Wednesday, June 20, 2012
paywalled: Nanocarrier systems for delivery of siRNA to ovarian cancer tissues, Expert Opinion on Drug Delivery
Nanocarrier systems for delivery of siRNA to ovarian cancer tissues, Expert Opinion on Drug Delivery
Expert opinion:
Gene silencing therapy based on siRNA represents a possible opportunity
for treatment of ovarian cancer patients. However, this approach
requires selection of suitable nanocarriers that can safely and
effectively deliver siRNA to the target site to induce its effect. Very
little work has been done in this field; therefore, it is a good
direction for future development.
paywalled: Cochrane Review - Removal of nail polish and finger rings to prevent surgical infection.
Cochrane Database Syst Rev. 2012 May 16;5:CD003325.
Removal of nail polish and finger rings to prevent surgical infection.
Abstract
BACKGROUND:
Surgical wound infections may be caused by the transfer of bacteria from the hands of surgical teams to patients during operations. Surgical scrubbing prior to surgery reduces the number of bacteria on the skin, but wearing rings and nail polish on the fingers may reduce the efficacy of scrubbing, as bacteria may remain in microscopic imperfections of nail polish and on the skin beneath rings.OBJECTIVES:
To assess the effect of the presence or absence of rings and nail polish on the hands of the surgical scrub team on postoperative wound infection rates.MAIN RESULTS:
We identified: no new trials; no RCTs that compared wearing of rings with the removal of rings; and no trials of nail polish versus no nail polish that measured surgical infection rates. We found one small RCT (102 scrub nurses) that evaluated the effect of nail polish on the number of bacterial colony forming units left on hands after pre-operative surgical scrubbing. Nurses had either unpolished nails, freshly-applied nail polish (less than two days old), or old nail polish (more than four days old). There were no significant differences in the number of bacteria on hands between the groups before and after surgical scrubbing.AUTHORS' CONCLUSIONS:
No trials have investigated whether wearing nail polish or finger rings affects the rate of surgical wound infection. There is insufficient evidence to determine whether wearing nail polish affects the number of bacteria on the skin post-scrub.Characteristics and Outcomes of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Patients with Cancer Treated with Vancomycin: 9-Year Experience at a Comprehensive Cancer Center - The Oncologist
Abstract
Abstract Background. Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) can cause significant morbidity and mortality in patients with cancer. However, data
on outcomes of patients treated with vancomycin are lacking.
Methods. We identified
223 patients with cancer who developed MRSA BSIs between January 2001
and June 2009 and were treated with vancomycin.
Treatment failure was defined as death within 60
days of infection, persistent bacteremia ≥5 days, fever ≥4 days,
recurrence
or relapse, and secondary MRSA infection.
Results. The treatment
failure rate was 52% (116 of 223 patients). These patients were more
likely to have been hospitalized, been
treated with steroids within the previous 3
months, developed acute respiratory distress syndrome, required
mechanical ventilation,
required intensive care unit care, and
community-onset infections (all p < .05). Risk factors for
MRSA-associated mortality (27 of 223 patients; 12%) included hematologic
malignancy and hematopoietic
stem cell transplantation, community-onset
infection, secondary BSI, MRSA with minimum inhibitory concentration
(MIC) ≥2.0
μg/mL, mechanical ventilation, and a late switch
to an alternative therapy (≥4 days after treatment failure; all p
< .05). On multivariate analysis, mechanical ventilation and recent
hospitalization were identified as independent predictors
of vancomycin failure, and community-onset
infection, secondary BSIs, and MIC ≥2 μg/mL were identified as
significant predictors
of MRSA-associated mortality.
Conclusions. We found a
high treatment failure rate for vancomycin in patients with cancer and
MRSA BSIs, as well as a higher mortality.
A vancomycin MIC ≥2 μg/mL was an independent
predictor of MRSA-associated mortality. An early switch to an
alternative therapy
at the earliest sign of failure may improve
outcome.
paywalled: Causes of death of mutation carriers in Finnish Lynch syndrome families.
Fam Cancer. 2012 Jun 9. [Epub ahead of print]
Abstract
Lynch syndrome (LS) is an autosomal dominant cancer syndrome including increased life-long risk for colorectal (CRC) and endometrial (EC) cancer, but also for cancers of other types. The risk for CRC is up to 70-80 % and for EC up to 50-60 %. Due to screening and early diagnosing the mortality related to CRC and EC seems to be low. In spite of many studies on surveillance of mutation carriers, there is no comprehensive evaluation on causes of death in LS families. The disease history and cause of death of all the deceased, tested mutation carriers and their mutation negative relatives in the Finnish LS families (N = 179) was examined utilizing hospital records and relevant national registries. Out of 1069 mutation carriers 151 had succumbed; 97 (64 %) from cancer. Out of 1146 mutation-negative family 44 members had died; 11 (25 %) of them from cancer. In 12 (7.7 %) of the deceased mutation carriers no cancer had been diagnosed. The mean age of death from cancer was 63.2 years vs. 68.8 years from non-cancer causes. Only 7.9 % of the patients with CRC had died from CRC and 5 % of those with EC, respectively. 61 % of the cancer deaths were related to extra-colonic, extra-endometrial cancers. The cumulative overall and cancer specific death rates were significantly increased in Mut+ compared to Mut- family members. Even surveillance yields decrease in the life-long risk and mortality of the most common cancers CRC and EC in LS, almost all mutation carriers will contract with cancer, and two thirds of the deceased have died from cancer. This should be taken in account in genetic counseling. Mutation carriers should be encouraged to seek help for abnormal symptoms.
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