Trastuzumab and first-line taxane chemotherapy in metastatic breast cancer patients with a HER2-negative tumor and HER2-positive circulating tumor cells: a phase II trial.

PURPOSE: HER2 overexpressing circulating tumor cells (CTCs) are observed in up to 25% of HER2-negative metastatic breast cancer patients. Since targeted anti-HER2 therapy has drastically improved clinical outcomes of patients with HER2-positive breast cancer, we hypothesized that patients with HER2 overexpressing CTCs might benefit from the addition of trastuzumab to chemotherapy. METHODS: In this single-arm, phase II trial, patients with HER2-positive CTCs received trastuzumab as addition to first-line treatment with taxane chemotherapy. Patients with detectable CTCs but without HER2 overexpression that received taxane chemotherapy only, were used as control group. The primary outcome measure was progression-free rate at 6 months (PFR6), with a target of 80%. In November 2022, the study was terminated early due to slow patient accrual. RESULTS: 63 patients were screened, of which eight patients had HER2-positive CTCs and were treated with trastuzumab. The median number of CTCs was 15 per 7.5 ml of blood (range 1-131) in patients with HER2-positive CTCs, compared to median 5 (range 1-1047) in the control group. PFR6 was 50% in the trastuzumab group and 54% in the taxane monotherapy group, with no significant difference in median PFS (8 versus 9 months, p = 0.51). CONCLUSION: No clinical benefit of trastuzumab was observed, although this study was performed in a limited number of patients. Additionally, we observed a strong correlation between the number of evaluable CTCs and the presence of HER2-positive CTCs. We argue that randomized studies investigating agents that are proven to be solely effective in the HER2-positive patient group in patients with HER2-positive CTCs and HER2-negative tissue are currently infeasible. Several factors contribute to this impracticality, including the need for more stringent thresholds, and the rapidly evolving landscape of cancer treatments.

Food impaction on three-dimensional printed models with periodontal ligament simulation.

OBJECTIVE: This study aims to evaluate food impaction on three-dimensional (3D) printed models with periodontal ligament simulation. MATERIALS AND METHODS: Based on a commercial typodont pair, 3D maxillary and mandibular models were created with no teeth and with tooth sockets that were 1 mm wider than the original ones from 24 to 27 or 34 to 37 for periodontal ligament simulation with vinyl polysiloxane impression material. In total, 35 pairs of 7 combinations, including maxillary/mandibular typodonts in occlusion with maxillary/mandibular 3D models with/without a distal gap of canines on 3D models (tooth 23 or 33) were mounted on hinge articulators and divided into seven groups (n = 5). Each sample experienced the same manual chewing simulation on a customized device. The proximal surfaces were photographed to measure the percentage of food impaction area using ImageJ software. RESULTS: Group with fixed maxillary and mandibular teeth showed more food impaction than other groups with significant differences in the average of maxilla and the average of all proximal areas. CONCLUSION: The flexibility of the periodontal ligament and the degree of freedom of the teeth in their sockets may contribute to the extent of food impaction in proximal spaces.

SARS-CoV-2 seroprevalence and associated factors of infection before and after the Delta wave in French Polynesia: a cross-sectional study.

