Tropism of herpes simplex virus type 1 to nonmelanoma skin cancers

Background Current treatments for nonmelanoma skin cancer include surgery, Mohs micrographic surgery, radiation, cryosurgery, photodynamic therapy, local chemotherapy and application of immunomodulators such as imiquimod. However, all have a 5‐year recurrence rate of 1–40%. Gene therapy for the treatment of skin cancers is a promising new approach, as delivery of the vectors to the skin is simple and safety issues can be properly addressed. Objectives To develop an ex‐vivo organ culture system for basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) tumours, and to test the feasibility of applying oncolytic viruses to these tumours. Methods We first optimized conditions for the maintenance of BCC and SCC tissues in organ culture, and demonstrated viability of the tissues ex vivo for 3–7 days. The tropism of two potential oncolytic viral vectors, herpes simplex virus type 1 (HSV‐1) and adenovirus (AD), was next evaluated. Results Immunohistological analysis revealed that HSV‐1 targeted tumour cells that expressed p63 and did not express keratin 15 or keratin 14 markers of keratinocytes. Further examination indicated that uninfected BCC and SCC tissues express two isoforms of p63 mRNA, and HSV‐1 infection specifically enhanced expression of the TAp63 isoform. Furthermore, following infection, both HSV‐1 and AD induced apoptosis in the BCC and SCC cells as indicated by the induction of activated caspase‐3. Conclusions The results indicated a specific pattern of viral tropism to skin cancer cells that are critical for maintenance of the tumour. This new experimental system should aid in the analysis of new therapeutic modalities, such as oncolytic viruses, for future treatment of these skin tumours.     

Duration of temporary disability of patients after selective proximal vagotomy

The investigation of factual terms of temporary invalidity after selective proximal vagotomy without draining operations of the stomach in a number of regions of the Ukrainian SSR has shown their considerable variability (56.4 +/- 13.8 days). Under observation were 178 patients. It has been established that normal indices of homeostasis, functions of the gastro-intestinal tract, regeneration of the postoperative scar and recovery of their physical labour capacity is taking place during 30-33 days. Criteria for the determination of terms of temporary invalidity after selective proximal vagotomy for the ulcer disease of the duodenum have been elaborated.     

Validity of self-reports of breast cancer treatment in low-income, medically underserved women with breast cancer

Few studies have assessed the agreement between subjects’ self-report and medical records among patients with breast cancer (BC), and none has addressed this issue in low-income women with BC. We assessed the level of agreement between self-report and medical records data for key BC treatment and prognostic characteristics using correct proportion and the Kappa statistic, among 726 low-income BC patients. Unconditional regression was used to investigate the association between accuracy of self-report and potential explanatory factors. Overall agreement between self-report and medical records was 95.3–99.6% for BC treatments including surgery, chemotherapy, radiotherapy and hormone therapy (Kappa = 0.79–0.99). Specific agreement was 87–89.5% for surgery type (Kappa = 0.51–0.96); 86.3% for chemotherapy completion (Kappa = 0.46) and 98.7% for radiotherapy completion (Kappa = 0.43); 95.2% for medical oncologist consultation (Kappa = 0.59) and 96% for radiation oncologist consultation; 97.3% for metastasis (Kappa = 0.56); and 93.6% for recurrence (Kappa = 0.30). When accepting answers within 15 days of the medical record date, 78.2% of women correctly reported surgery date, yet only around 55% of women correctly reported the start and/or end date of radiotherapy. Older age, less education, BC recurrence and poor patient–physician communication were associated with the lesser accuracy of patients’ self-report compared to medical records (P < 0.05). The results of this study suggest that self-reporting of key treatment and prognostic information is relatively accurate among low-income women with BC. Self-report seems to be a reliable source for accurate information when medical record review is unavailable or unfeasible. Interventions to enhance patient–physician communication may facilitate more accurate information reporting among vulnerable populations.     

Incidence of Chlamydia trachomatis infections in pregnant patients in Vienna

Pregnant women were examined for chlamydia trachomatis-infection on a routine basis during a multicentric study in Vienna. Samples were taken from the cervix and fornix between the 30th and 34th week pregnancy. FTIC-conjugated monoclonal antibodies and immunofluorescence techniques were used to verify chlamydia trachomatis. Out of 1238 pregnant women, 101 (8.16%) were positive for chlamydia trachomatis. Since chlamydia infections can result in severe local or generalized complications and also spread to the newborn baby, screening investigations should be regularly performed during pregnancy and, if indicated, adequate treatment undertaken.     

