Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Peer reviewe

A novel sub-20nm Depletion-Mode Double-gate (DMDG) FET

Abstract-We present a novel Depletion-Mode Double-Gate (DMDG) FET. As opposed to the conventional, un-doped body, double-gate MOSFETs, the DMDG device confines the carriers to the center of the device for all applied gate voltages. The device exhibits high mobility due to the carrier confinement in the very low E-field region in the center of the device. Simulations show very high I on /I off ratios (NMOS=2.07mA/25nA, PMOS= 1.02mA/0.98nA), excellent sub-threshold slopes and Fan-OutFour (FO4) delays under 5.5ps for 15nm gate lengths

A Method for Prediction of Femoral Component of Hip Prosthesis Durability due to Aseptic Loosening by Using Coffin/Manson Fatigue Model

The purpose of this work is to develop a new model estimate of the fatigue life of a hip prosthesis due to aseptic loosening as a multifactorial phenomenon. The formula developed here is a three-parameter model based on Basquin’s law for fatigue, eccentric compression formula for the compressive stress and torsion in the prosthesis due to the horizontal components of the contact force. With our model, we can accurately predict the durability of a hip prosthesis due to the following four parameters: body weight, femoral offset, duration, and intensity of daily physical activities of a patient. The agreement of the prediction with the real life of the prosthesis, observed on 15 patients, is found to be adequate. Based on the formula derived for a particular implant, there was a high degree of concurrence between the model-predicted and actual values of aseptic loosening (durability) proved by the Mann–Whitney U test. By virtue of the validated model, it is possible to predict, quantitatively, the influence of various factors on the hip life. For example, we can conclude that a 10% decrease of a patient’s body mass, with all other conditions being the same, causes 5% increase of the hip fatigue life

Classification of Healthy and Cancer States of Colon Epithelial Tissues Using Opto-magnetic Imaging Spectroscopy

Colorectal carcinoma (CRC) as a major health problem in industrialized countries is highly preventable and can be successfully treated in the early stages. However, incidence and mortality of CRC has increased over the last two decades. The reason could be that the current recommended options for screening are costly, unpleasant for patients, have low sensitivity and poor accessibility for screening. These reasons provide a strong rationale for the development of a new method. Opto-magnetic imaging spectroscopy (OMIS) as a new imaging method for the characterisation of various materials, including human tissues, is based on light-matter interaction, using a Poincare sphere for light properties and a Bloch sphere for electron properties, and allows the detection of biophysical characteristics within human tissue samples. Compared with histopathology examination, the OMIS method achieved an accuracy of 92.59% using Multilayer Perceptron Neural Network as a classifier, and 89.87% using Naive-Bayes, respectively. The obtained results, based on the investigation of 316 samples, both tumour and normal mucosa (162 cancer cases), strongly suggest that the new non-invasive OMIS method might be used for tissue characterization ex vivo to discriminate between the healthy and carcinoma state of the colon. However, it opens up the possibility of using the same method in in vivo studies to assist physicians in targeting biopsies of colorectal tissue

Current trends in clinical genetics of colorectal cancer

Recent innovations in molecular biology and colorectal cancer (CRC) genetics have facilitated the understanding of the pathogenesis of sporadic and hereditary CRC syndromes. The development of technology has enabled data collection for a number of genetic factors, which lead to understanding of the molecular mechanisms underlying CRC. The incidence and the nature of CRC is a mixture of genetic and environmental factors. The current field of interest is to understand how molecular basis could shape predisposition for developing CRC, disease progression and response to chemotherapy. In this article, we summarize new and developing genetic markers, and assess their clinical value for inherited and sporadic CRC

Microsatellite instability & survival in patients with stage II/III colorectal carcinoma

Background & objectives: The two key aspects associated with the microsatellite instability (MSI) as genetic phenomenon in colorectal cancer (CRC) are better survival prognosis, and the varying response to 5-fluorouracil (5-FU)-based chemotherapy. This study was undertaken to measure the survival of surgically treated patients with stages II and III CRC based on the MSI status, the postoperative 5-FU treatment as well as clinical and histological data. Methods: A total of 125 consecutive patients with stages II and III (American Joint Committee on Cancer, AJCC staging) primary CRCs, were followed prospectively for a median time of 31 months (January 2006 to December 2009). All patients were assessed, operated and clinically followed. Tumour samples were obtained for cytopathological verification and MSI grading. Results: Of the 125 patients, 21 (20%) had high MSI (MSI-H), and 101 patients (80%) had MSI-L or MSS (low frequency MSI or stable MSI). Patients with MSS CRC were more likely to have recurrent disease (P=0.03; OR=3.2; CI 95% 1-10.2) compared to those with MSI-H CRC. Multi- and univariate Cox regression analysis failed to show a difference between MSI-H and MSS groups with respect to disease-free, disease-specific and overall survival. However, the disease-free survival was significantly lower in patients with MSI-H CRC treated by adjuvant 5-FU therapy (P=0.03). Interpretation & conclusions: MSI-H CRCs had a lower recurrence rate, but the prognosis was worse following adjuvant 5-FU therapy