scholarly journals Intravenous Chemotherapy for Retinoblastoma in the Era of Intravitreal Chemotherapy: A Systematic Review

2020 ◽  
Vol 7 (2) ◽  
pp. 142-148
Author(s):  
Vishal Raval ◽  
Randy Christopher Bowen ◽  
Hansell Soto ◽  
Arun Singh
Keyword(s):  
Potential Role ◽  
Practice Patterns ◽  
Survival Rates ◽  
Published Data ◽  
Intravenous Chemotherapy ◽  
Intravitreal Chemotherapy ◽  
The Mean ◽  
Patterns Of Recurrence ◽  
Vitreous Seeding

<b><i>Purpose:</i></b> The published data on ocular survival following intravenous chemotherapy of retinoblastoma (RB) seems to be skewed by evolving practice patterns induced by use of intravitreal chemotherapy (iVitc). We aimed to explore potential role of iVitc for vitreous seeding for patients treated with intravenous chemotherapy (IVC). <b><i>Methods:</i></b> A literature search was performed to identify cases of RB treated with primary IVC prior to advent of iVitc by various search engines (PubMed, Medline, and Google) from 1992 to 2018. Studies were excluded if number of cases were less than 40 or lacked data related to type of recurrence and its treatment. Rates and patterns of recurrence and its management were categorized. <b><i>Results:</i></b> Out of 15 studies identified, only 10 studies (797 eyes) met the inclusion criteria. The mean age at presentation was 15.3 months (range 0–192.8 months). Unilateral cases represented 25% of the cohort. The ocular survival rate with primary IVC was 63% (500/797 eyes). Of the 297 eyes (37%) that failed IVC therapy, additional 99 eyes could be salvaged with EBRT (599/797 eyes, 75%). Remaining 198 eyes were enucleated (198/797 eyes 25%). K-M survival analysis could not be done due lack of sufficient data. Recurrences that occurred (mean 12.2 months) after completion of primary IVC included relapse of retinal tumor (143 eyes [48%]), vitreous seeding (73 eyes [25%]), subretinal seeding (49 eyes [16%]), or any combination (103 eyes [35%]). Out of 73 eyes with vitreous seeding, additional 66 eyes (90%) would have been salvaged with iVitc, potentially improving ocular survival rates to 71% (500 + 66/797). <b><i>Conclusions:</i></b> Evolving practice patterns of RB treatment have unfavorably skewed published ocular survival rates following IVC. With incorporation of iVitc, the ocular survival rates with IVC can be potentially improved to be non-inferior to those achieved with intra-arterial chemotherapy.

scholarly journals Study of the Immunological Status of Iraqi Vitiligo Patients

2016 ◽  
Vol 13 (3) ◽  
pp. 454-462
Author(s):  
Baghdad Science Journal
Keyword(s):  
Potential Role ◽  
Immunoglobulin E ◽  
Ultraviolet B ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Serum ◽  
Healthy Control ◽  
The Mean ◽  
Age Range ◽  
Apparently Healthy

Vitiligo is an acquired idiopathic skin disorder characterized by depigmented macules due to loss of cutaneous melanocytes. A potential role of the immune dysfunction has been suggested in vitiligo, so to test this hypothesis, certain cytokines (IL-17A and TNF-?) and immunoglobulins (IgM, IgG, IgA and total IgE) were investigated in all participants. The study included: 60 patients with age range between (6-55) year; 30(11 males and 19 females) were untreated and 30(12 males and 18 females) were treated with Narrow Band Ultraviolet-B (NB-UVB) and 30 (14 males and 16 females) apparently healthy control. Serum was separated and cytokines (IL-17A and TNF-?) and total immunoglobulin E (IgE) were detected by using Enzyme Linked Immunosorbent Assay (ELISA); while immunoglobulins (IgM, IgG and IgA) were detected by using Single Radial Immunodiffusion (SRID) method. The results showed that the mean levels of serum IL-17A and TNF-? in both untreated and NB-UVB treated vitiligo patients were increased significantly (p ? 0.05) as compared with healthy control. The mean levels of serum IgG and IgA in untreated vitiligo patients showed non significant decreased (P

