Κυριακή 22 Απριλίου 2018

Attitude Towards End of Life Communication of Austrian Medical Students

Abstract

Medical students have to acquire theoretical knowledge, practical skills, and a personal attitude to meet the emerging needs of palliative care. The present study aimed to assess the personal attitude of Austrian medical students towards end of life communication (EOLC), as key part of palliative care. This cross-sectional, mono-institutional assessment invited all medical students at the Medical University of Vienna in 2015. The assessment was conducted web-based via questionnaire about attitudes towards EOLC. Additional socio-demographic and medical education-related parameters were collected. Overall, 743 medical students participated in the present report. Differences regarding the agreement or disagreement to several statements concerning the satisfaction of working with chronically ill patients, palliative care, and health care costs, as well as the extent of information about palliative disease, were found for age, gender, and academic years. The overall attitude towards EOLC in the present sample can be regarded as quite balanced. Nevertheless, a considerable number of medical students are still reluctant to inform patients about their incurable disease. Reservations towards palliative care as part of the health care system seem to exist. The influence of the curriculum as well as practical experiences seems to be important but needs further investigation.



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Sociocultural Barriers Related to Late-Stage Presentation of Breast Cancer in Morocco

Abstract

Breast cancer is the most prevalent cancer affecting women globally and in Morocco, where more than one fourth of patients are diagnosed at advanced stages. This study aimed to investigate sociocultural barriers that contribute to delayed presentation and diagnosis of breast cancer among women in Marrakesh, Morocco. Qualitative interviews were conducted with 25 breast cancer patients who received care at the CHU Mohammed VI Hospital in Marrakesh to elicit barriers to diagnosis and treatment and ease of access to care. Interviews with breast cancer patients revealed several themes regarding structural and sociocultural barriers to initial diagnosis and treatment. Structural barriers included high treatment-associated costs for patients and their families, burden of transportation to central treatment centers, and limited access to appropriate health care resources. Sociocultural barriers included perceived attack on one's identity associated with breast cancer diagnosis and treatment, influence of the local community, and ideas of faith, spirituality, and conception of death. Findings from this study can help identify areas for improved access and education of patients in order to improve breast cancer diagnostic and treatment efforts and enhance opportunities for early detection.



https://ift.tt/2HlZ87D

Attitude Towards End of Life Communication of Austrian Medical Students

Abstract

Medical students have to acquire theoretical knowledge, practical skills, and a personal attitude to meet the emerging needs of palliative care. The present study aimed to assess the personal attitude of Austrian medical students towards end of life communication (EOLC), as key part of palliative care. This cross-sectional, mono-institutional assessment invited all medical students at the Medical University of Vienna in 2015. The assessment was conducted web-based via questionnaire about attitudes towards EOLC. Additional socio-demographic and medical education-related parameters were collected. Overall, 743 medical students participated in the present report. Differences regarding the agreement or disagreement to several statements concerning the satisfaction of working with chronically ill patients, palliative care, and health care costs, as well as the extent of information about palliative disease, were found for age, gender, and academic years. The overall attitude towards EOLC in the present sample can be regarded as quite balanced. Nevertheless, a considerable number of medical students are still reluctant to inform patients about their incurable disease. Reservations towards palliative care as part of the health care system seem to exist. The influence of the curriculum as well as practical experiences seems to be important but needs further investigation.



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Sociocultural Barriers Related to Late-Stage Presentation of Breast Cancer in Morocco

Abstract

Breast cancer is the most prevalent cancer affecting women globally and in Morocco, where more than one fourth of patients are diagnosed at advanced stages. This study aimed to investigate sociocultural barriers that contribute to delayed presentation and diagnosis of breast cancer among women in Marrakesh, Morocco. Qualitative interviews were conducted with 25 breast cancer patients who received care at the CHU Mohammed VI Hospital in Marrakesh to elicit barriers to diagnosis and treatment and ease of access to care. Interviews with breast cancer patients revealed several themes regarding structural and sociocultural barriers to initial diagnosis and treatment. Structural barriers included high treatment-associated costs for patients and their families, burden of transportation to central treatment centers, and limited access to appropriate health care resources. Sociocultural barriers included perceived attack on one's identity associated with breast cancer diagnosis and treatment, influence of the local community, and ideas of faith, spirituality, and conception of death. Findings from this study can help identify areas for improved access and education of patients in order to improve breast cancer diagnostic and treatment efforts and enhance opportunities for early detection.



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Attitude Towards End of Life Communication of Austrian Medical Students

Abstract

Medical students have to acquire theoretical knowledge, practical skills, and a personal attitude to meet the emerging needs of palliative care. The present study aimed to assess the personal attitude of Austrian medical students towards end of life communication (EOLC), as key part of palliative care. This cross-sectional, mono-institutional assessment invited all medical students at the Medical University of Vienna in 2015. The assessment was conducted web-based via questionnaire about attitudes towards EOLC. Additional socio-demographic and medical education-related parameters were collected. Overall, 743 medical students participated in the present report. Differences regarding the agreement or disagreement to several statements concerning the satisfaction of working with chronically ill patients, palliative care, and health care costs, as well as the extent of information about palliative disease, were found for age, gender, and academic years. The overall attitude towards EOLC in the present sample can be regarded as quite balanced. Nevertheless, a considerable number of medical students are still reluctant to inform patients about their incurable disease. Reservations towards palliative care as part of the health care system seem to exist. The influence of the curriculum as well as practical experiences seems to be important but needs further investigation.



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Attitude Towards End of Life Communication of Austrian Medical Students

Abstract

Medical students have to acquire theoretical knowledge, practical skills, and a personal attitude to meet the emerging needs of palliative care. The present study aimed to assess the personal attitude of Austrian medical students towards end of life communication (EOLC), as key part of palliative care. This cross-sectional, mono-institutional assessment invited all medical students at the Medical University of Vienna in 2015. The assessment was conducted web-based via questionnaire about attitudes towards EOLC. Additional socio-demographic and medical education-related parameters were collected. Overall, 743 medical students participated in the present report. Differences regarding the agreement or disagreement to several statements concerning the satisfaction of working with chronically ill patients, palliative care, and health care costs, as well as the extent of information about palliative disease, were found for age, gender, and academic years. The overall attitude towards EOLC in the present sample can be regarded as quite balanced. Nevertheless, a considerable number of medical students are still reluctant to inform patients about their incurable disease. Reservations towards palliative care as part of the health care system seem to exist. The influence of the curriculum as well as practical experiences seems to be important but needs further investigation.



https://ift.tt/2F7d6UT

Gene Expression Profiles in Chemokine (C-C Motif) Ligand 21-Overexpressing Pancreatic Cancer Cells

Abstract

Chemokine (C-C Motif) ligand 21 (CCL21) plays an important role in tumor immunity. However, the molecular mechanisms by which CCL21 regulates tumor immunity remain largely unknown. In this study, we successfully generated a lentiviral vector expressing human CCL21 (Lenti-hCCL21), which was confirmed by biological assays. The Lenti-hCCL21 was transduced into PANC-1 cells, a chemokine (C-C motif) receptor 7 (CCR7)-positive human pancreatic cancer cell line. We used the scratch wound and transwell assays to measure cell migration of the CCL21-overexpressing PANC-1 cells. A DNA microarray assay was performed to determine gene expression profiles. The results showed that CCL21 lentiviral transduction significantly up- or down-regulated a panel of tumor-associated genes, although CCL21 appeared to have no effect on PANC-1 cell migration. Importantly, CCL21 promoted matrix metallopeptidase-9 (MMP-9) expression in PANC-1 cells. CCL21 regulates pancreatic cancer immunity possibly through governing the expression of a panel of tumor-associated genes, including MMP-9.



