Prognostic value of nonangiogenic and angiogenic growth patterns in non-small-cell lung cancer

An essential prerequisite of nonangiogenic growth appears to be the ability of the tumour to preserve the parenchymal structures of the host tissue. This morphological feature is visible on a routine tissue section. Based on this feature, we classified haematoxylin and eosin-stained tissue sections from 279 patients with non-small-cell lung cancer into three growth patterns: destructive (angiogenic; n=196), papillary (intermediate; n=38) and alveolar (nonangiogenic; n=45). A Cox multiple regression model was used to test the prognostic value of growth patterns together with other relevant clinicopathological factors. For overall survival, growth pattern (P=0.007), N-status (P=0.001), age (P=0.020) and type of operation (P=0.056) were independent prognostic factors. For disease-free survival, only growth pattern (P=0.007) and N-status (P<0.001) had an independent prognostic value. Alveolar (hazard ratio=1.825, 95% confidence interval=1.117-2.980, P=0.016) and papillary (hazard ratio=1.977, 95% confidence interval=1.169-3.345, P=0.011) growth patterns were independent predictors of poor prognosis. The proposed classification has an independent prognostic value for overall survival as well as for disease-free survival, providing a possible explanation for survival differences of patients in the same disease stage

Imaging data in COVID-19 patients: focused on echocardiographic findings

To assess imaging data in COVID-19 patients and its association with clinical course and survival and 86 consecutive patients (52 males, 34 females, mean age = 58.8 year) with documented COVID-19 infection were included. Seventy-eight patients (91) were in severe stage of the disease. All patients underwent transthoracic echocardiography. Mean LVEF was 48.1 and mean estimated systolic pulmonary artery pressure (sPAP) was 27.9 mmHg. LV diastolic dysfunction was mildly abnormal in 49 patients (57.6) and moderately abnormal in 7 cases (8.2). Pericardial effusion was present in 5/86 (minimal in size in 3 cases and mild- moderate in 2). In 32/86 cases (37.2), the severity of infection progressed from �severe� to �critical�. Eleven patients (12.8) died. sPAP and computed tomography score were associated with disease progression (P value = 0.002, 0.002 respectively). Tricuspid annular plane systolic excursion (TAPSE) was significantly higher in patients with no disease progression compared with those who deteriorated (P value = 0.005). Pericardial effusion (minimal, mild or moderate) was detected more often in progressive disease (P = 0.03). sPAP was significantly lower among survivors (P value = 0.007). Echocardiographic findings (including systolic PAP, TAPSE and pericardial effusion), total CT score may have prognostic and therapeutic implication in COVID-19 patients. © 2021, The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature

Breast adenocarcinoma liver metastases, in contrast to colorectal cancer liver metastases, display a non-angiogenic growth pattern that preserves the stroma and lacks hypoxia

Although angiogenesis is a prerequisite for the growth of most human solid tumours, alternative mechanisms of vascularisation can be adopted. We have previously described a non-angiogenic growth pattern in liver metastases of colorectal adenocarcinomas (CRC) in which tumour cells replace hepatocytes at the tumour-liver interface, preserving the liver architecture and co-opting the sinusoidal blood vessels. The aim of this study was to determine whether this replacement pattern occurs during liver metastasis of breast adenocarcinomas (BC) and whether the lack of an angiogenic switch in such metastases is due to the absence of hypoxia and subsequent vascular fibrinogen leakage. The growth pattern of 45 BC liver metastases and 28 CRC liver metastases (73 consecutive patients) was assessed on haematoxylin- and eosin-stained tissue sections. The majority of the BC liver metastases had a replacement growth pattern (96%), in contrast to only 32% of the CRC metastases (P<0.0001). The median carbonic anhydrase 9 (CA9) expression (M75 antibody), as a marker of hypoxia, (intensity x % of stained tumour cells) was 0 in the BC metastases and 53 in the CRC metastases (P<0.0001). There was CA9 expression at the tumour-liver interface in only 16% of the BC liver metastases vs 54% of the CRC metastases (P=0.002). There was fibrin (T2G1 antibody) at the tumour-liver interface in only 21% of the BC metastases vs 56% of the CRC metastases (P=0.04). The median macrophage count (Chalkley morphometry; KP-1 anti-CD68 antibody) at the interface was 4.3 and 7.5, respectively (P<0.0001). Carbonic anhydrase 9 score and macrophage count were positively correlated (r=0.42; P=0.002) in all metastases. Glandular differentiation was less in the BC liver metastases: 80% had less than 10% gland formation vs only 7% of the CRC metastases (P<0.0001). The liver is a densely vascularised organ and can host metastases that exploit this environment by replacing the hepatocytes and co-opting the vasculature. Our findings confirm that a non-angiogenic pattern of liver metastasis indeed occurs in BC, that this pattern of replacement growth is even more prevalent than in CRC, and that the process induces neither hypoxia nor vascular leakage

