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Abstract: Radiotherapy-associated angiosarcoma (RAA) of the breast is a rare complication of radiotherapy, which is often difficult to identify and has poor prognosis. It usually presents as violaceous skin, erythema or rapidly growing palpable firm mass that can be confused with other benign skin lesions. Patients and methods After reviewing the literature, we found only four cases with RAA after mastectomy and autologous breast reconstruction. The presented case is the first that was treated by electrochemotherapy. The patient presented with secondary angiosarcoma of the breast five years after mastectomy, immediate breast reconstruction with deep inferior epigastric artery perforator free flap and adjuvant radiotherapy. Results Electrochemotherapy was feasible, safe and effective in treatment of radiation induced sarcoma. Most of the treated lesions in several consecutive electrochemotherapy sessions responded with complete response, but multiple recurrences occurred in non-treated areas. Conclusions Patients with breast cancer after skin-sparing mastectomy and immediate breast reconstruction, who receive radiotherapy, need regular long-term follow up and low threshold for biopsy of any suspicious lesions is mandatory. Electrochemotherapy proved as one of feasible modalities of treatment for RAA.
Keywords: angiosarcoma, breast reconstruction, breast cancer, electrochemotherapy
Published in DiRROS: 22.07.2024; Views: 451; Downloads: 138
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Abstract: Background. Ovarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125. Patients and methods. At the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS). Results. The median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4%9.5) and 18 months (95% CI 12.5%23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6%29.5) and 46 months (95% CI 32.9%62.1), respectively. Conclusions. Preoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.
Keywords: ovarian cancer, tumour marker, neoadjuvant chemotherapy, CA-125
Published in DiRROS: 22.07.2024; Views: 315; Downloads: 114
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Abstract: For mitigation of the effects of pollution, the media, policy makers and, in turn, the scientific community and industry each provide contributions through development of a sense of urgency, and with guidelines and solutions. For non-indigenous species (NIS) that can frequently have negative impacts on the native biota, this is often conveyed in an emotive way to the general public, who are typically keen to help and to get personally involved. This might be through organization of cleaning campaigns, influence on the media, or collaboration with scientists, to inform them of the local presence and abundance of NIS. Alternatively, they might proactively develop technological solutions themselves. To assess the current state of affairs, we reviewed the presence and effects of NIS in the Mediterranean Sea. As so often, any well-planned and successful activity is directly linked to financing, or a lack thereof, and this leads to sometimes untargeted and sporadic measures that are developed within a project or over a limited timeframe, without any sustainability measures. Therefore, we also assessed the activities and strategies that have been financed in this area of NIS mitigation. Based on this review of the presence and impact of NIS, and previous and ongoing activities, we propose a new paradigm to mitigate such pollution: the 8Rs model (i.e., Recognize, Reduce, Replace, Reuse, Recycle, Recover/Restore, Remove, and Regulate). This model extends from the more traditional 3Rs model (i.e., Reduce, Reuse, and Recycle) that is often used and promoted for innovative waste management strategies. Importantly, the 8Rs model can be applied sequentially, for either prevention of NIS introduction, or preparation of mitigation measures. The 8Rs model was constructed based on Mediterranean NIS, although we believe it can be applied to other sources of pollution and other geographic areas. Importantly, the 8Rs model represents a general framework to organize and categorize future pollution mitigation strategies. This approach is essential for development of any action plan to influence the administrative and financial decision makers who essentially enable these activities, and therefore who have important roles in the guarantee of sustainability of these actions, and the creation of innovative societies.
Keywords: non-indigenous species, pollution mitigation, pollution mitigation, 8Rs model, quadruple helix, Mediterranean Sea, citizen science, communication, sustainability
Published in DiRROS: 22.07.2024; Views: 378; Downloads: 258
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Abstract: Agricultural intensification and associated loss of high-quality habitats are key drivers of insect pollinator declines. With the aim of decreasing the environmental impact of agriculture, the 2014 EU Common Agricultural Policy (CAP) defined a set of habitat and landscape features (Ecological Focus Areas: EFAs) farmers could select from as a requirement to receive basic farm payments. To inform the post-2020 CAP, we performed a European-scale evaluation to determine how different EFA options vary in their potential to support insect pollinators under standard and pollinator-friendly management, as well as the extent of farmer uptake. A structured Delphi elicitation process engaged 22 experts from 18 European countries to evaluate EFAs options. By considering life cycle requirements of key pollinating taxa (i.e. bumble bees, solitary bees and hoverflies), each option was evaluated for its potential to provide forage, bee nesting sites and hoverfly larval resources. EFA options varied substantially in the resources they were perceived to provide and their effectiveness varied geographically and temporally. For example, field margins provide relatively good forage throughout the season in Southern and Eastern Europe but lacked early-season forage in Northern and Western Europe. Under standard management, no single EFA option achieved high scores across resource categories and a scarcity of late season forage was perceived. Experts identified substantial opportunities to improve habitat quality by adopting pollinator-friendly management. Improving management alone was, however, unlikely to ensure that all pollinator resource requirements were met. Our analyses suggest that a combination of poor management, differences in the inherent pollinator habitat quality and uptake bias towards catch crops and nitrogen-fixing crops severely limit the potential of EFAs to support pollinators in European agricultural landscapes. Policy Implications. To conserve pollinators and help protect pollination services, our expert elicitation highlights the need to create a variety of interconnected, well-managed habitats that complement each other in the resources they offer. To achieve this the Common Agricultural Policy post-2020 should take a holistic view to implementation that integrates the different delivery vehicles aimed at protecting biodiversity (e.g. enhanced conditionality, eco-schemes and agri-environment and climate measures). To improve habitat quality we recommend an effective monitoring framework with target-orientated indicators and to facilitate the spatial targeting of options collaboration between land managers should be incentivised.
Keywords: agri-environment schemes, bees, CAP Green Architecture, Common Agricultural Policy, Ecological Focus Areas, habitat complementarity, pollination services, pollinator conservation
Published in DiRROS: 22.07.2024; Views: 383; Downloads: 345
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Abstract: In genetic toxicology, there is a trend against the increased use of in vivo models as highlighted by the 3R strategy, thus encouraging the development and implementation of alternative models. Two-dimensional (2D) hepatic cell models, which are generally used for studying the adverse effects of chemicals and consumer products, are prone to giving misleading results. On the other hand, newly developed hepatic three-dimensional (3D) cell models provide an attractive alternative, which, due to improved cell interactions and a higher level of liver-specific functions, including metabolic enzymes, reflect in vivo conditions more accurately. We developed an in vitro 3D cell model from the human hepatocellular carcinoma (HepG2) cell line. The spheroids were cultured under static conditions and characterised by monitoring their growth, morphology, and cell viability during the time of cultivation. A time-dependent suppression of cell division was observed. Cell cycle analysis showed time-dependent accumulation of cells in the G0/G1 phase. Moreover, time-dependent downregulation of proliferation markers was shown at the mRNA level. Genes encoding hepatic markers, metabolic phase I/II enzymes, were time-dependently deregulated compared to monolayers. New knowledge on the characteristics of the 3D cell model is of great importance for its further development and application in the safety assessment of chemicals, food products, and complex mixtures.
Published in DiRROS: 22.07.2024; Views: 306; Downloads: 223
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