Non steroidal anti-inflammatory drugs and COX-2 inhibitors as anti-cancer therapeutics: hypes, hopes and reality.

Non-steroidal anti-inflammatory drugs (NSAIDs) and specific inhibitors of cyclooxygenase (COX)-2, are therapeutic groups widely used for the treatment of pain, inflammation and fever. There is growing experimental and clinical evidence indicating NSAIDs and COX-2 inhibitors also have anti-cancer activity. Epidemiological studies have shown that regular use of Aspirin and other NSAIDs reduces the risk of developing cancer, in particular of the colon. Molecular pathology studies have revealed that COX-2 is expressed by cancer cells and cells of the tumor stroma during tumor progression and in response to chemotherapy or radiotherapy. Experimental studies have demonstrated that COX-2 over expression promotes tumorigenesis, and that NSAIDs and COX-2 inhibitors suppress tumorigenesis and tumor progression. Clinical trials have shown that NSAIDs and COX-2 inhibitors suppress colon polyp formation and malignant progression in patients with familial adenomatous polyposis (FAP) syndrome. Recent advances in the understanding of the cellular and molecular mechanisms of the anti-cancer effects of NSAIDs and COX-2 inhibitors have demonstrated that these drugs target both tumor cells and the tumor vasculature. The therapeutic benefits of COX-2 inhibitors in the treatment of human cancer in combination with chemotherapy or radiotherapy are currently being tested in clinical trials. In this article we will review recent advances in the understanding of the anti-tumor mechanisms of these drugs and discuss their potential application in clinical oncology.

Tal med anledning av regeringsformens 40-årsjubileum (17.7.1959 i radio och TV)

Puhe

Diagnostic de la maladie coronarienne stable par FFR non invasive, mythe ou réalité [Diagnosis of stable coronary artery disease with non-invasive FFR: myth or reality?].

Decision to revascularize a patient with stable coronary artery disease should be based on the detection of myocardial ischemia. If this decision can be straightforward with significant stenosis or in non-significant stenosis, the decision with intermediate stenosis is far more difficult and require invasive measures of functional impact of coronary stenosis on maximal blood (flow fractional flow reserve=FFR). A recent computer based method has been developed and is able to measure FFR with data acquired during a standard coronary CT-scan (FFRcT). Two recent clinical studies (DeFACTO and DISCOVER-FLOW) show that diagnostic performance of FFRcT was associated with improved diagnostic accuracy versus standard coronary CT-scan for the detection of myocardial ischemia although FFRcT need further development.

Då "de två storas" samarbete befästes (tal hållet den 31.10.1954 i Kangaslampi)

Puhe

TV or not TV? Subtitling and English skills

We study the influence of television translation techniques on the quality of the English spoken across the EU and OCDE. We identify a large positive effect for subtitled original version as opposed to dubbed television, which loosely corresponds to between four and twenty years of compulsory English education at school. We also show that the importance of subtitled television is robust to a wide array of specifications.We then find that subtitling and better English skills have an influence on high-tech exports, international student mobility, and other economic and social outcomes.

Tasavallan Presidentti Urho Kekkosen vierailu Tshekkoslovakiaan 1.-4.10.1969 (Tasavallan Presidentin radio- ja TV-haastattelu Romanian, Unkarin ja Tshekkoslovakian matkojen jälkeen 6.10.1969)

Haastattelu

Access to a simulator is not enough: the benefits of virtual reality training based on peer-group-derived benchmarks--a randomized controlled trial.

BACKGROUND: Virtual reality (VR) simulators are widely used to familiarize surgical novices with laparoscopy, but VR training methods differ in efficacy. In the present trial, self-controlled basic VR training (SC-training) was tested against training based on peer-group-derived benchmarks (PGD-training). METHODS: First, novice laparoscopic residents were randomized into a SC group (n = 34), and a group using PGD-benchmarks (n = 34) for basic laparoscopic training. After completing basic training, both groups performed 60 VR laparoscopic cholecystectomies for performance analysis. Primary endpoints were simulator metrics; secondary endpoints were program adherence, trainee motivation, and training efficacy. RESULTS: Altogether, 66 residents completed basic training, and 3,837 of 3,960 (96.8 %) cholecystectomies were available for analysis. Course adherence was good, with only two dropouts, both in the SC-group. The PGD-group spent more time and repetitions in basic training until the benchmarks were reached and subsequently showed better performance in the readout cholecystectomies: Median time (gallbladder extraction) showed significant differences of 520 s (IQR 354-738 s) in SC-training versus 390 s (IQR 278-536 s) in the PGD-group (p < 0.001) and 215 s (IQR 175-276 s) in experts, respectively. Path length of the right instrument also showed significant differences, again with the PGD-training group being more efficient. CONCLUSIONS: Basic VR laparoscopic training based on PGD benchmarks with external assessment is superior to SC training, resulting in higher trainee motivation and better performance in simulated laparoscopic cholecystectomies. We recommend such a basic course based on PGD benchmarks before advancing to more elaborate VR training.

