Years of life that could be saved from prevention of hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) causes premature death and loss of life expectancy worldwide. Its primary and secondary prevention can result in a significant number of years of life saved. AIM: To assess how many years of life are lost after HCC diagnosis. METHODS: Data from 5346 patients with first HCC diagnosis were used to estimate lifespan and number of years of life lost after tumour onset, using a semi-parametric extrapolation having as reference an age-, sex- and year-of-onset-matched population derived from national life tables. RESULTS: Between 1986 and 2014, HCC lead to an average of 11.5 years-of-life lost for each patient. The youngest age-quartile group (18-61 years) had the highest number of years-of-life lost, representing approximately 41% of the overall benefit obtainable from prevention. Advancements in HCC management have progressively reduced the number of years-of-life lost from 12.6 years in 1986-1999, to 10.7 in 2000-2006 and 7.4 years in 2007-2014. Currently, an HCC diagnosis when a single tumour <2 cm results in 3.7 years-of-life lost while the diagnosis when a single tumour 65 2 cm or 2/3 nodules still within the Milan criteria, results in 5.0 years-of-life lost, representing the loss of only approximately 5.5% and 7.2%, respectively, of the entire lifespan from birth. CONCLUSIONS: Hepatocellular carcinoma occurrence results in the loss of a considerable number of years-of-life, especially for younger patients. In recent years, the increased possibility of effectively treating this tumour has improved life expectancy, thus reducing years-of-life lost

Metabolic disorders across hepatocellular carcinoma in Italy

BACKGROUND: Metabolic disorders are well-known risk factors for HCC. Conversely, their impact on the natural history of HCC is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC patients regardless of its aetiology. METHODS: We analysed the ITA.LI.CA database regarding 839 HCC patients prospectively collected. The following metabolic features were analysed: BMI, diabetes, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. According to these features, patients were divided into 3 groups: 0-1, 2 and 3-5 metabolic features. RESULTS: As compared with patients with 0-1 metabolic features, patients with 3-5 features showed lower percentage of HCC diagnosis on surveillance (P = .021), larger tumours (P = .038), better liver function (higher percentage of Child-Pugh class A [P = .007] and MELD &lt; 10 [P = .003]), higher percentage of metastasis (P = .024) and lower percentage of portal vein thrombosis (P = .010). The BCLC stage and treatment options were similar among the 3 groups, with the exception of a less frequent access to loco-regional therapies for BCLC stage B patients with 3-5 features (P = .012). Overall survival and survival according to BCLC stage and/or treatment did not significantly differ among the 3 groups. Only using a probabilistic sensitivity analysis, diabetic patients showed a lower survival (P = .046). MELD score, HCC morphology, nodule size, BCLC stage, portal vein thrombosis and metastasis were independent predictors of lead-time adjusted survival. CONCLUSIONS: Our "real world" study suggests that metabolic disorders shape the clinical presentation of HCC but do not seem to play a major role in setting patient survival.Background: Metabolic disorders are well-known risk factors for HCC. Conversely, their impact on the natural history of HCC is not established. This study aimed at evaluating the impact of metabolic disorders on clinical features, treatment and survival of HCC patients regardless of its aetiology. Methods: We analysed the ITA.LI.CA database regarding 839 HCC patients prospectively collected. The following metabolic features were analysed: BMI, diabetes, arterial hypertension, hypercholesterolaemia and hypertriglyceridaemia. According to these features, patients were divided into 3 groups: 0-1, 2 and 3-5 metabolic features. Results: As compared with patients with 0-1 metabolic features, patients with 3-5 features showed lower percentage of HCC diagnosis on surveillance (P&nbsp;=.021), larger tumours (P&nbsp;=.038), better liver function (higher percentage of Child-Pugh class A [P&nbsp;=.007] and MELD&nbsp;&lt;&nbsp;10 [P&nbsp;=.003]), higher percentage of metastasis (P&nbsp;=.024) and lower percentage of portal vein thrombosis (P&nbsp;=.010). The BCLC stage and treatment options were similar among the 3 groups, with the exception of a less frequent access to loco-regional therapies for BCLC stage B patients with 3-5 features (P&nbsp;=.012). Overall survival and survival according to BCLC stage and/or treatment did not significantly differ among the 3 groups. Only using a probabilistic sensitivity analysis, diabetic patients showed a lower survival (P&nbsp;=.046). MELD score, HCC morphology, nodule size, BCLC stage, portal vein thrombosis and metastasis were independent predictors of lead-time adjusted survival. Conclusions: Our \u201creal world\u201d study suggests that metabolic disorders shape the clinical presentation of HCC but do not seem to play a major role in setting patient survival