Secondary intra-arterial chemotherapy and/or intravitreal chemotherapy as salvage treatment for retinoblastoma

2020 ◽  
pp. 112067212095758
Author(s):  
Ibadulla Mirzayev ◽  
Ahmet Kaan Gündüz ◽  
Kıvılcım Yavuz ◽  
Mehmet Zahid Şekkeli ◽  
Funda Seher Özalp Ateş ◽  
...  
Keyword(s):  
Survival Rates ◽  
Primary Treatment ◽  
Salvage Treatment ◽  
External Radiotherapy ◽  
Intravitreal Chemotherapy ◽  
The Mean ◽  
Group B ◽  
Group D

Purpose: To evaluate the results of secondary intra-arterial chemotherapy (IAC) and/or intravitreal chemotherapy (IVC) as a salvage treatment for retinoblastoma (RB). Materials and Methods: The medical records of 31 (20 male, 11 female) cases (with 38 eyes) who underwent secondary IAC and/or IVC between February 2010 and June 2019 were retrospectively reviewed. Results: Thirteen (41.9%) cases had unilateral and 18 (58.1%) had bilateral RB. According to the International Classification of RB, 6 (15.8%) eyes had group B, 9 (23.7%) eyes had group C, 16 (42.1%) eyes had group D, and 7 (18.4%) eyes had group E RB at diagnosis. All patients underwent six-cycle intravenous chemotherapy as primary treatment and 8 eyes received external radiotherapy before IAC/IVC. Secondary IAC was performed in 21 (55.3%) eyes, IVC in 10 (26.3%) eyes, and IAC + IVC in 7 (18.4%) eyes. External radiotherapy was applied in 2 (5.3%) eyes after IAC/IVC, one of which was later enucleated. In total, 17 (44.7%) eyes undergoing secondary IAC/IVC treatments were enucleated. Metastasis and death were not observed in any case during the mean follow-up period of 59.3 (median 61, range: 10–98) months. Discussion: Although 60.5% of the eyes undergoing IAC/IVC consisted of groups D and E RB, globe salvage and survival rates were 55.3% and 100.0%, respectively. External radiotherapy was required in 5.3% of the eyes after IAC/IVC. In conclusion, IAC and IVC are safe and effective treatment methods in eyes with RB unresponsive to other eye-preserving treatments and those demonstrating recurrence.

Treatment of Large Non-Muscle-Invasive Bladder Cancer: The Potential Role of Neoadjuvant Intravesical Chemotherapy

2020 ◽  
pp. 1-6
Author(s):  
Marco Raber ◽  
Noor Buchholz ◽  
Augusto Vercesi ◽  
Nashaat A. Hendawi ◽  
Vincenzo Inneo ◽  
...  
Keyword(s):  
Potential Role ◽  
Tumor Volume ◽  
Neoadjuvant Treatment ◽  
Complete Resection ◽  
Bladder Mucosa ◽  
Bladder Tumors ◽  
Muscle Invasive Bladder Cancer ◽  
The Mean ◽  
Muscle Invasive

<b><i>Introduction:</i></b> The endoscopic resection of large and bulky bladder cancers represents a challenge. To reduce the tumor and make it more easy to resect, we used neoadjuvant short and intensive intravesical mitomycin (MMC) therapy. <b><i>Methods:</i></b> Patients with large bladder tumors were evaluated for this study. At cystoscopy, the surgeon evaluated the feasibility of complete resection. In patients where this was not possible, biopsies from the tumor, bladder mucosa, and prostatic urethra were taken. These patients then underwent a short and intensive cytoreductive schedule of intravesical MMC. This was then followed by TUR-BT. <b><i>Results:</i></b> Fifteen patients were included in our study. The mean age was 74 years (range: 56–82; SD ±6 years). Mean tumor size was 51 mm (range: 35–65; SD ±8 mm). After neoadjuvant treatment, complete resection was then feasible in all patients. The mean tumor volume after the chemo-resection had reduced to 34 mm (range: 10–50; SD ±13 mm). No adverse effects were reported. <b><i>Conclusion:</i></b> Intravesical cytoreductive neoadjuvant MMC as an initial treatment of large NMIBC can be considered safe, effective, and feasible.

