bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Two Cardioplegia Solution—del Nido Solution and St. Thomas Solution Used in Adult Cardiac Surgery
Authors: Khajuria Atul , Jahan Swaleha
Published: March 2023

Introduction:

del Nido (DN) cardioplegia induces a depolarizing arrest during cardiac surgery. It is more dilute (1,4, blood crystalloid) as compared to the traditional 4:1 blood cardioplegia; it has lower Ca+2 and contains lidocaine. St. Thomas’ (ST) cardioplegia has been a popular crystalloid cardioplegia among cardiac surgeons; still, it must be administered constantly at short intervals during the surgery.

Aim:

To determine whether DN cardioplegia, with longer period of arrest provides better myocardial protection as compared to ST cardioplegia, with shorter period of arrest.

Materials and Methods:

The study population comprised 46 patients who undergone on pump coronary artery bypass grafting or any valve replacement surgery, which include aortic valve replacement, mitral valve replacement, and double valve replacement between February 2022 and June 2022. The patients were divided into two groups based on the type of cardioplegia given during surgery: (1) ST group (ST, n = 23) and (2) DN cardioplegia group (DN, n = 23). We compared the aortic cross clamp (CC) and cardiopulmonary bypass (CPB) times, number of doses required, and postoperative outcome in the two groups.

Results:

The CC of time of DN versus ST group (75.82 ± 27.24 vs 85.69 ± 37.20) min and bypass times of DN versus ST group (102.73 ± 35.28 vs 104.86 ± 38.9) min. The DN group was noticed to have shorter CC and CPB times with (P < 0.05). Fewer cardioplegia doses were required in the DN group versus the ST group (1.21 ± 0.42 vs 2.86 ± 1.28; P = 0.001), while a single cardioplegia dose was given to 18 DN patients (78.26%) versus 2 ST patients (8.69%) (P < 0.001). LVEF was better preserved in the DN group.

Conclusions:

The use of DN cardioplegia results in shorter CC and CPB times, reduces cardioplegia doses, and also provides better myocardial protection with a safety profile as compared to ST cardioplegia.
Association between the rs2736100 polymorphisms of telomerase reverse transcriptase gene and digestive cancers
Authors: Song Hongxia , Han Mei , Li Kun , Zhao Yingying , Xu Changqing , Lei Xiaofei
Published: March 2023

Aim of Study:

The conclusions on the association between the rs2736100 polymorphisms of telomerase reverse transcriptase (TERT) gene polymorphism and digestive cancers risk are still debated. This meta-analysis was conducted to update the association between the TERT rs2736100 polymorphisms and the risk of digestive cancers.

Materials and Methods:

The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using the meta-analysis method.

Results:

Eight case-control studies were included in this meta-analysis for associating TERT rs2736100 gene polymorphism and digestive cancer susceptibility. Pooled odds ratio with 95% confidence interval was calculated using a fixed or random-effects model. Overall, no evidence has shown that the TERT rs2736100 polymorphism was associated with the susceptibility to digestive cancers. Besides, stratified analysis with ethnicity also indicated no significant association between TRET rs2736100 and the risk of digestive cancers under all genetic models in both Asian and Caucasian populations were observed.

Conclusion:

According to the meta-analysis, TERT rs2736100 polymorphism might be unrelated to digestive cancer susceptibility. Evidence with adequate sample size is still needed.
Comparison of percutaneous microwave ablation with radiofrequency ablation for hepatocellular carcinoma adjacent to major vessels
Authors: Shen Qiang , Wang Neng , Wu Pan-pan , Tan Bi-bo , Qian Guo-jun
Published: March 2023

Purpose:

To compare the therapeutic efficacy and safety of percutaneous microwave ablation (MWA) with those of percutaneous radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) adjacent to major vessels.

Methods:

From January 2010 to April 2011, 78 patients with a single nodule, no >5 cm, adjacent to major vessels were enrolled in this study. Forty-four patients (forty-one men, three women; age range, 33–72 years) treated by MWA were compared with thirty-four patients (thirty-one men, three women; age range, 33–75 years) treated by RFA. Local tumor progression rate, overall survival rate, and disease-free survival rate were calculated using the Kaplan–Meier method, and differences between groups were estimated by log-rank test.

Results:

No death related to treatment occurred in the two groups. The 1-, 2-, and 3-year local tumor progression rates were 6.8%, 11.4%, and 15.9%, respectively, in the microwave group versus 17.6%, 20.6%, and 20.6%, respectively in the radiofrequency group (P = 0.544). The rates of major complications associated with microwave and RFA were 2.3% (1/44) versus 0% (0/34; P = 0.376). The microwave group's 1-, 2-, and 3-year disease-free survival rates were 72.7%, 65.9%, and 51.8%, respectively, and those in the radiofrequency were 58.8%, 52.9%, and 47.1%, respectively (P = 0.471). The microwave group's 1-, 2-, and 3-year overall survival rates were 93.2%, 90.9%, and 83.6%, respectively, and those in the radiofrequency group were 91.2%, 88.2%, and 82.4%, respectively (P = 0.808) There was no significant difference in local tumor progression, complications related to treatment, and long-term results between the two modalities. The incidence of peritumoral structure damage on image scan was significantly higher in the microwave group than in the RFA group (P = 0.025).

