Pub Date : 2016-02-20DOI: 10.4172/2329-6771.S1-005
Saleha Resham
Hepatocellular carcinoma (HCC) is a global health problem, although developing countries are disproportionally affected: over 80% of HCCs occur in such regions. Surprisingly about three-quarters of HCCs are attributed to chronic HBV and HCV infections. In areas endemic for HCV and HBV, viral transmission occurs at an early age, and unfortunately the infected individuals develop HCC in midadulthood. Reducing the life expectancy [1]. HCC is the 5th most common cancer in the world [2]. Among the major concerns; HCC prognosis is poor and is mostly diagnosed at an advanced stage [2].The number of patients is rising exponentially with each passing day. HCC is a concern that needs immediate attention [3].About 185 million people are living with HCV, of which estimated 80% are living in low income and middle-income countries (LMICs) [4]. HCV infection that remains untreated leads to liver cirrhosis in up to two thirds of those who are chronically infected and these individuals are at risk for developing complications such as HCC and hepatic decompensation [5].
{"title":"Why Hepatocellular Carcinoma (hcc)s Management and Control is Challenging in the Developing Countries? Problems vs. Strategies","authors":"Saleha Resham","doi":"10.4172/2329-6771.S1-005","DOIUrl":"https://doi.org/10.4172/2329-6771.S1-005","url":null,"abstract":"Hepatocellular carcinoma (HCC) is a global health problem, although developing countries are disproportionally affected: over 80% of HCCs occur in such regions. Surprisingly about three-quarters of HCCs are attributed to chronic HBV and HCV infections. In areas endemic for HCV and HBV, viral transmission occurs at an early age, and unfortunately the infected individuals develop HCC in midadulthood. Reducing the life expectancy [1]. HCC is the 5th most common cancer in the world [2]. Among the major concerns; HCC prognosis is poor and is mostly diagnosed at an advanced stage [2].The number of patients is rising exponentially with each passing day. HCC is a concern that needs immediate attention [3].About 185 million people are living with HCV, of which estimated 80% are living in low income and middle-income countries (LMICs) [4]. HCV infection that remains untreated leads to liver cirrhosis in up to two thirds of those who are chronically infected and these individuals are at risk for developing complications such as HCC and hepatic decompensation [5].","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"31 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74037278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-19DOI: 10.4172/2329-6771.S1-006
D. Cardinali, G. Escames, D. Acuña-Castroviejo, F. Ortiz, Beatriz I Fernandez-Gil, Ana Guerra Librero, Sergio, García-López, Ying-Qiang Shen, J. Florido
Melatonin is a natural substance ubiquitously distributed and present in almost all living species, from unicellular organisms to humans. Melatonin is synthesized not only in the pineal gland but also in most tissues in the body where it may have a cytoprotective function via paracrine or autocrine effects. Melatonin is effective in suppressing neoplastic growth in a variety of tumors. The mechanisms involved include antiproliferative effects via modulation of cell cycle, ability to induce apoptosis in cancer cells, anti-angiogenic and antimetastatic effects, anti-estrogenic activity, the capacity to decrease telomerase activity, immune modulation, and direct and indirect antioxidant effects. Besides these oncostatic properties, melatonin deserves to be considered in the treatment of cancer for two other reasons. First, because its hypnotic-chronobiotic properties, melatonin use that can allow the clinician to effectively address sleep disturbances, a major co-morbidity in cancer. Second, because melatonin’s anxiolytic and antidepressant effects, it has a possible application in two other major co-morbidities seen in cancer patients, i.e. depression and anxiety. This report summarizes the possible mechanisms involved in melatonin oncostasis and reviews what is known about the clinical application of melatonin as an adjuvant therapy in cancer patients.
