Quality of life in elderly patients with localized breast cancer treated with radiotherapy. A prospective study

PurposeThere is a debate on the role of adjuvant Radiotherapy (RT) in elderly breast cancer patients.The aim is to study Quality of Life (QL) throughout the treatment and follow-up periods in early stages breast cancer patients who have started radiotherapy, and to compare the QL of axillary surgery groups.Methods173 patients, ≥65 years completed the EORTC QLQ-C30 and QLQ-BR23, and the Interview for Deterioration in Daily Living Activities in Dementia(IDDD) questionnaires three times throughout treatment and follow-up periods. Linear mixed effect models were used to evaluate longitudinal changes in QL, and whether these changes differed among axillary surgery groups.ResultsQL scores were high (>70/100 points) in most QL areas, with moderate limitations (>30) in sexual functioning and enjoyment, future perspective and global QL.In six areas there was a decline at the RT sessions end, that after 6 weeks was recovered. For three areas, there was an improvement in the follow-up measurement compared to the previous assessments. Changes in seven areas were <5 points.Axillary node dissection patients had a body image decrease (6 points) in the follow up period. The lymphadenectomy group had more fatigue (10 points, p = 0.078) than the other two axillary surgery groups.ConclusionsResults orientate towards good patients' adaptation to their disease and treatments, and to administering RT in early stages breast cancer patients. QL differences between the axillary surgery groups and in their evolutions were few but have appeared in key QL areas.     

Safety and tolerability of vildagliptin vs. thiazolidinedione as add-on to metformin in type 2 diabetic patients with and without mild renal impairment: A retrospective analysis of the GALIANT study

ObjectiveThis retrospective analysis assessed safety and tolerability of vildagliptin (Vilda) as an add-on to metformin in type 2 diabetes mellitus (T2DM) patients with normal renal function (GFR > 80 mL/min/1.73 m²) and mild renal impairment (GFR: >50 to ≤80 mL/min/1.73 m²).MethodsAdverse events (AE) from this 12-week, randomized, open-label study comparing Vilda 100 mg and thiazolidinediones (TZD) as an add-on therapy in patients with T2DM inadequately controlled (HbA_1c: 7–10%) on a stable dose of metformin (≥1000 mg/day) were analyzed.ResultsOf 2627 randomized patients, 1278 in the Vilda and 635 in the TZD groups had normal renal function; 463 in the Vilda and 230 in the TZD groups had mild renal impairment. Higher incidence of headache and rash was noted in both Vilda groups, whereas those with mild renal impairment receiving TZD experienced a higher incidence of peripheral edema and URI. Fewer patients in the Vilda group discontinued the study due to AEs compared to TZD group. Serious AEs were greater in TZD groups (normal: 2.4%; mild renal impairment: 3.0%) compared to Vilda groups (normal: 1.6%; mild renal impairment: 2.4%).ConclusionThe safety profile of Vilda or TZD as an add-on to metformin was similar in patients with mild renal impairment and normal renal function.     

以精品课程建设为契机 促进核医学学科建设

本文探讨了精品课程的标准,分析了同济大学医学院核医学教研室在建设精品课程的过程中,更新教学理念、打造优秀教学团队以及促进核医学学科建设等方面的具体措施。同时,结合实践经验,强调应用现代教育信息技术优化课程所产生的巨大作用,并对精品课程提出了展望和要求。     

313例甲状腺疾病核素显像的回顾性分析

目的 分析甲状腺疾病核素显像的特点,探讨核素显像在甲状腺疾病中的诊断价值.方法 回顾性分析行核素显像检查的313例患者,其中亚急性甲状腺炎和桥本氏甲状腺炎各110例、甲状腺结节性疾病(不包含亚急性甲状腺炎、慢性淋巴细胞性甲状腺炎患者)93例,根据各种甲状腺炎的放射功能特点进行分组,用SPSS15.0进行统计分析.结果 ...     