Trend of hospital utilization for encephalitis

2011 ◽  
Vol 140 (4) ◽  
pp. 753-764 ◽  
Author(s):  
P. BARBADORO ◽  
A. MARIGLIANO ◽  
A. RICCIARDI ◽  
M. M. D'ERRICO ◽  
E. PROSPERO
Keyword(s):  
Potential Role ◽  
Viral Encephalitis ◽  
Seasonal Pattern ◽  
Hospitalization Rate ◽  
Preventive Interventions ◽  
Emerging Pathogens ◽  
Hospitalization Rates ◽  
Not Otherwise Specified ◽  
The Mean

SUMMARYEncephalitis generally results in a serious illness requiring hospitalization. The aim of this study was to describe the epidemiology of hospitalization for encephalitis in Italy, taking into account the geographical distribution, aetiology, seasonality and evolution of hospitalization rates over recent years. The mean hospitalization rate was 5·88/100 000. For most of these hospitalizations (n=13 119, 55·6%), no specific cause of encephalitis was reported. The most common aetiological category was ‘viral’, which accounted for 40·1% (n=4205) of such hospitalizations (rate 1·05/100 000). Within this category, herpes virus was the leading causative agent (n=1579, 0·39/100 000). This report highlights a significant increase of ‘viral encephalitis not otherwise specified’ (ICD-9 code 049·9) vs. a reduction of all other causes. A seasonal pattern was noted in people aged ⩾65 years in this group. Specific surveillance of encephalitis without known origin should be reinforced in order to identify the potential role of emerging pathogens and to design preventive interventions.

scholarly journals Current and Emerging Strategies for Prediction and Diagnosis of Prelabour Rupture of the Membranes: A Narrative Review

2021 ◽  
Vol 28 (3) ◽  
pp. 5-17
Author(s):  
Saadia Ghafoor
Keyword(s):  
Biochemical Markers ◽  
Potential Role ◽  
Narrative Review ◽  
Diagnostic Tools ◽  
Published Data ◽  
Effective Management ◽  
Emerging Trends ◽  
Foetal Membranes ◽  
Diagnostic Modalities

Prelabour rupture of membranes (PROM) refers to the disruption of foetal membranes before the onset of labour, resulting in the leakage of amniotic fluid. PROM complicates 3% and 8% of preterm and term pregnancies, respectively. Accurate and timely diagnosis is crucial for effective management to prevent adverse maternal- and foetal-outcomes. The diagnosis of equivocal PROM cases with traditional methods often becomes challenging in current obstetrics practice; therefore, various novel biochemical markers have emerged as promising diagnostic tools. This narrative review is sought to review the published data to understand the current and emerging trends in diagnostic modalities in term and preterm pregnancies complicated with PROM and the potential role of various markers for predicting preterm PROM (pPROM) and chorioamnionitis in women with pPROM.

The potential role of somatostatin analogues in the treatment of gastrointestinal (GI) cancers.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 150-150
Author(s):  
J. Hasskarl ◽  
M. Kaufmann ◽  
H. Schmid ◽  
D. C. Metz
Keyword(s):  
Solid Tumors ◽  
Potential Role ◽  
Somatostatin Receptors ◽  
Somatostatin Analogues ◽  
Published Data ◽  
Antitumor Effects ◽  
High Affinity ◽  
Antitumor Properties ◽  
Gi Cancers

150 Background: Somatostatin receptors (sstr) are expressed in various normal and malignant tissues, including non-neuroendocrine GI solid tumors. Gastric cancer (GC) cells mainly express sstr2 and sstr5, colorectal cancer (CRC) cells predominantly express sstr1 followed by sstr5 and sstr2, and hepatocellular carcinoma (HCC) cells express mainly sstr5 as well as sstr1,2,3. Somatostatin analogues (SAs) may have direct and indirect antitumor activity. Octreotide and lanreotide primarily target sstr2, whereas the new agent pasireotide has high affinity for sstr1,2,3 and sstr5. Methods: Published data evaluating the antitumor properties of SAs in GI tumors were reviewed. Results: The table lists the results of clinical studies in which SAs were evaluated as antitumor therapies in GI cancers. Conclusions: Although octreotide and lanreotide are efficacious in the treatment of symptoms of neuroendocrine tumors, these agents have demonstrated mixed results in the antitumor treatment of non-neuroendocrine GI tumors. Data suggesting potential favorable outcomes with SAs alone or in combination with other agents have been seen in solid tumors with predominant sstr2 expression such as GC. Novel SAs such as pasireotide may have improved antitumor effects in non-neuroendocrine solid tumors expressing multiple sstr compared with octreotide and lanreotide. [Table: see text] [Table: see text]

