Immune Checkpoint Inhibitors: Therapeutic Tools for Breast Cancer.

Breast cancer is one of the major threats to female health, and its incidence is rapidly increasing in many countries. Currently, breast cancer is treated with surgery, followed by chemotherapy or radiation therapy, or both. However, a substantial proportion of breast cancer patients might have a risk for local relapse that leads to recurrence of their disease and/or metastatic breast cancer. Therefore searching for new and potential strategies for breast cancer treatment remains necessary. Immunotherapy is an attractive and promising approach that can exploit the ability of the immune system to identify and destroy tumors and thus prevent recurrence and metastatic lesions. The most promising and attractive approach of immunotherapeutic research in cancer is the blockade of immune checkpoints. In this review, we discuss the potential of certain inhibitors of immune checkpoints, such as antibodies targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed death 1 (PD-1) and lymphocyte activation gene-3 (LAG-3), in breast cancer therapeutics. Immune checkpoint inhibitors may represent future standards of care for breast cancer as monotherapy or combined with standard therapies.

Effectiveness of silver-impregnated central venous catheters for preventing catheter-related blood stream infections: a meta-analysis.

OBJECTIVES: The purpose of this meta-analysis was to examine the effectiveness of silver-impregnated central venous catheters (CVCs) in preventing catheter bacterial colonization and catheter-related blood stream infections (CRBSIs). METHODS: PubMed, Cochrane, and Embase databases were searched up to April 30, 2014. Studies in which other antiseptic reagents were used (e.g., chlorhexidine, octenidine dihydrochloride, urokinase rinses, benzalkonium chloride, rifampin-minocycline) were excluded. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Tests of heterogeneity and publication bias were performed. RESULTS: Twelve studies were included in the meta-analysis. The studies enrolled a total of 2854 patients; 1440 received a standard CVC and 1414 received a silver-impregnated CVC. No significant difference in catheter bacterial colonization rates was found between silver-impregnated and standard CVCs (OR 0.907, 95% CI 0.758-1.087, p=0.290). No significant difference in CRBSI rates was found between silver-impregnated and standard CVCs (pooled OR 0.721, 95% CI 0.476-1.094, p=0.124). No significant heterogeneity or publication bias was noted. CONCLUSIONS: Silver-impregnated CVCs are not associated with reduced rates of bacterial colonization or CRBSI.

[Indications and effect of the intra-aortic balloon pump in 38 patients during the cardiac surgery].

OBJECTIVE: To review the indications and effect of the intra-aortic balloon pump (IABP) in 38 patients during the cardiac surgery. METHODS: From June 2004 to August 2007, 38 patients were performed IABP in the cardiac surgery, including 28 coronary artery bypass grafting (CABG) and 10 valve replacements. The intra-operation prophylactic use of IABP was in 5 cases, the use of IABP for weaning from cardiopulmonary bypass (CPB) during the cardiac surgery was in 22 cases, and the rest use of IABP was after the operation in the intensive care unit. Low molecular weight heparin was used for IABP anticoagulation. RESULTS: Thirteen died out of the 38 IABP patients. The total IABP success rate was 66%.The IABP success rate in CABG was 82%, and 20% in the valve replacement. The patients with intra-operation prophylactic use of IABP all recovered, and 16 recovered out of the 22 patients with IABP uses for weaning from CPB, and 6 recovered out of the 11 patients with post-operation IABP application. No severe complications related to IABP occurred. CONCLUSION: IABP has better effect in CABG patients than in valve replacements. Effect of the prophylactic use of IABP is better than both the IABP use for weaning from CPB or the post-operation IABP application. For IABP anticoagulation, low molecular weight heparin is the better alternative than routine heparin, and the proper ACT is controlled at 150-170 s.