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Background and Aim: Antibiotics are used in veterinary clinics and animal hospitals to treat infectious diseases. However, the improper use of antibiotics causes antibiotic resistance, which threatens future disease therapeutics in pet animals. This study aimed to estimate the prevalence of Escherichia coli and Salmonella spp. in cats and their resistance to antibiotics in Yogyakarta Province, Indonesia (IDN), and Dili, Timor-Leste (TL). Materials and Methods: A total of 255 cat’s rectal swab samples from veterinary clinics and hospitals in Yogyakarta Province, IDN, and Dili, TL were collected. All samples were transferred aseptically into an enrichment medium and subjected to various culture tests for E. coli and Salmonella spp. identification. All identified isolates were tested for antibiotic sensitivity using Kirby−Bauer disk diffusion method. Results: This study successfully isolated E. coli from 172/255 (67.45%) rectal swab samples, that is, 122/188 samples (64.89%) from Yogyakarta Province, IDN, and 50/67 samples (74.6%) from Dili, TL. Salmonella spp. was isolated from 13/188 samples (6.91%) from Yogyakarta, IDN. The antibiotic susceptibility test indicated that more than 30% of E. coli were resistant to ampicillin (AMP) (IDN = 39.3%, TL = 50%) and tetracycline (TE) (IDN = 41.8%, TL = 42%), and more than 40% of Salmonella spp. were resistant to enrofloxacin (44%), TE (56%), streptomycin (61%), and AMP (83%). Conclusion: E. coli and Salmonella spp. succeeded isolation in cats from IDN and TL, and some isolates were resistant to antibiotics. Cats with diarrhea or digestive problems have a 9.5-fold increased risk of infection by Salmonella spp. Considering the prevalence of resistance to E. coli and Salmonella spp., it is important to manage antibiotic resistance distribution across companion animals and humans because both species share the same living environment.

Latar Belakang: Toxocariasis merupakan penyakit infeksi yang sering menyerang pada hewan kesayangan anjing kucing disebabkan oleh cacing Toxocara sp. Penyakit ini termasuk dalam golongan penyakit zoonosis karena dapat menular pada hewan dan pada manusia dapat menyebabkan visceral larval migrans. Tujuan penelitian ini adalah untuk mengetahui angka kejadian penyakit zoonotik Toxocariasis pada pasien anjing dan kucing yang ditangani di Klinik Hewan Jogja selama masa pandemi Covid-19 tahun 2019-2020. Hasil penelitian diharapkan dapat memberikan gambaran angka kejadian penyakit zoonosis Toxocariasis pada anjing kucing, yang selanjutnya akan sangat bermanfaat untuk dasar edukasi ke masyarakat luas untuk pencegahan atau antisipasi penyakit zoonosis tersebut. Metode: Penelitian dilakukan dengan wawancara, dan melakukan pemeriksaan secara langsung pada pasien anjing kucing yang terindikasi menderita cacingan yang ditangani di KHJ selama covid-19 tahun 2019-2020. Selanjutnya dilakukan anamnesa, pemeriksaan fisik, pemeriksaan laboratorium feses, dan penanganan pasien. Apabila ditemukan telur cacing Toxocara sp pada pemeriksaan mikroskopis feses, maka pasien dinyatakan positif menderita Toxocariasis. Penelitian juga memanfaatkan data medical record yang ada di Klinik Hewan Jogja. Hasil data yang diperoleh, selanjutnya dicatat, disajikan dalam bentuk tabel, dan dianalisis secara diskriptif. Hasil: Berdasar pada hasil penelitian menunjukkan bahwa angka kejadian penyakit zoonosis Toxocariasis tahun 2019 dan 2020 adalah pada pada anjing 1,60% dan 1,58%, dan pada kucing 4,30% dan 6,66%. Hasil penelitian menunjukkan bahwa selama covid-19 sepanjang tahun 2019-2020 Januari sampai Desember di Klinik Hewan Jogja selalu menangani pasien anjing dan kucing yang menderita Toxocariasis.Simpulan Hasil penelitian memberikan gambaran bahwa kejadian penyakit zoonosis Toxocariasis selalu ada di masyarakat, sehingga edukasi ke masyarakat luas untuk pencegahan atau antisipasi penyakit zoonosis tersebut harus terus dilakukan, sehingga masyarakat sehat terbebas dari penyakit zoonosis Toxocariasis.

