Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 21 Απριλίου 2017

Weight stigma predicts inhibitory control and food selection in response to the salience of weight discrimination

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Publication date: 1 July 2017
Source:Appetite, Volume 114
Author(s): Ashley M. Araiza, Joseph D. Wellman
ObjectiveFear and stigmatization are often used to motivate individuals with higher body weight to engage in healthy behaviors, but these strategies are sometimes counterproductive, leading to undesirable outcomes. In the present study, the impact of weight-based stigma on cognition (i.e., inhibitory control) and food selection (i.e., calories selected) was examined among individuals who consider themselves to be overweight. It was predicted that participants higher in perceived weight stigma would perform more poorly on an inhibitory control task and order more calories on a food selection task when they read about discrimination against individuals with higher weight versus discrimination against an out-group.MethodsParticipants completed online prescreen measures assessing whether they considered themselves to be overweight and their perceptions of weight stigma. Individuals who considered themselves to be overweight were invited into the laboratory to complete tasks that manipulated weight-based discrimination, then inhibitory control and food selection were measured.ResultsThe higher participants were in perceived weight stigma, the more poorly they performed on the inhibitory control task and the more calories they ordered when they read about discrimination against individuals with higher body weight. These relationships were not observed when participants read about discrimination against an out-group.ConclusionsThe present findings provide evidence that perceptions of weight stigma are critical in understanding the impact of weight-based discrimination. Additionally, these results have theoretical and practical implications for both understanding and addressing the psychological and physical consequences of weight-based stigma.



http://ift.tt/2oegbia

Efficacy of fractionated microneedle radiofrequency with and without adding subcision for the treatment of atrophic facial acne scars: A randomized split-face clinical study

Summary

Background

There is no gold standard treatment for facial acne scars, and overall, little literature exists about the combination therapy for treatment of acne scar.

Aims

The aim of this study was to evaluate the efficacy of fractionated microneedle radiofrequency (FMR) vs FMR combined with subcision for the treatment of atrophic acne scars.

Patients/Methods

This was a randomized, split-face clinical study of 25 patients with II-IV Fitzpatrick skin types with moderate to severe facial atrophic acne scars. Initially, standard subcision by Nokor needle was performed on one side. Two weeks after subcision, FMR treatment was performed on both cheeks of each participant. Second and third FMR treatment sessions were performed within 4-week intervals. Two-blinded dermatologists performed clinical assessments using a quartile grading scale, and patients were also asked to judge their satisfaction using a visual analog scale (VAS) scoring system.

Results

The age of the patients varied from 24 to 40 years (mean: 30.08±4.94 years). Only nine patients (36%) were males. Clinical assessment by two-blinded dermatologists showed statistically significant improvement in the combination (FMR+subcision) group (P=.009). Patient satisfaction was statistically significantly better in the combination group (P=.001). A darkening of skin phototype was associated with a decrease in patient's satisfaction VAS score (P=.07).

Conclusion

The combination of subcision and FMR is a safe and effective modality for mixed type acne scars. Additional randomized clinical study with long-term follow-up is necessary for further evaluation of FMR in combination with other procedures.

The full trial protocol can be accessed in: http://ift.tt/2q1emS9.

The clinical trial registration number is IRCT2016103130597N1.



http://ift.tt/2pnBLkv

Effect of Ficus carica leaf extract on the gene expression of selected factors in HaCaT cells

Summary

Background

Ficus carica Linn. (Fc), common fig, has been traditionally used for many metabolic, cardiovasculary, respiratory, gastrointestinal, and skin disorders. Several studies were performed showing its anti-inflammatory, anti-angiogenic, anticancerogenic, and tissue-protective effects. In all of those studies, the positive effects of Fc were concluded as the result of its antioxidant and anti-inflammatory features due to the polyphenols it contains.

Aims

To study the phenolic compounds of Fc extract and to investigate the molecular basis of anti-inflammatory, anti-angiogenic, antimitotic, and anti-androgenic effects of Fc leaf extract in vitro.

Materials and Methods

The gene expression levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-a), interleukin 1-alpha (IL-1a), and 5 alpha-reductase type II (SRD5A2) were tested in human keratinocyte cells (HaCaT) by RT-qPCR.

Results

The gene expression analysis showed that the plant extract caused statistically significant downregulation of VEGF, TNF-a, IL-1a, and SRD5A2 compared to the untreated cells.

Discussion

These preliminary results of this in vitro study may partially explain the clinical success of Fc in the traditional medicine.

Conclusion

Topical Fc leaf extract may be beneficial for some inflammatory disorders and androgen-dependent disorders of the skin such as androgenetic alopecia.



http://ift.tt/2pnDvdH

Efficacy of fractionated microneedle radiofrequency with and without adding subcision for the treatment of atrophic facial acne scars: A randomized split-face clinical study

Summary

Background

There is no gold standard treatment for facial acne scars, and overall, little literature exists about the combination therapy for treatment of acne scar.

Aims

The aim of this study was to evaluate the efficacy of fractionated microneedle radiofrequency (FMR) vs FMR combined with subcision for the treatment of atrophic acne scars.

Patients/Methods

This was a randomized, split-face clinical study of 25 patients with II-IV Fitzpatrick skin types with moderate to severe facial atrophic acne scars. Initially, standard subcision by Nokor needle was performed on one side. Two weeks after subcision, FMR treatment was performed on both cheeks of each participant. Second and third FMR treatment sessions were performed within 4-week intervals. Two-blinded dermatologists performed clinical assessments using a quartile grading scale, and patients were also asked to judge their satisfaction using a visual analog scale (VAS) scoring system.

Results

The age of the patients varied from 24 to 40 years (mean: 30.08±4.94 years). Only nine patients (36%) were males. Clinical assessment by two-blinded dermatologists showed statistically significant improvement in the combination (FMR+subcision) group (P=.009). Patient satisfaction was statistically significantly better in the combination group (P=.001). A darkening of skin phototype was associated with a decrease in patient's satisfaction VAS score (P=.07).

Conclusion

The combination of subcision and FMR is a safe and effective modality for mixed type acne scars. Additional randomized clinical study with long-term follow-up is necessary for further evaluation of FMR in combination with other procedures.

The full trial protocol can be accessed in: http://ift.tt/2q1emS9.

The clinical trial registration number is IRCT2016103130597N1.



http://ift.tt/2pnBLkv

Effect of Ficus carica leaf extract on the gene expression of selected factors in HaCaT cells

Summary

Background

Ficus carica Linn. (Fc), common fig, has been traditionally used for many metabolic, cardiovasculary, respiratory, gastrointestinal, and skin disorders. Several studies were performed showing its anti-inflammatory, anti-angiogenic, anticancerogenic, and tissue-protective effects. In all of those studies, the positive effects of Fc were concluded as the result of its antioxidant and anti-inflammatory features due to the polyphenols it contains.

Aims

To study the phenolic compounds of Fc extract and to investigate the molecular basis of anti-inflammatory, anti-angiogenic, antimitotic, and anti-androgenic effects of Fc leaf extract in vitro.

Materials and Methods

The gene expression levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-a), interleukin 1-alpha (IL-1a), and 5 alpha-reductase type II (SRD5A2) were tested in human keratinocyte cells (HaCaT) by RT-qPCR.

Results

The gene expression analysis showed that the plant extract caused statistically significant downregulation of VEGF, TNF-a, IL-1a, and SRD5A2 compared to the untreated cells.

Discussion

These preliminary results of this in vitro study may partially explain the clinical success of Fc in the traditional medicine.

Conclusion

Topical Fc leaf extract may be beneficial for some inflammatory disorders and androgen-dependent disorders of the skin such as androgenetic alopecia.



http://ift.tt/2pnDvdH

Clinical predictors of remission and persistence of adult-onset asthma

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Publication date: Available online 22 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Guus A. Westerhof, Hanneke Coumou, Selma B. de Nijs, ElsJ. Weersink, Elizabeth H. Bel
BackgroundAdult-onset asthma is an important but relatively understudied asthma phenotype and little is known about its natural course and prognosis. The remission rate is believed to be low, and it is still obscure which factors predict remission or persistence of the disease.ObjectiveTo determine the remission rate, and identify predictors of persistence and remission of adult-onset asthma.MethodsTwo hundred adult patients with recently diagnosed (<1 year) asthma were recruited from secondary and tertiary pulmonary clinics and prospectively followed for 5 years. Clinical, functional and inflammatory parameters were assessed at baseline and at yearly visits. Asthma remission was defined as absence of asthma symptoms for ≥1 year and no asthma medication use for ≥1 year. Descriptive statistics and logistic regression analysis were performed.ResultsFive-year follow-up data of 170 patients (85%) was available. Of these, 27 patients (15.9%) experienced asthma remission. Patients with asthma persistence were older, had worse asthma control, required higher doses of inhaled corticosteroids, had more severe airway hyperresponsiveness, more often nasal polyps and higher levels of blood neutrophils as compared to patients who experienced clinical remission.In a multivariable logistic regression analysis, only moderate-severe bronchial hyperresponsiveness and nasal polyps were independent predictors of asthma persistence. Patients with these two characteristics had less than 1% chance of asthma remission.ConclusionOne in six patients with adult-onset asthma experiences remission within the first 5 years of the disease. In patients with moderate to severe bronchial hyperresponsiveness and nasal polyposis the chance of remission is close to zero.

Teaser

Adult-onset asthma remission occurs in 16% of the patients within 5 years after diagnosis. Nasal polyposis and moderate to severe bronchial hyperresponsiveness at the time of asthma diagnosis reduces the chance of remission to <1%.


http://ift.tt/2q0TbQ7

Contribution of inhibitory receptor TIGIT to NK cell education

Publication date: Available online 21 April 2017
Source:Journal of Autoimmunity
Author(s): Yuke He, Hui Peng, Rui Sun, Haiming Wei, Hans-Gustaf Ljunggren, Wayne M. Yokoyama, Zhigang Tian
Engagement of inhibitory receptors by cognate host MHC-I molecules triggers NK cell education, resulting in functional maturation and allowing NK cells to sense missing-self. However, NK cells also express inhibitory receptors for non-MHC-I ligands and their role in NK cell education is poorly understood. TIGIT is a recently identified inhibitory receptor that recognizes a non-MHC-I ligand CD155. Here, we demonstrated that TIGIT+ NK cells from wild-type mice exerted augmented responsiveness to various stimuli, including targets that lacked expression of CD155 ligand. TIGIT+ NK cells derived from CD155-deficient hosts, however, exhibited functional impairment, indicating that the engagement of TIGIT receptor by host CD155 promoted NK cell functional maturation. Furthermore, TIGIT deficiency impaired NK cell-mediated missing-self recognition and rejection of CD155- targets, such as allogenic splenocytes and certain tumor cells, in an MHC-I-independent and CD226-unrelated manner. Thus, TIGIT-CD155 pathway is also involved in the acquisition of optimal NK cell effector function, representing a novel MHC-I-independent education mechanism for NK cell tolerance and activation.

