No abstract

Background/aim: Celecoxib, a cyclooxygenase-2 inhibitor and antiangiogenic agent, has demonstrated potent anticancer effects in preclinical studies and in human clinical trials. To evaluate the potential utility of this agent in the treatment of retinoblastoma, the authors investigated the effects of celecoxib in retinoblastoma cell lines and in a murine model of this disease. Methods: Growth inhibitory effects of celecoxib were evaluated in Y79 and Weri-RB1 human retinoblastoma cell lines by WST-1 cell proliferation assay. For animal study, two groups of 24, 8 week old LHb-TAg transgenic mice were treated with celecoxib (250 mg/kg, orally once a day) or vehicle control, 5 days/week for 6 weeks. Mice were sacrificed on day 43. Enucleated eyes were serially sectioned and ocular tumour burden was quantified by histopathological analysis. Results: Celecoxib did not inhibit proliferation of Y79 or Weri-RB1 cells, even at concentrations far exceeding clinically achievable levels. No significant difference in ocular tumour burden between celecoxib treated and control mice (p = 0.73) was found. Conclusion: Celecoxib was ineffective at inhibiting proliferation of retinoblastoma cells in vitro and was ineffective at controlling retinoblastoma tumour growth in a murine model of this disease. On the basis of these findings, oral celecoxib therapy is unlikely to have clinical utility in the treatment of retinoblastoma.

Standardized counseling improves patient knowledge about induction of labor. In the future, this information can be used to appropriately direct patients' expectations and improve satisfaction with the induction process.

l Malpresentation is associated with uterine anomalies, fibroids, placenta previa, grand multiparity, contracted maternal pelvis, pelvic tumors, prematurity (the earlier the gestational age, the higher the incidence of malpresentation), multiple gestation, polyhydramnios, short umbilical cord, fetal anomalies (e.g., anencephaly, hydrocephalus), abnormal fetal motor ability, and prior breech delivery. l Complications of breech presentation are congenital anomalies, preterm birth (PTB), birth trauma, low Apgar scores, and lower pH, mostly regardless of mode of delivery. Cord prolapse, head hyperextension, and head or arm entrapment are more common with vaginal breech delivery. l External cephalic version (ECV) is a safe and effective intervention. Urgent cesarean delivery (CD) for nonreassuring fetal heart rate tracing (NRFHT) and placental abruption occur in <0.5% of ECV. l ECV is avoided with any contraindications to vaginal delivery such as placenta previa, or prior classical uterine incision, and, relatively, with rupture of membranes, oligohydramnios, known uterine or fetal anomaly, unexplained uterine bleeding, or active phase of labor. l ECV reduces the incidences of noncephalic birth by 54% and CD by 37%. Because ECV is associated with a very low incidence of adverse events and with a significant decrease in CD, all women at or near term with nonvertex presentations should be offered an ECV attempt. Success rates range roughly average 50% to 70%. Success is increased with higher parity, transverse or oblique lie, nonengagement of the breech, a relaxed uterus, a palpable fetal head, and maternal weight less than 65 kg. l There is insufficient evidence to assess the best gestational age at which to perform ECV. Compared with ECV at term, ECV before term (e.g., 34-35 weeks) reduces noncephalic presentation at birth but does not reduce the rate of CD, and may be associated with an increase in the incidence of PTB. About 36 weeks is generally considered to be the optimal time for attempted version.l Tocolysis with betamimetics prior to attempt at ECV is associated with fewer failures of ECV, and less CDs. l Anesthetic dose neuraxial blockade (usually with spinal) is associated with a 44% increase in the success rate of external fetal version. l ECV should be performed in a facility with ready availability for emergency CD, after appropriate counseling and consent, with ultrasound availability. l