The discovery of electroporation in 1968 has led to the development of electrochemotherapy (ECT) and irreversible electroporation (IRE). ECT and IRE have been established as treatments of cutaneous and subcutaneous tumors and locally advanced pancreatic cancer, respectively. Interestingly, the treatment modalities have been shown to elicit immunogenic cell death, which in turn can induce an immune response towards the tumor cells. With the dawn of the immunotherapy era, the potential of combining ECT and IRE with immunotherapy has led to the launch of numerous studies. Data from the first clinical trials are promising, and new combination regimes might change the way we treat tumors characterized by low immunogenicity and high levels of immunosuppression, such as melanoma and pancreatic cancer. In this review we will give an introduction to ECT and IRE and discuss the impact on the immune system. Additionally, we will present the results of clinical and preclinical trials, investigating the combination of electroporation modalities and immunotherapy.

Background Systematic reviews (SRs) are considered one of the most reliable types of studies in evidence-based medicine. SRs rely on a comprehensive and systematic data gathering, including the search of academic literature databases. This study aimed to investigate which combination of databases would result in the highest overall recall rate of references when conducting SRs of qualitative research regarding diabetes mellitus. Furthermore, we aimed to investigate the current use of databases and other sources for data collection. Methods Twenty-six SRs (published between 2010 and 2020) of qualitative research regarding diabetes mellitus, located through PubMed, met the inclusion criteria. References of the SRs were systematically hand searched in the six academic literature databases CINAHL, MEDLINE/PubMed, PsycINFO, Embase, Web of Science, and Scopus and the academic search engine Google Scholar. Recall rates were calculated using the total number of included references retrieved by the database or database combination divided by the total number of included references, given in percentage. Results The SRs searched five databases on average (range two to nine). MEDLINE/PubMed was the most commonly searched database (100% of SRs). In addition to academic databases, 18 of the 26 (69%) SRs hand searched the reference lists of included articles. This technique resulted in a median (IQR) of 2.5 (one to six) more references being included per SR than by database searches alone. 27 (5.4%) references were found only in one of six databases (when Google Scholar was excluded), with CINAHL retrieving the highest number of unique references (n = 15). The combinations of MEDLINE/PubMed and CINAHL (96.4%) and MEDLINE/PubMed, CINAHL, and Embase (98.8%) yielded the highest overall recall rates, with Google Scholar excluded. Conclusions We found that the combinations of MEDLINE/PubMed and CINAHL and MEDLINE/PubMed, CINAHL, and Embase yielded the highest overall recall rates of references included in SRs of qualitative research regarding diabetes mellitus. However, other combinations of databases yielded corresponding recall rates and are expected to perform comparably. Google Scholar can be a useful supplement to traditional scientific databases to ensure an optimal and comprehensive retrieval of relevant references.

Background Systematic reviews (SRs) are considered one of the most reliable types of studies in evidence-based medicine. This relies on a comprehensive and systematic search by choosing ideal data gathering methods including selection of databases. The aim of this study was to investigate which combination of databases results in the highest recall of references when conducting SRs on qualitative research regarding diabetes mellitus. Furthermore, we aimed to investigate the current use of databases and the importance of other sources for data collection. Methods 23 SRs (published between the year 2010 and 2019) on qualitative research regarding diabetes mellitus were located through searching PubMed and met the inclusion criteria. Data, including number of databases searched, names of databases, use of additional data sources and use of information specialists were collected for each SR. The SRs concluded a total of 459 unique, qualitative references on diabetes mellitus. These references were systematically hand searched in the five most searched databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Embase and PubMed. Results The SRs searched four databases on average (range two to eight). CINAHL was the most searched database, (19 of the 23 SRs). Two SRs mentioned the involvement of an information specialist and 16 of 23 (70%) SRs searched reference lists of included references, which on average resulted in 16% more references being included. A total of 36 (8%) references were found only in one of the five databases, with CINAHL retrieving the highest number of unique references. Searching the combination of the three databases PubMed, Embase and CINAHL resulted in an overall recall rate of 99.3%, while adding PsycINFO increased overall recall to 99.8%. Conclusions We recommend combining the searches of CINAHL, PubMed, Embase and PsychINFO, and to involve an information specialist to ensure high recall rates, when conducting SRs on qualitative research regarding diabetes mellitus. Especially CINAHL is highly relevant and important to use when searching for qualitative research.

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Background and purpose — It is well recognized that some knee arthroplasty (KA) patients present with prolonged postoperative inflammation and some develop persistent pain. It can reasonably be speculated that some of these problems develop because of low-grade infections with low virulence bacteria caused by intraoperative contamination. This prospective study was performed to investigate whether intraoperative contamination results in lower patient-reported outcomes (PRO) for patients who were clinically uninfected in the first year after surgery. Patients and methods — We combined data from 2 major prospective studies on patients undergoing primary KA at 2 Danish hospitals between September 2016 and January 2018. Pre- and postoperative (1.5, 3, 6, and 12 months) PROs and intraoperative microbiological cultures were obtained on a total of 714 patients who were included in the study. Based on the microbiological cultures, the patients were divided into 2 groups, contaminated and non-contaminated, and differences in PROs between the 2 groups were analyzed. Results — 84 of 714 (12%) patients were intraoperatively contaminated; none of the 714 patients developed clinical infection. The preoperative Oxford Knee Score was 24 and 23 for contaminated and non-contaminated patients, respectively, improving to 40 and 39 at 1 year (p = 0.8). 1-year AUC for Oxford Knee Score and absolute improvement at each postoperative time point for Forgotten Joint Score and EQ-5D-5L also were similar between contaminated and non-contaminated patients. Interpretation — Patient-reported outcomes from 714 patients do not indicate that intraoperative contamination affects the knee-specific or general health-related quality of life in primary KA patients who are clinically uninfected 1 year after surgery.