Prediction of survival among patients receiving transarterial chemoembolization for hepatocellular carcinoma: A response-based approach

Background and aims: The heterogeneity of intermediate-stage hepatocellular carcinoma (HCC) and the widespread use of transarterial chemoembolization (TACE) outside recommended guidelines have encouraged the development of scoring systems that predict patient survival. The aim of this study was to build and validate statistical models that offer individualized patient survival prediction using response to TACE as a variable. Approach and results: Clinically relevant baseline parameters were collected for 4,621 patients with HCC treated with TACE at 19 centers in 11 countries. In some of the centers, radiological responses (as assessed by modified Response Evaluation Criteria in Solid Tumors [mRECIST]) were also accrued. The data set was divided into a training set, an internal validation set, and two external validation sets. A pre-TACE model ("Pre-TACE-Predict") and a post-TACE model ("Post-TACE-Predict") that included response were built. The performance of the models in predicting overall survival (OS) was compared with existing ones. The median OS was 19.9 months. The factors influencing survival were tumor number and size, alpha-fetoprotein, albumin, bilirubin, vascular invasion, cause, and response as assessed by mRECIST. The proposed models showed superior predictive accuracy compared with existing models (the hepatoma arterial embolization prognostic score and its various modifications) and allowed for patient stratification into four distinct risk categories whose median OS ranged from 7 months to more than 4 years. Conclusions: A TACE-specific and extensively validated model based on routinely available clinical features and response after first TACE permitted patient-level prognosticatio

Nanotechnology and osteoarthritis; part 1: Clinical landscape and opportunities for advanced diagnostics

Osteoarthritis (OA) is a disease of the entire joint, often triggered by cartilage injury, mediated by a cascade of inflammatory pathways involving a complex interplay among metabolic, genetic, and enzymatic factors that alter the biochemical composition, microstructure, and biomechanical performance. Clinically, OA is characterized by degradation of the articular cartilage, thickening of the subchondral bone, inflammation of the synovium, and degeneration of ligaments that in aggregate reduce joint function and diminish quality of life. OA is the most prevalent joint disease, affecting 140 million people worldwide; these numbers are only expected to increase, concomitant with societal and financial burden of care. We present a two-part review encompassing the applications of nanotechnology to the diagnosis and treatment of OA. Herein, part 1 focuses on OA treatment options and advancements in nanotechnology for the diagnosis of OA and imaging of articular cartilage, while part 2 (10.1002/jor.24842) summarizes recent advances in drug delivery, tissue scaffolds, and gene therapy for the treatment of OA. Specifically, part 1 begins with a concise review of the clinical landscape of OA, along with current diagnosis and treatments. We next review nanoparticle contrast agents for minimally invasive detection, diagnosis, and monitoring of OA via magnetic resonace imaging, computed tomography, and photoacoustic imaging techniques as well as for probes for cell tracking. We conclude by identifying opportunities for nanomedicine advances, and future prospects for imaging and diagnostics.</p

Nanotechnology and Osteoarthritis. Part 2: Opportunities for advanced devices and therapeutics

Osteoarthritis (OA) is a multifactorial disease of the entire joint which afflicts 140 million individuals worldwide regardless of economic or social status. Current clinical treatments for OA primarily center on reducing pain and increasing mobility, and there are limited therapeutic interventions to restore degraded cartilage or slow disease pathogenesis. This second installment of a two-part review on nanotechnology and OA focuses on novel treatment strategies. Specifically, Part 2 first discusses current surgical and nonsurgical treatments for OA and then summarizes recent advancements in nanotechnology-based treatments, while Part 1 (10.1002/jor.24817) described advances in imaging and diagnostics. We review nano delivery systems for small molecule drugs, nucleic acids, and proteins followed by nano-based scaffolds for neocartilage formation and osteochondral regeneration, and lastly nanoparticle lubricants. We conclude by identifying opportunities for nanomedicine advances, and prospects for OA treatments.</p

Nanotechnology and Osteoarthritis. Part 1: Clinical Landscape and Opportunities for Advanced Diagnostics

Osteoarthritis (OA) is a disease of the entire joint, often triggered by cartilage injury, mediated by a cascade of inflammatory pathways involving a complex interplay among metabolic, genetic, and enzymatic factors that alter the biochemical composition, microstructure, and biomechanical performance. Clinically, OA is characterized by degradation of the articular cartilage, thickening of the subchondral bone, inflammation of the synovium, and degeneration of ligaments that in aggregate reduce joint function and diminish quality of life. OA is the most prevalent joint disease, affecting 140 million people worldwide; these numbers are only expected to increase, concomitant with societal and financial burden of care. We present a two-part review encompassing the applications of nanotechnology to the diagnosis and treatment of OA. Herein, part 1 focuses on OA treatment options and advancements in nanotechnology for the diagnosis of OA and imaging of articular cartilage, while part 2 (10.1002/jor.24842) summarizes recent advances in drug delivery, tissue scaffolds, and gene therapy for the treatment of OA. Specifically, part 1 begins with a concise review of the clinical landscape of OA, along with current diagnosis and treatments. We next review nanoparticle contrast agents for minimally invasive detection, diagnosis, and monitoring of OA via magnetic resonace imaging, computed tomography, and photoacoustic imaging techniques as well as for probes for cell tracking. We conclude by identifying opportunities for nanomedicine advances, and future prospects for imaging and diagnostics.</p

Mapas de zonas de risco de epidemias e zoneamento agroclimático para o Cancro Cítrico no Estado de São Paulo Maps of zones of risk epidemics and agriculture climatical zoning of the citrus canker in the State of São Paulo

O cancro cítrico, causado pela bactéria Xanthomonas axonopodis pv. citri Valterin et alii 1995, é uma doença conhecida mundialmente e sempre constituiu séria ameaça para a citricultura brasileira. O objetivo do presente trabalho foi analisar as condições climáticas do Estado de São Paulo e desenvolver mapas de zonas de maior risco de epidemias de cancro cítrico. Foram utilizados dados meteorológicos referentes aos anos de 2002 a 2005, os quais foram baseados no modelo de previsão desenvolvido por Campbell & Madden (4) e Hau & Kranz (10). A freqüência dos dados foi horária e quando alguma estação apresentava falha, esses eram extrapolados da estação mais próxima. Foram contabilizados os índices de favorabilidade e posteriormente calculadas as porcentagens de dias favoráveis à ocorrência da doença no período de um ano. A partir destas informações, foram gerados os mapas temáticos do Estado de São Paulo, com a distribuição espacial da porcentagem de dias favoráveis à ocorrência de cancro cítrico. A região Noroeste do Estado foi a que apresentou a maior porcentagem de dias favoráveis à ocorrência de cancro cítrico.<br>The citrus canker, caused by the bacterium Xanthomonas axonopodis pv. citri Valterin et alii 1995, is a known disease world-wide known and it is always a serious threat for the brazilian citriculture. The objective of the present study was to analyze the climatic conditions of the State of São Paulo in order to develop zone maps of great risk for citrus canker epidemics. They had been used given meteorological referring from the years 2002 to 2005, which had been used in the model of forecast of citrus canker developed by Campbell and Madden in 1990 and Hau and Kranz in 1990. The data frequency was in hourly and when some metheorological station showed problems in the data series, these had been surpassed of the nearest station. After the accounting of the indexes had been calculated the percentages of days favorable to the occurrence of the disease in the period of one year. From this information, the thematic maps of the state of São Paulo had been generated, with the space distribution of the percentage of days favorable to the occurrence of citrus canker. The region the northwest region of the state was the one that presented the greatest percentage of days favorable to the occurrence of the disease