BACKGROUND: French Polynesia (FP) comprises 75 inhabited islands scattered across five archipelagos. Between July and October 2021, the SARS-CoV-2 Delta variant triggered a much stronger second epidemic wave in FP than the original Wuhan strain, which was dominant from August 2020 to March 2021. Although previous seroprevalence surveys made it possible to determine the proportion of the population infected by SARS-CoV-2 on the two most populated islands (Tahiti and Moorea) after the first (20.6% in Tahiti and 9.4% in Moorea) and second (57.7% in Tahiti) epidemic waves, no data are available for more remote islands. We used blood samples and personal data collected before, during, and after the second wave from inhabitants of several islands within the five archipelagos to assess the prevalence of SARS-CoV-2 infections and identify associated factors. METHODS: Blood samples and personal data were collected between April and December 2021 as part of the MATAEA study, a cross-sectional survey conducted on a random sample of the adult population representative of the five FP archipelagos and stratified by age and gender. IgG antibodies targeting the SARS-CoV-2 nucleocapsid (N) protein were detected using a recombinant antigen-based microsphere immunoassay. Factors associated with anti-SARS-CoV-2-N seropositivity were identified using logistic regression models. RESULTS: Of 1,120 participants, 503 (44.9%) tested positive for anti-SARS-CoV-2-N antibodies, corresponding to a weighted prevalence of 56.8% for the FP population aged 18-69 years. The seroprevalence increased from 21.9% to 62.1% before and during/after the Delta wave. Of these infections, only 28.4% had been diagnosed by health professionals. The odds of being seropositive were lower in males, participants recruited before the Delta wave, those who had never been married, those with a diagnosed respiratory allergy, smokers, and those vaccinated against COVID-19. CONCLUSIONS: Our results confirm the high impact of the Delta wave in FP. By the end of 2021, 56.8% of the FP population aged 18-69 years had been infected by SARS-CoV-2; the majority of these infections went undetected. Individuals with respiratory allergies were found to be less susceptible to SARS-CoV-2 infection.

Investigation of in vitro Biological Activity from Extracts of Ruellia tuberosa.

<b>Background and Objective:</b> <i>Ruellia tuberosa</i> is a common plant in the Mekong Delta and is widely used in many Vietnamese folk remedies. This study was conducted to investigate the potential use of roots, stems, leaves of <i>Ruellia tuberosa</i> as antioxidant, antimicrobial, α-amylase and α-glucosidase inhibitors. <b>Materials and Methods:</b> The extracts were tested for their ability to inhibit the enzymes α-amylase and α-glucosidase associated with diabetes. The antioxidant activities of the extracts were evaluated using 2,2-Diphenyl-1-Picrylhydrazyl (DPPH) and 2,2-Azino-Bis-(3-Ethylbenzothiazoline-6-Sulfonic Acid) (ABTS), ferric reducing antioxidant power (FRAP), total antioxidant capacity (TAC) and reducing power (RP) assays. The antibacterial activity of extracts from <i>Ruellia tuberosa</i> was evaluated by the agar well diffusion method. <b>Results:</b> The root extract of <i>Ruellia tuberosa</i> has more polyphenols (32.49±0.72 mg GAE/g extract) and flavonoids (15.48±1.32 mg QE/g extract) than the other parts. Simultaneously, the root extract of <i>Ruellia tuberosa</i> has antioxidant activity (IC₅₀ values range from 117.67±2.82 to 569.20±7.68 µg/mL), inhibiting amylase (IC₅₀ = 266.72±10.58 µg/mL) and glucosidase (IC₅₀ = 147.13±3.58 µg/mL) enzymes more effectively than the other parts. Research results also show that extracts from <i>Ruellia tuberosa</i> are capable of inhibiting <i>Staphylococcus aureus</i>, <i>Escherichia coli</i> and <i>Pseudomonas aeruginosa</i> bacteria with minimum inhibitory concentrations ranging from 1280 to 10240 mg/mL. <b>Conclusion:</b> These results highlighted the potential using of <i>Ruellia tuberosa</i> extracts as natural antioxidant, antimicrobial, α-amylase and α-glucosidase inhibitors agents.

Duplication cyst in adult cases: a journey from diagnosis to treatment.