Laser ablation is superior to TACE in large-sized hepatocellular carcinoma: A pilot case-control study

Background:Limited therapies are available for large ( 6540 mm) unresectable hepatocellular carcinoma (HCC). Currently, the standard treatment with transarterial chemoembolisation (TACE) is unsatisfactory with high recurrence rate and limited effect on survival. Laser Ablation (LA) has emerged as a relatively new technique characterized by high efficacy and good safety. This study is aimed to evaluate the efficacy of LA in comparison to TACE in patients with large HCC. Methods: Eighty-two patients with a single HCC nodule 6540 mm (BCLC stage A or B) were enrolled in this case-control study. Forty-one patients were treated with LA and 41 patients were treated with TACE. Response to therapy was evaluated according to the mRECIST criteria. Survival was calculated with Kaplan-Meier from the time of cancer diagnosis to death with values censored at the date of the last follow-up. Results: Twenty-six (63.4%) and 8 (19.5%) patients had a complete response after LA and TACE, respectively (p &lt; 0.001). Subsequently we stratified the HCCs in 3 categories according to the nodule size: 40-50 mm, 51-60 mm, and &gt; 60 mm. LA resulted superior to TACE especially in nodules ranging between 51 and 60 mm in diameter, with a complete response rate post-LA and post-TACE of 75% and 14.3%, respectively (p = 0.0133). The 36 months cumulative survival rate in patients treated with LA and TACE was 55.4% and 48.8%, respectively. The disease recurrence rates after LA and TACE were 19.5% and 75.0%, respectively. Conclusions: LA is a more effective therapeutic option than TACE in patients with solitary large HCC

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

High frequency shoot regeneration from immature embryo explants of Hungarian vetch

Efficient and reproducible shoot regeneration has been established from immature cotyledons and embryo axes of Hungarian vetch. Immature embryo axes showed higher regeneration capacity than immature cotyledons in most media tested. Immature cotyledons appeared to produce the highest frequency of shoot regeneration on 20 ?M 6-benzylaminopurine (BA) and 2.5 ?M ?-naphthaleneacetic acid (NAA)-containing medium; whereas, shoot regeneration on immature embryo axes was best achieved on a medium supplemented with 5 ?M each of BA and NAA. Regenerated shoots were excised and rooted in half-strength MS medium supplemented with 5 ?M indole-3-butyric acid (IBA). Rooted plantlets were acclimatized to ambient conditions and later established under greenhouse conditions.The authors wish to thank the State Planning Organization of Turkey and Ankara University for financial support

TDZ x IBA induced shoot regeneration from cotyledonary leaves and in vitro multiplication in safflower (Carthamus tinctorius L.)

