Feasibility of recruitment to an oral dysplasia trial in the United Kingdom

Background: Oral epithelial dysplasia (OED) has a malignant potential. Therapeutic options for OED remain both limited and without good evidence. Despite surgery being the most common method of treating OED, recurrence and potentially significant morbidity remain problematic. Consequently, there has been much interest in non-surgical treatments for OED. Cyclo-oxygenase (COX) up-regulation is known to occur in the dysplasia-carcinoma sequence and evidence now exists that COX-2 is a prognostic marker of malignant transformation in OED. COX-inhibitors are therefore considered a potential therapeutic strategy for treating this condition. We aimed to provide both proof of principal evidence supporting the effect of topical COX inhibition, and determine the feasibility of recruitment to an OED chemoprevention trial in the UK. Methods: Recruitment of 40 patients with oral leukoplakia to 4 study arms was planned. The total daily dose of Aspirin would increase in each group and be used in the period between initial diagnostic and follow-up biopsies. Results: During the 15-month recruitment period, 15/50 screened patients were eligible for recruitment, and 13 (87%) consented. Only 1 had OED diagnosed on biopsy. 16 patients were intolerant of, or already taking Aspirin and 16 patients required no biopsy. Initial recruitment was slow, as detection relied on clinicians identifying potentially eligible patients. Pre-screening new patient letters and directly contacting patients listed for biopsies improved screening of potentially eligible patients. However, as the incidence of OED was so low, it had little impact on trial recruitment. The trial was terminated, as recruitment was unlikely to be achieved in a single centre. Conclusion: This feasibility trial has demonstrated the low incidence of OED in the UK and the difficulties in conducting a study because of this. With an incidence of around 1.5/100,000/year and a high proportion of those patients already taking or intolerant of Aspirin, a large multi-centred trial would be required to fulfil the recruitment for this study. The ability of topical non-steroidal anti-inflammatory drugs to modify COX and prostaglandin expression remains an important but unanswered question. Collaboration with centres in other parts of the world with higher incidences of the disease may be required to ensure adequate recruitment. ISRCTN: 31503555

NANOSPHERE-LOADED TADALAFIL WITH ENHANCED ORAL BIOAVAILABILITY: INNOVATIVE APPLICATION OF ELECTROHYDRODYNAMIC TECHNIQUE

Objective: Electrohydrodynamic atomization is a technique that utilizes electrical potential differences for the fabrication of particles ranging from nano to micrometer size, where the ultra-charged droplets of drug-loaded mist deposit as nanospheres after solvent evaporation. The drug-loaded polymeric spherical nanocomposites have a small volume with large surface area, which is a beneficial characteristic for dissolution and bioavailability enhancement of class II drugs. Methods: This facile approach is employed for the preparation of tadalafil-loaded nanosystems, a class II drug used for erectile dysfunction treatment. Tadalafil-loaded nanoparticles prepared with different polymer concentrations were evaluated through process yield, drug loading, morphology and functional performance. Further, drug solid-state and compatibility of formulation components were assessed. Results: The results obtained pointed out that nanoparticles were of uniform spherical morphologies with a size range between 1279±141 and 374±13 nm. The system maintained a high loading efficacy of 88%, with most of the loaded drug released within 2 min during the in vitro dissolution studies. The differential scanning calorimetry, X-ray diffraction and Fourier-transform infrared spectroscopy demonstrated the presence of tadalafil in an amorphous form or as a molecular dispersion within the polymer matrix. Conclusion: Tadalafil-loaded nanoparticles manufactured through this methodology is qualified as a strategy to ameliorate its solubility and bioavailability

Células Germinativas E Espermatogênese Do Lagarto Tropidurus Torquatus (tropiduridae) De Uma área Urbana No Bioma Cerrado Do Centro-oeste Brasileiro

