Cancer Incidence in Indians from Three Areas: Delhi and Mumbai,India, and British Columbia,Canada

Background Studies of immigrants have provided unique opportunities for examining disparities in cancer screening and the impact of lifestyles and environmental exposures on cancer risk. Findings have been useful for planning cancer control strategies and generating etiological hypotheses. Although India is a leading source of immigration to British Columbia (BC), Canada, little is known about the cancer profiles of Indo-Canadians, information needed for planning health services and health promotion initiatives for this population. Methods Using data from three population-based cancer registries, cancer incidence was compared for four population groups (in each of Delhi and Mumbai, India; Indo-Canadians in BC, Canada; and the BC general population) over three time periods (1976–1985, 1986–1995 and 1996–2003). BC Indo-Canadians were identified by using Indian surnames. Results Age-standardized incidence rates (ASRs) for all cancers combined were lowest for men and women in Delhi and Mumbai, intermediate for BC Indo-Canadians, and highest for the BC general population. Ranking of common cancer sites and ASRs for Indo-Canadian men and women more closely resembled those for the BC general population, rather than those for either Delhi or Mumbai. ASRs and rankings of common cancer sites are presented by gender for the four population groups. Conclusions Cancer incidence patterns in BC Indo-Canadian men and women differed from those in India, being more similar to the BC general population.     

Assessing the economic burden of breast cancer in a US managed care population

BACKGROUND: Breast cancer is the most commonly diagnosed non-skin cancer and second leading cause of cancer deaths among women in the US. This study compared healthcare resource utilization and costs in women with breast cancer to a control group in a managed care population. MATERIAL AND METHODS: Women >or= 18 years with breast cancer were identified using ICD-9 codes from claims databases of five US health plans during 2004. A randomly matched control group of women without cancer served as a comparator group. Healthcare costs included all medical and pharmacy costs during the year. Comparisons were made using per patient per month (PPPM) costs (total costs per patient within 2004 calendar year/months of eligibility). RESULTS: 10,697 women (mean age 55 years) with breast cancer were identified (prevalence of 250 per 100,000) in 2004, with prevalence increasing with age. Mean attributable PPPM costs associated with breast cancer were $2,896 (median = $1,940) with hospitalization contributing most of the costs ($1,340), followed by pharmacotherapy ($537), and surgical intervention ($470). Mean unadjusted all-cause PPPM total costs were $4,421 (median = $2,964) compared to $3,352 (median = $665) p < 0.0001) for cases and controls respectively. Multivariate analyses controlling for differences in comorbidities showed mean adjusted PPPM costs to be 2.28 times (p < 0.0001) higher than non-breast cancer controls. DISCUSSION: This study demonstrated that breast cancer treatment was associated with substantial healthcare costs, driven mainly by hospitalizations. Projected annual costs for a breast cancer patient would be at least $12,828 higher than that for women without breast cancer based upon unadjusted cost differences.     

Trends in the brain cancer incidence in India

Trends in cancers of the central nervous system in both sexes in five Indian population based cancer registries (Mumbai, Chennai, Bangalore, Delhi and Bhopal) were evaluated over a period of the last two decades. For this purpose we applied a model that fits the data to a Linear Regression model. This approach revealed an increasing trend in cancers of nervous system in both sexes throughout the entire period of observation in almost all registries. As CNS cancers are increasing, analytic epidemiological studies should be planned in a near future on a priority basis to understand the etiology of these cancers in depth.     

Total laparoscopic hysterectomy with earlier uterine artery ligation

We compared the feasibility, blood loss, duration of surgery, and complications between patients in whom both uterine arteries were sutured at the beginning of total laparoscopic hysterectomy (TLH) and patients in whom suturing was done after cornual pedicles. Using a prospective study (Canadian Task Force classification II-2) at a dedicated high-volume gynecologic laparoscopy center, a total of 350 women who underwent TLH from January 2005 through January 2007 were assigned into 2 groups. The indications for TLH were predominantly myomas and menorrhagia. In group A, TLH was done by suturing both uterine arteries at the beginning of the procedure. In group B, the uterine arteries were sutured after the cornual pedicles as done conventionally. All the other pedicles were desiccated and cut either with harmonic ultracision or bipolar diathermy. The uterus with cervix was removed either vaginally or by morcellation. The median age of patients in group A was 46 years and in group B was 44 years. Mean uterine size, weight, estimated blood loss, total operating time, need for blood transfusion, and complications were analyzed. In group A the total duration of surgery was 60 minutes (range 20-210). In group B, the total duration of surgery was 70 minutes (range 30-190). In group A, the median total blood loss was 50 mL (range 10-2000). In group B the total blood loss was 60 mL (range 10-2500). The comparison between the 2 groups revealed a statistically significant difference (p <.05, Mann-Whitney test). Need for blood transfusion was less in group A. One patient in group A had secondary hemorrhage 3 weeks later and the vaginal vault was resutured. In group B, 2 patients had blood loss more than 1500 mL (uterus weight > 1000 g) and required 4 units of packed cell transfusion in each. One patient in group B with previous cesarean section had a bladder wall rent and this was sutured laparoscopically using 3-0 delayed absorbable sutures. Uterine artery ligation at the beginning of TLH as done in group A is a technically feasible procedure. It reduces the total blood loss and decreases the time taken for the procedure.     

