Exploring the Biochemistry of Calorie Restriction
View the Article Under Discussion: http://pmid.us/18225956
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The trial, designed as a safety study, successfully showed that BrachySilTM, in combination with standard chemotherapy (gemcitabine), was well tolerated with no clinically significant adverse events related to BrachySil. Data showed disease control in 82% of patients and an overall median survival of 309 days. BrachySil was found to be easily deliverable by endoscopic ultrasound. BrachySilTM is a novel oncology product which comprises a combination of BioSiliconTM, a proprietary porous silicon, and the isotope 32Phosphorus, a proven anti-cancer therapeutic.
"These findings are very interesting, and although this was a small study and was not designed to prove efficacy, these results are encouraging," said Dr. Ross.
In the trial, seventeen patients were treated with BrachySil injected directly into the primary tumors via endoscopic ultrasound (used to assist in locating the delivery point). All patients had advanced inoperable pancreatic cancer and received gemcitabine in addition to BrachySil. CT assessments of response were performed at weeks 8, 16 and 24. The study was conducted at three major centers for cancer therapy: Guy's and St Thomas' NHS Foundation Trust, UK, University Hospital Birmingham NHS Foundation Trust, UK and Singapore General Hospital.
Pancreatic cancer is the fourth most frequent cause of cancer death, and at least 80% of patients present with inoperable locally advanced or metastatic disease. The median survival for these patients following diagnosis is typically less than six months with standard chemotherapy. Accordingly, there is significant clinical and market demand for more effective therapies.
Dr Paul Ashton, Managing Director of pSivida Limited, the company that developed BrachySil and sponsored the trial, said, "We are very pleased with the favorable results of this study of BrachySil for the treatment of advanced, inoperable pancreatic. Our next step for BrachySil is a dose-ranging study planned to commence this quarter."
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Researchers at McMaster University have found a mechanism that explains why an infant's ability to respond to oxygen deprivation after birth-or a hypoxic episode-is dramatically compromised by exposure to nicotine in the womb, even light to moderate amounts.
The findings are published online in the journal Federation of American Societies for Experimental Biology (FASEB) and will appear in the May 2008 print issue.
"While cigarette smoke contains many different compounds, we found there is a direct impact of one component, nicotine, on the ability of certain cells to detect and respond to oxygen deprivation," says Josef Buttigieg, lead author and a PhD graduate student in the department of Biology. "When a baby is lying face down in bed, for example, it should sense a reduction in oxygen and move its head. But this arousal mechanism doesn't work as it should in babies exposed to nicotine during pregnancy."
The research, which was conducted on laboratory rats in collaboration with Dr. Alison Holloway, explains the critical role that catecholamines-a group of hormones released by the adrenal glands-play in a baby's transition to the outside world.
During birth, the baby is exposed to low oxygen, which signals the adrenal glands to release the catecholamines, which contain adrenaline, or the 'fight or flight' hormone, explains Buttigieg.
It is these catecholamines that signal the baby's lungs to reabsorb fluid, to take its first breath, and help the heart to beat more efficiently. And for some months after birth, the adrenal gland still acts as an oxygen sensor, aiding in the baby's arousal and breathing responses during periods of apnea or asphyxia. But the ability to release catecholamines during these moments-a critical event in the adaptation of life outside the womb-is impaired due to nicotine exposure.
"At birth, the nervous control of the adrenal gland is not active and so a baby relies on these direct oxygen sensing mechanisms to release catecholamines," says Colin Nurse, academic advisor on the study and a professor in the department of Biology. "But nicotine causes premature loss of these mechanisms, which would normally occur later in development after nervous control is established. Thus, the infant becomes much more vulnerable to SIDS."
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The results, from the Digital Mammographic Imaging Screening Trial (DMIST), appear in the February issue of Radiology. UNC's Dr. Etta D. Pisano is principal investigator and lead author of the study, which found that digital mammography performed better than film mammography for pre- and perimenopausal women under age 50 with dense breasts.
"We looked at a cross-section of characteristics," Pisano said. "This paper confirms that if you are under 50, pre- or perimenopausal, and have dense breasts, you should definitely be screened with digital rather than film."
Pisano is Kenan professor of radiology and biomedical engineering and vice dean for academic affairs and in the UNC School of Medicine. She is also director of the Biomedical Research Imaging Center and a member of UNC Lineberger Comprehensive Cancer Center.
DMIST enrolled 49,528 women at 33 centers in the U.S. and Canada. The women underwent both digital and film mammography. Breast cancer status was determined for 42,760 women.
"The original DMIST results showed that digital was statistically similar to film in the overall screening population but performed better than film in pre- and perimenopausal women under 50," Pisano said.
For this paper, the researchers sought to retrospectively compare the accuracy of digital mammography versus film mammography in subgroups defined by combinations of age, menopausal status and breast density, using either biopsy results or follow-up information.
They compared results in 10 different subgroups of women: pre- and perimenopausal women under age 50 with fatty breasts, pre- and perimenopausal women under age 50 with dense breasts, postmenopausal women under 50 with fatty breasts, postmenopausal women under 50 with dense breasts, pre- and perimenopausal women between the ages of 50 and 64 with fatty breasts, pre- and perimenopausal women age 50 to 64 with dense breasts, postmenopausal women age 50 to 64 with fatty breasts, postmenopausal women age 50 to 64 with dense breasts, women over age 65 with fatty breasts and women over 65 with dense breasts.
The results confirmed the trial's original findings in favor of improved diagnostic accuracy of digital mammography over film for pre- and perimenopausal women under 50 years old with dense breasts. The findings also showed a trend toward improved diagnostic accuracy of film over digital mammography for women over 65 with fatty breasts. However, this finding was not statistically significant, and further investigation is needed to determine the reason that film performed slightly better in this subgroup. For other groups evaluated, there was no significant difference.
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