Graphical abstract

image


http://ift.tt/2p5WDf1

Mass cytometry identifies a distinct monocyte cytokine signature shared by clinically heterogeneous pediatric SLE patients

Publication date: Available online 4 April 2017
Source:Journal of Autoimmunity
Author(s): W.E. O'Gorman, D.S. Kong, I.M. Balboni, P. Rudra, C.R. Bolen, D. Ghosh, M.M. Davis, G.P. Nolan, E.W.Y. Hsieh
Systemic Lupus Erythematosus (SLE) is a heterogeneous autoimmune disease with heightened disease severity in children. The incomplete understanding of the precise cellular and molecular events that drive disease activity pose a significant hurdle to the development of targeted therapeutic agents. Here, we performed single-cell phenotypic and functional characterization of pediatric SLE patients and healthy controls blood via mass cytometry. We identified a distinct CD14hi monocyte cytokine signature, with increased levels of monocyte chemoattractant protein-1 (MCP1), macrophage inflammatory protein-1β (Mip1β), and interleukin-1 receptor antagonist (IL-1RA). This signature was shared by every clinically heterogeneous patient, and reproduced in healthy donors' blood upon ex-vivo exposure to plasma from clinically active patients only. This SLE-plasma induced signature was abrogated by JAK1/JAK2 selective inhibition. This study demonstrates the utility of mass cytometry to evaluate immune dysregulation in pediatric autoimmunity, by identification of a multi-parametric immune signature that can be further dissected to delineate the events that drive disease pathogenesis.



http://ift.tt/2p5Lfjn

Monoclonal Antibody AbCR1 Against Guinea Pig CXCR1 and Monoclonal Antibody AbCR2 Against Guinea Pig CXCR2

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Apr 2017, Vol. 36, No. 2: 82-82.


http://ift.tt/2pNWpXV

Monoclonal Antibody: 5C9H2 Against Human Ghrelin Receptor

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy Apr 2017, Vol. 36, No. 2: 80-81.


http://ift.tt/2p5JOBD

A Tribute to Robert W. Entenmann (Bob)-12/10/16.

A Tribute to Robert W. Entenmann (Bob)-12/10/16.

Int Tinnitus J. 2017 Apr 19;20(2):106-107

Authors: Goldstein BB, Shulman A

PMID: 28422032 [PubMed - in process]



http://ift.tt/2pFVCIy

The Importance of Labyrinthine Examination in the Prognosis and Therapy for Balance in Spinocerebellar Ataxia.

The Importance of Labyrinthine Examination in the Prognosis and Therapy for Balance in Spinocerebellar Ataxia.

Int Tinnitus J. 2017 Apr 19;20(2):93-101

Authors: Faryniuk JH, Zeigelboim BS, Teive HAG, Fo VR, Liberalesso PBN, Marques JM

Abstract
INTRODUCTION: Spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases that are characterized by the presence of progressive cerebellar ataxia.
OBJECTIVE: Identify vestibular disorders and demonstrate the importance of labyrinthine examination in the prognosis and therapy for balance in patients with SCAs.
MATERIALS AND METHODS: The study had a retrospective cross-sectional design and evaluated 57 patients, mean age of 41.6 years and standard deviation of 13 years. Patients underwent the following procedures: anamnesis, ENT examination and vestibular exam using electronystagmography (ENG).
RESULTS: The most frequent complaints were gait imbalance (71.9%), dysarthria (49.1%), dizziness (43.8%) and dysphagia (36.8%). 84.2% of the tests showed alterations. The most common tests with alterations were the caloric test (78.9%), slow saccades (61.4%) and the rotating chair test (49.1%).
CONCLUSION: The clinical history of the patient and oculomotor alterations in the labyrinthine examination provide sufficient information for the proper use of virtual rehabilitation protocols in the treatment of imbalance, making it the most effective therapy method. It was evident that changes in ENG are related to the severity of the SCA or the clinical stage of the disease. The labyrinthine examination proved to be an important concomitant tool to clinical and genetic study.

PMID: 28422031 [PubMed - in process]



http://ift.tt/2opNhry

Analysis of Hearing and Tinnitus in Workers Exposed to Occupational Noise.

Analysis of Hearing and Tinnitus in Workers Exposed to Occupational Noise.

Int Tinnitus J. 2017 Apr 19;20(2):88-92

Authors: Boger ME, Sampaio ALL, Oliveira CACP

Abstract
INTRODUCTION: Noise is one of the harmful agents to health that is present in the various branches of economic activity. Hearing loss and tinnitus are among the most frequently reported complaints by workers exposed to occupational noise.
OBJECTIVE: To analyze the hearing and tinnitus in normal-hearing workers exposed to occupational noise.
METHODS: This is a cross-sectional analytical trial in metallurgical industries, in which we evaluated normal-hearing workers through anamnesis, audiometry and otoacoustic emissions.
RESULTS: It was observed high prevalence of failure of otoacoustic emissions (40%) and tinnitus (66.6%). Both in the amplitude and in the signal-to-noise ratio, the higher is the frequency of the sound, the worse the results. Despite having audiometry within normal limits, the results indicate that workers are suffering the effects of exposure and reveals association between failure of otoacoustic emissions and tinnitus in this population (X(2) = 6,732).
CONCLUSION: It is concluded that failures in DPOAE and tinnitus are predictors of hearing damage in normal-hearing workers.

PMID: 28422030 [PubMed - in process]



http://ift.tt/2oYrAlt

Interpreting Treatment-Related Changes Using the Tinnitus Questionnaire in Argstatter H, Grapp M, Plinkert PK, Bolay HV. Heidelberg Neuro-Music Therapy for Chronic-tonal Tinnitus - Treatment Outline and Psychometric Evaluation. Int Tinnitus J 2012;17(1):31-41.

Interpreting Treatment-Related Changes Using the Tinnitus Questionnaire in Argstatter H, Grapp M, Plinkert PK, Bolay HV. Heidelberg Neuro-Music Therapy for Chronic-tonal Tinnitus - Treatment Outline and Psychometric Evaluation. Int Tinnitus J 2012;17(1):31-41.

Int Tinnitus J. 2017 Apr 19;20(2):73-75

Authors: Hall D

PMID: 28422029 [PubMed - in process]



http://ift.tt/2pFNqrE

Malnutrition and Oral Disease in the Elderly––Is There Any Bidirectional Relationship?

Abstract

Purpose of Review

The purpose of the review is to find recent evidence for a bidirectional relationship between oral diseases and malnutrition.

Recent Findings

Electronic search of MEDLINE using PubMed and a manual search of key journals for literature published in English between January 2013 and June 2016, was conducted and resulted in the selection of 25 papers. These selected studies comprised 19 observational studies, which included 17 cross-sectional and 2 longitudinal designs, and 6 interventional studies. A majority of the studies demonstrated a significant association between the following conditions in older adults: older adults with oral diseases are at risk for malnutrition and malnourished older adults are at risk for oral diseases. Treatment with dental prosthesis may have positive effects on the nutritional status of older adults.

Summary

The current review revealed that research findings support a potential bidirectional relationship between oral diseases and malnutrition; however, there is insufficient evidence to draw definitive conclusions. Additional high-quality studies are necessary to accumulate more evidence.



http://ift.tt/2obaZM3

Digital Workflow in Implant Dentistry

Abstract

Purpose of Review

Implant dentistry is going through a digital revolution. Through the development of new equipment and their corresponding workflows, the diagnosis and treatment of our patients are becoming simpler and more efficient. This review examines the workflows and techniques that apply digital technology to the pre-operative planning stages, the surgical placement, and the prosthetic phases of implant treatment.

Recent Findings

With the current influx of new hardware and software into the market, dental technology has the potential to infiltrate every area of clinical implant dentistry. Its use generally begins with the diagnostic scanning by means of an intra-oral scanner and cone beam computed tomography. These modalities, in conjunction with implant planning software, allow for the planning and the guided surgical execution of dental implants. Technology can further be used with the prosthetic design and manufacturing of the interim and final restorations of the implants allowing all areas of clinical diagnosis and care to have the opportunity to apply digital dentistry. These tools can allow for more predictable, profitable, and pleasant treatment for our patients.

Summary

As our clinical landscape changes with the influx of digital tools, the uses, workflows, and clinical protocols associated with implant dentistry can be learned and applied in our daily clinical practice allowing for the streamlining and simplification of patient care.



http://ift.tt/2otdzcf

Comprehensive Analysis of Interaction Networks of Telomerase Reverse Transcriptase with Multiple Bioinformatic Approaches: Deep Mining the Potential Functions of Telomere and Telomerase

Rejuvenation Research , Vol. 0, No. 0.


http://ift.tt/2pPhF2t

A Tribute to Robert W. Entenmann (Bob)-12/10/16.

Related Articles

A Tribute to Robert W. Entenmann (Bob)-12/10/16.

Int Tinnitus J. 2017 Apr 19;20(2):106-107

Authors: Goldstein BB, Shulman A

PMID: 28422032 [PubMed - in process]



http://ift.tt/2pFVCIy

The Importance of Labyrinthine Examination in the Prognosis and Therapy for Balance in Spinocerebellar Ataxia.

Related Articles

The Importance of Labyrinthine Examination in the Prognosis and Therapy for Balance in Spinocerebellar Ataxia.

Int Tinnitus J. 2017 Apr 19;20(2):93-101

Authors: Faryniuk JH, Zeigelboim BS, Teive HAG, Fo VR, Liberalesso PBN, Marques JM

Abstract
INTRODUCTION: Spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative diseases that are characterized by the presence of progressive cerebellar ataxia.
OBJECTIVE: Identify vestibular disorders and demonstrate the importance of labyrinthine examination in the prognosis and therapy for balance in patients with SCAs.
MATERIALS AND METHODS: The study had a retrospective cross-sectional design and evaluated 57 patients, mean age of 41.6 years and standard deviation of 13 years. Patients underwent the following procedures: anamnesis, ENT examination and vestibular exam using electronystagmography (ENG).
RESULTS: The most frequent complaints were gait imbalance (71.9%), dysarthria (49.1%), dizziness (43.8%) and dysphagia (36.8%). 84.2% of the tests showed alterations. The most common tests with alterations were the caloric test (78.9%), slow saccades (61.4%) and the rotating chair test (49.1%).
CONCLUSION: The clinical history of the patient and oculomotor alterations in the labyrinthine examination provide sufficient information for the proper use of virtual rehabilitation protocols in the treatment of imbalance, making it the most effective therapy method. It was evident that changes in ENG are related to the severity of the SCA or the clinical stage of the disease. The labyrinthine examination proved to be an important concomitant tool to clinical and genetic study.

PMID: 28422031 [PubMed - in process]



http://ift.tt/2opNhry

Analysis of Hearing and Tinnitus in Workers Exposed to Occupational Noise.

Related Articles

Analysis of Hearing and Tinnitus in Workers Exposed to Occupational Noise.

Int Tinnitus J. 2017 Apr 19;20(2):88-92

Authors: Boger ME, Sampaio ALL, Oliveira CACP

Abstract
INTRODUCTION: Noise is one of the harmful agents to health that is present in the various branches of economic activity. Hearing loss and tinnitus are among the most frequently reported complaints by workers exposed to occupational noise.
OBJECTIVE: To analyze the hearing and tinnitus in normal-hearing workers exposed to occupational noise.
METHODS: This is a cross-sectional analytical trial in metallurgical industries, in which we evaluated normal-hearing workers through anamnesis, audiometry and otoacoustic emissions.
RESULTS: It was observed high prevalence of failure of otoacoustic emissions (40%) and tinnitus (66.6%). Both in the amplitude and in the signal-to-noise ratio, the higher is the frequency of the sound, the worse the results. Despite having audiometry within normal limits, the results indicate that workers are suffering the effects of exposure and reveals association between failure of otoacoustic emissions and tinnitus in this population (X(2) = 6,732).
CONCLUSION: It is concluded that failures in DPOAE and tinnitus are predictors of hearing damage in normal-hearing workers.