Tropidurus comprises a Neotropical genus of lizard that currently has about 30 species widely distributed in the South American. Among these species, Tropidurus torquatus, which has the characteristic of great physiological plasticity, occupying a variety of habitats in open areas and urbanized environments. Considering this, the aim of the study was to investigate the germinative cells and spermatogenesis of a population of T. torquatus in an urban area under Cerrado Biome influences to understand how to establish the temporal development of germinative cells and spermatogenesis during a period of one year. Individuals were obtained in the Zoological Collection of Vertebrates at the Universidade Federal de Mato Grosso (UFMT), and the germinative cells and full spermatogenesis were described with light microscopy. Tropidurus torquatus presented germ cells with similar characteristics already documented for the other species of lizards and reptiles. Spermatogonia type A and B, primary and secondary spermatocytes, and spermatids were present in almost all months evaluated. The gonadosomatic ratio presented its highest value in October, moment in which spermatogenesis presented all the germinative cells and spermatozoa in the lumen, of the seminiferous tubules. In the seasonal climate of the Cerrado Biome, we observe discontinuous spermatogenesis in T. torquatus with the production of spermatozoa in almost every month of the year, however with sperm storage in the epididymis during the phase of testicular regression. © 2016, Universidade Federal de Uberlandia. All rights reserved.3261595160

Proučavanje optičkih vlakana sa skokovitim indeksima loma interferometrijskom metodom s dva snopa

The Pluta polarizing interference microscope is used to measure the refractive index profile and material dispersion of step index optical fibers. The refractive index profile of the fiber has been determined experimentally at different wavelengths using two-beam interference technique. Measuring these values at different wavelengths gives useful information about the structural behavior of highly oriented fibers. Also, the theoretical consideration for determining the refractive index is given. Some optical parameters which characterize the optical fiber such as the numerical aperture NA, normalized frequency ν, the acceptance angle θa and the number of modes MN propagating in the fiber with wavelength have been calculated. Also, the constants of the Cauchy’s dispersion formula were determined.Primijenili smo Plutinov polarizacijski interferometrijski mikroskop u mjerenjima profila indeksa loma i disperzije materijala optičkih vlakana sa skokovitim indeksima loma. Mjerili smo profil indeksa vlakna za više valnih duljina primjenom interferentne metode s dva snopa. Ta mjerenja na više valnih duljina dala su važne podatke o strukturnim svojstvima jako usmjerenih vlakana. Opisuju se također osnove teorije za određivanje indeksa loma u vlaknima. Izračunali smo niz optičkih parametara koji su značajke optičkih vlakana: brojnog otvora, normalizirane frekvencije, ν, kuta prihvaćanja, θa, i broja modova, MN , kojima se na nekoj frekvenciji šire valovi. Također smo odredili konstante Cauchyjeve disperzijske formule

Proučavanje optičkih vlakana sa skokovitim indeksima loma interferometrijskom metodom s dva snopa

The Pluta polarizing interference microscope is used to measure the refractive index profile and material dispersion of step index optical fibers. The refractive index profile of the fiber has been determined experimentally at different wavelengths using two-beam interference technique. Measuring these values at different wavelengths gives useful information about the structural behavior of highly oriented fibers. Also, the theoretical consideration for determining the refractive index is given. Some optical parameters which characterize the optical fiber such as the numerical aperture NA, normalized frequency ν, the acceptance angle θa and the number of modes MN propagating in the fiber with wavelength have been calculated. Also, the constants of the Cauchy’s dispersion formula were determined.Primijenili smo Plutinov polarizacijski interferometrijski mikroskop u mjerenjima profila indeksa loma i disperzije materijala optičkih vlakana sa skokovitim indeksima loma. Mjerili smo profil indeksa vlakna za više valnih duljina primjenom interferentne metode s dva snopa. Ta mjerenja na više valnih duljina dala su važne podatke o strukturnim svojstvima jako usmjerenih vlakana. Opisuju se također osnove teorije za određivanje indeksa loma u vlaknima. Izračunali smo niz optičkih parametara koji su značajke optičkih vlakana: brojnog otvora, normalizirane frekvencije, ν, kuta prihvaćanja, θa, i broja modova, MN , kojima se na nekoj frekvenciji šire valovi. Također smo odredili konstante Cauchyjeve disperzijske formule