Anti-angiogenic therapy for cancer: Current progress, unresolved questions and future directions

Tumours require a vascular supply to grow and can achieve this via the expression of pro-angiogenic growth factors, including members of the vascular endothelial growth factor (VEGF) family of ligands. Since one or more of the VEGF ligand family is overexpressed in most solid cancers, there was great optimism that inhibition of the VEGF pathway would represent an effective anti-angiogenic therapy for most tumour types. Encouragingly, VEGF pathway targeted drugs such as bevacizumab, sunitinib and aflibercept have shown activity in certain settings. However, inhibition of VEGF signalling is not effective in all cancers, prompting the need to further understand how the vasculature can be effectively targeted in tumours. Here we present a succinct review of the progress with VEGF-targeted therapy and the unresolved questions that exist in the field: including its use in different disease stages (metastatic, adjuvant, neoadjuvant), interactions with chemotherapy, duration and scheduling of therapy, potential predictive biomarkers and proposed mechanisms of resistance, including paradoxical effects such as enhanced tumour aggressiveness. In terms of future directions, we discuss the need to delineate further the complexities of tumour vascularisation if we are to develop more effective and personalised anti-angiogenic therapies. © 2014 The Author(s)

The Effect of Peer-Mentoring Program on Nursing Students’ Clinical Environment Stressors

Abstract Background & aim: Clinical training in nursing education is one of the most stressful experiences. Mentoring is a method that has been considered and different aspect of it such as effect on stress is argued. The present study is conducted to evaluate the effect of Peer-Mentoring program on Abadan College of nursing students in 2010-2011. Methods: In this Case-Control study, all second semester nursing students (n = 40) who were matched for age, gender, and GPA were divided in two case and control groups randomly (patients 19 and controls 21). Both groups spent their apprenticeship under the guidance of the instructor. In the case group, a 6th semester nursing student was assigned to 3-4 per second semester nursing student and, took the role of guiding and supporting them. The instruments for data collection were an individual characteristic form, and clinical experience assessment form. Pre- and post-tests were performed and the data analyzed using the SPSS 17 software. . Results: There was a significant difference between stress scores before and after of the intervention in both groups (p=0.00). Mean difference of clinical environment stress factors in two groups were not statistically significant (p=0.99). Conclusions: Peer-mentoring program is not significant effective on clinical environment stress reduction. Key Words: Nursing Education, Peer Mentoring, Clinical Environment Stressor

The Impact Of Oral Vitamin E In Preventing Mucositis (Bucal Mucous Inflammation) Resulting From The Radiotherapy In Tumors Of Head And Neck

Background: Mucositis [bucal Mucous inflamation] is the most common complication resulting from the radiotherapy in tumors of head and neck. These malignancies are often curable through radiotherapy. This complication, however, may impair the treatment process and cause malnutrition. So far no medicine has been Known to prevent this complication. Vitamin E is a stabilizer of cell membrane and is also used in mucositis treatment. The survey of oral vitamin E effect on mucositis prophylaxis in radiotherapy of head and neck malignancies. Materials and Methods: Seventy patients afflicted with head and neck malignancies referring to Imam Khomeini Hospital were randomly divided into 2groups, two of whom died during treatment process. The first group (The case group consisting of 34 patients) Consumed oral vitamin E 200 mg daily for seven days. The second group (The control group) did not use any medicine at all. The two group underwent radiotherapy. They were compared and contrasted as to mucositis severity and dysphagia during treatment. Results: In the first group, since the fourth week up to the end of the treatment, there was a lower frequency and grade of mucositis in contrast with the control group. In the fourth week, the grade two mucositis in the first group (Case group) was 20.6% and 47.5% in the control group the difference was statistically significant (P=0.024). There was also a lower frequency and grade of dysphagia in the case group since the fourth week versus the control group. In the fourth week, moderate dysphagia was 29.4% in the case group and 55.9% in the control group. The difference was statistically significant (P=0.023). Conclusion: Oral vitamin E has Proved to be effective in the Prophylaxis of Moderate and severe mucositis and dysphagia resulting from radiotherapy. It is advisable to conduct more research with more cases, lengthier duration and heavier doses