PMID: 28422030 [PubMed - in process]



http://ift.tt/2oYrAlt

Interpreting Treatment-Related Changes Using the Tinnitus Questionnaire in Argstatter H, Grapp M, Plinkert PK, Bolay HV. Heidelberg Neuro-Music Therapy for Chronic-tonal Tinnitus - Treatment Outline and Psychometric Evaluation. Int Tinnitus J 2012;17(1):31-41.

Related Articles

Interpreting Treatment-Related Changes Using the Tinnitus Questionnaire in Argstatter H, Grapp M, Plinkert PK, Bolay HV. Heidelberg Neuro-Music Therapy for Chronic-tonal Tinnitus - Treatment Outline and Psychometric Evaluation. Int Tinnitus J 2012;17(1):31-41.

Int Tinnitus J. 2017 Apr 19;20(2):73-75

Authors: Hall D

PMID: 28422029 [PubMed - in process]



http://ift.tt/2pFNqrE

DNA repair and damage pathways in breast cancer development and therapy

Publication date: June 2017
Source:DNA Repair, Volume 54
Author(s): Maryam Majidinia, Bahman Yousefi
DNA damage/repair constitutes several key pathways working in concert to eliminate DNA lesions and maintain genome stability and integrity. Defective components in DNA damage and repair machinery are an underlying cause for the development and progression of different types of cancers, and breast cancer is no exception. In this paper, we will briefly explain the importance of DNA damage and repair, introduce the current classification schemes for breast cancer, and review the known defects in the repair machinery that have been associated with the risk of breast cancer. Finally, we discuss how the understanding of these pathways can help to design therapeutics for specific targeting of breast cancer tumors.



http://ift.tt/2pOZg5K

ADAR deaminase A-to-I editing of DNA and RNA moieties of RNA:DNA hybrids has implications for the mechanism of Ig somatic hypermutation

Publication date: Available online 21 April 2017
Source:DNA Repair
Author(s): Edward J. Steele, Robyn A. Lindley
The implications are discussed of recently published biochemical studies on ADAR-mediated A-to-I DNA and RNA deamination at RNA:DNA hybrids. The significance of these data are related to previous work on strand-biased and codon-context mutation signatures in B lymphocytes and cancer genomes. Those studies have established that there are two significant strand biases at A:T and G:C base pairs, A-site mutations exceed T-site mutations (A>>T) by 2.9 fold and G-site mutations exceed C-site mutations (G>>C) by 1.7 fold. Both these strand biases are inconsistent with alternative "DNA Deamination" mechanisms, yet are expected consequences of the RNA/RT-based "Reverse Transcriptase" mechanism of immunoglobulin (Ig) somatic hypermutation (SHM). The A-to-I DNA editing component at RNA:DNA hybrids that is likely to occur in Transcription Bubbles, while important, is of far lower A-to-I editing efficiency than in dsRNA substrates. The RNA moiety of RNA:DNA hybrids is also edited at similar lower frequencies relative to the editing rate at dsRNA substrates. Further, if the A-to-I DNA editing at RNA:DNA hybrids were the sole cause of A-to-I (read as A-to-G) mutation events for Ig SHM in vivo then the exact opposite strand biases at A:T base pairs (T>>A) of what is actually observed (A>>T) would be predicted. It is concluded that the strand-biased somatic mutation patterns at both A:T and G:C base pairs in vivo are best interpreted by the sequential steps of the RNA/RT-based mechanism. Further, the direct DNA A-to-I deamination at Transcription Bubbles is expected to contribute to the T-to-C component of the strand-biased Ig SHM spectrum.



http://ift.tt/2p1JBNP

Bypass of an anesthesiologist-directed preoperative evaluation clinic results in greater first-case tardiness and turnover times

We evaluated 4 hypotheses related to bypass of an anesthesiologist-directed preoperative evaluation clinics (APEC): 1) first-case tardiness and turnover times increased; 2) turnover times increased more than first-case tardiness; and higher American Society of Anesthesiologists Physical Status (ASA PS) resulted in both an ordered increase among ASA PS and within ASA PS in 3) first-case tardiness; and 4) turnover times.

http://ift.tt/2pONM29

A novel treatment for chronic opioid use after surgery

In a recent article from the Center for Disease Control, the authors addressed the current opioid epidemic in America and emphasized the importance of utilizing non-opioid analgesic alternatives to opioid medication for treating chronic pain. In cases where non-opioid analgesic drugs alone have failed to produce adequate pain relief, these authors suggested that non-pharmacologic therapies should also be considered. This Case Series describes a pilot study designed to evaluate a novel non-pharmacologic approach to treating long-standing (>1year) opioid dependency.

http://ift.tt/2q0EjkM

Ultrasound-guided “lateral” thoracolumbar interfascial plane (TLIP) block: A cadaveric study of the spread of injectate

To the Editor:

http://ift.tt/2pOZGsI

Rationale for New Checkpoint Inhibitor Combinations in Melanoma Therapy

Abstract

The use of monoclonal antibodies that block immunologic checkpoints, which mediate adaptive immune resistance, has revolutionized the treatment of metastatic melanoma patients. Specifically, targeting single immune suppressive molecules such as cytotoxic T lymphocyte-associated protein 4 (CTLA-4), or programmed cell death protein 1 (PD-1) expressed on T cells or its primary ligand, programmed cell death ligand 1 (PD-L1), resulted in pronounced clinical benefit for a subset of melanoma patients. Although single-agent immune checkpoint inhibitor therapy has demonstrated promising clinical activity in metastatic melanoma patients, there is still a significant proportion of patients who show primary resistance to these therapies. Increased clinical efficacy was reported in phase II and III randomized studies by co-targeting CTLA-4 and PD-1 in the treatment of advanced melanoma, indicating the existence of multiple non-redundant immunosuppressive pathways in the tumor microenvironment. Nevertheless, only 50% of patients responded to combined anti-CTLA-4 and anti-PD-1 treatment. Additionally, the combination regimen was associated with severe toxicity in >50–60% of patients. In this review we summarize the rationale for new checkpoint inhibitor combinations in melanoma therapy and discuss how biologic-driven stratification enables the design of optimal combination therapies tailored to target different tumor microenvironments.



http://ift.tt/2pOSHjC

Psoriasis, Depression, and Inflammatory Overlap: A Review

Abstract

Psoriasis has an enormous impact on patients' lives and is frequently associated with depression. Depression in psoriasis may be attributed, at least in part, to elevated proinflammatory cytokines rather than the psychosocial impact of psoriasis itself. Biologics that target inflammatory cytokines treat the clinical manifestations of psoriasis, but may also play a role in reducing associated depression. Multiple biologics have decreased symptoms of depression during clinical trials in psoriasis; however, these studies used a variety of depression screening tools, which limits comparison. Furthermore, it is difficult to distinguish whether improved depression is the result of the direct anti-inflammatory effect of the biologic, or the indirect effect of improved psoriasis leading to better psychological status. Future studies evaluating depression in patients with psoriasis could benefit from a standardized depression screening tool to mitigate discrepancies and facilitate comparison across treatment types. Here, we highlight the inflammatory overlap between psoriasis and depression by examining the pathophysiology of depression, and reviewing psoriasis clinical studies that assessed depression as an outcome measure.



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Trends of Second Primary Malignancy in Patients with Thyroid Cancer: A Population-Based Cohort Study in Israel

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Thyroid , Vol. 0, No. 0.


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Molecular Profiling of Papillary Thyroid Carcinoma in Korea with a High Prevalence of BRAFV600E Mutation

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Thyroid , Vol. 0, No. 0.


http://ift.tt/2pNIrp9

Molecular Profiling of Papillary Thyroid Carcinoma in Korea with a High Prevalence of BRAFV600E Mutation

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Thyroid , Vol. 0, No. 0.


http://ift.tt/2pNIrp9

Trends of Second Primary Malignancy in Patients with Thyroid Cancer: A Population-Based Cohort Study in Israel

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Thyroid , Vol. 0, No. 0.


http://ift.tt/2png1Fx

CHMP Recommends Skilarence for Psoriasis

The Committee for Medicinal Products for Human Use of the European Medicines Agency recommended granting marketing approval for Skilarence for treatment of psoriasis.
International Approvals

http://ift.tt/2q0jK82

Cone beam computed tomography assessment of the pterygomaxillary region and palatine canal for Le Fort I osteotomy

The aim of this study was to evaluate the anatomical linear measurements of the descending palatine canal and the pterygomaxillary fissure for Le Fort I preoperative planning. Seventy-five patients, comprising 46 females (61.3%) and 29 males (39.7%), underwent multi-slice computed tomography examinations performed for preoperative orthognathic surgical planning. The images were categorized according to sex, craniofacial side, and skeletal and craniofacial patterns. The anterior length between the descending palatine canal and the lateral wall of the piriform rim showed a higher mean value for males compared to females (P=0.0121).

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In-ear medical devices for acoustic therapies in tinnitus treatments, state of the art

Cochrane reviews indicate there is very limited support for all forms of sound therapy and cognitive behavioral therapy has the strongest support. American Academy of Otolaryngology (AAO) recently published some guidelines which recommends Cognitive Behavioral Therapy (CBT) for tinnitus intervention, and only indicates that sound therapy should be considered an "option" for intervention.Nevertheless, acoustic therapy could lead to cause changes in the tinnitus perception and has been appreciated by the affected people for years.

http://ift.tt/2oe0mb6

In-ear medical devices for acoustic therapies in tinnitus treatments, state of the art

Cochrane reviews indicate there is very limited support for all forms of sound therapy and cognitive behavioral therapy has the strongest support. American Academy of Otolaryngology (AAO) recently published some guidelines which recommends Cognitive Behavioral Therapy (CBT) for tinnitus intervention, and only indicates that sound therapy should be considered an "option" for intervention.Nevertheless, acoustic therapy could lead to cause changes in the tinnitus perception and has been appreciated by the affected people for years.

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Effects of different radiation doses on the microhardness, superficial morphology, and mineral components of human enamel

Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Sandra Ribeiro de Barros da Cunha, Felipe Paiva Fonseca, Pedro Augusto Minorin Mendes Ramos, Cecília Maria Kalil Haddad, Eduardo Rodrigues Fregnani, Ana Cecília Corrêa Aranha
ObjectiveTo evaluate the effects of three different radiotherapy doses (20, 40, and 70Gy) on the microhardness, superficial morphology, and mineral content (based on Ca and P values) of three different depths of human enamel (cervical, middle, and occlusal).DesignThirty-four third molars were cut, separated, and prepared. Microhardness samples (n=30) were embedded in acrylic resin and then polished, and depths were delimited. Microhardness tests were performed on cervical, middle, and occlusal enamel pre- and post-radiotherapy with a load of 50g for 30s. For the scanning electron microscopy (SEM) analysis (n=4) and energy dispersive X-ray spectroscopy (EDS) (n=12), samples were fixed in a 3% glutaraldehyde solution, washed in 0.1M cacodylate solution, and dehydrated in crescent concentrations of ethanol. Microhardness data were tested for significant differences using a two-way analysis of variance (ANOVA) and Tukey's test (p<0.05), while SEM and EDS were evaluated qualitatively.ResultsThe results showed a decrease in microhardness values only in the cervical enamel, regardless of the radiation dose used; no morphological or mineral change was observed.ConclusionRadiotherapy can affect the microhardness values of only cervical enamel without compromising the morphological or mineral (Ca and P) content at any depth.



