Oncology

Placental blood flow was measured with the aid of radioactive microspheres, in normal (N) and manifest diabetic (MD) rats, and related to fetal body growth and incidence of congenital malformations. The total blood flow in the placentae of the MD rats was decreased to about one-half of the normal flow on gestational days 20 and 22. The placentae of the MD offspring were enlarged, whereas the fetuses in this group were smaller than normal. Thus, the placental blood flow per placental weight was drastically decreased in the MD fetuses on both days 20 and 22. In contrast, the placental blood flow per fetal weight was not different in the N and MD groups on gestational day 20 whereas it was decreased in the MD offspring on gestational day 22. Placental blood flow in the malformed fetuses of the MD group did not differ significantly from that in the nonmalformed MD fetuses.

Malignancy is a major cause of childhood death in developed world and in developing countries like India, paediatric tumours are on the rise. Appropriate management of paediatric tumours requires epidemiological data in different geographical areas. Present study was conducted to classify and find out the histopathological profile of solid tumours of childhood and infancy in 15 years from January 1999 to December 2013. In our study of 168 paediatric tumours, 108 (64.29%) were benign, and 60 (35.71%) were malignant. Maximum incidence of paediatric tumours was seen in the age group of 11-14 years (41.67%) and least in the age group of <1 year (10.71%), with male to female ratio of 1. Amongst the benign tumours, soft tissue tumours were most common (56.48%), with highest incidence of vascular tumours (57.36%). Amongst the malignant tumours, most common were Lymphomas (36.67%) and amongst lymphomas, Hodgkin's lymphomas were more common (63.64%) than non-Hodgkin's lymphoma (36.36%).

Humans around the globe probably discovered natural remedies against disease and cancer by trial and error over the millennia. Biomolecular archaeological analyses of ancient organics, especially plants dissolved or decocted as fermented beverages, have begun to reveal the preliterate histories of traditional pharmacopeias, which often date back thousands of years earlier than ancient textual, ethnohistorical, and ethnological evidence. In this new approach to drug discovery, two case studies from ancient Egypt and China illustrate how ancient medicines can be reconstructed from chemical and archaeological data and their active compounds delimited for testing their anticancer and other medicinal effects. Specifically, isoscopoletin from Artemisia argyi, artemisinin from Artemisia annua, and the latter&#39;s more easily assimilated semi-synthetic derivative, artesunate, showed the greatest activity in vitro against lung and colon cancers. In vivo tests of these compounds previously u...

Purpose: Ongoing symptoms and impairments in quality of life (QOL) among breast cancer survivors remain a significant problem. We tested the feasibility and acceptability of a manualized Ayurvedic nutrition and lifestyle intervention for breast cancer survivors. Methods: Eligible participants had Stage I-III breast cancer, underwent treatment within the past year that included che-motherapy, and were without active disease. The 4-month individualized Ayurvedic intervention included counseling on nutrition, lifestyle, yoga, and marma (like acupressure) during 8 one-on-one visits with an Ayurvedic practitioner. Feasibility and acceptability were the primary outcomes. QOL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ C30]) and symptoms-sleep disturbance (General Sleep Disturbance Scale [GSDS]), fatigue (Lee Fatigue Scale [LFS]), depressive symptoms (Center for Epidemiological Studies-Depression Scale [CES-D]), anxiety (Spielberger State-Trait Anxiety Inventory [STAI-S, STAI-T]), and stress (Perceived Stress Scale [PSS])-were measured prior to, at midpoint, and at the end of the 4-month intervention. Effect sizes (Cohen's d) were calculated along with paired t tests comparing baseline to end of month 4 time points. Mixed effects models were used for repeated measures analyses. Results: Participants (n ¼ 32) had a mean age of 48 years (SD ¼ 10). Retention at the end of the intervention was 84%. Among those who completed the intervention (n ¼ 27), adherence was high (99.5% of visits with practitioners attended). Large improvements were seen in QLQ-C30 emotional functioning (d ¼ 0.84, P < 0.001), QLQ-C30 cognitive functioning (d ¼ 0.86, P < 0.001), GSDS (d ¼-1.23, P < 0.001), and CES-D (d ¼-1.21, P < 0.001). Moderate improvements were seen in QLQ-C30 global health (d ¼ 0.65, p ¼ 0.003), LFS (d ¼-0.68, P ¼ 0.002), and PSS (d ¼-0.75, P < 0.001). No adverse events were observed due to the intervention.