Duplication cysts are rare congenital abnormalities of the alimentary tract, typically manifesting symptoms in the first 2 years but uncommon in adults. Medical data on duplication cysts is scarce in Vietnam's Mekong Delta region. These two adult cases aim to provide fundamental knowledge, clinical characteristics, diagnosis, risks, complications, surgical and observational treatment methods, and future bilateral tumor research. Case 1: A 21-year-old male with intestinal obstruction symptoms. Computed tomography (CT)-scan revealed a strangulated small bowel obstruction with ischemia. Laparotomy discovered a twisted ileal duplication cyst causing necrosis in ~30 cm of the small intestine. Case 2: A 34-year-old woman hospitalized for right lower quadrant pain. CT-scan showed a cystic structure protruding into the ascending colon lumen. She underwent a laparoscopic right hemicolectomy, and an ascending colonic cyst was found in the specimen. Conclusions: Duplication cysts are rare anomalies, especially in adults. Comprehending and acquiring knowledge ensures prompt diagnosis and appropriate treatment.

Towards elimination of chronic viral hepatitis in French Polynesia: results from a national population-based survey.

Background: In French Polynesia, hepatitis B virus (HBV) infection appears as a major risk factor for hepatocellular carcinoma (HCC), which detection rate in the Austral archipelago is among the highest in the world. Through a nationally representative cross-sectional survey of the adult population, this study aimed at assessing the prevalence of HBV, but also hepatitis C virus (HCV), and hepatitis delta virus (HDV). Methods: A total of 1942 blood samples from participants aged 18-69 years were tested for anti-HBc, anti-HBs, HBsAg, anti-HCV IgG, and HDV RNA. Complete genome sequencing of detected HBV strains was performed. Findings: Among participants, 315/1834, 582/1834, 33/1834, 0/1857, and 0/33 tested positive for anti-HBc, anti-HBs, HBsAg, anti-HCV IgG, and HDV RNA, respectively. The population prevalence of HBsAg was estimated at 1.0% (95% CI: 0.6-1.7). All HBsAg carriers were born in French Polynesia before vaccination at birth became mandatory. In multivariate analyses, identified factors associated with HBsAg carriage included: the archipelago of residence (p < 0.0001), age (p < 0.0001), and education level (p = 0.0077). HBV genotypes B, C, and F were detected. Interpretation: French Polynesia has a low endemicity level of HBV and its population may be considered at low risk for HCV and HDV infection. However, prevalence of HBsAg was found concerning in Austral (3.8%; 95% CI: 1.9-7.5) and Marquesas (6.5%; 95% CI: 3.8-11) archipelagoes. In the Austral archipelago, the presence of genotype C may account for the elevated rate of HCC. Our findings warrant more efforts to improve access to detection, prevention and care to people born before the systematic vaccination policy application, and residing in higher-risk areas, to achieve HBV elimination in French Polynesia. Funding: Research Delegation of French Polynesia.

Research on Passiflora foetida L. as a Pharmaceutical Treatment for Neurasthenia in Humans.

<b>Background and Objective:</b> This plant is known in many parts of the world and is used as medicine in some countries. In Vietnam, people know how to use <i>Passiflora foetida </i>L.,<i> </i>as an herb. There are many research works in the world, most of them focus on medicinal properties. The objective of this study was to determine the genetic diversity of samples of <i>Passiflora foetida </i>L., yellow fruit based on agronomic traits and the gene region of "<i>rbcL</i>". <b>Materials and Methods:</b> Seed samples were arranged in a completely randomized design with three replications. The trial was a sample of <i>Passiflora foetida </i>L., species. The distance between sample plant is 3×2 m, so the total number of trees is 1,330 trees ha¹. The genetic relationship between them was determined through the construction of a phylogenetic tree in the "<i>rbcL</i>" gene region sequence. Data analysis and processing methods done by using X software. <b>Results:</b> The PCR results that amplify the "<i>rbcL</i>" gene region around 670 bp, the PCR products were then sequenced. The sequence results were compared with the sequences on the NCBI gene bank, showing that the sequences of the nine varieties/species all coincided with the <i>Passiflora foetida </i>Sims species sequences with a high similarity coefficient from 98.77 to 99.9%. Genetically shows that all nine species samples belong to <i>Passiflora foetida</i> which can be classified into three genetic samples of An Giang (LA1), Ca Mau (LA2) and Can Tho (LA3) which are genetically close to each other, have the same index. <b>Conclusion:</b> The heritability in the broad sense is high in the two traits of stem height and leaf length, so it can be considered that these two traits are controlled by genes. The cultivation of algae seeds to improve the productivity of these medicinal plant varieties is important in providing raw materials for the oriental medicine industry.