The prevalence of non-accidental trauma among children with polytrauma: A nationwide level-I trauma centre study

ObjectiveWe aimed to investigate the prevalence and characteristics of non-accidental trauma (NAT) in children with polytrauma treated at level-I trauma centres (TC).Summary of backgroundData 6–10% Of children who present at the emergency department with injuries, sustain polytrauma. Polytrauma may result from either accidental (AT) or NAT, i.e. inflicted or neglect. The prevalence of NAT among children with polytrauma is currently unclear.MethodsThis is a retrospective study that included children (0–18 years) with an Injury Severity Score >15, who presented at one of the 11 Level-I trauma centers (TC) in the Netherlands between January 1, 2010 and January 1, 2016. Outcomes were classified based on the conclusions of the Child Abuse and Neglect-team. Cases in which conclusions were unavailable and there was no clear accidental cause of injuries were reviewed by an expert panel.ResultsThe study included 1623 children, 1452 (89%) were classified as AT, 171 (11%) as NAT; 39 (2,4%) inflicted and 132 (8,1%) neglect. Of pre-school aged children (<5 years) 41% sustained NAT (OR26.73, 95%CI 17.70–40.35), 35/342 (10%) inflicted and 104/342 (31%) neglect. Admission due to ‘cardiopulmonary arrest’ was the result of inflicted trauma (30% vs 0%,p < 0.001). NAT had a higher mortality rate (16% vs 10%, p = 0.006). Indicators of NAT were: (near-)drowning (OR10.74, 95%CI 5.94–19.41), burn (OR8.62, 95%CI 4.08–18.19) and fall from height (OR2.18, 95%CI 1.56–3.02).ConclusionsNAT was the cause of polytrauma in 11% of children in our nationwide level-I TC study; 41% of these polytrauma were the result of NAT experienced by preschool-aged children. Our data show the importance of awareness for NAT.     

The effect of obesity on pathological complete response and survival in breast cancer patients receiving uncapped doses of neoadjuvant anthracycline-taxane-based chemotherapy

PurposeThe effect of obesity in breast cancer patients undergoing neoadjuvant chemotherapy (NAC) remains controversial. The aim of this study was to determine the obesity-related effect on pathological complete response (pCR) and survival in women receiving full uncapped doses of NAC.MethodsWe retrospectively analyzed the data of all consecutive women who underwent anthracycline-taxane-based NAC for primary breast cancer between 2005 and 2015 at the Department of Obstetrics and Gynecology, Medical University of Vienna. Following the WHO criteria, women with a body mass index (BMI) ≥30 kg/m² at baseline were considered obese, whereas those with a BMI <30 kg/m² were considered non-obese. Those with dose reductions or dose capping were not eligible for study inclusion. Cox regression and logistic regression were performed. The Kaplan-Meier method was used to analyze disease-free, progression-free, and overall survival. The pCR served as the main outcome measure.ResultsAmong 120 women who received neoadjuvant epirubicin plus cyclophosphamide and docetaxel, 28 (23.3%) were obese and 92 (76.7%) were non-obese. In the multivariate logistic regression model that adjusted for potentially confounding variables, obesity had an independent positive predictive effect on pCR (OR 4.29, 95% CI, 1.42–13.91; p = 0.011), which was significant in the postmenopausal subgroup (OR 4.72, 95% CI, 1.47–15.84; p = 0.01). When comparing non-obese with obese women, we found that obese women experienced longer progression-free survival (HR 0.10, 95% CI, 8.448 × 10⁻⁴–0.81; p = 0.025).ConclusionsObese women receiving full uncapped doses of anthracycline-taxane-based NAC have increased pCR and favorable progression-free survival. This could result from increased dose intensity with increased efficacy and toxicity.     

Modulation of radioresponse of glyoxalase system by curcumin

Human beings have been exposed to radiation for many years. It is quite possible that antioxidant phytochemicals consumed in their diet might be providing a variable degree of radioprotection. However, their radiomodifying ability is not well understood. In the present work, curcumin (diferuloyl methane), a phytochemical present in the rhizome of Curcuma longa Linn. has been examined for its radioprotective property using the glyoxalase system which is vital for various biological functions. Curcumin (5, 25 and 50 mg/kg body weight) in olive oil was given orally to Swiss albino male mice (7–8 weeks old) daily for 2 weeks and irradiated with different doses of γ-radiation (0–6 Gy) at 0.027 Gy per second dose rate on last day of the treatment. The specific activities of glyoxalase I and II were determined in the liver and spleen. The treatment of curcumin prior to irradiation restored the specific activity of glyoxalase system to almost the control level which was suggestive of the radioprotective ability of curcumin. Free radical scavenging and electron/hydrogen donation are probable attributes for the protective effect of curcumin.