scholarly journals Antimicrobial resistance among GLASS priority pathogens from Pakistan: 2006–2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dania Khalid Saeed ◽  
Joveria Farooqi ◽  
Sadia Shakoor ◽  
Rumina Hasan
Keyword(s):  
Antimicrobial Resistance ◽  
Potential Role ◽  
Carbapenem Resistance ◽  
Steady Increase ◽  
Published Data ◽  
Situational Analysis ◽  
Antimicrobial Surveillance ◽  
Evolution Of Resistance ◽  
Resistance Rates

Abstract Background In 2018 Pakistan initiated its national antimicrobial resistance (AMR) surveillance aligned with Global Antimicrobial Surveillance System (GLASS). To complement this surveillance, we conducted a situational analysis of AMR rates among GLASS organisms in the country. Data from published studies and from antibiograms was compared and role of antibiograms as potential contributors to national AMR surveillance explored. Methods AMR rates for GLASS specified pathogen/antimicrobials combination from Pakistan were reviewed. Data sources included published studies (2006–2018) providing AMR rates from Pakistan (n = 54) as well as antibiograms (2011–2018) available on the Pakistan Antimicrobial Resistance Network (PARN) website. Resistance rates were categorized as follows: Very low: 0–10%, Low: 11–30%, Moderate: 30–50% and High: > 50%. Results Published data from hospital and community/laboratory-based studies report resistance rates of > 50% and 30–50% respectively to 3rd generation cephalosporins, fluoroquinolones and cotrimoxazole amongst Klebsiella pneumoniae and Escherichia coli. Carbapenem resistance rates amongst these organisms remained below 30%. High (> 50%) resistance was reported in Acinetobacter species to aminoglycosides and carbapenems among hospitalized patients. The evolution of ceftriaxone resistant Salmonella Typhi and Shigella species is reported. The data showed > 50% to fluoroquinolones amongst Neisseria gonorrhoeae and the spread of methicillin resistant Staphylococcus aureus (< 30%; 2008) to (> 50%; 2010) in hospital settings. Resistance reported in published studies aligned well with antibiogram data. The latter also captured a clear picture of evolution of resistance over the study period. Conclusion Both published studies as well antibiograms suggest high rates of AMR in Pakistan. Antibiogram data demonstrating steady increase in AMR highlight its potential role towards supplementing national AMR surveillance efforts particularly in settings where reach of national surveillance may be limited.

Congenital Hypertrophic Pyloric Stenosis: The Role of Gastrin Reevaluated

PEDIATRICS ◽  
1978 ◽  
Vol 61 (6) ◽  
pp. 883-885
Author(s):  
Steven L. Werlin ◽  
Richard J. Grand ◽  
David E. Drum
Keyword(s):  
Cord Blood ◽  
Pyloric Stenosis ◽  
Potential Role ◽  
Serum Gastrin ◽  
Hypertrophic Pyloric Stenosis ◽  
Elevated Serum ◽  
Serum Gastrin Concentration ◽  
Congenital Hypertrophic Pyloric Stenosis ◽  
The Mean

In order to evaluate the potential role of gastrin in the etiology of pyloric stenosis, serum gastrin levels were measured in cord blood of affected infants, matched controls, and mothers of both. No differences were identified when values from infants with pyloric stenosis were compared with those from control infants. Mean cord serum gastrin levels of the infants were significantly greater than the mean maternal gastrin levels. The data effectively dismiss the possibility that elevated serum gastrin concentration in mother or infant at the time of delivery can be implicated as a cause of pyloric stenosis.