Conclusions:

Both RFA and MWA are safe and effective techniques for HCC adjacent to major vessels and have the same clinical value.
Expert consensus on thermal ablation therapy of pulmonary subsolid nodules (2021 Edition)
Authors: Ye Xin , Fan Weijun , Wang Zhongmin , Wang Junjie , Wang Hui , Wang Jun , Wang Chuntang , Niu Lizhi , Fang Yong , Gu Shanzhi , Tian Hui , Liu Baodong , Liu Lingxiao , Zhong Lou , Zhuang Yiping , Chi Jiachang , Sun Xichao , Yang Nuo , Wei Zhigang , Li Xiao , Li Xiaoguang , Li Yuliang , Li Chunhai , Li Yan , Yang Xia , Yang Wuwei , Yang Po , Yang Zhengqiang , Xiao Yueyong , Song Xiaoming , Zhang Kaixian , Chen Shilin , Chen Weisheng , Lin Zhengyu , Lin Dianjie , Meng Zhiqiang , Zhao Xiaojing , Hu Kaiwen , Liu Chen , Liu Cheng , Gu Chundong , Xu Dong , Huang Yong , Huang Guanghui , Peng Zhongmin , Dong Liang , Jiang Lei , Han Yue , Zeng Qingshi , Jin Yong , Lei Guangyan , Zhai Bo , Li Hailiang , Pan Jie
Published: March 2023

The Expert Consensus reviews current literatures and provides clinical practice guidelines for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The main contents include the following: (1) clinical evaluation of GGN; (2) procedures, indications, contraindications, outcomes evaluation, and related complications of thermal ablation for GGN; and (3) future development directions.
Imaging features of dermatofibrosarcoma protuberans
Authors: Ren Qingguo , Li Jiuwen , Shangguan Jingjun , Feng Xiushuan , Ma Xiangxing
Published: March 2023

Aims:

The study highlights diffusion-weighted imaging (DWI) and dynamic enhancement features of DFSP and characterizes unenhanced and enhanced computed tomography (CT) and magnetic resonance imaging (MRI) scans.

Settings and Design:

Image findings and clinical histories of 23 patients with DFSP were reviewed. Nine patients underwent CT before and after intravenous administration of contrast material. MRI was performed for 17 patients. CT and MRI findings were analyzed using location, size, edge, shape, infiltration sign, density and signal enhancement mode, and degree.

Results:

Patients showed 26 superficial and one deep lesion. Ten superficial lesions bulged onto the skin surface. Fourteen lesions were well-defined and 13 ill-defined. All lesions were nodular, with nine being multilobular. Thirteen showed infiltration to adjacent skin, fat, and fascia. Seven lesions on CT were iso- or hypo-dense to muscle without calcification. Contrast-enhanced CT showed inhomogeneous moderate and progressive enhancement in the arterial phase. Small tortuous vessels were seen in the arterial phase in one case. Sixteen tumors displayed signals that were similar to muscle by T1WI. Ten lesions were either hyper-intense to muscle or iso-intense to fat; the deep DFSP was hypo-intense by T2WI. All lesions were hyper-intense homogeneously or heterogeneously under fat-suppressed T2WI. Twelve superficial lesions showed high-intermediate signal, and one deep lesion showed low-intermediate signal with DWI. Seven cases showed low signal diffusion coefficient (ADC) images. Dynamic enhancement and signal intensity-time (SI-T) curves of four tumors showed rapid SI increases followed by steady or slightly rising SI. All lesions showed inhomogeneous, progressive enhancement in the arterial phase.

Conclusions:

This report is the first on dynamic curves and highlights DWI and T2WI features of DFSP. DFSP can be correctly diagnosed by combining a patient's clinical manifestations with imaging characteristics.
Adjuvant therapy fails to show survival benefit for patients with spindle cell carcinoma
Authors: Li Ting , Xie Qi , Li Junwei , Li Zhen , Xiao Junjuan , Liu Mingguo , Wang Jun , Li Yan , Tang Fang , Liang Jing
Published: March 2023

Background:

Spindle cell carcinoma (SpCC) is a rare tumor type with poor prognosis, and standard treatment modalities are not available yet. However, large-scale studies on this topic are sparse. In this study, data from the surveillance, epidemiology, and end results (SEER) database were used to determine cancer-specific survival (CSS) rates of SpCC and to investigate the impact of different therapeutic strategies including surgery with or without chemotherapy, radiotherapy, or chemoradiotherapy on patient outcome.

Methods:

A total of 665 cases of SpCC, diagnosed from 1996 to 2015, were extracted from the SEER database. Kaplan–Meier survival curves and log-rank tests were used to assess CSS rates and differences on survival curves. Multiple COX-proportional hazards models were used to analyze the association between various treatments and prognosis of SpCC patients classified by organs or systems.

Results:

Different treatments for SpCC in different organ or system were associated with prognosis of SpCC patients. Surgery alone exhibits survival benefit, whereas adjuvant therapy fails to show survival benefit for patients with SpCC.

Conclusions:

The prognosis of SpCC patients varied significantly with different clinical treatments. Adjuvant radiotherapy or chemotherapy did not show survival benefit, even increasing the risk of mortality for SpCC patients.
SOX7 modulates the progression of hepatoblastoma through the regulation of Wnt/β-catenin signaling pathway
Authors: Ge Juntao , Zheng Qipeng , Qu Hongyi , Zhao Zuohui , Xu Yue , Wang Hao , Gao Huayu , Zhan Jianghua
Published: March 2023

Aims:

Hepatoblastoma (HB) was reported as the frequently diagnosed primary hepatic malignant tumor among children. No reports have shown the function of SOX7 and its relationship with the Wnt/β-catenin pathway in HB.

Materials and Methods:

SOX7 and factors related to Wnt/β-catenin pathway were detected using reverse transcription–quantitative polymerase chain reaction (RT-PCR) and Western blotting. MTT 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium and flow cytometry were used to detect HB cell proliferation and apoptosis. The transwell assay uses cell invasion.

