Systematic literature review assessing tobacco smoke exposure as a risk factor for serious respiratory syncytial virus disease among infants and young children

BACKGROUND: The role of environmental tobacco smoke (ETS) exposure as a risk factor for serious respiratory syncytial virus (RSV) disease among infants and young children has not been clearly established. This systematic review was conducted to explore the association between ETS exposure and serious RSV disease in children younger than 5 years, including infants and young children with elevated risk for serious RSV disease. METHODS: A systematic review of English-language studies using the PubMed and EMBASE databases (1990-2009) was performed to retrieve studies that evaluated ETS as a potential risk factor for serious RSV illness. Studies assessing risk factors associated with hospitalization, emergency department visit, or physician visit due to RSV (based on laboratory confirmation of RSV or clinical diagnosis of RSV) in children under the age of 5 years were included. RESULTS: The literature search identified 30 relevant articles, categorized by laboratory confirmation of RSV infection (n = 14), clinical diagnosis of RSV disease (n = 8), and assessment of RSV disease severity (n = 8). Across these three categories of studies, at least 1 type of ETS exposure was associated with statistically significant increases in risk in multivariate or bivariate analysis, as follows: 12 of 14 studies on risk of hospitalization or ED visit for laboratory-confirmed RSV infection; 6 of 8 studies of RSV disease based on clinical diagnosis; and 5 of the 8 studies assessing severity of RSV as shown by hospitalization rates or degree of hypoxia. Also, 7 of the 30 studies focused on populations of premature infants, and the majority (5 studies) found a significant association between ETS exposure and RSV risk in the multivariate or bivariate analyses. CONCLUSION: We found ample evidence that ETS exposure places infants and young children at increased risk of hospitalization for RSV-attributable lower respiratory tract infection and increases the severity of illness among hospitalized children. Additional evidence is needed regarding the association of ETS exposure and outpatient RSV lower respiratory tract illness. Challenges and potential pitfalls of assessing ETS exposure in children are discussed

Regulation of NF-κB, AP-1, NFAT, and STAT1 Nuclear Import in T Lymphocytes by Noninvasive Delivery of Peptide Carrying the Nuclear Localization Sequence of NF-κB p50

Abstract Activation of T lymphocytes by Ags or cytokines results in translocation of the transcription factors NF-κB, AP-1, NFAT, and STAT from the cytoplasm into the nucleus. The first step in the nuclear import process is recognition of a nuclear localization sequence (NLS) within the karyophilic protein by a cytoplasmic receptor such as the importin (karyopherin)-α subunit. The NLSs of NF-κB, AP-1, and NFAT differ and the NLS of STAT1 has not yet been identified. Herein we demonstrate that the inducible nuclear import of NF-κB, AP-1, NFAT, and STAT1 in Jurkat T lymphocytes is significantly inhibited by a cell-permeable peptide carrying the NLS of the NF-κB p50 subunit. NLS peptide-mediated disruption of the nuclear import of these transcription factors results in inhibition of IκBα and IL-2 gene expression, processes dependent on NF-κB or the combination of NF-κB, AP-1, and NFAT. Further, we show that inhibitory NLS peptide interacts in vitro with a cytoplasmic NLS receptor complex comprised of the Rch1/importin (karyopherin)-β heterodimer expressed in Jurkat T cells. Taken together, these data indicate that the inducible nuclear import of NF-κB, AP-1, NFAT, and STAT1 in Jurkat T cells can be regulated by NLS peptide delivered noninvasively to the cytoplasm of Jurkat T cells to target members of the importin (karyopherin)-αβ NLS receptor complex.</jats:p

Abstract B85: Impact of patient/provider communications on quality of care for cancer

Abstract Objectives: Quality of care for cancer could be impacted by a variety of factors. The objective of this study was to identify aspects of patient/provider communications that impact the quality of care for cancer patients in general. Methods: A systematic literature review regarding perceptions of the quality of cancer care in the U.S. was conducted in PubMed, EMBASE and Cochrane Reviews for the last ten years, English only articles. Oncology medical subject heading (MESH) terms were cross-matched with quality of care MESH terms to obtain 875 abstracts. Of these, 140 publications were selected for full-article review based on defined inclusion/ exclusion criteria. Results: Most of the articles on patient/physician communications and quality of care were for breast cancer. The amount of information patients receive regarding their cancer and their communications with providers affects their perceptions of quality of cancer care. Women with breast cancer who reported high levels of surgeon-initiated communication were more likely to be satisfied with their care than women receiving low-levels of communications. Women who were provided with a nurse case manager had more positive perception regarding their treatment choices and quality of care. Poor communication and lack of information are often cited as factors affecting service quality. While providers may consider technically proficient care to mean quality care, patients with cancer define quality care as care that comes with good communication, provision of adequate information, respect, and attention. Conclusions: Communications with providers and provision of adequate information are important aspects of quality of cancer care for patients with cancer. These findings may be more pronounced in circumstances where diversity issues are relevant. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B85.</jats:p

A Systematic Literature Review of Adverse Events Associated with Systemic Treatments Used in Advanced Soft Tissue Sarcoma

This systematic literature review describes adverse events (AEs) among patients with soft tissue sarcoma (STS) who received second-line or later anticancer therapies. Searches were conducted in PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for studies of adults with advanced or metastatic STS who received systemic anticancer therapy before enrollment in a randomized-controlled trial of pazopanib, another targeted cancer agent, or cytotoxic chemotherapy. Of 204 publications identified, seven articles representing six unique studies met inclusion criteria. Additional safety results for pazopanib were identified on ClinicalTrials.gov. Hematologic toxicities were common with all therapies evaluated (pazopanib, trabectedin, dacarbazine ± gemcitabine, gemcitabine ± docetaxel, cyclophosphamide, and ifosfamide). Studies differed in AE type, timing of assessment, and outcomes reported, although patient populations and AE assessment timing were relatively similar for pazopanib and trabectedin. AEs that were more common with trabectedin than pazopanib were anemia, neutropenia, nausea/vomiting, and elevations in aspartate aminotransferase and alanine aminotransferase. An AE that was more common with pazopanib than trabectedin was anorexia. Only the pazopanib study reported AE frequencies versus placebo. A planned meta-analysis was not feasible, as there was no common comparator. More well-designed studies that include common comparators are needed for comparison of safety effects among treatments for STS