Role of Dermatologists in Advanced Cutaneous Melanoma Treatment: A Call for Action (Preprint)

2021 ◽  
Author(s):  
Louay Samir Abdulkarim
Keyword(s):  
Adverse Events ◽  
Health Care Professionals ◽  
Cutaneous Melanoma ◽  
Detrimental Effect ◽  
Survival Rates ◽  
Melanoma Treatment ◽  
Melanoma Patients ◽  
The Impact ◽  
Fragmentation Of Care

UNSTRUCTURED Advanced cutaneous melanoma has always been a dreaded diagnosis, but with the introduction of a number of practice-changing agents, namely targeted therapy and immunotherapy, considerable strides have been achieved in terms of survival rates. However, the introduction of these agents was associated with a variety of dermatological adverse event, some of which have shown a detrimental effect on the continuity of treatment. This holds especially true in the light of the current fragmentation of care provided by the managing health care professionals. This article sheds light on the impact of the scarcity of dermatology specialist input in the management of dermatological adverse events associated with advanced melanoma treatment. Furthermore, it looks into the potential avenues where dermatological input can bridge the gap in the care provided by oncologists, hence standardising the care provided to melanoma patients with dermatological adverse events.

Pupil with Obsessive-Compulsive Disorder

2017 ◽  
Vol 7 (2) ◽  
pp. 7-25
Author(s):  
Karolina Diallo
Keyword(s):  
Obsessive Compulsive Disorder ◽  
School Performance ◽  
School Environment ◽  
Detrimental Effect ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Past ◽  
And Performance ◽  
The Impact

Pupil with Obsessive-Compulsive Disorder. Over the past twenty years childhood OCD has received more attention than any other anxiety disorder that occurs in the childhood. The increasing interest and research in this area have led to increasing number of diagnoses of OCD in children and adolescents, which affects both specialists and teachers. Depending on the severity of symptoms OCD has a detrimental effect upon child's school performance, which can lead almost to the impossibility to concentrate on school and associated duties. This article is devoted to the obsessive-compulsive disorder and its specifics in children, focusing on the impact of this disorder on behaviour, experience and performance of the child in the school environment. It mentions how important is the role of the teacher in whose class the pupil with this diagnosis is and it points out that it is necessary to increase teachers' competence to identify children with OCD symptoms, to take the disease into the account, to adapt the course of teaching and to introduce such measures that could help children reduce the anxiety and maintain (or increase) the school performance within and in accordance with the school regulations and curriculum.

scholarly journals Examining the role of MEDLINE as a patient care information resource: an analysis of data from the Value of Libraries study

2017 ◽  
Vol 105 (4) ◽  
Author(s):  
Kathel Dunn ◽  
Joanne Gard Marshall ◽  
Amber L. Wells ◽  
Joyce E. B. Backus
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Patient Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Resources ◽  
Information Resource ◽  
Care Providers ◽  
Other Information

Objective: This study analyzed data from a study on the value of libraries to understand the specific role that the MEDLINE database plays in relation to other information resources that are available to health care providers and its role in positively impacting patient care.Methods: A previous study on the use of health information resources for patient care obtained 16,122 responses from health care providers in 56 hospitals about how providers make decisions affecting patient care and the role of information resources in that process. Respondents indicated resources used in answering a specific clinical question from a list of 19 possible resources, including MEDLINE. Study data were examined using descriptive statistics and regression analysis to determine the number of information resources used and how they were used in combination with one another.Results: Health care professionals used 3.5 resources, on average, to aid in patient care. The 2 most frequently used resources were journals (print and online) and the MEDLINE database. Using a higher number of information resources was significantly associated with a higher probability of making changes to patient care and avoiding adverse events. MEDLINE was the most likely to be among consulted resources compared to any other information resource other than journals.Conclusions: MEDLINE is a critical clinical care tool that health care professionals use to avoid adverse events, make changes to patient care, and answer clinical questions.