Abstract Background Gut microbiome community composition differs between cervical cancer (CC) patients and healthy controls, and increased gut diversity is associated with improved outcomes after treatment. We proposed that functions of specific microbial species adjoining the mucus layer may directly impact the biology of CC. Method Metagenomes of rectal swabs in 41 CC patients were examined by whole-genome shotgun sequencing to link taxonomic structures, molecular functions, and metabolic pathway to patient’s clinical characteristics. Results Significant association of molecular functions encoded by the metagenomes was found with initial tumor size and stage. Profiling of the molecular function abundances and their distributions identified 2 microbial communities co-existing in each metagenome but having distinct metabolism and taxonomic structures. Community A (Clostridia and Proteobacteria predominant) was characterized by high activity of pathways involved in stress response, mucus glycan degradation and utilization of degradation byproducts. This community was prevalent in patients with larger, advanced stage tumors. Conversely, community B (Bacteroidia predominant) was characterized by fast growth, active oxidative phosphorylation, and production of vitamins. This community was prevalent in patients with smaller, early-stage tumors. Conclusions In this study, enrichment of mucus degrading microbial communities in rectal metagenomes of CC patients was associated with larger, more advanced stage tumors.

Purpose: The immune system’s role in mediating the cytotoxic effects of chemoradiotherapy remains not completely understood. The integration of immunotherapies into treatment will require insight into features and timing of the immune microenvironment associated with treatment response. Here, we investigated the role of circulating neutrophils and tumor-associated myeloid cells (TSAMs) as potential agents and biomarkers for disease-related outcomes in locally advanced cervical cancer (LACC). Material and Methods: Hematologic parameters for two LACC patient cohorts, a retrospective clinical and a prospective translational cohort, were obtained at baseline, weekly during chemoradiotherapy for the retrospective cohort, biweekly during chemoradiotherapy for the prospective cohort, and at the first follow-up visit for both cohorts (mean 14.7 weeks, range 8.1–25.1 weeks for the prospective cohort and 5.3 weeks with a range of 2.7–9.0 weeks for the retrospective cohort). In both cohorts, baseline as well as mean and lowest on-treatment values for platelets, hemoglobin, absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) were analyzed for correlations with disease-related outcomes. In the prospective cohort, circulating myeloid cells were isolated from peripheral blood mononuclear cells (PBMCs), and TSAMs were isolated from tumor tissue via a novel serial cytobrush sampling assay. The samples were analyzed by flow cytometry. Results: In both cohorts, the only hematologic parameter significantly associated with survival was elevated on-treatment mean ANC (mANC), which was associated with lower local failure-free and overall survival rates in the retrospective and prospective cohorts, respectively. mANC was not associated with a difference in distant metastases. CD11b+CD11c- TSAMs, which act as a surrogate marker for intratumoral neutrophils, steadily decreased during the course of chemoRT and nadier’d at week 5 of treatment. Conversely, circulating myeloid cells identified from PBMCs steadily increased through week 5 of treatment. Regression analysis confirmed an inverse relationship between circulating myeloid cells and TSAMs at this time point. Conclusions: These findings identify on-treatment mean neutrophil count as a predictor of disease-related outcomes, suggest that neutrophils contribute to chemoradiation treatment resistance, and demonstrate the importance of techniques to measure intratumoral immune activity.

