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Richards Stilling posted an update 6 months ago
Of the total number of recommendations, 60% had no accompanying citation and 28% of recommendations provided citations that did not directly support the statement made. Additionally, 52% of included documents did not state the methods of document development. That is, it was not clear if there was a literature review and/or expert consensus that was used to form recommendations included within. CONCLUSION Almost no cited evidence underpinning the extracted recommendations from the included guiding documents, nor any acknowledgement of this deficiency was established. There were limited explanations found for the methods involved in developing such guiding documents.BACKGROUND Although tumor grade, defined by either the nuclear grade (NG) or the histological grade (HG), is widely accepted as one of the prognostic factors for breast cancer, there is a limited direct comparison between these two grading systems. The object of the current study was to compare their prognostic capabilities on the same specimen in a single institutional cohort. METHODS We collected data from 1125 patients with breast cancer who underwent surgery at Kaizuka City Hospital between 2002 and 2016 and analyzed the prognostic capability of NG and HG in comparison with other clinicopathological factors. Pathological diagnoses were performed by a single pathologist throughout the study period. RESULTS The median follow-up was 52.9 months. During the follow-up period, 103 distant recurrences were observed. The concordance rate of grades between NG and HG was 72.1%. The 5-year recurrence-free survival (RFS) rates for patients with NG1, NG2, and NG3 were 90.6%, 91.8%, and 82.2%, respectively, and the rates for patients with HG1, HG2, and HG3 were 92.7%, 88.6%, and 82.5%, respectively. Significant differences in RFS were noted among each grade for HG. However, this was not true for NG; a significant difference was not noted between NG1 and NG2. In terms of subtypes, both NG3 and HG3 were significantly associated with worse outcomes in patients with ER-positive/HER2-negative tumors. CONCLUSIONS Although not a few patients exhibited discordant results between NG and HG, both NG and HG predict outcomes for breast cancer patients, but the latter might appear to be superior as a three-grade classification scale.BACKGROUND Cyclin-dependent kinase (CDK) 4/6 inhibitors represent a significant advancement in the treatment of estrogen receptor (ER)-positive human epidermal growth factor receptor 2-negative advanced breast cancer. However, mechanisms of alterations after acquired resistance to CDK4/6 inhibitors and the optimal treatment options are still not established. METHODS Abemaciclib-resistant cell lines were established from the models of estrogen deprivation-resistant cell lines which retained ER expression and activated ER function derived from MCF-7 breast cancer cell lines. Ribocilib-resistant cell lines were established in the same method as previously reported. RESULTS Both abemaciclib- and ribociclib-resistant cell lines showed decreased ER expression. ER transcriptional activity was maintained in these cell lines; however, the sensitivity to 4-hydroxytamoxifen and fulvestrant was almost completely lost. These cell lines did not exhibit any ERα gene mutation. Abemaciclib-resistant cell lines demonstrated low sensitivity to other CDK4/6 inhibitors; sensitivities to PI3K inhibitor, mTOR inhibitor, and chemotherapeutic drugs were maintained. CONCLUSIONS Dependence on ER signaling appears to decrease after the development of acquired resistance to CDK4/6 inhibitors. ML348 concentration Further, CDK4/6 inhibitor-resistant cells acquired cross-resistance to other CDK4/6 inhibitors, PI3K/Akt/mTOR inhibitor therapy and chemotherapeutic drugs might serve as optimal treatment options for such breast cancers.BACKGROUND At present, little is known about the genetic background of breast cancer (BC) in Kyrgyz. Therefore, the aim of this study was to assess gene-to-gene interactions and the contribution of p.Arg72Pro (TP53 gene), p.Gln399Arg (XRCC1 gene), p.Arg194Trp (XRCC1 gene), g.4682G > A (TNFα gene), p.Val353Ala (HMMR gene), c.14 + 309 T > G (MDM2 gene) and g.38444 T > G (PALB2 gene) polymorphic loci in breast cancer (BC) risk in females of Kyrgyz ethnicity. METHODS The case-control study comprised 103 females with histologically verified BC and 102 controls with no cancer. We used polymerase chain reaction-based restriction fragment length polymorphism to genotype polymorphic loci. RESULTS Gln/Arg heterozygous variant of XRCC1 gene’s p.Gln399Arg locus, as well as combined carriage of Arg/Gln//Arg/Pro of XRCC1/TP53; Arg/Gln//T/T of XRCC1/MDM2; Arg/Gln//G/G and Arg/Gln//G/A of XRCC1/TNFα, Arg/Gln//T/T of XRCC1/PALB2; Arg/Gln//Arg/Arg and Arg/Gln//Arg/Trp for p.Gln399Arg and p.Arg194Trp polymorphic loci of XRCC1 were associated with BC in Kyrgyz females. CONCLUSION TP53, XRCC1, TNFα, HMMR, MDM2 and PALB2 genes’ polymorphic site combinations appear to be candidate markers of genetic predisposition to BC in Kyrgyz population and prompt targeted personalized care.Older adults are the fastest growing segment of the population and surgical procedures in this group increase each year. Chronic post-surgical pain is an important consideration in the older adult as it affects recovery, physical functioning, and overall quality of life. It is increasingly recognized as a public health issue but there is a need to improve our understanding of the disease process as well as the appropriate treatment and prevention. Frailty, delirium, and cognition influence post-operative outcomes in older adults and have been implicated in the development of chronic post-surgical pain. Further research must be conducted to fully understand the role they play in the occurrence of chronic post-surgical pain in the older adult. Additionally, careful attention must be given to the physiologic, cognitive, and comorbidity differences between the older adult and the general population. This is critical for elucidating the proper chronic post-surgical pain treatment and prevention strategies to ensure that the older adult undergoing surgical intervention will have an appropriate and desirable post-operative outcome.