{"title":"Melatonin-Induced Oncostasis, Mechanisms and Clinical Relevance","authors":"D. Cardinali, G. Escames, D. Acuña-Castroviejo, F. Ortiz, Beatriz I Fernandez-Gil, Ana Guerra Librero, Sergio, García-López, Ying-Qiang Shen, J. Florido","doi":"10.4172/2329-6771.S1-006","DOIUrl":"https://doi.org/10.4172/2329-6771.S1-006","url":null,"abstract":"Melatonin is a natural substance ubiquitously distributed and present in almost all living species, from unicellular organisms to humans. Melatonin is synthesized not only in the pineal gland but also in most tissues in the body where it may have a cytoprotective function via paracrine or autocrine effects. Melatonin is effective in suppressing neoplastic growth in a variety of tumors. The mechanisms involved include antiproliferative effects via modulation of cell cycle, ability to induce apoptosis in cancer cells, anti-angiogenic and antimetastatic effects, anti-estrogenic activity, the capacity to decrease telomerase activity, immune modulation, and direct and indirect antioxidant effects. Besides these oncostatic properties, melatonin deserves to be considered in the treatment of cancer for two other reasons. First, because its hypnotic-chronobiotic properties, melatonin use that can allow the clinician to effectively address sleep disturbances, a major co-morbidity in cancer. Second, because melatonin’s anxiolytic and antidepressant effects, it has a possible application in two other major co-morbidities seen in cancer patients, i.e. depression and anxiety. This report summarizes the possible mechanisms involved in melatonin oncostasis and reviews what is known about the clinical application of melatonin as an adjuvant therapy in cancer patients.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"30 1","pages":"1-25"},"PeriodicalIF":0.0,"publicationDate":"2016-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73491105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-17DOI: 10.4172/2329-6771.1000159
G. Mukherjee, K. Lakshmaiah, M. Vijayakumar, J. Prabhu, Deepthi Telikicherla, T. Sridhar, R. Kumar
Background: Clinical epidemiology studies of breast cancer in India have reported younger age at detection, presentation at a later stage with a greater proportion of Triple Negative Breast Cancer (TNBC). The aim of this study was to examine the standard clinic-pathological variables in the hormone-receptor based sub-types for patterns indicative of intrinsic differences from that reported in Western, Caucasian women. Methods: Clinico-pathological variables from 645 patients who were diagnosed with breast cancer during 2012 at the regional cancer were retrospectively analyzed for clinical and immunohistochemistry details. Results: The median age at first diagnosis is 48 years which is decade earlier than that reported in Western case-series, 65% were lymph-node positive, and 33% of all cases were Triple negative Breast Cancers. Sub-type specific examination of tumor size and lymph-node (LN) status showed the HER2 positive tumors to have the highest proportion of tumors that were pT4 and 75% were LN positive. Conversely, despite 92% of TNBCs being grade 3, 40% of them were LN negative. Conclusion: We confirm the three cardinal clinical epidemiological features reported by other Indian centres. The clinical behavior of the HER2 positive and TNBC sub-types are no different from that reported in Western caseseries suggesting that these aspects are innate and conserved.
{"title":"Analysis of Clinico-Pathological Characteristics of Indian Breast CancersShows Conservation of Specific Features in the Hormone Receptor Sub-Types","authors":"G. Mukherjee, K. Lakshmaiah, M. Vijayakumar, J. Prabhu, Deepthi Telikicherla, T. Sridhar, R. Kumar","doi":"10.4172/2329-6771.1000159","DOIUrl":"https://doi.org/10.4172/2329-6771.1000159","url":null,"abstract":"Background: Clinical epidemiology studies of breast cancer in India have reported younger age at detection, presentation at a later stage with a greater proportion of Triple Negative Breast Cancer (TNBC). The aim of this study was to examine the standard clinic-pathological variables in the hormone-receptor based sub-types for patterns indicative of intrinsic differences from that reported in Western, Caucasian women. \u0000Methods: Clinico-pathological variables from 645 patients who were diagnosed with breast cancer during 2012 at the regional cancer were retrospectively analyzed for clinical and immunohistochemistry details. \u0000Results: The median age at first diagnosis is 48 years which is decade earlier than that reported in Western case-series, 65% were lymph-node positive, and 33% of all cases were Triple negative Breast Cancers. Sub-type specific examination of tumor size and lymph-node (LN) status showed the HER2 positive tumors to have the highest proportion of tumors that were pT4 and 75% were LN positive. Conversely, despite 92% of TNBCs being grade 3, 40% of them were LN negative. \u0000Conclusion: We confirm the three cardinal clinical epidemiological features reported by other Indian centres. The clinical behavior of the HER2 positive and TNBC sub-types are no different from that reported in Western caseseries suggesting that these aspects are innate and conserved.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86285387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-14DOI: 10.4172/2329-6771.1000158
F. Lai-Tiong