Biochemical markers as diagnostic/prognostic indicators for ischemic disease

Objective: The use of a biomarker was extremely useful in clinical emergencies such as stroke to aid in triage and early management of cases. The diagnostic accuracy of laboratory biomarkers is run to approve the identification of easy, cheap and fast tests associated with cerebral ischemia and intracranial hemorrhage. The present study was designed to screen serum enolase activity, activities of CK-BB, LDH and lipid profile in patients with ischemic or related diseases as good diagnostic/ prognostic indicator for ischemic diseases. Methods: Sixty male subjects in the age range of (45 ±2years) were divided into four groups each with 15 participants: Group (I) normal . Group (II) patients recently diagnosed as ischemic disease; Group (III) hypertensive patients and Group (IV); diabetic patients enolase activity (p<0.001) and CK-BB (p<0.01) in ischemic and hypertensive patients compared with control and diabetic groups. LDH level was significantly elevated in ischemic, hypertensive and diabetic patients compared with controls (p<0.001). The cut -off value for serum enolase was 62.5 nmol/l showing 90% sensitivity and 93% specificity for differentiation of ischemic disease. Positive correlations were observed between serum enolase (r = 0.56), and CK-BB (r = 0.53). Conclusion: Serum enolase can be considered as a more sensitive and specific marker and used as a sensitive diagnostic or prognostic marker for ischemic related diseases.Keywords: Serum enolase, ischemia, hypertension, diagnosis, prognostic

Provision of physiotherapy rehabilitation following neck dissection in the UK

Background Neck dissection is associated with post-operative shoulder dysfunction in a substantial number of patients, affecting quality of life and return to work. There is no current UK national practice regarding physiotherapy after neck dissection. Method Nine regional centres were surveyed to determine their standard physiotherapy practice pre- and post-neck dissection, and to determine pre-emptive physiotherapy for any patients. Results Eighty-nine per cent of centres never arranged any pre-emptive physiotherapy for any patients. Thirty-three per cent of centres offered routine in-patient physiotherapy after surgery. No centres offered out-patient physiotherapy for all patients regardless of symptoms. Seventy-eight per cent offered physiotherapy for patients with any symptoms, with 11 per cent offering physiotherapy for those with severe dysfunction only. Eleven per cent of centres never offered physiotherapy for any dysfunction. Conclusion The provision of physiotherapy is most commonly reactive rather than proactive, and usually driven by patient request. There is little evidence of pre-arranged physiotherapy for patients to treat or prevent shoulder dysfunction in the UK

Triple-negative breast cancer: Current perspective on the evolving therapeutic landscape

Triple-negative breast cancer (TNBC) is known to have a poor prognosis and limited treatment options, namely chemotherapy. Different molecular studies have recently classified TNBC into different subtypes opening the door to potential new-targeted treatment options. In this review, we discuss the current standard of care in the treatment of TNBC in the neoadjuvant, adjuvant and metastatic settings. In addition, we summarize the ongoing phase III clinical trials evaluating different associations between the 3 pillars of anticancer treatment: chemotherapy, targeted therapy and immunotherapy

Reconstructive considerations in head and neck surgical oncology:United Kingdom National Multidisciplinary Guidelines

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. The reconstructive needs following ablative surgery for head and neck cancer are unique and require close attention to both form and function. The vast experience accrued with microvascular reconstructive surgery has meant a significant expansion in the options available. This paper discusses the options for reconstruction available following ablative surgery for head and neck cancer and offers recommendations for reconstruction in the various settings. Recommendations • Microsurgical free flap reconstruction should be the primary reconstructive option for most defects of the head and neck that need tissue transfer. (R) • Free flaps should be offered as first choice of reconstruction for all patients needing circumferential pharyngoesophageal reconstruction. (R) • Free flap reconstruction should be offered for patients with class III or higher defects of the maxilla. (R) • Composite free tissue transfer should be offered as first choice to all patients needing mandibular reconstruction. (R) • Patients undergoing salvage total laryngectomy should be offered vascularised flap reconstruction to reduce pharyngocutaneous fistula rates. (R).</p