Integrative medicine in the cancer setting: a new challenge for physicians and patients

In 2019, World Cancer Research Journal launched a new topic, dedicated to Complementary and alternative medicine (CAM), enjoying good scientific interest. The articles, published on this topic, highlights the concept and the importance of a new integrative medicine approach. According to the National Center Institute of USA for Complementary and Integrative Health (NCCIH), integrative medicine is an approach to medical care that combines traditional medicine (TM) with CAM practices, which have demonstrated safety and benefits as adjuncts to mainstream cancer care

A wot-based method for creating digital sentinel twins of iot devices

The data produced by sensors of IoT devices are becoming keystones for organizations to conduct critical decision-making processes. However, delivering information to these processes in real-time represents two challenges for the organizations: the first one is achieving a constant dataflow from IoT to the cloud and the second one is enabling decision-making processes to retrieve data from dataflows in real-time. This paper presents a cloud-based Web of Things method for creating digital twins of IoT devices (named sentinels).The novelty of the proposed approach is that sentinels create an abstract window for decision-making processes to: (a) find data (e.g., properties, events, and data from sensors of IoT devices) or (b) invoke functions (e.g., actions and tasks) from physical devices (PD), as well as from virtual devices (VD). In this approach, the applications and services of decision-making processes deal with sentinels instead of managing complex details associated with the PDs, VDs, and cloud computing infrastructures. A prototype based on the proposed method was implemented to conduct a case study based on a blockchain system for verifying contract violation in sensors used in product transportation logistics. The evaluation showed the effectiveness of sentinels enabling organizations to attain data from IoT sensors and the dataflows used by decision-making processes to convert these data into useful information

Tel-eVax: a genetic vaccine targeting telomerase for treatment of canine lymphoma

Background: we have recently shown that Tel-eVax, a genetic vaccine targeting dog telomerase (dTERT) and based on Adenovirus (Ad)/DNA Electro-Gene-Transfer (DNA–EGT) technology can induce strong immune response and increase overall survival (OS) of dogs affected by multicentric Diffuse Large B cell Lymphoma (DLBCL) when combined to COP therapy in a double-arm study. Here, we have utilized a clinically validated device for veterinary electroporation called Vet-ePorator , based on Cliniporator technology currently utilized and approved in Europe for electro- chemotherapy applications and adapted to electrogenetransfer (EGT). Methods: 17 dogs affected by DLBCL were vaccinated using two Ad vector injections (Prime phase) followed by TM DNA–EGT (Boost phase) by means of a Vet-ePorator device and treated in the same time with a 27-week Madison Wisconsin CHOP protocol. The immune response was measured by ELISA assays using pool of peptides. Results: No significant adverse effects were observed. The OS of vaccine/CHOP animals was 64.5 weeks, in line with the previous study. Dogs developed antibodies against the immunizing antigen. Conclusions: Tel-eVax in combination with CHOP is safe and immunogenic in lymphoma canine patients. These data confirm the therapeutic efficacy of dTERT vaccine and hold promise for the treatment of dogs affected by other cancer types. More importantly, our findings may translate to human clinical trials and represent new strategies for cancer treatment

Mediastinal Images Resembling Thymus Following 131-I Treatment for Thyroid Cancer

The follow-up of Differentiated Thyroid Cancer conventionally includes serum thyroglobulin and periodic Whole Body Scans. The uptake of 131-I in normal and pathological tissues different from metastatic thyroid cancer sites is a cause of false-positive scans. Among them, mediastinal uptake caused by thymic hyperplasia can be observed. The aim of the present study was to review a series of 573 patients with differentiated thyroid cancer treated with 131-I after surgery between 1992 and 2003 looking above all for those with mediastinal images resembling thymus. This evaluation is presented together with some hypotheses on the relationships between thymus and thyroid. Moreover, some considerations are made on the differential diagnosis between thymus and mediastinal tumour thyroid residues

A wot-based method for creating digital sentinel twins of iot devices

The data produced by sensors of IoT devices are becoming keystones for organizations to conduct critical decision-making processes. However, delivering information to these processes in real-time represents two challenges for the organizations: the first one is achieving a constant dataflow from IoT to the cloud and the second one is enabling decision-making processes to retrieve data from dataflows in real-time. This paper presents a cloud-based Web of Things method for creating digital twins of IoT devices (named sentinels).The novelty of the proposed approach is that sentinels create an abstract window for decision-making processes to: (a) find data (e.g., properties, events, and data from sensors of IoT devices) or (b) invoke functions (e.g., actions and tasks) from physical devices (PD), as well as from virtual devices (VD). In this approach, the applications and services of decision-making processes deal with sentinels instead of managing complex details associated with the PDs, VDs, and cloud computing infrastructures. A prototype based on the proposed method was implemented to conduct a case study based on a blockchain system for verifying contract violation in sensors used in product transportation logistics. The evaluation showed the effectiveness of sentinels enabling organizations to attain data from IoT sensors and the dataflows used by decision-making processes to convert these data into useful information.This research was partially funded by the project Num.41756 “Plataforma tecnológica para la gestión, aseguramiento, intercambio y preservación de grandes volúmenes de datos en salud y construcción de un repositorio nacional de servicios de análisis de datos de salud” by FORDECYT-PRONACES, Conacyt (México

Toward a personalized therapy in soft-tissue sarcomas: State of the art and future directions