Results:

In this study, RT-PCR, Western blotting, and immunohistochemistry results indicated that the expression of SOX7 was significantly reduced in HB tissues compared with adjacent noncancerous tissues, while the β-catenin was significantly increased in HB tissues compared with adjacent noncancerous tissues. There were significant differences in the PRETEXT stage and tumor metastasis between patients with low expression and high expression of SOX7. Moreover, it was found that the overexpression of SOX7 and inhibiting Wnt/β-catenin pathway significantly reduced the cell proliferation and invasion, while the cell apoptosis was significantly increased compared with the control group.

Conclusions:

This study shows that SOX7 was downexpressed in HB tumor tissues. Moreover, ex vivo experiments indicated that SOX7 was related to β-catenin and regulated the progression of HB cells.
Systemic inflammation-based predictors of pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients
Authors: Xu Ning , Li Wenliang , Huang Fengchang , Yang Jun , Wen Zhengqi , Yin Liang , Zhang Yunfei , Zhao Jingjiao , Zhou Ruize , Yang Jingyu
Published: March 2023

Aim:

To investigate whether systemic inflammation-based predictors can predict tumor response to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC).

Materials and Methods:

Totally, 205 LARC patients undergoing neoadjuvant CRT and curative surgery between 2008 and 2017 were analyzed. After propensity score matching, 132 patients were included in the study. Hematological parameters were collected, and their relationship with tumor response was investigated.

Results:

After propensity score matching, patients in good response group before CRT displayed significantly lower neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) than those in poor response group, while there were no significant differences in all hematological characteristics between the two groups after CRT. The cutoff values of pre-CRT NLR and pre-CRT PLR after receiver operating characteristic analysis were 3.10 and 198.7, respectively. Multivariate analysis revealed that while there was no association between pre-CRT PLR and tumor response, pre-CRT NLR ≥3.1 was identified as the predictor of poor tumor response (P = 0.007).

Conclusion:

An increased NLR before CRT can serve as a hematological factor for predicting a poor tumor response in LARC.
Camrelizumab (SHR-1210) with carboplatin and albumin-binding paclitaxel in patients with metastatic or recurrent cervical cancer
Authors: Zhang Xiaoling , Chen Jinlong , Liu Naifu , Wang Qian , Wu Qian , Gao Fufeng , Sang Yingchun , Wang Ping
Published: March 2023

Aims:

This study evaluates the safety and preliminary antitumor efficacy of camrelizumab with albumin-binding paclitaxel and cisplatin as first-line therapy for patients with recurrent or metastatic cervical carcinoma.

Methods and Material:

In this phase 2, open-label, prospective study, 35 patients with recurrent or metastatic cervical carcinoma with no previous systemic chemotherapy were included. The patients were treated with a maximum of six cycles of camrelizumab on day 1, albumin-binding paclitaxel, and carboplatin on day 2, every 3 weeks, followed by camrelizumab once every 3 weeks. The primary outcomes were objective response rate (ORR) and disease control rate (DCR). Secondary outcomes were duration of response (DoR) and safety. Furthermore, 27 patients were included in the per-protocol set for efficacy analysis, whereas for the safety analysis, all patients were included.

Results:

The median follow-up was 4.53 months, and the complete response, partial response, and stable disease were also achieved in 4 (14.81%), 6 (22.22%), and 13 (48.15%) patients. The ORR and DCR were 40.00% (95% confidence interval: 21.13–61.33%) and 92.00% (73.97–99.01%), respectively. The median DoR was 6.70 months. In addition, the most common adverse events (AEs) were reactive cutaneous capillary endothelial proliferation (RCCEP) (23, 65.71%), gastrointestinal reaction (8, 22.86%), and fever (8, 22.86%). Grade 3 AEs included 5 (14.29%) myelosuppression, and grade 4 AEs included 1 (2.86%) RCCEP and 1 (2.86%) bladder inflammation.

Conclusions:

Combination therapy of camrelizumab and albumin-bound paclitaxel and carboplatin shows promising efficacy and manageable toxicities in patients with recurrent or metastatic cervical cancer.
Prognostic value of circulating tumor cells and analysis of clinicopathological factors in liver cancer
Authors: Cui Kai , Ou Yang , Ning Dawei , Li Hao , Xi Yue , Li Sheng
Published: March 2023

Objective and Aims:

The number of circulating tumor cells (CTCs) and the presence of circulating tumor microemboli (CTM) were determined in the peripheral blood of patients with liver cancer (LC). The relationship between CTCs, CTM, clinicopathologic features, and prognosis of LC was analyzed. The objective of this study was to determine the diagnostic and prognostic value of CTCs/CTM in LC.

Subjects and Methods:

Patients with LC were enrolled between May 2013 and August 2017, and 67 patients were included in the study. Overall survival curves were built using the Kaplan–Meier method and the log-rank test to identify risk factors. The results were analyzed using a Cox proportional hazards model and expressed as hazard ratio and 95% confidence interval (95% CI).

Results:

CTCs and either CTCs or CTM were detected in 27 patients (40.3%) and 29 patients (43.3%). CTM were found in four patients. One-year, 3-year, and 5-year survival rates were 42%, 20%, and 15%, respectively. Univariate Cox regression analysis showed that alpha-fetoprotein (AFP), number of CTCs, presence of CTM, and positive CTC/CTM were associated with survival time. Multivariate Cox regression analysis showed that alpha fetoprotein (AFP), number of CTCs, and presence of CTM were independent risk factors for survival in patients with LC.

