Conjugated linoleic acids (CLA) decrease the breast cancer risk in DMBA-treated rats

The aim of this study was to investigate how supplementation of diet of female Sprague-Dawley rats with different doses of conjugated linoleic acids and for a varied period of time influences breast cancer risk, fatty acids profile and lipids peroxidation in chemically induced mammary tumors. Animals were divided into nine groups with different modifications of diet (vegetable oil, 1.0 or 2.0% of CLA) and period of supplementation, which lasted after (A), before (B) and before and after (BA) carcinogenic agent - 7,12- dimethylbenz[a]anthracene administration at 50th day of life. Mammary adenocarcinomas occurred in all groups, but CLA supplementation decreased the cancer morbidity. Two percent CLA seem to be excessive because of the coexisting cachexia. Two CLA isomers (cis-9, trans-11 and trans-10, cis-12) were detected in tumors but content of rumenic acid was higher. Dietary supplementation significantly influenced some unsaturated fatty acids content (C18:2 n-6 trans, C20:1, C20:5 n-3, C22:2), but the anti- or prooxidant properties of CLA were not confirmed. CLA can inhibit chemically induced mammary tumors development in female rats, but their cytotoxic action seems not to be connected with lipids peroxidation. CLA isomers differ with their incorporation into cancerous tissues and they influence the content of some other fatty acids

Effect of dietary supplementation on the prognostic value of urinary and serum 8-isoprostaglandin F2α in chemically-induced mammary carcinogenesis in the rat

<p>Abstract</p> <p>Backround</p> <p>The aim of the present study was to assess the effects of zinc or copper and polyphenolic compounds on the 8-isoprostaglandin F_2αconcentration in the serum and urine of rats with mammary cancer (<it>adenocarcinoma</it>) induced with 7,12-dimethylbenz[a]antracene. The research focused on the kinetics of alterations in urinary 8-isoPGF_2αat the early stage of carcinogenesis as well as the influence of dietary factors on the process. The impact of selected compounds on the intensity of DMBA - induced carcinogenesis was also assessed.</p> <p>Result and conclusions</p> <p>Administration of DMBA, a compound that inducers mammary tumors in experimental animals, increased the serum and urinary 8-isoPGF_2αlevels in study rats. In the rat model, diet supplementation with zinc, combined with selected polyphenolic compounds (resveratrol or genistein) yielded a statistically significant decrease in the rat serum and urinary biomarker concentration with a simultaneously significant stimulation of carcinogenesis.</p> <p>The results indicate that there is an inverse correlation between the intensity of DMBA-induced carcinogenicity and the level of 8-isoPGF_2αin urine and serum of rats.</p

Influence of diet enriched with conjugated linoleic acids on their distribution in tissues of rats with DMBA induced tumors

<p>Abstract</p> <p>Backround</p> <p>Conjugated linoleic acids (CLA) are a group of positional and geometric isomers of linoleic acid with proven beneficial influence on health. They show e.g. anticarcinogenic, antiobesity, and antiatherogenic effect. Milk, dairy products and meat of poligastric animals are their most valuable dietary sources, with cis-9, trans-11 CLA (RA - rumenic acid) being the predominant isomer. Dietary supplements with CLA became very popular, mainly among the overweight and bodybuilders.</p> <p>The aim of this study was to examine the influence of the food supplements with conjugated linoleic acid on carcinogenesis in female Sprague-Dawley rats and evaluation of CLA and other fatty acids distribution in their bodies.</p> <p>Animals were divided into four groups depending on the diet supplementation (oil or Bio-C.L.A. (Pharma Nord Denmark) given intragastrically) and presence or absence of carcinogenic agent (7,12-dimethylbenz[a]antharcene). Animals were decapitated at 21st week of experiment and serum and microsomes were extracted.</p> <p>Results and conclusions</p> <p>The mammary tumours (adenocarcinoma) occurred in groups treated with DMBA. Diet enriched with CLA decreased the cancer morbidity (67% in Bio-C.L.A. compared to 88% in oil) and delayed the cancer induction (p = 0.0018). There were no differences in body and organs weight.</p> <p>The supplement used in the study was a mixture of several fatty acids with the greatest proportion of CLA isomers: trans-10, cis-12 (33%) and cis-9, trans-11 (31%). Both of them were present in tissues but the content of rumenic acid was greater. Dietary supplementation had also significant impact on other fatty acids content, both in serum and in microsomes.</p