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Gene Expression Profiles in Chemokine (C-C Motif) Ligand 21-Overexpressing Pancreatic Cancer Cells

Abstract

Chemokine (C-C Motif) ligand 21 (CCL21) plays an important role in tumor immunity. However, the molecular mechanisms by which CCL21 regulates tumor immunity remain largely unknown. In this study, we successfully generated a lentiviral vector expressing human CCL21 (Lenti-hCCL21), which was confirmed by biological assays. The Lenti-hCCL21 was transduced into PANC-1 cells, a chemokine (C-C motif) receptor 7 (CCR7)-positive human pancreatic cancer cell line. We used the scratch wound and transwell assays to measure cell migration of the CCL21-overexpressing PANC-1 cells. A DNA microarray assay was performed to determine gene expression profiles. The results showed that CCL21 lentiviral transduction significantly up- or down-regulated a panel of tumor-associated genes, although CCL21 appeared to have no effect on PANC-1 cell migration. Importantly, CCL21 promoted matrix metallopeptidase-9 (MMP-9) expression in PANC-1 cells. CCL21 regulates pancreatic cancer immunity possibly through governing the expression of a panel of tumor-associated genes, including MMP-9.



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Sociocultural Barriers Related to Late-Stage Presentation of Breast Cancer in Morocco

Abstract

Breast cancer is the most prevalent cancer affecting women globally and in Morocco, where more than one fourth of patients are diagnosed at advanced stages. This study aimed to investigate sociocultural barriers that contribute to delayed presentation and diagnosis of breast cancer among women in Marrakesh, Morocco. Qualitative interviews were conducted with 25 breast cancer patients who received care at the CHU Mohammed VI Hospital in Marrakesh to elicit barriers to diagnosis and treatment and ease of access to care. Interviews with breast cancer patients revealed several themes regarding structural and sociocultural barriers to initial diagnosis and treatment. Structural barriers included high treatment-associated costs for patients and their families, burden of transportation to central treatment centers, and limited access to appropriate health care resources. Sociocultural barriers included perceived attack on one's identity associated with breast cancer diagnosis and treatment, influence of the local community, and ideas of faith, spirituality, and conception of death. Findings from this study can help identify areas for improved access and education of patients in order to improve breast cancer diagnostic and treatment efforts and enhance opportunities for early detection.



https://ift.tt/2HlZ87D

Sociocultural Barriers Related to Late-Stage Presentation of Breast Cancer in Morocco

Abstract

Breast cancer is the most prevalent cancer affecting women globally and in Morocco, where more than one fourth of patients are diagnosed at advanced stages. This study aimed to investigate sociocultural barriers that contribute to delayed presentation and diagnosis of breast cancer among women in Marrakesh, Morocco. Qualitative interviews were conducted with 25 breast cancer patients who received care at the CHU Mohammed VI Hospital in Marrakesh to elicit barriers to diagnosis and treatment and ease of access to care. Interviews with breast cancer patients revealed several themes regarding structural and sociocultural barriers to initial diagnosis and treatment. Structural barriers included high treatment-associated costs for patients and their families, burden of transportation to central treatment centers, and limited access to appropriate health care resources. Sociocultural barriers included perceived attack on one's identity associated with breast cancer diagnosis and treatment, influence of the local community, and ideas of faith, spirituality, and conception of death. Findings from this study can help identify areas for improved access and education of patients in order to improve breast cancer diagnostic and treatment efforts and enhance opportunities for early detection.



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Resolution of Metastatic Colon Cancer upon Withdrawal of Anti-TNF Therapy for Crohn’s Disease



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Resolution of Metastatic Colon Cancer upon Withdrawal of Anti-TNF Therapy for Crohn’s Disease



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Progress in preventive therapy for cancer: a reminiscence and personal viewpoint

Progress in preventive therapy for cancer: a reminiscence and personal viewpoint

Progress in preventive therapy for cancer: a reminiscence and personal viewpoint, Published online: 23 April 2018; doi:10.1038/s41416-018-0039-4

Progress in preventive therapy for cancer: a reminiscence and personal viewpoint

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Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis

Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis

Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis, Published online: 23 April 2018; doi:10.1038/s41416-018-0065-2

Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis

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Progress in preventive therapy for cancer: a reminiscence and personal viewpoint

Progress in preventive therapy for cancer: a reminiscence and personal viewpoint

Progress in preventive therapy for cancer: a reminiscence and personal viewpoint, Published online: 23 April 2018; doi:10.1038/s41416-018-0039-4

Progress in preventive therapy for cancer: a reminiscence and personal viewpoint

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Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis

Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis

Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis, Published online: 23 April 2018; doi:10.1038/s41416-018-0065-2

Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis

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Generation and characterization of a paclitaxel-resistant human gastric carcinoma cell line

The main aim of this study was to establish a novel paclitaxel (PTX)-resistant human gastric carcinoma cell line and to investigate its biological significance. A cell line, MGC803/PTX, was established by gradually increasing PTX density on the basis of MGC803 over a period of 10 months. In addition, a pair of resistant cell lines (SW620 and SW620/PTX) were added to further explain the resistant mechanism of PTX. The drug resistance index and stability of MGC803/PTX cells were detected using the Cell Counting Kit-8 method. The morphological features were observed using inverted microscopy. Apoptosis was measured by flow cytometry (FCM) and Hoechst 33258 fluorescence staining. The distribution of the cell cycle was determined by FCM, and protein expressions of P-gp, Bcl-2, Bax, and PARP were detected by western blot analysis. When characterizing the resistance in vitro, we found that MGC803/PTX cells were 10.3-fold more resistant to PTX compared with MGC803 cells. In addition, MGC803/PTX cells showed cross-resistance to 5-fluorouracil and adriamycin. FCM and Hoechst 33258 fluorescence staining indicated that MGC803/PTX cells had a significantly lower percentage of apoptotic cells after treatment with PTX compared with MGC803 cells. Other differences between parental cells and resistant cells included morphology, proliferation rate, doubling time, cell cycle distribution, and colony-formation rate. Western blot analysis indicated that P-gp, Bcl-2, and PARP protein were more abundant in MGC803/PTX and SW620/PTX cells compared with MGC803 and SW620 cells, whereas Bax protein levels were lower in resistant cells. Furthermore, MGC803/PTX cells showed obvious resistance to PTX in vivo. To our knowledge, this is the first report on the establishment of a PTX-resistant MGC803 cell line, which is an important tool to explore the resistance of anticancer drugs and to overcome tumor drug resistance. * Ling Fu, Fen Yin and Xiao-Rui Li contributed equally to the writing of this article. Correspondence to Dr Hong-Min Liu, Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, Henan Province, China Tel: +86 371 6778 1908; fax: +86 371 6778 1890; e-mail: liuhm@zzu.edu.cn Received September 27, 2017 Accepted January 11, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Generation and characterization of a paclitaxel-resistant human gastric carcinoma cell line

