Effects of dog-assisted therapy in adults with dementia: a systematic review and meta-analysis.

BACKGROUND: Dog-assisted therapy (DAT) is a non-pharmacological intervention based on the interaction between patients and dogs, which has been proposed to help adults with dementia. However, evidence to support it is lacking. Thus, we aim to evaluate the effects of DAT on this population and to assess the certainty of the evidence of the RCTs estimates. METHODS: A systematic search was performed. We included randomized controlled trials (RCTs) and quasi-experimental (QE) controlled studies published up to March 2018, which evaluated the beneficial and deleterious effects of DAT in adults with dementia. Mean differences (MD) or standardized mean differences (SMD) and their 95% confidence intervals (95% CI) were calculated and random effects meta-analyses were performed. Certainty of evidence was assessed for RCTs estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol has been registered in PROSPERO (CRD42018090434). RESULTS: Ten studies (six RCTs and four QE controlled studies) were eligible for inclusion. Meta-analysis of RCTs showed no effect of DAT in daily life activities (SMD: 0.16; 95% CI: -0.80 to 1.12), depression (SMD: -0.45; 95% CI: -2.81 to 1.91), agitation (SDM: -1.12; 95% CI: -2.67 to 0.43), quality of life (SDM: 0.16; 95% CI: -0.41 to 0.73), and cognitive impairment (SDM: -0.52; 95% CI: -1.33 to 0.30), but it found a beneficial effect in apathy (1 study, n = 37, MD: 1.81; 95% CI: 1.26 to 2.36). All outcomes had a very low certainty of evidence according to GRADE methodology. CONCLUSIONS: RCTs evidence of very low certainty suggests that, in adults with dementia, DAT has no effect in daily life activities, depression, agitation, quality of life, and cognitive impairment, although one small study found an apparent beneficial effect in apathy. More well-designed and correctly reported studies are needed in order to provide a conclusion. TRIAL REGISTRATION: CRD42018090434 (PROSPERO).

SAINT: A Phase I/Expanded Phase II Study Using Safe Amounts of Ipilimumab, Nivolumab and Trabectedin as First-Line Treatment of Advanced Soft Tissue Sarcoma.

BACKGROUND: This Phase 1/2 study is based on the hypothesis that immune checkpoint inhibitors are more effective when given earlier in the course of the disease for advanced soft tissue sarcoma. METHODS: Phase I endpoints-maximum tolerated dose in previously treated patients; Phase II endpoints-best response, progression free survival and overall survival and incidence of adverse events in previously untreated patients; Phase I treatments-escalating doses of trabectedin (1.0, 1.2, 1.5 mg/m2) as continuous intravenous infusion over 24 h every 3 weeks, 1 mg/kg of ipilimumab given intravenously every 12 weeks, and 3 mg/kg of nivolumab given intravenously every 2 weeks; Phase II treatments-maximum tolerated dose of trabectedin and defined doses of ipilimumab and nivolumab. RESULTS: Phase I (n = 9)-the maximum tolerated dose of trabectedin was 1.2 mg/m2; Phase II (n = 79)-6 complete responses, 14 partial responses, 49 stable disease, 25.3% best response rate, 87.3% disease control rate; median progression-free survival, 6.7 months (CI 95%: 4.4-7.9), median overall survival, 24.6 months (CI 95%: 17.0-.); Grade 3/4 therapy-related adverse events (n = 92)-increased ALT (25%), fatigue (8.7%), increased AST (8.7%), decreased neutrophil count (5.4%) and anemia (4.6%). CONCLUSION: SAINT is a safe and effective first-line treatment for advanced soft tissue sarcoma.

Activity of TNT: a phase 2 study using talimogene laherparepvec, nivolumab and trabectedin for previously treated patients with advanced sarcomas (NCT# 03886311).

