Background: The older population is very heterogeneous with regard to the co-morbidity and the physical reserve. This can result in unacceptably high postoperative complications rates. Th erefore, the aim of the study was to review the literature regarding the outcomes of older patients treated for pancreatic cancer, including the usage of minimal invasive techniques.
Methodology: A review of the literature was carried out including studies on pancreatic cancer in older patients published between 2011 and 2016.
Results: Seventeen retrospective studies were included. The total number of patients was 9981 with the age range of 65 years and more. Studies on surgical treatment alone (1.4%), neoadjuvant/adjuvant treatment with or without surgery (89.4%) and palliative therapy (9.2%) were assessed separately. Appropriate comparison was diffi cult due to the retrospective character and heterogeneity of the study population. Mortality was low, yet there was a great diff erence in morbidity ranging from some percent to even 100% of the study population. Long-term results were poor.
Conclusions: The functional status, not the chronological age alone, is the factor limiting therapeutic options in older patients with pancreatic cancer.
We talk to Prof. Bożena Kamińska-Kaczmarek from the Nencki Institute of Experimental Biology about treating cancer, obvious and impossible discoveries, and academic courage and strength.
Dr. Magdalena Winiarska from the Warsaw Medical University discusses what we know and don’t know about cancer, the importance of exchanging ideas in science and the meaning of success.
Purpose: The aim of this paper is to discuss exposure to stress and the incidence of occupational burnout among oncology nurses.
Methods: To study the discussed issue, we analyzed six full-text research papers which were searchable by EBSCO and met all required criteria (words included in the abstract, English publication, size of the study group).
Results: Exposure to chronic occupational stress may lead to developing burnout syndrome. Social service professionals are especially affected as they are expected to be emotionally engaged in their jobs, which particularly applies to such health care professionals as nurses, psychologists, police officers and social workers. Because of occupational burnout work efficiency may deteriorate. Oncology nurses are among the most affected nurse groups in terms of exposure to the risk of burnout.
Conclusions: Oncology nurses as well as other oncology workers exhibit an increased risk and a higher grade of burnout. Psychological training sessions are available which effectively prevent and alleviate the effects of burnout.
Ultrasound is used for breast cancer detection as a technique complementary to mammography, the standard screening method. Current practice is based on reflectivity images obtained with conventional instruments by an operator who positions the ultrasonic transducer by hand over the patient’s body. It is a non-ionizing radiation, pain-free and not expensive technique that provides a higher contrast than mammography to discriminate among fluid-filled cysts and solid masses, especially for dense breast tissue. However, results are quite dependent on the operator’s skills, images are difficult to reproduce, and state-of-the-art instruments have a limited resolution and contrast to show micro-calcifications and to discriminate between lesions and the surrounding tissue. In spite of their advantages, these factors have precluded the use of ultrasound for screening.
This work approaches the ultrasound-based early detection of breast cancer with a different concept. A ring array with many elements to cover 360◦ around a hanging breast allows obtaining repeatable and operator-independent coronal slice images. Such an arrangement is well suited for multi-modal imaging that includes reflectivity, compounded, tomography, and phase coherence images for increased specificity in breast cancer detection. Preliminary work carried out with a mechanical emulation of the ring array and a standard breast phantom shows a high resolution and contrast, with an artifact-free capability provided by phase coherence processing.
This paper presents simulations of a three-dimensional model of the bone remodelling process. The model consists of a set of variable order partial differential equations, in which the varying order depends on the presence of tumour cells. The simulations are of a two-dimensional bone, to make visualisation simpler. They show that this model corresponds to the known evolution of bone remodelling, and is simpler than integer order models found in the literature.
Psychotherapist and psycho-oncologist Justyna Pronobis-Szczylik talks about the need for tenderness and the insensitivities of the healthcare system.
Pancreatic ductal adenocarcinoma (PDAC) is characterized by very poor prognosis. It is caused by asymptomatic course of the disease at early stage. Symptomatic PDAC means usually advanced stage of the disease, making radical treatment impossible. Finding of biological PDAC marker could improve PDAC treatment through early diagnosis. In our study, we investigated two adipokines: omentin and chemerin concentration in PDAC, chronic pancreatitis (CP) and healthy individuals. We examined 27 PDAC patients, 10 CP patients and 36 controls. To determine concentration of adipokines we used ELISA immunoenzymatic assay. Level of both adipokines was increased when comparing control group to PDAC patients. Additionally, chemerin concentration in CP group was elevated comparing to control. To evaluate both adipokines as potential PDAC biomarkers we performed ROC analysis. Chemerin (AUC = 0.913) displayed better discriminant ability than omentin-1 (AUC = 0.73). Some authors believe that chemerin may promote tumour growth by stimulating angiogenesis and is supposed to be a factor recruiting mesenchymal stroma cells (MSC) in tumour regions. Omentin-1 can inhibit tumourigenesis by TP53 stimulation. On the other hand, according to some studies, omentin-1 may promote cancer proliferation via Akt signalling pathway. Results from our study showed signifi cantly elevated level of chemerin and omentin-1 in PDAC patients. Th erefore, w e believe that both investigated adipokines may provide promising and novel pharmacological insights for oncological diagnosis in the near future.
