Carnegie Mellon University researchers have developed a new method for delivering chemotherapy nanodrugs that increases their bioavailability and reduces side effects.  Their study shows that administering an FDA-approved nutrition source prior to chemotherapy can reduce the amount of the toxic drugs that settle in the spleen, liver and kidneys.
Nanodrugs — drugs attached to tiny biocompatible particles — show great promise in the treatment of a number of diseases, including cancer. Delivery of these drugs, however, is not very efficient — only about 0.7 percent of chemotherapy nanodrugs reach their target tumour cells. The remainder are absorbed by other cells, including those in the liver, spleen and kidneys. When the drugs build up in these organs, they cause toxicity and side-effects that negatively impact a patient’s quality of life.
Chien Ho, professor of biological sciences at Carnegie Mellon, and his colleagues have developed a novel way to improve delivery of chemotherapy nanodrugs by using Intralipid, an FDA-approved nutrition source to temporarily blunt the reticuloendothelial system — a network of cells and tissues found throughout the body, including in the blood, lymph nodes, spleen and liver, that play an important role in the immune system.
Ho and colleagues tested their technique in a rat model of cancer using three FDA-approved chemotherapy nanodrugs, Abraxane, Marqibo and Onivyde, and one experimental platinum-based anti-cancer nanodrug. In the study, they administered Intralipid one hour before giving the animal a chemotherapy nanodrug. They found their method reduced the amount of the drug found in the liver, spleen and kidneys and reduced the drugs’ toxic side-effects. They also found more of the drug was available to attack tumour cells. Additionally, the Intralipid treatment had no harmful impact on tumour growth or drug efficacy.
The researchers believe their drug delivery methodology can be applied to a variety of nanodrugs without any modifications to the drugs.
“This methodology could have a major impact in the delivery of nanodrugs not only for patients undergoing chemotherapy for cancer treatment but also to those being treated with nanodrugs for other conditions,” Ho said.

Carnegie Mellon Universityhttps://tinyurl.com/y768c9tg

A simple, non-invasive procedure that can indicate how long patients with cancer that has spread to the brain might survive and whether they are likely to respond to immunotherapy has been developed by researchers in Liverpool.
The technique, which can be done using standard hospital-based Magnetic Resonance Imaging (MRI) scans, could one day remove the need for patients to undergo life-threatening surgery to obtain a biopsy, and provide an easier, quicker and safer way for doctors to prescribe the most appropriate cancer treatment.
The research is a collaboration between the University of Liverpool and The Walton Centre in Liverpool and is published in the journal Cancer Research.
The major problem hindering the successful treatment of commonly-occurring cancers is not the primary tumour, which can usually be removed by surgery, but its spread or ‘metastasis’ to other organs in the body, forming secondary tumours. One of the most frequent sites of metastasis is the brain. Secondary brain tumours may also reflect the presence of further secondaries elsewhere in the body, any one of which can lead to the death of the patient.
As a general rule, cancer that has spread is treated with chemotherapy or with targeted therapies such as immunotherapy – a relatively new treatment that works by stimulating the body’s immune system to fight cancer.
Immunotherapy is revolutionizing the way doctors treat cancer as it does not come with many of the debilitating side effects produced by chemotherapy. However, it does not work for everyone or for every type of cancer and although successful in some cases, there is currently no simple test to determine who is likely to benefit.
To investigate why some patients with secondary brain cancer do better than others, researchers at the University of Liverpool’s Department of Biochemistry and The Walton Centre Neurosurgery Department used an MRI technique called Diffusion Tensor Imaging (DTI) to analyse brain tumours from appropriate patients and then to sample the same areas for comparative biochemical tests.
They found that the higher the level of immune reactive cells round these tumours the longer a patient survives, irrespective of the cancer type or other biological parameters and that this level matched that derived from the DTI technique.
The research draws upon material in the Walton Research Tissue Bank, which provides researchers with access to brain tumour tissue and blood samples to help facilitate the development and testing of new treatments.
University of Liverpoolhttps://tinyurl.com/yc77mvjl

Mandatory flu vaccines for health care workers improve participation by as much as 30 percent and reduce absenteeism during critical periods of patient surges by about 6 percent, findings from a multi-institutional study show.
Previous work focused on the impact of health care worker vaccination on improving patient outcomes. The findings expand the potential benefits of an institutional policy and help settle previous conflicting data on whether the mandatory policies reduce health care worker absenteeism. As seen this year, health care institutions can struggle to care for surging numbers of patients with influenza when the number of workers available is declining due to illness.
“Studies suggest that higher vaccination rates among health care workers decrease patient mortality and health care associated influenza in certain settings,” said Dr. Trish Perl, Chief of Infectious Diseases at UT Southwestern Medical Center, and one of the study corresponding authors and overall Principal Investigator. “In addition, absenteeism can pose a serious threat to how effectively a hospital is able to manage the surge of patients during an outbreak. Our study shows that mandatory vaccination policies help maintain better staffing levels and staffing options during those critical surges.”
Researchers studied the effects over three separate flu seasons at three institutions with mandatory vaccination policies and four institutions that offered optional vaccination. For all individuals studied (4,000-plus health care workers), vaccination was offered free and on-site.
Researchers found that:

• At mandatory sites, 97 percent, 96 percent and 92 percent of health care workers received vaccinations in the three years studied.
• At non-mandatory sites, 67 percent, 63 percent, and 60 percent of workers were vaccinated over the same period.
• Absenteeism among health care workers was about 6 percent lower at mandatory sites than non-mandatory sites, and the number of days absent also was lower.
• Males, older workers, and those at non-mandatory vaccination sites had longer durations of sick leave.
• Vaccinated health care workers had a 30 percent reduction in absenteeism compared with non-vaccinated health care workers.