Enrichment of maternal diet with conjugated linoleic acids influences desaturases activity and fatty acids profile in livers and hepatic microsomes of the offspring with 7,12-dimethylbenz[a] antracene- induces mammary tumors

The aim of this study was to assess the influence of diet supplementation of pregnant and breastfeeding female Sprague-Dawley rats with conjugated linoleic acids (CLA) on the Δ6- and Δ5-desaturase activity in hepatic microsomes as well as on fatty acids profile and lipids peroxidation in liver and hepatic microsomes of the progeny with chemically induced mammary tumors. Rats were divided into two groups with different diet supplementation (vegetable oil (which did not contain CLA) or CLA). Their female offspring was divided within these groups into two subgroups: (1) ñ fed the same diet as mothers (K1 ñ oil, O1 ñ CLA), and (2) ñ fed the standard fodder (K2, O2). At 50th day of life, the progeny obtained carcinogenic agent (7,12- dimethylbenz[a]anthracene). Higher supply of CLA in diet of mothers resulted in lower susceptibility to chemically induced mammary tumors in their offspring (p = 0.0322). It also influenced the fatty acids profile in livers and in hepatic microsomes, especially polyunsaturated n3 and n6 fatty acids. CLA inhibited the activity of the desaturases, which confirmed that CLA can reduce the level of arachidonic acid directly, reducing linoleic acid content in membranes, or indirectly, through the regulation of its metabolism. We were unable to confirm or deny the antioxidative properties of CLA. Our results indicate that the higher supply of CLA in mothersí diet during pregnancy and breastfeeding causes their incorporation into tissues of children, changes the efficiency of fatty acids metabolism and exerts health-promoting effect in their adult life reducing the breast cancer risk

Left main disease management strategy: Indications and revascularization methods in particular groups of subjects

Surgical revascularization with coronary artery by-pass grafting is still recommended in vast majority of patients with unprotected left main disease. The aim of the paper was to analyze optimal treatment of left main disease in selected groups of patients, on the basis of current guidelines and information gained from literature data. We focused on data in relation to treatment of elderly patients, diabetics and those hemodynamically unstable. Additionally we discussed the issue of anti-platelet therapy and informed consent. As far as efficacy of treatment is concerned, not only method of revascularization but also general condition of the patient, the factors influencing peri-operative risk and optimal pharmacotherapy should be taken into account. Therefore establishment of the heart team is crucial when choosing the most suitable method of invasive treatment of left main disease

Superficial lymph nodes involved by lymphoma in modern gray-scale ultrasound imaging

Background: Clinical evaluation by palpation of superficial lymph nodes involved by lymphoproliferative process is not sufficient. Ultrasound is a useful method of the initial differential diagnosis of lymph nodes. The aim was to assess the spectrum of ultrasound features of superficial lymphomatous nodes and possible diagnostic pitfalls. Material/Methods: Fifty five lymph nodes in 55 patients were prospectively examined in ultrasound with application of blood flow imaging modes and modern imaging techniques. Only forty lymph nodes with histopathologically proven lymphoma were selected for this analysis (3 Hodgkin, 37 non-Hodgkin). Results: 27.5% of the examined lymph nodes were longitudinal; 42.5% had an oval or round shape; 30% were oval-lobulated or lobulated. 32.5% of the nodes did not show an echogenic hilum, 20% had a normal hilum, and 25% - evidently abnormal. 12.5% of the nodes were anechoic. The general ultrasound impression of a reactive lymph node was presented by 37.5% of the lymphomatous nodes; 45% were suspicious. Among 26 patients with non-Hodgkin lymphoma with multiple lymph nodes involved, in 15 (58%) lymph nodes were modeling on each other. Conclusions: Lymphomatous nodes reveal diverse ultrasound presentations: from appearances indistinguishable from benign reactive lymph nodes to features typical of metastases. Ultrasound internal structure of lymphomatous nodes may be anechoic, causing the possibility of confusion with a cyst, especially in case of a single lymphomatous node. Multiple lymphomatous nodes with non-Hodgkin lymphoma often model on each other assuming geometrical shapes

Skuteczna alkoholowa ablacja guza insulinowego trzustki, obserwacja 4-letnia. Opis przypadku i przegląd literatury

