568 research outputs found
The role of salvage lymph node dissection in nonmetastatic castration-resistant prostate cancer: A single center experience
No full textObjective: To evaluate oncologic outcomes of patients with nonmetastatic, castration-resistant prostate cancer treated with salvage lymph node dissection (sLND) or androgen-deprivation therapy (ADT) for lymph nodes (LN)-only recurrence. Materials and Methods: Retrospective analysis of 23 (51.1%) patients who underwent sLND and 22 (48.9%) men who received ADT for LN-only recurrence. Biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) >0.2 ng/ml with an increased trend and radiological recurrence (RAR) was defined as a positive imaging study after sLND or ADT. Second line systemic therapies (SST) were defined as any systemic therapy administered for progression. Predictors of BCR, RAR, and SST were assessed with Cox regression analyses. Results: Mean PSA reduction was significantly higher after sLND than ADT (62.8% vs. 17.7%; P = 0.04). Clinical outcomes were not statistically different between the 2 groups. However, there was a trend toward a longer time to BCR (13.3 vs. 6 months; P = 0.2) and RAR (21.1 vs. 14.2 months, P = 0.09) in sLND patients than ADT. Median time to SST was longer in the sLND group than ADT (P = 0.04). Univariable Cox regression analyses showed that PSA doubling time and pT stage were associated with RAR and SST (all P < 0.05). Conclusions: In patients with nonmetastatic, castration-resistant prostate cancer, sLND resulted in greater PSA decrease than ADT. We noted a nonstatistically significant trend toward longer time to BCR and longer time to RAR for patients treated with sLND than ADT. Additionally, sLND may increase time to SST as compared to ADT
Vaginal cuff recurrence after radical cystectomy: an under - studied site of bladder cancer relapse
No full textVaginal cuff recurrence of tumor following radical cystectomy is a rare site of disease recurrence, however it has never been specifically studied. The aim of the study is to evaluate incidence, risk factors, and long-term oncologic outcomes of vaginal cuff recurrence in a cohort of female patients treated with radical cystectomy for invasive urothelial carcinoma of the bladder
MP69-05 ONCOLOGIC OUTCOMES AND BIOCHEMICAL PREDICTORS FOLLOWING SALVAGE LYMPH NODE DISSECTION FOR PROSTATE CANCER
No full textNano-biosensing platforms for detection of cow’s milk allergens: An overview
No full textAmong prevalent food allergies, cow milk allergy (CMA) is most common and may persist throughout the life. The allergic individuals are exposed to a constant threat due to milk proteins' presence in uncounted food products like yogurt, cheese, and bakery items. The problem can be more severe due to cross-reactivity of the milk allergens in the food products due to homologous milk proteins of diverse species. This problem can be overcome by proper and reliable food labeling in order to ensure the life quality of allergic persons. Therefore, highly sensitive and accurate analytical techniques should be developed to detect the food allergens. Here, significant research advances in biosensors (specifically immunosensors and aptasensors) are reviewed for detection of the milk allergens. Different allergic proteins of cow milk are described here along with the analytical standard methods for their detection. Additionally, the commercial status of biosensors is also discussed in comparison to conventional techniques like enzyme-linked immunosorbent assay (ELISA). The development of novel biosensing mechanisms/kits for milk allergens detection is imperative from the perspective of enforcement of labeling regulations and directives keeping in view the sensitive individuals
Prognostic utility of erectile dysfunction for cardiovascular disease in younger men and those with diabetes
No full textMultiple published studies have established erectile dysfunction (ED) as an independent risk marker for cardiovascular disease (CVD). In fact, incident ED has a similar or greater predictive value for cardiovascular events than traditional risk factors including smoking, hyperlipidemia, and family history of myocardial infarction. Here, we review evidence that supports ED as a particularly significant harbinger of CVD in 2 populations: men <60 years of age and those with diabetes. Although addition of ED to the Framingham Risk Score only modestly improved the 10-year predictive capacity of the Framingham Risk Score for myocardial infarction or coronary death data in men enrolled in the Massachusetts Male Aging Study, other epidemiologic studies suggest that the predictive value of ED is quite