Deep brain stimulation (DBS) is being used with increasing frequency for the treatment of mesial temporal lobe epilepsy (MTLE). Here, we report two patients treated with amygdalohippocampal (AH)-DBS for drug-resistant temporal lobe epilepsy. Two patients with temporal lobe epilepsy were admitted to Beijing Sanbo Brain Hospital. The first patient was a 34-year-old male with a 31-year history of epileptic seizures. The second patient was a 27-year-old male with a 19-year history of drug-resistant epilepsy. The patients received a comprehensive presurgical workup and were considered unsuitable candidates for resective surgery. AH-DBS was recommended for the two patients. The last follow-up for patient 1 was 36 months after surgery and the final parameter settings were 3.6 mA, 450 μsec, 130 Hz and cycling with 60 sec on, 180 sec off. The last follow-up for patient 2 was 18 months after surgery and the final parameter settings were 2.6 mA, 450 μsec, 130 Hz and cycling with 60 sec on, 180...

Introduction: Fluid cytology, a relatively non invasive technique, throws light on both malignant and non malignant causes of effusions. It especially contributes in cancer research and staging of various tumors.
Materials and Methods: This was a retrospective study done over a period of two years from January 2014 to December 2015 in the department of Pathology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad. The body fluids included in the study were pleural, peritoneal, pericardial and synovial fluids. All other fluids were excluded. The relevant clinical data was noted. Gross, cell count and cytomorphological examinations of fluid were done.
Results: Out of 302 cases, pleural fluids, 148 (49.0%) cases, were most common, followed by peritoneal fluid, 125 (41.39%) cases and least common was pericardial fluid, 8 (2.64%) cases. The maximum numbers of cases was in 5th decade. The age range was 3 years to 84 years. Female preponderance was observed with M: F ratio of 1: 1.17. Lymphocyte rich exudates were most common in pleural effusion. In peritoneal and pericardial effusions, transudates were more and suppurative inflammation was predominant in synovial fluid analysis. Over all, malignant effusions constituted 18.54% of effusions. Metastatic adenocarcinoma was the commonest malignancy detected in all body cavity effusions.
Conclusions: Fluid cytology is relatively painless, simple, cost effective, rapid technique that yields quick and reliable results. Some cases may present major interpretative challenges to the pathologist. Ancillary studies such as cell count, biochemical, microbiologic evaluation, cell block and immunohistochemistry (IHC) study help in accurate identification of diagnosis.
Keywords: Body fluids, Malignant effusions, Transudates.

The NCCN Guidelines for Uveal Melanoma include recommendations for staging, treatment, and follow-up of patients diagnosed with uveal melanoma of the choroid or ciliary body. In addition, because distinguishing between uveal melanoma and benign uveal nevi is in some cases difficult, these guidelines also contain recommendations for workup of patients with suspicious pigmented uveal lesions, to clarify the tests needed to distinguish between those who should have further workup and treatment for uveal melanoma versus those with uncertain diagnosis and low risk who should to be followed and later reevaluated. These NCCN Guidelines Insights describe recommendations for treatment of newly diagnosed nonmetastatic uveal melanoma in patients who have already undergone a complete workup.

Marine floras, such as bacteria, actinobacteria, cyanobacteria, fungi, microalgae, seaweeds, mangroves, and other halophytes are extremely important oceanic resources, constituting over 90% of the oceanic biomass. They are taxonomically diverse, largely productive, biologically active, and chemically unique offering a great scope for discovery of new anticancer drugs. The marine floras are rich in medicinally potent chemicals predominantly belonging to polyphenols and sulphated polysaccharides. The chemicals have displayed an array of pharmacological properties especially antioxidant, immunostimulatory, and antitumour activities. The phytochemicals possibly activate macrophages, induce apoptosis, and prevent oxidative damage of DNA, thereby controlling carcinogenesis. In spite of vast resources enriched with chemicals, the marine floras are largely unexplored for anticancer lead compounds. Hence, this paper reviews the works so far conducted on this aspect with a view to provide a b...