The main aim of this study was to establish a novel paclitaxel (PTX)-resistant human gastric carcinoma cell line and to investigate its biological significance. A cell line, MGC803/PTX, was established by gradually increasing PTX density on the basis of MGC803 over a period of 10 months. In addition, a pair of resistant cell lines (SW620 and SW620/PTX) were added to further explain the resistant mechanism of PTX. The drug resistance index and stability of MGC803/PTX cells were detected using the Cell Counting Kit-8 method. The morphological features were observed using inverted microscopy. Apoptosis was measured by flow cytometry (FCM) and Hoechst 33258 fluorescence staining. The distribution of the cell cycle was determined by FCM, and protein expressions of P-gp, Bcl-2, Bax, and PARP were detected by western blot analysis. When characterizing the resistance in vitro, we found that MGC803/PTX cells were 10.3-fold more resistant to PTX compared with MGC803 cells. In addition, MGC803/PTX cells showed cross-resistance to 5-fluorouracil and adriamycin. FCM and Hoechst 33258 fluorescence staining indicated that MGC803/PTX cells had a significantly lower percentage of apoptotic cells after treatment with PTX compared with MGC803 cells. Other differences between parental cells and resistant cells included morphology, proliferation rate, doubling time, cell cycle distribution, and colony-formation rate. Western blot analysis indicated that P-gp, Bcl-2, and PARP protein were more abundant in MGC803/PTX and SW620/PTX cells compared with MGC803 and SW620 cells, whereas Bax protein levels were lower in resistant cells. Furthermore, MGC803/PTX cells showed obvious resistance to PTX in vivo. To our knowledge, this is the first report on the establishment of a PTX-resistant MGC803 cell line, which is an important tool to explore the resistance of anticancer drugs and to overcome tumor drug resistance. * Ling Fu, Fen Yin and Xiao-Rui Li contributed equally to the writing of this article. Correspondence to Dr Hong-Min Liu, Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, Henan Province, China Tel: +86 371 6778 1908; fax: +86 371 6778 1890; e-mail: liuhm@zzu.edu.cn Received September 27, 2017 Accepted January 11, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Progress in preventive therapy for cancer: a reminiscence and personal viewpoint



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Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis



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Progress in preventive therapy for cancer: a reminiscence and personal viewpoint



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Impact of NICE guidance on tamoxifen prescribing in England 2011–2017: an interrupted time series analysis



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Outcomes of Anesthesia Selection in Endovascular Treatment of Acute Ischemic Stroke

Background: The association between anesthesia type and outcomes in patients with acute ischemic stroke undergoing endovascular treatment (EVT) remains a subject of ongoing debate. Methods: This prospective nonrandomized controlled trial included 149 consecutive patients with acute anterior circulation stroke who underwent EVT. The primary outcome was functional independence assessed by the modified Rankin Scale (mRS) after 3 months. Results: A total of 105 (70.5%) and 44 (29.5%) patients undergoing EVT who received conscious sedation (CS) and general anesthesia (GA), respectively. The patients who received GA had similar demographics and basic National Institute of Health Stroke Scale scores (17 vs. 16, P>0.05) as the patients who received CS. The recanalization time (304 vs. 311 min, P=0.940) and the recanalization rate (86.4% vs. 84.1%, P=0.170) did not differ between the patients receiving the different types of anesthesia. The National Institute of Health Stroke Scale at 24 hours was lower in the patients who received CS than in those who received GA (β=−2.26, 95% confidence interval, −5.30 to 0.79). The independence (modified Rankin Scale score 0 to 2) at 3 months was equal between patients who received GA and those who received CS (odds ratio=0.73, 95% confidence interval, 0.32-1.68). The mortality and the morbidity rates did not differ. Conclusions: The data indicated that the selection of GA or CS during EVT had no impact on the independent outcomes of patients with anterior circulation occlusion. Z.M. and R.H. contributed equally. Y.P., Z.M., and R.H.: helped with the study design and manuscript preparation. Y.W., J.L., and F.L.: helped with the data collection and manuscript preparation. X.H. helped with the patient recruitment. X.L. and Y.Z.: helped with the data collection. P.W. and Y.P.: helped with the data analyses. Clinical Trial Registration: www.clinicaltrials.gov (NCT02350283). The trial was funded by the 'Youth Program' (QML20150508) and Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201708) from the Beijing Municipal Administration of Hospitals and programs from National Science and Technology Major Project of China (2011BAI08B02, 2015BAI12B04, and 2015BAI12B02). The authors have no conflicts of interest to disclose. Address correspondence to: Ruquan Han, MD, PhD, Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xili, Dongcheng District, Beijing 100050, PR China (e-mail: ruquan.han@gmail.com). Received November 28, 2017 Accepted March 12, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

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Effect of Dexmedetomidine on Cerebral Vasospasm and Associated Biomarkers in a Rat Subarachnoid Hemorrhage Model

Background: The α2 adrenergic agonist dexmedetomidine (DEX) has huge potential for protecting against cerebral vasospasm, a leading cause of death and disability after subarachnoid hemorrhage (SAH). Biomarker assays for SAH have recently emerged as tools for predicting vasospasm and outcomes. We investigated the effects of DEX on vasospasm and assessed relevant biomarkers in a rat SAH model. Methods: Male Wistar rats were randomly assigned to sham (n=10), vehicle (n=10), SAH (n=10), or SAH+ DEX (n=10) groups. The SAH and SAH+DEX groups received 0.3 mL injections of autologous blood into the cisterna magna, followed by intraperitoneal injections of normal saline or 10 μg/kg DEX. Forty-eight hours later, neurological deficits as well as the basilar artery (BA) wall thickness and cross-sectional area were measured. Cerebrospinal fluid (CSF) and blood samples were obtained to assess concentrations of interleukin (IL)-6, C-reactive protein (CRP), endothelin-1, and S100-β using enzyme-linked immunosorbent assays. Results: The SAH and SAH+DEX groups exhibited deteriorated neurological function as well as structural and morphological BA vasospasm. The SAH+DEX group showed an improved neurological function score (ie, a 52% decrease), a 10% reduction in wall thickness, and a BA cross-sectional area enlarged by 157%. Compared with the sham group, CSF levels of IL-6 and CRP in the SAH and SAH+DEX groups, as well as serum IL-6 and CRP levels in the SAH group, were significantly elevated. The SAH+DEX group showed significantly lower CSF IL-6 levels than the SAH group. Serum and CSF levels of endothelin-1 and S100-β were similar across all groups. Conclusions: DEX administration reduced the severity of cerebral vasospasm and improved neurological function in SAH rats; this may be closely linked to reduced CSF IL-6 levels. This study was supported by special research grant funded by the Korean Society of Neuroscience in Anesthesiology and Critical Care (KSNACC-2016) for Young Song. The remaining authors have no conflicts of interest to disclose. Address correspondence to: Dong Woo Han, MD, PhD, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul 06273, Republic of Korea (e-mail: hanesth@yuhs.ac). Received November 22, 2017 Accepted March 27, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

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Intracranial Space–occupying Lesion Inducing Intracranial Hypertension Increases the Encephalographic Effects of Isoflurane in a Swine Model

Background: Patients with a brain tumor are susceptible to the hypnotic effect of anesthetics depending on the tumor's size. We investigated whether intracranial space–occupying lesions (ICSOLs) inducing intracranial hypertension increase isoflurane's effect on electroencephalographic (EEG) results. Materials and Methods: After anesthetic induction with isoflurane, 11 swine were studied with regard to isoflurane's effect on EEGs at 0.5% to 2.0% inhalational concentration at sequential stages: baseline 1, ICSOL 1, baseline 2, ICSOL 2, baseline 3. At each ICSOL stage, an intracranial epidural balloon catheter was inflated and the intracranial pressure maintained at twice the baseline pressure. The balloon was deflated after each ICSOL stage (baselines 2 and 3). A 95% spectral edge frequency (SEF), which correlates with anesthetic hypnosis, was used to measure isoflurane's effect. Pharmacodynamics was characterized using a sigmoidal inhibitory maximum effect model for the SEF versus end-tidal concentration. Results: ICSOL shifted the relations between SEF and the effect-site concentration (Ce) downward. Baseline and 50% of the maximum spectral edge effect levels significantly decreased during balloon inflation. The Ce that produced SEF=15 was 1.12 (1.04-1.20) (mean [95% confidence interval])% for baseline 1; 0.92 (0.81-1.03) for ICSOL 1; 1.02 (0.94-1.11) for baseline 2; 0.88 (0.82-0.94) for ICSOL 2; 1.05 (0.93-1.17) for baseline 3. Isoflurane's effect on EEGs increased during balloon inflation, with the alteration tending to recover after balloon deflation. Conclusions: ICSOLs inducing intracranial hypertension increase the EEG effect of isoflurane, and external compression from the brain surface enhances the anesthetic hypnosis despite minimum brain injury. Support was provided solely from institutional and/or departmental sources. The authors have no conflicts of interest to disclose. Address correspondence to: Tadayoshi Kurita, MD, Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan (e-mail: tadkur@hama-med.ac.jp). Received December 20, 2017 Accepted March 22, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