Introduction: EUS-guided ethanol ablation of insulinoma is a new method of treatment of this neuroendocrine tumour. Ablation is recommended in patients who are poor surgical candidates or refuse surgery. We present a case of an 81-year-old female with symptomatic insulinoma, treated successfully with EUS-guided alcoholic ablation, along with a literature review including 28 other previously described cases. The effectiveness, safety of the therapy, and technical procedure-related issues are summarised. To the best of our knowledge, this is the first described case of successful insulinoma EUS-guided ablation in Poland. Material and methods: We searched the PubMed/Medline database to identify cases of EUS-guided alcoholic ablation. Our analysis included 14 articles (case reports or case series), with a total of 27 patients and 31 tumours described, published before February 2017. Results: The described tumours were relatively small (mean 13 mm), and the most common location was pancreatic head. The mean ethanol volume injected to the tumour was 1.8 ml and the concentration of infused alcohol varied from 95% to 98%.Side effects were observed in six cases; apart from one, they were mild and self-limiting. There was only one severe adverse event, treated conservatively with success. The median follow-up was 14.4 months (2–55 months). In all described cases ablation led to improvement of the symptoms and normalisation of glycaemia. Conclusions: The EUS-guided alcoholic ablation of insulinoma is a safe and effective method of treatment in patients who are poor surgical candidates and/or refuse surgery. The adverse effects are rare and mild and were observed when the volume of injected ethanol was equal to or above 3.0 ml. However, the data is limited, the follow-up is relatively short, and prospective studies are needed to confirm the long-term effects of treatment. The study shows also that there are important procedural differences (concentration and volume of alcohol, needle gauge, number of sessions) between the endoscopists, which should be specified.Wstęp: Przedstawiono 81-letnią chorą z objawowym guzem insulinowym głowy trzustki. Pacjentka, z uwagi na liczne choroby współistniejące, została zdyskwalifikowana z leczenia chirurgicznego. Leczona diazoksydem, ciągłymi wlewami z glukozy, analogami somatostatyny bez istotnej poprawy(obserwowano działania niepożądane). Następnie pod kontrolą EUS wykonano alkoholową ablację zmiany. Nie obserwowano powikłań. Odstawiono diazoksyd, obserwując normalizację glikemii. Pacjentka w 4-letniej obserwacji pozostaje bez objawów klinicznych hipoglikemii. Według naszej wiedzy jest to pierwszy opisany przypadek skutecznej alkoholowej ablacji guza insulinowego w Polsce. W pracy przeprowadzono przegląd literatury i podsumowanie wcześniej przeprowadzonych i opisanych zabiegów alkoholowej ablacji guzów insulinowych, ze szczególnym naciskiem na skuteczność i bezpieczeństwo, czas obserwacji po leczeniu i szczegóły techniczne przeprowadzenia procedury. Materiał i metody: Przeszukano bazę Pub Med/Medline, aby zidentyfikować opisane przypadki alkoholowej ablacji guza insulinowego trzustki. Do analizy włączono 14 artykułów opublikowanych przed końcem lutego 2017, w których opisano łącznie 27 przypadków i 31 guzów insulinowych. Wyniki: Opisane guzy były stosunkowo małymi zmianami (średnio 13 mm), ich najczęstsza lokalizacją była głowa trzustki. Średnia objętość podawanego alkoholu to 1,8 ml, a stężenie wynosiło 95–98%. Efekty uboczne obserwowano w 6 przypadkach, poza jednym były one łagodne i ustępowały samoistnie. Zaobserwowano tylko jedno poważne powikłanie leczone zachowawczo z sukcesem. Średni czas obserwacji pacjenta wyniósł 14,4 miesiąca (od 2 do 55 miesięcy). U wszystkich opisanych chorych ablacja doprowadziła do ustąpienia objawów i normalizacji glikemii. Wnioski: Alkoholowa ablacja guza insulinowego trzustki pod kontrolą EUS jest bezpieczną i skuteczną metoda leczenia tego guza u pacjentów z przeciwwskazaniami do zabiegu lub takich, którzy nie godzą się na zabieg. Większość powikłań ma charakter łagodny i były one obserwowane, gdy objętość podawanego do guza etanolu przekraczała 3,0 ml. Krótki czas obserwacji pacjentów i niewielka liczba opisanych przypadków, sprawiają że konieczne jest zaplanowanie badań prospektywnych, które mogłyby potwierdzić długoterminowe efekty leczenia. Analiza pokazuje również, że występują istotne różnice pomiędzy endoskopistami w zakresie sposobu przeprowadzenia samej procedury (stężenie i objętość alkoholu, rozmiar igły, liczba sesji). Powinno dążyć się do sprecyzowania sposobu jej wykonania.