Anti-angiogenic role of microRNA-23b in melanoma by disturbing NF-κB signaling pathway via targeted inhibition of NAMPT

2020 ◽  
Vol 16 (10) ◽  
pp. 541-458 ◽  
Author(s):  
Renrong Lv ◽  
Jing Yu ◽  
Qian Sun
Keyword(s):  
Signaling Pathway ◽  
Tumor Tissues ◽  
Melanoma Treatment ◽  
Melanoma Patients ◽  
Targeted Inhibition ◽  
Nicotinamide Phosphoribosyl Transferase ◽  
Poor Patient Survival

Aim: Melanoma is the major cause of death in patients inflicting skin cancer. We identify miR-23b plays an anti-angiogenic role in melanoma. Materials & methods: We collected tumor tissues from melanoma patients. Experiments in vivo and in vitro were designed to evaluate the role of miR-23b in melanoma. Results & conclusion: miR-23b was found to be downregulated in melanoma tissues, and associated with poor patient survival. Elevating miR-23b inhibited cell viability and colony formation, reduced pro-angiogenetic ability, and accelerated apoptosis in SK-MEL-28 cells. miR-23b targeted NAMPT. Disturbing NF-κB signaling pathway with ammonium pyrrolidinedithiocarbamate (an inhibitor of NF-kB signaling pathway) impeded acquired pro-angiogenetic ability of nicotinamide phosphoribosyl transferase-overexpressed SK-MEL-28 cells. MiR-23b is a prognostic factor in melanoma. This study provides an enhanced understanding of microRNA-based targets for melanoma treatment.

The current role of systemic therapy in the management of Malignant Melanoma of the skin: a literature review

2004 ◽  
Vol 4 (4) ◽  
pp. 161-175 ◽  
Author(s):  
Elizabeth Reeves ◽  
P. Bridge ◽  
R. M. Appleyard
Keyword(s):  
Clinical Trials ◽  
Literature Review ◽  
Metastatic Melanoma ◽  
Systemic Therapy ◽  
Survival Rates ◽  
Success Rates ◽  
Systemic Treatments ◽  
Melanoma Patients ◽  
Disease Free

Melanoma patients can be split into two main categories that have different aims for treatment; localised disease with either intermediate or high-risk of recurrence after surgery, and metastatic disease. Over the past decade, there have been many clinical trials looking at improving the success rates for localised and metastatic melanoma with alternative systemic treatments, namely immunotherapy, biochemotherapy and vaccines. This literature review summarises the clinical trials for each form of systemic treatment in localised and metastatic melanoma and assesses the effectiveness of each by an evaluation and comparison of relevant clinical trials for each systemic modality. The main objective was to assess whether alternative forms of systemic therapy have improved the disease free and overall survival rates achieved with chemotherapy.

XPG D1104 single-nucleotide polymorphisms and the prognosis of melanoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11096-11096
Author(s):  
J. C. Becker ◽  
M. Schneider ◽  
D. Scherer ◽  
S. Ugurel ◽  
M. Zapatka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Dna Repair ◽  
Cutaneous Melanoma ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Dna Repair Enzymes ◽  
Repair Enzymes ◽  
Melanoma Patients ◽  
T Classification ◽  
The Impact

11096 Background: Sunlight is a major risk factor for melanoma. Since UV radiation causes DNA damage, it is not surprisingly, that genetic variants in DNA repair enzymes contribute to the susceptibility to cutaneous melanoma. Methods: Presence of common non-synonymous single-nucleotide polymorphism in different DNA repair enzymes were established and correlated with overall survival of melanoma patients. To this end, the SNPs of 6 different DNA repair enzymes were evaluated in a cohort of 742 melanoma patients. The impact of these polymorphisms on overall survival was subsequently calculated by the cox hazard model. Results: This analysis demonstrated that after adjustment to gender and primary tumor T classification XPG 1104 His/His as well as XPD 751 Lys/Lys genotypes were significantly associated with improved survival. Cox hazard coefficients were 0.744 for XPG 1104 His/His (p = 0.0059) and 0.651 for XPD 751 Lys/Lys (p = 0.017). Importantly, bootstrapping confirmed theses results for subpopulations. Furthermore, multivariate analysis demonstrated that XPG 1104 His/His is an independent factor affecting overall survival (cox coefficient 0.95788; p = 0.0011). Conclusions: XPG codon 1104 polymorphism may be predictive of survival outcome in patients with cutaneous melanoma. No significant financial relationships to disclose.