strong in younger men. Indeed, in the Olmstead County Study, men 40 to 49 years of age with ED had a 50-fold higher incidence of new-incident coronary artery disease than those without ED. However, ED had less predictive value (5-fold increased risk) for coronary artery disease in men 70 years and older. Several studies, including a large analysis of more than 6300 men enrolled in the ADVANCE study, suggest that ED is a particularly powerful predictor of CVD in diabetic men as well. Based on the literature reviewed here, we encourage physicians to inquire about ED symptoms in all men more than 30 years of age with cardiovascular risk factors. Identification of ED, particularly in men <60 years old and those with diabetes, represents an important first step toward CVD risk detection and reduction
Neurocognitive functioning in schizophrenia, their unaffected siblings and healthy controls: A comparison
No full textAim: Neurocognitive functions are considered to be reliable endophenotypes for schizophrenia. This study aimed to study the neurocognitive functioning of unaffected siblings of patients with schizophrenia and compare the same with a group of patients with schizophrenia and a group of healthy controls. Materials and Methods: Three study groups, that is, unaffected siblings of patients with schizophrenia, patients of schizophrenia and healthy controls, each group comprising of 20 participants were evaluated on Wisconsin Card Sorting Test, Brief Visuospatial Memory Test-Revised, Hopkins Verbal Learning Test-Revised, Wechsler Adult Intelligence Scale and Digit Symbol Test. Results: Compared to healthy controls, unaffected siblings of patients with schizophrenia performed poorly on the tests of short-term verbal learning and memory, but no significant differences were seen between the two groups for executive functions, visual learning and psychomotor speed, concentration and graphomotor abilities. However, when compared with patients with schizophrenia, unaffected siblings performed poorly on the tests of executive functions, visual memory, verbal memory, psychomotor speed, concentration and graphomotor abilities. Conclusion: Cognitive markers like verbal memory deficits can distinguish unaffected siblings of schizophrenia from healthy controls and serve as an endophenotype for schizophrenia
Assessment and comparison of the memory profile in traumatic brain injury and subarachnoid hemorrhage patients
No full textBackground: Traumatic brain injury (TBI) and Subarachnoid Hemorrhage (SAH) are the leading cause of death and disability in both developed and developing countries. They have significant cognitive and behavioral consequences, affecting the quality of life of both patients and their families. Aim: To compare the memory functioning of TBI and SAH and study the effect of demographics on the same through a retrospective study. Materials and Methods: A sample of 210 patients clinically diagnosed as TBI (N = 165; M = 145/F = 20) and SAH (N = 45; M = 35/F = 10) were using post graduate institute of memory scale (PGI-MS) which assesses 10 memory domains. Results: Odds Ratio (OR) was calculated by categorizing the scores as average and impaired on PGI-MS, the percentage of impaired cases of SAH were significantly less as compared to TBI (8.9% vs. 22.4%; OR = 0.34) Moreover, only two domains were found to have significant results, i.e. delayed recall and recognition. When the scores were adjusted for age, education and gender, memory impairment was found to be statistically significant in domains of remote memory (OR = O.10) recent memory (OR = 0.32), delayed recall (OR = 0.26), immediate memory (OR = 0.30), new learning ability (OR = 0.38), and recognition (OR = 0.17). Conclusion: A primary prevention (awareness program about risk factors) and tertiary prevention (holistic rehabilitation) would play a crucial role in improving the quality of life of both patients as well as the population at risk
Synthesis of SWNT/Pt nanocomposites for their effective role in hydrogen storage applications
No full textDetection of recurrent prostate cancer after primary radiation therapy: An evaluation of the role of multiparametric 3T magnetic resonance imaging with endorectal coil
No full textObjectives: The value of multiparametric magnetic resonance imaging (mpMRI) in staging prostate cancer (PCa) before salvage prostatectomy is currently unclear because of the minimal data comparing mpMRI results to final pathologic stage at surgery. The aim of the study is to determine the diagnostic performance of mpMRI in characterizing viable recurrent tumor and lymph node metastasis following radiation therapy (RT) failure.