Background: Intratumoral injection of talimogene laherparepvec evokes a cytotoxic immune response. Therefore, the combination of talimogene laherparepvec with trabectedin and nivolumab may have synergistic effects in advanced sarcomas. Patients and methods: This phase 2 trial was conducted from May 30, 2019 to January 31, 2022. Endpoints: Primary: Progression free survival rate at month 12. Secondary: Best overall response, progression free survival rate at 6 and 9 months, overall survival rate at 6, 9, and 12 months, incidence of conversion of an unresectable tumor to a resectable tumor, and incidence of adverse events. Eligible patients had to be ≥ 18 years of age, have advanced histologically proven sarcoma, at least 1 previous chemotherapy regimen, and at least one accessible tumor for intratumoral injection. Treatment: Trabectedin intravenously (1.2 mg/m2 q3 weeks), nivolumab intravenously (3 mg/kg q2 weeks), and intratumoral talimogene laherparepvec (1x108 plaque forming units/ml q2 weeks). Results: Median time of follow-up: 15.2 months. Efficacy analysis: Thirty-nine patients who had completed at least one treatment cycle and had a follow-up computerized tomography were evaluable for efficacy analysis. Median number of prior therapies: 4 (range 1-11). Progression free survival rate at month 12, 36.7%. Confirmed Best Overall Response by Response Evaluation Criteria in Solid Tumors v1.1 = 3 partial responses, 30 stable disease, 6 progressive disease. Best Overall Response Rate, 7.7%, Disease Control Rate, 84.6%; median progression free survival, 7.8 (95% Confidence Intervals: 4.1-13.1) months; 6-, 9-, 12-month progression free survival rates, 54.5%/45.9%/36.7%; median overall survival 19.3 (95% Confidence Intervals: 12.8 -.) months; 6-, 9- and 12-month overall survival rate, 86.9%/73.3%/73.3%. One patient had a complete surgical resection. Fifty percent of patients had a ≥ grade 3 treatment related adverse events which included anemia (6%), thrombocytopenia (6%), neutropenia (4%), increased alanine transaminase (4%), decreased left ventricular ejection fraction (4%), dehydration (4%), hyponatremia (4%). Conclusions: Taken together these data suggest that the TNT regimen is effective and safe for advanced previously treated sarcomas, and is worth being further studied in a randomized phase 3 trial as first- or second- line treatment for patients with advanced sarcomas.

Conjunctival squamous cell carcinoma: prognostic factors for the recurrence and metastasis and clinicopathological characteristics at an oncological hospital in Peru.

BACKGROUND/AIMS: Conjunctival squamous cell carcinoma (CSCC) is the most frequent malignant tumour of the conjunctiva, with scarce recurrence and infrequent metastasis. The purpose of this study is to describe the clinical and pathological characteristics of this neoplasm and to identify the prognostic factors for recurrence and metastasis in a cancer hospital in Peru. MATERIALS AND METHOD: A longitudinal, retrospective study of 176 consecutive patients diagnosed with SCC of the conjunctiva. Sociodemographic and clinical characteristics were evaluated. In addition, Kaplan-Meier curves were performed, and Cox regression was used to determine prognostic factors for recurrence and metastasis over time. RESULT: Only 12.5% presented tumour size ≤5 mm. The highest proportion according to the histopathological type was the well-differentiated infiltrative forms (40.9%), and according to tumour, node, metastases (TNM), stage T3 was the most frequent (31.3%). The most performed initial treatment was orbital exenteration (38.6%). The proportion of recurrence was 6.8% and 8.0% for metastasis. The annual survival rate was 7% and the annual metastasis rate was 6%; for recurrence after 5 years, the survival rate was 11% and the metastasis rate was 14%. No prognostic factor evaluated was significant. CONCLUSION: This is the most extensive patient study in Latin America with CSCC, with a high proportion of advanced histopathological grade, TNM stages, and radical treatments such as exenteration. Recurrence rates on average are similar to other reported studies, and it describes the rates of metastasis that have been poorly described in the literature.

Text message reminders for improving sun protection habits: A systematic review.

BACKGROUND: Excessive exposure to ultraviolet radiation increases the risk of skin cancer and other conditions. SMS text reminders may be a useful tool to improve sun protection habits due to its massive reach, low cost, and accessibility. OBJECTIVE: To perform a systematic review of randomized controlled trials (RCTs) that evaluated the effects of SMS text reminders in promoting sun protection habits. METHODS: We performed a systematic search in PubMed, Central Cochrane Library, and Scopus; following the PRISMA recommendations to perform systematic reviews. We included RCTs published up to December 2018, which evaluated the benefits and harms of SMS text reminders to improve sun protection habits. Random-effects meta-analyses were performed whenever possible. The certainty of the evidence was assessed for RCTs estimates using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol was registered in PROSPERO (CRD42018091661). RESULTS: Five RCTs were included in this review. When pooled, the studies found no effect of SMS text reminders in "sunburn anytime during follow-up" (two studies, risk ratio: 0.93; 95% confidence interval: 0.83-1.05). Contradictory results were obtained for sunscreen use (three RCTs) and sun protection habits (two RCTs), however, they could not be meta-analyzed because outcomes were measured differently across studies. The certainty of the evidence was very low for these three outcomes according to GRADE methodology. CONCLUSIONS: RCTs that assessed effects of SMS text reminders did not find a significant benefit on objective outcomes, such as having a sunburn, sunscreen use and composite score of sun protection habits. Since certainty of the evidence was very low, future high-quality studies are needed to reach a conclusion regarding the balance of desirable and undesirable outcomes. PROTOCOL REGISTRATION NUMBER: PROSPERO (CRD42018091661).