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Correlation with lymphocyte infiltration, but lack of prognostic significance of MECA-79-positive high endothelial venules in primary malignant melanoma

High endothelial venules (HEVs) are specialized vessels in lymphoid organs, supporting lymphocyte trafficking from the blood. As the presence of these vessels was described recently in tumors, it was proposed that they could facilitate the development of antitumor immune response, resulting in improved prognosis. The aim of our study was to analyze the correlation of the density of HEVs with that of the different immune cell types as well as with the clinicopathologic parameters and the disease outcomes in patients with cutaneous melanoma. Primary melanoma samples of 118 patients were analyzed retrospectively by immunohistochemical labeling and quantitation of vessels stained with the MECA-79 antibody, as well as a panel of eight different immune cell types (CD8+ and CD45RO+ T cells, lymphocytes expressing the CD25, CD134, or CD137 activation markers, FOXP3+ regulatory T cells, CD20+ B cells, and DC-LAMP+ mature dendritic cells). Correlations of MECA-79+ vessel density with that of the immune cells, as well as with clinicopathologic parameters and disease outcomes were evaluated. We showed that the number of MECA-79+ vessels correlates strongly with the peritumoral density of B and T lymphocytes. Moreover, higher HEV numbers were detected in tumors hosting tertiary lymphoid structures as well as in those of axial location compared with the ones in the extremity and in men compared with women, whereas no association was found with patient age, tumor thickness, histologic type or ulceration, or with the survival of melanoma patients. The density of MECA-79+ HEVs in primary melanomas shows a correlation with B and T-lymphocyte density and differences according to the presence of tertiary lymphoid structures, tumor site, and the sex of the patient. However, it has no prognostic value. Correspondence to Andrea Ladányi, PhD, Department of Surgical and Molecular Pathology, National Institute of Oncology, 7–9. Ráth György u., Budapest H-1122, Hungary Tel: +36 12 248 600; e-mail: ladanyi@oncol.hu Received November 28, 2017 Accepted April 4, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Surveying the Literature: Synopsis of Recent Key Publications

No abstract available

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A Randomized Trial Comparing the Effect of Fiberoptic Selection and Guidance Versus Random Selection, Blind Insertion, and Direct Laryngoscopy, on the Incidence and Severity of Epistaxis After Nasotracheal Intubation

BACKGROUND: Epistaxis, or nasal bleeding, is a common complication after nasotracheal intubation (NTI). Because such bleeding is likely related to trauma during intubation, use of fiberoptic visualization and guidance rather than direct laryngoscopy may affect the incidence and severity of epistaxis. We compared the incidence of epistaxis after NTI using a fiberoptic versus a direct laryngoscopy approach. METHODS: Seventy patients who were able to breathe easily through unobstructed nostrils and required NTI as part of their anesthetic management were recruited. Exclusion criteria included unequal nasal airflow, nostril obstruction, previous nasal trauma or surgery, and coagulation abnormalities as determined by history. Patients were randomly assigned to undergo NTI with thermosoftened Mallinckrodt nasal Ring-Adair-Elwyn (RAE) tubes via either traditional direct laryngoscopy using a Macintosh blade or fiberoptic nasal intubation. All patients first underwent anesthetic induction and were randomized to blind or fiberoptic groups. Patients in the blind insertion/direct laryngoscopy group were then intubated via a randomly selected nostril. Patients in the fiberoptic group underwent an asleep nasal fiberoptic examination to determine the most patent nostril, followed by tube insertion under fiberoptic guidance. Ten minutes after NTI, the incidence and severity of epistaxis were evaluated and graded by the surgeon, who was blinded to the intubation method. RESULTS: Initial nasal fiberoptic endoscopy identified asymptomatic nasal pathology in 51% of patients: inferior turbinate hypertrophy (28.6%) and deviation of the nasal septum in (22.8%). The incidence of epistaxis was higher in the blind insertion/direct laryngoscopy group (88%) than in the fiberoptic group (51%; relative risk, 0.55; 95% confidence interval, 0.38–0.79; P = .0011). The severity of bleeding was also greater in the blind tube insertion/direct laryngoscopy cohort (Wilcoxon Mann-Whitney odds, 3.5; 95% confidence interval, 1.8–11.1). CONCLUSIONS: Fiberoptic nostril selection and guidance during NTI reduced the incidence and severity of epistaxis when compared with NTI performed via blind insertion and direct laryngoscopy. Accepted for publication March 14, 2018. Funding: None. Conflicts of Interest: See Disclosures at the end of the article. Reprints will not be available from the authors. Address correspondence to Jeffrey Leighton Tong, MD, FRCA, Department of Anesthesia and Critical Care, University of Chicago, 5841 S Maryland Ave, MC4028, Chicago, IL 60637. Address e-mail to jtong4@dacc.uchicago.edu. © 2018 International Anesthesia Research Society

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Caution When Dosing Anesthetic Medications: Are We Putting Too Much Weight on Patient Weight?

No abstract available

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Comprehensive Pain Management in the Rehabilitation Patient

No abstract available

https://ift.tt/2HSpZ83

Can Lung Ultrasound Be the First-Line Tool for Evaluation of Intraoperative Hypoxemia?

No abstract available

https://ift.tt/2F7YR22

Hyperchloremic Intravenous Fluids Should Be Abandoned

No abstract available

https://ift.tt/2HQ9MQQ

Practical Anesthetic Management: The Art of Anesthesiology

No abstract available

https://ift.tt/2F6Tr7u

In Response

No abstract available

https://ift.tt/2HUijT2

Harmful or Physiologic: Diagnosing Fibrinolysis Shutdown in a Trauma Cohort With Rotational Thromboelastometry

BACKGROUND: Despite its central role in early trauma coagulopathy, abnormal fibrinolysis continues to be poorly understood. Excessive fibrinolysis is a known contributor to mortality. Recent studies with thromboelastography (TEG) suggest decreased fibrinolysis (or shutdown) may be just as harmful. Considering the broad use of 2 different viscoelastic assays, which are not interchangeable, we proposed for the first time to define and characterize fibrinolysis shutdown using rotational thromboelastometry (ROTEM). METHODS: Retrospective cohort study of severely injured patients with admission ROTEM. Shutdown was defined by the best Youden index value of the maximum lysis. Fibrinolysis phenotypes were physiologic, hyperfibrinolysis, and shutdown. Multivariable logistic regression evaluated association between Injury Severity Score and the fibrinolysis phenotypes, and the association among shutdown phenotype with mortality, blood transfusion, and thrombotic events. RESULTS: Five hundred fifty patients were included. Maximum lysis

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In Response

No abstract available

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Pharmacological Basis of Anesthesia: How to Overcome Stagnation?

