Splenomegaly and Tumor Marker Response Following Selective Internal Radiation Therapy for Non-Resectable Liver Metastases from Neuroendocrine Tumor

PURPOSE:The aim of this study was to investigate changes in spleen size, the level of chromogranin Aas a tumor marker, and the relationship between these two parameters before and 3 months after selectiveinternal radiation therapy (SIRT) for non-resectable liver metastases from neuroendocrine tumor (NET).Our first serious adverse event with this relatively new treatment is also discussed.METHODS:A retrospective review of a prospective database identified patients with non-resectable livermetastases from NET who underwent SIRT between 2003 and 2007. Patients who underwent CT scansbefore and 3 months after treatment were included. The patients were divided into two groups:those withand without a 20 % or more increase in splenic volume on the CT scans. The percentages of patients showinga tumor marker response in the two groups were then comparedRESULTS:Fourteen patients were included in the present analysis. A tumor marker response was seenin 6 of 7 patients( 85.7%) who showed an increase in splenic volume of>20%, and in 3 of 7 patients( 42.9%) without an increase in splenic volume (p=0.266). There was one death as a result of oesophageal varicealbleeding due to portal hypertension at 9 months after treatment.CONCLUSION:Splenic enlargement after SIRT may be associated with tumor marker response, althoughthis could not be confirmed statistically in this study due to the small number of patients. Long-termsplenomegaly and portal hypertension may be important complications of SIRT. This issue needs to be investigatedfurther using a larger number of patients and longer follow-up

Measuring organisational readiness for patient engagement (MORE) : an international online Delphi consensus study

Date of Acceptance: 28/01/2015. © 2015 Oostendorp et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise statedWidespread implementation of patient engagement by organisations and clinical teams is not a reality yet. The aim of this study is to develop a measure of organisational readiness for patient engagement designed to monitor and facilitate a healthcare organisation’s willingness and ability to effectively implement patient engagement in healthcarePeer reviewedFinal Published versio

フクマク チュウヒシュ 11レイ ニ タイスル Peritonectomy オ モチイタ シュウガクテキ チリョウ セイセキ

目的 当科では腹膜中皮腫に対してPeritonectomyを用いた集学的治療(術中温熱化学療法(HIPEC),術後早期腹腔内化学療法(EPIC))を施行している.この治療結果を検討し,他施設と比較した.方法 1999年～2006年にPeritonectomyを施行した腹膜中皮腫11症例を対象に検討を加えた. 11例中, 3例に2回, 1例に3回,計16回のペリトネクトミーを, 9例に11回のHIPECを, 4例に6回のEPICを施行した.結果 男女比は7対4,平均年齢52.8±18.2,明らかなアスベスト暴露を4例で認めた. 11例中1例が周術期死亡, 3例が原病死, 7例が生存中である.統計学的検討では生存期間と2回目のPeritonectomy施行に10%の有意差を認めた(P=0.0734). Kaplan-Meier生存曲線からの1, 3, 5年生存率は72.7, 62.3, 62.3%であった.結論 我々と他施設の生存率に文献的考察を加えると, Peritonectomy集学的治療は腹膜中皮腫患者の予後の向上に寄与すると考えられる.AIMS : Recently, the issue of Asbestos-related disease has increased dramatically though out the world. Deaths from mesothelioma are often caused by asbestos exposure. The aim of the study was to present our unit\u27s experience in the treatment of peritoneal mesothelioma between 1999 and 2006. In addition, the data was assessed and validated compared with other peritonectomy units. METHODS : Records of 11 patients with peritoneal mesothelioma were reviewed retrospectively. All patients were treated by cytoreductive surgery with peritonectomy procedures, 4 patients had second and 1 patient had third peritonectomy (in total 16 times peritonectomy). Hyperthermic Intraperitoneal Perioperative Chemotherapy (HIPEC) was performed 11 times across 9 patients. Early Postoperative Intraperitoneal Chemotherapy (EPIC) was performed 6 times across 4 patients. RESULTS : 4 female and 7 male patients with a mean age of 52.8±18.2 years old were studied. Asbestos exposure was recorded in 4 patients. Overall projected survival at 1, 3 and 5 years were 72.7, 62.3 and 62.3 per cent from Kaplan-Meier survival curve. The most significant positive predictive factor of survival was second peritonectomy (P=0.0734). CONCLUSION : Our unit\u27s survival rate agreed with the experience from other units and supports peritonectomy with HIPEC and EPEC as the gold standard in the treatment of peritoneal mesothelioma worldwide

Evaluation of stromal HGF immunoreactivity as a biomarker for melanoma response to RAF inhibitors

Of more than 150,000 published studies evaluating new biomarkers, fewer than 100 biomarkers have been implemented for patient care[1]. One reason for this is lack of rigorous testing by the medical community to validate claims for biomarker clinical relevance, and potential reluctance to publish negative results when confirmation is not obtained. Here we sought to determine the utility and reproducibility of immunohistochemical detection of hepatocyte growth factor (HGF) in melanoma tissue, an approach of potential assistance in defining patients with innate resistance to BRAF inhibitor therapy[2]. To this end, a published and a revised method that retained sensitivity but with greater specificity for HGF detection, were evaluated in cells known to endogenously express HGF, models where HGF is upregulated via cytokine induction, and via overexpression by gene transfection. Consequent patient evaluation in collaboration with the Melanoma Institute Australia of a cohort of 41 melanoma specimens with extensive clinical annotation failed to validate HGF immunohistochemistry as a predictor of response to BRAF inhibitors. Targeted therapies for advanced melanoma[3–5] and other cancers show great promise, and rigorous validation studies are thus indicated for approaches that seek to personalize such therapies in order to maximize therapeutic efficacy

An appeal by the Sydney Hospital for a peace offering fund of L.100,000 : to provide an up-to-date home for its nursing staff and better facilities for carrying out its functions.

Also available online http://nla.gov.au/nla.aus-vn1602606; FERG copy from Ferguson First World War, 1914-1919 pamphlet collection.; One of Library's copies has its pages out of sequence.Special peace appeal, 1918-191

Obstetric Nurse's Certificate

Presented to "Frances O'Reilly". Printed at lower centre "William Andrews Printing Co. Ltd.

Obstructive Sleep Apnea and Neuro-Ophthalmic Conditions

There has been an emerging interest in the link between obstructive sleep apnea (OSA) and ocular health over the last decade. Though the evidence for OSA playing a role in cerebrovascular disease risk seems clear, the same cannot be said for optic neuropathies. The association between OSA and glaucoma or non-arteritic anterior ischemic optic neuropathy (NAION) may be secondary to either direct hypoxia or to vascular dysregulation, either systemically or at the optic nerve head itself. Papilledema and increased intracranial pressure are also reported in OSA patients and are postulated to be due to increased cerebral perfusion pressure and cerebral venous dilation secondary to hypoxia and hypercapnia.  Competencies Addressed: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Systems Based PracticeKBDdoonanteriorischemicopticneuropathy;  NTLnomanifestationscomplications; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Systems Based Practic