A high frequency adventitious shoot regeneration protocol for safflower (Carthamus tinctorius L.) cv. Dinçer with high yield (Turkish cultivar) using cotyledonary leaves of 10 day-old seedlings were optimized by studying the influence of different combinations of thidiazuron (TDZ) and indole-3-butyric acid (IBA). Cotyledonary leaves were cultured on Murashige and Skoog medium (MS) supplemented with different concentrations and combinations of TDZ and IBA. The highest percentage of regenerated shoots (33.33%) and the highest number of shoots per explant (6.5) occurred on a MS medium containing 0.5 mg/l TDZ and 0.25 mg/l IBA. Furthermore, cotyledonary nodes and meristem tips of 14 day-old seedlings were cultured on Murashige and Skoog (MS) medium supplemented with various concentrations of N6-benzylamino-purine (BAP) alone or combination of -naphthalene acetic acid (NAA). Direct multiple shoots from cotyledonary nodes and meristem tips developed within 18 - 21 days in most media tested. 100% shoot multiplication was achieved from cotyledonary node and meristem tip on a range of MS media supplemented with different concentrations of BAP and NAA

Antimicrobial Activity of Heracleum antasiaticum

1st International Medicinal and Aromatic Plants Conference on Culinary Herbs -- APR 30, 2009 -- Antalya, TURKEYWOS: 000305620000036Heracleum L. (Apiaceae) includes more than 70 species in the world. This variety is representing 17 species in Turkey of which 7 species are endemic. Heracleum antasiaticum is an endemic species for Turkey. Heracleum antasiaticum has been shown to possess medicinal value, in particular, and antimicrobial activity. Heracleum antasiaticum was assayed for their in vitro antibacterial activities against eight pathogenic bacteria, and three yeast spp. The antimicrobial activity of the ethanol extract and water extract of Heracleum antasiaticum was investigated using an agar diffusion method. Ethanolic and aqueous extract of Heracleum antasiaticum differed significantly in their activity against the test microorganisms.T.R. Prime Ministry State Planning Organization (DPT)Turkiye Cumhuriyeti Kalkinma Bakanligi [DPT 2003 K 120770]This financial support by T.R. Prime Ministry State Planning Organization (DPT), via a grant numbered DPT 2003 K 120770 is acknowledged gratefully

Land use/cover change modelling in a mediterranean rural landscape using multi-layer perceptron and markov chain (MLP-MC)

Mediterranean land use and land cover (LULC) have a very dynamic structure as a result of continuous transformation process due to anthropogenic effects and environmental gradients. LULC dynamics are important indicator of environmental condition in temporal and spatial scales. The aim of this paper was to simulate the future LULC of a Mediterranean type watershed located at the Eastern Mediterranean Region of Turkey by incorporating multi-layer perceptron (MLP), artificial neural network (ANN) and Markov chain (MC) approaches. Landsat TM/OLI images in 1990, 2003 and 2014 over the study area were classified using hybrid classification approach. The Kappa statistics of the hybrid classification that combines K-means, decision tree and object based classification method for these three images were 0.81, 0.85 and 0.87 respectively. The LULC map of 2014 was simulated using LULC maps of 1990 and 2003 for calibration and validation. The simulation results were compared with the actual 2014 LULC map to assess the accuracy of the simulation, and the rate of overlap was found as 89%. LULC map of 2025 was estimated using LULC maps of 2003 and 2014. These results indicated that, the area of bareground will reduce 13.31% whereas the rate of forest and agricultural area will increase 8.70% and 6.51% respectively. © 2018, ALÖKI Kft., Budapest, Hungary

In vitro micropropagation from immature embryos of the endemic and endangered Muscari muscarimi Medik

An efficient in vitro bulblet production procedure from immature zygotic embryos of endemic and endangered Muscari muscarimi Medik. was described in the current study. Zygotic embryos were first isolated from immature seeds and cultured on different nutrient media compositions supplemented with various combinations of ?-naphthalene acetic acid (NAA), picloram, dicamba, 6-benzylaminopurine (BAP), and thidiazuron (TDZ). The best bulblet regeneration (59 bulblets per explant) was achieved in Murashige and Skoog (MS) medium containing 4 mg/L BAP and 0.5 mg/L NAA after 1 year of culture initiation. Regenerated bulblets were then transferred into MS medium without plant growth regulators for rooting. Bulblets produced well-developed root systems and increased their size on this medium after 2 months. All rooted bulblets were successfully transplanted into a potting mixture and acclimatized to ambient conditions. © TÜBİTAK