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Astrocytic brain tumours, including glioblastomas, are incurable neoplasms characterized by diffusely infiltrative growth. Here we show that many tumour cells in astrocytomas extend ultra-long membrane protrusions, and use these distinct tumour microtubes as routes for brain invasion, proliferation, and to interconnect over long distances. The resulting network allows multicellular communication through microtube-associated gap junctions. When damage to the network occurred, tumour microtubes were used for repair. Moreover, the microtube-connected astrocytoma cells, but not those remaining unconnected throughout tumour progression, were protected from cell death inflicted by radiotherapy. The neuronal growth-associated protein 43 was important for microtube formation and function, and drove microtubedependent tumour cell invasion, proliferation, interconnection, and radioresistance. Oligodendroglial brain tumours were deficient in this mechanism. In summary, astrocytomas can develop functional multicellular network structures. Disconnection of astrocytoma cells by targeting their tumour microtubes emerges as a new principle to reduce the treatment resistance of this disease., Astrocytomas (World Health Organisation grades II, III and IV; grade IV are called glioblastomas) are prototypical examples for highly invasive tumours that diffusely colonize their host organ (1), which ultimately [...]

Preventive chemotherapy as a public health strategy Preventive chemotherapy (PC) is the public health strategy defined as the administration of a safe medicine, either alone or in combination, as a [...]

The global map of distribution of the 4 main helminthiases amenable to preventive chemotherapy (PC)--lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis and onchocerciasis--has been progressively refined and the population requiring PC annually [...]

Byline: Vikas. Kumar, Daljit. Singh, Hukum. Singh, Ravindra. Saran Glioblastoma (GBM) is the most common malignant tumor in adults. Extracranial metastasis of GBM is very rare. The incidence of brainstem [...]

Byline: Y. Yadav, V. Mallya, C. Ahluwalia, O. Gupta Sir, Pancreatic infiltration with leukemic cells is a rare manifestation of acute lymphoblastic leukemia (ALL) and it is even more rare [...]

Byline: K. Kaur, M. Sood, S. Bhagat, T. Singh, M. Jain, D. Arora, J. Sekhon, S. Kaushal Background: Adverse drug reaction (ADR) monitoring is slowly developing as an important aspect [...]

Byline: Rachel. Pavey, Srinath. Kambil, Ramesh. Bhat INTRODUCTION New anticancer drugs developed over the last few decades have improved the survival rate in cancer patients. Traditional chemotherapy drugs as well [...]

Introduction: HIV-associated Kaposi sarcoma (HIV-KS) is the most common cancer in Malawi. In 2008, the non-governmental organization, Partners In Health, and the Ministry of Health established the Neno Kaposi Sarcoma Clinic (NKSC) to treat HIV-KS in rural Neno district. We aimed to evaluate 12-month clinical outcomes and retention in care for HIV-KS patients in the NKSC, and to describe our implementation model, which featured protocol-guided chemotherapy, integrated antiretroviral therapy (ART) and psychosocial support delivered by community health workers. Methods: We conducted a retrospective cohort study using routine clinical data from 114 adult HIV-KS patients who received ART and [greater than or equal to] 1 chemotherapy cycle in the NKSC between March 2008 and February 2012. Results: At enrolment 97% of patients (n/N = 103/106) had advanced HIV-KS (stage T1). Most patients were male (n/N =85/ 114, 75%) with median age 36 years (interquartile range, IQR: 29-42). Patients started ART a median of 77 days prior to chemotherapy (IQR: 36-252), with 97% (n/N = 105/108) receiving nevirapine/lamivudine/stavudine. Following standardized protocols, we treated 20 patients (18%) with first-line paclitaxel and 94 patients (82%) with bleomycin plus vincristine (BV). Of the 94 BV patients, 24 (26%) failed to respond to BV requiring change to second-line paclitaxel. A Division of AIDS grade 3/4 adverse event occurred in 29% of patients (n/N = 30/102). Neutropenia was the most common grade 3/4 event (n/N = 17/102, 17%). Twelve months after chemotherapy initiation, 83% of patients (95% CI: 74-89%) were alive, including 88 (77%) retained in care. Overall survival (OS) at 12 months did not differ by initial chemotherapy regimen (p =0.6). Among patients with T1 disease, low body mass index (BMI) (adjusted hazard ratio, aHR =4.10, 95% CI: 1.06-15.89) and 1 g/dL decrease in baseline haemoglobin (aHR = 1.52, 95% CI: 1.03-2.25) were associated with increased death or loss to follow-up at 12 months. Conclusions: The NKSC model resulted in infrequent adverse events, low loss to follow-up and excellent OS. Our results suggest it is safe, effective and feasible to provide standard-of-care chemotherapy regimens from the developed world, integrated with ART, to treat HIV-KS in rural Malawi. Baseline BMI and haemoglobin may represent important patient characteristics associated with HIV-KS survival in rural sub-Saharan Africa. Keywords: Kaposi sarcoma; antiretroviral therapy; community health worker; Malawi; paclitaxel; bleomycin; vincristine; psychosocial support., Introduction Kaposi sarcoma (KS) is a major cause of morbidity and mortality in sub-Saharan Africa (SSA), resulting in 25,000 deaths each year [1]. In Malawi, KS is the most common [...]

Byline: Kuntal. Das, Sushila. Jaiswal, Mukesh. Shukla, Arun. Srivastava, Sanjay. Behari, Raj. Kumar Spinal intramedullary tuberculoma (SIT) is a rare manifestation of neurotuberculosis. Concurrent SIT and intracranial tuberculoma are further [...]

Byline: Viral. Bhanvadia, Jignesh. Parmar, Yogendra. Madan, Shamim. Sheikh Primary peritoneal serous carcinoma (PPSC) is a rare primary malignancy that diffusely involves the peritoneum, indistinguishable clinically and histopathologically from primary [...]

Byline: Ritesh. Kumar, Rakesh. Kapoor, Divya. Khosla, Narendra. Kumar, Pramod. Singh, Mahendra. Kumar, S. Sharma Background: Pelvic osteosarcoma is a rare and aggressive malignant neoplasm with poor outcomes. It represents [...]

Byline: Sandip. Chatterjee Central nervous system tuberculosis in children presents commonly as tubercular meningitis, post-tubercular meningitis hydrocephalus, and much more rarely as space-occupying lesions known as tuberculomas. The occurrence of [...]

Byline: Sandip. Chatterjee, Uttara. Chatterjee Intramedullary tumors of the spinal cord account for 35-40% of intraspinal tumors in children. The biological behavior of these tumors is of slow progression, and [...]

Paragangliomas are extra-adrenal chromaffin tumours (1) that develop at the expense of neuroectodermal cells of the autonomous nervous system. (2) Retroperitoneal and nonfunctioning forms are very rare. (3) They are [...]