Methods and materials: Between January 2007 and July 2014, 19 patients with biopsy-proven recurrent PCa after primary RT underwent 3T mpMRI and subsequent salvage prostatectomy with extended pelvic lymphadenectomy. mpMRI images were independently reviewed by 2 genitourinary MRI radiologists (R1 and R2), blinded to the pathology results, to evaluate extraprostatic extension (EPE), seminal vesicle invasion (SVI), and pelvic lymph node metastasis (PLNM). Sensitivity, specificity, positive predictive value, negative predictive value, receiver operating characteristic curves, and interobserver agreement (R1 and R2) were evaluated for each outcome on a per-patient basis. Final pathologic results were used as a gold standard for comparison in all patients. A multivariate analysis was conducted to assess the relationship between the index lesion's apparent diffusion coefficient value and its enhancement characteristics with the Gleason score.
Results: EPE was found in 14 (73.7%) patients, SVI in 13 (68.4%), and PLNMin 5 (26.3%). mpMRI sensitivity for PLNM was 60.0% (R1 and R2) with specificity of 85.7% (R1) and 92.8% (R2). With regards to SVI, the sensitivity was 61.5% (R1) and 76.9% (R2), with a specificity of 66.6% (R1 and R2). Sensitivity for EPE was 50.0% (R1) and 71.43% (R2), with a specificity of 80.0% (R1) and 100.00% (R2). No significant associations were found at multivariate analysis. The evaluation of PLNM, SVI, and PCa recurrence within the prostate demonstrated moderate interobserver agreement (kappa, 0.51-0.57).
Conclusions: mpMRI has good accuracy for detecting PLNM, SVI, and EPE after RT. mpMRI provides useful information in locally recurrent PCa following primary radiation therapy. (C) 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved
Mid-term Outcomes Following Salvage Lymph Node Dissection for Prostate Cancer Nodal Recurrence Status Postâradical Prostatectomy
No full textBackground: Patients with oligometastatic prostate cancer lymph node recurrence can be treated with many options including salvage lymph node dissection (sLND). Objective: EvaluationofoutcomesofsLNDandidentificationofclinicopathologicfeatures in predicting further biochemical and radiological relapse after sLND for prostate cancer. Design, setting, and participants: Between November 1, 2009 and March 31, 2015, 117 patients with biochemical recurrence (BCR) after radical prostatectomy (RP) un- derwent sLND by a single surgeon after a standardized 11C-choline positron emission tomography/computed tomography.
Outcomemeasurementsandstatisticalanalysis: Biochemicalresponse(BR)wasdefined as a prostate-specific antigen (PSA) < 0.2ng/ml after sLND, BCR was defined as a PSA greater than 0.2 ng/ml with an increased trend after sLND, and radiological recurrence (RAR) was defined as a positive 11C-choline positron emission tomography/computed tomography imaging study or biopsy proven metastasis after sLND. Kaplan-Meier method was used to assess time to BCR, RAR, and cancer-specific mortality. Preoperative and postoperative predictors of BCR and RAR were assessed with Cox regression analyses. Results and limitations: All patients had confirmed lymph node metastasis on final sLND pathology. Median follow-up after sLND was 20.2 mo (interquartile range: 11.8– 33.6). All but one patient had a decrease in PSA while 93/117 (79.5%) patients achieved BR after sLND. In those who achieved BR, a subsequent BCR occurred in 40% of cases (n = 37/93). The 5-yr BCR, RAR, and cancer-specific mortality-free survival rates were 31%, 51%, and 97% respectively. At multivariate analyses, predictors of both BCR and RAR were pathological stage of the tumor at original RP and whether the nodes were castrate resistant prostate cancer. Given the nonrandomized nature, it is not known how these men would have fared according to survival or quality of life by observation, and/or other systemic therapy.
Conclusions: An optimal candidate for sLND tends to have pT2 at the original RP and a castration sensitive disease state. sLND could be considered part of a multimodal treatment approach in select patients with castrate-resistant prostate cancer in which delayed/reduced cancer progression could be achieved with a cytoreductive surgery. Patient summary: We found that by performing a salvage lymph node dissection there are many men that can experience a biochemical response and eliminate further 11C- choline positron emission tomography/computed tomography radiographic recurrences
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