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Journal of Gastric Cancer Jul 2024Peritoneal carcinomatosis (PC) presents a major challenge in the treatment of late-stage, solid tumors, with traditional therapies limited by poor drug penetration. We...
PURPOSE
Peritoneal carcinomatosis (PC) presents a major challenge in the treatment of late-stage, solid tumors, with traditional therapies limited by poor drug penetration. We evaluated a novel hyperthermic pressurized intraperitoneal aerosol chemotherapy (HPIPAC) system using a human abdominal cavity model for its efficacy against AGS gastric cancer cells.
MATERIALS AND METHODS
A model simulating the human abdominal cavity and AGS gastric cancer cell line cultured dishes were used to assess the efficacy of the HPIPAC system. Cell viability was measured to evaluate the impact of HPIPAC under 6 different conditions: heat alone, PIPAC with paclitaxel (PTX), PTX alone, normal saline (NS) alone, heat with NS, and HPIPAC with PTX.
RESULTS
Results showed a significant reduction in cell viability with HPIPAC combined with PTX, indicating enhanced cytotoxic effects. Immediately after treatment, the average cell viability was 66.6%, which decreased to 49.2% after 48 hours and to a further 19.6% after 120 hours of incubation, demonstrating the sustained efficacy of the treatment. In contrast, control groups exhibited a recovery in cell viability; heat alone showed cell viability increasing from 90.8% to 94.4%, PIPAC with PTX from 82.7% to 89.7%, PTX only from 73.3% to 74.8%, NS only from 90.9% to 98.3%, and heat with NS from 74.4% to 84.7%.
CONCLUSIONS
The HPIPAC system with PTX exhibits a promising approach in the treatment of PC in gastric cancer, significantly reducing cell viability. Despite certain limitations, this study highlights the system's potential to enhance treatment outcomes. Future efforts should focus on refining HPIPAC and validating its effectiveness in clinical settings.
Topics: Humans; Stomach Neoplasms; Aerosols; Peritoneal Neoplasms; Paclitaxel; Hyperthermic Intraperitoneal Chemotherapy; Cell Survival; Cell Line, Tumor; Hyperthermia, Induced; Antineoplastic Agents, Phytogenic
PubMed: 38960884
DOI: 10.5230/jgc.2024.24.e24 -
Journal of Gastric Cancer Jul 2024
The Necessity of Guidance: Optimizing Adjuvant Therapy for Stage II/III MSI-H Gastric Cancer Through the Interplay of Evidence, Clinical Judgment, and Patient Preferences.
Topics: Humans; Stomach Neoplasms; Patient Preference; Chemotherapy, Adjuvant; Neoplasm Staging; Microsatellite Instability; Practice Guidelines as Topic; Clinical Reasoning
PubMed: 38960883
DOI: 10.5230/jgc.2024.24.e26 -
BMJ Open Jul 2024Despite universal access to government-funded direct-acting antivirals (DAAs) in 2016, the rate of hepatitis C treatment uptake in Australia has declined substantially....
INTRODUCTION
Despite universal access to government-funded direct-acting antivirals (DAAs) in 2016, the rate of hepatitis C treatment uptake in Australia has declined substantially. Most hepatitis C is related to injecting drug use; reducing the hepatitis C burden among people who inject drugs (PWID) is, therefore, paramount to reach hepatitis C elimination targets. Increasing DAA uptake by PWID is important for interrupting transmission and reducing incidence, as well as reducing morbidity and mortality and improving quality of life of PWID and meeting Australia's hepatitis C elimination targets.
METHODS AND ANALYSIS
A cluster randomised cross-over trial will be conducted with three intervention arms and a control arm. Arm A will receive rapid hepatitis C virus (HCV) antibody testing; arm B will receive rapid HCV antibody and rapid RNA testing; arm C will receive rapid HCV antibody testing and same-day treatment initiation for HCV antibody-positive participants; the control arm will receive standard of care. The primary outcomes will be (a) the proportion of participants with HCV commencing treatment and (b) the proportion of participants with HCV achieving cure. Analyses will be conducted on an intention-to-treat basis with mixed-effects logistic regression models.
ETHICS AND DISSEMINATION
The study has been approved by the Alfred Ethics Committee (number HREC/64731/Alfred-2020-217547). Each participant will provide written informed consent. Reportable adverse events will be reported to the reviewing ethics committee. The findings will be presented at scientific conferences and published in peer-reviewed journals.
TRIAL REGISTRATION NUMBER
NCT05016609.
TRIAL PROGRESSION
The study commenced recruitment on 9 March 2022 and is expected to complete recruitment in December 2024.
