Chemotherapy-induced peripheral neuropathy in cancer patients : a four-arm randomized trial on the effectiveness of electroacupuncture

Purpose. Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dose-limiting side effect of cytostatic drugs. Since there are no proven therapeutic procedures against CIPN, we were interested to define the role of electroacupuncture (EA) from which preliminary data showed promising results. Methods. In a randomized trial with a group sequential adaptive design in patients with CIPN, we compared EA (LV3, SP9, GB41, GB34, LI4, LI11, SI3, and HT3; n=14) with hydroelectric baths (HB, n=14), vitamin B1/B6 capsules (300/300 mg daily; VitB, n=15), and placebo capsules (n=17). The statistical power in this trial was primarily calculated for proving EA only, so results of HB and VitB are pilot data. Results. CIPN complaints improved by 0.8 +- 1.2 (EA), 1.7 +- 1.7 (HB), 1.6 +- 2.0 (VitB), and 1.3 +- 1.3 points (placebo) on a 10-point numeric rating scale without significant difference between treatment groups or placebo. In addition no significant differences in sensory nerve conduction studies or quality of life (EORTC QLQ-C30) were found. Conclusions. The used EA concept, HB, and VitB were not superior to placebo. Since, contrary to our results, studies with different acupuncture concepts showed a positive effect on CIPN, the effect of acupuncture on CIPN remains unclear. Further randomized, placebo controlled studies seem necessary. This trial is registered with DRKS00004448

Rehabilitación de los deterioros inducidos por la terapia en pacientes con cáncer de mama

Among various side effects of adjuvant chemotherapy neuropsychological deficits have been described within the last two decades. A literature review shows that especially breast cancer women after adjuvant chemotherapy are suffering from these deficits. Against this background the need for special rehabilitation programms has been discussed to help the patients to cope with this sequelae, but there are only few attempts for special neuropsychological training programms for cancer patient. In the study presented we compared two types of neuropsychological interventions in a rehab setting against a control group with no specific training in a total of 96 female in-patients undergoing inpatient oncological rehabilitation. Most results of a comprehensive neuropsychological test battery improved significantly during the patients’ oncological rehabilitation in all three groups, whereas we could not identify a specific intervention effect neither between the two intervention groups nor between the treatment and control groups. In terms of the follow-up examination we found that clinically relevant neuropsychological deficits were still evident 6 months later in a small subgroup of patientsdéficits neuropsicológicos se han descrito en las últimas dos décadas entre varios de los efectos secundarios de la quimioterapia adyuvante. Una revisión de la literatura muestra especialmente que las mujeres con cáncer de mama después de la quimioterapia adyuvante sufren de este déficit. En este contexto se ha discutido la necesidad de programas de rehabilitación especiales para ayudar a las pacientes a hacer frente a estas secuelas, pero hay sólo unos pocos intentos de programas de entrenamiento neuropsicológico para pacientes con cáncer. En el presente estudio se compararon dos tipos de intervenciones neuropsicológicas en un centro de rehabilitación con un grupo control sin entrenamiento específico, con un total de 96 mujeres hospitalizadas realizando rehabilitación oncológica. La mayoría de los resultados de una batería neuropsicológica compresiva mejoraban significativamente durante la rehabilitación oncológica de las pacientes en los tres grupos, mientras que no se pudo identificar un efecto de la intervención específica ni entre los dos grupos de intervención, ni entre los grupos tratamiento y control. En cuanto a los exámenes de seguimiento se encontró que los déficits neuropsicológicos clínicamente relevantes seguían siendo evidentes seis meses más tarde en un pequeño subgrupo de pacientes

Cell type-specific expression of endogenous cardiac Troponin I antisense RNA in the neonatal rat heart

Since the number of detected natural antisense RNA is growing, investigations upon the expression pattern of the antisense RNA become more important. As we focused our work on natural occurring antisense transcripts in human and rat heart tissues, we were interested in the question, whether the expression pattern of antisense and sense RNA can vary in different cell types of the same tissue. In our previous analysis of total neonatal rat heart tissue, we demonstrated the co-expression of both cTnI RNA species in this tissue. Now we investigated the expression of antisense and sense RNA quantitatively in neonatal cardiomyocytes (NCMs) and neonatal cardiac fibroblasts (NCFs). Performing northern blot as well as RT-PCR, we could detect natural antisense and sense RNA transcripts of cTnI in NCM and NCF implying that these transcripts are co-expressed in both cell types. The absolute amounts of the RNA transcripts were higher in NCM. Both RNA species showed identical sizes in the northern blot. Quantification by real-time PCR revealed a higher relative level of natural antisense RNA in NCF compared to NCM which points out to a cell type-specific expression of sense and antisense RNA. Our observations suggest that antisense RNA transcription may contribute to a cell type-specific regulation of the cTnI gen

Rehabilitation of therapy-related cognitive deficits in patients with breast cancer

Among various side effects of adjuvant chemotherapy neuropsychological deficits have been described within the last two decades. A literature review shows that especially breast cancer women after adjuvant chemotherapy are suffering from these deficits. Against this background the need for special rehabilitation programms has been discussed to help the patients to cope with this sequelae, but there are only few attempts for special neuropsychological training programms for cancer patient. In the study presented we compared two types of neuropsychological interventions in a rehab setting against a control group with no specific training in a total of 96 female in-patients undergoing inpatient oncological rehabilitation. Most results of a comprehensive neuropsychological test battery improved significantly during the patients’ oncological rehabilitation in all three groups, whereas we could not identify a specific intervention effect neither between the two intervention groups nor between the treatment and control groups. In terms of the follow-up examination we found that clinically relevant neuropsychological deficits were still evident 6 months later in a small subgroup of patient