Annual conversion to Alzheimer disease among patients with memory complaints attending an outpatient memory clinic: the influence of amnestic mild cognitive impairment and the predictive value of neuropsychological testing

Summary OBJECTIVE: The goals of this study were to determine the annual conversion rate to Alzheimer disease (AD) among patients reporting memory problems, including a subgroup with amnestic mild cognitive impairment (aMCI), and to investigate the predictive value of neurocognitive testing for future dementia. METHODS: A prospective study was carried out in an outpatient memory clinic. One hundred and seven patients underwent a clinical examination and completed a battery of standard cognitive tests at study entry and two years later. The conversion rate to clinically manifested AD two years later was investigated, and sensitivity, specificity, receiver operating characteristics (AUC), positive predictive value and negative predictive value for each neuropsychological test were determined. RESULTS: We found an annual rate of conversion to AD of 6.5% among patients reporting memory decline in the setting of our clinic. Specifically, patients with aMCI had an annual conversion rate of approximately 20%. The annual conversion rate for patients reporting memory problems but showing no memory deficit at memory testing was approximately 3%. Receiver operating characteristics (AUC) of the neuropsychological tests ranged from 0.60 to 0.94. CONCLUSIONS: Patients with aMCI have 8.6-fold higher odds of developing AD compared with patients without evident memory impairment on neuropsychological testing. Although the risk of developing AD among patients without objective memory decline is small, some patients in this group still convert to AD, and therefore, close clinical monitoring of patients is necessary.

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J?hrliche Konversionsrate von Patienten mit Ged?chtnisbeeintr?chtigung zur Alzheimerkrankheit: Der Einfluss von amnestischer MCI und die pr?diktive Aussagekraft der neuropsychologischen Testung

Zusammenfassung ZIEL: Ziel der vorliegenden Studie war die Bestimmung der j?hrlichen Konversionsrate von Patienten mit subjektiver Ged?chtnisbeeintr?chtigung zur Alzheimerkrankheit unter Berücksichtigung der amnestischen Milden Kognitiven St?rung (aMCI). Die Wertigkeit zur Vorhersage der Konversion durch einzelne neuropsychologische Testverfahren wurde ebenfalls untersucht. METHODIK: Im Rahmen einer Ged?chtnisambulanz wurde eine prospektive Studie durchgeführt. 107 Patienten wurden in die Studie inkludiert. Alle Patienten durchliefen eine neurologische und eine neuropsychologische Untersuchung am Beginn der Studie und nach zwei Jahren am Ende der Studie. Einerseits wurde die Konversionsrate zur Alzheimerkrankheit untersucht, und anderseits wurden einige Kennwerte der Kriteriumsvalidit?t (Sensitivit?t, Spezifit?t, Receiver Operating Characteristics [AUC], Positive Predictive Value, Negative Predictive Value) einzelner neuropsychologischer Testverfahren zur Vorhersage der Alzheimerkrankheit bestimmt. RESULTAT: Wir fanden eine j?hrliche Konversionsrate von 6,5 % für Patienten, die eine Beeintr?chtigung der Ged?chtnisfunktionen berichteten. Patienten mit aMCI hatten eine j?hrliche Konversionsrate von ungef?hr 20 %. Die j?hrliche Konversionsrate von Patienten mit subjektiver Ged?chtnisbeeintr?chtigung ohne testpsychologisch nachweisbare Ged?chtnist?rung lag bei ungef?hr 3 %. Receiver operating characteristics (AUC) für einzelne neuropsychologische Verfahren lagen zwischen 0,60 und 0,94. KONKLUSION: Patienten mit aMCI haben, im Vergleich zu Patienten ohne neuropsychologisch fassbare Ged?chtnisst?rung, eine 8,6-fache Wahrscheinlichkeit, innerhalb von zwei Jahren eine klinisch manifeste Alzheimerkrankheit zu entwickeln. Obwohl die Wahrscheinlichkeit für Patienten ohne neuropsychologisch fassbare Ged?chtnisst?rung, innerhalb von zwei Jahren eine Alzheimerkrankheit zu entwickeln, gering ist, konvertieren einige wenige Patienten doch zur Alzheimerkrankheit. Engmaschige Kontrolluntersuchungen sind deshalb notwendig.