Topics: Humans; Antiviral Agents; Cross-Over Studies; Substance Abuse, Intravenous; Hepatitis C; Australia; Randomized Controlled Trials as Topic; Hepatitis C Antibodies; Hepacivirus
PubMed: 38960465
DOI: 10.1136/bmjopen-2023-083502 -
BMJ Open Jul 2024We aimed to evaluate the risk of colorectal adenocarcinoma (CRA) associated with long-term use of proton pump inhibitors (PPIs) in a large nationwide cohort.
OBJECTIVES
We aimed to evaluate the risk of colorectal adenocarcinoma (CRA) associated with long-term use of proton pump inhibitors (PPIs) in a large nationwide cohort.
DESIGN
Retrospective cohort study.
SETTING
This research was conducted at the national level, encompassing the entire population of Sweden.
PARTICIPANTS
This study utilised Swedish national registries to identify all adults who had ≥180 days of cumulative PPI use between July 2005 and December 2012, excluding participants who were followed up for less than 1 year. A total of 754 118 maintenance PPI users were included, with a maximum follow-up of 7.5 years.
INTERVENTIONS
Maintenance PPI use (cumulative≥180 days), with a comparator of maintenance histamine-2 receptor antagonist (HRA) use.
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary outcome measure was the risk of CRA, presented as standardised incidence ratios (SIRs) with 95% confidence intervals (CIs). Subgroup analyses were performed to explore the impact of indications, tumour locations, tumour stages and the duration of follow-up. A multivariable Poisson regression model was fitted to estimate the incidence rate ratios (IRRs) and 95% CIs of PPI versus HRA use.
RESULTS
Maintenance PPI users exhibited a slightly elevated risk of CRA compared to the general population (SIR 1.10, 95% CI=1.06 to 1.13) for both men and women. Individuals aged 18-39 (SIR 2.79, 95% CI=1.62 to 4.47) and 40-49 (SIR 2.02, 95% CI=1.65 to 2.45) had significantly higher risks than the general population. Right-sided CRA showed a higher risk compared to the general population (SIR 1.26, 95% CI=1.20 to 1.32). There was no significant difference in the risk of CRA between maintenance PPI users and maintenance HRA users (IRR 1.05, 95% CI=0.87 to 1.27, <0.05).
CONCLUSIONS
Maintenance PPI use may be associated with an increased risk of CRA, but a prolonged observation time is needed.
Topics: Humans; Proton Pump Inhibitors; Male; Colorectal Neoplasms; Female; Sweden; Retrospective Studies; Middle Aged; Aged; Adult; Histamine H2 Antagonists; Incidence; Adenocarcinoma; Risk Factors; Registries; Young Adult; Aged, 80 and over; Adolescent
PubMed: 38960460
DOI: 10.1136/bmjopen-2023-079591 -
Endoscopy Dec 2024
Topics: Humans; Barrett Esophagus; Endoscopic Mucosal Resection; Male; Dilatation; Middle Aged; Esophageal Neoplasms; Aged; Esophagoscopy
PubMed: 38959980
DOI: 10.1055/a-2346-4577 -
Endoscopy Dec 2024
Topics: Humans; Female; Rectovaginal Fistula; Foreign Bodies; Middle Aged
PubMed: 38959979
DOI: 10.1055/a-2344-8608 -
Endoscopy Dec 2024
Topics: Humans; Clofazimine; Intestine, Small; Female; Male; Middle Aged; Intestinal Diseases
PubMed: 38959978
DOI: 10.1055/a-2344-8244 -
Endoscopy Dec 2024
Combined endoscopic management of a postoperative rectocutaneous fistula after cystectomy using modified percutaneous endofistular and transanal endoluminal vacuum therapy.
Topics: Humans; Cystectomy; Rectal Fistula; Male; Negative-Pressure Wound Therapy; Aged; Postoperative Complications; Urinary Bladder Neoplasms
PubMed: 38959977
DOI: 10.1055/a-2344-7445 -
Endoscopy Dec 2024
Topics: Humans; Stomach Neoplasms; Gastric Fundus; Ligation; Gastroscopy; Female; Male; Gastrointestinal Stromal Tumors; Middle Aged; Sutures; Suture Techniques
PubMed: 38959975
DOI: 10.1055/a-2337-7647 -
Endoscopy Dec 2024
Topics: Humans; Endoscopic Mucosal Resection; Rectal Neoplasms; Traction; Rectum; Male
PubMed: 38959973
DOI: 10.1055/a-2344-7374