Chemical constitution and effect of extracts of tomato plants byproducts on the enteric viral surrogates

Byproducts of tomato are known to include phenolic compounds but have not been studied in depth. In this study, the phenolic compositions of (stem, leaf, root, and whole plant) of two tomato cultivars, Pitenza and Floradade, were analyzed by HPLC-DAD. In parallel, the antiviral effects of crude extracts on viral surrogates, the bacteriophages MS2 and Av-05 were evaluated. The leaf extracts from the two varieties showed the highest concentration of phenolic compounds. The compounds identified were gallic acid, chlorogenic acid, ferulic acid, cafeic acid, rutin, and quercetin, and they represented 3174.3 and 1057.9?mg/100?g dried weight of the Pitenza and Floradade cultivars, respectively. MS2 and Av-05 titers at 5?mg/mL were reduced by 3.47 and 5.78 log₁₀ PFU/mL and 3.78 and 4.93 log₁₀ PFU/mL by Pitenza and Floradade cultivar leaf extract, respectively. These results show that tomato extracts are natural sources of bioactive substances with antiviral activity.     

Influence of hemoglobin levels on survival after radical treatment of esophageal carcinoma with radiotherapy

Introduction The objetive was to investigate the possible progn ostic value of blood hemoglobin concentration in the outcome of radical treatment for locally advanced esophageal carcinoma. Materials and method This was a retrospective analysis of data for 85 patients treated for locally advanced esophageal carcinoma between January 1991 and January 1997 with chemoradiotherapy alone or as neoadjuvant therapy. All patients received chemotherapy (4 cycles of cisplatin 100 mg/m² on day 1, and continuous infusion 5-fluorouracil 1 g/m² per day on days 1–5) with concomitant radiotherapy (40 Gy at 2 Gy/session to the esophageal tumor and mediastinum). The response was evaluated after 4 weeks. 69 patients continued toreceive chemoradiotherapy only to a total dose of 60–64 Gy to the esophageal tumor with a 2-cm margin. Sixteen patietns underwent radical surgery. Hemoglobin levels were measured before combined treatment in all patients. The prognostic value of hemoglobin concentration was analyzed statistically, along with other patient-, tumor- and treatment-related factors. Results Mean follow-up time: 82 months (range 60–99 months). Chemoradiotherapy was followed by an overall clinical response of 69.4%, with complete clinical response in 24.7% of the patients. Mean survival time was 12 months, and overall likelihood of survival after 3 years was 13%. Mean time to progression: 5 months. Median survival time was 12 months in the 69 patients who underwent chemoradiotherapy alone, and 26 months in patients who underwent radical surgery. Univariate analysis showed a hemoglobin value of >13 g/dl to be a prognostic factor for better survival, along with performance status according to the ECOG classification, weight loss <10%, tumor stage, tumor length, and complete response to chemoradiotherapy. Multivariate analysis showed that only hemoglobin concentration was an independent prognostic factor: for each unit increase in hemoglobin level, the risk of death from esophageal carcinoma decreased by 5%. In the subgroup of patients who did not undergo surgery, hemoglobin concentration was also an independent prognostic factor along with complete clinical response. Conclusions As found for other solid tumors, hemoglobin level was a determining factor in the prognosis for treatment outcome in patients with esophageal carcinoma. Our findings require confirmation in randomized studies and further documentation of the probable benefits of correcting hemoglobin levels.     

Pitfalls in left atrial reduction. Superior neo-cava with pericardium

Left atrial reduction is a surgical technique that has been proposed for eliminating chronic atrial fibrillation associated with mitral valve disease. A potential complication of the technique is the unnoticed rotation of the heart while the left atrium is anastomosed. Such an event makes it impossible to reconstruct the superior vena cava, leading to superior vena cava syndrome due to the rotation of that vessel. We report our experience with a case of left atrial reduction and rotation of the superior vena cava while it was being anastomosed. The complication was successfully resolved by placing an autologous pericardial tube between the two ends of the superior vena cava.     

Current treatment landscape for oligometastatic non-small cell lung cancer

The management of patients with advanced non-small cell lung carcinoma (NSCLC) has undergone major changes in recent years. On the one hand, improved sensitivity of diagnostic tests, both radiological and endoscopic, has altered the way patients are staged. On the other hand, the arrival of new drugs with antitumoral activity, such as targeted therapies or immunotherapy, has changed the prognosis of patients, improving disease control and prolonging survival. Finally, the development of radiotherapy and surgical and interventional radiology techniques means that radical ablative treatments can be performed on metastases in any location in the body. All of these advances have impacted the treatment of patients with advanced lung cancer, especially in a subgroup of these patients in which all of these treatment modalities converge. This poses a challenge for physicians who must decide upon the best treatment strategy for each patient, without solid evidence for one optimal mode of treatment in this patient population. The aim of this article is to review, from a practical and multidisciplinary perspective, published evidence on the management of oligometastatic NSCLC patients. We evaluate the different alternatives for radical ablative treatments, the role of primary tumor resection or radiation, the impact of systemic treatments, and the therapeutic sequence. In short, the present document aims to provide clinicians with a practical guide for the treatment of oligometastatic patients in routine clinical practice.