Introduction: Chemotherapy-induced nausea and vomiting are the most common side-effects feared by patients. Although significant advances have been made, chemotherapy-induced nausea and vomiting remain an important adverse effect of treatment. Purpose: The purpose of our study was to evaluate the prevalence of chemotherapy-induced nausea and vomiting in an oncology day unit in France. We described then the management of this side-effect. Methods: This retrospective mono-centric observational study assessed 65 patients in our oncology day unit. They all were on chemotherapy for solid tumors and should have had already received one cycle of chemotherapy. Patients were metastatic or treated with a curative intent. During three days, patients were asked if they had experienced nausea and/or vomiting after their last cycle of treatment. Results: 65 patients were enrolled, 45 women (69%) and 20 men (31%). The median age was 63 years. 20 patients were elderly people. 48 patients were metastatic (74%) and 17(26%) were on neo-adjuvant or adjuvant therapy. 24 people (37%) experienced nausea (20 patients) or vomited (4 patients). Nausea was essentially grade I (60%). All patients received anti-emetic therapies. In the 24 patients who suffered from adverse effects, only 6 had corticosteroids, 15 had NK1 receptor inhibitors, 12 received 5-HT3 receptor inhibitors and 12 anti D2 treatments. 9 patients (14%) experienced refractory nausea and vomiting. Conclusion: Even if guidelines exist and despite many therapeutics agents have improved patients’ quality of life in terms of nausea and vomiting, in some cases it seems not to be enough.
{"title":"Chemotherapy-Induced Nausea and Vomiting: An Oncology-Day Unit Experience","authors":"F. Lai-Tiong","doi":"10.4172/2329-6771.1000158","DOIUrl":"https://doi.org/10.4172/2329-6771.1000158","url":null,"abstract":"Introduction: Chemotherapy-induced nausea and vomiting are the most common side-effects feared by patients. Although significant advances have been made, chemotherapy-induced nausea and vomiting remain an important adverse effect of treatment. \u0000Purpose: The purpose of our study was to evaluate the prevalence of chemotherapy-induced nausea and vomiting in an oncology day unit in France. We described then the management of this side-effect. \u0000Methods: This retrospective mono-centric observational study assessed 65 patients in our oncology day unit. They all were on chemotherapy for solid tumors and should have had already received one cycle of chemotherapy. Patients were metastatic or treated with a curative intent. During three days, patients were asked if they had experienced nausea and/or vomiting after their last cycle of treatment. \u0000Results: 65 patients were enrolled, 45 women (69%) and 20 men (31%). The median age was 63 years. 20 patients were elderly people. 48 patients were metastatic (74%) and 17(26%) were on neo-adjuvant or adjuvant therapy. 24 people (37%) experienced nausea (20 patients) or vomited (4 patients). Nausea was essentially grade I (60%). All patients received anti-emetic therapies. In the 24 patients who suffered from adverse effects, only 6 had corticosteroids, 15 had NK1 receptor inhibitors, 12 received 5-HT3 receptor inhibitors and 12 anti D2 treatments. 9 patients (14%) experienced refractory nausea and vomiting. \u0000Conclusion: Even if guidelines exist and despite many therapeutics agents have improved patients’ quality of life in terms of nausea and vomiting, in some cases it seems not to be enough.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90883796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-10DOI: 10.4172/2329-6771.S1-007
C. Elm’hadi, Mohammed Reda Khmamouche, M. Toreis, Meryem Zerrik, R. Tanz, H. Chahdi, M. Oukabli, H. Errihani, M. Ichou
Background: Ewing's sarcomas and peripheral primitive neuroectodermal tumors are high grade malignant neoplasms, arising from bone and soft tissues and are grouped in the Ewing family of tumors. Primary localization in the mediastinum is extremely rare and was treated in only a few case reports. Lymphatic localization has never been reported. We present a case of an extraskeletal Ewing sarcoma arising from lymphadenopathy in the hilar and anterior mediastinal regions with literature review. Case presentation: A 24 year old man was admitted to our institution for persistent cough, nocturnal diaphoresis, and weight loss of 6 kg. The chest X-ray displayed opacity of the left hilum at polycyclic contours. Chest Computed tomography scan confirmed supradiaphragmatic lymphadenopathy in the hilar and anterior mediastinal. Biopsy was performed. Histological and immunohistochemical analysis showed small and round cells tumor with positive staining for CD99 and vimentin, and negative staining of desmine, myogenine, actine muscle lisse, Proteine S-100, Chromogranine, CD56, pancytokeratin, myeloperoxidase and TTF1. Young age, morphological and immunohistological characters argued in favor of a tumor of Ewing group .We could not perform molecular cytogenetic analysis, because of the lack of technical structure. The staging was negative for any other metastatic disease or primitive bone tumor, and final diagnosis was primary localized Ewing sarcoma in mediastinal nodes. The patient received Ewing’s sarcoma chemotherapy regimen. Complete response was achieved after six courses. Radiotherapy was prescribed, and the same chemotherapy regimen was continued totaling a period of one year. The patient was well with no evidence of local relapse or metastasis three years after diagnosis. Conclusion: Extraskeletal Ewing sarcoma should be contemplated in the differential diagnosis of mediastinal lymphadenopathy. With multimodal treatment, the patients are potentially curable.
