Association of Insulin Resistance and Higher Oncotype DX™ Recurrence Score

Annals of Surgical Oncology - Black women with breast cancer have a worse overall survival compared with White women; however, no difference in Oncotype DX? (ODX) recurrence scores has been...     

ASO Visual Abstract: Will It Play in Peoria? A Pilot Study of a Robotic Skills Curriculum for Surgical Oncology Fellows

Annals of Surgical Oncology -     

Eating patterns and unhealthy weight control behaviors are associated with loss-of-control eating following bariatric surgery

BackgroundLoss-of-control (LOC) eating is associated with poor weight-loss outcomes following bariatric surgery. It is not clear whether eating patterns (e.g., total number of daily meals/snacks, eating after suppertime, eating when not hungry) and unhealthy weight control behaviors (e.g., smoking, using laxatives) are associated with or predictive of LOC eating.ObjectivesTo examine whether eating patterns and unhealthy weight-control behaviors are associated with LOC eating and, if so, whether they predict LOC eating in bariatric patients.SettingMulticenter study, United States.MethodsThis is a secondary analysis of the Longitudinal Assessment of Bariatric Surgery–2 study. Assessments were conducted before surgery and at 12, 24, 36, 48, 60, and 84 months after surgery. Logistic mixed models were used to examine the longitudinal associations between eating patterns, unhealthy weight-control behaviors, and LOC eating. Time-lag techniques were applied to examine whether the associated patterns and behaviors predict LOC eating.ResultsThe participants (n = 1477) were mostly women (80%), white (86.9%), and married (62.5%). At the time of surgery, the mean age was 45.4 ± 11.0 years and the mean body mass index was 47.8 ± 7.5 kg/m². The total number of daily meals/snacks, food intake after suppertime, eating when not hungry, eating when feeling full, and use of any unhealthy weight-control behaviors were positively associated with LOC eating (P < .05). Food intake after suppertime, eating when not hungry, and eating when feeling full predicted LOC eating (P < .05).ConclusionMeal patterns and unhealthy weight control behaviors may be important intervention targets for addressing LOC eating after bariatric surgery.     

The geographic distribution of un-immunized children in Ontario,Canada: Hotspot detection using Bayesian spatial analysis

BackgroundIn Ontario, Canada, little is currently known about the extent to which un-immunized children may cluster geographically. Our objectives were to: describe the geographic distribution of fully un-immunized children; identify geographic clusters (hotspots) of un-immunized children; and to characterize the contribution of spatial effects and covariates on hotspots, where found.MethodsOur analytic cohort consisted of Ontario students aged 7–17 years in the 2016–2017 school year. We defined students as un-immunized if they had zero doses of any vaccine and a non-medical exemption recorded in Ontario’s registry. We calculated unadjusted proportions of un-immunized students by Census Subdivision (CSD) and then used a sequential approach to identify hotspots starting first with hotspot identification at the CSD level and then probed identified hotspots further by Dissemination Area (DA) and including covariates. Hotspots were identified using the Besag-York-Mollie Bayesian spatial model and were defined as areas with >95% probability of having two times the proportion of un-immunized students, relative to the province overall.ResultsWe identified 15,208 (0.94%) un-immunized children within our cohort consisting of more than 1.61 million students. Unadjusted proportions of un-immunized students varied greatly by geography, ranging from 0% to 21.5% by CSD. We identified 16 hotspot CSDs which clustered in five distinct areas, all of which were located in southern Ontario. The contribution of covariates and spatial effects on the risk of having un-immunized students varied greatly across hotspot areas.ConclusionsAlthough the provincial proportion (0.94%) of un-immunized students is small, geographical clustering of such students is evident in Ontario and in some areas presents an important risk for future outbreaks. Further qualitative work within these hotspot areas would be a helpful next step to better characterize the factors associated with vaccine refusal in these communities.     

Two-Generation Reproductive Toxicity Study of Dietary Tributyl Phosphate in CD Rats

Tributyl phosphate (TBP) was tested for reproductive toxicityin rats. Thirty weanlings/sex (F0) were exposed to TBP in thediet ad libitum at 0, 200, 700, or 3000 ppm for 10 weeks andthen randomly mated within groups for 3 weeks with continuedexposure. F0 parents and 10 F1 weanlings/sex/dose were necropsied,and adult reproductive organs, urinary bladders (both sexes),kidneys (males), and livers (females) were evaluated histologically.Thirty F1 weanlings/sex/dose continued exposure for 11 weeksand were bred as described above. F1 parents and P2 weanlings,10/sex/dose, were then necropsied as described above. Adulttoxicity was observed in both sexes and generations at 700 and3000 ppm; observations included reduced body weights, weightgain and feed consumption, urinary bladder epithelial hyperplasia(both sexes), renal pelvis epithelial hyperplasia only at 3000ppm (male kidneys), and centrilobular hypertrophy (female livers).At 200 ppm, transient reductions in body weight were observedin F0 and F1 females, with urinary bladder epithelial hyperplasiain F0 males and females and in F1 males. There was no evidenceof reproductive toxicity, of reproductive organ pathology, orof effects on gestation or lactation at any dose tested. Postnataltoxicity was evidenced by consistent reductions in F1 and F2pup body weights at 3000 ppm and by occasional weight reductionsin F2 litters at 700 ppm, and was associated with maternal toxicityobserved at these doses and times. Under the conditions of thisstudy, a NOAEL was not determined for adult toxicity; the NOAELfor reproductive toxicity was at least 3000 ppm and the NOAELfor postnatal toxicity was approximately 200 ppm.     

Phase II study of intravenous melphalan (NSC-8806) in the treatment of patients with advanced squamous carcinoma of the head and neck

The Illinois Cancer Center entered 25 patients on a phase II trial of intravenous melphalan treating patients with recurrent, metastatic or locally advanced and inoperable squamous cell carcinoma of the head and neck. All patients had bi-dimensionally measurable disease, at least a sixty day life expectancy, and adequate performance status (ECOG scale 2). All patients except one had received prior radiotherapy, chemotherapy or both. Melphalan dosage was 30 mg/m² every three weeks. Twenty-four patients were evaluable for response. One patient with laryngeal carcinoma had a clinical complete response of a nodal metastasis. Four patients had stabilization of disease for one to three months. There was formidable toxicity, including neutropenia (ANC < 1000/l 36%), and thrombocytopenia (< 50,000/l 32%). There were no drug-related deaths. Melphalan administered intravenously does not appear to be efficacious therapy in patients with previously treated advanced head and neck squamous carcinomas.