Lymphoid proliferation in Eyelid: A Primary Follicular Lymphoma Case.

Ocular adnexal lymphoma (OAL) constitutes 8% of all extranodal lymphomas, being rare in the eyelids (5-20%). The objective was to report a case of eyelid follicular lymphoma in a young adult woman. A 35-year-old female with swelling in left lower eyelid with development for 2 months. The visual acuity was 20/20 in both eyes, the tumor mass was 3 cm wide and 1.5 cm long. The contrast-enhanced computed tomography showed a soft-tissue injury in the left lower eyelid but had no signs of local spread according to description. Grade 2 follicular lymphoma was diagnosed by biopsy. Oncological evaluation assessed positron emission tomography scan and bone marrow aspiration with negative results for systemic spread of disease. Patient started radiotherapy. This case highlights that young patients may present painless swelling lesions that may be largely underdiagnosed and should take into consideration some oncological pathologies.

Características de patentes de dispositivos para rehabilitación física registradas en los Estados Unidos / Characteristics of patents of physical rehabilitation devices registered in the United States

Introducción: La rehabilitación física puede verse beneficiada con el uso de dispositivos, los cuales en su mayoría suelen ser patentados. La oficina de patentes y marcas de los Estados Unidos (USPTO) es una de las oficinas de patentes y marcas más grandes y reconocidas. Resulta de interés evaluar las características y la evolución de las patentes para la rehabilitación física; sin embargo, existen pocos estudios al respecto. Objetivo: Identificar las características de las patentes de dispositivos de rehabilitación física de extremidades, registradas en la oficina de patentes y marcas de los Estados Unidos. Material y métodos: Estudio descriptivo transversal. Se realizó una búsqueda en UPSTO usando una lista de palabras clave relacionadas con la rehabilitación. Se eligieron 10 grupos de patentes relacionados con la rehabilitación. Las variables estudiadas fueron: número de la patente, fecha de publicación, país, titular, área de la patente, extremidades para las cuales es útil la patente y portabilidad. Se realizó un análisis descriptivo usando STATA v.14. Resultados: Se analizaron 1971 patentes, de las cuales 16,2 por ciento fueron incluidas en los grupos de rehabilitación y 83,8 por ciento en ejercicio físico. El 36,6 por ciento de todas las patentes fueron patentadas por un titular corporativo, el 29,9 por ciento fueron portables, y el 46,3 por ciento tenían utilidad para ambas extremidades. Conclusiones: De las patentes encontradas las enfocadas para ejercicio físico fueron las predominantes. Existe una mayor cantidad de patentes útiles para ambas extremidades. Además, existe una tendencia ascendente en el tiempo, en el número de patentes del área de rehabilitación y de las invenciones portables(AU)

ABSTRACT Introduction: Physical rehabilitation can be benefitted from the use of devices, which are usually patented. The United States Patent and Trademark Office (USPTO) is one of the largest and most recognized patent and trademark offices. The characteristics and evolution of patents for physical rehabilitation is of great interest; however, there are few studies in this respect. Objective: To identify the characteristics of patents of physical rehabilitation devices for the physical rehabilitation of damaged limbs registered the United States Patent and Trademark Office. Material and methods: A cross-sectional descriptive study was conducted. A search was made at UPSTO using a list of keywords related to rehabilitation. Ten groups of patents related to rehabilitation were chosen. The variables studied were: patent number, publication date, country, holder, patent area, limbs for which the patent is useful, and portability. A descriptive analysis was performed by using STATA v.14. Results: A total of 1971 patents were analyzed, of which 16.2 percent were included in the rehabilitation groups and 83.8 percent in the physical exercise groups. The 36.6 percent of them were corporate-owned patents, 29.9 percent were portable, and 46.3 percent had usability which demonstrated to be useful for both extremities. Conclusions: Of the patents found, those focused on physical exercise were predominant. There is a greater number of useful patents for both extremities. In addition, there is an upward trend over time, the number of patents in the area of ​​rehabilitation, and portable inventions(AU)