Combined chemotherapy and ALA-based photodynamic therapy in leukemic murine cells

The effects of combined administration of doxorubicin (DOX) and vincristine (VCR), with 5-aminolevulinic acid photodynamic treatment (ALA-PDT), were analyzed in sensitive murine leukemic cell lines (LBR-) and DOX and VCR chemoresistant LBR-D160 and LBR-V160 cell lines. Low doses of DOX and VCR increased anti-cancer effect of ALA-PDT in LBR-cells. Decrease in cell survival was higher when the combination VCR+ALA-PDT was used compared to DOX+ALA-PDT. Resistant cell lines LBR-D160 and LBR-V160 were sensitive to ALA-PDT; however, no changes occured when combining therapies. Thus, ALA-PDT can overcome drug resistance and is a good candidate for using treating multidrug resistant (MDR) cells.     

Checkpoint‐Inhibitoren in der Immuntherapie: Ein Meilenstein in der Behandlung des malignen Melanoms

It has been known for decades that the immune system is able to detect and destroy tumor cells. In the past, this knowledge – mostly acquired through animal experiments – could not be used to benefit our patients, because immuno‐oncological therapeutic approaches in humans had constantly failed over recent decades. With the exception of adjuvant interferon therapy, none of these approaches had found its way into everyday clinical practice, and only very few patients were able to enjoy long‐term survival associated with good quality of life. With the advent of novel immunological approaches, the meaning of long‐term survival as well as quality of life has been redefined for oncological patients. For the first time, a significant percentage of patients responds to treatment with immune checkpoint inhibitors, showing long‐term remission and even cure. It has already become apparent that immunotherapy will in the future be one of the therapeutic mainstays in the treatment of metastatic melanoma as well as many other tumor types. The present review article presents the most important new treatment modalities, their mechanism of action, clinical data regarding treatment response, and adverse events to be expected.     

A randomised clinical trial comparing the flexible fibrescope and the Pentax Airway Scope (AWS)® for awake oral tracheal intubation

We compared awake fibreoptic intubation with awake intubation using the Pentax Airway Scope^® in 40 adult patients. Sedation was achieved using a target‐controlled remifentanil infusion of 1–5 ng.ml^?1 and midazolam. The airway was anaesthetised with lidocaine spray and gargle. The total procedure time – a composite of sedation time, topical anaesthesia time and intubation time – was recorded. The operator's impression of the ease of the procedure and the patients' reported comfort were recorded on a 0–100 mm visual analogue scale. The median (IQR [range]) for total procedure time was 900 (739–1059 [616–1215]) s with the fibrescope and 651 (601–720 [498–900]) s with the Pentax Airway Scope (p = 0.0001). The median (IQR [range]) intubation time was 420 (283–480 [120–608]) s with the fibrescope and 183 (144–220 [107–420]) s with the Pentax Airway Scope (p = 0.0002). The median (IQR [range]) visual analogue scores for the operator's ease of intubation for the fibrescope and Pentax Airway Scope were 83.6 (72.0–98.0 [49.0–100.0]) and 86.8 (84.0–91.0 [61.0–100.0]), respectively (p = 0.3507). The median (IQR [range]) visual analogue score for patient comfort was 85.5 (81.0–97.0 [69.0–100.0]) and 79.4 (74.0–85.0 [59.0–100.0]) for the fibrescope and Pentax Airway Scope, respectively (p = 0.06). Total procedure time was significantly shorter with the Pentax Airway Scope compared with the fibrescope, with no difference in procedure difficulty or patient discomfort.     

Platinum-based chemotherapy in triple-negative advanced breast cancer

The purpose of this study was to evaluate the efficacy of platinum-based chemotherapy (PBC) versus conventional non-PBC regimens in a metastatic triple-negative breast cancer (TNBC) setting. We reviewed the electronic patient records of patients with confirmed metastatic TNBC at four major cancer centres in Canada. All patients were allocated into two groups based on type of chemotherapy received (PBC vs. non-PBC) and line of treatment (first-, second-, or third-line). The primary objective of this study was to evaluate the efficacy of PBC in metastatic TNBC in terms of median duration of overall survival (OS) from diagnosis of distant metastatic disease and compare it with the efficacy of conventional non-platinum-based chemotherapy in metastatic TNBC after controlling for known prognostic factors. A total of 153 metastatic TNBC patients were identified, 58 treated with PBC and 95 with non-PBC. The median time in first-line PBC versus non-PBC was not different between the two groups (2 vs. 2 months, p = 0.9), the median time on treatment in second and third-line therapy was longer for the PBC group compared to the conventional treated group (4 vs. 1 months, p = 0.004; 4 vs. 0.5 months, p = 0.004, respectively). Patients who received PBC had a longer OS compared to those managed conventionally (14.5 vs. 10 months, p = 0.041). This study evaluates the survival outcomes in a homogenous group of TNBC metastatic patients treated with or without PBC. Our results confirmed our hypothesis of a better OS among PBC-treated TNBC patients compared to conventionally managed TNBC patients. Currently ongoing Phase III trials assessing the benefit of PBC versus other chemotherapeutic regimens in advanced TNBC will help define the role of these agents for the management of this breast cancer subtype.     

