Chronic rhinitis in South Africa – more than just allergy!

Chronic rhinitis is a troublesome condition for sufferers. It is tempting to label all patients with chronic nasal symptoms as having allergic rhinitis (AR), but many such patients have other causes of chronic rhinitis that need a specific diagnosis and management strategy. Even when the patient fully fits the definition of AR, their condition will be best served by combining medication with ongoing patient education.http://www.samj.org.zaam2021OtorhinolaryngologyPaediatrics and Child Healt

Designing the selenium and bladder cancer trial (SELEBLAT), a phase lll randomized chemoprevention study with selenium on recurrence of bladder cancer in Belgium

<p>Abstract</p> <p>Background</p> <p>In Belgium, bladder cancer is the fifth most common cancer in males (5.2%) and the sixth most frequent cause of death from cancer in males (3.8%). Previous epidemiological studies have consistently reported that selenium concentrations were inversely associated with the risk of bladder cancer. This suggests that selenium may also be suitable for chemoprevention of recurrence.</p> <p>Method</p> <p>The SELEBLAT study opened in September 2009 and is still recruiting all patients with non-invasive transitional cell carcinoma of the bladder on TURB operation in 15 Belgian hospitals. Recruitment progress can be monitored live at <url>http://www.seleblat.org.</url> Patients are randomly assigned to selenium yeast (200 μg/day) supplementation for 3 years or matching placebo, in addition to standard care. The objective is to determine the effect of selenium on the recurrence of bladder cancer. Randomization is stratified by treatment centre. A computerized algorithm randomly assigns the patients to a treatment arm. All study personnel and participants are blinded to treatment assignment for the duration of the study.</p> <p>Design</p> <p>The SELEnium and BLAdder cancer Trial (SELEBLAT) is a phase III randomized, placebo-controlled, academic, double-blind superior trial.</p> <p>Discussion</p> <p>This is the first report on a selenium randomized trial in bladder cancer patients.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00729287">NCT00729287</a></p

The impact of sarcomatoid features on survival outcomes in metastatic renal cell carcinoma patients receiving upfront cytoreductive nephrectomy: a retrospective analysis of a contemporary series

Introduction: Sarcomatoid features (SF) correlate with worst survival outcomes in patients with primary metastatic renal cell carcinoma (mRCC). Some reports suggested a cut-off above 25% sarcomatoid features as a predictor of poorer outcome. We aimed to report survival outcomes on a large dataset of patients with SF treated with cytoreductive nephrectomy (CN). Materials and methods: A purpose built multi-institutional international database (REgistry of MetAstatic RCC- REMARCC project) was used for this retrospective analysis. Patients with diagnosis of mRCC treated with CN with or without metastasectomy were included. The cohort was stratified according to the presence of SF in the primary specimen. Kaplan Meier methods and Cox proportional Hazards Regression Analyses were used to estimate overall mortality rates. The reverse Kaplan Meier method was used to estimate the median (IQR) follow-up. Results: Overall 617 patients who underwent CN were included. Of all, 78 (12.6%) patients received synchronous/metachronous metastasectomy. A total of 118 (19.1%) patients had SF in the final specimen. The median involvement of the sarcomatoid component was 35.0% (IQR 10.0\u201372.5%). Patients with SF were more frequently classified as poor prognosis according to Heng\u2019s criteria (44.9 vs. 33.3%, p = 0.022). Moreover, patients with sarcomatoid features harbored more frequently locally advanced disease [pT3-4 stage tumors (88.1 vs. 73.7%, p = 0.003) and pN1 tumors (28.8 vs. 18.22%, p = 0.025)]. The median follow-up was 55.1 (IQR 25.9\u2013120.6) months. Overall, 395 (64.0%) deaths were recorded in the whole cohort. The median overall survival was shorter for patients with SF (13.1 vs. 27.9 months, p 35% nor those with a SF >50% showed higher overall mortality rates than those with <35% and <50% SF, respectively (p = 0.720 and 0.960, respectively). Patients with SF showed higher overall mortality rates even after accounting for Heng\u2019s risk group, type of surgery and pT and pN stage (HR: 1.35, 95% CI: 1.04\u20131.75, p = 0.024). Conclusions: Patients with mRCC and SF experience higher mortality rates, even when accounting for pathologic status and risk group. Interestingly, the extent of sarcomatoid defined as >50% in the specimen was not predictive of higher mortality rates within patients with SF. These results suggest that all patients with a SF on primary tumor should be carefully followed independently of percentage of sarcomatoid dedifferentiation

Treatment of patients with newly diagnosed metastatic hormone sensitive prostate cancer (mHSPC) in Belgium: a real world data analysis.

INTRODUCTION: Abiraterone acetate + prednisone (AAP) and docetaxel have proven their efficacy in the treatment of patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC) in clinical trials. However, real-world data are scarce. The goal of this study is to evaluate real-world data on the efficacy and safety of these therapies in mHSPC patients. PATIENTS AND METHODS: Records of 93 patients from 21 different centres were retrospectively reviewed. Primary and secondary endpoints were radiographic and PSA progression-free survival (RPFS - PSA-PFS) and cancer specific and overall survival (CSS - OS), respectively. Adverse events (AEs) were evaluated according to the Common Terminology Criteria for Adverse Events version 5.0. Differences in oncological outcome and AEs were evaluated between three treatment groups: ADT only (N=26) - ADT + AAP (N=48) - ADT + docetaxel (N=19). Survival analysis was performed using Kaplan-Meier statistics. RESULTS: Median RPFS was 13 months (95% confidence interval [CI]: 9-17) for ADT only, 21 months (95% CI: 19-23) for ADT + AAP and 12 months (95% CI: 11-14) for ADT + docetaxel (p = 0.004). The 1-year PSA-PFS, CSS and OS were 73.5%, 90.7% and 88.7%, respectively, with no significant differences between the three groups. Adverse events of grade 3 or higher were not observed more frequently. CONCLUSION: Retrospective real-world data show a significantly longer RPFS for mHSPC patients treated with ADT + AAP compared to ADT only or ADT + docetaxel at short-term follow-up. This can aid in counselling of mHSPC patients in daily clinical practice