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.
Cochrane Database Syst Rev. 2012 May 16;5:CD003325.
Removal of nail polish and finger rings to prevent surgical infection.
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 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.
Fam Cancer. 2012 Jun 9. [Epub ahead of print]