No abstract available

https://ift.tt/2F7YtAC

Transesophageal Lung Ultrasound Should Be the First-Line Tool to Evaluate Intraoperative Hypoxia

No abstract available

https://ift.tt/2HRatcL

Gender Distribution of the American Board of Anesthesiology Diplomates, Examiners, and Directors (1985–2015)

To understand the potential role of women in leadership positions, data from the American Board of Anesthesiology (ABA) were analyzed to explore the impact of women in the specialty of anesthesiology. The number of newly certified ABA diplomates, oral examiners, and directors from 1985 to 2015 was obtained from the ABA database. The percentages of women in each group were calculated for each year. Because it took an average of 10 years for a diplomate to become an oral examiner and an average of 7 years for an oral examiner to be elected as a director during the study period, the following percentages were compared: women oral examiners versus newly certified women diplomates 10 years prior and women directors versus women oral examiners 7 years prior. The correlation coefficients between the percentages of women oral examiners and of newly certified women diplomates 10 years prior and between the percentages of women directors and women oral examiners 7 years prior were calculated. From 1985 to 2015, the percentage of newly certified women diplomates increased from 15% to 38% with an average annual increase of 0.74%, percentage of women oral examiners increased from 8% to 26% with an average annual increase of 0.63%, and percentage of women directors increased from 8% to 25% with an average annual increase of 0.56%. The percentage of women examiners consistently lagged behind the percentage of women diplomates who were certified 10 years earlier; the average difference over 21 years from 1995 to 2015 was −3.7% with a standard deviation of 2.1%. The correlation coefficient between the percentages of women examiners and newly certified women diplomates 10 years earlier from 1995 to 2015 was 0.86 (P

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The Brachiocephalic Vein as a Safe and Viable Alternative to Internal Jugular Vein for Central Venous Cannulation

BACKGROUND: Although many studies have compared success and complication rates for central line insertion sites with and without ultrasound, few have examined the use of the brachiocephalic vein for central venous access. The aim of this study was to describe the brachiocephalic vein as an alternative site for elective ultrasound vascular cannulation in adults, and to compare it with the more commonly used internal jugular vein site in terms of procedural difficulties, first pass failure rate, overall failure rate, and safety. METHODS: In this single-center, retrospective cohort study, clinical data from consecutive adult patients undergoing elective ultrasound-guided central venous catheterization of upper body were retrieved from the department database. All of these central venous catheters were requested by department team, none was positioned for surgery. Seven hundred nine patients underwent central venous catheterization via the internal jugular approach and 285 patients via the brachiocephalic route. Patients catheterized via the brachiocephalic vein approach were then compared with those catheterized via the internal jugular vein in terms of ease of catheterization, success rate, and complications. Differences between approaches were assessed by univariate analyses and multivariable analysis. RESULTS: Overall, 994 patients underwent central venous catheterization. A total of 87% had a successful catheter implantation at the first attempt, 6.7% of insertions were difficult, 5.7% were complicated, and 3.4% failed. Procedural difficulty was more frequent with the internal jugular than with the brachiocephalic approach (odds ratio, 0.38; 95% confidence interval, 0.19–0.76; P = .007) after correction for potential confounders. Differences between groups in complication rate (6.3% vs 4.1%) or failure rate (3.4% vs 3.5%) were not significant. CONCLUSIONS: Brachiocephalic cannulation is a reasonable alternative to ultrasound-guided internal jugular vein catheterization. Accepted for publication February 26, 2018. Funding: None. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). Reprints will not be available from the authors. Address correspondence to Paolo Federico Beccaria, MD, Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132 Italy. Address e-mail to beccaria.paolo@hsr.it. © 2018 International Anesthesia Research Society

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Prognostic Significance of Nodal Location and Ratio in Stage IIIC Endometrial Carcinoma Among a Multi-Institutional Academic Collaboration

Purpose/Objective(s): Stage IIIC endometrial carcinoma (EC) represents pathologically heterogenous patients with single/multiple pelvic (stage IIIC1) or paraaortic (stage IIIC2) lymph nodes (LNs). There is an increasing trend to offer adjuvant chemotherapy (CT) +/− radiation (RT) uniformly to these patients, regardless of substage. We investigate the prognostic significance of positive LN (pLN) number, ratio (%pLN), location (IIC1 vs. IIC2), and adjuvant treatment on patterns of failure and survival in a large collaborative multi-institutional series. Materials and Methods: Clinical data for stage III EC patients such as patient characteristics, surgery/pathologic details, adjuvant therapies (including CT, RT, and chemotherapy and radiation), and outcomes (including pelvic control [PC], disease-free survival [DFS], distant DFS, and overall survival [OS]) were collected from 3 academic institutions. Log-rank analyses, Cox regression univariate and multivariate analyses were performed. Results: Of the 264 patients queried for stage III disease, 237 (73%) had pLN, and complete LN sampling for analysis. The mean number of pLN in the combined data were 3.9, with 26.1% of all LN sampled positive; 121 patients (51%) staged IIIC1, and 116 patients (49%) staged IIIC2. There was a significant difference in number of pLN (P=0.0006) and total LN sampled by institution (range, 13 to 35; P=0.0004), without a difference in %pLN (P=0.35). Ninety-seven of 220 (44.1%) have ≥20% pLN. While controlling for substage and institution, a decrease in DFS (hazard ratio [HR], 1.1; P=0.007), and OS (HR, 1.1; P=0.01) was observed with every increase of 10% in the pLN ratio. There was a significant difference in DFS (HR, 1.8; P=0.003), PC (HR, 1.9; P=0.004), and distant DFS (HR, 1.6; P=0.03), as well as a trend for decreased OS (HR, 1.6; P=0.08) for substage IIIC2 versus IIIC1 disease; 5 years DFS 40% versus 45%, OS 50% versus 57%. Patients received no adjuvant therapy (10%), CT alone (27%), RT alone (16%), or chemotherapy and radiation (47%). There was no significant difference in PC, DFS, or OS between the various treatment regimens. On univariate analysis, while pLN was significant, treatment type did not impact DFS or OS. On multivariate analysis for DFS, patient age, race, and IIIC1 versus IIIC2 substage retained significance (HR, 0.56; P=0.01). Conclusions: Stage III EC patients with substage IIIC2 disease have a significantly increased risk of local and distant disease recurrence and death from EC. A decrease in DFS and OS was observed with every increase of 10% in the pLN ratio. Stage IIIC2 patients represent a high-risk subpopulation for whom clinical trials, or targeted regimens should be explored to achieve improved oncologic outcomes. The authors declare no conflicts of interest. Reprints: Jyoti Mayadev, MD, Department of Radiation Oncology, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093. E-mail: jmayadev@ucsd.edu. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Prognostic Significance of Nodal Location and Ratio in Stage IIIC Endometrial Carcinoma Among a Multi-Institutional Academic Collaboration