UT Southwestern Medical Centerwww.utsouthwestern.edu/newsroom/articles/year-2018/flu-vaccines.html

Supplementation with probiotics can improve a person’s gut health, but the benefits are often fleeting, and colonization by the probiotic’s good microbes usually doesn’t last. Breast milk may help sustain those colonies in the long run, say researchers at the University of California, Davis.
In a study they report that breastfeeding babies who received a three-week course of a probiotic that consumes human milk still had colonies of those beneficial gut microbes 30 days after the end of probiotic treatment.
The study is the first to show that a combination of breast milk and a probiotic organism can lead to lasting changes in the gut microbiome, says neonatologist Mark Underwood, who led the study.
“Even though we stopped giving the probiotic on day 28 of life, the particular organisms we gave stayed in their fecal community out to 60 days and even longer,” he says. “They were surviving and dominating, and that’s something we really have not seen before.”
For the study, Underwood and his colleagues recruited 66 breastfeeding mothers. In one group, 34 mothers fed their newborns a three-week course of Bifidobacterium longum subspecies infantis EVC001, a probiotic supplement. In the other group, the mothers did not administer probiotics. Analyses of fecal samples from the infants, collected during the first 60 days of life, revealed stark differences.
Genetic sequencing, PCR analysis, and mass spectrometry revealed larger populations of B. infantis, which improves gut health, in the infants who received supplementation than in the infants who did not. Those colonies persisted for at least 30 days after the end of supplementation, suggesting that the changes were durable, say the researchers. They hypothesize that because the benefit is linked directly to breastfeeding, once the infant stops breastfeeding the colonies will diminish.
Underwood says he and his group suspected B. infantis would pair well with the sugars in breastmilk to shape the gut microbiota. “Compared to all the bugs we’ve tested, this one is a really good consumer of milk oligosaccharides,” he says. “It’s able to use the sugar molecules in mom’s milk better than any other gut microbe, including commensal and pathogenic bugs.” Accordingly, the study’s analysis showed that infants who received supplementation had lower levels of human milk oligosaccharides in their feces, which meant more had been consumed by B. infantis.
Studies conducted over the last decade or so have shown deep connections between disease and dysbiosis, which is an imbalance in gut microbial populations. Disruption of the microbiota, particularly early in life, may increase risk for many diseases both inside and outside the gut, including diabetes, allergies and asthma, irritable bowel syndrome, and some cancers, says Underwood. Finding ways to colonize an infant’s intestines with beneficial bacteria might lower those lifelong risks.
Further comparisons of the two groups of infants showed other benefits. Fecal samples from infants who received supplementation had lower numbers of potential pathogens and higher levels of lactate and acetate, which are beneficial products of fermentation of human milk sugars by B. infantis.
Underwood says formula could be developed to include oligosaccharides , which might extend the benefits to children who aren’t breastfed as well. “If mom can’t breastfeed for whatever reason, our hypothesis would be if you give that baby a 3-week course of this probiotic and a formula with added human milk oligosaccharides, colonization should happen and persist as long as they’re on that formula,” he says.

The American Society for Microbiologyhttps://tinyurl.com/y7yntxhm

A growing number of individuals of all ages are surviving intensive care unit hospitalization, however their mental and physical health problems persist. A new study from Regenstrief Institute and Indiana University researchers reports that a care model they originally developed for older adults with dementia could benefit ICU survivors of all ages.
ICU survivors have high rates of persistent cognitive impairment similar to Alzheimer’s disease due to a combination of critical illness, medications administered during hospitalization, and physiological aspects of delirium that are not well understood.
The Critical Care Recovery Center (CCRC) care model developed by the Regenstrief Institute and IU Center for Aging Research scientists is the first collaborative care concept in the US focusing on the extensive cognitive, physical, and psychological recovery needs of intensive care unit survivors and decreasing the likelihood of serious illness after discharge from an ICU. The CCRC is an outpatient clinic with an interdisciplinary care team working closely with family caregivers as well as the ICU survivors themselves after hospital or rehabilitation facility discharge.
The 51 ICU survivors in the new study were the initial patients seen in the first CCRC — the Eskenazi Health Critical Care Recovery Center. They ranged in age from 40 to 70 with an average age of 55. Prior to the trauma or illness that had brought them to the ICU, nearly all were psychiatrically normal and functionally independent.
During their ICU stay more than three-quarters of the study participants had required mechanical ventilation and almost half were given antipsychotic medications for delirium. Following ICU discharge 88 percent had cognitive impairment and 60 percent experienced depression, recognized upon their subsequent follow-up as outpatients in the CCRC.
“The ICU survivor population is very heterogeneous which makes it a complicated population to understand and serve,” said Sophia Wang, MD, an implementation scientist at the Center for Health Innovation and Implementation Science and assistant professor of clinical psychiatry at the IU School of Medicine who led the study. “ICU survivors of all ages have high rates of persistent cognitive impairment similar to Alzheimer’s disease. Their complex needs match the traditional complexity of geriatric syndromes.”
According to Dr. Wang, the problems encountered after ICU discharge, known as Post Intensive Care Syndrome or PICS, should be viewed as a multifaceted disorder of cognitive, psychiatric, and physical impairment. Because the CCRC model is equipped to handle those complexities, it is a good fit for the ICU survivor population, regardless of the individual’s age.
“In this study we have demonstrated how novel concepts initially used to create a successful model of collaborative care for dementia were successfully applied to create the CCRC providing innovative collaborative care for ICU survivors,” she said. “We will be conducting future studies of how the CCRC meets the complex needs of ICU survivors and the healthcare systems they navigate.”
Regenstrief Institutehttps://tinyurl.com/y7ld8kjv