{"title":"An Atypical Etiology of Mediastinal Lymphadenopathy: Extraskeletal Ewing Sarcoma","authors":"C. Elm’hadi, Mohammed Reda Khmamouche, M. Toreis, Meryem Zerrik, R. Tanz, H. Chahdi, M. Oukabli, H. Errihani, M. Ichou","doi":"10.4172/2329-6771.S1-007","DOIUrl":"https://doi.org/10.4172/2329-6771.S1-007","url":null,"abstract":"Background: Ewing's sarcomas and peripheral primitive neuroectodermal tumors are high grade malignant neoplasms, arising from bone and soft tissues and are grouped in the Ewing family of tumors. Primary localization in the mediastinum is extremely rare and was treated in only a few case reports. Lymphatic localization has never been reported. We present a case of an extraskeletal Ewing sarcoma arising from lymphadenopathy in the hilar and anterior mediastinal regions with literature review. \u0000Case presentation: A 24 year old man was admitted to our institution for persistent cough, nocturnal diaphoresis, and weight loss of 6 kg. The chest X-ray displayed opacity of the left hilum at polycyclic contours. Chest Computed tomography scan confirmed supradiaphragmatic lymphadenopathy in the hilar and anterior mediastinal. Biopsy was performed. Histological and immunohistochemical analysis showed small and round cells tumor with positive staining for CD99 and vimentin, and negative staining of desmine, myogenine, actine muscle lisse, Proteine S-100, Chromogranine, CD56, pancytokeratin, myeloperoxidase and TTF1. Young age, morphological and immunohistological characters argued in favor of a tumor of Ewing group .We could not perform molecular cytogenetic analysis, because of the lack of technical structure. The staging was negative for any other metastatic disease or primitive bone tumor, and final diagnosis was primary localized Ewing sarcoma in mediastinal nodes. The patient received Ewing’s sarcoma chemotherapy regimen. Complete response was achieved after six courses. Radiotherapy was prescribed, and the same chemotherapy regimen was continued totaling a period of one year. The patient was well with no evidence of local relapse or metastasis three years after diagnosis. \u0000Conclusion: Extraskeletal Ewing sarcoma should be contemplated in the differential diagnosis of mediastinal lymphadenopathy. With multimodal treatment, the patients are potentially curable.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"146 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80521915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-10DOI: 10.4172/2329-6771.1000157
D. Mastrangelo, L. Massai, G. Fioritoni, F. Coco, R. Nuti
The anticancer properties of Vitamin C (ascorbic acid o sodium ascorbate) are known since at least four decades, However, being a cheap and "natural" product, Vitamin C is not patentable and therefore has never been developed as an anticancer molecule. Recent in vitro investigations have confirmed the extraordinary antitumor properties of high doses of Vitamin C (sodium ascorbate), particularly when administered by the intravenous route, and phase I/II randomized, controlled clinical trials have been started to verify its anticancer properties in vivo. Unfortunately, the controlled clinical trials performed so far, do not confirm the extraordinary results obtained with Vitamin C (sodium ascorbate) in vitro. However, this may depend on a number of different factors, such as the pharmaceutical preparation (Sodium ascorbate may be more suitable than buffered ascorbic acid), the schedule of administration (slow infusion better than rapid infusion), tumor tissue oxygenation (Cancer tissue oxygenation is lower that oxygenation of tumor cell lines, in vitro), etc., which deserve further in depth investigation. Even with these limitations, Vitamin C (sodium ascorbate) in high doses, administered by intravenous route, beyond being extremely effective in vitro, against a number of human tumor cell lines, is safe, has minimal contraindications, improves the quality of life of patients, and is highly selective for cancer cells. The Authors discuss these important aspects and suggest possible solutions to improve the in vivo anticancer effects of Vitamin C (sodium ascorbate).