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Depressive behavior induced by unpredictable chronic mild stress increases dentin hypersensitivity in rats

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Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Fabiane Martins Barbosa, Danilo Cabral, Fernanda Kabadayan, Eduardo Fernandes Bondan, Maria de Fátima Monteiro Martins, Thiago Berti Kirsten, Leoni Villano Bonamin, Nicolle Queiroz-Hazarbassanov, Maria Martha Bernardi, Cintia Helena Coury Saraceni
ObjectiveThe present study evaluated the nociceptive response induced by dentin hypersensitivity after dental erosion in rats that were exhibited to unpredictable chronic mild stress (UCMS)-induced depressive-like behavior.DesignAdult male rats were subjected to UCMS (depression [D] group) or not (no depression [ND] group) for 30days and received either acidic solution to induce dental erosion (E) or water (W), thus forming the WND, END, WD, and ED groups. After the end of treatment, depressive-like parameters (i.e., sucrose preference and immobility in the forced swim test) and dentin hypersensitivity were evaluated. Plasma tumor necrosis factor α (TNF-α) and corticosterone levels were measured, and astrocytic glial fibrillary acidic protein (GFAP) expression was evaluated in the prefrontal cortex, hippocampus, amygdala, and hypothalamus.ResultsAdministration of the acidic solution potentiated dentin hypersensitivity and increased corticosterone levels in the ED group compared with the WD group. TNF-α levels only increased in the WD group. The ED group exhibited an increase in astrocytic GFAP expression in the hypothalamus and prefrontal cortex but decreases in the hippocampus.ConclusionsThese results suggest that UCMS exacerbated the nociceptive response associated with dentin hypersensitivity, concomitant with an increase in plasma corticosterone levels. Hypothalamic and prefrontal cortex astrogliosis in the ED group may be attributable to the increase in corticosterone associated to UCMS procedure. The reduction of astrocytic GFAP expression in the hippocampus in the ED group supports the association between dentin hypersensitivity and depression.



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Response of mandibular condyles of juvenile and adult rats to abnormal occlusion and subsequent exemption

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Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Guang Zeng, Bin Kuang, Wen-xing Xun, Gao-tong Ren, Ke-wen Wei
ObjectiveThe adaptation capacities of the mandibular condyle in response to mechanical stimuli might be different between juveniles and adults, but has not been compared. This study aimed to investigate whether abnormal molar occlusion and subsequent molar extraction could lead to different remodeling responses in the mandibular condyles of juvenile and adult rats.MethodsAbnormal molar occlusion (AMO) was established in the 5- and 16-wk old rats by moving their maxillary left and mandibular right third molars distally. AMO was removed in the molar extraction group at 4 weeks but remained in the AMO group. All rats were sacrificed at 8 weeks. Micro-computed tomography, histomorphology, immunohistochemistry and real-time PCR were adopted to evaluate the remodeling of condylar subchondral bone.ResultsCondylar subchondral bone loss and increased osteoclastic activities were observed in both juvenile and adult AMO groups, while increased osteoblastic activities were only seen in the juvenile AMO group. Decreased bone mineral density, bone volume fraction and trabecular thickness, but increased trabecular separation, number and surface of osteoclasts and mRNA levels of TRAP, cathepsin-K, RANKL in the juvenile AMO group were all reversed after molar extraction (all P<0.05). However, these parameters showed no difference between adult AMO and extraction groups (all P>0.05).ConclusionsAbnormal molar occlusion led to degenerative remodeling in the mandibular condyles of both juvenile and adult rats, while exemption of abnormal occlusion caused significant rescue of the degenerative changes only in the juvenile rats.



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The mucosal pellicle – An underestimated factor in oral physiology

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Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Christian Hannig, Matthias Hannig, Anna Kensche, Guy Carpenter
Bioadhesion and bio-adsorption of proteins, glycoproteins and other biomolecules are ubiquitous phenomena in the oral cavity. While the protective role of the adsorbed salivary biomolecules on teeth (the acquired enamel pellicle) is well established, it has yet to be defined whether comparable processes occur on the desquamating oral soft tissues. The general term for these layers is pellicle, but due to the different characteristics of the coated surfaces the enamel pellicle and mucosal pellicle are their own entities. There is considerable information on the enamel pellicle, whereas only limited data are available on the mucosal pellicle. This can be attributed to the difficult standardized preparation of this biological structure. Based on the present knowledge the abundant and characteristic components of the mucosal pellicle include secreted soluble mucins (MUC5B, MUC7), membrane-associated epithelial mucins (MUC1), and to a lesser degree CA VI, sIgA, and cystatin. However, it seems to be of completely different ultrastructure as compared with the enamel pellicle. Since it is comprised of larger glycoproteins retaining water, it might be considered as a hydrogel, and it appears to have a lower tenacity than the enamel pellicle. Maturation and turnover are influenced by the delivery of salivary proteins, by the flow of saliva and the underlying desquamating oral epithelium. Its probable functions include lubrication and moisture retention.In general, the mucosal pellicle can be regarded as an underestimated key player in oral physiology.



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Lysophosphatidic acid induces expression of genes in human oral keratinocytes involved in wound healing

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Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Hong Huynh Thorlakson, Stian Andre Engen, Olav Schreurs, Karl Schenck, Inger Johanne Schytte Blix
ObjectiveEpithelial cells participate in wound healing by covering wounds, but also as important mediators of wound healing processes. Topical application of the phospholipid growth factor lysophosphatidic acid (LPA) accelerates dermal wound healing and we hypothesized that LPA can play a role in human oral wound healing through its effects on human oral keratinocytes (HOK).DesignHOK were isolated from gingival biopsies and exposed to LPA. The LPA receptor profile, signal transduction pathways, gene expression and secretion of selected cytokines were analyzed.ResultsHOK expressed the receptors LPA1, LPA5 and LPA6 and LPA activated the ERK1/2, JNK and p38 intracellular pathways, substantiated by secretion of IL-6 and IL-8. The early (2h) and intermediate (6h) gene expression profiles of HOK after LPA treatment showed a wide array of regulated genes. The majority of the strongest upregulated genes were related to chemotaxis and inflammation, and became downregulated after 6h. At 6h, genes coding for factors involved in extracellular matrix remodeling and re-epithelialization became highly expressed. IL-36γ, not earlier known to be regulated by LPA, was strongly transcribed and translated but not secreted.ConclusionsAfter stimulation with LPA, HOK responded by regulating factors and genes that are essential in wound healing processes. As LPA is found in saliva and is released by activated cells after wounding, our results indicate that LPA has a favorable physiological role in oral wound healing. This may further point towards a beneficial role for application of LPA on oral surgical or chronic wounds.



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Lack of pathogenic mutations in SOS1 gene in phenytoin-induced gingival overgrowth patients

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Publication date: August 2017
Source:Archives of Oral Biology, Volume 80
Author(s): Katia Margiotti, Giulia Pascolini, Federica Consoli, Valentina Guida, Carlo Di Bonaventura, Anna Teresa Giallonardo, Antonio Pizzuti, Alessandro De Luca
ObjectiveGingival overgrowth is a side effect associated with some distinct classes of drugs, such as anticonvulsants, immunosuppressants, and calcium channel blockers. One of the main drugs associated with gingival overgrowth is the antiepileptic phenytoin, which affects gingival tissues by altering extracellular matrix metabolism. It has been shown that mutation of human SOS1 gene is responsible for a rare hereditary gingival fibromatosis type 1, a benign gingival overgrowth. The aim of the present study is to evaluate the possible contribution of SOS1 mutation to gingival overgrowth-related phenotype.DesignWe selected and screened for mutations a group of 24 epileptic patients who experienced significant gingival overgrowth following phenytoin therapy. Mutation scanning was carried out by denaturing high-performance liquid chromatography analysis of the entire coding region of the SOS1 gene. Novel identified variants were analyzed in-silico by using Alamut Visual mutation interpretation software, and comparison with normal control group was done.ResultsMutation scanning of the entire coding sequence of SOS1 gene identified seven intronic variants and one new exonic substitution (c.138G>A). The seven common intronic variants were not considered to be of pathogenic importance. The exonic substitution c.138G>A was found to be absent in 100 ethnically matched normal control chromosomes, but was not expected to have functional significance based on prediction bioinformatics tools.ConclusionsThis study represents the first mutation analysis of the SOS1 gene in phenytoin-induced gingival overgrowth epileptic patients. Present results suggest that obvious pathogenic mutations in the SOS1 gene do not represent a common mechanism underlying phenytoin-induced gingival overgrowth in epileptic patients; other mechanisms are likely to be involved in the pathogenesis of this drug-induced phenotype.



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Tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx: A study of 206 cases

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RN Satarkar, S Srikanth

Indian Journal of Cancer 2016 53(4):478-482

INTRODUCTION: The nasal cavity, paranasal sinuses, and nasopharynx though in continuity form a complex system of upper respiratory tract; this region is endowed with a variety of elements such as epithelial, glandular, lymphoid, cartilage, and bone and is also exposed to a variety of infections, tumor-like and true neoplastic conditions. AIMS AND OBJECTIVES: To find out the frequency of various tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx. MATERIALS AND METHODS: The present study is an analysis of 206 tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx diagnosed during a period of 5 years. RESULTS: The patients' age ranged from 14 months to 85 years. Benign lesions were predominant in the second and third decades, with 30 cases (68.1%) occurring in that age group. Malignancies occurred predominantly in the sixth and seventh decades with 28 (60.9%) cases in this age group. Benign lesions in the nasopharynx comprised 75% cases and malignancies 25%. Eighty-three (71.5%) tumor-like conditions occurred in the nose and antrochoanal region. CONCLUSION: Angiofibroma was the most common benign tumor accounting for 25.55% of all neoplastic lesions. Squamous cell carcinoma was the most common malignancy at this site constituting 50% of all malignancies.

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A case series of salvage CCNU in high-grade glioma who have previously received temozolomide from a tertiary care institute in Mumbai

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VM Patil, R Abhinav, R Tonse, S Epari, T Gupta, R Jalali

Indian Journal of Cancer 2016 53(4):558-561

INTRODUCTION: In our center, we routinely use CCNU (Lomustine) as salvage treatment in high-grade glioma patients who cannot afford bevacizumab. This exploratory analysis was done to report the efficacy and toxicity associated with this regimen. METHODS: Patients who were treated with salvage CCNU (postexposure to temozolomide) between January 2015 and August 2016 were included for this retrospective analysis. SPSS version 16 was used for this analysis. Time-to-event analysis was performed using the Kaplan–Meier method. Progression-free survival (PFS) and overall survival (OS) were estimated. The maximum grade of toxicity during salvage CCNU was noted in accordance with CTCAE version 4.02. RESULTS: In the stipulated period, 16 patients were selected for the analysis. The median age of patients was 43 years (range 15–63 years), and 12 (80.0%) patients were males. The Eastern Cooperative Oncology Group performance status was 0–1 in 11 patients (73.3%) and 2–4 in 4 patients (26.7%). The tumor histopathology at diagnosis was glioblastoma in ten patients (66.6%), anaplastic astrocytoma in four (26.7%) patients, and anaplastic oligodendroglioma in one patient (6.7%). Grade 3–4 myelosuppression was seen in five patients (33.3%). The median PFS and OS were 192 days (95% confidence interval [CI]: 156.0–227.5 days) and 282 days (95% CI: 190.9–373.1 days), respectively. CONCLUSION: CCNU is associated with modest treatment outcomes in recurrent/relapsed high-grade gliomas. The high rate of myelosuppression is a concern. Urgent efforts are required to improve upon these results.

