Relevance of circulating nucleosomes and oncological biomarkers for predicting response to transarterial chemoembolization therapy in liver cancer patients

<p>Abstract</p> <p>Background</p> <p>Transarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers predicting therapy response are urgently required.</p> <p>Methods</p> <p>Here, sera of 50 prospectively and consecutively included HCC patients undergoing 71 TACE therapies were taken before and 3 h, 6 h and 24 h after TACE application to analyze concentrations of circulating nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), alpha fetoprotein (AFP), C-reactive protein (CRP) and several liver biomarkers, and to compare these with radiological response to therapy.</p> <p>Results</p> <p>While nucleosomes, CYFRA 21-1, CRP and some liver biomarkers increased already 24 h after TACE, percental changes of nucleosome concentrations before and 24 h after TACE and pre- and posttherapeutic values of AFP, gamma-glutamyl-transferase (GGT) and alkaline phosphatase (AP) significantly indicated the later therapy response (39 progression versus 32 no progression). In multivariate analysis, nucleosomes (24 h), AP (24 h) and TACE number were independent predictive markers. The risk score of this combination model achieved an AUC of 81.8% in receiver operating characteristic (ROC) curves and a sensitivity for prediction of non-response to therapy of 41% at 97% specificity, and of 72% at 78% specificity.</p> <p>Conclusion</p> <p>Circulating nucleosomes and liver markers are valuable tools for early estimation of the efficacy of TACE therapy in HCC patients.</p

SARS-CoV-2 and regular patient treatment – from the use of rapid antigen testing up to treatment specific precaution measures

INTRODUCTION The COVID-19 pandemic poses a continued challenge for all parties involved especially for the dentist as routine operation must be resumed. Rapid Antigen Tests (RATs) are actually recommended to identify and minimize infectious risks. However, there is still no guideline on the implementation of RATs in a dental or medical setting. METHODS Based on data and an extensive literature research regarding rapid antigen testing and reflecting the recommendations given by the various professional societies a task force was formed to determine a specific testing and treatment strategy. RESULTS A comprehensive test and treatment strategy and risk analysis was developed with practical suggestions for a wide range of typical activities in dental and medical offices. The transmission of SARS-CoV-2 and its variants via aerosols and droplets as well as the difficulties to maintain the minimum distance form special challenges to the dental routine. RATs might in addition to optimal and necessary hygienic standards in combination with the use of adequate personal protection equipment be an important instrument in managing the challenges. CONCLUSIONS The present work gives recommendations for dental routine operation (dental practices, outpatient clinics) to provide the necessary dental care for the population while protecting the doctor, practice team and patient at the same time

Induction of DNA strand breaks by dental composite components compared to X-ray exposure in human gingival fibroblasts

The toxicity of dental composites has been attributed to the release of residual monomers from polymerized resin-based composites due to degradation processes or incomplete polymerization. Some of these eluted substances have a genotoxic potential. We tested the hypothesis that realistic concentrations (and/or worst case concentrations/situations) of bisphenol-A-glycidyldimethacrylate (BisGMA), triethyleneglycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA) and methyl methacrylate (MMA) found in elution experiments can cause DNA strand breaks in human gingival fibroblasts (HGF). Such DNA damage was compared with that resulting from ionizing radiation coming from natural sources, dental radiography or tumor therapy. TEGDMA, HEMA and MMA did not induce DNA strand breaks at concentrations of up to 10 mM. About 24 h after incubation with 0.25 mM BisGMA, significantly more DNA strand breaks were found in HGF compared to controls. DNA strand breaks caused by 0.25 mM BisGMA, correspond to DNA strand breakage caused by irradiation with 4 Gy, only used in the high single-dose irradiation tumor therapy. But 0.25 mM BisGMA is more than 100-fold higher than that concentration found in worst case calculations. Therefore, our data did not support our hypothesis