Prediction of Liquid Density by Gamma-Ray Measurement for Materials with Low Atomic Number

A new method has been developed and evaluated for density measurement of liquid materials based on conventional gamma density meter, whether a low strength gamma radioactive source as the backscatter technique with collimated detector cannot be properly used for density measurement. In this comparative study, proposed method aimed to improve the linearity of the density measurement without using time consuming spectroscopy. Both transmission and backscatter methods for density measurement were used together in a combined model. The whole measurement system was designed, constructed and simulated for nuclear gamma�gamma density measurement. MCNP modeling results were benchmarked with experimental data, showing a good correlation between combined density measurement method and conventional transmission density measurement while values of MRE(), RMSE and MAE() are lower in combined model. This study shows that, MRE() in combined model, and for both experimental and simulation results, is improved with the average of about 41 in comparison with the conventional density measurement. Also in this comparative study, RMSE decreased significantly about 56. Additionally, average MAE () reduced about 36. Furthermore, R-square values were also improved in both experimental and simulation results. Evaluating different methods of nuclear density measurements led us to propose an innovative formula, to investigate an accurate density measurement. This paper discusses advantages of proposed model in comparison with the conventional transmission method for gamma interaction with lower percentage errors and better calibration curve fitting. © 2020, Metrology Society of India

Dental Health Status in Renal Dialysis Patients Compared to Healthy Individuals

Introduction: Although patients with end-stage renal disease confront  numerous oral manifestations such as oral uremic odor, enamel hypoplasia, increased dental calculus and periodontal diseases, which may be hazardous for their systemic health, dialysis can change occurrence of such complications. Therefore, this study aimed to compare dialysis patients with the healthy individuals in regard with dental health index. Methods: In this case-control study, 134 hemodialysis and healthy patients were evaluated. Both groups were matched according to their age, gender, and educational background. The study data were colleted utilizing DMFS index (Decayed, Missed and Filled Surfaces of teeth) as well as demographic data forms. The data were analysed via Mann-Whitney, Kruskal-Wallis and Spearman tests. Results: Mean DMFS was reported 90.28±42.95 and 96.12±42.35 within dialysis patients and the control group, respectively. Even though DMFS within dialysis patients was lower compared to that of the control group, this difference was not statistically significant(P=0.79). In dialysis patients, the individuals with higher education level were demonstrated to have lower DMFS index, wheres those with a higher age revealed an increased DMFS. Moreover, no significant correlation was detected between length of dialysis period as well as number of dialysis times per month with the dental health indexes. Conclusion: The present study findings revealed no significant diference between dialysis and healthy groups in regard with the dental health. However, a significant correlation was reported between low education level and old age with the low dental health indexes

Synthesis and Antimycobacterial Activity of some Triazole Derivatives–New Route to Functionalized Triazolopyridazines

A series of cyclic analogues of bioactive thiosemicarbazide derivatives have been synthesized as potential antimycobacterial agents. The 4-amino-1,2,4-triazole-5-thione analogues (Ia-f) were prepared by heating a mixture of thiocarbohydrzide and appropriate carboxylic acids. Reaction of thiocarbohydrazide with γ-ketoesters in the presence of sodium methoxide furnished triazolopyridazine derivatives IIa-b. Finally, condensation of 4-amino-1,2,4-triazole-5-thione with some aldehydes gave Schiff bases IIIa-e. After characterization by different spectroscopic and analytical methods, the derivatives were tested for their inhibitory activity against Mycobacterium bovis BCG. Among the derivatives, compound Ib proved to be the most potent derivatives with MIC value of 31.25 µg/mL. Given the fact that 4-amino-1,2,4-triazole-5-thiones Ia-f were the most active derivatives, it could be suggested that this group of derivatives have the potential to be considered as lead compounds for future optimization efforts