{"title":"The Cure from Nature: The Extraordinary Anticancer Properties of Ascorbate (Vitamin C)","authors":"D. Mastrangelo, L. Massai, G. Fioritoni, F. Coco, R. Nuti","doi":"10.4172/2329-6771.1000157","DOIUrl":"https://doi.org/10.4172/2329-6771.1000157","url":null,"abstract":"The anticancer properties of Vitamin C (ascorbic acid o sodium ascorbate) are known since at least four decades, However, being a cheap and \"natural\" product, Vitamin C is not patentable and therefore has never been developed as an anticancer molecule. Recent in vitro investigations have confirmed the extraordinary antitumor properties of high doses of Vitamin C (sodium ascorbate), particularly when administered by the intravenous route, and phase I/II randomized, controlled clinical trials have been started to verify its anticancer properties in vivo. Unfortunately, the controlled clinical trials performed so far, do not confirm the extraordinary results obtained with Vitamin C (sodium ascorbate) in vitro. However, this may depend on a number of different factors, such as the pharmaceutical preparation (Sodium ascorbate may be more suitable than buffered ascorbic acid), the schedule of administration (slow infusion better than rapid infusion), tumor tissue oxygenation (Cancer tissue oxygenation is lower that oxygenation of tumor cell lines, in vitro), etc., which deserve further in depth investigation. Even with these limitations, Vitamin C (sodium ascorbate) in high doses, administered by intravenous route, beyond being extremely effective in vitro, against a number of human tumor cell lines, is safe, has minimal contraindications, improves the quality of life of patients, and is highly selective for cancer cells. The Authors discuss these important aspects and suggest possible solutions to improve the in vivo anticancer effects of Vitamin C (sodium ascorbate).","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89776182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-10DOI: 10.4172/2329-6771.1000156
Ronaldo Sousa Oliveiro Filho, Ana Carolina Tamburrino, V. Trevisani, V. M. Rosa
Introduction: The Nutrition Risk in Critically ill (NUTRIC) score is a specific tool for assessing the nutritional risk in the Intensive Care Unit (ICU). Under these conditions, it is extremely important to monitor Enteral Nutrition Therapy and identify main barriers in the control of energy-protein deficit. Objective: To identify main barriers to control the energy-protein deficit in critically ill patients at nutritional risk, on enteral nutrition (EN) and on mechanical ventilation (MV). Methods: Prospective, observational, descriptive study was conducted in an ICU in 2015. Patients >19 years of age on MV and underwent EN for >72 hours. The data collected were NUTRIC score, Subjective Global Assessment (SGA), Cachexia Syndrome, APACHE II, SOFA, ICU time, MV and EN times and main barriers for pausing EN. The protein-calorie deficit was compiled into total days of EN. Results: Total of 62 patients, 22 were excluded, 40 analyzed. The scores were NUTRIC 7 (+0.7), APACHE 26 (+5.2), SOFA 11.5 (+2.2), Body Mass Index 23.2 (+6.2) kg/m², 47% malnourished (SGA B+C), 70% cachexia syndrome and mortality rate of 52.5%. Among these patients, 77.5% underwent early EN and percentage of volume prescribed infused was 89%. It was observed total deficit of -296 (+339) calories and -28 (IQ -58:-2.95) g/protein. Main barriers for pausing EN were extubation 38%, hemodynamic instability 29%, tracheostomy, diarrhea and vomiting, both 6.5%. There was a statistically significant difference between calorie (p<0.003) and protein (p<0.002) deficits in the subgroups of adult patients compared to malnourished elderly patients with cachexia syndrome: -358.9 (+305) calories and -33 (+14.24) g/protein; -91.6 (+190) calories and -18.8 (+7.96) g/protein, respectively. Conclusion: The main barriers in control of energy-protein deficit in critical oncologic patient at nutritional risk on EN and on MV were extubation and hemodynamic instability.