Towards a better understanding of somatic embryogenesis in Cyclamen persicum

Somatic embryogenesis in Cyclamen persicum was first reported in 1984 and has potential applications for propagation and breeding of this economically important ornamental crop. This in vitro regeneration system can be used for vegetative propagation of parental lines of F1 hybrids and elite plants, production of artificial seeds, Agrobacterium tumefaciens-mediated genetic transformation, long-term cryopreservation, protoplast to plant regeneration and somatic hybridization. Somatic embryogenesis was shown to be a powerful propagation system for some C. persicum genotypes, but commercial application in large scale so far is hindered by several limitations, i.e., asynchronous development, malformations or secondary somatic embryogenesis. However, recent molecular approaches by transcriptomic and proteomic analyses were undertaken in order to better understand and control this in vitro regeneration system and to overcome these problems. Our studies aim at comparing somatic embryos to their zygotic counterparts regarding their proteomes. Protein separation by two dimensional isoelectric focusing - sodium do-decyl sulfate polyacrylamide gel electrophoresis led to a resolution of about 1000 protein spots per gel, of which the first 253 were identified by mass spectrometry. Most were found to be involved in glycolysis/gluconeogenesis and stress response pathways. A proteome reference map of zygotic embryos will be publicly released soon and may serve as a basis for further investigations and improvements of somatic embryogenesis

Cancer Rehabilitation Indicators for Europe

Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data on follow-up and treatments for samples of cases archived in cancer registries. (b) Indicators of rehabilitation success. These include: return to work, quality of life, and satisfaction of specific rehabilitation needs. Studies can be performed to estimate these indicators in individual countries, but to obtain comparable data across European countries it will be necessary to administer a questionnaire to randomly selected samples of patients from population-based cancer registry databases. However, three factors complicate questionnaire studies: patients may not be aware that they have cancer; incomplete participation in surveys could lead to bias; and national confidentiality laws in some cases prohibit cancer registries from approaching patients. Although these studies are expensive and difficult to perform, but as the number of cancer survivors increases, it is important to document their needs in order to provide information on cancer control

Treatment of Allergic Airway Inflammation and Hyperresponsiveness by Antisense-Induced Local Blockade of Gata-3 Expression

Recent studies in transgenic mice have revealed that expression of a dominant negative form of the transcription factor GATA-3 in T cells can prevent T helper cell type 2 (Th2)-mediated allergic airway inflammation in mice. However, it remains unclear whether GATA-3 plays a role in the effector phase of allergic airway inflammation and whether antagonizing the expression and/or function of GATA-3 can be used for the therapy of allergic airway inflammation and hyperresponsiveness. Here, we analyzed the effects of locally antagonizing GATA-3 function in a murine model of asthma. We could suppress GATA-3 expression in interleukin (IL)-4–producing T cells in vitro and in vivo by an antisense phosphorothioate oligonucleotide overlapping the translation start site of GATA-3, whereas nonsense control oligonucleotides were virtually inactive. In a murine model of asthma associated with allergic pulmonary inflammation and hyperresponsiveness in ovalbumin (OVA)-sensitized mice, local intranasal administration of fluorescein isothiocyanate–labeled GATA-3 antisense oligonucleotides led to DNA uptake in lung cells associated with a reduction of intracellular GATA-3 expression. Such intrapulmonary blockade of GATA-3 expression caused an abrogation of signs of lung inflammation including infiltration of eosinophils and Th2 cytokine production. Furthermore, treatment with antisense but not nonsense oligonucleotides induced a significant reduction of airway hyperresponsiveness in OVA-sensitized mice to levels comparable to saline-treated control mice, as assessed by both enhanced pause (PenH) responses and pulmonary resistance determined by body plethysmography. These data indicate a critical role for GATA-3 in the effector phase of a murine asthma model and suggest that local delivery of GATA-3 antisense oligonucleotides may be a novel approach for the treatment of airway hyperresponsiveness such as in asthma. This approach has the potential advantage of suppressing the expression of various proinflammatory Th2 cytokines simultaneously rather than suppressing the activity of a single cytokine

Minimally invasive, imaging guided virtual autopsy compared to conventional autopsy in foetal, newborn and infant cases: study protocol for the paediatric virtual autopsy trial

BACKGROUND: In light of declining autopsy rates around the world, post-mortem MR imaging is a promising alternative to conventional autopsy in the investigation of infant death. A major drawback of this non-invasive autopsy approach is the fact that histopathological and microbiological examination of the tissue is not possible. The objective of this prospective study is to compare the performance of minimally invasive, virtual autopsy, including CT-guided biopsy, with conventional autopsy procedures in a paediatric population. METHODS/DESIGN: Foetuses, newborns and infants that are referred for autopsy at three different institutions associated with the University of Zurich will be eligible for recruitment. All bodies will be examined with a commercial CT and a 3 Tesla MRI scanner, masked to the results of conventional autopsy. After cross-sectional imaging, CT-guided tissue sampling will be performed by a multifunctional robotic system (Virtobot) allowing for automated post-mortem biopsies. Virtual autopsy results will be classified with regards to the likely final diagnosis and major pathological findings and compared to the results of conventional autopsy, which remains the diagnostic gold standard. DISCUSSION: There is an urgent need for the development of alternative post-mortem examination methods, not only as a counselling tool for families and as a quality control measure for clinical diagnosis and treatment but also as an instrument to advance medical knowledge and clinical practice. This interdisciplinary study will determine whether virtual autopsy will narrow the gap in information between non-invasive and traditional autopsy procedures. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01888380