Conclusion:

There was no significant correlation between the number of CTCs, the presence of CTM, and clinicopathologic factors. AFP, number of CTCs, and presence of CTM were independent risk factors for survival in patients with LC.
Percutaneous microwave ablation under ultrasound guidance for renal cell carcinomas at clinical staging T1 in patients aged 65 years and older
Authors: Cheng Zhigang , Yu Xiaoling , Han Zhiyu , Liu Fangyi , Yu Jie , Yang Jian , Ai Danni , Liang Ping
Published: March 2023

Objectives:

To ascertain the clinical outcomes of patients aged ≥65 years with clinical staging T1 (cT1) renal cell carcinoma (RCC) treated with percutaneous microwave ablation (MWA) under ultrasound control compared with those aged <65.

Materials and methods:

From September 2009 to December 2016, clinical data of two groups, Group O (≥ 65 years) consisting of 75 patients (76 RCCs) and Group Y (< 65 years) consisting of 91 patients (99 RCCs), who underwent MWA treatment for RCC with comparable mean diameters at baseline, were retrospectively evaluated. The methodological effectiveness, cumulative overall survival (OS) and disease-free survival (DFS), local tumor progression (LTP), major and minor complications, and renal performance, including serum creatinine (Cr) and blood urea nitrogen (BUN) between the two categories, were statistically assessed by SPSS.

Results:

After excision, there were no significant differences between the two groups concerning technical efficacy, LTP, and major and minor complications. The cumulative OS and DFS rates at 1, 3, and 5 years in Group O versus Group Y were 100%, 92.6%, and 92.6% versus 98.6%, 96.9%, and 90.9% (P = 0.701), and 100%, 92.5%, and 92.5% versus 98.6%, 96.9%, and 90.4% (P = 0.697), respectively. There was no significant variance between serum Cr and BUN between the two groups before MWA and at the last follow-up.

Conclusion:

Due to the corresponding clinical outcomes for the treatment of cT1 RCCs in patients aged <65 years and ≥65 years, the US-guided MWA is a safe and effective method and may be suggested as one of the first-line nonsurgical options for identified older patients.
Clinicopathological factors affecting the prognosis of massive hemorrhage after radiotherapy for patients having nasopharyngeal carcinoma
Authors: Huang Yanqiu , Yan Donghui , Wang Maoxin , Chen Shiyan , Yang Fan
Published: March 2023

Aims:

The aim of the study is to investigate the clinicopathological factors that determine prognosis of nasopharyngeal hemorrhage after radiotherapy in patients with nasopharyngeal carcinoma (NPC).

Patients and Methods:

The clinicopathological data of 539 patients with NPC, who received radiotherapy, were analyzed retrospectively. Parameters included gender; age; T-stage; N-stage; pathological type; type of radiotherapy; synchronous chemotherapy; secondary-course radiotherapy; radiation-induced skull base osteonecrosis; diabetes, hypertension, or other systemic diseases; results of nasopharyngeal bacterial culture; and nasopharyngeal tumor recurrence. Univariate and multivariate analyses were performed using the Chi-square test and logistic regression. Afterward, the Kaplan–Meier's method was applied to analyze the survival of patients with nasopharyngeal hemorrhage.

Results:

Among all patients examined, 64 (11.9%) had nasopharyngeal hemorrhage after radiotherapy. The univariate analysis showed that T-stage (P < 0.01), secondary-course radiotherapy (P < 0.01), radiation-induced skull base osteonecrosis (P < 0.01), nasopharyngeal bacterial culture results (P < 0.01), and nasopharyngeal tumor recurrence (P < 0.01) were associated with nasopharyngeal hemorrhage. Multivariate analysis showed that only radiation-induced skull base osteonecrosis was significantly associated with nasopharyngeal hemorrhage after radiotherapy (odds ratio = 41.83, P = 0.0001). Nevertheless, in patients with internal carotid artery hemorrhage, the survival rate was much lower than that in patients with external carotid artery bleeding. The main cause of death during follow-up was rebleeding.

Conclusion:

The rate of mortality in patients with nasopharyngeal hemorrhage after radiotherapy was high. The presence of radiation-induced skull base osteonecrosis was a decisive factor in these patients. However, after successful rescue, arterial embolization or stent implantation is proposed to prolong survival.
Human epidermal growth factor receptor 2 inhibits activating transcription factor 7 to promote breast cancer cell migration by activating histone lysine demethylase 1
Authors: Lin Juli , Mao Hehui , Ji Zhuannan , Lin Weijie , Wang Tao
Published: March 2023

Background:

Receptor tyrosine-protein kinase erbB-2 (human epidermal growth factor receptor 2 [HER2])-based therapies can improve the prognosis of HER2-positive breast cancer (BRCA) patients; however, HER2-positive patients with distal metastasis do not gain significant clinical benefit from molecular targeted therapy.

Materials and Methods:

A database analysis, immunohistochemistry, and quantitative real-time polymerase chain reaction were used to evaluate the expression of activating transcription factor 7 (ATF7) and its clinical value. A transwell chamber assay was used to assess migration and cell signaling was assessed by immunoblotting.

Results:

ATF7 was expressed at a low level in HER2-enriched BRCA specimens compared with normal or HER2-negative specimens, which was corroborated in HER2-positive tissue chips and cultured cells. ATF7 gradually decreased with increased tumor stage and low ATF7 was associated with poor prognosis in HER2-positive BRCA patients. ATF7-upregulation inhibited, whereas ATF7-knockdown promoted migration, activity of matrix metalloproteinase 9 (MMP9), MMP2, and uridylyl phosphate adenosine and plasminogen activator inhibitor-1 (PAI-1) expression in HER2-positive cells. HER2 overexpression markedly reduced ATF7 expression in MCF-10A mammary epithelial cells, along with decreased E-cadherin, and increased N-cadherin and migration, which were abrogated by exogenous ATF7 transfection. Mechanistically, HER2 upregulation mediated the decline of ATF7 and activated histone lysine demethylase 1 (LSD1), followed by elevation of histone H3K9 dimethylation (H3K9me2) and H3K4me2. However, the enhanced effects on LSD1 and H3K9me2, excluding H3K4me2, were abrogated by exogenous ATF7. ATF7 was negatively associated with KDM1A (encoding LSD1 protein) expression.

