Thyroid cancer: possible role of telemedicine.

Telemedicine is extremely useful when distance could hinder diagnostic procedures, disease management, or when severe side-effects may occur in patients not within easy reach of medical care and requiring prompt action and specific therapies. Telemedicine has been successfully adopted in the management of chronic patients, particularly in those with cardiologic or oncologic diseases. In the treatment of differentiated thyroid cancer, requiring long-term check-ups and visits as well as administration of high doses of levothyroxine (TSH - thyroid-stimulating hormone - suppression), also in elderly patients, telemedicine seems particularly indicated. Moreover, these distant monitoring techniques could not only reduce long-term management costs but also considerably decrease cardiovascular risks associated with these patients. The present review aims to provide some general information on telemedicine and its possible fields of action with regard to distant monitoring of patients with differentiated thyroid carcinoma.

A mathematical model of cancer treatment by immunotherapy.

In this paper, a detailed mathematical study of cancer immunotherapy will be presented. General principles of cancer immunotherapy and the model equations and hypotheses will be discussed. Mathematical analyses of the model equations with regard to dissipativity, boundedness of solutions, invariance of non-negativity, nature of equilibria, persistence, extinction and global stability will be analyzed. It will also be shown that bifurcations can occur, and criteria for total cure will also be derived.

Modelling and simulation of chemotherapy of haematological and gynaecological cancers.

In this paper elaborate mathematical models and investigative computer simulations for the chemotherapy of haematological and gynaecological cancers are presented. The pharmacodynamics of the actions of the antineoplastic drugs are described by multicompartmental models with the associated model equations taking into account the drug dosage, type of delivery, route of delivery, the intercompartmental drug-transition constants, degradation parameters, and leakage coefficients. The cell-cycle phase-specific six-compartmental cytokinetic tumour growth model presented here incorporates the cell-cycle phase residence time, time lags associated with drug-induced cell-kill, or progression delays due to repair of cell damage. Investigative computer simulations are performed depicting the effects of cell-cycle phase-specific antineoplastic drugs on haematological and gynaecological cancer cells. The computer simulations are performed under various clinically plausible parametric configurations to elucidate the effects of certain critical variables such as tumour cell burden, mode of antineoplastic drug delivery, tumour cell loss and cell-cycle cytokinetic parameters.

Oxygen consumption.

It gets more and more frequent to use oxygen consumption (VO2) to evaluate exercise capacity and response to treatment in heart failure patients. The amount of VO2 is due to ventilation, oxygen transport and muscle activity. No one of these single steps can define by itself VO2, but all these physiological functions are integrated each other. In this paper we examine the modifications of cardiac output, arteriovenous oxygen content difference, and the temporal behavior of their variations during exercise in heart failure. We specifically describe changes in VO2 during simulated altitude; we also contemplate mechanisms governing oxygen diffusion from capillary bed to mitochondria and critical capillary PO2 concept.

Modelling and simulation of Rosenberg-type adoptive cellular immunotherapy.

A mathematical model is developed to describe the process of adoptive cellular immunotherapy (ACI) using the scheme of Rosenberg and other investigators. The model exhibits the dynamics of tumour cells as well as the time evolution of the tumoricidal immunocytes, such as ex vivo interleukin-2 (IL-2) expanded natural killer (NK) cells, lymphokine activated killer (LAK) cells, tumour derived activated cells (TDAC), and interferon-gamma (IFN-gamma) activated killer monocytes (AKM). The model is described mathematically by a system of nonlinear functional-differential equations. Computer simulations based on the model equations are performed using parametric configurations analogous to the protocols used in the clinical trials. The model elucidates explicitly the effects of time delays, effector immunocyte-to-tumour cell ratio, tumour growth parameters, and other critical variables on the prognosis, and the therapeutic efficacy of adoptive cellular immunotherapy.