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Editor’s Choice : Experience with Lexicomp® Online Drug Database for Medication Review and Drug-Drug Interaction Analysis within a Comprehensive Geriatric Assessment in Elderly Cancer Patients
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Abstract: Background: We studied the use of Lexicomp®, an online drug information database, for adequate identification of drug-drug interactions (DDIs) within Comprehensive Geriatric Assessment (CGA) in cancer patients. Materials and Methods: Data of 149 onco-geriatric patients were reviewed. Sixty-three percent participated in an observational study recruiting head and neck cancer patients (H&N-group), 37% in a registry recruiting general oncology patients (GO-group). Baseline drug information was collected by a health professional, through the medical interview within CGA. Drug class usage was quantified and potential DDIs were assessed and categorized (risk rating "C": monitor therapy, "D": consider therapy modification, "X": avoid combination) with Lexicomp®. Results: On average, H&N and GO-patients took 5 and 8 prescription drugs at presentation, respectively. An average of 4 drugs were added in both groups as part of their proposed therapy. Potential DDIs (n=211 H&N; n=247 GO) were detected by Lexicomp® in 64.9% (85.3% "C", 14.7% "D", 0% "X") and 83.6% (83.4% "C", 15.8% "D", 0.8% "X") of H&N and GO patients, respectively, at therapy start. Administration of cancer-therapy-related drugs lead to additional DDIs (n=75 H&N; n=68 GO) in 73.7% and 58.3% of H&N and GO cases, respectively. DDIs occurred mainly with supportive drugs (100% H&N and 83.8% GO). Sixteen percent of potential DDIs were identified with anti-neoplastic drugs in the GO-group. In 28.7% and 60.0% of H&N and GO patients, respectively, at least one drug was not recognized by Lexicomp®. Conclusions: Use of Lexicomp® drug database within CGA is feasible. It could reduce the administration of inappropriate drugs, and in that way improve the quality of patient-individualized therapy. Keywords: Elderly cancer patients, polypharmacy, Comprehensive Geriatric Assessment, Lexicomp® online drug database, drug-drug interactions, safe prescription behavior, cancer treatment.Download Full Article |
Editor’s Choice : Innovations in Analytical Oncology - Status quo of Mass Spectrometry-Based Diagnostics for Malignant Tumor
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Abstract: Recent innovations in mass spectrometry make it possible to diagnose malignant tumors through a rapid, non-destructive and less-expensive way. One of the important facets in this achievement lies in the development of several superior ionization techniques that are essentially derivatives of two authentic methods; matrix-assisted laser desorption ionization (MALDI) and electrospray ionization (ESI). In this review article, we introduce a novel cancer diagnostic system based on probe electrospray ionization (PESI) and logistic regression algorithm. This method uses a very fine needle with a tip diameter of several hundreds nm, which serves as a sampling as well as ionization device. Only a few picolitre (pL) of sample are sufficient to acquire mass spectra for making a diagnosis. Furthermore, as this method does not require any sample pre-treatments that often disorganize the original molecular composition of samples, it has a potential in delineating substances that have been missed by conventional analytical methods. By implementing this technology, we have successfully made in situ diagnosis of malignant tumors in human tissues and in living animals. On the other hand, there are two promising and competitive diagnostic methods; one is desorption ionization mass spectrometry (DESI-MS), and the other is rapid evaporation ionization mass spectrometry (REI-MS) coupled with electrical surgical knife. They are also promising technologies in the new era of analytical oncology. We compare these three methods briefly and attempt to give a new perspective in cancer diagnostics. Keywords: Cancer, Diagnosis, Imaging, Electrospray, Ionization, Regression, Surgery.Download Full Article |
Editor’s Choice : Reflectance Confocal Microscopy – Real-Time In Vivo Imaging of Basal and Squamous Cell Carcinomas
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Abstract: Reflectance and confocal microscopy (RCM) is an in vivo non-invasive imaging tool that captures horizontal images of the epidermis and superficial dermis at nearly the same resolution of routine histopathology. Due to the overlying superficial scaling, RCM characterization of squamous cell carcinomas (SCCs) and associated keratinizing tumors is difficult to visualize due to the obscure appearance of underlying structures. To date, although an increasing frequency of abnormal RCM features are observed across the spectrum, only a few authors have described the features of SCCs. One recent study suggested a disarranged and atypical honeycomb pattern along with round nucleated cells within the spinous/granular layers and round vessels traversing through dermal papilla as key features of SCC. Meanwhile several RCM features have been linked to basal cell carcinomas (BCCs) regardless of type including:
Our objective is to identify and describe characteristic RCM findings of SCCs and BCCs by imaging biopsy-proven lesions and reviewing the most recent literature. We will also explain how these features may facilitate diagnosis and recognize future trends for research. Applications of RCM criteria concerning surgical management of these lesions will also be discussed. Keywords: Reflectance confocal microscopy, Basal cell carcinomas, Squamous cell carcinomas, Actinic keratosis, In vivo, Non-melanoma skin cancer, Imaging.Download Full Article |
Editor’s Choice : Imaging Analysis of Ameloblastoma of Mandible – 5 Cases
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Abstract: Ameloblastoma is the most common odontogenic tumor of the jaws. It is seen in all age groups but the lesion is most commonly diagnosed in the third and fourth decades. It is often asymptomatic, presents as a slowly enlarging swelling or an incidental finding on a radiograph. Radiologically, usually appears as multilocular radiolucency with well defined and corticated borders but can also presents as unilocular radiolucency. Other radiological findings commonly associated are tooth displacement, and root resorption. Computed tomography (CT) shows cortical expansion and in some cases even cortical perforation. Ameloblastoma is a locally destructive tumor with a propensity for recurrence if not entirely excised. In this paper, we report 5 cases of ameloblastoma of mandible collected over the period of 8 months with various imaging findings and their analysis using panoramic radiograph under conventional radiography and CT scan under advanced imaging which may further aid in optimal treatment planning and outcome. Keywords: Ameloblastoma, mandible, CT, bicortical expansion.Download Full Article |