The Effects of Enhanced Milieu Teaching and a Voice Output Communication Aid on the Requesting of Three Children with Autism

The purpose of this study was to evaluate the effects of enhanced milieu teaching when combined with a voice output communication aid on the requesting skills of three children with autism. The research design was a multiple probe across participants. All sessions were conducted during 5-min play sessions in the child's classroom. All three children learned to use the voice output communication aid to request items during play. Additionally, all three children increased their total requesting during play.     

Nanocomposites based on the graphene family for food packaging: historical perspective,preparation methods,and properties

Nanotechnology experienced a great technological advance after the discovery of the graphene family (graphene – Gr, graphene oxide – GO, and reduced graphene oxide-rGO). Based on the excellent properties of these materials, it is possible to develop novel polymeric nanocomposites for several applications in our daily routine. One of the most prominent applications is for food packaging, offering nanocomposites with improved thermal, mechanical, anti-microbial, and barrier properties against gas and water vapor. This paper reviewed food packaging from its inception to the present day, with the development of more resistant and intelligent packaging. Herein, the most common combinations of polymeric matrices (derived from non-renewable and renewable sources) with Gr, GO, and rGO and their typical preparation methods are presented. Besides, the interactions present in these nanocomposites will be discussed in detail, and their final properties will be thoroughly analyzed as a function of the preparation technique and graphene family-matrix combinations.

Food packaging based on nanotechnology of polymeric nanocomposites of graphene and graphene oxide results in packaging with better thermal, mechanical, antimicrobial, electrical packaging, moisture barrier and gas properties.     

Gout Severity in Recipients of Kidney Transplant

PurposeThis retrospective analysis of medical chart data was performed to compare severity and treatment of gout in patients with or without a history of kidney transplantation (KT).MethodsVia an online survey, a panel of board-certified US nephrologists (N = 104) provided the following deidentified chart data for their 3 most recent patients with gout: age, sex, serum uric acid, numbers of swollen or tender joints, visible tophi, gout flare events (prior 12 months), gout drug treatment history, and KT history. The presence of “severe, uncontrolled gout” was defined as: serum uric acid ≥ 7.0 mg/dL, ≥1 tophi and ≥2 flares in the last 12 months, and history of xanthine oxidase inhibitor treatment.ResultsTwenty-five out of 312 (8.0%) gout patients had a history of KT. Univariate analysis found that patients with gout and history of kidney transplants had: greater prevalence of severe uncontrolled gout (27% vs 8%, P = .007) and tophi (36% vs 17%, P = .030), and higher rates of failure or physician perceived contraindication to allopurinol (44% vs 23%, P = .028).ConclusionThis study provides preliminary evidence that gout in patients with history of KT is more severe and poses greater challenges to pharmacologic management. Although gout has been linked to worse outcomes among kidney recipients in the literature, there are presently no publications on gout severity among patients with KT in comparison to other patients with gout. Further investigation of disease severity and appropriate, effective treatment options in recipients of kidney transplant with a diagnosis of gout, especially prior to the transplant, is warranted.     

PREDICTION OF NEURODEVELOPMENTAL IMPAIRMENT AT FOUR YEARS FROM BRAIN ULTRASOUND APPEARANCE OF VERY PRETERM INFANTS

The neurodevelopmental status of 171 very preterm infants whose brains had been scanned prospectively with ultrasound was assessed blind at four years using a wide range of tests, including tests of cognitive function. Highly significant correlations were found between the ultrasound appearance of the brain and outcome. The probability of a major neurodevelopmental impairment among the 137 children who had a normal ultrasound scan or uncomplicated periventricular haemorrhage at discharge from the unit was 7 per cent; and for any neurodevelopmental impairment (major plus minor) it was 22 per cent. The probabilities for major, or any, neurodevelopmental impairment among the 18 children who had ventricular dilatation were 33 and 50 per cent, respectively; and for the 16 with hydrocephalus and/or cerebral atrophy (loss of brain-tissue from any cause) the probabilities were 56 and 69 per cent. Impairments predicted from lesions detected by ultrasound were largely neurological. There was no evidence that cognitive impairments could be predicted among infants free of neurological impairments.