Przezustna miotomia endoskopowa (POEM) — nowy standard w leczeniu achalazji?

Achalazja, czyli kurcz wpustu, jest rzadką przewlekłą, czynnościową chorobą polegającą na wzmożonym ciśnieniu dolnego zwieracza przełyku, jego upośledzonej relaksacji i utracie prawidłowej perystaltyki przełyku. Objawia się dysfagią, bólem w klatce piersiowej, regurgitacją oraz wtórną do tych objawów utratą masy ciała. Diagnostyka achalazji opiera się na kontrastowym badaniu przełyku oraz manometrii wysokiej rozdzielczości. Na podstawie tego ostatniego badania wyróżniono trzy typy achalazji, a także inne typy zaburzeń czynnościowych przełyku. Do niedawna „złotym standardem” w leczeniu achalazji była miotomia laparoskopowa z fundoplikacją. Inne stosowane metody to rozszerzanie pneumatyczne balonami o dużych średnicach lub, w wybranych przypadkach, iniekcje toksyny botulinowej w okolicę dolnego zwieracza przełyku. Nową metodą leczenia achalazji jest przezustna miotomia endoskopowa (POEM). Cechuje się ona mniejszą inwazyjnością oraz podobną skutecznością i profilem bezpieczeństwa co miotomia laparoskopowa. Dzięki tym zaletom technika POEM rozpowszechniła się w ostatnich latach w wielu ośrodkach klinicznych na świecie i w niedługiej przyszłości może stać się metodą z wyboru w leczeniu achalazji

State-of-the-art of transcatheter treatment of aortic valve stenosis and the overview of the InFlow project aiming at developing the first Polish TAVI system

Initial experience of transcatheter aortic valve implantation (TAVI) or replacement (TAVR) has ap-peared as a promising minimally invasive technology for patients disqualified from surgical treatment (SAVR). Safety and efficacy of TAVI has been analyzed and assessed through numerous registries and trials. Furthermore, results obtained from comparative TAVI vs. SAVR trials proved that both treat¬ments can be considered equal in terms of post-procedural mortality and morbidity in high-risk, as well as lower risk patients. However, there are still some issues that have to be addressed, such as higher chance of paravalvular leakage, vascular injuries, conduction disturbances, malpositioning and the yet unmet problem of insufficient biological valves durability. Recent technological developments along with the learning curve of operators prove a great potential for improvement of TAVI and a chance of surpassing SAVR in various groups of patients in the near future. In pursuit of finding new solutions, the CardValve Consortium consisting of leading scientific and research institutions in Poland has been created. Under the name of InFlow and financial support from the National Center for Research and Development, they have started a project with the aim to design, create and implement into clinical practice the first, Polish, low-profile TAVI valve system, utilizing not only biological but also artificial, polymeric-based prosthesis. This review focuses on current developments in TAVI technologies including the InFlow project

Safety and feasibility of minimally invasive coronary artery bypass surgery early after drug eluting stent implantation due to acute coronary syndrome

Background: The evidence of performing minimally invasive coronary artery surgery early after drug eluting stent (DES) implantation due to acute coronary syndrome (ACS) is limited. Aim: The aim of the study is to determine the safety and feasibility of this approach. Methods: This registry includes 115  (78% male) patients from 2013‒2018, who underwent non-LAD percutaneous coronary intervention (PCI) due to ACS with contemporary DES implantation (39% diagnosed with myocardial infarction at baseline), followed by endoscopic atraumatic coronary artery bypass (EACAB) surgery within 180 days, after temporary P2Y12 inhibitor discontinuation. Primary composite endpoint of MACCE (Major Adverse Cardiac and Cerebrovascular Events), defined as death, myocardial infarction (MI), cerebrovascular incident and repeat revascularization was evaluated in long- term follow-up. The follow-up was collected via telephone survey and with National Registry for Cardiac Surgery Procedures. Results: Median (interquartile range [IQR]) time interval separating both procedures was 100.0 (62.0‒136.0) days. Median (IQR) follow-up duration was 1338.5 (753.0‒2093.0) days and was completed from all patients with regard to mortality. Eight patients (7%) died; 2 (1.7%) had a stroke; 6 (5.2%) suffered from MI and 12 (10.4%) required repeat revascularization. Overall, the incidence of MACCE was 20 (17.4%). Conclusions: EACAB is a safe and feasible method of LAD revascularization in patients who received DES for ACS within 180 days prior to surgery, despite early dual antiplatelet therapy discontinuation. The adverse event rate is low and acceptable