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Background Although molecular testing has become standard in managing advanced nonsquamous non-small-cell lung cancer (NSCLC), most patients undergo minimally invasive procedures, and the diagnostic tumour specimens available for testing are usually limited. A knowledge translation initiative to educate diagnostic specialists about sampling techniques and laboratory processes was undertaken to improve the uptake and application of molecular testing in advanced lung cancer. Methods A multidisciplinary panel of physician experts including pathologists, respirologists, interventional thoracic radiologists, thoracic surgeons, medical oncologists, and radiation oncologists developed a specialty-specific education program, adapting international clinical guidelines to the local Ontario context. Expert recommendations from the program are reported here. Results Panel experts agreed that specialists procuring samples for lung cancer diagnosis should choose biopsy techniques that maximize tumour cellularity, and that conservation strategies to maximize tissue for molecular testing should be used in tissue processing. The timeliness of molecular reporting can be improved by pathologist-initiated reflex testing upon confirmation of nonsquamous NSCLC and by prompt transportation of specimens to designated molecular diagnostic centres. To coordinate timely molecular testing and optimal treatment, collaboration and communication between all clinicians involved in diagnosing patients with advanced lung cancer are mandatory. Conclusions Knowledge transfer to diagnostic lung cancer specialists could potentially improve molecular testing and treatment for advanced lung cancer patients. [ABSTRACT FROM AUTHOR]

This study assessed the associations between gender, anthropometry, predominant training environment and Vitamin D status in 72 elite athletes. Additionally, any links between Vitamin D status and recent injury/health status, or sun protection practices were investigated. Athletes underwent an anthropometric assessment and provided venous blood samples for the determination of 25-hydroxyvitamin D (25(OH)D), the accepted biological marker of Vitamin D status. Finally, athletes completed a questionnaire relating to their recent training and injury history, and their sun protection practices. The athlete cohort were divided by predominant training environment as either indoor, outdoor, or mixed training environment athletes. The average ( ± SD) 25(OH)D levels of the group were 111 ± 37 nmol/L, with the indoor training group (90 ± 28 nmol/L) significantly lower than the outdoor (131 ± 35 nmol/L), and mixed (133 ± 29 nmol/L) training groups (p = 0.0001). Anthropometrical measures were positively associated with 25(OH)D levels; however, recent injury status or sun protection practice showed no association. Given the significant differences in 25(OH)D levels between the outdoor and indoor predominant training environments, coaches of indoor athletes may wish to monitor their athletes' Vitamin D levels throughout the year, in order to avoid any possibilities of a deficiency occurring. [ABSTRACT FROM AUTHOR]

Aim: The present investigation was designed to determine the in vivo antidiabetic effect of naringenin (NG) in normoglycaemic and diabetic rat models through blood glucose (GLU) measurements following acute and subchronic time periods. Possible modes of action of NG were investigated and its acute toxicity determined. Methods: Normoglycaemic and non-insulin-dependent diabetes mellitus (NIDDM) rat models were treated for acute and subchronic (5 days) time periods with 50 mg/kg/day of NG. Blood biochemical profiles were determined after 5 days of the treatment in normoglycaemic and NIDDM rats using commercial kits for GLU, triglycerides (TG), total cholesterol (CHOL) and high-density lipoprotein (HDL). In order to elucidate its antidiabetic mode of action, NG was administered intragastrically and an oral glucose tolerance test performed using GLU and sucrose (2 g/kg) as substrates. The inhibitory effect of a single concentration of NG (10 μM) on 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity in vitro was determined. Finally, the preclinical safety and tolerability of NG was determined by toxicological evaluation in mice and rats using Organization for Economic Cooperation and Development (OECD) protocols. Results: Intragastrically administered NG (50 mg/kg) induced a significant decrease in plasma GLU in normoglycaemic and NIDDM rat models (p < 0.05) following acute and subchronic time periods. After 5 days of administration, NG produced significant diminished blood GLU and TG levels in streptozotocin–nicotinamide–induced diabetic rats. The administration of NG to normal rats significantly increased the levels of TG, CHOL and HDL (p < 0.05). NG (5 and 50 mg/kg) induced a total suppression in the increase of plasma GLU levels after administration of substrates (p < 0.01), but NG did not produce inhibition of α-glucosidase activity in vitro. However, NG (10 μM) was shown to inhibit 11β-HSD1 activity by 39.49% in a cellular enzyme assay. Finally, NG showed a Medium Lethal Dose LD50 > 5000 mg/kg and ranking at level five based on OECD protocols. Conclusion: Our findings suggest that NG may exert its antidiabetic effect by extra-pancreatic action and by suppressing carbohydrate absorption from intestine, thereby reducing the postprandial increase in blood GLU levels. [ABSTRACT FROM AUTHOR]

Aims: To assess the effects of (1) mydriasis and (2) single versus three field photography on screening for diabetic eye disease using digital photography Method: Slit lamp examination findings were compared to digital fundal photographs for the detection of any retinopathy and for referable retinopathy in 398 patients (794 eyes). A Topcon TRC-NW6S digital non-mydriatic hindus camera was used. Three photographic strategies were used: undilated single field, dilated single field, and dilated multiple fields. The photographs were presented in random order to one of two retinal screeners. For the single field photographs the screeners were masked to the use of mydriatics. In 13% of fundal photographs, grading was performed by both, rather than lust one grader. Results: Mydriasis reduced the proportion of ungradable photographs from 26% to 5% (p<0.001). Neither mydriasis nor three field photography improved the sensitivity or specificity For the detection of any retinopathy or of referable retinopathy when compared with undilated single field photography. The sensitivity and specificity for detecting referable retinopathy using undilated single field photography was 77% (95% Cl 71 to 84) and 95 % (95% Cl 93 to 97) respectively. Using dilated single field photography the figures were 81% (95% Cl 76 to 87) and 92% (95% Cl 90 to 94) respectively. Using dilated three field photography the figures were 83% (95% CI 78 to 88) and 93% (95% Cl 91 to 96) respectively. Intergrader reliability for the detection of referable retinopathy in gradable photographs was excellent (Kappa values 0.86-1.00). Conclusions: Mydriasis reduces the technical failure rate. Mydriasis and the three field photography as used in this study do not increase the sensitivity or specificity of detecting diabetic retinopathy. [ABSTRACT FROM AUTHOR]