotherapy drugs are also commonly used to treat symptoms of rheumatoid arthritis. However, a colossal multitude of such cancer therapeutics has demonstrated highly varied results in rheumatoid arthritis patients, including both beneficial and adverse effects. Herein, we attempt to present a holistic account of the variegated modalities of this complex tripartite cross-talk between cancer, rheumatoid arthritis and chemotherapy drugs in order to decode the sinuous correlation between these two appalling pathological conditions.

Graphical abstract

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The role of bevacizumab on tumour angiogenesis and in the management of gynaecological cancers: A review

Publication date: June 2018
Source:Biomedicine & Pharmacotherapy, Volume 102
Author(s): Dinesh Kumar Chellappan, Kun Hooi Leng, Lee Jia Jia, Nur Amirah Binti Abdul Aziz, Wong Chun Hoong, Yap Cheng Qian, Fam Yi Ling, Gwee Sing Wei, Tiong Ying, Jestin Chellian, Gaurav Gupta, Kamal Dua
ObjectiveThe study aims to analyze the effectiveness of bevacizumab in addressing the complications associated with gynecological cancers and evaluates effective treatments for various gynecological cancers.MethodsThe study follows a systematic review approach that has been implemented to analyze the qualitative published data from previous studies. Studies related with the trials of angiogenesis and bevacizumab were selected in the review.ResultsIn general, the management of gynecological cancers include chemotherapy, surgery and radiation therapy. Results suggest bevacizumab as an effective treatment modality for cervical and several other cancers. Overall, bevacizumab showed promising results in improving the overall survival rate of gynecological cancer patients through the combination of bevacizumab with other chemotherapeutic agents.ConclusionBevacizumab possess less documented adverse effects when compared to other chemotherapeutic agents. The manifestation and severity of adverse effects reported varied according to the chemotherapeutic agent(s) that were used with bevacizumab in combination therapy. Overall, bevacizumab effectively improved the survival rate in patients with several gynaecological cancers.



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Does inhibition cause forgetting after selective retrieval? A reanalysis and failure to replicate

Publication date: Available online 4 April 2018
Source:Cortex
Author(s): Kevin W. Potter, Lucas D. Huszar, David E. Huber
Retrieval practice can produce forgetting, but it remains unclear using only behavioral data whether this forgetting is caused by targeted inhibition versus interference. Therefore, Wimber et al. (2015) used pattern classifier analyses of fMRI data to track individual memories in a novel variant of retrieval induced forgetting. After initial learning, people recalled target images across selective retrieval practice trials, and cortical activity patterns gradually became more similar to those evoked by the target pictures (i.e., pattern enhancement) and less similar to those evoked by competing pictures (i.e., pattern suppression). The key question was whether this inhibition of competing memories would cause forgetting. Wimber et al. found a significant forgetting effect (p<.01) on a subsequent forced choice picture recognition test, with lower accuracy for competitors than for baseline items. Because fMRI data is correlative, a causal interpretation of the data would require, at a minimum, more forgetting following cortical pattern suppression (as occurred for competitors) than cortical pattern enhancement (as occurred for targets). The interaction necessary to reach this conclusion was significant (p=0.041). However, reanalyzing the original data revealed that the interaction depended on the decision to code missing responses as equivalent to choosing the wrong picture. Even if missing trials reflected memory failures, at worst they would produce 50/50 guessing, rather than an error every time. Treating these trials as missing, or setting them to chance performance, resulted in no reliable forgetting difference between competitors and targets. Because this might reflect inadequate statistical power, we undertook two replication attempts of the behavioral paradigm, failing both times to observe more forgetting for competitors than targets. In fact, we failed to find any forgetting at all. We conclude that the study of Wimber et al. does not support the conclusion that forgetting is caused by targeted inhibition.



