Clinical and genomic analysis of a randomised phase II study evaluating anastrozole and fulvestrant in postmenopausal patients treated for large operable or locally-advanced hormone-receptor-positive breast cancer

Background: The aim of this study was to assess the efficacy of neoadjuvant anastrozole and fulvestrant treatment of large operable or locally-advanced hormone- receptor-positive breast cancer not eligible for initial breast-conserving surgery, and to identify genomic changes occurring after treatment. Methods: 120 post-menopausal patients were randomised to receive 1 mg anastrozole (61 patients) or 500 mg fulvestrant (59 patients) for 6 months. Genomic DNA copy number profiles were generated for a subgroup of 20 patients before and after treatment. Results: 108 patients were evaluable for efficacy and 118 for toxicity. The objective response rate determined by clinical palpation was 58.9% (95% CI 45.0-71.9) in the anastrozole arm and 53.8% (95% CI 39.5-67.8) in the fulvestrant arm. The breast- conserving surgery rate was 58.9% (95% CI 45.0-71.9) in the anastrozole arm and 50.0% (95% CI 35.8-64.2) in the fulvestrant arm. Pathological responses >50% occurred in 24 patients (42.9%) in the anastrozole arm and 13 (25.0%) in the fulvestrant arm. The Ki-67 score fell after treatment but there was no significant difference between the reduction in the two arms (anastrozole 16.7% [95%CI 13.3-21.0] before, 3.2% [95%CI 1.9-5.5] after, n=43; fulvestrant 17.1% [95%CI 13.1-22.5] before, 3.2% [95%CI 1.8-5.7] after, n=38) or between the reduction in Ki-67 in clinical responders and non- responders. Genomic analysis appeared to show a reduction of clonal diversity following treatment with selection of some clones with simpler copy number profiles. Conclusion: Both anastrozole and fulvestrant were effective and well-tolerated, enabling breast-conserving surgery in over 50% of patients. Clonal changes consistent with clonal selection by the treatment were seen in a subgroup of patients

Experimental Animal Models in Periodontology: A Review

In periodontal research, animal studies are complementary to in vitro experiments prior to testing new treatments. Animal models should make possible the validation of hypotheses and prove the safety and efficacy of new regenerating approaches using biomaterials, growth factors or stem cells. A review of the literature was carried out by using electronic databases (PubMed, ISI Web of Science). Numerous animal models in different species such as rats, hamsters, rabbits, ferrets, canines and primates have been used for modeling human periodontal diseases and treatments. However, both the anatomy and physiopathology of animals are different from those of humans, making difficult the evaluation of new therapies. Experimental models have been developed in order to reproduce major periodontal diseases (gingivitis, periodontitis), their pathogenesis and to investigate new surgical techniques. The aim of this review is to define the most pertinent animal models for periodontal research depending on the hypothesis and expected results

Superpower Dominance: the Yum Kippur Case

The Yum Kippur War, or as the Egyptians call it The October War, is one of the most important wars in the history of the Middle East between the coalition of Egypt and Syria versus Israel. It occurred at a time when the two superpowers then, the Americans and the Soviet Union, were in engaging in what was called the Cold War. For that every Superpower used to support a certain party of conflict to assure the balance of global dominance isn't affected. This paper reviews American foreign policy during the war in 1973. It concentrates on how the American institutions and foreign policy activists acted and influenced the outcome of the war. The paper finally conducts a counter analysis on what could have happened if the Americans didn't support the Israelis in the war

Altération de la distribution des lymphocytes B dans les parodontites sévères

International audienc

The oral cavity microbiota: between health, oral disease, and cancers of the aerodigestive tract.

Many studies show that the human microbiome plays a critical role in the chronic pathologies of obesity, inflammatory bowel diseases, and diabetes. More recently, the interaction between cancer and the microbiome has been highlighted. Most studies have focused on the gut microbiota because it represents the most extensive bacterial community, and the body of evidence correlating it with gut syndromes is increasing. However, in the strict sense, the gastrointestinal (GI) tract begins in the oral cavity, and special attention should be paid to the specific flora of this cavity. This study reviewed the current knowledge about the various microbial ecosystems of the upper part of the GI tract and discussed their potential link to carcinogenesis. The overall composition of the microbial communities, as well as the presence or absence of "key species", in relation to carcinogenesis is addressed. Alterations in the oral microbiota can potentially be used to predict the risk of cancer. Molecular advances and the further monitoring of the microbiota will increase our understanding of the role of the microbiota in carcinogenesis and open new perspectives for future therapeutic and prophylactic modalities

Can Doppler ultrasonography twinkling artifact be used as an alternative imaging modality to non-contrast-enhanced computed tomography in patients with ureteral stones? A prospective clinical study

We aimed to evaluate the use of twinkling artifact (TA) on color Doppler ultrasonography (USG) as an alternative imaging modality to non-contrast-enhanced computed tomography (CT) in patients with ureteral stones in this prospective study. Totally, 106 consecutive patients who had been diagnosed with ureterolithiasis by CT were enrolled in this prospective study. A urinary system color Doppler ultrasonography was performed on the same day with CT by an experienced radiologist who was blinded to the CT scan. TA was graded as 0, 1 and 2. The overall specificity of TA was calculated according to the NCCT as a gold standard method. The size, side and localization of stone and the demographic characteristics of patients were compared with twinkling positivity. TA on color Doppler USG was detected in 92 (86.8 %) patients. Statistically significant difference was found between the TA and localization of ureteral stones (p = 0.044). When we sub-grouped the patients according to the TA grades as 0, 1 and 2, 14 patients were with TA grade 0, 55 with TA grade 1 and 37 with TA grade 2. The mean stone size of groups was significantly different (p = 0.012). Bigger and proximal ureteral stones tended to have more TA on color Doppler USG. TA on color Doppler USG could be a good and safe alternative imaging modality with comparable results between NCCT. It could be useful for the diagnosis and follow-up of patients with ureterolithiasis