Purpose/Objective(s): Stage IIIC endometrial carcinoma (EC) represents pathologically heterogenous patients with single/multiple pelvic (stage IIIC1) or paraaortic (stage IIIC2) lymph nodes (LNs). There is an increasing trend to offer adjuvant chemotherapy (CT) +/− radiation (RT) uniformly to these patients, regardless of substage. We investigate the prognostic significance of positive LN (pLN) number, ratio (%pLN), location (IIC1 vs. IIC2), and adjuvant treatment on patterns of failure and survival in a large collaborative multi-institutional series. Materials and Methods: Clinical data for stage III EC patients such as patient characteristics, surgery/pathologic details, adjuvant therapies (including CT, RT, and chemotherapy and radiation), and outcomes (including pelvic control [PC], disease-free survival [DFS], distant DFS, and overall survival [OS]) were collected from 3 academic institutions. Log-rank analyses, Cox regression univariate and multivariate analyses were performed. Results: Of the 264 patients queried for stage III disease, 237 (73%) had pLN, and complete LN sampling for analysis. The mean number of pLN in the combined data were 3.9, with 26.1% of all LN sampled positive; 121 patients (51%) staged IIIC1, and 116 patients (49%) staged IIIC2. There was a significant difference in number of pLN (P=0.0006) and total LN sampled by institution (range, 13 to 35; P=0.0004), without a difference in %pLN (P=0.35). Ninety-seven of 220 (44.1%) have ≥20% pLN. While controlling for substage and institution, a decrease in DFS (hazard ratio [HR], 1.1; P=0.007), and OS (HR, 1.1; P=0.01) was observed with every increase of 10% in the pLN ratio. There was a significant difference in DFS (HR, 1.8; P=0.003), PC (HR, 1.9; P=0.004), and distant DFS (HR, 1.6; P=0.03), as well as a trend for decreased OS (HR, 1.6; P=0.08) for substage IIIC2 versus IIIC1 disease; 5 years DFS 40% versus 45%, OS 50% versus 57%. Patients received no adjuvant therapy (10%), CT alone (27%), RT alone (16%), or chemotherapy and radiation (47%). There was no significant difference in PC, DFS, or OS between the various treatment regimens. On univariate analysis, while pLN was significant, treatment type did not impact DFS or OS. On multivariate analysis for DFS, patient age, race, and IIIC1 versus IIIC2 substage retained significance (HR, 0.56; P=0.01). Conclusions: Stage III EC patients with substage IIIC2 disease have a significantly increased risk of local and distant disease recurrence and death from EC. A decrease in DFS and OS was observed with every increase of 10% in the pLN ratio. Stage IIIC2 patients represent a high-risk subpopulation for whom clinical trials, or targeted regimens should be explored to achieve improved oncologic outcomes. The authors declare no conflicts of interest. Reprints: Jyoti Mayadev, MD, Department of Radiation Oncology, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093. E-mail: jmayadev@ucsd.edu. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Caring for the person with cancer: Information and support needs and the role of technology

Psycho-Oncology, EarlyView.


https://ift.tt/2K8LthA

Assessing cognitive function in patients treated with immune checkpoint inhibitors: A feasibility study

Psycho-Oncology, EarlyView.


https://ift.tt/2F72tkT

Caring for the person with cancer: Information and support needs and the role of technology

Psycho-Oncology, EarlyView.


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Assessing cognitive function in patients treated with immune checkpoint inhibitors: A feasibility study

Psycho-Oncology, EarlyView.


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Long-term continuous N-carbamylglutamate treatment in frequently decompensated propionic acidemia: a case report

Propionic acidemia is a rare autosomal recessive inherited metabolic disorder that can inhibit the synthesis of N-acetylglutamate, the obligatory activator in urea synthesis, leading to hyperammonemia. N-carbamyl...

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PLOD2 as a potential regulator of peritoneal dissemination in gastric cancer

International Journal of Cancer, EarlyView.


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HDAC5–LSD1 axis regulates antineoplastic effect of natural HDAC inhibitor sulforaphane in human breast cancer cells

International Journal of Cancer, EarlyView.


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Issue Information

International Journal of Cancer, Volume 142, Issue 12, Page 2625-2626, 15 June 2018.


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Issue Information

International Journal of Cancer, Volume 142, Issue 12, Page 2407-2413, 15 June 2018.


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HDAC5–LSD1 axis regulates antineoplastic effect of natural HDAC inhibitor sulforaphane in human breast cancer cells

International Journal of Cancer, EarlyView.


https://ift.tt/2HDPdJF

PLOD2 as a potential regulator of peritoneal dissemination in gastric cancer

International Journal of Cancer, EarlyView.


https://ift.tt/2HlZAyk

Issue Information

International Journal of Cancer, Volume 142, Issue 12, Page 2625-2626, 15 June 2018.


https://ift.tt/2HIwI74

Issue Information

International Journal of Cancer, Volume 142, Issue 12, Page 2407-2413, 15 June 2018.


https://ift.tt/2Jc0H4j

Issue Information

Pediatric Blood &Cancer, Volume 65, Issue 6, June 2018.


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High‐dose chemotherapy without whole lung radiation for refractory pulmonary metastases in an infant with stage IV favorable histology Wilms tumor

Pediatric Blood &Cancer, EarlyView.


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Role of clinical trials in survival progress of American adolescents and young adults with cancer—and lack thereof

Pediatric Blood &Cancer, EarlyView.


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Acute myelogenous leukemia in adolescents and young adults

Pediatric Blood &Cancer, EarlyView.


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Association between body mass index and pancreatitis in children with acute lymphoblastic leukemia

Pediatric Blood &Cancer, EarlyView.


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Issue Information

Pediatric Blood &Cancer, Volume 65, Issue 6, June 2018.


https://ift.tt/2JeVTLu

High‐dose chemotherapy without whole lung radiation for refractory pulmonary metastases in an infant with stage IV favorable histology Wilms tumor

Pediatric Blood &Cancer, EarlyView.


https://ift.tt/2qPYV28

Role of clinical trials in survival progress of American adolescents and young adults with cancer—and lack thereof

Pediatric Blood &Cancer, EarlyView.


https://ift.tt/2Hm39F0

Acute myelogenous leukemia in adolescents and young adults

Pediatric Blood &Cancer, EarlyView.


https://ift.tt/2qVBSmH

Association between body mass index and pancreatitis in children with acute lymphoblastic leukemia

Pediatric Blood &Cancer, EarlyView.


https://ift.tt/2Hj2bJy

DNA repair protein XPA is differentially expressed in colorectal cancer and predicts better prognosis

Cancer Medicine, EarlyView.


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Identification of four plasma microRNAs as potential biomarkers in the diagnosis of male lung squamous cell carcinoma patients in China

Cancer Medicine, EarlyView.


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Mitochondrial DNA copy number is associated with risk of head and neck squamous cell carcinoma in Chinese population

Cancer Medicine, EarlyView.


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DNA repair protein XPA is differentially expressed in colorectal cancer and predicts better prognosis

Cancer Medicine, EarlyView.


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Major pathologic response and RAD51 predict survival in lung cancer patients receiving neoadjuvant chemotherapy

Cancer Medicine, EarlyView.


https://ift.tt/2JgUh42

Overexpression of HACE1 in gastric cancer inhibits tumor aggressiveness by impeding cell proliferation and migration

Cancer Medicine, EarlyView.


https://ift.tt/2qQ9xOl

Major pathologic response and RAD51 predict survival in lung cancer patients receiving neoadjuvant chemotherapy

Cancer Medicine, EarlyView.


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Mitochondrial DNA copy number is associated with risk of head and neck squamous cell carcinoma in Chinese population

Cancer Medicine, EarlyView.


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Overexpression of HACE1 in gastric cancer inhibits tumor aggressiveness by impeding cell proliferation and migration

Cancer Medicine, EarlyView.


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Lenalidomide versus lenalidomide + dexamethasone prolonged treatment after second‐line lenalidomide + dexamethasone induction in multiple myeloma

Cancer Medicine, EarlyView.


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Lenalidomide versus lenalidomide + dexamethasone prolonged treatment after second‐line lenalidomide + dexamethasone induction in multiple myeloma

Cancer Medicine, EarlyView.


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Programmed death‐ligand 1 expression in gastric cancer: correlation with mismatch repair deficiency and HER2‐negative status

Cancer Medicine, EarlyView.


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Programmed death‐ligand 1 expression in gastric cancer: correlation with mismatch repair deficiency and HER2‐negative status

Cancer Medicine, EarlyView.


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Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

Cancer Medicine, EarlyView.


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Smoking, drinking, and depression: comorbidity in head and neck cancer patients undergoing radiotherapy

Cancer Medicine, EarlyView.


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Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

Cancer Medicine, EarlyView.


