bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative high-dose-rate interstitial brachytherapy boost for patients with early breast cancer
Authors: Sharma Daya Nand , Deo SVS , Rath Goura Kisor , Shukla Nootan Kumar , Thulkar Sanjay , Madan Renu , Julka Pramod Kumar 
Published: February 2018

Aims and background To evaluate the clinical results of perioperative high-dose-rate interstitial brachytherapy boost treatment preceding whole breast external beam radiation therapy in patients with early breast cancer. Methods and study design From 2005–2010, 100 patients with early breast cancer who met the eligibility criteria were enrolled in the study. Brachytherapy implant was performed during the breast-conserving surgery procedure. The boost treatment was started on the 3rd postoperative day to deliver a dose of 15 Gy in 6 fractions over 3 days. Three weeks later, external beam radiation therapy to the whole breast was started for a prescription dose of 50 Gy. The study end points were local recurrence, acute toxicity and cosmetic outcome. Results Median age of the patients was 46 years, and median follow-up was 52 months. No patient developed a local recurrence but 5 patients developed distant metastases. The 5-year overall survival and disease-free survival were 86% and 77%, respectively. Eleven patients had acute toxicity; 4 wound complications and 7 grade III skin toxicity. Nine of the 11 patients had breast size of more than 1500 cc. Except for the breast volume (>1500 cc), there was no statistically significant correlation between any of the patient or dosimetry-related factors and acute toxicity. Good-excellent cosmesis was observed in 87% of patients. Conclusions Perioperative high-dose-rate interstitial brachytherapy boost followed by whole breast external beam radiation therapy provides excellent local control, acceptable acute toxicity and good-excellent breast cosmesis in patients with early breast cancer.
Clinical outcome of stereotactic body radiotherapy for abdominal lymph node metastases
Authors: Bonomo Pierluigi , Cipressi Samantha , Saieva Calogero , Greto Daniela , Masi Laura , Paiar Fabiola , Di Cataldo Vanessa , Meattini Icro , Cecchini Sara , Mangoni Monica , Doro Raffaela , Iermano Carmine , Bonucci Ivano , Livi Lorenzo , Biti Giampaolo 
Published: February 2018

Aims and background To report the clinical outcome of linac-based or robotic, image-guided stereotactic body radiotherapy in patients affected by abdominal lymph node metastases from different primary cancers. Methods and Methods Twenty-six patients with 32 abdominal lymph node metastases were consecutively treated at the University of Florence between April 2011 and May 2012. The mean follow-up was 4.6 months (SD, 3.9; range, 0.3–13). The dose prescription ranged between 24 Gy and 36 Gy delivered in 1–5 fractions. Results In terms of local control, complete response to stereotactic body radiotherapy was obtained in 18 cases (66.7%), partial response in 7 (25.9%), and stable disease in 2 (7.4%). At the Cox univariate regression analysis, an increased risk of partial response or absence of local response to radiotherapy was found for subjects of the female sex (P = 0.036), age less than 50 years (P = 0.022), primary tumor of the genital tract (P = 0.007), and previous chemotherapy (P = 0.057). An excellent local control rate (90.9%) was obtained in patients affected by abdominal lymph node metastases of prostatic origin. Conclusions Stereotactic body radiotherapy for abdominal lymph node metastases is a safe and effective treatment in terms of high rates of local control, especially in a subset of patients affected by prostate cancer.
What is the price of functional surgical organ preservation in local-regionally advanced supraglottic cancer? Long-term outcome for partial laryngectomy followed by radiotherapy in 32 patients
Authors: Alterio Daniela , Ansarin Mohssen , Jereczek-Fossa Barbara A , Zorzi Stefano , Santoro Luigi , Zerini Dario , Massaro Mariangela , Rondi Elena , Ferrario Silvia , Piperno Gaia , Rocca Maria Cossu , Griseri Mara , Preda Lorenzo , Chiesa Fausto , Orecchia Roberto 
Published: February 2018

