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Purpose: To assess the safety and effectiveness of transarterial radioembolization (TARE) in the treatment of hepatic metastases from pancreatic ductal adenocarcinoma (PDAC).Materials and Methods: A systematic search of the Embase and MEDLINE databases was conducted using keywords and Medical Subject Headings terms related to TARE and hepatic metastases from PDAC. Observational studies and clinical trials reporting overall survival (OS), hepatic progression-free survival (hPFS), or tumor response after TARE were included.Results: Eight studies, comprising 145 patients with metastatic PDAC, met the inclusion criteria. No randomized controlled trials were identified, and 4 studies were prospective. Forty-four (30.3%) patients underwent previous pancreatic resection, and 66 (45.5%) had extrahepatic metastases at the time of TARE. Most studies (n = 6) used resin microspheres for TARE. The pooled disease control rate was 69.4% at a median of 3 months. The median OS from the time of TARE ranged from 3.7 to 9 months. The median hPFS ranged from 2.4 to 5.2 months. There were 31 Grade 3-4 biochemical toxicities and 4 treatment-related deaths.Conclusions: The role of TARE in patients with hepatic metastases from PDAC remains unclear owing to low patient numbers, limited prospective data, and heterogeneity in the study design. Further prospective studies are required to evaluate the role of TARE in carefully selected patients with liver-only metastatic disease. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study aimed to investigate whether the endogenous active levels of MMP-9 or tissue inhibitor of metalloproteinases-1 (TIMP-1) were related to indices of diastolic dysfunction (DD) in the setting of contemporary treatment of coronary artery disease (CAD). Methods and results: We prospectively studied 116 patients with CAD and preserved left ventricular LV systolic function (ejection fraction≥45%). All patients were free of heart failure symptoms at recruitment and underwent percutaneous intervention (PCI) of culprit lesions. Demographic and angiographic characteristics were collected. Plasma samples were analysed for the active form of MMP-9 and TIMP-1 using enzyme-linked immunosorbent assay-based isoform sensitive assays. Conventional and tissue Doppler-echocardiographic assessment of diastolic filling was undertaken with measurements of maximal early (E) and late (A) transmitral velocities in diastole, E/A ratio, E-wave deceleration time, isovolumic relaxation time, peak systolic (S), diastolic (D) and atrial reversal velocities of pulmonary venous flow, S/D fraction, time difference between A and duration of atrial reversal flow, early diastolic peak velocities of the lateral mitral annulus (E′) and E/E′. Active MMP-9 level was higher in patients with more severe phases of DD (normal [n=22]: median 0.57ng/ml; mild [n=19] 0.83ng/ml; mild-moderate [n=41] 0.64ng/ml; moderate or severe [n=34] 1.63ng/ml; p<0.0001 for trend). Three month post-PCI elevated levels of active MMP-9 had an adjusted odds ratio of 11.2 (2.3–56.0, p<0.004) for association with moderate or severe DD. Conclusion: Elevated active MMP-9 level is associated with more severe DD in patients with CAD and preserved systolic function, which may indicate abnormal extracellular matrix metabolism in myocardial ischaemia. [Copyright &y& Elsevier]

The influence of ankle kinematics and plantar pressure from mid-range barefoot running on T2 relaxation times of tibiotalar cartilage is unknown. This study aimed to quantitatively evaluate the T2 relaxation time of tibiotalar cartilage and ankle biomechanics following 5 km barefoot running. Twenty healthy runners (who had no 5 km barefoot running experience) underwent 3.0-Tesla magnetic resonance (MR) scans and assessment of running gait before and after 5 km barefoot running. Participants were divided into two groups consisting of marathon-experienced (n = 10) and novice (n = 10) with equal number of males and females in each group. Three musculoskeletal radiologists measured T2 relaxation times in 18 regions of the ankle cartilage: anterior zone, central zone, and posterior zone, or lateral, middle, and medial sections in the sagittal plane. Three-dimensional ankle kinetics, kinematics, and plantar pressure were all also assessed during barefoot running. In the novice group, the T2 relaxation time in the posterior zone of tibial cartilage (p = 0.001) and lateral section in both tibial (p = 0.02) and talar (p = 0.02) cartilage were significantly increased after barefoot running. Ankle kinematics exhibited significant changes in females. Plantar loading was shifted from the medial to lateral aspect after running. This included a significant reduction in the loading under the toes and the 1st, 2nd and 3rd metatarsals, with a significant increase under the 4th and 5th metatarsals and lateral midfoot. The results suggest that plantar pressure may directly lead to local increases in cartilage T2 signal, which was not associated with changes in ankle kinematics. [ABSTRACT FROM AUTHOR]