Introduction: Oral cancer is cause mainly due to habits of tobacco consumption and it is a major health hazard across the world. The death rate due to the disease is also very high. However, the association of tobacco exposure with stage of the disease and treatment outcome is not reported. Therefore, we assessed correlation between levels of tobacco exposure with the disease status and treatment outcome in oral cancer patients. Materials and Methods: Urine samples were collected from enrolled pre-therapeutic oral cancer patients (N=96), healthy individuals with tobacco habits (N=19) and healthy individuals without tobacco habits (N=14). Urinary nicotine and cotinine levels were analyzed as indicators of tobacco exposure by HPLC methods. Data was statistically analyzed using the SPSS statistics version 20.0. Results: Present study revealed that tobacco exposure levels were significantly higher in oral cancer patients and healthy individuals with tobacco habits as compared to healthy individuals without tobacco habits. Receiver Operating Characteristics (ROC) curve analysis revealed that tobacco exposure levels have a good discriminatory efficacy between healthy individuals without habit of tobacco and oral cancer patients as well as between healthy individuals without habit of tobacco and healthy individuals with habits of tobacco. Kaplan Meier survival curve analysis also revealed that patients who were having higher tobacco exposure levels at the time of diagnosis showed worse survival than patients who were having lower tobacco exposure levels. Conclusion: Tobacco exposure levels could be a simple, non-invasive and cost effective prognostic biomarker for management of oral cancer.

We compared the benefits of sorafenib therapy with continued transarterial chemoembolization (TACE) in TACE-refractory patients with intermediate-stage hepatocellular carcinoma (HCC). This retrospective study reviewed intermediate-stage HCC patients who underwent the first TACE. Patients were defined as TACE-refractory and divided into two cohorts: (1) patients who switched from TACE to sorafenib and (2) those who continued TACE. We evaluated the patient overall survival (OS) and time to disease progression (TTDP; the time patients reached Child-Pugh C or developed advanced-stage HCC). A total of 509 patients with HCC underwent TACE. Of 249 intermediate-stage HCC patients undergoing the first TACE, 122 were deemed refractory. At the time they were identified as refractory, 20 patients converted to sorafenib, whereas 36 patients continued TACE. We excluded patients with Child-Pugh scores of ≥ 8, those with advanced-stage HCC, those who had undergone hepatic arterial infusion chemothe...

With a longer life expectancy of the population, there was also an increase in the incidence of cancer. In addition, advances in high-performance molecular diagnosis and personalized therapy for cancer patients have provided longer survival for these patients. With that, there was a change in the paradigm of cancer pain treatment, since pain is one of the main symptoms that affect the quality of life of these patients. Thus, the multimodal treatment is very important to patients with cancer pain. This review found studies that address several pharmacological and non-pharmacological cancer pain treatment options, although some have shown weak evidence in their results. Knowing these options and the results of these interventions is essential for health professionals who deal with pain management. Among the pharmacological options, opioids remain the foundation of treatment, however, because of their known adverse effects, the range of associations with other classes of drugs (cannabinoids, bisphosphonates and adjuvants) expanded. The use of other drug administration routes, such as intrathecal devices, has also been shown to be beneficial in pain control and in reducing side effects. Interventional procedures, even with positive results, are underused due to lack of training and knowledge. Multiple interventions of Integrative medicine (mind-body practices, acupuncture, music etc.) showed to be effective in reduce anxiety, depression, phobia and cancer pain. They can be used to complement pain management. As there are few randomized double-blind studies with a large number of patients regarding the effectiveness of these interventions, more systematic studies are needed.

Drug hypersensitivity reactions to chemotherapy agents are an important problem that Allergy Departments should be proactively prepared to confront, by meeting the necessary high standards to offer optimal management pathways, including high-risk techniques such as drug provocation testing or rapid drug desensitisation, which will cost-effectively improve the prognosis of many patients. Comprehensive risk management strategies, access to expert staff, specific diagnostic techniques, and a dedicated allergy-led area are fundamental to ensure safety. In this manuscript, we will explore current diagnostic and management pathways for hypersensitivity reactions to chemotherapy agents.

Introduction: To evaluate the efficacy of cycled oral cyclophosphamide therapy in recurrent and advanced ovarian cancer patients. Materials and Method: Recurrent and advanced ovarian cancer patients who are unfit for intensive chemotherapy were prescribed oral cyclophosphamide at the dose of 50 mg twice daily for 10 days, cycled every 28 days. Treatment-related toxicity was assessed by National cancer institute – common terminology criteria for adverse events(NCI-CTCAE) and response to treatment were assessed by Response evaluation criteria in solid tumours (RECIST) and clinical assessment. Progression-free (PFS), and overall survival (OS) were assessed using Kaplan meier survival analysis. Results: 71 patients of ovarian cancer admitted to our centre from January 2012 to March 2015 with mean age of 61.2±0.74 years were analyzed: 44 patients (61.9%) were platinum refractory/resistant, while 26 patients (36.6%) were platinum sensitive; 60 patients (84%) had received atleast one previous chemotherapy before starting MOC. The objective response rate (ORR) (complete and partial response) was 20%. Stable disease was seen in 22 patients (30.9%) and 17patients had response duration ≥6 months, 8 patients had continued response for more than 1 year. Progression during treatment was observed in 49 patients (69.01%). Median PFS was 5 months (range 2 – 25 months), and the 12-month PFS was 11%; and the 12-month OS was 26% Median PFS for patients who responded to MOC was 9 months whereas 2 months for those who progressed (p = 0.01). Median OS of responding patients was 14 months whereas it was 8 months for patients progressive on MOC (p = 0.02). No significant toxicity was observed. Conclusions: MOC is an effective therapy in the treatment of recurrent and advanced ovarian cancer patients, unfit for intensive chemotherapy.

