THE ROLE OF HIPEC IN PERITONEAL CARCINOMATOSIS DUE TO COLORECTAL CANCER – PROCEDURE, COMPLICATIONS, AND LITERATURE EVIDENCE

Cytoreductive surgery and HIPEC have become de pillars of treatment in advanced, metastatic colorectal cancer. This state of evolution of the disease was considered terminal just a few years ago. It has been demonstrated that by combining these therapies in selected patients one can increase survival time. Once this has been obtained to some length modern studies have been focused on the quality of life, safety, and how this time interval can be increased. We have reviewed the most important prospective, randomized clinical trials regarding HIPEC and peritoneal carcinomatosis. The technique, complications, principles of action, and evolution through time of HIPEC have been addressed and covered. Special consideration had been given to the correlation between the carcinomatosis index and HIPEC. HIPEC with maximal cytoreduction can be considered a curative procedure only in strictly selected patients diagnosed with colorectal cancer and peritoneal carcinomatosis. Although it has been present in the medical field for almost 30 years, it is not wide-spread due to the high costs of implementation and the requirement of highly specialized surgical and medical teams. As technology evolves, the costs can be decreased and HIPEC should be largely available in oncological centers since the foundation of implementation is solid and the fact that clear benefits although small have been demonstrated. Taking into account all of the above, HIPEC should not be considered a standard treatment at present and should only be performed in experienced centers. The correct selection of patients is critical to the success of this procedure. Maximum cytoreduction should only be performed if the carcinomatosis index allows.

Can Cytosine Arabinoside With Prednisolone Treatment for Canine Meningoencephalitis of Unknown Origin Increase Survival Time Compared to Prednisolone Treatment Alone?

<strong>PICO question</strong><br /><p>In treatment of canine patients with meningoencephalitis of unknown origin (MUO), is combination therapy of cytosine arabinoside (CA) with prednisolone more effective than prednisolone as a sole therapy at increasing survival time?</p><strong>Clinical bottom line</strong><br /><p>Based on current available evidence, cytosine arabinoside with prednisolone has greater median survival time than prednisolone as a sole therapy in dogs with meningoencephalitis of unknown origin. The evidence to support this is very weak, as there are currently a low number of published papers with a relatively small number of cases reported in these studies evaluating cytosine arabinoside with prednisolone or prednisolone as a sole therapy for treatment of meningoencephalitis of unknown origin.</p><p> </p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

A ‘NanoSuit’ surface shield successfully protects organisms in high vacuum: observations on living organisms in an FE-SEM

Although extremely useful for a wide range of investigations, the field emission scanning electron microscope (FE-SEM) has not allowed researchers to observe living organisms. However, we have recently reported that a simple surface modification consisting of a thin extra layer, termed ‘NanoSuit’, can keep organisms alive in the high vacuum (10 −5 to 10 −7 Pa) of the SEM. This paper further explores the protective properties of the NanoSuit surface-shield. We found that a NanoSuit formed with the optimum concentration of Tween 20 faithfully preserves the integrity of an organism's surface without interfering with SEM imaging. We also found that electrostatic charging was absent as long as the organisms were alive, even if they had not been coated with electrically conducting materials. This result suggests that living organisms possess their own electrical conductors and/or rely on certain properties of the surface to inhibit charging. The NanoSuit seems to prolong the charge-free condition and increase survival time under vacuum. These findings should encourage the development of more sophisticated observation methods for studying living organisms in an FE-SEM.

The use of albendazole and diammonium glycyrrhizinate in the treatment of eosinophilic meningitis in mice infected with Angiostrongylus cantonensis

Angiostrongylus cantonensis (A. cantonensis) infection causes eosinophilic meningitis in humans. Eosinophilia and a Th2-type immune response are the crucial immune mechanisms for eosinophilic meningitis. CD4+CD25+ regulatory T cells (Treg) are involved in the pathogenesis of A. cantonensis. Diammonium glycyrrhizinate (DG) is a compound related to glycyrrhizin (GL), a triterpene glycoside extracted from liquorice root. We investigated the curative effects and probable mechanisms of therapy involving a combination of albendazole and DG in BALB/c mice infected with A. cantonensis, and compared these with therapy involving albendazole and dexamethasone. We analysed survival time, body weight, signs, eosinophil numbers, immunoglobulin E (IgE), interleukin-5 (IL-5), and eotaxin concentrations, numbers and Foxp3 expression of CD4+CD25+ Treg, worm recovery and histopathology. The present results demonstrated that the combination of albendazole and DG could increase survival time more efficiently and relieve neurological dysfunction; decrease weight loss, eosinophil numbers, concentrations of IgE, IL-5 and eotaxin, the number and expression of Foxp3 of CD4+CD25+ Treg; and improve worm recovery and histopathology changes in treated animals, compared with the combination of albendazole and dexamethasone. The observations presented here suggest that the albendazole and dexamethasone combination could be replaced by the combination of albendazole and DG.