Neurological and cytological response as potential early predictors of time-to-progression and overall survival in patients with leptomeningeal carcinomatosis treated with intrathecal liposomal cytarabine: a retrospective cohort study

Interesting neurological and cytological response rates after intrathecal (i.t) liposomal cytarabine have been observed in patients with leptomeningeal carcinomatosis (LMC) from solid tumors. However, the potential use of those responses as early predictors of time-to-progression (TTP) and overall survival (OS) is unexplored. 27 consecutive patients with LMC treated with 50 mg i.t liposomal cytarabine under compassionate drug use were retrospectively studied. All patients received i.t treatment every 2 weeks during induction and every 4 weeks during maintenance periods. Neurological and cytological responses were assessed before every liposomal cytarabine cycle. Most of the patients were female (17/27) diagnosed with breast cancer (15/27). A complete neurological response was seen among 11 % of the patients; partial response in 22 % of the patients; stable disease in 30 % of the patients and progressive disease in 37 % of them. Cytological assessment was available in 11/27 patients showing a 26 % complete response rate. The median time to neurological and cytological response was 15 days and 14 days, respectively. Patients showing a combined neurological and cytological response showed a significantly longer median TTP (122 vs. 3 days; p = 0.001) and OS (141 vs. 3 days; p = 0.002) compared to those showing both neurological and cytological progression. No grade 4 toxicities were recorded. According to these preliminary results, early neurological and cytological responses may be further studied as early predictors of TTP and OS in patients receiving i.t liposomal cytarabine for LMC.     

Impact of prior treatment with immune checkpoint inhibitors on dacarbazine efficacy in metastatic melanoma

Background Despite its low efficacy, chemotherapy with dacarbazine remains an option in metastatic melanoma patients after failure of immune checkpoint inhibitors (ICI) ± targeted therapy. Some observations suggested an increased efficacy of chemotherapy in melanoma or lung cancer patients previously treated with ICI; we aimed to evaluate the efficacy of dacarbazine in a controlled-group study of patients pre-treated or not with ICI.Methods We retrospectively collected data from all consecutive patients treated with dacarbazine for advanced cutaneous melanoma without brain metastasis, in our skin cancer centre between June 2006 and September 2019. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall response rates (ORR), overall survival (OS) and safety of dacarbazine.Results Among 72 patients, 17 (23.6%) received dacarbazine after ICI and 55 (76.3%) without prior ICI. Despite less favourable prognostic factors in patients ICI-pre-treated, median PFS was 4.27 months (range 0.89–43.69) in this group versus 2.04 months (range 1.25–39.25) P = 0.03 in non-ICI-pre-treated patients; ORR were 35.3% and 12.7%, respectively. The median OS and the occurrence of adverse events were similar in both groups.Conclusion Dacarbazine seems to offer a short-lived benefit in patients with progressive advanced disease despite ICI (±targeted therapy), and could be an alternative before considering best supportive care.Subject terms: Melanoma, Immunization     

即刻植入牙槽的种植体预后受种植体周围炎的影响：一个回顾性试点研究

本研究旨在描述一个试验方案,并且分析由种植体周围炎导致的即刻种植体失败的结果。总共17名患者（平均年龄58±10岁）进行了即刻种植,共计有22颗失败的种植体。一颗种植体在植入16个月后失败了,导致种植体成功率为94.7%。平均随访时间为种植后40±16个月（范围在9～52个月内）。近、远中骨的吸收量分别为0.89±0.62mm和0.97±0.66mm。对于因种植体周围炎而导致种植失败的病例,应考虑即刻种植。     

Altered Peptidase Activities in Thyroid Neoplasia and Hyperplasia

Background. Papillary thyroid carcinoma (PTC), follicular thyroid adenoma (FTA), and thyroid nodular hyperplasia (TNH) are the most frequent diseases of the thyroid gland. Previous studies described the involvement of dipeptidyl-peptidase IV (DPPIV/CD26) in the development of thyroid neoplasia and proposed it as an additional tool in the diagnosis/prognosis of these diseases. However, very little is known about the involvement of other peptidases in neoplastic and hyperplastic processes of this gland. Methods. The catalytic activity of 10 peptidases in a series of 30 PTC, 10 FTA, and 14 TNH was measured fluorimetrically in tumour and nontumour adjacent tissues. Results. The activity of DPPIV/CD26 was markedly higher in PTC than in FTA, TNH, and nontumour tissues. Aspartyl aminopeptidase (AspAP), alanyl aminopeptidase (AlaAP), prolyl endopeptidase, pyroglutamyl peptidase I, and aminopeptidase B activities were significantly increased in thyroid neoplasms when compared to nontumour tissues. AspAP and AlaAP activities were also significantly higher in PTC than in FTA and TNH. Conclusions. These data suggest the involvement of DPPIV/CD26 and some cytosolic peptidases in the neoplastic development of PTC and FTA. Further studies will help to define the possible clinical usefulness of AlaAP and AspAP in the diagnosis/prognosis of thyroid neoplasms.     

Delayed granulomatous reaction and cutaneous fistula induced by retained electrodes from a cardiac pacemaker in a child

Permanent epicardial pacing wires are sometimes left in place and can lead to long‐term complications. We report on a case of a granulomatous reaction with a cutaneous fistula secondary to the retained epicardial pacing wires in a child and highlight the relevance of sonography as an additional tool in the diagnosis and management of dermatologic conditions.     

Mathematical Difficulties vs. High Achievement: An Analysis of Arithmetical Cognition in Elementary School

ABSTRACT

This study analyzed the contribution of cognitive processes (planning, attention, simultaneous and successive processing) and domain-specific skills (counting, number processing and conceptual comprehension) to the arithmetic performance achieved in the last three grades (4th, 5th, and 6th) of elementary school. Three groups of students with a different arithmetic achievement level were characterized. The predictive value of the cognitive processes and the math specific skills are explored through diverse covariance and discriminant analyses. Participants were 110 students (M = 10.5 years, SD = 1.17) classified in three groups: mathematical difficulties (MD; n = 26), high achieving (HA; n = 26), and typical achieving (TA; n = 58). Cognitive processes and domain-specific skills were evaluated in two individual sessions at the end of the school year. Nonverbal intelligence was assessed in a final collective session with each class. The mathematical difficulties group’s achievement was deficient in simultaneous and successive processing, number processing, and conceptual comprehension compared to the typical achievement group. High achievement children obtained significantly better results than the typical achievement children in simultaneous processing, counting, number processing, and conceptual comprehension. Number processing and conceptual comprehension were the most consistent classifiers, although successive and simultaneous processing, respectively, also contributed to identifying students with mathematical difficulties and high achievement. These findings have practical implications for preventive and intervention proposals linked to the observed profiles.     

Utilidad y versatilidad del colgajo en isla de la arteria supraclavicular en reconstrucción de cabeza y cuello

Introduction

The supraclavicular island flap is a rotational pedicled flap and may have some advantages in head and neck reconstruction compared with free-tissue transfer when this kind of reconstruction is not affordable or recommended.

Baby and us: Community-based,Feasibility Trial of a Psychosocial Intervention for New Parents and their Infants

Journal of Prevention - Infancy is a critical period during which major developmental transformations occur. Early parenting is one of the strongest influences on infants’ immediate and...