Aims and background To achieve the goal of organ preservation, both a chemoradiotherapy and a conservative surgical approach can be proposed. The aim of the study was to review all patients treated in our Institute with conservative surgery and postoperative radiotherapy for locally advanced supraglottic tumor. Methods and study design A retrospective analysis of 32 patients treated between 2000 and 2010 was performed. Overall survival, disease-free survival and late laryngeal toxicity were evaluated. The impact of surgical procedures, radiotherapy characteristics and addition of chemotherapy on late laryngeal toxicity was studied. Results The median follow-up was 38 months. Overall survival and disease-free survival at 5 years were 73% and 66%, respectively. Three (9%) patients experienced local recurrence (after 22, 25 and 40 months, respectively) and were treated with total laryngectomy. The larynx preservation rate was 93%. Severe treatment-related late laryngeal toxicity (grade 3 and 4 laryngeal edema, laryngeal stenosis, presence of tracheotomy at last follow-up because of treatment-related toxicity, and the need for enteral nutrition) was experienced by 34% of patients. The functional larynx preservation rate was 81%. The statistically significant risk factors for severe late toxicity were: female gender, extension of the surgical procedure, removal of one arytenoid and association with concomitant chemotherapy. Conclusions We confirmed literature data on the feasibility and efficacy of a surgical organ preservation strategy. However, the high incidence of severe late toxicity requires further studies to improve patient selection and to reduce side effects.
Temperament and character and quality of life in lung cancer patients
Authors: Kukulj Suzana , Margetic Branka Aukst , Jakovljevic Miro , Samarzija Miroslav 
Published: February 2018

Aim The aim of this study was to test whether personality variables are independently associated with health-related quality of life (HRQOL) in lung cancer patients. Methods In a cross-sectional study, 86 non-small cell lung cancer patients and 73 healthy subjects matched for gender and age were assessed with the Temperament and Character Inventory. In the patient group QOL was assessed with EORTC QLQ-C30. We used multiple linear regressions to determine whether personality dimensions predict HRQOL. Data on tumor stage, patient age, education and marital status were also collected. Results Lung cancer patients differed from healthy controls in the temperament dimension of persistence and the character dimension of self-transcendence. The temperament dimension of harm avoidance and the character dimension of cooperativeness were significant predictors of QOL functional scales and global health status. Conclusions In lung cancer patients, the personality dimensions of harm avoidance and cooperativeness showed associations with most QOL dimensions. Personality factors are relevant for patients' QOL perception and should be included in cancer patients' QOL assessment.
Insulin-like growth factor I regulates the expression of isoforms of Wilms' tumor 1 gene in breast cancer
Authors: Tuna Musaffe , Itamochi Hiroaki 
Published: February 2018

Aim and background The Wilms' tumor 1 gene (WT1) is overexpressed in many cancers, including breast cancer, and its high expression is an adverse prognostic factor. However, the factors that regulate WT1 expression are poorly understood. Methods and study design Expression of genes at the RNA and protein level was detected by reverse transcriptase-polymerase chain reaction, western blotting, and reverse-phase protein array assays in breast cancer cell lines and tumor samples. Results In the study, we showed that the treatment of MCF-7 breast cancer cells with insulin-like growth factor I (IGF-I) increases WT1 protein expression by 77%. IGF-I uses Akt to up-regulate WT1 expression. Conversely, inhibition of IGF-I by IGF-binding protein 3 and of IGF-I receptor (IGF-IR) by anti-IGF-IR antibody (α-IR3) uses Akt to decrease WT1 protein levels in MCF-7 cells. We thus newly identified a mechanism by which IGF-I up-regulates WT1, especially the (+exon 5/-KTS) isoform, at the post-transcriptional level in MCF-7 cells and primary breast tumor samples. Conclusions The results indicate a novel posttranscriptional regulatory factor of WT1 in MCF-7 breast cancer cells.
Accreditation for Excellence of Cancer Research Institutes: Recommendations from the Italian Network of Comprehensive Cancer Centers
Authors: Deriu Pier Luigi , La Pietra Leonardo , Pierotti Marco , Collazzo Raffaele , Paradiso Angelo 
Published: February 2018

A panel of experts from Italian Comprehensive Cancer Centers defines the recommendations for external quality control programs aimed to accreditation to excellence of these institutes. After definition of the process as a systematic, periodic evaluation performed by an external agency to verify whether a health organization possesses certain prerequisites regarding structural, organizational and operational conditions that are thought to affect health care quality, the panel reviews models internationally available and makes final recommendations on aspects considered of main interest. This position paper has been produced within a special project of the Ministry of Health of the Italian Government aimed to accredit, according to OECI model, 11 Italian cancer centers in the period 2012–2014. The Project represents the effort undertaken by this network of Comprehensive Cancer Centers to find a common denominator for the experience of all Institutes in external quality control programs. Fourteen shared “statements” are put forth, designed to offer some indications on the main aspects of this subject, based on literature evidence or expert opinions. They deal with the need for “accountability” and involvement of the entire organization, the effectiveness of self-evaluation, the temporal continuity and the educational value of the experience, the use of indicators and measurement tools, additionally for intra- and inter-organization comparison, the system of evaluation models used, the provision for specific requisites for oncology, and the opportunity for mutual exchange of evaluation experiences.
Serum ALDH1A1 is a Tumor Marker for the Diagnosis of Non-Small Cell Lung Cancer
Authors: Cao Yong-Tong , Li Jing-Hua , Wang Yuan-Tao , Fu Yao-Wen , Xu Jing 
Published: February 2018

