Imaging biomarker roadmap for cancer studies.

Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.Development of this roadmap received support from Cancer Research UK and the Engineering and Physical Sciences Research Council (grant references A/15267, A/16463, A/16464, A/16465, A/16466 and A/18097), the EORTC Cancer Research Fund, and the Innovative Medicines Initiative Joint Undertaking (grant agreement number 115151), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in kind contribution

Systemic HIV and SIV latency reversal via non-canonical NF-κB signalling in vivo

Long-lasting, latently infected resting CD4+ T cells are the greatest obstacle to obtaining a cure for HIV infection, as these cells can persist despite decades of treatment with antiretroviral therapy (ART). Estimates indicate that more than 70 years of continuous, fully suppressive ART are needed to eliminate the HIV reservoir1. Alternatively, induction of HIV from its latent state could accelerate the decrease in the reservoir, thus reducing the time to eradication. Previous attempts to reactivate latent HIV in preclinical animal models and in clinical trials have measured HIV induction in the peripheral blood with minimal focus on tissue reservoirs and have had limited effect2–9. Here we show that activation of the non-canonical NF-κB signalling pathway by AZD5582 results in the induction of HIV and SIV RNA expression in the blood and tissues of ART-suppressed bone-marrow–liver–thymus (BLT) humanized mice and rhesus macaques infected with HIV and SIV, respectively. Analysis of resting CD4+ T cells from tissues after AZD5582 treatment revealed increased SIV RNA expression in the lymph nodes of macaques and robust induction of HIV in almost all tissues analysed in humanized mice, including the lymph nodes, thymus, bone marrow, liver and lung. This promising approach to latency reversal—in combination with appropriate tools for systemic clearance of persistent HIV infection—greatly increases opportunities for HIV eradication

La santé publique à l'interface des parcours de vie: l'exemple du tabac en milieu carcéral

Le milieu carcéral est par essence un microcosme où les intérêts individuels et collectifs s'affrontent de manière plus aiguë qu'ailleurs. Les enjeux liés à toute action de santé publique y sont mis en évidence, notamment la nécessité d'une implication de tous les acteurs concernés (réd)

Une consultation pour les femmes tabagiques ::l’apport de la sage-femme

Les femmes enceintes n’arrêtent pas toutes de fumer lorsqu’elle apprennent leur grossesse, malgré les risques du tabagisme. Les auteur-e-s de cet article présentent les résultats de différents types d’interventions et mettent en évidence la pertinence d’une prise en soins des femmes fumeuses par les sages-femmes

Self-efficacy for smoking cessation vs. temporary abstinence: two aspects of a complex process

Introduction Smokers receiving mental health care are particularly in need of tailored interventions. Objective Study of patients enrolled in a specialized smoking cessation program based upon a 26-hour smoking abstinence period aimed better understanding of self-efficacy for smoking cessation and of the decision to quit. Methods A logistic regression predicting success/failure of abstinence included different variables. Self-efficacy for temporary abstaining from smoking (TASE) and for permanent quitting (QSE) were distinguished. Results In 174 subjects enrolled at baseline, TASE was the only predictor of successful abstinence (OR=1.43; p=.001). Assessment of 138 subjects present 1 week after intervention showed increases in TASE and QSE (median TASE from 8 to 10, p<.0001; median QSE from 8 to 9, p=.02). In subgroups of successful abstainers and of those engaging into smoking cessation, only TASE increased. Interestingly, for subjects who had planned a quit attempt already before the intervention, 52% were still abstinent at 1 week vs. 87% of those who decided to quit during the intervention (p=.02). Conclusion A multicomponent program for all smokers can be a powerful method to increase self-efficacy, in particular for temporary smoking abstinence, and trigger unplanned quit attempts, shown here to be more successful than planned attempts

An innovative smoking cessation program using Facebook reaching 7´000 Swiss smokers

