Long-term follow-up of Helicobacter pylori eradication therapy in Vietnam: reinfection and clinical outcome

AIM: To assess the long-term Helicobacter pylori reinfection rates, as well as the clinical outcome in peptic ulcer disease patients in Vietnam. METHOD: At a 1-year evaluation of H. pylori eradication treatment in 226 peptic ulcer patients, long-term H. pylori status was assessed with serology and/or culture, peptic ulcer status by gastroscopy, and DNA-fingerprinting performed with random amplified polymorphic DNA and restriction fragment polymorphism. RESULT: Follow-up was performed a mean 11 months after the post-treatment evaluation on day 30 after beginning of treatment. The overall reinfection rate was 23.5%, with 58.8% of the strains being identical to the pre-treatment isolates and 41.2% being different. Peptic ulcer was found in 22.9% of the reinfected patients and in 6.3% of the non-reinfected. At the long-term follow-up of successful eradication cases, 89.8% of the patients were free of peptic ulcer disease. The corresponding result was 58.7% in patients in whom H. pylori eradication failed. CONCLUSION: Following successful H. pylori eradication, reinfection with H. pylori in patients in Vietnam was found to be higher than in industrialized countries but the long-term recurrence of peptic ulcer disease was still low. Helicobacter pylori eradication treatment is therefore of value also in developing countries as the rate of peptic ulcer disease was low at the 1-year follow-up.     

Combined androgen blockade in advanced prostate cancer: looking back to move forward

In 1989, Crawford and colleagues suggested that combined androgen blockade with castration plus antiandrogen therapy provided significantly improved survival compared with castration alone. Since then, some studies have supported these results, whereas others have not. To resolve this discrepancy, the Prostate Cancer Trialists' Collaborative Group conducted a metaanalysis of 27 randomized trials to evaluate whether combined androgen blockade has benefits compared with castration alone. The results published in 2000 showed that combined androgen blockade using a nonsteroidal antiandrogen treatment (nilutamide or flutamide) improved survival compared with castration alone, whereas combined androgen blockade using a steroidal antiandrogen agent (cyproterone acetate) reduced survival compared with castration alone. In 2004, an analysis was carried out to evaluate the nonsteroidal antiandrogen agent bicalutamide in the combined androgen blockade setting, by incorporating the data from a trial of combined androgen blockade with bicalutamide versus combined androgen blockade with flutamide with the Prostate Cancer Trialists' Collaborative Group metaanalysis data for combined androgen blockade with flutamide versus castration. This analysis showed that combined androgen blockade with bicalutamide was associated with a 20% reduction in the risk of death compared with castration alone. The survival benefit associated with combined androgen blockade using a nonsteroidal antiandrogen agent should be weighed against the potential for increased toxicity and expense compared with castration alone. Studies have shown that bicalutamide has a better tolerability profile than flutamide or nilutamide. Furthermore, cost-benefit analyses of combined androgen blockade with bicalutamide suggest it is a cost-effective option versus castration alone and versus combined androgen blockade with flutamide. In summary, the present evidence suggests that combined androgen blockade with a nonsteroidal antiandrogen agent should be a first-line therapy option in patients with advanced disease.     

Engineered nanoparticles to enhance natural killer cell activity towards onco-immunotherapy: a review

Natural killer (NK) cells have emerged as a potent alternative immunotherapeutic approach to T cell therapy for cancer. Despite promising results from preclinical and clinical studies, numerous challenges have limited the application of NK cell-based therapy, including poor expansion of NK cells in vitro, their short in vivo life span, time-intensiveness, treatment complexities, and the cost burden of the treatment. Recent advancements in the development of immune cell-delivering nanosystems have led to promising strategies to overcome these limitations and enhance NK cell toxicity towards cancer cells. This review first summarizes the biological roles of NK cells and their tumoricidal mechanisms. NK cells, in the context of the immune system and the tumor microenvironment, have reportedly provided novel insights into specific therapeutic targets. Eventually, various strategies targeting NK cells using nanoplatforms to modulate the NK cell responses for effective cancer immunotherapy are described herein. Altogether, this review discusses the potential of nanotechnology in advancements in NK cell-based onco-immunotherapy.     

Radioimmunoassay of progesterone in saliva: a simplified technique using 125I-radioligand

The value of serial salivary progesterone (P) determinations for evaluation of corpus luteum function compared with sporadic serum samplings is recognized. Salivary P concentrations have previously been determined by a relatively difficult assay which utilizes a tritiated radioligand. The present study was designed to compare this conventional method with a simpler assay utilizing an iodinated radioligand. The values obtained with two different radioimmunoassay (RIA) systems were compared for samples collected throughout the luteal phase of seven normal menstrual cycles and three conception cycles. In the seven nonconception luteal phases as well as in the three conception luteal phases, daily salivary P determinations by the two techniques correlated significantly with each other (r = 0.56; P less than 0.001). For the seven nonconception luteal phases, the salivary P determinations obtained by 125I RIA (Saliva 125I) correlated significantly with the matched serum values (r = 0.54; P less than 0.001). However, the correlation was poor between the salivary P determinations obtained by the 3H RIA (Saliva 3H) and the matched serum values. The simplicity and accuracy of the 125I RIA and the convenience of saliva sampling provide a practical approach to monitor human luteal function.     

Porphyria cutanea tarda and HLA-linked hemochromatosis. Evidence against a systematic association

This study was designed to test the hypothesis that a hemochromatosis allele is implicated in the expression of porphyria cutanea tarda. HLA phenotypes were determined in 69 porphyria cutanea tarda patients, 42 of which had the sporadic type (normal erythrocyte uroporphyrinogen decarboxylase activity) and 27 unrelated patients who had the familial type (diminished erythrocyte uroporphyrinogen decarboxylase activity). The incidence of HLA antigen A3, a marker of the hemochromatosis allele, was identical in the sporadic patients (23.8%), in the familial patients (22.2%), and in the controls (24.5%). Furthermore, no clinical difference could be found between A3 and non-A3 patients. These results demonstrate no systematic association between hemochromatosis and porphyria cutanea tarda in the population studied. Another HLA-linked gene, however, could be implicated in the expression of the disease as HLA antigen DR7 presented an incidence statistically different (p less than 0.05) between sporadic (16.6%) and familial patients (43%).     

A new porous cohesive support bandage

A new support bandage has been developed that is cohesive, sticking only to itself without adhering to the skin. It is warpknit product, impregnated with an acrylic compound, that consists of individual panels connected by a hinge stitch. It exhibits moderate extensibility under low loads which allows the health professional to apply the bandage so that it gives firm support to the underlying tissue without constriction. Its macroporous structure permits sufficient water vapor transmission to allow the underlying skin and/or wound to remain dry.