Publications by authors named "Ruff P"

Background: Breast cancer is the most common malignancy diagnosed among women in South Africa, with the aggressive triple-negative subtype comprising approximately 15% of breast cancers in this population. South Africa has the largest population of people with HIV in the world. This study aims to evaluate the association between HIV status and the proportion of patients with breast cancer with the triple-negative subtype.

View Article and Find Full Text PDF

Intravenous pembrolizumab 400 mg every 6 weeks was approved across tumor types based on pharmacokinetic modeling, which showed exposures consistent with previous standard dosing of 200 mg or 2 mg/kg every 3 weeks, and early results of cohort B of the phase 1 KEYNOTE-555 study. Results after ≥1 year of potential follow-up for all patients in cohort B of KEYNOTE-555 are presented. Patients aged ≥18 years with previously untreated stage III/IV melanoma received pembrolizumab 400 mg every 6 weeks for ≤18 cycles.

View Article and Find Full Text PDF

Background: The introduction of medical advancements requires ongoing critical evaluation of clinical practice and patient outcomes to improve results and safety. Since the development of minimally invasive, energy-based devices, this process has been occurring throughout the field of aesthetic medicine.

Objectives: To collect retrospective procedure and safety data of liposuction procedures with or without adjunct utilization of a helium-based plasma device, compare 3 groups, and delineate the learning curve.

View Article and Find Full Text PDF

The discovery of novel and innovative therapeutic strategies for cancer treatment and management remains a major global challenge. Exosomes are endogenous nanoscale extracellular vesicles that have garnered increasing attention as innovative vehicles for advanced drug delivery and targeted therapy. The attractive physicochemical and biological properties of exosomes, including increased permeability, biocompatibility, extended half-life in circulation, reduced toxicity and immunogenicity, and multiple functionalization strategies, have made them preferred drug delivery vehicles in cancer and other diseases.

View Article and Find Full Text PDF

Cervical cancer is a major cause of morbidity and mortality globally with a disproportionate impact on women in low- and middle-income countries. In 2021, the World Health Organization (WHO) called for increased vaccination, screening, and treatment to eliminate cervical cancer. However, even with widespread rollout of human papillomavirus (HPV) prophylactic vaccines, millions of women who previously acquired HPV infections will remain at risk for progression to cancer for decades to come.

View Article and Find Full Text PDF

Purpose: We aimed to evaluate for associations between HIV status, psychosocial factors, and adjuvant endocrine therapy (AET) adherence in South African (SA) women with estrogen receptor positive (ER+) breast cancer (BC).

Methods: We enrolled South African women with early-stage ER + BC in remission and prescribed tamoxifen or an aromatase inhibitor to the prospective observational study. We performed AET pill counts at enrollment, 12 weeks, and 24 weeks, and calculated adherence ratios of pills consumed between visits to days between visits.

View Article and Find Full Text PDF

Quality improvement (QI) programs have rapidly grown in health care over recent years. Despite increasing evidence of successful QI initiatives resulting in improved outcomes, the adoption and implementation of QI programs remain a challenge worldwide. This paper briefly describes political and administrative barriers that impede the implementation of QI programs, including political and ideological factors, socioeconomic and educational barriers, and barriers related to data collection, privacy, and security.

View Article and Find Full Text PDF

This paper examines the practice of using a helium plasma radiofrequency (RF) device for contracting subcutaneous soft tissue following liposuction in all body areas. A review of the data from 6 industry-sponsor-initiated retrospective studies was performed, wherein 483 real-world patients underwent liposuction followed by contraction of the subcutaneous soft tissue with the helium plasma RF system. These data were evaluated to determine if any new or increased risks were introduced compared to the risks of liposuction alone.

View Article and Find Full Text PDF
Article Synopsis
  • - The study explores an energy-based device using helium-based radiofrequency to enhance the preparation of recipient sites for autologous fat grafting, aiming to improve volume retention of fat grafts.
  • - Results from a mouse model showed that pretreatment with the device led to higher survival rates of adipocytes and increased concentrations of adipose-derived stem cells (ASCs) in the treated tissue compared to the control group, although vascularity remained unchanged.
  • - The findings suggest that the helium-based radiofrequency treatment may enhance tissue viability and ASC presence, potentially through increased cell proliferation or recruitment, but further research is needed to understand these mechanisms.
View Article and Find Full Text PDF

Background: Patients are referred to functional coronary artery disease (CAD) testing based on their pre-test probability (PTP) to search for myocardial ischemia. The recommended prediction tools incorporate three variables (symptoms, age, sex) and are easy to use, but have a limited diagnostic accuracy. Hence, a substantial proportion of non-invasive functional tests reveal no myocardial ischemia, leading to unnecessary radiation exposure and costs.