Background Tobacco smoking causes multiple diseases, premature mortality and is a major public health threat. In Switzerland, smoking prevalence is high (25%) but stable since 2011. Half of smokers want to quit but they underuse effective smoking cessation services. Programs using social networks are a new smoking cessation approach potentially able to reach many smokers. We designed, implemented and tested an innovative large-scale smoking cessation program using Facebook for 7 months in 2016 in 4 states of Switzerland. Methods 7008 smokers were enrolled within 2 months through Facebook advertising. The program created 4 communities of smokers of each state interacting on a Facebook page. 2400 Facebook publications, which triggered 67000 comments, stimulated interaction. After a 3-week preparation providing information and advice, all participants quit smoking together on March 21, 2017. Then, they received mutual support from peers and professional help daily during 6 months. Professional support included 3 levels: community managers watching and regulating the activity; counsellors providing personalised smoking cessation counselling; physicians providing personalised counselling for complex and medical issues. Personalised counselling at 2 nd and 3 rd levels included help for cessation plans, relapse prevention strategies and use of nicotine replacement. Evaluation surveys were conducted at 1 week, 3 and 6 months among 1270 participants, of whom 37% responded. Results 81% of participants attempted to stop smoking. At 6 months,13.5% reported total smoking abstinence while 19% were trying to quit despite occasional consumption. Smoking cessation was not associated with socio-demographic factors. The community dynamics, a strong intention to quit and relapse prevention strategies predicted success while high nicotine dependence, exposure to smokers and negative affect were negative predictors. Conclusions A large-scale smoking cessation program using Facebook, providing mutual and professional support seems effective to reach large numbers of smokers, stimulate smoking cessation attempts and promote smoking abstinence at 6 months

Gynécologie-obstétrique. Aide à l’arrêt du tabac en période périnatale ::pourquoi et comment ?

Le tabagisme en Suisse, et particulièrement chez la femme enceinte, est un problème majeur de santé publique. Les problèmes de santé que rencontrent les femmes enceintes et leurs fœtus nécessitent une prise en soins spécifique pour le soutien à l’abstinence tabagique. Une consultation spécifique d’aide au sevrage tabagique durant la grossesse a été créée en mai 2019 à la maternité des HUG, avec le soutien de la Fondation privée des HUG et de Carrefour addictionS/Centre d’information pour la prévention du tabagisme de Genève. La création d’un réseau d’aide par les professionnels formés en tabacologie de base constitue une étape importante pour soutenir les femmes durant le sevrage tabagique

Withdrawal symptoms upon a short motivational 26-hour smoking abstinence program in psychiatric patients

Background Concerns about withdrawal effects and worsening of mental health conditions are barriers to proposing smoking cessation to psychiatric patients. Methods The study included 156 smokers who attended public psychiatric services and participated in a motivational intervention that included a 26-hour tobacco abstinence period and other components*. Carbon monoxide levels and withdrawal symptoms (MNWS) were evaluated at pre- (3 days before), during (9 hr and 26 hr abstinence) and post-intervention (7 days after). Results Irritability, anxiety, depressed mood and concentration difficulties significantly decreased during the intervention (pre- and 26 hr comparison), both for patients who did and did not succeed with smoking abstinence. Whereas craving decreased for those who succeeded, it remained elevated for those not succeeding. [MNWS scores (0-4)] Conclusions Results are at odds with usual observations of increased discomfort associated with smoke deprivation and suggest that mental health patients may tolerate short abstinence periods, without worsening of their mental health condition. Although not systematically observed, craving may remain an obstacle for a subgroup of patients. We hypothesize that behavioural associations, habits and environmental factors could be more important obstacles when stopping smoking than usual withdrawal effects. _________ *Keizer, I., Gex-Fabry, M., Croquette, P. and Khan, A. N. (2016). A Short Motivational Program Based on Temporary Smoking Abstinence: Towards Increased Self-Efficacy to Quit in Psychiatric Inpatients . Journal of Addiction Research &amp; Therapy, 7:4

Implementation and impact of anti-smoking interventions in three prisons in the absence of appropriate legislation

To assess the acceptability and impact of anti-smoking policies in three prisons in Switzerland.; A before-after intervention study in A) an open prison for sentenced prisoners, B) a closed prison for sentenced prisoners, and C) a prison for pretrial detainees. Prisoners and staff were surveyed before (2009, n=417) and after (2010-2011, n=228) the interventions. Medical staff were trained to address tobacco dependence systematically in prisoners. In prison A, a partial smoking ban was extended. No additional protection against second-hand smoke was feasible in prisons B and C.; In prison A, more prisoners reported receiving medical help to quit smoking in 2011 (20%) than in 2009 (4%, p=0.012). In prison A, prisoners and staff reported less exposure to second-hand smoke in 2011 than in 2009: 31% of prisoners were exposed to smoke at workplaces in 2009 vs 8% in 2011 (p=0.001); in common rooms: 43% vs 8%, (p>0.001). No changes were observed in prisons B and C.; Reinforcement of non-smoking rules was possible in only one of the three prisons but had an impact on exposure to tobacco smoke and medical help to quit. Implementing anti-smoking policies in prisons is difficult in the absence of appropriate legislation