Kristillisen TV-ohjelman ennakkosuunnitteluvaiheen erityispiirteitä

Opinnäytetyöni on kirjallinen tutkielma ja käsittelen siinä uuden kristillisiin arvoihin pohjaavan tv-ohjelmasarjan ennakkosuunnitteluvaihetta kristilliselle televisiokanavalle. Varsinainen tavoitteeni oli selvittää ennakkosuunnitteluvaiheen erityispiirteitä kristityn tuottajan näkökulmasta. Tutkimukseni perustuu teemahaastatteluun, ja haastattelin kolmea kristittyä av-tuottajaa, jotka ovat aiemmin tuottaneet kristillisiä ohjelmia, sekä oman työni havainnointiin ja reflektointiin tuottajana. Aluksi määrittelen kristillisyyden käsitteen ja sen, mitä sillä tässä työssä tarkoitetaan. Lisäksi esittelen viitekehyksenä kristilliseen tv-toimintaan liittyvää tietoa kotimaassa ja ulkomailla. Haastattelut paljastivat, että kristillistä tv-ohjelmaa suunniteltaessa on tärkeää huomioida se, että kristilliselle tv-kanavalle tehdyistä ohjelmista ei makseta, vaan kustannukset jäävät ohjelman tekijöille. Rahanpuute ilmeneekin kristillisten ohjelmien tuotantojen ongelmana. Ohjelman sisällöllä on keskeinen merkitys suunnitteluvaiheessa. Sen on oltava sisällöllisesti syvällistä ja tarkkaan mietittyä ja suunniteltua. Ohjelman tekijöiltä tarvitaankin kristillistä näkökulmaa, jotta haluttu lopputulos saavutettaisiin. Rukous oli haastateltujen tuottajien kristillisyyden ilmentymä ohjelman suunnittelussa. Sen avulla he kokivat, että Jumala pääsee vaikuttamaan heissä tahtomisen ja tekemisen. Kun halutaan välittää kristillistä sanomaa, ohjelman sisällöntuottajien, eli käsikirjoittajan ja ohjaajan, on oltava kristittyjä, mikäli he vaikuttavat suoraan sisältöön. Muun työryhmän kristillisyydellä ei ole niin suurta merkitystä, jos asenne on positiivinen kristillisiä arvoja, muuta työryhmää ja työtä kohtaan. Tuottajien kristillisyys vaikuttaa heidän tekemiinsä valintoihin, ohjelmien sisältöön ja kanssakäymiseen muiden ihmisten kanssa.

Advance directives as autonomy enhancers: reality or myth?

In the last few decades there has been a wealth of literature and legislation on advance directives. As you all know, it is an instrument by which a person can express their wishes as regards what treatmentthey should be given or, more to the point, not to be given, when he is in a situation when he can not do so himself.Regulations in the western world seem to promote advance directives as a way to enhance patient¿s autonomy in thecontext of human rights, and the media has presented advance directives as another milestone in this era of selfdetermination.However, if we look closely at some of thoseregulations we will see that there are a few elements which may undermine their efficacy, shattering this nicely presentedpicture. I will focus on two elements. First, formal requirements, and secondly, certain limits or what I like to call "escape clauses".

Advance directives as autonomy enhancers: reality or myth?

In the last few decades there has been a wealth of literature and legislation on advance directives. As you all know, it is an instrument by which a person can express their wishes as regards what treatmentthey should be given or, more to the point, not to be given, when he is in a situation when he can not do so himself.Regulations in the western world seem to promote advance directives as a way to enhance patient¿s autonomy in thecontext of human rights, and the media has presented advance directives as another milestone in this era of selfdetermination.However, if we look closely at some of thoseregulations we will see that there are a few elements which may undermine their efficacy, shattering this nicely presentedpicture. I will focus on two elements. First, formal requirements, and secondly, certain limits or what I like to call "escape clauses".

Advance directives as autonomy enhancers: reality or myth?

In the last few decades there has been a wealth of literature and legislation on advance directives. As you all know, it is an instrument by which a person can express their wishes as regards what treatmentthey should be given or, more to the point, not to be given, when he is in a situation when he can not do so himself.Regulations in the western world seem to promote advance directives as a way to enhance patient¿s autonomy in thecontext of human rights, and the media has presented advance directives as another milestone in this era of selfdetermination.However, if we look closely at some of thoseregulations we will see that there are a few elements which may undermine their efficacy, shattering this nicely presentedpicture. I will focus on two elements. First, formal requirements, and secondly, certain limits or what I like to call "escape clauses".

Postmortem biochemistry: mith or reality?

Postmortem biochemistry is becoming increasingly essential in the forensic casework and considerable progress has been made over the past years. Biochemical analyses of blood, postmortem serum, pericardial fluid, vitreous humor and urine may indeed provide significant information in identifying the cause of death as well as characterizing the precipitating conditions and the predisposing disorders. Postmortem biochemical analyses are decisive in determining the cause of death when the pathophysiological changes involved in the process cannot be otherwise ascertained by morphological investigations (mainly diabetic and alcoholic ketoacidosis). It can also provide significant information and useful support in numerous situations on forensic interest, including cold exposure-related deaths, fatal anaphylaxis, bacterial infection-related fatalities and hormonal disturbances. In this report we present an overview pertaining to the diagnostic performance of classical and novel biochemical markers in the forensic setting.