{"title":"Main Barriers in Control of Energy-Protein Deficit in Critical Oncologic Patient at Nutritional Risk","authors":"Ronaldo Sousa Oliveiro Filho, Ana Carolina Tamburrino, V. Trevisani, V. M. Rosa","doi":"10.4172/2329-6771.1000156","DOIUrl":"https://doi.org/10.4172/2329-6771.1000156","url":null,"abstract":"Introduction: The Nutrition Risk in Critically ill (NUTRIC) score is a specific tool for assessing the nutritional risk in the Intensive Care Unit (ICU). Under these conditions, it is extremely important to monitor Enteral Nutrition Therapy and identify main barriers in the control of energy-protein deficit. \u0000Objective: To identify main barriers to control the energy-protein deficit in critically ill patients at nutritional risk, on enteral nutrition (EN) and on mechanical ventilation (MV). \u0000Methods: Prospective, observational, descriptive study was conducted in an ICU in 2015. Patients >19 years of age on MV and underwent EN for >72 hours. The data collected were NUTRIC score, Subjective Global Assessment (SGA), Cachexia Syndrome, APACHE II, SOFA, ICU time, MV and EN times and main barriers for pausing EN. The protein-calorie deficit was compiled into total days of EN. \u0000Results: Total of 62 patients, 22 were excluded, 40 analyzed. The scores were NUTRIC 7 (+0.7), APACHE 26 (+5.2), SOFA 11.5 (+2.2), Body Mass Index 23.2 (+6.2) kg/m², 47% malnourished (SGA B+C), 70% cachexia syndrome and mortality rate of 52.5%. Among these patients, 77.5% underwent early EN and percentage of volume prescribed infused was 89%. It was observed total deficit of -296 (+339) calories and -28 (IQ -58:-2.95) g/protein. Main barriers for pausing EN were extubation 38%, hemodynamic instability 29%, tracheostomy, diarrhea and vomiting, both 6.5%. There was a statistically significant difference between calorie (p<0.003) and protein (p<0.002) deficits in the subgroups of adult patients compared to malnourished elderly patients with cachexia syndrome: -358.9 (+305) calories and -33 (+14.24) g/protein; -91.6 (+190) calories and -18.8 (+7.96) g/protein, respectively. \u0000Conclusion: The main barriers in control of energy-protein deficit in critical oncologic patient at nutritional risk on EN and on MV were extubation and hemodynamic instability.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"91 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79003871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-19DOI: 10.4172/2329-6771.S1-004
C. Pedrazzani, M. Vitali, S. Conci, M. Moro, S. Pecori, A. Ruzzenente, A. Guglielmi
Laparoscopic surgery and tyrosine kinase-inhibitor (TKI) therapy are frequently used to treat gastrointestinal stromal tumors (GISTs). The purpose of this review was to analyze the published data on minimally invasive treatment of GISTs, with special focus on tumor location and on the possible role of laparoscopy in association with imatinib mesylate therapy in the treatment of advanced forms. The MEDLINE® and Embase® databases were searched for potentially eligible English-language studies published through June 30, 2015. Laparoscopic surgery can be considered a treatment option for GISTs at all locations. Most gastric GISTs are suitable for laparoscopic wedge resection (44-100% in recent series). Gastric GISTs in difficult-to-treat areas may benefit from innovative approaches such as transgastric or intragastric resection. Few data are available for small-bowel and colonic GISTs, although laparoscopic resection complying with the oncologic principles seems feasible and safe with reported morbidity and mortality rates of 3.8-6.7% and 0%, respecively. Primary resection of large rectal GISTs carries a risk of recurrence up to 40%. To improve long-term results and reduce the invasiveness of surgery in this setting, as in other difficultto- treat areas, neoadjuvant imatinib therapy should be considered. In selected cases, the combination of imatinib mesylate therapy and laparoscopy can minimize surgical trauma. The appropriate adoption of laparoscopic surgery and TKI therapy can reduce surgical trauma and optimize long-term results.