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Cancer statistics in Kamrup urban district: Incidence and mortality in 2007–2011

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Jagannath Dev Sharma, Amal Chandra Kataki, Debanjana Barman, Arpita Sharma, Manoj Kalita

Indian Journal of Cancer 2016 53(4):600-606

Purpose: The aim of this study was to report cancer statistics in Kamrup Urban District, including incidence and, mortality. Introduction: In the last five year PBCR-Guwahati witnessed a remarkable growth in cancer incidence cases. The number of new cases of all cancer was increased from 155.3 to 188.5 and 102.7 to 165.3 per 100,000 men and women respectively from the year 2007 to 2011 in KUD. The data from KUD also have shown that for some of the specific types of cancer are highest or some of the highest incidence in rates in the world; particularly cancers of upper aero-digestive tract consist of anatomical sites such as oral cavity, hypopharynx, larynx gallbladder, stomach, lung, prostate and oesophageal cancer. Materials and Methods: Age-standardized rates (ASR) (per 100,000 person-years) for incidence, mortality were calculated using the World Standard Population as proposed by Segi and modified by Doll et al. Descriptive statistics were presented by tables and figures. Results: A total of 6623 number of cases (male = 3809, female = 2814) were diagnosed with cancer in the last five years (2007-2011) period of time. The overall age standardized cancer incidence rate is almost 21% higher in men than in women. The pooled ASR for the five year period is 175.2 and 144.7 per 100,000 men and women. Conclusion: Overall cancer incidence and mortality rates have increased since 2007.

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Detailed study of survival of patients with renal cell carcinoma in India

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GP Abraham, T Cherian, P Mahadevan, TS Avinash, D George, E Manuel

Indian Journal of Cancer 2016 53(4):572-574

PURPOSE: Renal cell carcinoma (RCC) accounts for approximately 90% of all renal malignancies. The rates of kidney cancers are high in developed countries and low in eastern countries and Africa. The objective was to conduct a survival study among Indian population following nephrectomy for RCC as there was a paucity of Indian studies in medical literature. MATERIALS AND METHODS: We conducted a follow-up study of eighty RCC patients who had nephrectomy between January 2003 and December 2010. These patients had pathological diagnosis after nephrectomy. The follow-up was done up to December 2015. The survival statistics were compiled according to Kaplan–Meier survival curves. RESULTS: The overall survival of eighty patients was 77%. The patients with tumor size ≤7 cm and the patients with tumor size >7 cm showed significant statistical difference at 5-year survival (P < 0.0001). The patients with low nuclear grade (1 and 2) and the patients with high nuclear grade (3 and 4) showed significant statistical difference at 5-year survival (P < 0.0001). The patients with tumor node metastasis stage below T3 and the patients with clinical stage above or equal to T3 showed significant statistical difference at 5-year survival (P = 0.003). CONCLUSION: This study has demonstrated the importance of factors such as tumor size, nuclear grade, and stage in the assessment of prognosis of RCC patients. More studies in India with more patients are needed to demonstrate the importance of these prognostic factors.

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Palliative hypofractionated radiation therapy in a patient of locally advanced nasopharyngeal cancer with cardiac implantable electronic device (CIED): Management of a challenging case

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SA Varughese, SJ Bharti, A Biswas, S Verma

Indian Journal of Cancer 2016 53(4):482-482



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Opium consumption: A potential risk factor for lung cancer and pulmonary tuberculosis

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A Safari, M Reazai, A Tangestaninejad, AR Mafi, SAJ Mousavi

Indian Journal of Cancer 2016 53(4):587-589

OBJECTIVE: Lung cancer is the most common malignancy, as well as the leading cause of cancer-related mortality worldwide. Several studies have shown the causative effect of cigarettes smoking in lung cancer, however, the effect of opium consumption has not yet been well studied. This study has been designed to evaluate the risk of developing lung cancer and pulmonary tuberculosis in pure opium addicts. MATERIALS AND METHODS: We designed an analytic case–control study with 490 participants. People were divided into three groups: Group A were pure opium addicts, Group B consisted of nonsmoker patients who visited the chest medicine clinic due to complaints such as asthma, respiratory tract infections, and other signs and symptoms unrelated to smoking. Group C were chosen from nonsmoker individuals who visited the Emergency Department due to nonrespiratory problems. RESULTS: Statistical analysis showed that the three groups were similar with respect to mean age and gender. In Group A, one patient was diagnosed as having bronchoalveolar carcinoma. No other case of lung cancer was found in all three groups. Furthermore, four patients in Group A (5.3%; 95% confidence interval, 1.3–10.3) were found to have pulmonary tuberculosis, as this was significantly higher as compared with groups B and C (P = 0.009 and P< 0.001, respectively). CONCLUSION: Although, owing to limited number of cases, a robust conclusion cannot be made, this study can be considered as a base for a well-designed, larger study to further clarify the potential effect of opium abuse in developing lung cancer.

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Radical chemo-irradiation using intensity-modulated radiotherapy for locally advanced head and neck cancer in elderly patients: Experience from a tertiary care center in South India

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JR Chalissery, PC Sudheeran, KM Varghese, K Venkatesan

Indian Journal of Cancer 2016 53(4):483-486

OBJECTIVE: To assess the feasibility, tolerance and response of radical chemo irradiation using Intensity modulated Radiotherapy [IMRT] in elderly patients [age >65] with locally advanced head and neck cancer. MATERIAL AND METHODS: Patients aged 65 and above [range 65 to 84years] registered in oncology outpatient unit in our institution between December 2011 to 2014, with stage III and IV head and neck cancer were treated with radical dose of radiotherapy using IMRT and concurrent chemotherapy with cisplatin 40mg/sq.m weekly. Response evaluation and toxicity profile assessment was done 6 to 8 weeks after completion of treatment and 3 monthly thereafter with median follow up of 3 years. RESULTS: Total number of patients analysed were 47. 43(91.5%) patients tolerated 66-.70Gy of radiotherapy and 4 or more cycles of weekly chemotherapy with cisplatin. First follow up evaluation at 6 to 8 weeks showed 81% patients having complete loco regional response. Grade III skin reaction and mucositis was noticed in 24% and 47% respectively. No grade III neutropenia observed. Median follow up of 3 years showed a complete local control in 53% and overall survival of 60%. CONCLUSION: Radical chemo irradiation with IMRT in elderly patients is a feasible option. Long term local control and overall survival benefits needs to be followed up.

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Current status of systemic therapy for recurrent and/or metastatic squamous cell carcinoma of the head and neck

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LA Jacob, T Chaudhuri, KC Lakshmaiah, KG Babu, L Dasappa, MCS Babu, AH Rudresha, KN Lokesh, LK Rajeev

Indian Journal of Cancer 2016 53(4):471-477

Head and neck squamous cell carcinoma (HNSCC) is now the seventh most common cancer worldwide. The median overall survival for patients with recurrent and/or metastatic (R/M) HNSCC remains <1 year despite modern systemic chemotherapy and targeted agents. Palliative systemic therapy for patients with R/M HNSCC typically includes a platinum-based doublet, with an understanding that the increase in efficacy compared with single agents is primarily related to improved response rate, and not survival. Till date, the only systemic therapy regimen to demonstrate survival superiority over platinum-5-fluorouracil (5-FU) doublet is platinum, FU, and cetuximab. Epidermal growth factor receptor inhibitors, including monoclonal antibodies and tyrosine kinase inhibitors, have achieved only a modest success in R/M HNSCC. Immunotherapy represents an attractive treatment option for R/M HNSCC, with encouraging preliminary data from studies involving immune checkpoint inhibitors (e.g., pembrolizumab, nivolumab) and toll-like receptor agonists (e.g., motolimod). Given the poor prognosis of R/M HNSCC, enrollment of patients into clinical trials to investigate novel systemic agents, is necessary for further improvement of oncologic outcomes in this patient population.

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Plasma cell leukemia: Single institution experience

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K Govind Babu, Linu Abraham Jacob, Ankit Agarwal, KC Lakshmaiah, D Lokanatha, MC Suresh Babu, LK Rajeev, KN Lokesh, AH Rudresha

Indian Journal of Cancer 2016 53(4):619-620

BACKGROUND: The first case of plasma cell leukemia (PCL) was recognized by Gluzinski and Reichentein. It is the most aggressive among the monoclonal gammopathies. It is diagnosed by the presence of more than 20% plasma cells in the peripheral blood or an absolute plasma cell count of >2000/mm3. Because of the relatively low incidence, most data come from case reports and retrospective studies. No prospective series have been published, and only seven reports including more than twenty patients have been identified. We report a retrospective series of 18 patients identified as PCL. AIM: To study the clinical features and outcome of patients with PCL. MATERIALS AND METHODS: A retrospective study was conducted from the year 2006 to 2015 wherein all the patients diagnosed with PCL were identified. Complete clinical and treatment details and outcome were obtained from the records. RESULTS: There were total 18 cases of PCL (3.7% of cases with multiple myeloma) diagnosed between the year 2006 and 2015. 16 cases (84%) were primary PCL, and two cases were secondary PCL. Twelve patients were males and six were females. The median age was 56.5 years. All patients had aggressive clinical course and median overall survival even with immunomodulatory agents was only 3 months. CONCLUSION: PCL is a very aggressive disease, and no prospective trials have been conducted. Patients with PCL require induction with immunomodulators, proteasome inhibitors, and further trials are needed to evaluate the role of autologous stem cell transplant in this disease.

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Efficacy and toxicity of cetuximab with chemotherapy in recurrent and metastatic head and neck cancer: A prospective observational study

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S Tiwari, V Goel, MC John, N Patnaik, DC Doval

Indian Journal of Cancer 2016 53(4):487-492

BACKGROUND: In squamous cell carcinoma of the head and neck (SCCHN), epidermal growth factor receptor is expressed at very high levels. Hence, we have done this study to assess the response and tolerability of cetuximab and platinum-based chemotherapy in recurrent and metastatic (R/M) head and neck squamous cell cancer (HNSCC) in view of paucity of data from the Indian subcontinent. MATERIALS AND METHODS: In this prospective study, patients of R/M SCCHN were randomly enrolled from September 2012 to April 2015. Chemotherapy (cisplatin/carboplatin/5-fluorouracil) and cetuximab-based treatment were administered up to 6 cycles or unacceptable toxicity. The response rates (RRs), progression-free survival (PFS), and overall survival (OS) were analyzed. RESULTS: In total, fifty patients were enrolled. The median age was 51.0 years. A total of 255 cycles of treatment were administered (median = 6 cycles/patient). Four patients (8.0%) experienced complete response and 21 (42.0%) experienced partial response. Twenty-one patients (42.0%) had stable disease and four patients (8.0%) experienced progressive disease. The disease control rate was 92.0%. Median PFS was 5.3 months (95% confidence interval [CI]: 4.52–6.14 months). Median OS was 9.933 months (95% CI: 8.58–11.28 months). There was statistically significant correlation between overall response and Eastern Cooperative Oncology Group performance status (P = 0.014), site of tumor (P = 0.027), and histological grade of tumor (P = 0.001). The main Grade 3/4 side effects seen were hematological in 44 (88%) and gastrointestinal in 28 (56%) patients. CONCLUSIONS: The RR of cetuximab plus chemotherapy of >45% and the promising PFS rates are strong arguments for clinically testing this combination and this treatment schedule further in R/M HNSCC.