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Numerical encoding in early visual cortex

Publication date: Available online 4 April 2018
Source:Cortex
Author(s): Nicholas K. DeWind, Joonkoo Park, Marty G. Woldorff, Elizabeth M. Brannon
The ability to estimate the number in a visual array arose early in evolution, develops early in human development, and is correlated with mathematical ability. Previous work with visually presented arrays indicates that the intraparietal sulcus (IPS) represents number. However, it is not clear if the number signal originates in IPS or is propagated from earlier visual areas. Previous work from our group has demonstrated a rapidly instantiated representation of number in low-level regions of visual cortex using the high temporal resolution of event-related electro-encephalography (EEG). Here, we use a rapid event-related functional magnetic resonance imaging (fMRI) paradigm and find convergent evidence for a number signal in low-level visual cortex (areas V1, V2, and V3). Employing a stringent set of stimulus controls, we demonstrate that this signal cannot be explained by the total extent of the array, the density of the items in the array, the aggregate visual area of the items, the size of individual items, the proportion of the array covered by items, nor the overall scale of the array and items. Our findings thus provide strong support for the hypothesis that number is rapidly and directly encoded early in the visual processing stream.



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Adding Methylphenidate to prism-adaptation improves outcome in neglect patients. A randomized clinical trial

Publication date: Available online 4 April 2018
Source:Cortex
Author(s): Jacques Luauté, Laurent Villeneuve, Adeline Roux, Stuart Nash, Jean-Yves Bar, Eric Chabanat, François Cotton, Sophie Ciancia, Pierre-Olivier Sancho, Patrick Hovantruc, François Quelard, Thierry Sarraf, Yann Cojan, Fadila Hadj-Bouziane, Alessandro Farné, Audrey Janoly-Dumenil, Dominique Boisson, Sophie Jacquin-Courtois, Gilles Rode, Yves Rossetti
Spatial neglect is one of the main predictors of poor functional recovery after stroke. Many therapeutic interventions have been developed to alleviate this condition, but to date the evidence of their effectiveness is still scarce.ObjectiveThe purpose of this study was to test whether combining prism adaptation (PA) and methylphenidate (MP) could enhance the recovery of neglect patients at a functional level.MethodsRITAPRISM is a multicentre, randomized, double-blind, placebo-controlled study comparing PA plus placebo (control) versus PA plus MP. 24 patients were prospectively enrolled (10 in the placebo group and 14 in the MP group).ResultsThe main result is a long-term functional improvement (on the functional independence measure and on Bergego's scale) induced by MP combined with PA. No serious adverse event occurred.ConclusionsThe long-term benefit on activities of daily living (ADL) obtained in this randomized controlled trial set this intervention apart from previous attempts and supports with a high level of evidence the value of combining PA and MP in order to improve the autonomy of neglect patients. Further studies will be needed to clarify the mechanism of this improvement. Although not specifically assessed at this stage, a part of the improvement in ADL might be related to the collateral effect of MP on mood, executive functions or fatigue, and/or the combined effect of PA and MP on motor intentional bias of neglect patients.Classification of EvidenceThis study provides Class I evidence that adding methylphenidate to PA improves the functional outcome of neglect patients. WHO Trial Registration ID: EUCTR2008-000325-20-FR.



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Shedding New Light on Disorders of Consciousness Diagnosis: The Dynamic Functional Connectivity

Publication date: Available online 4 April 2018
Source:Cortex
Author(s): Antonino Naro, Alessia Bramanti, Antonino Leo, Alberto Cacciola, Alfredo Manuli, Placido Bramanti, Rocco Salvatore Calabrò
It has been proposed that awareness may depend on the highly-dynamic functional connectivity of large-scale cortico-thalamo-cortical networks. We investigated how brain connectivity changes over time in the resting state in a group of patients with chronic disorders of consciousness (DoC). To this end, we assessed dynamic functional connectivity (DFC) in the resting state by analyzing the time-dependent EEG phase synchronization in five frequency bands (δ, θ, α, β, and γ). Patients in Minimally Conscious State showed changes in DFC matrices and topography over time (mainly in the γ range), which were significantly different from those observed in patients with Unresponsive Wakefulness Syndrome. The degree of DFC significantly correlated with the level of behavioral responsiveness measured using the Coma Recovery Scale-Revised. The analysis of DFC seems promising to differentiate patients with DoC. Moreover, sharpening the current knowledge of DFC by using EEG-based approaches may shed light on the processes of consciousness and their pathophysiology, and may help to design neuromodulation protocols aimed at targeting maladaptive and dysfunctional FC.