Sarcoligo: Impact of local ablative treatment of oligometastatic sarcomas on overall survival.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10042-10042
Author(s):  
Juliette Thariat ◽  
Laurence Moureau-Zabotto ◽  
Nicolas Penel ◽  
Antoine Italiano ◽  
Jacques-Olivier Bay ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lung Metastases ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Locoregional Treatment ◽  
Metastatic Sites ◽  
The Impact

10042 Background: 40-50% of sarcomas become metastatic. Median survival of metastatic patients has improved over time. The probably multifactorial reasons for such improvement are not fully clear. Noteworthy, for patients with a controlled primary and a limited number of lung metastases, complete resection of their metastases yields survival rates of up to 40% at three years. Advances in surgery, radiotherapy and radiofrequency have fostered the use of local treatments for various metastatic sites (lung, liver, spine...). Methods: A multicentric retrospective study of the Groupe Sarcome Francais (GSF-GETO); approved by the nationally-review board and ethical committee, was conducted to assess the impact of local ablative treatment on overall survival. Patients who had had oligometastases (any site, 1-5 synchronous metastases) at diagnostic or during the course of disease between 2000 and 2010 were included. Results: Median age of the 243 oligometastatic sarcoma patients was 53 years-old (11-86). Patients had grade I, II and III in 7.5%, 29.6% and 63.3% of cases, respectively with various histologies. 69% of patients underwent local ablative treatment of metastases. Median follow-up was 59 months (4-212) for living patients. Median overall survival was 51 months (1-348). On univariate analysis, grade, histology, absence of chemotherapy, local ablative treatment (surgery, irradiation, radiofrequency or chemoembolisation) correlated with survival but not age or site of oligometastasis. On multivariate analyses, grade (hazard ratio HR 0.12 [CI95 0.3-0.6]) and local ablative treatment (HR 3.8 [CI95 2.1-7.1]) remained significant. Conclusions: Local ablative treatment of metastases is associated with better survival in sarcoma patients with oligometastatic disease. The role of the locoregional treatment of metastases and its impact on quality of life should be assessed prospectively.

scholarly journals Infection-induced miR-126 suppresses tsc1- and cxcl12a-dependent permissive macrophages during mycobacterial infection

2021 ◽  
Author(s):  
Kathryn Wright ◽  
Kumudika de Silva ◽  
Karren M. Plain ◽  
Auriol C. Purdie ◽  
Warwick J. Britton ◽  
...  
Keyword(s):  
Immune Response ◽  
Detrimental Effect ◽  
Mycobacterial Infection ◽  
Protective Role ◽  
Zebrafish Embryos ◽  
Zebrafish Model ◽  
Effector Pathways ◽  
The Impact ◽  
Mtor Signalling

AbstractRegulation of host microRNA (miRNA) expression is a contested node that controls the host immune response to mycobacterial infection. The host must overcome concerted subversive efforts of pathogenic mycobacteria to launch and maintain a protective immune response. Here we examine the role of miR-126 in the zebrafish model of Mycobacterium marinum infection and identify a protective role for this infection-induced miRNA through multiple effector pathways. Specifically, we analyse the impact of the miR-126 knockdown-induced tsc1a and cxcl12a/ccl2/ccr2 signalling axes during early host-M. marinum interactions. We find a strong detrimental effect of tsc1a upregulation that renders zebrafish embryos susceptible to higher bacterial burden and increased cell death despite dramatically higher recruitment of macrophages to the site of infection. We demonstrate that infection-induced miR-126 suppresses tsc1 and cxcl12a expression thus improving macrophage function early in infection, partially through activation of mTOR signalling and strongly through preventing the recruitment of Ccr2+ permissive macrophages, resulting in the recruitment of protective tnfa-expressing macrophages. Together our results demonstrate an important role for infection-induced miR-126 in shaping an effective immune response to M. marinum infection in zebrafish embryos.

scholarly journals Tumor Suppressor Role of hsa-miR-193a-3p and -5p in Cutaneous Melanoma

2020 ◽  
Vol 21 (17) ◽  
pp. 6183
Author(s):  
Beatrice Polini ◽  
Sara Carpi ◽  
Stefano Doccini ◽  
Valentina Citi ◽  
Alma Martelli ◽  
...  
Keyword(s):  
Cell Lines ◽  
Melanoma Cell ◽  
Cutaneous Melanoma ◽  
Luciferase Assay ◽  
Strong Increase ◽  
Over Expression ◽  
Functional Features ◽  
Melanoma Patients ◽  
Melanoma Cell Lines