View Article and Find Full Text PDF
Article Synopsis
  • The SABCHO study focuses on survival determinants for HIV-positive and HIV-negative South African women with breast cancer, highlighting disparities in diagnosis and treatment across different cancer centers.
  • The study identified that urban centers (Johannesburg, Soweto, and Durban) catered to better-educated, socioeconomically advantaged patients, while rural centers (Pietermaritzburg and Empangeni) served less educated and poorer communities.
  • The Johannesburg, Soweto, and Empangeni sites treated younger patients, whereas Durban and Pietermaritzburg had older patients with a significant proportion being Asian Indian women, indicating variations in demographic and health factors across locations.
View Article and Find Full Text PDF

Black African populations are more genetically diverse than others, but genetic variants have been studied primarily in European populations. The present study examined the association of four single nucleotide polymorphisms (SNPs) of the fibroblast growth factor receptor 2, associated with breast cancer in non‑African populations, with breast cancer in Black, southern African women. Genomic DNA was extracted from whole blood samples of 1,001 patients with breast cancer and 1,006 controls (without breast cancer), and the rs2981582, rs35054928, rs2981578, and rs11200014 polymorphisms were analyzed using allele‑specific Kompetitive allele‑specific PCR™, and the χ or Fisher's exact tests were used to compare the genotype frequencies.

View Article and Find Full Text PDF

Unlabelled: Ultrasound-assisted liposuction (UAL) is a popular and minimally invasive cosmetic procedure. Third-generation devices such as the vibration amplification of sound energy at resonance (VASER)lipo system are used for body contouring with enhanced tissue specificity. Despite the widespread use of VASER UAL, published guidelines and recent expert consensus recommendations are lacking.

View Article and Find Full Text PDF

There is a rising noncommunicable disease (NCD) burden in low- and middle-income countries. Sub-Saharan Africa (SSA) bears a higher burden than the global average with South Africa (SA) enduring the highest regional burden. SA among other southern African countries also bears a high prevalence of HIV and other chronic communicable diseases.

View Article and Find Full Text PDF

Background: Colon cancer incidence is rising in low- and middle-income countries (LMICs), where resource limitations and cost often dictate treatment decisions. In this study, we evaluate the cost-effectiveness of adjuvant chemotherapy for high-risk stage II and stage III colon cancer treatment in South Africa (ZA) and illustrate how such analyses can inform cancer treatment recommendations in a LMIC.

Methods: We created a decision-analytic Markov model to compare lifetime costs and outcomes for patients with high-risk stage II and stage III colon cancer treated with three adjuvant chemotherapy regimens in a public hospital in ZA: capecitabine and oxaliplatin (CAPOX) for 3 and 6 months, and capecitabine for 6 months, compared to no adjuvant treatment.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated how the PAM50 gene expression assay influences breast cancer survival in both HIV-positive and HIV-negative patients.
  • The analysis of 384 RNA samples revealed that luminal B was the most prevalent subtype, with a significant number of patients at high risk for disease recurrence.
  • Poor overall and disease-free survival were linked to HIV infection and certain PAM50 subtypes, especially in HIV-positive patients with luminal types, indicating a need for tailored treatment approaches.
View Article and Find Full Text PDF
Article Synopsis
  • Clinical outcomes of tamoxifen (TAM) treatment show high variability among individuals, influenced by genetic differences and other medications.
  • A study involving 229 South African Black women with breast cancer found that certain genetic variants (CYP2D6*17 and CYP2D6*29) significantly impact the metabolism of TAM and its active metabolites.
  • While antiretroviral therapy affected certain metabolite levels of TAM, the overall risk of significant drug interactions was considered low for patients undergoing TAM treatment.
View Article and Find Full Text PDF

Introduction: In the South African Breast Cancer and HIV Outcomes (SABCHO) study, we previously found that breast cancer patients living with HIV and treated with neoadjuvant chemotherapy achieve lower rates of complete pathologic response than patients without HIV. We now assess the impact of comorbid HIV on receipt of timely and complete neoadjuvant and adjuvant chemotherapy.

Materials And Methods: Since June 2015, the SABCHO study has collected data on women diagnosed with breast cancer at 6 South African hospitals.

View Article and Find Full Text PDF

Background: Minimally invasive procedures that deliver thermal energy to subcutaneous tissue offer a solution when deciding between excisional and noninvasive options to address face and neck aging-related changes. A minimally invasive helium plasma device, Renuvion, was first utilized for subdermal tissue heating to reduce skin laxity under an FDA general clearance for cutting, coagulation, and ablation of soft tissue.

Objectives: The purpose of this study was to demonstrate the safety and effectiveness of the helium plasma device for improving the appearance of loose skin in the neck and submental region.

View Article and Find Full Text PDF

Purpose: Breast cancer is a heterogeneous disease with different gene expression profiles, treatment options and outcomes. In South Africa, tumors are classified using immunohistochemistry. In high-income countries multiparameter genomic assays are being utilized with implications for tumor classification and treatment.

View Article and Find Full Text PDF

Objective: In low- and middle-income countries (LMICs), advanced-stage diagnosis of breast cancer (BC) is common, and this contributes to poor survival. Understanding the determinants of the stage at diagnosis will aid in designing interventions to downstage disease and improve survival from BC in LMICs.

Methods: Within the South African Breast Cancers and HIV Outcomes (SABCHO) cohort, we examined factors affecting the stage at diagnosis of histologically confirmed invasive breast cancer at five tertiary hospitals in South Africa (SA).

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how having multiple chronic conditions affects survival rates in South African women diagnosed with breast cancer.
  • Approximately 45% of the 3,261 women analyzed had multimorbidity, with obesity, hypertension, and HIV being the most common conditions.
  • Women with multimorbidity showed significantly lower overall survival rates than those without, indicating that managing these additional health issues is crucial for improving survival outcomes.
View Article and Find Full Text PDF