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Identification of four plasma microRNAs as potential biomarkers in the diagnosis of male lung squamous cell carcinoma patients in China

Cancer Medicine, EarlyView.


https://ift.tt/2qOlmEC

Smoking, drinking, and depression: comorbidity in head and neck cancer patients undergoing radiotherapy

Cancer Medicine, EarlyView.


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Smoking cessation drugs alone may not help people to quit

Cancer, Volume 124, Issue 9, Page 1855-1855, May 1, 2018.


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Smoking cessation drugs alone may not help people to quit

Cancer, Volume 124, Issue 9, Page 1855-1855, May 1, 2018.


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A fluid solution

Cancer, Volume 124, Issue 9, Page 1853-1854, May 1, 2018.


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Issue Information

Cancer, Volume 124, Issue 9, Page 1845-1852, May 1, 2018.


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A fluid solution

Cancer, Volume 124, Issue 9, Page 1853-1854, May 1, 2018.


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Immunotherapy and the role of imaging

Cancer, EarlyView.


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Targeting autophagy in cancer

Cancer, EarlyView.


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Issue Information

Cancer, Volume 124, Issue 9, Page 1845-1852, May 1, 2018.


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The state of survivorship care in radiation oncology: Results from a nationally distributed survey

Cancer, EarlyView.


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Meeting the needs of long‐term survivors: A testament to success in the care of patients with cancer

Cancer, EarlyView.


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Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: A prospective cohort study in Korea

Cancer, EarlyView.


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Racial disparity in oncologic and quality‐of‐life outcomes in patients with locally advanced head and neck squamous cell carcinomas enrolled in a randomized phase 2 trial

Cancer, EarlyView.


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Immunotherapy and the role of imaging

Cancer, EarlyView.


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Genetic testing for hereditary prostate cancer: Current status and limitations

Cancer, EarlyView.


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Targeting autophagy in cancer

Cancer, EarlyView.


https://ift.tt/2HT9yZp

The state of survivorship care in radiation oncology: Results from a nationally distributed survey

Cancer, EarlyView.


https://ift.tt/2HiMvWC

Meeting the needs of long‐term survivors: A testament to success in the care of patients with cancer

Cancer, EarlyView.


https://ift.tt/2HTX7fW

Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: A prospective cohort study in Korea

Cancer, EarlyView.


https://ift.tt/2F7lAez

Racial disparity in oncologic and quality‐of‐life outcomes in patients with locally advanced head and neck squamous cell carcinomas enrolled in a randomized phase 2 trial

Cancer, EarlyView.


https://ift.tt/2HQeAWf

Genetic testing for hereditary prostate cancer: Current status and limitations

Cancer, EarlyView.


https://ift.tt/2F6InHt

Pseudochylothorax Combined with Spontaneous Pneumothorax: Case Report of a Rare Complication of Rheumatoid Arthritis

Pleural involvement is the most frequent thoracic complication of rheumatoid arthritis (RA), usually occurring in patients with known RA. Typical rheumatoid pleural effusion is an exudate characterized by low pH and glucose levels and high LDH activity. Rarely, it has features of pseudochylothorax. Other uncommon complications are pneumothorax, hydropneumothorax, empyema, and bronchopleural fistula. The case of a 51-year-old man with a spontaneous, small, and asymptomatic hydropneumothorax with features of pseudochylothorax is presented. After careful clinical and laboratory evaluation, he was diagnosed with rheumatoid arthritis, and we admitted that the pleural changes were secondary to the connective tissue disease. He started immunosuppressive treatment and maintained stability during follow-up, without need of specific pleural treatment. We hypothesized that the pleural nodule found on the chest computed tomography scan was related with the simultaneous occurrence of pleural effusion and pneumothorax. This is a rare presentation and complication of RA, highlighting the utility of a comprehensive clinical and laboratory evaluation and focusing on the importance of pleural rheumatoid nodules in the pathogenesis of RA pleural disease.

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Ethnic disparity in breast cancer survival in southern Thai women

S18777821.gif

Publication date: June 2018
Source:Cancer Epidemiology, Volume 54
Author(s): Shama Virani, Elizabeth C. Wetzel, Suphawat Laohawiriyakamol, Pleumjit Boonyaphiphat, Alan Geater, Celina G. Kleer, Judy Pang, Katie M. Rentschler, Justin A. Colacino, Carlos F. Mendes de Leon, Laura S. Rozek, Hutcha Sriplung
BackgroundBreast cancer has the highest incidence in women of all cancers and its burden is expected to continue to increase worldwide, especially in middle-income countries such as Thailand. The southern region of Thailand is unique in that it is comprised of 30% Muslims, whereas the rest of Thailand is 95% Buddhist. Breast cancer incidence and survival differ between these religious groups, but the association between clinical subtype of breast cancer and survival has not yet been assessed.MethodsHere we characterized differences in breast cancer survival with consideration to clinical subtype by religious group (Muslim Thai and Buddhist Thai women). We compared distributions of age, stage and clinical subtype and assessed overall survival by religion.ResultsOur findings show that Muslim Thai women with breast cancer are diagnosed at a younger age, at later stages and have shorter overall survival times compared to Buddhist Thai women with breast cancer. We also observe a higher proportion of triple negative tumors characterized in Muslim Thai women.ConclusionsOur findings confirm previous studies that have shown lower survival rates in Muslim Thai women compared to Buddhist women with breast cancer and offer novel information on subtype distribution. To date, this is the first study assessing clinical subtypes in southern Thailand by religious status.ImpactOur findings are critical in providing information on the role of clinical subtype in cancer disparities and provide evidence from the Southeast Asian region for global studies on breast cancer survival.



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Evaluation of racial disparities in pediatric optic pathway glioma incidence: Results from the Surveillance, Epidemiology, and End Results Program, 2000–2014

S18777821.gif

Publication date: June 2018
Source:Cancer Epidemiology, Volume 54
Author(s): Erin C. Peckham-Gregory, Roberto E. Montenegro, David A. Stevenson, David H. Viskochil, Michael E. Scheurer, Philip J. Lupo, Joshua D. Schiffman
BackgroundRacial predilection to pediatric cancer exists; however optic pathway glioma (OPG) risk differences by race/ethnicity are undefined. We estimated differences in OPG incidence across racial/ethnic groups in a multi-state cancer surveillance registry in the United States.MethodsOPG data were obtained from the Surveillance, Epidemiology, and End Results (SEER-18) Program, 2000–2014. Race/ethnicity was categorized as: White; Black; Asian; Other; and Latino/a ("Spanish-Hispanic-Latino"). Latino/a included all races, while all other categories excluded those identified as Latino/a. Age-adjusted incidence rates and rate ratios (IRR) with 95% confidence intervals (CIs) were generated in SEER-STAT (v8.3.4).ResultsData on 709 OPG cases ages 0–19 were abstracted from SEER-18. Minority children experienced lower age-adjusted OPG incidence rates compared to White children (IRRBlack = 0.38, 95% CI: 0.28–0.50; IRRAsian = 0.41, 95% CI: 0.29–0.58; and IRRLatino/a = 0.39, 95% CI: 0.32–0.48). In subgroup analyses among the highest risk age categories (0–4, 5–9), minority children experienced lower incidence rates compared to White children. Specific patterns for Latinos/as also emerged. Latino/a children ages 0–4 experienced the lowest incidence rates of all racial/ethnic groups compared to Whites (0.24 per 100,000 person-years versus 0.66 per 100,000 person-years, respectively), whereas among those ages 5–9, Black and Asian children experienced the lowest incidence rates (0.08 per 100,000 person-years each).ConclusionsIncidence of OPGs was highest among White children. This study represents one of the largest to assess differences in OPG susceptibility by race/ethnicity. These findings may inform future studies that seek to evaluate modifying factors for this pediatric tumor including tumorigenesis, treatment, outcome, and long-term late effects.