Conclusions:

ATF7 may be a useful diagnostic and prognostic marker for metastatic HER2-positive BRCA. The ATF7/LSD1/H3K9me2 axis may be responsible for metastasis in HER2-positive cells.
Comparing endoscopic thyroidectomy using the breast approach and conventional open thyroidectomy
Authors: Zhang Hanyuan , Shi Weichen , Zhang Jiqing , Xu Jia , Zhou Dongsheng , Liu Wei , Fu Rongzhan , Chen Hongqiang
Published: March 2023

Aims:

Endoscopic thyroidectomy (ET) using the breast approach and conventional open thyroidectomy (OT) are effective approaches to treating thyroid tumors. This study evaluates the effectiveness of ET and OT regarding safety, cosmetic effects, and feasibility.

Subjects and Methods:

Four hundred and fifty-six patients who underwent thyroidectomy in our department from January 2019 to August 2020 were included in this study. Based on the intraoperative rapid pathology, all patients with papillary thyroid carcinoma underwent unilateral thyroid lobectomy and central neck lymph node dissection. Whereas all benign patients underwent unilateral thyroid lobectomy. Differences in various factors such as clinical characteristics, operation time, postoperative drainage volume, parathyroid hormone (PTH) levels, calcium (Ca) levels, total number of central lymph nodes resected, the number of metastatic central lymph nodes resected, hospital duration, hospitalization costs, and cosmetic effects were compared in each group.

Results:

Baseline characteristics among the four groups were similar, except for patient age and tumor size. Patients in the malignant ET group were younger than those in the malignant OT group with smaller tumors (P < 0.05). There were no significant differences between the OT and ET groups in postoperative Ca levels, PTH levels, the total number of lymph nodes resected, and the number of metastatic central lymph nodes resected.

Conclusions:

Compared with conventional OT, ET is a feasible, practical, and safe procedure with excellent cosmetic benefits.
The role of surgery on locoregional treatment of patients with breast cancer newly diagnosed with ipsilateral supraclavicular lymph node metastasis
Authors: Liu Bo-Wen , Chen Li-Xuan , Ma Ke , Chi Jiang-Rui , Yang Zheng-Jun , Yu Yue , Cao Xu-Chen
Published: March 2023

Background:

Radiotherapy is a practical locoregional treatment approach for women with breast cancer who show ipsilateral supraclavicular lymph node metastasis (ISLNM) on diagnosis. However, there is controversy around the role of supraclavicular lymph node dissection. Therefore, we aimed to study the significance of supraclavicular surgery based on radiotherapy.

Patients and Methods:

We retrospectively reviewed the data of 142 patients with breast cancer who presented with isolated ISLNM and received radiotherapy between the years 2000 and 2016. We also defined the effect of surgery on locoregional treatment of these patients by analyzing the prognostic factors for recurrence-free survival (RFS), distant metastasis-free survival (DMFS), and overall survival (OS).

Results:

We observed that, of the 142 patients, 104 who received radiotherapy underwent supraclavicular lymph node dissection. Also, among the study group, the progesterone receptor (PR) status (P = 0.044) and the number of axillary lymph nodes (ALNs) involved (P = 0.002) were significant independent predictors of RFS. Also, tumor size (P = 0.007), PR (P < 0.001), and number of ALNs (P < 0.001) were independent predictors of DMFS and were statistically significant. Also, PR was an independent prognostic factor of OS (P = 0.033), whereas the supraclavicular surgery was not an independent prognostic factor for RFS, DMFS, and OS. Furthermore, our study focused on 92 patients with negative estrogen receptors (ERs). The result showed that supraclavicular surgery was statistically significant for RFS (P = 0.023); no significant differences in DMFS and OS were found between patients who received supraclavicular surgery and those who did not.

Conclusion:

Radiotherapy may be the primary locoregional treatment approach for patients with breast cancer who present with newly diagnosed ISLNM. Additionally, supraclavicular surgery may be more appropriate for patients with negative ER who received radiotherapy.
Effectiveness and safety of camrelizumab combined with chemotherapy in nonsquamous nonsmall cell lung cancer as the second-line therapy
Authors: Huang Wei , Zhang Qinyuan , Da Liangshan , Shen Yuanyuan , Xiong Fuxing , Zhang Congjun
Published: March 2023

Background:

The role of camrelizumab combined with chemotherapy as the second-line therapy in nonsquamous nonsmall cell lung cancer (NSCLC) remains unverified. The retrospective study investigated efficacy and safety of camrelizumab combined with chemotherapy in the treatment of nonsquamous NSCLC as the second-line therapy.

Subjects and Methods:

Patients of nonsquamous NSCLC who were already discharged or died of the First Affiliated Hospital of Anhui Medical University between August 2019 and September 2020. According to the treatment method, the patients who received chemotherapy were denoted as the C group and those who received camrelizumab plus chemotherapy were denoted as the C&C group.

Statistical Analysis Used:

Patients responses were statistically analyzed. The Cox proportional hazards regression model was used in the assessment of the prognostic value of factors. Furthermore, adverse event evaluation was estimated.

