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Abstract: Although the availability of funding has been described as the major limitation on advances in cancer, the progress in the war on cancer has been deterred mainly by poor science, poorly trained scientists, and poor NIH policies. This is the result of NIH policies of its extreme focus on molecular biology (genomics, molecular genetics, molecular biology) identification of the molecular factors and pathways; which are required for the acceptability of treatment and preventive protocols. As such, this has influenced virtually all agencies that provide grants for medical research to adopt the NIH policies. This has impacted the funding of the research as well as the focus of the training of scientists. Directors of NCI Dr. Varmus (also Nobel Prize awardee) and Dr. Zerhouni had addressed this issue; and they rejected the necessity of molecular biology studies and information. NIH should return to the holistic physiological/pathophysiological approach to studies of cancer issues. This would provide the best approach for winning the war on cancer. Keywords: Cancer, NIH policies, training of scientists, excessive molecular biology, holistic physiological/pathophysiological approach. Download Full Article |
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Abstract: Background: Colorectal cancer (CRC) is the fourth most common cause of cancer death worldwide and has an annual incidence of 917,000 cases. In Ecuador the CRC is the fifteenth most common form of cancer and the fourth leading cause of cancer deaths. Aim: Our goal was to establish frequencies related to the polymorphic variants: (CA)n in the EGFR gene and A870G in the CCND1 gene and their influence on the development of CRC in the Ecuadorian population. Methods: This is a retrospective case-control study consisting of colorectal cancer patients (n = 96 cancer tissues) compared to a control group (n = 62 adjacent healthy tissues). For the sequencing of the fragments, PCR and Sanger method was used. Results: The polymorphic variant A870G in CCND1 has a genotype frequency for the common homozygous G/G = 0.69, for the heterozygous A/G = 0.25 and for the less frequent homozygous A/A = 0.06 in the control group. We studied 7 alleles, repeats 14-19 have been reported in other studies, but the 13 repeats allele was first described here. The most common number of repetitions was 18 with a frequency of 0.326 in patients and 0.25 in controls (χ2 = 22.58, p <0.01). The odds ratio showed that the risk of developing colorectal cancer is 5 times greater if the individual is carrying the heterozygous G/A (p <0.01). Meanwhile, if the individual is carrying the allele 'A' the risk is 4 times more likely to develop this disease (p <0.01). Keywords: Colorectal cancer, CCND1, A870G, polymorphic association. Download Full Article |
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Abstract: Introduction: This study evaluated the possibility of performing in our midst the open radical prostatectomy with discharge on the same day of the procedure, aiming the improvement of postoperative recovery and reduce hospital costs without loss of quality of care, or decreased patient satisfaction with treatment. Patients and Methods: We selected 27 patients with localized prostate cancer during the period from April 2011 to January 2012, which had a low surgical risk and opted for the open radical prostatectomy. We evaluated the feasibility of outpatient open radical prostatectomy, perioperative complications, and patient satisfaction with treatment. Results: Eleven (40.7%) patients were discharged on the same day of the procedure; thirteen were discharged in the morning after surgery and three in the second postoperative day. All patients underwent general anesthesia. The use of opioids in safe doses for epidural anesthesia was administered in 13 patients, improving pain control and enabling early discharge in 8 (61.5%) patients. Only 3 (21.4%) patients who did not receive epidural opioid achieved discharge on the same day of surgery (p = 0.04). No patient had a major complication or was readmitted to the hospital. There was no difference in patient satisfaction with treatment between the group of the same day surgery and the patients with longer hospitalization. Conclusion: The open radical prostatectomy can be performed with safety on an outpatient basis, in properly selected patients, with no decrease in patient satisfaction with treatment. Keywords: Prostate cancer, retropubic prostatectomy, day care, hospital costs, ambulatory surgical procedures.Download Full Article |
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Abstract: Melanoma incidence is increasing constantly worldwide in recent years: 132,000 melanoma skin cancers occur globally each year (WHO-INTERSUN). Despite this, no adequate evidence regarding the role of cumulative solar UV exposure in inducing the skin cancer has been provided. Recently, some studies appear to indicate that, also in patients with melanoma history, the habit of completely avoiding sun exposure is not a positive prognostic factor. According to IARC monograph published in 2012, evidences regarding UV risk factors for melanoma are the intermittent UV exposure with recurrent sunburns, especially in childhood and adolescence. According to these findings, various studies on occupational exposure to solar radiation (SR) failed to find an association between the performance of an outdoor job and the risk of melanoma. Recently, in Italy melanoma due to SR exposure has been erased from the national list of occupational diseases (D.P.R. 1124/65, last modification in 2014). But, in Europe an occupational health surveillance is needed for workers exposed to Artificial UV radiation according to EU Directive 2006/25/CE, and a skin examination for these workers is suggested, but quite paradoxically there are not similar indications for workers exposed to natural UV radiation. Considering the great number of outdoor workers employed in Europe, at least 14 million according to OSHA, and worldwide, the consideration of occupational solar radiation exposure as a specific professional risk requiring the health surveillance of exposed workers will be very helpful in order to prevent melanoma and other UV related diseases. Keywords: Malignant melanoma, occupational cancer, solar radiation, outdoor work, UV exposure prevention. Download Full Article |
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Abstract: Mammalian P-glycoproteins (P-gp) are members of the broad family of ABC transporters and play important physiological roles in establishing physical barriers that limit access of toxic compounds and thus in the pharmacokinetics of these compounds. Cancer cells exploit the presence of P-gp to fend off anti-cancer drugs, rendering them multidrug resistant (MDR). Structural investigations of P-gp involve the expression and isolation of this large integral membrane protein in high quality and in sufficient quantity for it to be amenable to electron microscopic (EM) and crystallographic studies. EM studies have defined the shape of the molecule and delineated its various conformations in solution but major breakthrough in obtaining atomic resolution structures of P-gp were accomplished by X-ray crystallography. Structures with increasing resolution and accuracy in various substrate and inhibitor bound forms are available for analysis and novel mechanistic insights have been obtained. These advances have paved the way for future research to further our understanding of the mechanism of P-gp function and development of potential inhibitors that may reverse MDR in cancer treatment. Keywords: P-glycoprotein, ABC transporters, Multidrug Resistance, Mechanisms, Structures. Download Full Article |