clinical impact of whey protein and nutritional counseling in gastrointestinal cancer patients

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Blood Levels, Apoptosis, and Homing of the Endothelial Progenitor Cells After Skin Burns and Escharectomy

BACKGROUND: Skin burns are an acute trauma involving an extensive vascular damage and an intense inflammatory response. Bone marrow-derived circulating endothelial progenitor cells (EPC) are known to migrate to sites of neovascularization in response to mediators (vascular endothelial growth factor and stromal cell-derived factor-1) released after trauma and ischemia, to contribute to wound healing, and to increase neovascularization of animal prefabricated flaps. Recent data showed an increase in EPC number in burned patients and a positive correlation between EPC number and total body surface area (TBSA) burnt, but data were limited to the first 5 days after thermal injury. METHODS: By using flow cytometry, we studied EPC (CD34, CD133, CD45, and KDR cells) blood levels, apoptosis, and homing (stromal cell-derived factor-1 receptor expression and CXC chemokine receptor 4) in a 1-month follow-up postburn in 25 patients with 6515% TBSA burnt, at least grade II burns and escharectomy performed at days 5 to 6, with respect to 31 controls. RESULTS: EPC count at admission showed a positive linear correlation with TBSA burnt. The EPC blood levels of the patients were low (50.7 cells/mL\ub161.8 cells/mL) immediately after thermal injury, then increased with two peaks, at day 1 (188.3 cells/mL\ub1223.2 cells/mL) and day 12 (253.1 cells/mL\ub1430.7 cells/mL) with respect to controls (95.2 cells/mL\ub128.5 cells/mL, p<0.05), and then returned to normal levels in 1 month. EPC apoptotic rate and inflammatory parameters paralleled EPC blood count. No significant variations were found in CXC chemokine receptor 4 expression. CONCLUSIONS: Thermal injury and escharectomy seem to induce an intense response in EPC production. In particular, escharectomy could improve physiologic wound repair by increasing EPC levels

Second primary tumors in head and neck cancer patients: The importance of a \u201ctailored\u201d surveillance

Objective: Head and neck cancer survivors have increased risk of developing second primary tumors compared to overall population. Because second primary represents a major cause of morbidity and mortality in this population, early detection is fundamental. Materials and Methods: In this 10-year single-institution study, we investigated the following: incidence, clinical-pathological risk factors, and survival of patients with second primary tumor. We included all patients with diagnosis of squamous cell carcinoma of the head and neck seen at the Modena University Hospital from 2008 to 2018. Results: Among 1,177 patients included, 222 (18.9%) developed second primary tumor; its survival probability at 5&nbsp;years was 40.6%. Alcohol consumption (p&nbsp;=.0055) and index cancer in oropharynx (p&nbsp;=.0029), supraglottic larynx (p&nbsp;=.0000), glottic larynx (p&nbsp;=.0222) were associated with higher risk of second primary. The most common second primary sites were head and neck district and lung (70, 31.5%, and 67, 30.2%, respectively). Head and neck district were more common in oral cavity (18, 43%) and oropharynx index cancer (20, 31%); lung second primary in hypopharynx (4, 40%), supraglottic larynx (17, 43%), and glottic larynx index cancer (23, 35%). Conclusion: Head and neck cancer survivors developing a second primary tumor have dismal prognosis. Tailored surveillance is recommended