Results:

Of the 60 patients with nonsquamous NSCLC included in the research, 29 patients received chemotherapy, and 31 patients received camrelizumab plus chemotherapy. The objective response rate was 13.79% and 32.26% for chemotherapy and camrelizumab plus chemotherapy groups, and the disease control rate was 72.41% and 80.65%. The median progression-free survival (mPFS) in camrelizumab plus chemotherapy group was obviously higher than that in the chemotherapy group (9.67 vs. 6.87 months, P = 0.01). The median overall survival of the camrelizumab plus chemotherapy was longer than the chemotherapy (10.89 vs. 7.95 months, P < 0.01). In the current treatment, radiotherapy and smoking were independent risk factors for the mPFS of patients with nonsquamous NSCLC. The occurrence of adverse events was similar between chemotherapy and camrelizumab plus chemotherapy groups.

Conclusions:

Camrelizumab combined with chemotherapy was an effective regimen with manageable toxicity in treating nonsquamous NSCLC as the second-line therapy.
Association of miR-155 and MIR155HG polymorphisms with cancer risk
Authors: Zou Zhishan , Lu Hui , Zhang Wenliang , Li Yiming , He Yi , Lin Huancai , Zhao Wei , Yu Dongsheng , Zeng Binghui
Published: March 2023

Background:

Analysis of emerging data shows that miRNAs, including miR-155, play important roles in tumorigenesis. Several studies have indicated that miR-155 and MIR155HG polymorphisms may be related to cancer risk, but the association was controversial. Therefore, we conducted this first-reported comprehensive meta-analysis of the association of miR-155 and MIR155HG polymorphisms with cancer risk.

Materials and Methods:

We searched several databases, including PubMed, Embase, and Web of Science, to identify the eligible studies reporting the association of miR-155 and MIR155HG polymorphisms with cancer risk. We calculated the pooled odds ratios (ORs) and 95% confidence intervals (CIs) to analyze the association. Stata software (version 16.0) was used to analyze the data we collected.

Results:

After being carefully and strictly screened, eight articles reporting on six common single-nucleotide polymorphisms consisting of 6184 cases and 6896 controls were included in this meta-analysis. The six polymorphisms included were rs767649 (T>A), rs928883 (A>G), rs2829803 (G>A), rs1893650 (T>C), rs4143370 (G>C), and rs12482371 (T>C). Our results showed that, in the overall analysis, heterozygotes increased cancer risk, with a marginal P value, compared with wild-type (OR = 1.06, 95% CI = 1.00–1.12, P = 0.062). Subsequent analyses showed that only rs767649 was associated with an increased risk of non-small-cell lung cancer (NSCLC) in an allele model (T vs. A: OR = 1.15, 95% CI = 1.04–1.26, P = 0.007), a homozygote model (TT vs. AA: OR = 1.31, 95% CI = 1.06–1.60, P = 0.011), and a recessive model (TT vs. AT + AA: OR = 1.30, 95% CI = 1.08–1.55, P = 0.005).

Conclusion:

The present meta-analysis indicates that the rs767649 polymorphism might be a potential factor for NSCLC risk; however, more studies should be conducted to confirm these findings.
A Comparative Study on Predictive Validity of Modified Shock Index, Shock Index, and Age Shock Index in Predicting the Need for Mechanical Ventilation among Sepsis Patients in a Tertiary Care Hospital
Authors: Prasad K. J. Devendra , Bindu K. C. Hima , Abhinov T. , Moorthy Krishna , K Rajesh
Published: March 2023

Introduction:

The shock index (SI), modified shock index (MSI), and age multiplied by SI (ASI) are used to assess the severity of shock. They are also used to predict the mortality of trauma patients, but their validity for sepsis patients is controversial. The aim of this study is to assess the predictive value of the SI, MSI, and ASI in predicting the need for mechanical ventilation after 24 h of admission among sepsis patients.

Methods:

A prospective observational study was conducted in a tertiary care teaching hospital. Patients with sepsis (235) diagnosed based on systemic inflammatory response syndrome criteria and quick sequential organ failure assessment were included in the study. The need for mechanical ventilation after 24 h is the outcome variables MSI, SI, and ASI were considered as predictor variables. The utility of MSI, SI, and ASI in predicting mechanical ventilation was assessed by receiver operative curve analysis. Data were analyzed using coGuide.

Results:

Among the study population, the mean age was 56.12 ± 17.28 years. MSI value at the time of disposition from the emergency room had good predictive validity in predicting mechanical ventilation after 24 h, as indicated by the area under the curve (AUC) of 0.81 (P < 0.001), SI and ASI had fair predictive validity for mechanical ventilation as indicated by AUC (0.78, P < 0.001) and (0.802, P < 0.001), respectively.

Conclusion:

SI had better sensitivity (78.57%) and specificity (77.07%) compared to ASI and MSI in predicting the need for mechanical ventilation after 24 h in sepsis patients admitted to intensive care units.
Relationship between Incontinence and Disease Severity in Patients Transported by Ambulance
Authors: Hamada Michika , Takeuchi Ikuto , Muramatsu Ken-Ichi , Nagasawa Hiroki , Ohsaka Hiromichi , Ishikawa Kouhei , Yanagawa Youichi
Published: March 2023

Introduction:

Retrospectively investigated this relationship using data from Shimoda Fire Department.

Methods:

We investigated patients who were transported by Shimoda Fire Department from January 2019 to December 2021. The participants were divided into groups based on the existence of incontinence at the scene or not (Incontinence [+] and Incontinence [−]). We compared the variables mentioned above between these groups.

Results:

There were 499 cases with incontinence and 8241 cases without incontinence. There were no significant differences between the two groups with respect to weather and wind speed. The average age, percentage of male patients, percentage of cases in the winter season, rate of collapse at home, scene time, rate of endogenous disease, disease severity, and mortality rate in the incontinence (+) group were significantly greater in comparison to the incontinence (−) group, whereas the average temperature in the incontinence (+) group was significantly lower than that in the incontinence (−) group. Regarding the rates of incontinence of each disease, neurologic, infectious, endocrinal disease, dehydration, suffocation, and cardiac arrest at the scene had more than twice the rate of incontinence in other conditions.