Background ALDH1A1 (aldehyde dehydrogenase 1 family, member A1) is highly expressed in non-small-cell lung cancer (NSCLC). We assessed the potential clinical value of serum ALDH1A1 in the diagnosis and prognosis of non-small-cell lung cancer. Method Between 2010 and 2011, serum samples from 100 non-small-cell lung cancer patients before tumor resection, 60 patients with benign lung disease, and 60 healthy volunteers were collected and analyzed retrospectively for ALDH1A1, using sandwich ELISA. We further evaluated the serum and tumor ALDH1A1 levels of non-small-cell lung cancer patients before and after surgery. We compared the diagnostic and prognostic values of serum ALDH1A1 with that of carcinoembryonic antigen. Results Elevated serum ALDH1A1 levels were observed in 55 of the 100 (55%) non-small-cell lung cancer patients. The ALDH1A1 levels were much higher in patients with advanced stages than in those with early stage tumors. Of the 30 non-small-cell lung cancer patients who underwent surgery, 19 had elevated serum ALDH1A1 levels before surgery, but the serum ALDH1A1 level was undetectable by postoperative day 7. Analysis of receiver operating characteristic curves showed that ALDH1A1 might be better than carcinoembryonic antigen in distinguishing non-small-cell lung cancer from benign disease or the healthy control. Combined application of ALDH1A1 and carcinoembryonic antigen significantly increased the sensitivity of carcinoembryonic antigen alone, with an accuracy of 83%. Conclusions Our results showed that serum levels of ALDH1A1 were correlated with carcinogenesis and progression of non-small-cell lung cancer. Detection of serum ALDH1A1 can be helpful in the diagnosis and prognosis of non-small-cell lung cancer. The diagnosis rate of non-small-cell lung cancer could be significantly improved when carcinoembryonic antigen is combined with ALDH1A1.
Surgical Treatment of an Isolated Omental Cervical Cancer Recurrence: Report of a Case and Review of the Literature
Authors: Gasparri Maria Luisa , Bellati Filippo , Pernice Milena , Di Donato Violante , Morano Giuseppina , Marchetti Claudia , Donfrancesco Cristina , Antonilli Morena , Panici Pierluigi Benedetti 
Published: February 2018

Aims and Background Recurrent cervical cancer has traditionally been associated with a dismal prognosis. Historically, patients who developed distant metastases from cervical cancer were not considered eligible for surgical resection; only palliative treatment options are available, generally consisting of chemo- and/or radiotherapy. Metastases usually appear in the liver, lung or lymph nodes. The abdominal cavity is a quite unusual site of recurrence and the disease usually has multiple foci. For this reason, peritoneal involvement by cervical cancer is considered a contraindication to local treatment. Methods and Study Design We report the first case of a 30-year-old woman with isolated intra-abdominal cervical cancer recurrence diagnosed with 18F-FDG PET/CT, successfully surgically treated. Results Histopathological analysis confirmed the tumor to be an omental relapse of squamous cervical cancer previously treated with anterior pelvic exenteration and platinum based chemotherapy. The patient underwent adjuvant treatment with 3 cycles of topotecan and has remained free of disease during the 4 years of follow-up. Conclusions In selected cases with isolated recurrences, a surgical resection may provide a long term complete remission in recurrent cervical cancer patients.
Antithrombotic Therapy Underutilization in Patients With Atrial Flutter
Authors: Lee Sanghun , Je Nam Kyung 
Published: February 2018