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An institutional analysis of clinicopathological features of triple negative breast cancer

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D Sharma, G Singh

Indian Journal of Cancer 2016 53(4):566-568

AIM: Most common breast cancer in India among female is breast cancer. This is heterogeneous disease, one of the subtypes, triple negative breast cancer (TNBC) defined as no expression of estrogen, progesterone receptor and neither expression nor amplification of human epidermal growth factor receptor 2/neu. TNBC is more frequent and aggressive in younger age group. The aim of this study was to evaluate clinicopathological features and outcome in TNBC versus non-TNBC group of patients. MATERIALS AND METHODS: Medical record of 373 patients diagnosed with invasive breast cancer from January 2011 to December 2014 was retrieved. The last follow-up was done in December 2015. Patients were evaluated and grouped on the basis of receptor status (TNBC vs. non-TNBC). Baseline categorical variables were analyzed using the Chi-square test or Fisher's exact test. Noncategorical variables were analyzed using t-test. RESULTS: Out of 373 cases, 149 (39.94%) were diagnosed as TNBC. Patients with TNBC had a significantly lower median age (45 vs. 48 years). Data analysis revealed significant difference in number of metastasis in TNBC as compared to non-TNBC group (45.6% vs. 25.6%, P = 0.001). In the present study, mean disease-free survival was 14.73 versus 17.03 months (P = 0.22, not significant) and mean overall survival was 24.71 versus 27.38 months (P = 05, significant) in TNBC versus non-TNBC group, respectively. CONCLUSION: TNBC represented 39.94% which is higher than the range normally reported in literature. TNBC is associated with younger age, high-grade tumors, and a higher rate of distant metastasis.

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Outcomes in nasopharyngeal carcinoma: Results from a nonendemic cohort

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SG Laskar, L Gurram, T Gupta, A Budrukkar, V Murthy, JP Agarwal

Indian Journal of Cancer 2016 53(4):493-498

INTRODUCTION: The treatment of nasopharyngeal carcinoma (NPC) has come a long way from treatment with conventional radiotherapy (RT) alone for the use of concurrent chemoradiotherapy (CCRT) and sequential chemotherapy (CT). We report the outcomes of patients treated with combined modality at a tertiary cancer center in India over a period of 10 years. MATERIALS AND METHODS: A total of 206 patients with NPC between 1994 and 2004, who completed planned treatment, were retrospectively analyzed. Demographic features, disease, and treatment-related factors were analyzed for their impact on loco-regional control (LRC), disease-free survival (DFS), and overall survival (OS). RESULTS: Most patients had Stage III or IV (70.8%) disease. Twenty-six percent received RT alone, 37% received neoadjuvant chemotherapy (NACT) followed by RT alone, 29% received NACT + CCRT, and 8% received CCRT alone. Median RT dose was 64 Gy with 84% receiving RT doses of ≥60 Gy. At a median follow-up of 29 months, 112 (54.4%) patients were alive and disease free. Three-year DFS and OS were 64% and 82.3%, respectively. LRC at 3 years was 71.1%. Independent factors for significantly better LRC and DFS were younger age at presentation, RT dose of more than 64 Gy, and immediate response to RT. The use of CCRT in advanced nodal stages (N2–N3) resulted in significantly better LRC and DFS on multivariate analysis. CONCLUSIONS: Combined modality treatment in advanced stage NPC results in favorable outcomes. RT doses of more than 64 Gy should be considered in all patients, respecting normal tissue tolerances. The role of NACT remains debatable.

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Patterns of care and outcomes for second-line targeted therapy in metastatic renal cell carcinomas: A registry based analysis

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S Zanwar, A Joshi, V Noronha, VM Patil, N Sable, P Popat, S Menon, R Kothari, P Bhargava, A Kapoor, K Prabhash

Indian Journal of Cancer 2016 53(4):579-582

AIM: Patterns of care for metastatic renal cell carcinomas (mRCC) have seen tremendous reform in the last decade. Here, we present our pattern of care in second-line targeted therapy for mRCC. METHODS: Patients with mRCC treated with second-line therapy were included from a prospective database. Demographics, risk stratification, and treatment details were noted. Event-free survival (EFS) and overall survival (OS) was calculated using Kaplan–Meier method. Log-rank test was used to identify factors affecting EFS and OS. Multivariate analysis was performed using cox regression. RESULTS: Nearly 21.7% (46/212) of patients received second-line targeted treatment. Heng score for risk stratification showed 21.7% of patients in low risk, 36.9% in intermediate, and 34.8% in high risk group. Everolimus followed by pazopanib were the most common second-line therapies used in 65.2% and 13% of patients, respectively. The estimated median EFS was 3.5 months (95% confidence interval [CI] 2.7–4.26 months) and estimated median OS from the start of second-line therapy was 6.2 months (95% CI 3.4–9.0 months) with a median follow-up of 4.3 months. On univariate log-rank analysis, EFS of more than 6 months with first-line therapy was associated with improvement in EFS with second-line therapy (9.5 vs. 2.0 months; hazard ratio (HR) 0.364; P = 0.002). There was no factor independently associated with EFS or OS on multivariate analysis. CONCLUSION: Patterns of care for second line targeted therapy tend to vary with setting. A longer EFS with first-line therapy predicts improved outcomes with second-line treatment.

http://ift.tt/2pYM5LY

Clinical observation and retrospective study of the influential factors of liver metastasis in 306 cases of colon cancer

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X Lin, M Lin, X Wei, Q Chen

Indian Journal of Cancer 2016 53(4):499-504

PURPOSES/OBJECTIVES: By observing and analyzing the clinical features of the colon cancer and the influence factors of liver metastasis, we try to find out independent risk factors with significant influence on colon cancer liver metastasis as well as to provide reference for clinical treatment. MATERIALS AND METHODS: A total of 306 cases of colon cancer patients' clinical data, including gender, age, primary focal size, primary focal intestinal segment, degree of differentiation, infiltration depth, level of serum carcinoembryonic antigen (CEA) before surgery, lymph node metastasis, liver basic diseases were collected and recorded. Single-factor Chi-square analysis and multifactor logistic regression analysis (SPSS 16.0 software) were used to retrospectively study the possible influence factors of colon liver metastases and to preliminary discuss the potential risk factors of liver metastasis in colon cancer patients. RESULTS: The Chi-square analysis showed that patients' primary focal segment, degree of differentiation, infiltration depth, level of serum CEA before surgery, and states of hepatitis B does 2 half-and-half had significant effect on the incidence of liver metastasis. However, in the further logistic regression analysis, it showed that only the infiltration depth and the states of hepatitis B does 2 half-and-half were the independent risk factors that influence the hepatic metastases. What was more, the both subgroups of positive hepatitis B with infection and vaccine showed significant statistical differences when comparing with hepatitis B all negative in the event of the probability of liver metastases (P = 0.011 and 0.004). CONCLUSIONS: The infiltration depth and the states of hepatitis B does 2 half-and-half were the independent risk factors on colon cancer patients' hepatic metastases. Those with the infiltration depth of T4 had a higher rate of hepatic metastases. Patients with does 2 half-and-half-positive hepatitis B (whether subgroup of hepatitis B virus infection or subgroup hepatitis B vaccine related) had a lower incidence rate of liver metastasis than those with hepatitis B all negative.

http://ift.tt/2pZ7l46

Monotherapy versus combination therapy against carbapenem-resistant Gram-negative bacteria: A retrospective observational study

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A Ghafur, V Devarajan, T Raja, J Easow, MA Raja, S Sreenivas, B Ramakrishnan, SG Raman, D Devaprasad, B Venkatachalam, R Nimmagadda

Indian Journal of Cancer 2016 53(4):592-594

BACKGROUND: Colistin-based combination therapy (CCT) is extensively used to treat infections due to carbapenem-resistant Gram-negative bacteria (CRGNB). There are no data available from India on the usefulness of combination therapy, especially in the oncology setup. The aim of this study was to analyze the clinical effectiveness of CCT over monotherapy in patients with CRGNB. MATERIALS AND METHODS: We conducted a retrospective, observational study of patients with CRGNB bloodstream infections in our oncology and bone marrow transplant center. RESULTS: Over a 3-year study period (2011–2014), we could identify 91 patients satisfying study criteria. There was no statistically significant difference in the 28-day mortality between monotherapy and combination therapy arms (mono n = 26, mortality 10 (38.5%); combination n = 65, mortality 28 (40%); P = 0.886). Neutropenic patients with Enterobacteriaceae bloodstream infections performed better with combination therapy (mono n = 7, mortality 6 (85.7%); combination therapy n = 22, mortality 8 (36.4%); P = 0.035). There was no significant difference in the 28-day mortality between the two treatment arms in other subgroups. CONCLUSION: Our study did not find CCT superior to colistin monotherapy in patients with CRGNB blood stream infections; except in the subgroup of neutropenic patients with Enterobacteriaceae bloodstream infections, where combination therapy performed better.

http://ift.tt/2pYUJKF

Human epidermal growth factor receptor 2 expression in gastric carcinoma and its association with histopathological parameters in Indian population

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P Gupta, S Rao, S Bhalla

Indian Journal of Cancer 2016 53(4):505-511

Introduction: Gastric carcinoma is a leading cause of death worldwide with a five year survival of 10-15% even after curative resection. Trastuzumab has emerged as a potential targeted therapy in treatment of Her 2 positive gastric cancer. Her2 positivity ranges from 7-34% in studies across the world. There is a paucity of Indian studies hence a need for determination of Her2 expression in Indian population for better patient management. This study was carried out to determine the frequency of Her 2 expression in gastric carcinoma by immunohistochemistry (IHC) technique and to evaluate its association with histopathological parameters. Material and Methods: A total of 110 cases of gastric adenocarcinoma diagnosed on histopathological examination from July 2013 to June 2015 were included. Of these, 40 cases were resection specimens and 70 were biopsies. Histological typing of gastric carcinoma was done on the basis of Lauren classification. IHC for Her2 was done in all 110 cases. Her 2 expression was correlated with various histopathological parameters. Results: Positive Her 2 expression (IHC 3+) was seen in 24.5% cases of gastric carcinoma. Patients in older age group(> 60 years) showed higher Her 2 positivity rate as compared to middle age (40-60 years) and younger population (<40 years). Higher percentage of Her 2 positivity was noted in male patients as compared to female patients. Her 2 positivity was seen more commonly in intestinal type of tumor as compared to diffuse and mixed types. Her 2 positivity was seen more in well differentiated carcinoma and higher stage tumors (pT3 and pT4). However, out of all, a statistically significant association of Her2 expression was found only with (intestinal) type of tumors (p= 0.005) and no significant association was seen with age, gender, site of tumor, tumor stage, lymph node status, lymphovascular, perineural and perinodal invasion or survival. Conclusion: Inspired by promising results of Trastuzumab therapy in Her 2 positive gastric carcinoma worldwide, it is recommended to routinely test all cases of gastric carcinoma for Her 2 expression and to use the targeted therapy with curative intentions in Indian population.