Background: Remarkable deregulation of several microRNAs (miRNAs) is demonstrated in cutaneous melanoma. hsa-miR-193a-3p is reported to be under-expressed in tissues and in plasma of melanoma patients, but the role of both miR-193a arms in melanoma is not known yet. Methods: After observing the reduced levels of miR-193a arms in plasma exosomes of melanoma patients, the effects of hsa-miR-193a-3p and –5p transfection in cutaneous melanoma cell lines are investigated. Results: In melanoma cell lines A375, 501Mel, and MeWo, the ectopic over-expression of miR-193a arms significantly reduced cell viability as well as the expression of genes involved in proliferation (ERBB2, KRAS, PIK3R3, and MTOR) and apoptosis (MCL1 and NUSAP1). These functional features were accompanied by a significant downregulation of Akt and Erk pathways and a strong increase in the apoptotic process. Since in silico databases revealed TROY, an orphan member of the tumor necrosis receptor family, as a potential direct target of miR-193a-5p, this possibility was investigated using the luciferase assay and excluded by our results. Conclusions: Our results underline a relevant role of miR-193a, both -3p and -5p, as tumor suppressors clarifying the intracellular mechanisms involved and suggesting that their ectopic over-expression could represent a novel treatment for cutaneous melanoma patients.

First-line Advanced Cutaneous Melanoma Treatments: Where Do We Stand? (Preprint)

2021 ◽  
Author(s):  
Louay Samir Abdulkarim
Keyword(s):  
Targeted Therapy ◽  
Cutaneous Melanoma ◽  
Specific Immunotherapy ◽  
Survival Rates ◽  
Mek Inhibitor ◽  
Advanced Melanoma ◽  
First Line ◽  
Growth And Survival ◽  
Clear Cut ◽  
Melanoma Treatment

UNSTRUCTURED Cutaneous melanoma has always been a dreaded diagnosis due to its high mortality rate and its proclivity for invasiveness and metastasis. Historically, advanced melanoma treatment was limited to chemotherapy and nonspecific immunotherapy agents that displayed poor curative potential and high toxicity. However, during the last decade, the evolving understanding of the mutational burden of melanoma and the immune system evasion mechanisms has led to the development of targeted therapy and specific immunotherapy agents that have transformed the landscape of advanced melanoma treatment. Targeted therapy comprises of agents that directly inhibit mutated kinases, namely BRAF and MEK, which have been implicated in the growth and survival of cancerous melanocytes. However, the efficacy of BRAF and MEK inhibitor monotherapies was limited by early resistance and an upsurge in treatment-associated skin tumours. Consequently, a combined BRAF/MEK inhibitor approach was trialled, which resulted in superior survival rates while minimising the aforementioned limitations. On the other hand, specific immunotherapy agents were developed on the heels of Nobel Prize-winning discoveries that outlined the pivotal role of certain immune downregulatory signals that facilitate tumour growth. Despite the considerable strides in understanding the clinical implication of these agents, there is a scarcity in randomised clinical trials that directly compare the efficacy of the aforementioned agents, hence there are no clear-cut preferences among the available first-line options. This paper attempts to summarise the current understanding of first-line treatments. Additionally, it describes the indirect comparative evidence that aids in bridging the gap in the literature.

scholarly journals New Insights into the Role of Sphingolipid Metabolism in Melanoma

Cells ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 1967 ◽  
Author(s):  
Lorry Carrié ◽  
Mathieu Virazels ◽  
Carine Dufau ◽  
Anne Montfort ◽  
Thierry Levade ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Skin Cancer ◽  
Immune Responses ◽  
Cutaneous Melanoma ◽  
Sphingolipid Metabolism ◽  
Metastatic Dissemination ◽  
Resistance To Treatment ◽  
Melanoma Progression ◽  
The Impact

Cutaneous melanoma is a deadly skin cancer whose aggressiveness is directly linked to its metastatic potency. Despite remarkable breakthroughs in term of treatments with the emergence of targeted therapy and immunotherapy, the prognosis for metastatic patients remains uncertain mainly because of resistances. Better understanding the mechanisms responsible for melanoma progression is therefore essential to uncover new therapeutic targets. Interestingly, the sphingolipid metabolism is dysregulated in melanoma and is associated with melanoma progression and resistance to treatment. This review summarises the impact of the sphingolipid metabolism on melanoma from the initiation to metastatic dissemination with emphasis on melanoma plasticity, immune responses and resistance to treatments.

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