Background: Patients with atrial fibrillation not being adequately treated with oral anticoagulant (OAC) therapy, with therapy underutilization or premature termination, have been commonly reported. However, studies on the utilization pattern of OAC therapy for patients with atrial flutter (AFL) are few. The aim of this study was to investigate the utilization of OAC therapy, and its influencing factors for patients with AFL in South Korea, as well as the types and percentages of anticoagulants used. Methods: We analyzed Aged Population Sample data compiled by the Health Insurance Review & Assessment Service from 2011 to 2015. We identified patients with AFL having the KCD-6 code I48.1. Patients at high risk of stroke with a congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke (or transient ischemic attack), vascular disease, sex score of ≥2 and at low risk of bleeding with an anticoagulation and risk factors in atrial fibrillation score of ≤4 were included in the study. Oral anticoagulant therapy underutilization was estimated in these patients using anticoagulant underutilization (ACU) scales. Demographic and clinical factors associated with OAC therapy underutilization were investigated using a logistic regression model. Results: The mean ACU value was calculated as 67.4% between 2011 and 2015. Positive risk factors for ACU were identified as follows: female sex, aspirin utilization, and limited anticoagulant options. Negative risk factors included comorbidities, such as congestive heart failure and valvular heart disease, and a history of stroke or transient ischemic attack. Conclusions: Our study demonstrates that two-third of patients with AFL in South Korea failed to obtain adequate stroke prevention treatment, even in the era of direct OAC availability. This tendency was more profound in women or those on aspirin therapy.
Endovascular Management of Ureteroarterial Fistula: Single Institution Experience and Systematic Literature Review
Authors: Subiela José D. , Balla Andrea , Bollo Jesús , Dilme Jaume F. , Soto Carricas Begoña , Targarona Eduard M. , Rodriguez-Faba Oscar , Breda Alberto , Palou Juan 
Published: February 2018

Background: Ureteroarterial fistula (UAF) represents an uncommon complication after urological surgery; however, this is a well-documented condition in patients with predisposing risk factors. The aim of the present study is to report and analyze the endovascular management of a series of patients with UAF, treated in authors’ hospital, and to report and analyze the same data concerning patients retrieved from a systematic literature review. Methods: Authors conducted a retrospective analysis of prospectively collected data and a systematic literature review. The research was carried out through PubMed database searching the following keywords: “uretero arterial fistula” and “uretero iliac fistula.” It includes only articles reporting the endovascular management. Results: Forty-six articles were included in the present study for a total of 94 patients. Risk factors were as follows: chronic indwelling ureteral stents, pelvic surgery, radiotherapy, iliac artery pseudo-aneurysm, and chemotherapy. All patients had gross hematuria at presentation. Stent graft placement was performed in 89 patients, embolization in 5 patients, and iliac internal artery embolization combined with stent graft placement was performed in 24 patients. Four postprocedural complications were observed (4.2%). During a median follow-up of 8 months, 10 complications related to UAF were observed (10.6%): rebleeding (7 cases) and stent thrombosis (3 cases). Two patients died for causes related to UAF (2.1%): rebleeding (1) and retroperitoneal abscess (1). Conclusion: Based on the present data, endovascular treatment is feasible and safe with low postprocedural complications and mortality rate. Considering the increase in surgery and radiotherapy performed, UAF should be always debated in patients with massive hematuria.
Wunder-women: Systematic review of causes, treatment and outcomes of Wunderlich syndrome during pregnancy
Authors: Ahn Thomas , Roberts Matthew J , Navaratnam Anojan , Chung Eric , Wood Simon T 
Published: February 2018

Objective: The objective of this article is to conduct a contemporary literature review on Wunderlich syndrome, or spontaneous renal haemorrhage (SRH), among pregnant women to describe contemporary aetiology, investigations and management patterns. Methods: A systematic review of MEDLINE and CENTRAL in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed. All articles, including case reports and case series on SRH published from 2000 to 2016, were included. Full-text manuscripts describing SRH among pregnant women were reviewed for clinical parameters, which were collated and analysed. Results: Twenty cases of SRH in pregnant women were identified. The median age and gestation were 32.1 years and 26.5 weeks, respectively, with SRH most commonly occurring in the third trimester (nine patients; 45%) and due to renal neoplasm, specifically angiomyolipoma (AML; 12 patients; 60%), followed by renal artery aneurysm (RAA; five patients; 25%). Surgical intervention (55%) was most commonly used for acute SRH. Foetal demise was not uncommon (15%). Conclusions: SRH in pregnant women is an uncommon but complex urological and obstetric emergency with potentially catastrophic consequences. A multidisciplinary approach is key to timely diagnosis and appropriate management considering the well-being both of mother and foetus. Pre-emptive diagnosis and intervention may reduce complications. Level of evidence: 4
Levels of Patient Satisfaction on Integrative Medicine Before and After Implementation of Diagnosis-related Groups
Authors: Romeyke Tobias , Noehammer Elisabeth , Scheuer Hans Christoph , Stummer Harald 
Published: February 2018

