Effect of timing of pulmonary metastasis occurrence on the outcome of metastasectomy in osteosarcoma patients

Background

Complete metastasectomy is the best predictor of survival in patients with osteosarcoma pulmonary metastases. There has been some controversy in the literature regarding the prognostic significance of the timing of occurrence of lung metastasis.

Building Canada��s health research capacity within the framework of the Canadian Institutes of Health Research

The establishment of the Canadian Institutes of Health Research (CIHR) generated considerable excitement about the capacity for health research in Canada. The long term success of the CIHR will be determined, in part, by its ability to recruit, train and retain a cadre of talented researchers. During a workshop to develop the research agenda for one of the proposed institutes within the CIHR, a national, multidisciplinary group of clinical and basic science research trainees were invited to present their views about the challenges that face Canadian researchers of tomorrow. The objective of this paper is to present the challenges associated with recruiting, training and retaining health researchers, and to identify new opportunities provided by the creation of the CIHR. The present paper concludes with suggestions that may improve the success of researchers and, ultimately, the success of the CIHR.     

Intralesional injection of platelet-rich plasma versus steroid in the treatment of oral lichen planus

Background

Oral licen planus (OLP) is a chronic inflammatory disease and may have immunological background. Both intralesional injection of PRP and steroids succeeded in treating and decreasing recurrence of the disease.

Patients and Methods

Twenty-four participants with clinically diagnosed as OLP were enrolled in this study. We separated the patients in 2 groups, 12 patients in group A were treated by intralesional PRP every two weeks for 2 months or stopped if healing occurred earlier. Group B (12 patients) treated by intralesional Triamcinolone Acetonide (TA) (20 mg) every two weeks for 2 months or may be less if healing occurred earlier. The response of OLP lesions to treatment was evaluated by reduction of lesional areas, REU scores, and NRS scores. The patients with complete response (CR; 80%–100% reduction in the lesion area) were followed for 3 months biweekly.

Results

There was a statistically significant decrease in REU and pain score in both groups after treatment compared to before. There was a statistically increase in frequency of side effects among patients received PRP especially pain compared to those treated by steroid. Also, recurrence of the disease after treatment during follow-up for 3 months was more significant among patients treated by PRP.

Conclusion

Intralesional PRP is a good and safe modality for treatment of OLP and intralesional TA. However, there were some side effects and recurrence of disease after follow-up for three months in patients treated by PRP more than those treated by TA.     

Neo‐Adjuvant chemotherapy and its affects to the axilla—Can we safely downgrade axillary surgery to mirror the approach in the breast

The use of neo‐adjuvant chemotherapy (NACT) to downgrade surgery in the breast from mastectomy to breast‐conserving surgery is well‐established. In certain patients, the use of adjuvant axillary radiotherapy can be safe and effective in place of axillary node clearance. What remains less clear are the alternative surgical options to the axilla following NACT. The aim of this study was to examine the effects of NACT in the axilla and whether downgrading axillary node clearance to axillary conserving surgery to mirror the approach in the breast may be a viable and safe practice. Patients undergoing neo‐adjuvant chemotherapy were identified over a seven‐year period between 2010 and 2017. Surgical plans were compared with pre‐ and post‐chemotherapy. Histological information at the time of diagnosis was compared to surgical excision specimens. 349 patients were included for analysis, and 264 had axillary status documented at diagnosis. The average patient age was 51 years, and Grade 3, ER‐positive, and Her2‐negative cancers made the biggest histological subgroups. Complete pathological response (CPR) was seen in the breast in 27% of cases. 19% of patients requiring mastectomy had their surgery downgraded. Following NACT, axillary CPR was seen in 42% of patients and residual axillary nodal burden was limited to four nodes in 73% of patients. Axillary conserving surgery may be a safe alternative surgical approach in the downstaged axilla following neo‐adjuvant chemotherapy. Advances in perioperative identification of suspicious nodes may be needed to facilitate progress.     

Biocontrol of Fusarium graminearum,a Causal Agent of Fusarium Head Blight of Wheat,and Deoxynivalenol Accumulation: From In Vitro to In Planta

Crop diseases caused by Fusarium graminearum threaten crop production in both commercial and smallholder farming. F. graminearum produces deoxynivalenol mycotoxin, which is stable during food and feed processing. Therefore, the best way to prevent the sporulation of pathogens is to develop new prevention strategies. Plant-based pesticides, i.e., natural fungicides, have recently gained interest in crop protection as alternatives to synthetic fungicides. Herein we show that treatment with the methanolic extract of medicinal plant Zanthoxylum bungeanum (M20 extract), decreased F. graminearum growth and abrogated DON production. The F. graminearum DNA levels were monitored by a quantitative TaqMan real-time PCR, while DON accumulation was assessed by HPLC quantification. This M20 extract was mainly composed of four flavonoids: quercetin, epicatechin, kaempferol-3-O-rhamnoside, and hyperoside. The in vitro bioassay, which measured the percent inhibition of fungal growth, showed that co-inoculation of four F. graminearum strains with the M20 extract inhibited the fungal growth up to 48.5%. After biocontrol treatments, F. graminearum DNA level was reduced up to 85.5% compared to that of wheat heads, which received F. graminearum mixture only. Moreover, DON production was decreased in wheat heads by 73% after biocontrol treatment; meanwhile in wheat heads inoculated with F. graminearum conidia, an average of 2.263 ± 0.8 mg/kg DON was detected. Overall, this study is a successful case from in vitro research to in planta, giving useful information for wheat protection against F. graminearum responsible for Fusarium Head Blight and DON accumulation in grains. Further studies are needed to study the mechanism by which M20 extract inhibited the DON production and what changes happened to the DON biosynthetic pathway genes.     

Methotrexate Mechanism of Action in Plaque Psoriasis: Something New in the Old View

BackgroundDespite the era of biologic therapy in the management of psoriasis, methotrexate, the traditional backbone of psoriasis treatment, does not stop surprising us with what it can offer.ObjectiveIn this study, we aimed to evaluate the peripheral expression and the serum levels of TWEAK in patients with psoriasis vulgaris before and after receiving methotrexate treatment.MethodsThe study included 58 patients with moderate to severe psoriasis vulgaris, and 90 apparently healthy individuals as a control group. Before starting the treatment course, all patients were evaluated clinically using Psoriasis Area Severity Index (PASI) score and were subjected to TWEAK serum levels and peripheral expression measurement using ELISA and qRT-PCR techniques, respectively. After 12 weeks of treatment with methotrexate (intramuscular methotrexate; up to 30mg per week) the patients were re-evaluated both clinically and in the laboratory.ResultsThe baseline serum TWEAK levels and its peripheral mRNA expression in the patients group were significantly lower than those in the control group. After 12 weeks of treatment with methotrexate, the PASI scores were reduced significantly while the serum TWEAK levels and its peripheral expression were significantly elevated. ConclusionEnhancing TWEAK expression and elevating its serum levels in psoriasis patients seems to be a newly observed mechanism of action of methotrexate.