Unravelling the determinants of human health in French Polynesia: the MATAEA project.

Background: French Polynesia is a French overseas collectivity in the Southeast Pacific, comprising 75 inhabited islands across five archipelagoes. The human settlement of the region corresponds to the last massive migration of humans to empty territories, but its timeline is still debated. Despite their recent population history and geographical isolation, inhabitants of French Polynesia experience health issues similar to those of continental countries. Modern lifestyles and increased longevity have led to a rise in non-communicable diseases (NCDs) such as obesity, diabetes, hypertension, and cardiovascular diseases. Likewise, international trade and people mobility have caused the emergence of communicable diseases (CDs) including mosquito-borne and respiratory diseases. Additionally, chronic pathologies including acute rheumatic fever, liver diseases, and ciguatera, are highly prevalent in French Polynesia. However, data on such diseases are scarce and not representative of the geographic fragmentation of the population. Objectives: The present project aims to estimate the prevalence of several NCDs and CDs in the population of the five archipelagoes, and identify associated risk factors. Moreover, genetic analyses will contribute to determine the sequence and timings of the peopling history of French Polynesia, and identify causal links between past genetic adaptation to island environments, and present-day susceptibility to certain diseases. Methods: This cross-sectional survey is based on the random selection of 2,100 adults aged 18-69 years and residing on 18 islands from the five archipelagoes. Each participant answered a questionnaire on a wide range of topics (including demographic characteristics, lifestyle habits and medical history), underwent physical measurements (height, weight, waist circumference, arterial pressure, and skin pigmentation), and provided biological samples (blood, saliva, and stool) for biological, genetic and microbiological analyses. Conclusion: For the first time in French Polynesia, the present project allows to collect a wide range of data to explore the existence of indicators and/or risk factors for multiple pathologies of public health concern. The results will help health authorities to adapt actions and preventive measures aimed at reducing the incidence of NCDs and CDs. Moreover, the new genomic data generated in this study, combined with anthropological data, will increase our understanding of the peopling history of French Polynesia. Clinical trial registration: https://clinicaltrials.gov/, identifier: NCT06133400.

Mylohyoid muscle revisited: anatomic features with clinical implications in dentistry / Revisión del músculo milohioideo: características anatómica con implicaciones clínicas en odontología

SUMMARY: The mylohyoid muscle, one of the suprahyoid group, forms the floor of the mouth. Its main function is swallowing. It is a margin between the sublingual and the submandibular spaces and is important in the pathway of oral and maxillofacial infection. In prosthodontics, it is one of anatomic landmarks that limits the lingual margin of the mandibular denture. Currently, the muscle receives much interest in the fields of maxillofacial reconstruction and rejuvenation. The hemorrhagic issue around the mandibular lingual region is usually involved with the mylohyoid especially in the dental implant installation. This review covers anatomic features of the mylohyoid muscle with diverse clinical implications.

RESUMEN: El músculo milohioideo es un músculo del grupo suprahioideo que forma el piso de la cavidad oral. Su función principal es la deglución. Es conocido como un límite entre los espacios sublingual y submandibular y es importante en la vía de infección oral y maxilofacial. En la prostodoncia, es uno de los hitos anatómicos que limita el margen lingual de la dentadura mandibular. Actualmente, el músculo recibe mucho interés en los campos de la reconstrucción y el rejuvenecimiento maxilofacial. El problema hemorrágico alrededor de la región lingual mandibular generalmente está relacionado con el músculo milohioideo, especialmente en la instalación de implantes dentales. Esta revisión cubre las características anatómicas del músculo milohioideo con diversas implicaciones clínicas.