Clinical value of 18F-FDG-PET/CT in suspected serious disease with special emphasis on occult cancer

Annals of Nuclear Medicine - Suspected serious disease (SSD) is a disease designation often given to patients with one or more non-specific symptoms of severe disease that could be due to cancer;...     

Effects of hair removal alexandrite laser on biometric parameters of the skin

The effects of alexandrite laser (AL) on skin parameters such as melanin content, skin layer depth, elasticity, and density have not been investigated through biometric methods. We aim to assess the effect of AL on the skin parameters through biometric devices to determine whether it has positive effects on treated region. In this pretest-posttest study, we recruited patients who attended Laser Clinic of Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran, from January through December 2014. Patients had to be free of any dermatologic conditions and lesion at the site of treatment or any contraindication to laser therapy. Baseline measurements were performed and patients received four sessions of AL therapy (spot size, 12 mm; fluence, 12 J/cm²; and pulse width, 5 Hz) with 4-week intervals. Four weeks after the last treatment session, the same parameters were assessed that included skin color, transepidermal water loss (TEWL), dermis and epidermis density and depth (through skin ultrasonography), melanin content, erythema intensity, and skin elasticity. Biometric parameters of 33 patients (27 females [81.8 %]), with mean (SD) age of 35.7 (9.5)?years were evaluated. The mean percent changes of skin parameters were as follows: skin color, 5.88 % through Visioface and by 56.8 % through Colorimeter devices (became lighter); melanin content, ?15.95 %; TEWL, ?2.96 %; elasticity, +14.88 %; dermis depth ?19.01 %; and dermis density, +1580.11 % (P?<?0.001 for changes in each parameter). AL could decrease melanin content of the skin and make the skin thinner while it could increase elasticity and density of epidermis and dermis, which might indicate increased collagen content of skin.     

Characterizing Short-Term Outcomes Following Surgery for Rectal Cancer: the Role of Race and Insurance Status

Background

There is a paucity of data demonstrating the effect race and insurance status have on postoperative outcomes for patients with rectal cancer. We evaluated factors impacting short-term outcomes following rectal cancer surgery.

Design

Patients who underwent surgery for rectal cancer using the University Health System Consortium database from 2011 to 2012 were studied. Univariate and multivariable analyses were used to identify patient related risk factors for 30-day outcomes after proctectomy: complication rate, 30-day readmission, ICU stay, and length of hospital stay (LOS).

Results

A total of 9272 proctectomies were identified in this cohort. After adjustment for potential confounders, black patients were more likely to have 30-day readmissions (OR 1.51, 95 % CI 1.26–1.81), ICU stays (OR 1.25, 95 % CI 1.03–1.51), and longer LOS (+1.67 days, 95 % CI 1.21–2.13) when compared to whites. Compared to those with private insurance, patients with public or military insurance or who were self-pay had a higher likelihood of having postoperative complications.

Conclusions

In patients who undergo elective proctectomy for rectal cancer, non-white and non-privately insured status are associated with significantly worse short-term outcomes. Further studies are needed to determine the implications with respect to receipt of adjuvant therapy and survival.

     

Advances in nano-delivery systems for doxorubicin: an updated insight

Doxorubicin (DOX) is the most effective chemotherapeutic drug developed against broad range of cancers such as solid tumours, transplantable leukemias and lymphomas. Conventional DOX-induced cardiotoxicity has limited its use. FDA approved drugs i.e. non-pegylated liposomal (Myocet^®) and pegylated liposomal (Doxil^®) formulations have no doubt shown comparatively reduced cardiotoxicity, but has raised new toxicity issues. The entrapment of DOX in biocompatible, biodegradable and safe nano delivery systems can prevent its degradation in circulation minimising its toxicity with increased half-life, enhanced pharmacokinetic profile leading to improved patient compliance. In addition, nano delivery systems can actively and passively target the tumour resulting increase in therapeutic index and decreased side effects of drug. Foreseeing the need of a comprehensive review on DOX nanoformulations, in this article we for the first time have given an updated insight on DOX nano delivery systems.     

Human variation and CYP enzyme contribution in benfuracarb metabolism in human in vitro hepatic models

Human responses to the toxicological effects of chemicals are often complicated by a substantial interindividual variability in toxicokinetics, of which metabolism is often the most important factor. Therefore, we investigated human variation and the contributions of human-CYP isoforms to in vitro metabolism of benfuracarb. The primary metabolic pathways were the initial sulfur oxidation to benfuracarb-sulfoxide and the nitrogen-sulfur bond cleavage to carbofuran (activation). The K_m, V_max, and CL_int values of carbofuran production in ten individual hepatic samples varied 7.3-, 3.4-, and 5.4-fold, respectively. CYP2C9 and CYP2C19 catalyzed benfuracarb sulphur oxidation. Carbofuran formation, representing from 79% to 98% of the total metabolism, was catalyzed predominantly by CYP3A4. The calculated relative contribution of CYP3A4 to carbofuran formation was 93%, while it was 4.4% for CYP2C9. The major contribution of CYP3A4 in benfuracarb metabolism was further substantiated by showing a strong correlation with CYP3A4-selective markers midazolam-1′-hydroxylation and omeprazole-sulfoxidation (r = 0.885 and 0.772, respectively). Carbofuran formation was highly inhibited by the CYP3A inhibitor ketoconazole. Moreover, CYP3A4 marker activities were relatively inhibited by benfuracarb. These results confirm that human CYP3A4 is the major enzyme involved in the in vitro activation of benfuracarb and that CYP3A4-catalyzed metabolism is the primary source of interindividual differences.     

Emotional regulation training for intensive and critical care nurses

Professional quality of life is related to psychological well‐being for nurses with implications for quality patient care. This study evaluated the effectiveness of emotional regulation training on depression, anxiety and stress, and professional quality of life for intensive and critical care nurses. In this experimental comparison trial, 60 intensive and critical care nurses were randomly assigned to treatment and wait‐list control groups. The treatment group received six sessions of emotional regulation training, while the wait‐list control group received no treatment. Outcome measures were: the Cognitive Emotion Regulation Questionnaire; the Depression, Anxiety and Stress Scale; and the Professional Quality of Life Scale in a pre‐post design. The treatment group demonstrated greater improvements in burnout and compassion satisfaction compared with the wait‐list control group. No significant reduction in compassion fatigue was found compared with controls. Some cognitive coping strategies improved in the treatment group compared with controls, with greater reductions in depression, anxiety, and stress. This study indicates the benefits of implementing emotional regulation training programs to improve psychological well‐being and professional quality of life for intensive and critical care nurses.