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Bayesian estimates of the incidence of rare cancers in Europe

S18777821.gif

Publication date: June 2018
Source:Cancer Epidemiology, Volume 54
Author(s): Laura Botta, Riccardo Capocaccia, Annalisa Trama, Christian Herrmann, Diego Salmerón, Roberta De Angelis, Sandra Mallone, Ettore Bidoli, Rafael Marcos-Gragera, Dorota Dudek-Godeau, Gemma Gatta, Ramon Cleries
BackgroundThe RARECAREnet project has updated the estimates of the burden of the 198 rare cancers in each European country. Suspecting that scant data could affect the reliability of statistical analysis, we employed a Bayesian approach to estimate the incidence of these cancers.MethodsWe analyzed about 2,000,000 rare cancers diagnosed in 2000–2007 provided by 83 population-based cancer registries from 27 European countries. We considered European incidence rates (IRs), calculated over all the data available in RARECAREnet, as a valid a priori to merge with country-specific observed data. Therefore we provided (1) Bayesian estimates of IRs and the yearly numbers of cases of rare cancers in each country; (2) the expected time (T) in years needed to observe one new case; and (3) practical criteria to decide when to use the Bayesian approach.ResultsBayesian and classical estimates did not differ much; substantial differences (>10%) ranged from 77 rare cancers in Iceland to 14 in England. The smaller the population the larger the number of rare cancers needing a Bayesian approach. Bayesian estimates were useful for cancers with fewer than 150 observed cases in a country during the study period; this occurred mostly when the population of the country is small.ConclusionFor the first time the Bayesian estimates of IRs and the yearly expected numbers of cases for each rare cancer in each individual European country were calculated. Moreover, the indicator T is useful to convey incidence estimates for exceptionally rare cancers and in small countries; it far exceeds the professional lifespan of a medical doctor.



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Ethnic disparity in breast cancer survival in southern Thai women

S18777821.gif

Publication date: June 2018
Source:Cancer Epidemiology, Volume 54
Author(s): Shama Virani, Elizabeth C. Wetzel, Suphawat Laohawiriyakamol, Pleumjit Boonyaphiphat, Alan Geater, Celina G. Kleer, Judy Pang, Katie M. Rentschler, Justin A. Colacino, Carlos F. Mendes de Leon, Laura S. Rozek, Hutcha Sriplung
BackgroundBreast cancer has the highest incidence in women of all cancers and its burden is expected to continue to increase worldwide, especially in middle-income countries such as Thailand. The southern region of Thailand is unique in that it is comprised of 30% Muslims, whereas the rest of Thailand is 95% Buddhist. Breast cancer incidence and survival differ between these religious groups, but the association between clinical subtype of breast cancer and survival has not yet been assessed.MethodsHere we characterized differences in breast cancer survival with consideration to clinical subtype by religious group (Muslim Thai and Buddhist Thai women). We compared distributions of age, stage and clinical subtype and assessed overall survival by religion.ResultsOur findings show that Muslim Thai women with breast cancer are diagnosed at a younger age, at later stages and have shorter overall survival times compared to Buddhist Thai women with breast cancer. We also observe a higher proportion of triple negative tumors characterized in Muslim Thai women.ConclusionsOur findings confirm previous studies that have shown lower survival rates in Muslim Thai women compared to Buddhist women with breast cancer and offer novel information on subtype distribution. To date, this is the first study assessing clinical subtypes in southern Thailand by religious status.ImpactOur findings are critical in providing information on the role of clinical subtype in cancer disparities and provide evidence from the Southeast Asian region for global studies on breast cancer survival.



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Evaluation of racial disparities in pediatric optic pathway glioma incidence: Results from the Surveillance, Epidemiology, and End Results Program, 2000–2014

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Publication date: June 2018
Source:Cancer Epidemiology, Volume 54
Author(s): Erin C. Peckham-Gregory, Roberto E. Montenegro, David A. Stevenson, David H. Viskochil, Michael E. Scheurer, Philip J. Lupo, Joshua D. Schiffman
BackgroundRacial predilection to pediatric cancer exists; however optic pathway glioma (OPG) risk differences by race/ethnicity are undefined. We estimated differences in OPG incidence across racial/ethnic groups in a multi-state cancer surveillance registry in the United States.MethodsOPG data were obtained from the Surveillance, Epidemiology, and End Results (SEER-18) Program, 2000–2014. Race/ethnicity was categorized as: White; Black; Asian; Other; and Latino/a ("Spanish-Hispanic-Latino"). Latino/a included all races, while all other categories excluded those identified as Latino/a. Age-adjusted incidence rates and rate ratios (IRR) with 95% confidence intervals (CIs) were generated in SEER-STAT (v8.3.4).ResultsData on 709 OPG cases ages 0–19 were abstracted from SEER-18. Minority children experienced lower age-adjusted OPG incidence rates compared to White children (IRRBlack = 0.38, 95% CI: 0.28–0.50; IRRAsian = 0.41, 95% CI: 0.29–0.58; and IRRLatino/a = 0.39, 95% CI: 0.32–0.48). In subgroup analyses among the highest risk age categories (0–4, 5–9), minority children experienced lower incidence rates compared to White children. Specific patterns for Latinos/as also emerged. Latino/a children ages 0–4 experienced the lowest incidence rates of all racial/ethnic groups compared to Whites (0.24 per 100,000 person-years versus 0.66 per 100,000 person-years, respectively), whereas among those ages 5–9, Black and Asian children experienced the lowest incidence rates (0.08 per 100,000 person-years each).ConclusionsIncidence of OPGs was highest among White children. This study represents one of the largest to assess differences in OPG susceptibility by race/ethnicity. These findings may inform future studies that seek to evaluate modifying factors for this pediatric tumor including tumorigenesis, treatment, outcome, and long-term late effects.



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Bayesian estimates of the incidence of rare cancers in Europe

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Publication date: June 2018
Source:Cancer Epidemiology, Volume 54
Author(s): Laura Botta, Riccardo Capocaccia, Annalisa Trama, Christian Herrmann, Diego Salmerón, Roberta De Angelis, Sandra Mallone, Ettore Bidoli, Rafael Marcos-Gragera, Dorota Dudek-Godeau, Gemma Gatta, Ramon Cleries
BackgroundThe RARECAREnet project has updated the estimates of the burden of the 198 rare cancers in each European country. Suspecting that scant data could affect the reliability of statistical analysis, we employed a Bayesian approach to estimate the incidence of these cancers.MethodsWe analyzed about 2,000,000 rare cancers diagnosed in 2000–2007 provided by 83 population-based cancer registries from 27 European countries. We considered European incidence rates (IRs), calculated over all the data available in RARECAREnet, as a valid a priori to merge with country-specific observed data. Therefore we provided (1) Bayesian estimates of IRs and the yearly numbers of cases of rare cancers in each country; (2) the expected time (T) in years needed to observe one new case; and (3) practical criteria to decide when to use the Bayesian approach.ResultsBayesian and classical estimates did not differ much; substantial differences (>10%) ranged from 77 rare cancers in Iceland to 14 in England. The smaller the population the larger the number of rare cancers needing a Bayesian approach. Bayesian estimates were useful for cancers with fewer than 150 observed cases in a country during the study period; this occurred mostly when the population of the country is small.ConclusionFor the first time the Bayesian estimates of IRs and the yearly expected numbers of cases for each rare cancer in each individual European country were calculated. Moreover, the indicator T is useful to convey incidence estimates for exceptionally rare cancers and in small countries; it far exceeds the professional lifespan of a medical doctor.



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