Patients with cervical cancer undergoing chemoradiation have high symptom burden. We performed an analysis of prospectively collected data on patient-reported outcomes to determine characteristics predictive of poor treatment experience. Between 2021 and 2023, we prospectively collected data on patient-reported outcomes from patients with cervical cancer undergoing definitive chemoradiation. The European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Question-Core 30 and the EORTC-Quality of Life Question-Cervical Cancer module were completed at baseline (BL) and at the end of treatment (EOT). Poor treatment experience was defined as EOT poor health-related quality of life (HRQOL), low physical function, or significant overall symptom burden. Predictive factors analyzed included demographic, clinical, and disease-specific factors and BL financial toxicity, depression, social function, and emotional function. Receiver operating characteristic analysis provided appropriate predictive cutoff values. Univariable and multivariable (MVA) linear regression analyses were performed. Forty-nine patients completed BL and EOT questionnaires. Median age was 43 years (range, 18-85 years). Most patients (59%) had stage III disease. BL financial toxicity ≥66.7, depression ≥66.7, social function ≤50, and emotional function ≤58 on the EORTC linear transformed scale of 0 to 100 were significant predictors for poor treatment experience (p ≤.04) based on receiver operating characteristic analysis. On MVA, poor BL social function was associated with reduced EOT HRQOL (β, −9.3; 95% CI, −16.1 to −2.6; p <.008), decreased physical function (β, −24.4; 95% CI, −36.3 to −12.6; p <.001), and high symptom burden (β, 26.9; 95% CI, 17.5-36.3; p <.001). Earlier disease stage predicted decreased symptom burden (β, −6.7; 95% CI, −13.1 to −0.3; p =.039). BL financial toxicity was a significant predictor in univariable analysis (p =.001-.044) and showed a significant interaction term on MVA (p =.024-.041) for all 3 domains of poor treatment experience. Demographic and treatment-related factors were not predictive. Patients with cervical cancer with poor BL social function or high financial toxicity were at risk for increased symptom burden and poor HRQOL. Screening for these factors provides an opportunity for early intervention to improve treatment experience. [ABSTRACT FROM AUTHOR]

BackgroundA diverse and abundant gut microbiome can improve cancer patients' treatment response; however, the effect of pelvic chemoradiotherapy (CRT) on gut diversity and composition is unclear. The purpose of this prospective study was to identify changes in the diversity and composition of the gut microbiome during and after pelvic CRT.Materials and methodsRectal swabs from 58 women with cervical, vaginal, or vulvar cancer from two institutions were prospectively analyzed before CRT (baseline), during CRT (weeks 1, 3, and 5), and at first follow-up (week 12) using 16Sv4 rRNA gene sequencing of the V4 hypervariable region of the bacterial 16S rRNA marker gene. 42 of these patients received antibiotics during the study period. Observed operational taxonomic units (OTUs; representative of richness) and Shannon, Simpson, Inverse Simpson, and Fisher diversity indices were used to characterize alpha (within-sample) diversity. Changes over time were assessed using a paired t-test, repeated measures ANOVA, and linear mixed modeling. Compositional changes in specific bacteria over time were evaluated using linear discriminant analysis effect size.ResultsGut microbiome richness and diversity levels continually decreased throughout CRT (mean Shannon diversity index, 2.52 vs. 2.91; all P ConclusionAfter CRT, the diversity of the gut microbiomes in this population tended to return to baseline levels by the 12 week follow-up period, but structure and composition remained significantly altered. These changes should be considered when designing studies to analyze the gut microbiome in patients who receive pelvic CRT for gynecologic cancers.

Patients with gynecologic malignancies have high psychosocial and symptom burden. We report data from a prospective trial evaluating patient-reported outcome (PRO) metrics in women undergoing definitive chemoradiation with brachytherapy (BT). A single-institution prospective trial evaluating outcomes of gynecologic cancer patients undergoing BT. Questionnaires to assess PROs at baseline, post-BT, and 60-day follow-up were collected, using European Organization for Research and Treatment of Cancer-Quality of Life Question-Core 30 and European Organization for Research and Treatment of Cancer-Quality of Life Question-Cervical Cancer Module validated metrics. Higher scores for functional scales/global health and lower scores for symptom items are favorable. European Organization for Research and Treatment of Cancer-Quality of Life Question-Core 30 mean scores were compared with a reference population. When comparing the study population between time points, medians, interquartile range, and nonparametric testing were used. Thirty-three patients were enrolled, and 29 (88%) completed baseline PRO metrics. Mean global health score was worse than the reference population of women with any cancer diagnosis at baseline (41 vs 59, P <.001) and decreased further at follow-up (42 vs 33, P =.005). Compared with the cervical cancer reference, our patients had significantly worse social function (62 vs 83, P =.03), financial toxicity (49 vs 10, P <.001), fatigue (49 vs 34, P =.04), nausea/vomiting (26 vs 9, P =.001), and appetite loss (36 vs 16, P =.004).The majority of patients described depression (53%), feeling less attractive (64%), life interference (66%), and/or worry (69%). At baseline, higher global health scores were associated with improved physical functioning (R20.58, P <.001), social functioning (R20.56, P <.001), and body image (R20.40, P <.001); lower scores with more symptom burden (R20.71, P <.001), financial toxicity (R20.50, P <.001), and/or sexual worry (R20.25, P =.001). Patients with cervical cancer have significant symptom burden and psychosocial toxicity, contributing to decreased quality of life. These data highlight the need for improved support throughout treatment for this high-risk population. [ABSTRACT FROM AUTHOR]

