Long-term efficacy of single-dose radiofrequency-induced heat therapy vs. intralesional antimonials for cutaneous leishmaniasis in India

BACKGROUND

Radiofrequency-induced heat therapy (RFHT) has been found to be safe and effective against cutaneous leishmaniasis (CL) in the short term, but its long-term efficacy is unclear.

OBJECTIVES

To compare the long-term efficacy of RFHT vs. intralesional sodium stibogluconate (SSG) injections in the treatment of CL in India.

METHODS

One hundred patients with a confirmed diagnosis of CL were randomly assigned in a 1 : 1 ratio to receive topical RFHT for 30-60 s or seven intralesional injections of SSG (50 mg cm(-2) of lesion). Improvement and recurrence were monitored every 15 days after the initiation of treatment for 4 months and then at 5, 6, 9, 12 and 18 months post-treatment; the rates of complete cure were compared.

RESULTS

Lesions were healed in 47 out of 50 patients (94%) in the RFHT group and in 46 out of 50 patients (92%) in the SSG group at week 12. Time to complete healing was comparable in the two groups. At 6 months post-treatment, cure rates in the RFHT and SSG groups were 98% [95% confidence interval (CI) 94-100%] and 94% (95% CI 86-100%), respectively. Age, sex and lesion size or number had no effect on cure rates. No relapse of infection was recorded in cured patients in either group up to 12-18 months after initiation of treatment. Skin biopsies of cured lesions in eight out of eight (100%) patients from the RFHT group and three of three from the SSG group at 12 months showed minimal fibrosis and were negative for Leishmania tropica by polymerase chain reaction test.

CONCLUSIONS

A single application of RFHT is safe, cosmetically acceptable and effective in inducing a long-term cure of CL.

Shortened isoforms of the androgen receptor are regulated by the cytoprotective heat-shock protein HSPB1 and the tumor-suppressive microRNA miR-1 in prostate cancer cells

BACKGROUND

Shortened, constitutively active androgen receptor (AR) isoforms have been characterized and linked to tumor progression and chemoresistance in prostate cancer (PCa). We examined the regulation of shortened AR isoforms by a newly-identified AR regulatory signaling pathway involving heat-shock protein HSPB1 and microRNA miR-1.

MATERIALS AND METHODS

HSPB1 and miR-1 were modulated by overexpression and knock-down approaches utilizing the model PCa system, 22Rv1. Subsequently, AR isoform expression levels were quantified by western blot analysis.

RESULTS

HSPB1 was identified as an inducer and miR-1 as an inhibitor of AR variants, with no detectable discrimination between long and short AR isoform regulation.

CONCLUSION

In 22Rv1 cells, all AR isoforms were co-regulated by the cytoprotective factor HSPB1 and the tumor suppressor miR-1. Notably, our data provide evidence that HSPB1 inhibition is able to target expression of long as well as of short AR isoforms.

The association between different night shiftwork factors and breast cancer: a case-control study

BACKGROUND

Research on the possible association between shiftwork and breast cancer is complicated because there are many different shiftwork factors, which might be involved including: light at night, phase shift, sleep disruption and changes in lifestyle factors while on shiftwork (diet, physical activity, alcohol intake and low sun exposure).

METHODS

We conducted a population-based case-control study in Western Australia from 2009 to 2011 with 1205 incident breast cancer cases and 1789 frequency age-matched controls. A self-administered questionnaire was used to collect demographic, reproductive, and lifestyle factors and lifetime occupational history and a telephone interview was used to obtain further details about the shiftwork factors listed above.

RESULTS

A small increase in risk was suggested for those ever doing the graveyard shift (work between midnight and 0500 hours) and breast cancer (odds ratio (OR)=1.16, 95% confidence interval (CI)=0.97-1.39). For phase shift, we found a 22% increase in breast cancer risk (OR=1.22, 95% CI=1.01-1.47) with a statistically significant dose-response relationship (P=0.04). For the other shiftwork factors, risks were marginally elevated and not statistically significant.

CONCLUSION

We found some evidence that some of the factors involved in shiftwork may be associated with breast cancer but the ORs were low and there were inconsistencies in duration and dose-response relationships.

Comparison of image quality using a X-ray stereotactical whole-body system and a direct flat-panel X-ray device in examinations of the pelvis and knee

PURPOSE

The novel biplanar X-ray unit "EOS", EOS Imaging, allows to acquire simultaneously 2 perpendicular planes of full-length spine and limbs and to measure spatially correct angles based on the acquired image data sets. This is to be seen alongside with a low spatial resolution, high investment costs and high operating expenses. The use of the biplanar X-ray unit in morphology based scelettal radiography might improve the cost-benefit-relation. Thus, the purpose of this study was to compare image quality of the EOS-unit and the flat panel (FP)-technology as reference in a clinical setting.

MATERIALS AND METHODS

All 114 patients of the Orthopedic Hospital Dept., who had a biplanar full-length lower limb radiograph and a FP-examination of the pelvis and/or the knee with maximum time interval of 3 months without changes in the clinical and radiological findings were included in the study. All X-ray examinations had been carried out due to clinical indications. Secondary captures comparable to the FP-images were extracted from the electronic EOS-image data sets. 4 radiologists independently from each other compared the visualization of normal anatomical structures of the pseudonymous EOS- and FP-images in a randomized order.