Conclusions:

This is the first study to report that patients with incontinence at the scene tended to be older, showed a male predominance, severe disease, high mortality, and required a long scene time in comparison to patients without incontinence. Prehospital care providers should therefore check for incontinence when evaluating patients.
Pattern of Presentation and Outcome of Adult Patients with Abdominal Trauma – A 7-Year Retrospective Study in a Nigerian Tertiary Hospital
Authors: Adenuga Adedire Timilehin , Adeyeye Ademola
Published: March 2023

Introduction:

Abdominal trauma is a major cause of morbidity and mortality in low- and middle-income countries. There is a paucity of trauma data in this region and this study aimed to show the pattern of presentation and outcome of patients with abdominal trauma at a North-Central Nigerian Teaching Hospital.

Methods:

This was a retrospective, observational study of patients with abdominal trauma who presented at the University of Ilorin Teaching Hospital from January 2013 to December 2019. Patients with clinical and/or radiological evidence of abdominal trauma were identified, and data extracted and analyzed.

Results:

A total of 87 patients were included in the study. There were 73 males and 14 females (5.2:1) with a mean age of 34.2 years. Blunt abdominal injury occurred in 53 (61%) patients with 10 patients (11%) having concomitant extra-abdominal injuries. A total of 105 abdominal organ injuries occurred in 87 patients with the small bowel being the most frequently injured organ in penetrating trauma, while in blunt abdominal injury, the spleen was most commonly injured. A total of 70 patients (80.5%) had emergency abdominal surgery with a morbidity rate of 38.6% and negative laparotomy rate of 2.9%. There were 15 deaths in the period accounting for 17% of patients with sepsis as the most common cause of death (66%). Shock at presentation, late presentation >12 h, need for perioperative intensive care unit admission, and repeat surgery were associated with a higher risk of mortality (P < 0.05).

Conclusion:

Abdominal trauma in this setting is associated with a significant amount of morbidity and mortality. Typical patients present late and with poor physiologic parameters often resulting in an undesirable outcome. There should be steps targeted at preventive policies focused on reducing the incidence of road traffic crashes, terrorism, and violent crimes as well as improving health care infrastructure to cater to this specific group of patients.
Frontal Region Focal Meningioma Mimicking Ischemic Stroke
Authors: Ayara Charles Oshevire , Marchie Tagbo Tobechukwu
Published: March 2023

Meningiomas typically present with gradual onset of symptoms but on rare occasions may present mimicking an ischemic stroke. The case of a 46-year-old homemaker with a right frontal region focal meningioma mimicking an ischemic stroke is presented here. A review of the literature was carried out, and the important role of radiological evaluation in resolving the diagnostic puzzle and various treatment options are also discussed.
A Comparative Analysis of Thoracic Ultrasound with Radiography in the Detection of Lung Pathologies Among Patients in Intensive Care Units
Authors: Obande Ogenyi , Akinmoladun Janet Adetinuke , Osinaike B. Babatunde , Agunloye M. Atinuke , Ogunseyinde O. Ayotunde
Published: March 2023

Introduction:

Chest X-ray (CXR) is a common study in intensive care unit (ICU) and to a lesser extent, chest computed tomography. Both studies use ionizing radiation. Bedside ultrasound (US) avoids exposure to ionizing radiation or potentially hazardous movement of the patient.

Materials and Methods:

This was a prospective, cross-sectional, comparative study of B-mode thoracic ultrasound (TUS) with CXR in the detection of lung pathologies in ICU patients. M-mode was further used in suspected pneumothorax (PTX). Patients with clinical suspicion or diagnosis of lung pathologies were recruited. CXR with portable machine and TUS using mobile US machine were done.

Results:

Seventy patients were recruited; 38 (54.3%) were female. Pleural effusion was detected in 17 patients, 15 (88.2%) by TUS and 11 (64.7%) by CXR. TUS and CXR detected lung consolidations in 11 (84.6%) and 9 (69.2%) patients, respectively. PTX was seen by CXR in 6 (85.7%) patients and 5 (71.4%) were seen on TUS. Both modalities diagnosed equal numbers of alveolar and interstitial edemas.

Conclusion:

Overall, there was no statistically significant difference in imaging diagnosis of lung pathologies by TUS and CXR. However, TUS detected more pleural effusion and consolidations; hence, it may be considered an alternative in the management of pediatric patients and pregnant women to avoid ionizing radiation.
An Ordeal of Multiple Pathologies in a 45-Year-Old Homemaker in a Developing Country
Authors: Theyra-Enias Hadiza , Kwis Sam , Jimeta-Tuko Jummai Desiree
Published: March 2023

Globally, breast cancer is the most frequently diagnosed cancer in females and a leading cause of cancer death. On the other hand, cervical cancer is the fourth most common cancer among females worldwide. In the less developed countries, it is the second most diagnosed cancer and third leading cause of cancer death in women. Synchronous malignancy of the breast and cervix is rare due to different etiological factors. Comorbidities such as hypertension and diabetes are frequent findings in patients with cancer. In a study in this environment, diabetes mellitus was the second most common comorbidity in the elderly cancer patients. This is the case report of a 45-year-old homemaker with cervical cancer and incidental finding of a synchronous breast cancer.
Uncovering biomarkers for potential therapeutic targeting for COVID-19-related acute kidney injury: A bioinformatic approach
Authors: Gong Rui , Long Gangyu , Wang Qian , Wang Qiongya , Huang Chaolin , Zhang Dingyu
Published: March 2023

Objective:

The Coronavirus Disease 2019 (COVID-19) is a recently-emerging infectious disease caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), posing a significant threat to public health around the world. In patients with COVID-19, acute kidney injury (AKI) is a common complication associated with poor prognoses. We analyzed co-expressed genes to explore relationships between SARS-CoV2 infection and AKI, and revealed potential biomarkers and therapeutic targets of the COVID-19-associated AKI (COVID-19-AKI).