Introduction: The standard treatment for locally advanced cervical cancer is chemoradiation, with the majority of patients having a complete response to the therapy. The current surveillance recommendations from the Society of Gynecologic Oncology include annual cytology, with a small proportion of patients subsequently diagnosed with high-grade cervical dysplasia (CIN 2/3). To date, there is limited information regarding the optimal treatment and outcome for patients diagnosed with CIN 2/3. The current report describes the diagnosis, management and outcome of 4 patients diagnosed with CIN 2/3 following chemoradiation. Case Description: We describe 4 patients who developed CIN 2/3 seven months to 8 years following radiation therapy for locally advanced cervical cancer. All 4 patients were asymptomatic and the abnormalities were first detected by a Pap test. Three of the patients were managed conservatively with observation, and the CIN 2/3 resolved without intervention. One patient underwent 2 cervical conizations followed by a hysterectomy with no residual dysplasia noted on the hysterectomy specimen. Conclusion: The majority of patients with recurrent cervical cancer after chemoradiation are symptomatic, and most cases are detected by a physical examination. The role of cytology, colposcopy and biopsies may be of limited value. Furthermore, the significance of the diagnosis of CIN 2/3 in patients previously treated with radiation therapy was not associated with recurrent disease in the 4 patients described. Our results suggest that cytology may be of limited value in detecting recurrence in patients following radiation therapy, even when CIN 2/3 is detected.

We compared the magnitude of changes in bone mineral density (BMD), within and outside the radiation field, among women who received pelvic radiation therapy (RT) with or without chemotherapy for cervical cancer. In this secondary analysis of a prospective study, we analyzed serial computed tomography scans and dual-energy x-ray absorptiometry scans from 78 patients who received definitive RT or chemoradiation therapy (CRT) for cervical cancer at a single institution from 2008 to 2015. BMD values at L1, L2, L3, and L4 were measured. We compared changes in BMD within the radiation field (ie, at L4) with those outside the field (ie, at L1). Linear mixed models were also used to examine the effect of RT on changes in BMD over time and covariate adjustment. The median age of the 78 patients was 45.5 years (range, 23-88 years); all received RT and 76 (97%) received concurrent CRT. Treatment was associated with significant declines in BMD in all 4 lumbar vertebral bodies over time (P <.05), with nadir at 3 months for L4 and at 1 year for L1. Pairwise comparisons at 3 months and 2 years after treatment indicated that BMD in L4 (within the RT field) had improved (P =.037), but BMD in L1 (outside the RT field) was no different at 3 months and 2 years. Significant BMD declines were observed in all lumbar vertebral bodies immediately after RT. However, in-field vertebral bodies reached nadir BMD earlier than those located outside the RT field. Our results suggest that treatment and patient-related factors other than RT may contribute to declines in BMD after treatment for cervical cancer. Routine bone density screening and post-RT therapy with hormones may be beneficial for selected patients who receive CRT for cervical cancer. [ABSTRACT FROM AUTHOR]

