Prehabilitation for lymphedema in head and neck cancer patients at a community cancer center

Patients with head and neck cancer often develop morbidities as a result of their treatment with surgery, radiation, and chemotherapy. One of the most prevalent side effects of the treatment is lymphedema, the accumulation of interstitial fluid in tissues that have inadequate lymph drainage. Secondary lymphedema, an acquired abnormality in the lymphatic network, is commonly caused by cancer and/or its treatment. Lymphedema is both under-recognized and under-treated in head and neck cancer. While recent advances in radiation therapy techniques have resulted in a corresponding drop in other treatment-related morbidities, an estimated 50% of treated head and neck cancer patients will develop lymphedema. Indeed, at some places the incidence is much higher, at 75%, following treatment with surgery and radiation. Clearly, there is an unmet need to recognize and treat lymphedema in head and neck cancer patients. This article describes an early intervention prehabilitation program that was established for the early identification and treatment of patients at risk of lymphedema and compares the observed outcomes before and after the initiation of the program

Modulation of immune responses by targeting CD169/Siglec-1 with the glycan ligand

A fundamental role in the plant-bacterium interaction for Gram-negative phytopathogenic bacteria is played by membrane constituents, such as proteins, lipopoly- or lipooligosaccharides (LPS, LOS) and Capsule Polysaccharides (CPS). In the frame of the understanding the molecular basis of plant bacterium interaction, the Gram-negative bacterium Agrobacterium vitis was selected in this study. It is a phytopathogenic member of the Rhizobiaceae family and it induces the crown gall disease selectively on grapevines (Vitis vinifera). A. vitis wild type strain F2/5, and its mutant in the quorum sensing gene ΔaviR, were studied. The wild type produces biosurfactants; it is considered a model to study surface motility, and it causes necrosis on grapevine roots and HR (Hypersensitive Response) on tobacco. Conversely, the mutant does not show any surface motility and does not produce any surfactant material; additionally, it induces neither necrosis on grape, nor HR on tobacco. Therefore, the two strains were analyzed to shed some light on the QS regulation of LOS structure and the consequent variation, if any, on HR response. LOS from both strains were isolated and characterized: the two LOS structures maintained several common features and differed for few others. With regards to the common patterns, firstly: the Lipid A region was not phosphorylated at C4 of the non reducing glucosamine but glycosylated by an uronic acid (GalA) unit, secondly: a third Kdo and the rare Dha (3-deoxy-lyxo-2-heptulosaric acid) moiety was present. Importantly, the third Kdo and the Dha residues were substituted by rhamnose in a not stoichiometric fashion, giving four different oligosaccharide species. The proportions among these four species, is the key difference between the LOSs from both the two bacteria. LOS from both strains and Lipid A from wild type A. vitis are now examined for their HR potential in tobacco leaves and grapevine roots