Methods:

We utilized the GSE147507 and GSE139061 datasets from the Gene Expression Omnibus database to identify differentially expressed genes (DEGs) in SARS-CoV-2 infection and AKI, respectively. This was followed by analyzing protein-protein interaction networks, Gene Ontology, and pathway enrichment to uncover the relationship between DEGs. DEGs in common (co-DEGs), as well as corresponding interactive transcription factors (TFs) and microRNAs, were identified from the above results, followed by drug molecules uncovered for managing COVID-19-AKI. Aims: To reveal potential biomarkers and therapeutic targets for COVID-19-AKI by bioinformatic approach.

Results:

We discovered 345 DEGs in the lung and 310 DEGs AKI samples from COVID-19 patients, respectively. IFIT1, ISG15, MX1, IFIT3, and IFIT2 were involved in SARS-CoV-2 pulmonary infection, while hub genes such as RPL23, EIF4A1, RPS8, RPL13, and UPF2 were associated with AKI. We further derived co-DEGs including ERRFI1, KLK10, NR4A1, PODXL, RASGEF1C, RNU11, SNORA12, SNORA74B, and VTRNA1-1 coupled with their predicted transcription factors, including BACH2, HNF4A, MYC, and microRNAs containing miR-637, miR-542-3p, and miR-224. These targets may correlate with COVID-19-AKI, for which candidate drugs were identified.

Conclusions:

ERRFI1, KLK10, NR4A1, PODXL, RASGEF1C, RNU11, SNORA12, SNORA74B, and VTRNA1-1 may be associated with COVID-19-AKI and serve as novel markers.
Tele-psychotherapy practice in India: Ethical and professional concerns
Authors: Singh Shweta , Garaya Amandeep Singh
Published: March 2023

Tele-psychotherapy is especially prominent in times when access to in-person psychotherapy sessions is restricted. For a developing country like India there is a prominent call on mental health care resources on top of the existing mental health treatment gap. The current scenario may have significant implications for telephonic psychotherapy in India. It can be viewed as a reminder to direct changes in mental health laws, training, and research regarding delivering telephonic and online psychotherapy services in India. These changes will need to be supplemented with progress in the design and implementation of research studies to ascertain the efficacy, equivalence, and cost-effectiveness of offering psychotherapy over the online platforms.
Coping strategies used by adult survivors in the process of recovery from disaster trauma: A narrative review
Authors: Kar Nilamadhab
Published: March 2023

CONTEXT:

The catastrophic stress of disasters and the associated secondary traumas lead to negative mental health outcomes in a great proportion of survivors. A range of coping strategies are used, which may have possible preventive and therapeutic effects related to posttraumatic stress-related manifestation.

AIMS:

It is essential to learn about the coping strategies employed by the survivors following disasters to reflect about their usability as possible intervention methods. This review intended to explore the literature about coping mechanisms used by adult survivors of the disasters.

METHODS:

Comprehensive literature search and review.

RESULTS:

It was observed that various coping strategies have been reported, along with posttraumatic mental health conditions. Many of the coping strategies differ in different cultures and other demographic groups. Some articles have made reference to the effectiveness of the coping strategies. It has been observed that the ways coping can be facilitated at different levels. These observations may help in designing culture-specific, pre- and post-disaster management programs for effective and holistic recovery of the survivors.

CONCLUSION:

There is a need to understand the coping mechanisms in different cultures and the factors associated with the resilience in the face of the massive trauma of disasters. It is probable that these could be instrumental in recovery process and expected to help in supporting disaster survivors.
Cannabinoid-induced psychotic disorder: A descriptive study
Authors: Mohanty Nitya Gopal , Nayak Mihir Ranjan , Mahanta Debasish
Published: March 2023

INTRODUCTION:

where cannabis use is very much prevalent in India, the occurrence of cannabis-induced psychotic disorder is not uncommon. Its symptoms are highly variable and become more ambiguous when comorbid with another psychiatric illness.

AIM OF THE STUDY:

This study aims to find out the phenomenology of psychotic symptoms due to cannabinoids use among patients who attended a tertiary care hospital.

MATERIALS AND METHODS:

It is a hospital-based cross-sectional study conducted over 3 months. Patients age group between 18 and 65 years, satisfying the criteria for psychotic disorder due to cannabinoids use (F12.5) according to International Classification of Disease-10 Diagnostic Criteria for Research were included in the study. Patients having a history of other psychiatric illness or general medical condition that needs medical attention were excluded from the study. The Brief Psychiatric Rating Scale is used to evaluate psychiatric symptoms. Descriptive statistics are used to analyze the data.

RESULTS:

Out of 30 patients of cannabinoids use psychosis, the most common type was found to be predominantly manic symptoms (F12.55), followed by schizophrenia-like (F12.50), followed by predominantly depressive symptoms (F12.54), and followed by others. The most common cannabinoid-induced psychiatric symptoms found are unusual thoughts, hostility, grandiosity, excitement, suspiciousness, and followed by others.

CONCLUSION:

Cannabinoid-induced psychotic disorders have symptoms very similar to various psychiatric illnesses. It is very much essential to identify and distinguish it from other psychotic disorders at an early stage to manage it effectively.