http://ift.tt/2pLCiww

A review of squamous cell carcinoma arising in mature cystic teratoma of the ovary

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N Abhilasha, UD Bafna, VR Pallavi, PS Rathod, S Krishnappa

Indian Journal of Cancer 2016 53(4):612-614

INTRODUCTION: Germ cell tumors account for 20-25% of ovarian neoplasms. Mature cystic teratoma (MCT) is the most common ovarian germ cell tumor. Malignancy in MCT is seen in 1-2% of the cases. Squamous cell carcinoma (SCC) accounts for 80% of the cases and carries a poor prognosis. AIM: To study the clinicopathological factors, management protocols and its outcome. MATERIALS AND METHODS: Case records reviewed from August 2006 to August 2011 at our institute identified 10 women with SCC in ovarian MCT. Staging was done according to FIGO 2009 guidelines. Primary surgery followed by adjuvant treatment with platinum based chemotherapy was given. RESULTS: Median age was 53.5 years. Six out of 10 patients were postmenopausal and aged above 50 years. Abdominal pain and abdominal mass were the most common presenting symptoms. According to FIGO: Two in stage 1, five in stage 2, two in stage 3 and one in stage 4. Among six optimally cytoreduced patients, five (83%) had no evidence of disease with a median follow up of 10 months. Whereas all four (100%) suboptimally cytoreduced patients had progressive disease within 3 to 4 months of primary surgery despite chemotherapy. CONCLUSION: Squamous cell carcinoma in MCT of ovary is a rarity. It carries a poor prognosis, especially in advanced stages and suboptimally cytoreduced patients. Platinum with or without taxane based chemotherapy may be useful as adjuvant treatment. However, further studies and standardization of treatment protocols are required for any recommendations.

http://ift.tt/2ovuI5j

Incidence and pattern of childhood cancers in India: Findings from population-based cancer registries

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Abu Bashar

Indian Journal of Cancer 2016 53(4):511-512



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Microsatellite instability in stage II colorectal cancer: An Indian perspective

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AP Dubey, S Vishwanath, P Nikhil, A Rathore, A Pathak

Indian Journal of Cancer 2016 53(4):513-517

INTRODUCTION: Around 80% of colorectal carcinoma are associated with chromosomal instability (CIN) while rest of 20 % are euploid, possessing defect in mis match repair system (MMR) quintessential for surveillance and correction of errors in introduced into microsatellites. MATERIALS AND METHODS: We analyse all stage II CRC for MSI who presented at MDTC at Army hospital (research and refrral) new delhi during last 2 years (Jan 14 to Dec 2015). RESULTS: We found that 22.2% patients out of 45 patients with stageII CRC being MSI-. high. We also noticed all suchcases were associated with loss of expression of PMS2 & MLH1, that was in contrast other studies where loss of MLH1 and MSH@, MSH6 were seen more commonly. CONCLUSION: MSI occurs in a significant proportion of colorectal cancers in young (<50 years old) patients. Young age at colorectal cancer diagnosis, proximal tumor location, family history of colorectal cancer were independent predictors of MSI status in our patients. In a proportion of these young patients with MSI tumors, loss of expression of proteins by 2 MMR genes PMS2 and hMLH1 has been identified.

http://ift.tt/2pLyIm8

Pediatric brain tumors: An analysis of 5 years of data from a tertiary cancer care center, India

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R Madhavan, BP Kannabiran, AM Nithya, J Kani, P Balasubramaniam, S Shanmugakumar

Indian Journal of Cancer 2016 53(4):562-565

BACKGROUND: Pediatric brain tumors are the most common solid tumors in children and a leading cause of mortality and morbidity in children worldwide. Even though there are enough data about the epidemiology of pediatric brain tumors in western population, there are only a few reports from developing countries like India. AIMS: To study the epidemiological patterns of brain tumors in children, to study the patterns of care, and to assess the treatment response. MATERIALS AND METHODS: A retrospective epidemiological approach is used. The records of children <18 years registered in our department from August 2006 to July 2011 diagnosed as primary brain tumors are selected. Data regarding age, sex, site of the tumor, clinical features, histology, treatment plan, and treatment response are collected. The World Health Organization classification of neoplasms was adopted. RESULTS: Of 250 cases, females (57%) slightly outnumbered males. The present study revealed that astrocytoma (52%) is the most common brain tumor in childhood. Surgery was the main modality of treatment. Chemotherapy was given to 16% of patients. Even though radiation therapy was offered to 74% of patients, only 42% completed radiotherapy. There was subjective clinical improvement in 68% of patient population after treatment. CONCLUSIONS: This is the second study from Tamil Nadu that deals with epidemiology of brain tumors. Multimodality management including surgery, chemotherapy, and radiation therapy remains the cornerstone in the management of pediatric brain tumors.

http://ift.tt/2pLPdhT

Acute Nanoparticle Exposure to Vocal Folds: A Laboratory Study

Airway exposure to nanoparticles is common in occupational settings. Inhaled nanoparticles have toxic effects on respiratory tissue. Vocal folds are also at direct risk from inhaled nanoparticles. This study investigated the effects of single-walled carbon nanotubes (SWCNT), a type of nanoparticle, on vocal fold epithelium and fibroblasts. These cell types were selected for study as the epithelium is the outer layer of the vocal folds and fibroblasts are the most common cell type in connective tissue underlying the epithelium.

http://ift.tt/2pOMWCy

Laryngopharyngeal Reflux and Voice Disorders: A Multifactorial Model of Etiology and Pathophysiology

The aim of this paper is to shed light on the pathogenesis and pathophysiological mechanisms underlying the development of hoarseness related to laryngopharyngeal reflux disease (LPRD).

http://ift.tt/2p1uqEh

Angiosarcoma of the tongue: A case series and literature review

Angiosarcoma of the tongue is an exceedingly rare malignancy of the head and neck. Such lesions can be primary in nature or occur in a previously irradiated field. We examine a series of cases with relation to clinical presentation, diagnosis, management, and outcomes.

http://ift.tt/2pNPoXg

Pleomorphic liposarcoma of the head and neck: Presentation of two cases and literature review

Pleomorphic liposarcoma (PL) is an exceedingly rare tumor of the head and neck. This aggressive liposarcoma variant portends a poorer prognosis compared to more typical sarcomatous tumors.

http://ift.tt/2odZVOo

Angiosarcoma of the tongue: A case series and literature review

Angiosarcoma of the tongue is an exceedingly rare malignancy of the head and neck. Such lesions can be primary in nature or occur in a previously irradiated field. We examine a series of cases with relation to clinical presentation, diagnosis, management, and outcomes.

http://ift.tt/2pNPoXg

Pleomorphic liposarcoma of the head and neck: Presentation of two cases and literature review

Pleomorphic liposarcoma (PL) is an exceedingly rare tumor of the head and neck. This aggressive liposarcoma variant portends a poorer prognosis compared to more typical sarcomatous tumors.

http://ift.tt/2odZVOo

Sphenopalatine Ganglion Block in the Management of Chronic Headaches

Abstract

Purpose of Review

Sphenopalatine ganglion (SPG) block has been used by clinicians in the treatment of a variety of headache disorders, facial pain syndromes, and other facial neuralgias. The sensory and autonomic fibers that travel through the SPG provided the scientific rationale for symptoms associated with these head and neck syndromes. Yet, despite the elucidation of this pathogenic target, the optimal method to block its pain-producing properties has not been determined. Clinicians have developed various invasive and non-invasive techniques, each of which has shown variable rates of success. We examined the available studies of sphenopalatine ganglion blockade and its efficacy in the treatment of cluster headaches, migraines, and other trigeminal autonomic cephalalgias.

Recent Findings

Studies have demonstrated that SPG blockade and neurostimulation can provide pain relief in patients with cluster headaches, migraines, and other trigeminal autonomic cephalalgias. Patients with these conditions showed varying levels and duration of pain relief from SPG blockade. The efficacy of SPG blockade could be related to the different techniques targeting the SPG and choice of therapeutic agents.

Summary

Based on current studies, SPG blockade is a safe and effective treatment for chronic headaches such as cluster headaches, migraines, and other trigeminal autonomic cephalalgias. Future studies are warranted to define the optimal image-guided technique and choice of pharmacologic agents for SPG blockade as an effective treatment for chronic headaches related to activation of the sphenopalatine ganglion.



http://ift.tt/2pOCQ4G

Neuropathic Pain: Central vs. Peripheral Mechanisms

Abstract

Purpose of Review

Our goal is to examine the processes—both central and peripheral—that underlie the development of peripherally-induced neuropathic pain (pNP) and to highlight recent evidence for mechanisms contributing to its maintenance. While many pNP conditions are initiated by damage to the peripheral nervous system (PNS), their persistence appears to rely on maladaptive processes within the central nervous system (CNS). The potential existence of an autonomous pain-generating mechanism in the CNS creates significant implications for the development of new neuropathic pain treatments; thus, work towards its resolution is crucial. Here, we seek to identify evidence for PNS and CNS independently generating neuropathic pain signals.

Recent Findings

Recent preclinical studies in pNP support and provide key details concerning the role of multiple mechanisms leading to fiber hyperexcitability and sustained electrical discharge to the CNS. In studies regarding central mechanisms, new preclinical evidence includes the mapping of novel inhibitory circuitry and identification of the molecular basis of microglia-neuron crosstalk. Recent clinical evidence demonstrates the essential role of peripheral mechanisms, mostly via studies that block the initially damaged peripheral circuitry. Clinical central mechanism studies use imaging to identify potentially self-sustaining infra-slow CNS oscillatory activity that may be unique to pNP patients.

Summary

While new preclinical evidence supports and expands upon the key role of central mechanisms in neuropathic pain, clinical evidence for an autonomous central mechanism remains relatively limited. Recent findings from both preclinical and clinical studies recapitulate the critical contribution of peripheral input to maintenance of neuropathic pain. Further clinical investigations on the possibility of standalone central contributions to pNP may be assisted by a reconsideration of the agreed terms or criteria for diagnosing the presence of central sensitization in humans.



http://ift.tt/2p1nsz2

Sphenopalatine Ganglion Block in the Management of Chronic Headaches

Abstract

Purpose of Review

Sphenopalatine ganglion (SPG) block has been used by clinicians in the treatment of a variety of headache disorders, facial pain syndromes, and other facial neuralgias. The sensory and autonomic fibers that travel through the SPG provided the scientific rationale for symptoms associated with these head and neck syndromes. Yet, despite the elucidation of this pathogenic target, the optimal method to block its pain-producing properties has not been determined. Clinicians have developed various invasive and non-invasive techniques, each of which has shown variable rates of success. We examined the available studies of sphenopalatine ganglion blockade and its efficacy in the treatment of cluster headaches, migraines, and other trigeminal autonomic cephalalgias.