Combination of brachytherapy and intravitreal chemotherapy in the treatment of retinoblastoma with vitreous seeding

2021 ◽  
Author(s):  
Sabrina Schlüter ◽  
Norbert Bornfeld ◽  
Elbrus Valiyev ◽  
Dirk Flühs ◽  
Martin Stuschke ◽  
...  
Keyword(s):  
Retention Rate ◽  
Serous Retinal Detachment ◽  
Line Treatment ◽  
Second Line ◽  
First Line ◽  
Tumour Control ◽  
Intravitreal Chemotherapy ◽  
The Mean ◽  
Vitreous Seeding

Purpose: To report the efficacy of combined intravitreal chemotherapy (IVC) and ruthenium-106 brachytherapy in retinoblastoma, either as first line or second line treatment following systemic chemoreduction or intraarterial chemotherapy. Methods: Retrospective data collection of 18 eyes from 18 patients treated with IVC and brachytherapy from August 2014 to December 2019. Results: The method described was our first line therapy in 6 patients, whereas it was used as second line treatment after chemoreduction in the remaining 12 patients. The eyes showed the following classification at initial presentation: 2 group B eyes, 3 group C eyes and 13 group D eyes. The mean follow-up was 19.5 months (range 2 – 53 months). Mean patient age at brachytherapy was 34.0 months (range 15 – 83 months). Median prescribed dose at the tumour base and apex was 574.5 ± 306.7Gy and 88.5 ± 12.2Gy, respectively. The ocular retention rate was 66.7%. Six eyes had to be enucleated due to uncontrollable subretinal and recurrent vitreous seeding, tumour relapse, recurrence of a solid tumour elsewhere in the eye and persistent vitreous bleeding with loss of tumour control. The mean number of intravitreal injections of Melphalan was 5.0. Two patients received a simultaneous injection of Topotecan for insufficient therapeutic response. With regard to radiogenic complications, we could observe temporary retinal and vitreous bleeding (27.8%), serous retinal detachment (44.4%) and radiogenic maculopathy and retinopathy (11.1%). None of the children showed metastatic disease during follow up. Conclusion: Ruthenium-106 plaque therapy in combination with intravitreal chemotherapy is an effective local therapy with good tumour control rates even in advanced eyes. Overall, the analysed therapeutic approach shows an acceptable side effect profile, especially when considering that EBRT and systemic polychemotherapy, or at least the number of cycles needed, with their increased incidence of adverse events can thus be avoided.

scholarly journals Oligometastatic Pancreatic Cancer to the Liver in the Era of Neoadjuvant Chemotherapy: Which Role for Conversion Surgery? A Systematic Review and Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3402
Author(s):  
Ottavia De Simoni ◽  
Marco Scarpa ◽  
Marco Tonello ◽  
Pierluigi Pilati ◽  
Francesca Tolin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Potential Role ◽  
Retrospective Studies ◽  
Meta Analysis ◽  
Survival Rates ◽  
Analysis Data ◽  
Conversion Surgery ◽  
Definition Of

Background: the improved survival rates achieved using new polychemotherapy regimens in patients with metastatic pancreatic cancer (mPDAC) have suggested a potential role for surgery following a favorable response to initial chemotherapy (IC). The purpose of this systematic review is to summarize the available evidence on the role of surgery following IC in mPDAC, focusing on oligometastatic disease to the liver (lmPDAC). Methods: studies reporting on patients with lmPDAC undergoing surgery after IC were included. The main outcome was overall survival (OS). Results: six observational retrospective studies were included in the qualitative analysis. Data were retrieved on 2087 patients. The most common IC regimen in patients undergoing surgery was FOLFIRINOX (N 84, 73%). Only three studies reported survival comparison among patients treated with IC+surgery vs. IC alone. Median OS varied from 23 to 56 months after conversion surgery vs. 11 to 16.4 months after IC alone. Conclusions: despite wide heterogeneity of chemotherapy regimens, different downstaging criteria and potential selection biases, patients with oligometastatic lmPDAC undergoing surgery after IC have significantly higher survival rates compared to patients treated with IC alone. Future trials are needed for definition of univocal criteria of downstaging, oligometastatic definition and indications for surgery.

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