RESULTS

In the overwiew of all readers and all sceletal regions image quality of the FP-images was considered being superior in a mean of 83 ± 13 % standard deviation of the pair comparisons (minimum 48 %, maximum 100 %). Image quality of the EOS-images was assessed as being superior in 2 ± 3 % of the cases (0 %, 10 %). Image quality of 0.8 ± 3 % of the FP-images (0 %, 17 %) and 30 ± 34 % (0 %, 100 %) of the EOS-images was estimated as diagnostically inadequate. 30 ± 33 % of the pair comparisons (0 %, 100 %) showed a diagnostically inadequate image quality of the EOS-images and a diagnostically good image quality of the FP-images.

CONCLUSION

Image quality of biplanar full-length lower limb X-ray examinations is not suitable to be used for the diagnostic assessment of the morphological bone structure using the currently available technological setting.

KEY POINTS

▶ biplanar full-length lower limb X-ray examinations ▶ plat-panel radiography ▶ image quality.

Size-dependent Auger spectra and two-hole Coulomb interaction of small supported Cu-clusters

Auger (L3M4,5M4,5) and X-ray photoionization spectra (2p, 3d) of mass-selected CuN-clusters supported by a thin natural silica layer are presented in the size range N = 8-55 atoms per cluster. The Auger spectra of all clusters are shifted to a lower kinetic energy with respect to the spectrum of the bulk. Furthermore the Auger energy decreases systematically with decreasing cluster size. The binding energies of the 2p and 3d valence states are higher than the corresponding bulk values. Using the energy of the Auger main line, the corresponding core hole peak and the centroid of the self-convoluted 3d valence band the on-site Coulomb interaction energy Udd of the two-hole final state as a function of cluster size has been determined.

Going beyond EGFR

a substantial proportion of non-small-cell lung cancer (NSCLC), and adenocarcinoma in particular, depends on a so-called 'driver mutation' for their malignant phenotype. This genetic alteration induces and sustains tumorigenesis, and targeting of its protein product can result in growth inhibition, tumor response and increased patient survival. NSCLC can thus be subdivided into clinically relevant molecular subsets. Mutations in EGFR best illustrate the therapeutic relevance of molecular classification. This article reviews the scope of presently known driving molecular alterations, including ROS1, BRAF, KRAS, HER2 and PIK3CA, with a special emphasis on aLK rearrangements, and outlines their potential therapeutic applications.

Cancer incidence and mortality among underground and surface goldminers in Western Australia

Background:

In a cohort of goldminers, we estimated cancer mortality and incidence, for both surface and underground workers, and we examined the hypothesis that (underground) mining may be protective against prostate cancer.

Methods:

Standardised mortality and incidence ratios (SMRs and SIRs) and 95% confidence intervals (CI) were calculated to compare cancer mortality and incidence of former goldminers with that of the general male population. Internal comparisons on duration of underground work were examined using Cox regression.

Results:

During 52 608 person-years of follow-up among 2294 goldminers, 1922 deaths were observed. For any cancer, mortality was increased for the total group of miners (SMR=1.27, 95% CI 1.16–1.39). In the Cox models, lung cancer mortality and incidence were particularly increased among underground miners, even after adjustment for smoking. The SMR for prostate cancer suggested a lower risk for underground miners, whereas incidence of prostate cancer was significantly increased (SIR=1.31, 95% CI 1.07–1.60) among underground miners.

Conclusion:

Overall cancer mortality and incidence was higher among Western Australian goldminers compared with the general male population, particularly for underground mining. This study does not support the hypothesis that miners have a decreased risk of prostate cancer.

Gut microbial metabolism of polyphenols from black tea and red wine/grape juice is source-specific and colon-region dependent

The colonic microbial degradation of a polyphenol-rich black tea extract (BTE) and red wine/grape juice extract (RWGE) was compared in a five-stage in vitro gastrointestinal model (TWINSHIME). Microbial metabolism of BTE and RWGE polyphenols in the TWINSHIME was studied subsequently in single- and continuous-dose experiments. A combination of liquid or gas chromatography with mass spectrometry (LC-MS or GC-MS) and NMR-based metabolic profiling was used to measure selected parent polyphenols, their microbial degradation into phenolic acids, and the production of short-chain fatty acids (SCFAs) in different colon compartments. Acetate production was increased by continuous feeding of BTE but not RWGE. During RWGE feeding, gallic acid and 4-hydroxyphenylpropionic acid remained elevated throughout the colon, while during BTE feeding, they were consumed in the distal colon, while 3-phenylpropionic acid was strongly produced. Gut microbial production of phenolics and SCFAs is dependent on colon location and polyphenol source, which may influence potential health benefits.

[Management pulmonary metastases: when operate?]

Thirty percent of patients suffering from malignant disease will develop pulmonary metastases. Effective chemotherapy is lacking for many of these tumors. Many studies suggest survival benefit in selected patients when pulmonary metastasectomy allows complete resection. Several operative approach may be offered in order to achieve complete resection and maximal lung sparring. Pre-operative workup must assess the control of the primary tumor and the possibility of performing complete resection. Minimally invasive approaches may offer better quality life and equivalent oncologic outcomes than open approach.

[VATS lobectomy for early-stage primary lung cancer]

Lobectomy via video-assisted thoracoscopic surgery (VATS) is now considered as a valid alternative to conventional thoracotomy for early-stage primary lung cancer. Various studies have reported that VATS lobectomy is a safe technique associated with fewer postoperative complications and better post-operative recovery than open thoracotomy. Furthermore, studies suggest oncological equivalence between VATS and open lobectomy.