Neoadjuvant versus Adjuvant Chemotherapy in Patients with Resectable Muscle-Invasive Bladder Cancer

Introduction: In regards to resectable muscle-invasive bladder cancer (MIBC) patients, contemporary guidelines recommend treatment with radical cystectomy and perioperative chemotherapy (neoadjuvant or adjuvant). In addition, the 5-year survival rate ranges from 36% to 48% in connection to T3 or T4 staged tumors or lymph node metastatic tumors. Perioperative treatment can improve overall survival, and the most robust evidence are in favor of neoadjuvant chemotherapy. The purpose of this study was to assess the impact of perioperative chemotherapy on the survival of patients with muscle-invasive bladder cancer (MIBC) who underwent radical cystectomy (RC). Methods: The medical records of ninety-four patients with muscle-invasive bladder cancer (MIBC) that were treated with radical cystectomy and perioperative chemotherapy from 2008 to 2018 were retrospectively analyzed at Songklanagarind hospital. Neoadjuvant and adjuvant chemotherapy groups were classified. Univariable and multivariable regression analyses were used to predict overall survival (OS) after treatment. The survival rates for each group were estimated and compared using long-rank testing. Results: Overall, we identified 94 eligible patients of whom 20 patients (21.2%) received neoadjuvant and 74 patients (78.8%) received adjuvant chemotherapy. The 5-year survival rate of the neoadjuvant group was 55.7%, and in regards to the adjuvant group it was 30.4%. A multivariable analysis yielded that, patients treated with neoadjuvant chemotherapy had longer survival than those treated with adjuvant chemotherapy (p =0.039).  The median survival here as log rank compares median survival. Conclusion: The overall survival of neoadjuvant chemotherapy (NAC) was better than adjuvant chemotherapy (AC) in regards to muscle-invasive bladder cancer. These data could support the use of neoadjuvant chemotherapy in MIBC prior to radical cystectomy.     

Anemia, iron deficiency and thalassemia among adolescents in Northeast Thailand: results from two independent surveys

The prevalence of adolescent anemia, iron deficiency and thalassemia were examined in 2 provinces of northeast Thailand. Blood specimens were collected from adolescent subjects aged 15-17 years in 2 areas; 185 (85 males and 100 females) in Mukdahan province and 313 (116 males and 197 females) in Roi-Et. RBC parameters, serum ferritin levels, Hb and DNA analyses for the identification of common thalassemia genes in Thailand were investigated. The prevalences of anemia were found to be 21.1% (8.1 in male and 13.0 in female) and 16.6% (8.9 in male and 7.7 in female) in Mukdahan and Roi-Et province, respectively. Iron deficiency was observed to be 24.3% in Mukdahan and 14.7% in Roi-Et. Various types of thalassemia were identified in 62.2 and 58.8% of the subject populations, respectively. The proportions of iron deficiency, thalassemia and combined thalassemia and iron deficiency among anemic subjects were 10.2, 53.8 and 30.8% in Mukdahan, and 7.7, 67.3 and 9.6% in Roi-Et. Hematological characteristics were analyzed and are presented. It is concluded that thalassemia and hemoglobinopathies rather than iron deficiency are major causes of adolescent anemia which should be taken into account in public health strategies for the control of anemia in the region.     

Reduction of Streptococcus mutans by probiotic milk: a multicenter randomized controlled trial

Clinical Oral Investigations - To investigate the effects of probiotics, Lactobacillus paracasei SD1, on the quantities of Streptococcus mutans in saliva and plaque samples of preschool children....     

Rapid diagnosis of tuberculosis by identification of Antigen 85 in mycobacterial culture system

The standard culture for identification of Mycobacterium tuberculosis takes a long time to perform. We introduce here a method for fast identification of M. tuberculosis in mycobacterial culture system. Antibodies to Antigen (Ag) 85 of M. tuberculosis were produced and subsequently used to develop enzyme-linked immunosorbent assay (ELISA) for detecting Ag85 in the culture filtrate. By this detection, rapid tuberculosis (TB) diagnosis was achieved in comparison to the standard culture system with 89.6% sensitivity and 94% specificity. We thus suggest a new TB diagnosis strategy in which clinical samples are cultured in mycobacteria liquid culture medium. The culture filtrates are taken for detection of the Ag85 by ELISA. Using this strategy, 25%, 50%, 80%, and 90% of TB patients will be detected within day 3, week 1, 2, and 4, respectively. The established assay will enable a faster diagnosis of TB, leading to more efficient treatment of TB patients and control of disease transmission.     

Wound healing activities of standardized pomegranate rind extract and its major antioxidant ellagic acid in rat dermal wounds

The in vivo wound healing potential of a standardized pomegranate rind extract (SPRE) and its major antioxidant constituent, ellagic acid (EA, 13 %, w/w), were investigated in three rat dermal wound models. It was found that both SPRE (5 and 2.5 %) and its equivalent amount of EA (0.65 and 0.325 %) increased the tensile strength of the incision wound by a maximum of 35.43 and 31.82 %, respectively. SPRE at 5 and 2.5 % accelerated wound contraction of the excision wound and the burn wound, while EA was effective only at 0.65 % in these two wound models. Further assays revealed that SPRE enhanced the synthesis of collagen by a maximum of 21.83 mg/g and inhibited neutrophil infiltration dose-dependently, while EA was not effective in increasing collagen accumulation and its inhibitory effect on neutrophil infiltration was milder. These results indicated that SPRE is a promising phytopharmaceutical effective in facilitating the healing of wounds and is superior to its marker compound EA.