Soft-tissue sarcomas are rare tumors characterized by pathogenetic, morphological, and clinical intrinsic variability. Median survival of patients with advanced tumors are usually chemo-and radio-resistant, and standard treatments yield low response rates and poor survival results. The identification of defined genomic alterations in sarcoma could represent the premise for targeted treatments. Summarizing, soft-tissue sarcomas can be differentiated into histotypes with reciprocal chromosomal translocations, with defined oncogenic mutations and complex karyotypes. If the latter are improbably approached with targeted treatments, many suggest that innovative therapies interfering with the identified fusion oncoproteins and altered pathways could be potentially resolu-tive. In most cases, the characteristic genetic signature is discouragingly defined as “undruggable”, which poses a challenge for the development of novel pharmacological approaches. In this review, a summary of genomic alterations recognized in most common soft-tissue sarcoma is reported together with current and future therapeutic opportunities

Health-care organization for the management and surveillance of SARS-CoV-2 infection in children during pandemic in Campania region, Italy

Background: In comparison with adults, severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection in children has a milder course. The management of children with suspected or confirmed coronavirus disease (COVID-19) needs to be appropriately targeted. Methods: We designed a hub-and-spoke system to provide healthcare indications based on the use of telemedicine and stringent admission criteria, coordinate local stakeholders and disseminate information. Result: Between March 24th and September 24th 2020, the Hub Centre managed a total of 208 children (52% males, median age, 5.2, IQR 2–9.6 years) with suspected or confirmed COVID-19. Among them, 174 were managed in cooperation with family pediatricians and 34 with hospital-based physicians. One hundred-four (50%) received a final diagnosis of SARS-CoV-2 infection. Application of stringent criteria for hospital admission based on clinical conditions, risk factors and respect of biocontainment measures, allowed to manage the majority of cases (74, 71.1%) through telemedicine. Thirty children (28%) were hospitalized (median length 10 days, IQR 5–19 days), mainly due to the presence of persistent fever, mild respiratory distress or co-infection occurring in infant or children with underlying conditions. However, the reasons for admission slightly changed over time. Conclusion: An hub-and-spoke system is effective in coordinate territorial health-care structures involved in management paediatric COVID-19 cases through telemedicine and the definition of stringent hospital admission criteria. The management of children with COVID-19 should be based on clinical conditions, assessed on a case-by-case critical evaluation, as well as on isolation measures, but may vary according to local epidemiological changes

Dietary folates and cancer risk in a network of case-control studies

Background Folate deficiency leads to DNA damage and inadequate repair, caused by a decreased synthesis of thymidylate and purines. We analyzed the relationship between dietary folate intake and the risk of several cancers. Patients and methods The study is based on a network of case-control studies conducted in Italy and Switzerland in 1991-2009. The odds ratios (ORs) for dietary folate intake were estimated by multiple logistic regression models, adjusted for major identified confounding factors. Results For a few cancer sites, we found a significant inverse relation, with ORs for an increment of 100μg/day of dietary folate of 0.65 for oropharyngeal (1467 cases), 0.58 for esophageal (505 cases), 0.83 for colorectal (2390 cases), 0.72 for pancreatic (326 cases), 0.67 for laryngeal (851 cases) and 0.87 for breast (3034 cases) cancers. The risk estimates were below unity, although not significantly, for cancers of the endometrium (OR=0.87, 454 cases), ovary (OR=0.86, 1031 cases), prostate (OR=0.91, 1468 cases) and kidney (OR=0.88, 767 cases), and was 1.00 for stomach cancer (230 cases). No material heterogeneity was found in strata of sex, age, smoking and alcohol drinking. Conclusions Our data support a real inverse association of dietary folate intake with the risk of several common cancer

A Root in Synapsis and the Other One in the Gut Microbiome-Brain Axis: Are the Two Poles of Ketogenic Diet Enough to Challenge Glioblastoma?

Glioblastoma is the most frequent and aggressive brain cancer in adults. While precision medicine in oncology has produced remarkable progress in several malignancies, treatment of glioblastoma has still limited available options and a dismal prognosis. After first-line treatment with surgery followed by radiochemotherapy based on the 2005 STUPP trial, no significant therapeutic advancements have been registered. While waiting that genomic characterization moves from a prognostic/predictive value into therapeutic applications, practical and easy-to-use approaches are eagerly awaited. Medical reports on the role of the ketogenic diet in adult neurological disorders and in glioblastoma suggest that nutritional interventions may condition outcomes and be associated with standard therapies. The acceptable macronutrient distribution of daily calories in a regular diet are 45–65% of daily calories from carbohydrates, 20–35% from fats, and 10–35% from protein. Basically, the ketogenic diet follows an approach based on low carbohydrates/high fat intake. In carbohydrates starvation, body energy derives from fat storage which is used to produce ketones and act as glucose surrogates. The ketogenic diet has several effects: metabolic interference with glucose and insulin and IGF-1 pathways, influence on neurotransmission, reduction of oxidative stress and inflammation, direct effect on gene expression through epigenetic mechanisms. Apart from these central effects working at the synapsis level, recent evidence also suggests a role for microbiome and gut-brain axis induced by a ketogenic diet. This review focuses on rationales supporting the ketogenic diet and clinical studies will be reported, looking at future possible perspectives