In the last few years, a great attention was paid to the deep learning Techniques used for image analysis because of their ability to use machine learning techniques to transform input data into high level presentation. For the sake of accurate diagnosis, the medical field has a steadily growing interest in such technology especially in the diagnosis of melanoma. These deep learning networks work through making coarse segmentation, conventional filters and pooling layers. However, this segmentation of the skin lesions results in image of lower resolution than the original skin image. In this paper, we present deep learning based approaches to solve the problems in skin lesion analysis using a dermoscopic image containing skin tumor. The proposed models are trained and evaluated on standard benchmark datasets from the International Skin Imaging Collaboration (ISIC) 2018 Challenge. The proposed method achieves an accuracy of 96.67% for the validation set .The experimental tests carried out on a clinical dataset show that the classification performance using deep learning-based features performs better than the state-of-the-art techniques.
Characterisation of copy number variation (CNV) and loss of heterozygosity (LOH) has pro- vided evidence for the relationship of this type of genetic variation with the occurrence of a broad spectrum of diseases, including cancer lesions. The role of CNVs and germinal or somatic LOHs in canine mammary tumours is still unknown. Therefore, the aim of this study was to identify CNVs and LOHs in canine mammary tumours. Forty-eight samples obtained from normal (n=24) and tumour (n=24) tissues of dogs were analysed. In the study, we used CanineHD BeadChip assay (Illumina) and OncoSNP software to identify copy number alternations in genomes of dif- ferent dog breeds and in different mammary cancer types occurring in this species. The analyses revealed that, in the case of CNV, the amplification-type variants were longer and more frequent than deletions. Based on the analysis of the frequency of different types of aberrations in the in- dividual parts of the genome, regions that are particularly susceptible to structural aberrations were indicated. The fraction of genes identified within these regions was associated with major processes of neoplastic transformation. Association analysis of such traits as tumour grading as well as the size and age of dogs demonstrated that structural aberrations were more frequent in dogs diagnosed with tumour malignancy grade II and III, in dogs with a larger body size, and in large dogs aged 7-8. The promising results of these pioneering investigations prompt continuation thereof to analyse other types of cancer.
Cells of a multicellular organism are genetically identical but differ in structure and function. This heterogeneity is created by several epigenetic mechanisms during the development of the organism. The epigenetic changes- including DNA methylation, histone post-translational modifications, chromatin remodeling and RNA interference have all been shown to control chromatin structure and regulate a plethora of cellular and organismal processes. There is a strong evidence that epigenetics play a crucial role in the development of diseases such as cancer, schizophrenia or metabolic disorders. The epigenetic regulation underlie memory formation or adaptation to external stimuli. The extent to which environmental effects can provoke epigenetic responses represents an exciting area of future research. Here we review the current knowledge about the epigenetic mechanisms and their relation to the human health and disease.
Minimally invasive procedures for the kidney tumour removal require a 3D visualization of topological relations between kidney, cancer, the pelvicalyceal system and the renal vascular tree. In this paper, a novel methodology of the pelvicalyceal system segmentation is presented. It consists of four following steps: ROI designation, automatic threshold calculation for binarization (approximation of the histogram image data with three exponential functions), automatic extraction of the pelvicalyceal system parts and segmentation by the Locally Adaptive Region Growing algorithm. The proposed method was applied successfully on the Computed Tomography database consisting of 48 kidneys both healthy and cancer affected. The quantitative evaluation (comparison to manual segmentation) and visual assessment proved its effectiveness. The Dice Coefficient of Similarity is equal to 0.871 ± 0.060 and the average Hausdorff distance 0.46 ± 0.36 mm. Additionally, to provide a reliable assessment of the proposed method, it was compared with three other methods. The proposed method is robust regardless of the image acquisition mode, spatial resolution and range of image values. The same framework may be applied to further medical applications beyond preoperative planning for partial nephrectomy enabling to visually assess and to measure the pelvicalyceal system by medical doctors.
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