This study aimed to validate the safety of paraaortic nodal (PAN) radiation therapy (RT) for patients with cervical cancer when the duodenal dose is limited to V 55 < 15 cm3 and V 60 < 2 cm3. A total of 97 patients who were treated with RT for cervical cancer between 2010 and 2018 received at least 56 Gy to grossly involved PANs. Patients were treated with concurrent chemoradiation (n = 88; 91%), with 93% of patients (n = 90) receiving intensity modulated RT to the initial PAN field and 98% (n = 95) receiving intensity modulated RT to a sequential PAN boost. The V 55 < 15 cm3 and V 60 <2 cm3 criteria were implemented in 2014. Normal tissues were contoured on computed tomography (CT) simulation data sets, and the duodenum was contoured from the gastric outlet to the duodenojejunal flexure. Sixty-six patients (68%) had a resimulation scan after approximately 20 fractions. Composite duodenal doses were calculated using the initial CT scan for 50 patients (52%) and the resimulation CT scan for 47 patients (48%) depending on the anatomic changes throughout treatment. The median duodenal V 55 was 3.5 cm3 (interquartile range [IQR], 0.2-8.1 cm3) and the median V 60 was 0.3 cm3 (IQR, 0.0-1.8). Constraints were exceeded in 18 patients, of whom 16 patients (89%) had been treated before 2014. Treatment for the 2 patients treated after 2014 was complicated by significant weight loss and reduced anterior-posterior diameter, which likely overestimated the true dose on the composite plan. Only 1 patient experienced grade 3 duodenal toxicity (stricture requiring endoscopic balloon dilation 3 months after treatment); however, the stricture was outside of the high-dose boost volume, and the patient had a history of gastritis. Six patients (6%) had a first recurrence within the PAN region. Limiting the duodenal dose to V 55 < 15 cm3 and V 60 < 2 cm3 for patients with cervical cancer and PAN involvement is feasible, and minimizes duodenal toxicity while maintaining acceptable local control rates. [ABSTRACT FROM AUTHOR]

State-of-the-art multi-beam optics suffer from a distortion of the multi-beam array when the array is scanned over the work piece. This distortion is inherent to 2D (and 3D) laser scan heads and heavily limits the usable scan field and/or achievable processing accuracy. Here, an optical system for the independent 3D-positioning of individual beams in a multi-beam setup is presented. This approach allows to dynamically and precisely position each individual beam even for large scan fields and on tilted or curved work pieces. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the impact of radiation therapy on outcomes for patients with uterine carcinosarcoma (UC). Methods/Materials: We retrospectively reviewed the records of 155 women with stage I (98), II (11), or III (46) UC who underwent total abdominal hysterectomy/bilateral salpingo-oophorectomy at our institution between 1990 and 2011. Survival rates were assessed using the Kaplan-Meier method and log-rank test. Univariate and multivariate Cox regression analyses were performed. Results: Seventy-six patients (49%) received radiation therapy: 38 (50%) had vaginal cuff brachytherapy (VBT) alone and 38 had external beam radiation therapy (EBRT) ± VBT. Seventy patients (45%) received chemotherapy (12 concurrent, 49 adjuvant, 9 both). The 5-year overall survival rate was 48.6% (stage I, 53.8%; II, 30.0%; and III, 42.5%). The disease-specific survival (DSS) rate was 57.2% (stage I, 60.9%; II, 44.4%; and III, 51.8%). Patients treated with EBRT had a higher 5-year pelvic disease control rate (88.3%) than did patients treated with VBT only (67.4%) or no radiation (71.2%; P = 0.04). In stage III patients, EBRT was associated with higher 5-year pelvic disease control (90.0% vs 55.5%, P = 0.046), DSS (64.6% vs 46.4%, P = 0.13), and overall survival (64.6%v s 34.0%, P = 0.04) rates. For all 155 patients, age at least 65 years, cervical involvement, and lymph vascular space invasion were correlated with lower DSS on univariate and multivariate analyses. In addition, treatment with concurrent chemoradiation therapy was independently associated with a higher DSS rate on multivariate analysis. Conclusions: Patients with UC have a high rate of relapse in the regional nodes and distant sites. External beam radiation therapy improves locoregional control in all stages and may improve survival in stage III patients who are at the highest risk of pelvic relapse. [ABSTRACT FROM AUTHOR]