111 research outputs found
The role of neoadjuvant and adjuvant treatment for adenocarcinoma of the upper gastrointestinal tract
Both locally advanced adenocarcinoma of the stomach and gastro-esophageal junction are associated with poor prognosis due to the lack of effective treatment. Recently multimodal treatment consisting of neoadjuvant chemotherapy in combination with radiotherapy is reported to improve survival when compared to surgery alone. Neoadjuvant therapy in these locally advanced tumors allows for early tumor responses and the extent of tumor regression that can be achieved is considered a significant prognostic factor. This, in turn, increases the resectability of these tumors. Also due to the high frequency of lymph node metastasis, patients with locally advanced adenocarcinoma should undergo a D2 lymphadenectomy. Postoperative chemoradiation and perioperative chemotherapy have been studied in gastric adenocarcinomas and showed a survival benefit. However, the surgical techniques used in these trials are no longer considered to be standard by today's surgical practice. In addition, there are no standard recommendations for adjuvant chemotherapy or chemoradiation after R0 resection and adequate lymph node dissection
Mucinous cystadenoma of the appendix misdiagnosed as cystic hydatid disease of the liver: a case report
<p>Abstract</p> <p>Introduction</p> <p>Primary neoplastic lesions presenting with a mucocele of the appendix are very rare and can be divided into benign variants of mucinous adenomas or cystadenomas, mucinous tumours of uncertain malignant potential or mucinous cystadenocarcinomas. Most of these tumourous mucoceles are asymptomatic and are found incidentally. The major complication of neoplastic mucinous appendiceal tumours is the development of a pseudomyxoma peritonei due to spreading of mucin-producing cells within the abdominal cavity.</p> <p>Case presentation</p> <p>A 44-year-old man presented with a history of non-specific symptoms of right upper abdominal pain. Abdominal ultrasound and computed tomography scan identified a cystic mass consistent with the morphological characteristics of an echinococcal hydatid cyst. After completing systemic albendazole therapy, an explorative laparotomy revealed a cystic tumour of the appendix. Ileocaecal resection was performed and pathology reports confirmed the diagnosis of a mucinous cystadenoma of the appendix. The postoperative course was uneventful.</p> <p>Conclusion</p> <p>Here we present the case of a man with a mucinous cystadenoma of the appendix mimicking cystic hydatid disease. We discuss the importance of re-evaluation and differential diagnostic reflections in cases of appendiceal mucocele.</p
Interleukin 10 (IL-10): an immunosuppressive factor and independent predictor in patients with metastatic renal cell carcinoma
Interleukin 10 (IL-10) is an immunosuppressive factor and has been detected in tumour cell cultures of renal cell carcinoma and of malignant melanoma. IL-10 has been described as a cytokine of the Th2 response; it is able to suppress antigen-presenting cells (APCs) and may lead to down-regulation of HLA class I and II molecules on dendritic cells and to anergy of T-lymphocytes. We evaluated pretreatment serum levels of soluble IL-10 and various clinical parameters to determine their prognostic value in 80 advanced renal cell carcinoma patients seen at our institution between May 1990 and April 1996. For statistical evaluation we used both univariate and multivariate Cox proportional hazards models. An elevated pretreatment serum level of IL-10 was a statistically independent predictor of unfavourable outcome (P < 0.0028), in addition to the well-known clinical and biochemical risk factors. These data support risk stratification for future therapeutic trials and identify a predictor which needs to be validated in prospective studies and may potentially influence decision making in palliative management of patients with metastatic renal cell carcinoma. These data also suggest a potential role of IL-10 in the development of advanced renal cell carcinoma and in the future design of therapeutic strategies. © 1999 Cancer Research Campaig
Calculating Marginal and Non-marginal Welfare Measures
AbstractThis chapter focuses on the calculation of marginal and non-marginal welfare measures. It outlines how the calculation of welfare measures is related to the specified model and the assumptions underlying that model. It further describes how the calculation of these measures is affected by the inclusion of preference heterogeneity, including the incorporation of interaction terms to capture observed preference heterogeneity or random parameters to capture unobserved preference heterogeneity. Finally, it discusses how these measures can be aggregated and compared
Online interprofessional education related to chronic illness for health professionals : a scoping review
This scoping review focuses on identifying the quantity and quality of research evidence available with
regard to online interprofessional education related to chronic disease management. Recent advances
have seen the emergence of information communication technology and digital health solutions that
may improve monitoring of and self-management of chronic disease. With the growing chronic disease
burden globally, and the advancement of information communication technology, digital health solutions may improve chronic disease monitoring and self-management. However, health professionals are
slow to utilize this technology in chronic disease management. Online education has the potential to
enhance utilization of digital health solutions across interprofessional healthcare teams. This scoping
review focuses on online interprofessional education and eLearning strategies used to promote engagement and achievement of learning outcomes between health care professionals in chronic disease
management. A systematic search of the literature yielded 3112 papers; 15 studies were included in the
review following an independent screening process. The review found very limited research for online
interprofessional education related to chronic disease so it is not feasible to comment or draw conclusions in relation to its impact on interprofessional learning, student engagement in education or its
impact in practice, services or health outcomes. Research methodology and online eLearning strategies
varied across studies, highlighting the need for further rigorous studies that include consistency in
online interprofessional education strategies, evaluations and study methods
Ep-CAM expression in squamous cell carcinoma of the esophagus: a potential therapeutic target and prognostic marker
BACKGROUND: To evaluate the expression and test the clinical significance of the epithelial cellular adhesion molecule (Ep-CAM) in esophageal squamous cell carcinoma (SCC) to check the suitability of esophageal SCC patients for Ep-CAM directed targeted therapies. METHODS: The Ep-CAM expression was immunohistochemically investigated in 70 primary esophageal SCCs using the monoclonal antibody Ber-EP4. For the interpretation of the staining results, we used a standardized scoring system ranging from 0 to 3+. The survival analysis was calculated from 53 patients without distant metastasis, with R0 resection and at least 2 months of clinical follow-up. RESULTS: Ep-CAM neo-expression was observed in 79% of the tumors with three expression levels, 1+ (26%), 2+ (11%) and 3+ (41%). Heterogeneous expression was observed at all expression levels. Interestingly, tumors with 3+ Ep-CAM expression conferred a significantly decreased median relapse-free survival period (log rank, p = 0.0001) and median overall survival (log rank, p = 0.0003). Multivariate survival analysis disclosed Ep-CAM 3+ expression as independent prognostic factor. CONCLUSION: Our results suggest Ep-CAM as an attractive molecule for targeted therapy in esophageal SCC. Considering the discontenting results of the current adjuvant concepts for esophageal SCC patients, Ep-CAM might provide a promising target for an adjuvant immunotherapeutic intervention
Nodale Mikrodissemination bei pN0 papillärem Schilddrüsenkarzinom: Prognostische Relevanz?
Koinzidenz von zufällig entdeckten Schilddrüsen-Karzinomen und primärem Hyperparathyreoidismus (pHPT)
Monitoring the relief of pressure points for pressure ulcer prevention: A subject dependent approach
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