{"title":"Update on Laparoscopic Treatment of Gastrointestinal Stromal Tumors","authors":"C. Pedrazzani, M. Vitali, S. Conci, M. Moro, S. Pecori, A. Ruzzenente, A. Guglielmi","doi":"10.4172/2329-6771.S1-004","DOIUrl":"https://doi.org/10.4172/2329-6771.S1-004","url":null,"abstract":"Laparoscopic surgery and tyrosine kinase-inhibitor (TKI) therapy are frequently used to treat gastrointestinal stromal tumors (GISTs). The purpose of this review was to analyze the published data on minimally invasive treatment of GISTs, with special focus on tumor location and on the possible role of laparoscopy in association with imatinib mesylate therapy in the treatment of advanced forms. The MEDLINE® and Embase® databases were searched for potentially eligible English-language studies published through June 30, 2015. Laparoscopic surgery can be considered a treatment option for GISTs at all locations. Most gastric GISTs are suitable for laparoscopic wedge resection (44-100% in recent series). Gastric GISTs in difficult-to-treat areas may benefit from innovative approaches such as transgastric or intragastric resection. Few data are available for small-bowel and colonic GISTs, although laparoscopic resection complying with the oncologic principles seems feasible and safe with reported morbidity and mortality rates of 3.8-6.7% and 0%, respecively. Primary resection of large rectal GISTs carries a risk of recurrence up to 40%. To improve long-term results and reduce the invasiveness of surgery in this setting, as in other difficultto- treat areas, neoadjuvant imatinib therapy should be considered. In selected cases, the combination of imatinib mesylate therapy and laparoscopy can minimize surgical trauma. The appropriate adoption of laparoscopic surgery and TKI therapy can reduce surgical trauma and optimize long-term results.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"1 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2016-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79748836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-19DOI: 10.4172/2329-6771.S1-003
S. Hussain, A. Hussein, Basim Mohammed Khashma
Background: Breast cancer remains a major health problem in women. The molecular mechanisms of tumor growth and progression are complicated but likely involve the interaction of tumor suppressor genes. Oncogenes, cell cycle regulatory proteins and other factors. Recently some studies showed that Cyclin D1 is a cell cycle regulatory gene emerging as a potentially significant oncogene in invasive breast cancers. Objective: To evaluate immunohistochemical expression of cyclin D1 in women with breast cancer in our population and correlate its expression with different variables such as age, type of tumor and grade. Materials and methods: We retrospectively analyzed data from 76 formalin-fixed of paraffin-embedded tissues diagnosed with breast cancer which were collected from teaching laboratory unit in Baghdad medical city, Iraq, during the period from 2009 till 2013 and compared with positive control. These samples were investigated immunohistochemically, nuclear and cytoplasmic staining of tumor cells was accepted as positive. Results: The results showed that age distribution ranging from (28-67 years) with a mean age of 47.63 years. Regarding tumor types 68 (89.47%) cases were wit invasive ductal carcinoma, 6 (7.89%) cases were with invasive lobular carcinoma and 2 (2.63%) cases were recurrent carcinoma. Histologically the tumor grade ranges from well differentiated (grade 1) in 10 (13.15%) cases, moderately differentiated (grade 11) in 52 (68.42%) cases and poorly differentiated (grade 111) in 14 (18.42%) cases. Cyclin D1 expression was positive in 30 (39.47%) cases, while 46 (60%) cases negative. On the other hand most positive cases occurred within age group (41-55 years), invasive ductal carcinoma 26 (86.66%) and moderately differentiated 18 (60%) cases. significant differences noticed between IHC expressions of this marker with age, type of tumor and grade. Conclusion: cyclin D1 is an important regulator of cell cycle progression and overexpression of cyclin D1 has been linked to the development and progression of cancer, Cyclin D1 expression was seen more in invasive ductal carcinoma also is considered a novel and good marker of invasiveness in breast cancer tissue and may be used for treatment.