Recent Findings

Studies have demonstrated that SPG blockade and neurostimulation can provide pain relief in patients with cluster headaches, migraines, and other trigeminal autonomic cephalalgias. Patients with these conditions showed varying levels and duration of pain relief from SPG blockade. The efficacy of SPG blockade could be related to the different techniques targeting the SPG and choice of therapeutic agents.

Summary

Based on current studies, SPG blockade is a safe and effective treatment for chronic headaches such as cluster headaches, migraines, and other trigeminal autonomic cephalalgias. Future studies are warranted to define the optimal image-guided technique and choice of pharmacologic agents for SPG blockade as an effective treatment for chronic headaches related to activation of the sphenopalatine ganglion.



http://ift.tt/2pOCQ4G

Neuropathic Pain: Central vs. Peripheral Mechanisms

Abstract

Purpose of Review

Our goal is to examine the processes—both central and peripheral—that underlie the development of peripherally-induced neuropathic pain (pNP) and to highlight recent evidence for mechanisms contributing to its maintenance. While many pNP conditions are initiated by damage to the peripheral nervous system (PNS), their persistence appears to rely on maladaptive processes within the central nervous system (CNS). The potential existence of an autonomous pain-generating mechanism in the CNS creates significant implications for the development of new neuropathic pain treatments; thus, work towards its resolution is crucial. Here, we seek to identify evidence for PNS and CNS independently generating neuropathic pain signals.

Recent Findings

Recent preclinical studies in pNP support and provide key details concerning the role of multiple mechanisms leading to fiber hyperexcitability and sustained electrical discharge to the CNS. In studies regarding central mechanisms, new preclinical evidence includes the mapping of novel inhibitory circuitry and identification of the molecular basis of microglia-neuron crosstalk. Recent clinical evidence demonstrates the essential role of peripheral mechanisms, mostly via studies that block the initially damaged peripheral circuitry. Clinical central mechanism studies use imaging to identify potentially self-sustaining infra-slow CNS oscillatory activity that may be unique to pNP patients.

Summary

While new preclinical evidence supports and expands upon the key role of central mechanisms in neuropathic pain, clinical evidence for an autonomous central mechanism remains relatively limited. Recent findings from both preclinical and clinical studies recapitulate the critical contribution of peripheral input to maintenance of neuropathic pain. Further clinical investigations on the possibility of standalone central contributions to pNP may be assisted by a reconsideration of the agreed terms or criteria for diagnosing the presence of central sensitization in humans.



http://ift.tt/2p1nsz2

Clinical predictors of remission and persistence of adult-onset asthma

Adult-onset asthma remission occurs in 16% of the patients within 5 years after diagnosis. Nasal polyposis and moderate to severe bronchial hyperresponsiveness at the time of asthma diagnosis reduces the chance of remission to <1%.

http://ift.tt/2pOMDaV

Oncological outcome following de-intensification of treatment for stage I and II HPV negative oropharyngeal cancers with transoral robotic surgery (TORS): A prospective trial

The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing in India. There were estimated 38,691 new cases of oropharyngeal cancers in India in 2012 [1]. As compared to the developed countries, where the increase in the incidence of OPSCC is mainly attributed to the epidemic increase in the incidence of HPV infection, the leading cause of OPSCC in India is still caused due to exposure to tobacco and alcohol. The prevalence of HPV positivity in newly diagnosed cases of OPSCC in developed countries like USA is>60% [2,3].

http://ift.tt/2pNAFeO

Everolimus Plus Exemestane in Advanced Breast Cancer: Safety Results of the BALLET Study on Patients Previously Treated Without and with Chemotherapy in the Metastatic Setting

Background.

The BALLET study was an open-label, multicenter, expanded access study designed to allow treatment with everolimus plus exemestane in postmenopausal women with hormone receptor-positive metastatic breast cancer progressed following prior endocrine therapy. A post hoc analysis to evaluate if previous chemotherapy in the metastatic setting affects the safety profile of the combination regimen of everolimus and exemestane was conducted on the Italian subset, as it represented the major part of the patients enrolled (54%).

Patients and Methods.

One thousand one hundred and fifty-one Italian patients were included in the present post hoc analysis, which focused on two sets of patients: patients who never received chemotherapy in the metastatic setting (36.1%) and patients who received at least one chemotherapy treatment in the metastatic setting (63.9%).

Results.

One thousand one hundred and sixteen patients (97.0%) prematurely discontinued the study drug, and the main reasons reported were disease progression (39.1%), local reimbursement of everolimus (31.1%), and adverse events (AEs) (16.1%). The median duration of study treatment exposure was 139.5 days for exemestane and 135.0 days for everolimus. At least one AE was experienced by 92.5% of patients. The incidence of everolimus-related AEs was higher (83.9%) when compared with those that occurred with exemestane (29.1%), and the most commonly reported everolimus-related AE was stomatitis (51.3%). However, no significant difference in terms of safety related to the combination occurred between patients without and with chemotherapy in the metastatic setting.

Conclusion.

Real-life data of the Italian patients BALLET-related cohort were an adequate setting to state that previous chemotherapy did not affect the safety profile of the combination regimen of everolimus and exemestane. The Oncologist 2017;22:1–8

Implications for Practice: With the advent of new targeted agents for advanced or metastatic breast cancer, multiple lines of therapy may be possible, and components of the combined regimens can overlap from one line to another. Thus, it is important to assess even the potential of cumulative and additive toxic effects among the drugs. Previous chemotherapy did not affect the safety profile of the combination regimen of everolimus and exemestane. The continuous monitoring of the safety signals of this drug combination from general clinical practice is important, in particular for stomatitis.



http://ift.tt/2p5kAU2

A Bacterial Cause of Cancer: An Historical Essay

This article reviews the history of the discovery of microbes that increase the risk of cancer of some tissues with a special emphasis on the bacterium Helicobacter pylori and the role played by two Australian physicians, neither schooled in research, who had open minds about the shibboleth that mycobacteria (acid-fast organisms) can survive the acid environment of the stomach, but that other pathogenic bacteria cannot. They discovered one of the most important human pathogens, Helicobacter pylori, and showed it capable of inducing severe gastric inflammatory disease. Subsequently, others built on their observations and showed it capable of inducing two gastric neoplasms: carcinoma and lymphoma. The Oncologist 2017;22:1–7



http://ift.tt/2pNAZtW

Chemo Heart



http://ift.tt/2pNkwWJ

Disorders of Thyroid Morphogenesis

Publication date: Available online 21 April 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Rasha Abu-Khudir, Stéphanie Larrivée-Vanier, Jonathan Wasserman, Johnny Deladoëy
Developmental anomalies of the thyroid gland, defined as thyroid dysgenesis, underlie the majority of cases of congenital hypothyroidism. Thyroid dysgenesis is predominantly a sporadic disorder although a reported familial enrichment, variation of incidence by ethnicity and the monogenic defects associated mainly with athyreosis or orthotopic thyroid hypoplasia, suggest a genetic contribution. Of note, the most common developmental anomaly, thyroid ectopy, remains unexplained. Ectopy may result from multiple genetic or epigenetic variants in the germline and/or at the somatic level. This review provides a brief overview of the monogenic defects in candidate genes that have been identified so far and of the syndromes which are known to be associated with thyroid dysgenesis.



http://ift.tt/2odZlQC

The role of GLIS3 in thyroid disease as part of a multisystem disorder

Publication date: Available online 21 April 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): P. Dimitri
Congenital hypothyroidism is the most common hereditary endocrine disorder. In a small number of cases, mutations have been identified that are associated with maldevelopment and maldescent of the thyroid. Some of these mutations present as syndromes with a multisystem phenotype such as NKX2-1, PAX8, and FOXE. The association of permanent neonatal diabetes and congenital hypothyroidism was first reported in 2003 and subsequently led to the identification GLIS3 as the mutation responsible for this presentation. GLIS3 is a member of the GLI-similar zinc finger protein family encoding for a nuclear protein with five zinc finger domains and maps to chromosome 9p24. Given the role of GLIS3 in transcriptional activation and repression during embryogenesis, in humans, GLIS3 mutations present with multisystem involvement that also includes renal cystic dysplasia, progressive liver fibrosis and osteopenia. Thyroid findings in GLIS3 patients include thyroid aplasia, diminished colloid with interstitial fibrosis at post-mortem, and apparently normal gross thyroid anatomy on ultrasonography but with temporary TSH resistance on treatment. To date no biological mechanism has explained this variable presentation.



http://ift.tt/2p1i5js

Design, synthesis, biological evaluation and molecular modelling of 2-(2-aryloxyphenyl)-1,4-dihydroisoquinolin-3(2H)-ones: A novel class of TSPO ligands modulating amyloid-β-induced mPTP opening

Publication date: Available online 21 April 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Ahmed Elkamhawy, Jung-eun Park, Ahmed H.E. Hassan, Ae Nim Pae, Jiyoun Lee, Beoung-Geon Park, Sora Paik, Jimin Do, Jong-Hyun Park, Ki Duk Park, Bongjin Moon, Woo Kyu Park, Heeyeong Cho, Dae Young Jeong, Eun Joo Roh
Translocator protein (TSPO) is involved in modulating mitochondrial permeability transition pore (mPTP) opening/closure leading to either apoptotic cell death via opening of mPTP or cell protection mediated by mPTP blocking and hence intercepting mPTP induced apoptosis. Herein, 2-(2-aryloxyphenyl)-1,4-dihydroisoquinolin-3(2H)-one derivatives have been designed and synthesized as new modulators for amyloid-β-induced mPTP opening. Among all, compound 7c remarkably enhanced mPTP opening while compound 7e showed the highest mPTP blocking activity. Molecular modelling study revealed different binding modes which might underlie the observed opposing biological activities. Both compounds bound to the translocator protein 18kDa (TSPO) in low micromolar range and elicited good profiles on CYP2D6 and CYP1A2. Taken as a whole, this report presents compound 7e as a hit TSPO ligand for treatment of neurodegenerative diseases and compound 7c as a hit TSPO ligand for promoting cell death of cells over-expressing TSPO.

Graphical abstract

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http://ift.tt/2ovv1gk

Dynamics of growth zone patterning in the milkweed bug Oncopeltus fasciatus [RESEARCH ARTICLE]

Tzach Auman, Barbara M. I. Vreede, Aryeh Weiss, Susan D. Hester, Terri A. Williams, Lisa M. Nagy, and Ariel D. Chipman

We describe the dynamic process of abdominal segment generation in the milkweed bug Oncopeltus fasciatus. We present detailed morphological measurements of the growing germband throughout segmentation. Our data are complemented by cell division profiles and expression patterns of key genes, including invected and even-skipped as markers for different stages of segment formation. We describe morphological and mechanistic changes in the growth zone and in nascent segments during generation of individual segments and throughout segmentation, and examine the relative contribution of newly formed versus existing tissue to segment formation. While abdominal segment addition is primarily generated through cell rearrangement of a pool of undifferentiated cells, there is nonetheless proliferation in the posterior. By correlating proliferation with gene expression in the growth zone, we propose a model for the dynamics of the growth zone during segmentation in which the growth zone is functionally subdivided into two separate regions: a posterior region devoted to a slow rate of growth among undifferentiated cells and an anterior region in which segmental differentiation is initiated and proliferation inhibited.



http://ift.tt/2pOL9NG

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