Circulating tumor cell detection in high-risk non-metastatic prostate cancer

Purpose The detection of circulating tumor cells (CTCs) provides important prognostic information in men with metastatic prostate cancer. We aim to determine the rate of detection of CTCs in patients with high-risk non-metastatic prostate cancer using the CellSearch® method. Method Samples of peripheral blood (7.5 mL) were drawn from 36 men with newly diagnosed high-risk non-metastatic prostate cancer, prior to any initiation of therapy and analyzed for CTCs using the CellSearch® method. Results The median age was 70 years, median PSA was 14.1, and the median Gleason score was 9. The median 5-year risk of progression of disease using a validated nomogram was 39 %. Five out of 36 patients (14 %, 95 % CI 5–30 %) had CTCs detected in their circulation. Four patients had only 1 CTC per 7.5 mL of blood detected. One patient had 3 CTCs per 7.5 mL of blood detected, which included a circulating tumor microemboli. Both on univariate analysis and multivariate analysis, there were no correlations found between CTC positivity and the classic prognostic factors including PSA, Gleason score, T-stage and age. Conclusion This study demonstrates that patients with high-risk, non-metastatic prostate cancer present infrequently with small number of CTCs in peripheral blood. This finding is consistent with the limited literature available in this setting. Other CTC isolation and detection technologies with improved sensitivity and specificity may enable detection of CTCs with mesenchymal phenotypes, although none as yet have been validated for clinical use. Newer assays are emerging for detection of new putative biomarkers for prostate cancer. Correlation of disease control outcomes with CTC detection will be important.

Dieting and non-dieting: Socio-cognitive determinants and associations with nutrition and health status indicators

Dieting and non-dieting are two contrasting approaches to the management of overweight/obesity, but less is known about why people follow non-dieting approaches and how these approaches are associated with health and nutrition status indicators. This thesis enables a greater understanding of why dieting and non-dieting approaches are adopted and provides insight into whether one approach is more favourably associated with nutrition and health status indicators. The findings of this thesis will be useful for clinicians who wish to encourage dieting or non-dieting approaches in their clients and for researchers wishing to understand how best to address overweight and obesity.

Expulsion of Afghan refugees from Pakistan: A violation of principle of non-refoulement

This article addresses the need of an implementation mechanism for the protection of refugees’ rights. However, it is contended that the principle forms part of Customary International Law, under which it is binding on all states irrespective of whether or not they are parties to the Convention Relating to the Status of Refugees 1951 or its Protocol 1967. Since last decade, U.S and its allies have been fighting to curve terrorism which has raised many issues such as human rights violation, deportation, expulsion, extradition, rendition and many more. Pakistan has played a very critical role in War against Terrorism, particularly in reference of war in Afghanistan. Particular concern of this article is the violation of refugees’ rights in Pakistan in 2008 and 2010. This article would highlight the legislation regarding non-expulsion of Afghan refugees from Pakistan to a territory where they have well founded fear of persecution. Article is divided into three parts, the first one deals with “Principle of Non-Refoulement”, the second one deals with “exceptions to the principle” whereas the last one discusses the violation of the very principle in Pakistan with reference to Afghan refugees.