{"title":"Immunohistochemical Expression of Cyclin D1 in Human Breast Carcinoma","authors":"S. Hussain, A. Hussein, Basim Mohammed Khashma","doi":"10.4172/2329-6771.S1-003","DOIUrl":"https://doi.org/10.4172/2329-6771.S1-003","url":null,"abstract":"Background: Breast cancer remains a major health problem in women. The molecular mechanisms of tumor growth and progression are complicated but likely involve the interaction of tumor suppressor genes. Oncogenes, cell cycle regulatory proteins and other factors. Recently some studies showed that Cyclin D1 is a cell cycle regulatory gene emerging as a potentially significant oncogene in invasive breast cancers. \u0000Objective: To evaluate immunohistochemical expression of cyclin D1 in women with breast cancer in our population and correlate its expression with different variables such as age, type of tumor and grade. \u0000Materials and methods: We retrospectively analyzed data from 76 formalin-fixed of paraffin-embedded tissues diagnosed with breast cancer which were collected from teaching laboratory unit in Baghdad medical city, Iraq, during the period from 2009 till 2013 and compared with positive control. These samples were investigated immunohistochemically, nuclear and cytoplasmic staining of tumor cells was accepted as positive. \u0000Results: The results showed that age distribution ranging from (28-67 years) with a mean age of 47.63 years. Regarding tumor types 68 (89.47%) cases were wit invasive ductal carcinoma, 6 (7.89%) cases were with invasive lobular carcinoma and 2 (2.63%) cases were recurrent carcinoma. Histologically the tumor grade ranges from well differentiated (grade 1) in 10 (13.15%) cases, moderately differentiated (grade 11) in 52 (68.42%) cases and poorly differentiated (grade 111) in 14 (18.42%) cases. Cyclin D1 expression was positive in 30 (39.47%) cases, while 46 (60%) cases negative. On the other hand most positive cases occurred within age group (41-55 years), invasive ductal carcinoma 26 (86.66%) and moderately differentiated 18 (60%) cases. significant differences noticed between IHC expressions of this marker with age, type of tumor and grade. \u0000Conclusion: cyclin D1 is an important regulator of cell cycle progression and overexpression of cyclin D1 has been linked to the development and progression of cancer, Cyclin D1 expression was seen more in invasive ductal carcinoma also is considered a novel and good marker of invasiveness in breast cancer tissue and may be used for treatment.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"128 18 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2016-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73030757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-19DOI: 10.4172/2329-6771.S1-002
Mir, A. Costa, E. Panutich, H. Zwickey
Objective: Renal cell carcinoma (RCC) is a rare and difficult to treat cancer. The case series aimed to observe the effects of medicinal mushrooms and integrative oncology care for renal cell carcinoma. Clinical Features: Patients diagnosed with RCC who were being treated with surgery and chemotherapy and were administered integrative treatment in the form of supplements and medicinal mushrooms and/or combinations of mushrooms. Interventions and outcomes: Integrative care included a combination of supplements and the medicinal mushrooms Ganoderma lucidum, Trametes versicolor, Cordyceps sinensis, Grifola frondosa, and Lentinus edodes in combination or alone, which was initiated following adjuvant care. These patients experienced increased overall survival compared to standard adjuvant treatment alone. Conclusion: Beneficial effects of integrative care were observed in this case series. Disease progression and symptoms related to adjuvant treatment were significantly decreased in these patients after integrative supportive care was initiated and effects persisted through the final observation period. Further controlled studies are needed among larger groups of patients to determine the clinical efficacy of medicinal mushrooms and integrative oncology in the treatment of RCC.
{"title":"Renal Cell Carcinoma: A Case Series with Integrative Treatment","authors":"Mir, A. Costa, E. Panutich, H. Zwickey","doi":"10.4172/2329-6771.S1-002","DOIUrl":"https://doi.org/10.4172/2329-6771.S1-002","url":null,"abstract":"Objective: Renal cell carcinoma (RCC) is a rare and difficult to treat cancer. The case series aimed to observe the effects of medicinal mushrooms and integrative oncology care for renal cell carcinoma. \u0000Clinical Features: Patients diagnosed with RCC who were being treated with surgery and chemotherapy and were administered integrative treatment in the form of supplements and medicinal mushrooms and/or combinations of mushrooms. \u0000Interventions and outcomes: Integrative care included a combination of supplements and the medicinal mushrooms Ganoderma lucidum, Trametes versicolor, Cordyceps sinensis, Grifola frondosa, and Lentinus edodes in combination or alone, which was initiated following adjuvant care. These patients experienced increased overall survival compared to standard adjuvant treatment alone. \u0000Conclusion: Beneficial effects of integrative care were observed in this case series. Disease progression and symptoms related to adjuvant treatment were significantly decreased in these patients after integrative supportive care was initiated and effects persisted through the final observation period. Further controlled studies are needed among larger groups of patients to determine the clinical efficacy of medicinal mushrooms and integrative oncology in the treatment of RCC.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"12 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2016-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83656625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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