The concept of sound symbolism proposes that even the tiniest sounds comprising a word may suggest the qualities of the object which that word represents. Cancer-related medication names, which are likely to be charged with emotional meaning for patients, might be expected to contain such sound-symbolic associations. We analyzed the sounds in the names of 60 frequently-used cancer-related medications, focusing on the medications&amp;amp;amp;amp;amp;amp;amp;#39; trade names as well as the names (trade or generic) commonly used in the clinic. We assessed the frequency of common voiced consonants (/b/, /d/, /g/, /v/, /z/; thought to be associated with slowness and heaviness) and voiceless consonants (/p/, /t/, /k/, /f/, /s/; thought to be associated with fastness and lightness), and compared them to what would be expected in standard American English using a reference dataset. A Fisher&amp;amp;amp;amp;amp;amp;amp;#39;s exact test for independence showed the chemotherapy consonantal frequencies to be significantly different from standard English (p=0.009 for trade; p&amp;amp;amp;amp;amp;amp;amp;lt;0.001 for &amp;amp;amp;amp;amp;amp;amp;quot;common usage&amp;amp;amp;amp;amp;amp;amp;quot;). For the trade names, the majority of the voiceless consonants were significantly increased compared to standard English; this effect was more pronounced with the &amp;amp;amp;amp;amp;amp;amp;quot;common usage&amp;amp;amp;amp;amp;amp;amp;quot; names (for the group, O/E=1.62; 95% CI [1.37, 1.89]). Hormonal and targeted therapy trade names showed the greatest frequency of voiceless consonants (for the group, O/E=1.76; 95% CI [1.20, 2.49]). Our results suggest that taken together, the names of chemotherapy medications contain an increased frequency of certain sounds associated with lightness, smallness and fastness. This finding raises important questions about the possible role of the names of medications in the experiences of cancer patients and providers.

Summary: To initiate an investigation into the biochemistry and mechanism of group B [beta]-hemolytic Streptococcus virulence, bacterial cultures grown in suspension were centrifuged, and the bacteria and media were subjected to extensive fractionation. Each ...

The changes in testosterone and gonadotropin levels in patients who have undergone radical prostatectomy (RP) for clinically localized prostate cancer (PCa) remain unclear. The aim of the present study was to prospectively evaluate the changes in serum testosterone (Te), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels in the early months after RP for PCa and the correlation between these hormones at various follow-up times. A total of 100 male patients with clinically localized PCa were consecutively included in the study. The serum levels of Te, LH and FSH were measured prior to RP (baseline) and at 1 and 3 months post-operatively. Changes in the levels of Te, LH and FSH between the baseline and at 1 and 3 months after RP were analyzed with paired sample t-tests. The correlations between LH and Te levels at the various follow-up times were evaluated with a Spearman&#39;s rank correlation coefficient. At 1 month subsequent to RP, the Te levels were significant...

Aims: To identify the characteristics of optimistic parents of children with cancer. To examine the relationship between optimism, anxiety, depression, life satisfaction, coping and subjective health perception in parents of children with cancer and parents of healthy children.Methods: One hundred parents of children with cancer were recruited during attendance at Oncology Out-patient Clinics at a UK Regional Cancer Centre. A comparison group of 117 parents of healthy children was also recruited. All parents completed a questionnaire, providing demographic and medical information relating to the child, dispositional optimism, psychological distress, life satisfaction, coping and subjective health perception.Results: Parents of children with cancer had higher levels of anxiety, depression, optimism, satisfaction with life and subjective health perception than the comparison group. Optimism was significantly correlated with satisfaction with life, subjective health perception, anxiety and depression in both groups.Conclusion: The findings highlight the importance of optimism in relationship to psychological distress in parents of children with cancer. Interventions targeting parents' optimism are recommended as a potential source of coping with adversity within this population. Copyright © 2007 John Wiley & Sons, Ltd.