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Skin Barrier Restoration and Moisturization Using Horse Oil-Loaded Dissolving Microneedle Patches

Background: Horse oil (HO) has skin barrier restoration and skin-moisturizing effects. Although cream formulations have been used widely and safely, their limited penetration through the stratum corneum is a major obstacle to maximizing the cosmetic efficacy of HO. Therefore, we aimed to encapsulate HO in a cosmetic dissolving microneedle (DMN) for efficient transdermal delivery. Methods: To overcome these limitations of skin permeation, HO-loaded DMN (HO-DMN) patches were developed and evaluated for their efficacy and safety using in vitro and clinical studies. Results: Despite the lipophilic nature of HO, the HO-DMN patches had a sharp shape and uniform array, with an average length and tip diameter of 388.36 ± 16.73 and 38.54 ± 5.29 µm, respectively. The mechanical strength of the HO-DMN patches was sufficient (fracture force of 0.29 ± 0.01 N), and they could successfully penetrate pig skin. During the 4-week clinical evaluation, HO-DMN patches caused significant improvements in skin and dermal density, skin elasticity, and moisturization. Additionally, a brief safety assessment showed that the HO-DMN patches induced negligible adverse events. Conclusion: The HO-DMNs are efficient, safe, and convenient for wide use in cosmetic applications for skin barrier restoration and moisturization.
Skin Pharmacol Physiol 2018;31:163–171

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Structured Reporting of CT Angiography Runoff Examinations of the Lower Extremities

Publication date: Available online 4 April 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Bastian O. Sabel, Jessica L. Plum, Michael Czihal, Christian Lottspeich, Frank Schönleben, Gabor Gäbel, Regina Schinner, Franziska Schoeppe, Felix G. Meinel
ObjectivesThe aim was to evaluate the effect of structured reporting of computed tomography angiography (CTA) runoff studies on clarity, completeness, clinical relevance, usefulness of the radiology reports, further testing, and therapy in patients with known or suspected peripheral arterial disease.MethodsConventional reports (CRs) and structured reports (SRs) were generated for 52 patients who had been examined with a CTA runoff examination of the lower extremities. The sample size was based on power calculations with a power of 95% and a significance level of .007 (adjusted for multiple testing). CRs were dictated in a free text form; SRs contained a consistent ordering of observations with standardised subheadings. CRs were compared with SRs. Two vascular medicine specialists and two vascular surgeons rated the reports regarding their satisfaction with clarity, completeness, clinical relevance, and usefulness as well as overall satisfaction. Additionally, they made hypothetical decisions on further testing and therapy. Median ratings were compared using the Wilcoxon signed rank test and generalised linear mixed effects models.ResultsSRs received higher ratings for satisfaction with clarity (median rating 9.0 vs. 7.0, p < .0001) and completeness (median rating 9.0 vs. 7.5, p < .0001) and were judged to be of greater clinical relevance (median rating 9.0 vs. 8.0, p < .0001) and usefulness (median rating 9.0 vs. 8.0, p < .0001). Overall satisfaction was also higher for SRs (median rating 9.0 vs. 7.0, p < .0001) than CRs. There were no significant differences in further testing or therapy.ConclusionReferring clinicians perceive SRs of CTA runoff examinations of the lower extremities as offering superior clarity, completeness, clinical relevance, and usefulness than CRs. Structured reporting does not appear to alter further testing or therapy in patients with known or suspected peripheral arterial disease.