Objectives The aim of this article is to study patient satisfaction with complementary and alternative medicine (CAM) in an in-hospital setting before and after the introduction of diagnosis-related groups (DRGs). Methods Patients were interviewed regarding a general evaluation of their hospital stay, the psychological talking therapy, the nutrition therapy, and the overall success of the treatment. Results The medical treatment was evaluated by 1158 patients. A very good success was reported by 347, a good by 609, a moderate by 181, and none by 21 patients. DRG implementation showed no significant effects. Psychological talking therapy was evaluated as “very good” ( P ≤ .05). With regard to the success of the medical talking and nutrition therapy, there were no significant differences ( P ≥ .05) between the time before and after DRG implementation. Conclusion Broadening conventional medical treatment with CAM practices can lead to a parallel treatment of DRGs in hospitals working with complementary medicine. This results in very patient-centered therapies, which may impact patient satisfaction.
Application of polyether amine, poly alcohol or KCl to maintain the stability of shales containing Na-smectite and Ca-smectite
Authors: Zhang Shifeng , He Yanfeng , Chen Zhixue , Sheng James J. , Fu Lipei 
Published: February 2018

ABSTRACTThe stability of a shale containing smectite with different exchangeable cations (Na+, Ca2+) was improved using optimum solutions containing polyether amine (PA), poly-alcohol (PO) or KCl. Two types of shale samples with Na+ and Ca2+ as the main exchangeable cations, respectively, were used and the optimized solutions were determined using X-ray diffraction (XRD), an adsorption test, an oedometer swelling test, and an immersion test. The use of KCl prevented intercalation of PA or PO and maintained the stability of the Na-smectite-bearing shale. PA or PO adsorption reduced water adsorption sites on the clay layer, and K+ reduced hydration of exchangeable Na+, resulting in good shale stability in mixed solutions of KCl+PA, and KCl+PO. More stable shale was achieved in KCl+ PA mixed solution, whereas in the KCl+ PO solution the transport of water or solute molecules in the shale was reduced. In the shale containing mainly Ca-smectite, PA, PO and KCl maintained shale stability when applied separately or in common, as PA or PO cannot exchange Ca2+ in the smectite interlayer. As a result, PA or PO should be used together with KCl during drilling in shale formations containing Na-smectite, whereas in shales with Ca-smectite, PA, PO or KCl may be used separately.
Motukoreaite from the Kłodawa Salt Dome, Central Poland
Authors: Wachowiak Jacek , Pieczka Adam 
Published: February 2018

AbstractMotukoreaite, Mg6Al3(OH)18[Na(H2O)6][SO4]2·6H2O, is a poorly-known, rare layered double hydroxide mineral belonging to the wermlandite group in the hydrotalcite supergroup. It was found in abundant quantities (at least hundreds of thousands of Mt) in the roof part the Younger Potash unit of the Leine cyclothem on the Kłodawa Salt Dome in central Poland (Permian–Mesozoic basin of Central Europe), outside its known typical environments like altered basalts and basaltic tuffs, including those deposited in submarine volcanic areas. The mineral displays varying SO2–4, Na+and H2O contents with negligible CO2–3, corresponding to the mean composition Mg5.75(Al3.20Fe3+0.04)∑3.25(OH)18.00{[Na(H2O)6]0.72□0.28}[(SO4)1.67(CO3)3.03(OH)0.57]·0.72H2O. It can be related to the partly dehydrated, hypothetical end-member Mg6Al3(OH)18[Na(H2O)6][(SO4)2]·6H2O. The Kł odawa motukoreaite represents the hexagonal, 3-layer polytype with the 3 × 3 superstructure in the xy plane, and unit cell a = b = 9.191(2)–9.199(2) Å, i.e. = 3 × 3.064–3.066 Å and c = 33.529(9)–33.562(7) Å, i.e. = 3 × 11.174–11.187 Å. The mineral was formed by alteration of clays delivered to the basin by an aeolian overprint and co-sedimented along with the evaporite sequence, initiated under the influence of Mg2+- and SO2–4-bearing brines at temperatures not exceeding 160–200°C, released from the evaporites during diagenetic/metamorphic processes.