Development and Validation of High-performance Thin Layer Chromatographic Method for Ursolic Acid in Malus domestica Peel

Ursolic acid, a pentacyclic triterpenoid possess a wide range of pharmacological activities. It shows hypoglycemic, antiandrogenic, antibacterial, antiinflammatory, antioxidant, diuretic and cynogenic activity. It is commonly present in plants especially coating of leaves and fruits, such as apple fruit, vinca leaves, rosemary leaves, and eucalyptus leaves. A simple high-performance thin layer chromatographic method has been developed for the quantification of ursolic acid from apple peel (Malus domestica). The samples dissolved in methanol and linear ascending development was carried out in twin trough glass chamber. The mobile phase was selected as toluene:ethyl acetate:glacial acetic acid (70:30:2). The linear regression analysis data for the calibration plots showed good linear relationship with r²=0.9982 in the concentration range 0.2-7 μg/spot with respect to peak area. According to the ICH guidelines the method was validated for linearity, accuracy, precision, and robustness. Statistical analysis of the data showed that the method is reproducible and selective for the estimation of ursolic acid.     

Treprostinil inhibits the adhesion and differentiation of fibrocytes via the cyclic adenosine monophosphate-dependent and Ras-proximate protein-dependent inactivation of extracellular regulated kinase

Fibrocytes comprise a recently described cell type of blood-derived, fibroblast-like cells that are recruited from the circulation to sites of wound repair, vascular remodeling, or fibrotic tissue remodeling. We recently showed that the stable prostacyclin analogue treprostinil, a clinically approved drug for pulmonary arterial hypertension (PAH), significantly reduced the recruitment of fibrocytes to sites of vascular remodeling in experimental hypoxic pulmonary hypertension. Here we report on the molecular mechanism underlying the inhibitory action of treprostinil on the adhesion and differentiation of human fibrocytes. Human fibrocytes expressed the prostanoid receptors, prostaglandin I (IP) receptors and prostaglandin E subtype receptors (EP2 and EP4). The generation of intracellular cyclic adenosine monophosphate (cAMP) by treprostinil reduced the expression of the integrins CD49 and CD29 when freshly isolated human peripheral blood mononuclear cells were treated with treprostinil. Cell-matrix adhesion was significantly impaired by treatment with treprostinil. We present evidence for a treprostinil/cAMP-induced downstream suppression of extracellular regulated kinase (ERK) that is transmitted via a protein kinase A-independent pathway through Rap proteins, which sequester Ras. The resulting dephosphorylated state of c-Raf limits the activity of ERK. The cell-matrix adhesion assay with the ERK inhibitor further confirmed that the adhesion of fibrocytes was impaired. Thus our data suggest that treprostinil inhibits the adhesion and differentiation of fibrocytes by limiting the activity of ERK via the cAMP-Rap axis.     

Docetaxel in cationic lipid nanocapsules for enhanced in vivo activity

The usefulness of Docetaxel (DT) as an anti-cancer agent is limited to parenteral route owing to its very poor oral bioavailability. Thus, to improve its oral efficacy, DT was loaded in novel cationic lipid nanocapsules (DT CLNC). The DT CLNC possessed size of 130–150?nm, zeta potential of +72mV, adequate DT loading and over 95% encapsulation efficiency. TEM revealed capsular structure of DT CLNC. Lipolysis study indicated improved solubilization of DT by nanocapsules in comparison to DT solution. DT CLNC exhibited significantly higher release of DT in comparison to DT solution during in vitro permeation studies employing non-reverted rat-intestinal sac. Superior uptake of DT in zebra fishes exposed to DT CLNC resulted in greater apoptosis-based cell death as compared to those exposed to DT solution. This correlated well with the significantly superior (p?<?0.05) anti-angiogenic activity of DT CLNC system over DT solution, in zebra fish model. DT CLNC also inhibited tumor growth in melanoma cell line induced tumors in C57BL/6 mice significantly, as compared to DT solution (p?<?0.05). The DT CLNC system demonstrated adequate stability, with tremendous potential to improve oral efficacy of DT and can serve as an alternative to existing DT formulations available commercially for parenteral use.