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Effectiveness of Screening Postmenopausal Women for Cardiovascular Diseases: A Population Based, Prospective Parallel Cohort Study

Publication date: Available online 4 April 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Marie Dahl, Rikke Søgaard, Lars Frost, Annette Høgh, Jes Lindholt
ObjectivesTo investigate the effectiveness of systematic screening for multifaceted cardiovascular disease (CVD) in postmenopausal women on all cause mortality and, secondarily, on CVD morbidity. Effectiveness was also evaluated across age strata.MethodsThis was a population based, prospective, parallel cohort study. In total, 107,491 women born in 1936–1951 living in the Central Denmark region were identified in the Danish Civil Registration System. From this population, all women born in 1936, 1941, 1946, and 1951 (n = 1984) living in the Viborg municipality were invited to attend screening. Of those invited to the screening, 1474 (74.3%) attended. The control group included all women from the general population born in 1936–1951 and living in the Central Denmark Region, excluding those invited for the screening. Information on medication and comorbidities prior to inclusion and study outcomes were retrieved from national registries for both groups. The screening included examination for abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), carotid plaque (CP), potential hypertension (HT), atrial fibrillation (AF), diabetes mellitus (DM), and dyslipidaemia. The adjusted Cox proportional hazards model with the intention to screen principle was used to assess effectiveness for the total population and across age groups.ResultsDuring follow up (median 3.3 years, IQR 2.9–3.9), the adjusted hazard ratios (HRs) for invited versus controls were the following: all cause mortality, 0.89 (95% CI 0.71–1.12); myocardial infarction (MI), 1.26 (95% CI 0.52–3.07); ischaemic heart disease (IHD), 0.72 (95% CI 0.49–1.05); PAD, 1.07 (95% CI 0.49–2.31); and ischaemic stroke, 1.20 (95% CI 0.78–1.85). A substantial number of women with AAA, PAD, and/or CP declined prophylactic therapy: 45% for antiplatelet and 35% for cholesterol lowering agents.ConclusionsThis multifaceted screening offer to a general population sample of postmenopausal women had no effects on all cause mortality or hospital admission for MI, IHD, PAD, and stroke within a short-term follow up period.



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Association of Muscle and Adiposity Measured by CT With Survival in Patients With Breast Cancer

This observational study examines associations of sarcopenia, muscle radiodensity, and adiposity with overall mortality in nonmetastatic breast cancer.

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Linking Mismatch Repair Mutation With Age at Gynecological Cancer Onset in Lynch Syndrome

To the Editor We read with interest the article by Ryan et al suggesting that patients with truncating MLH1 mutations develop endometrial cancer (EC) at a later age compared with those with nontruncating mutations and that surveillance guidelines should be adapted to accommodate these findings. This is a relevant observation because interfamilial variance of the Lynch phenotype is a well-known problem and a tailor-made surveillance program would benefit patients. However, we believe that it is too early to draw such rigorous conclusions.

https://ift.tt/2uRhpUk

Management of Metastatic Melanoma in 2018

This Insights discusses management strategies for metastatic melanoma using the most recent therapeutic options.

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Obesity, Body Composition, and Breast Cancer

The role of obesity in breast cancer development has been known for decades, but better and larger studies over time have uncovered more details about the complex association. There is strong evidence that obesity and weight gain during adulthood are associated with increased risk of postmenopausal breast cancer, particularly among women not using menopausal hormone therapy. On the other hand, obesity during adolescence and young adulthood is associated with reduced premenopausal breast cancer risk. Over time we also learned that what we have historically known about these associations only applies to hormone receptor–positive tumors (ie, estrogen receptor [ER]-positive and/or progesterone receptor–positive tumors). The literature on obesity and breast cancer prognosis is more recent and smaller, but currently an active research area. There is growing evidence that obesity is associated with higher breast cancer–specific and overall mortality in both women who are premenopausal and postmenopausal, with associations stronger among those with morbid obesity (body mass index [BMI; calculated as weight in kilograms divided by height in meters squared] ≥40). Furthermore, associations may vary by race/ethnicity, depending on the adiposity measure used. Fewer studies have evaluated associations by hormone receptor status, and most had limited statistical power, particularly for estrogen receptor (ER)-negative tumors. Overall, the evidence for higher mortality associated with obesity tends to be consistent for ER-positive tumors, but inconsistent for ER-negative and triple-negative breast cancer.

https://ift.tt/2uPc7sh

Oral Ketamine vs Placebo in Patients With Cancer-Related Neuropathic Pain

This multicenter randomized clinical trial compares oral ketamine with placebo for treating neuropathic pain in patients with cancer.

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