bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Non-Cavity Distorting Intramural Fibroids on Assisted Reproduction Outcomes: A Cohort Study
Authors: Marqueta Belen , Barri Pedro N. , Coroleu Buenaventura , Barri Soldevila Pedro N. , Rodriguez Ignacio 
Published: February 2015

Introduction The impact of uterine fibroids on fertility and the beneficial role of surgery is controversial. Current data suggest that submucosal and intramural fibroids that distort the endometrial cavity decrease pregnancy and implantation rates. However, the impact of intramural fibroids without intracavitary component is unclear. The aim of this study is to clarify the impact of the uterine myomas and myomectomy in patients undergoing assisted reproductive techniques (ART). Methods Retrospective cohort study performed in Instituto Universitario Dexeus including 1072 cycles of IVF performed in infertile patients: 473 in patients with uterine myomas not treated before ART, 79 in patients undergoing ART after myomectomy and 520 in patients included as a control group. Results Our results show that there is a significant 64% reduction in the clinical pregnancy rate in women with cavity-distorting intramural fibroids, a 51% significant reduction in the clinical pregnancy rate and a 53% significant reduction in the delivery rate in patients with non-distorting intramural fibroids. Conclusions Our study supports the opinion that non-cavity distorting intramural fibroids have a detrimental effect on live births, clinical pregnancy, implantation and delivery rates in patients undergoing ART.
Role and Technique of Nerve-Sparing Surgery in Deep Endometriosis
Authors: Ceccaroni Marcello , Clarizia Roberto , Tebache Linda 
Published: February 2015

Background Nerve-sparing (NS) surgery reduces bowel, bladder and sexual dysfunction without decreasing surgical efficacy. Objectives This study aimed to summarize the anatomical and surgical data of NS technique and to review the post-operative outcomes after NS surgery for deeply infiltrating endometriosis (DIE). Data Sources Data were collected from published research articles from MEDLINE and the Cochrane Library databases. Conclusions, implications of key findings The NS technique approach for DIE seems to be feasible and reproductive. In comparison to the conventional surgery (CS), it seems to demonstrate better preservation of pelvic visceral function and an improvement in quality of life with same recurrence rates. The concept of preservation of autonomic nerves during surgical treatment of DIE should become standard in reference center.
Lung cancer Presenting as a Metastasis to the Tibial Bones: A Case Report
Authors: Gurrieri Lorena , Longhi Alessandra , Braghetti Antonio 
Published: February 2015

Aims and Background Bone metastasis below the knee from primary lung cancer is rare. Discussion of such cases in a multidisciplinary team is important to establish the correct treatment approach. Case report We analyzed the diagnostic pathway of a 53-year-old female patient with a 5-month history of pain in the right foot. The patient underwent several radiological examinations for the pain. An initial diagnosis of osteoporotic syndrome was made, followed by a diagnosis of primary sarcoma. Only when the patient continued to have pain were other radiological examinations performed and a biopsy of the right ankle taken. This revealed a metastasis from undifferentiated pulmonary adenocarcinoma. A total-body computed tomography scan did not show any tumor locations apart from the primary lung cancer. The patient underwent chemotherapy and palliative therapies. This case has been reported for its rarity.
On and off Metronomic Oral Vinorelbine in Elderly Women with Advanced Breast Cancer
Authors: De Iuliis Francesca , Salerno Gerardo , Taglieri Ludovica , Lanza Rosina , Scarpa Susanna 
Published: February 2015

Background Elderly patients with metastatic breast cancer (MBC) have more problems receiving chemotherapy than younger patients, especially with the presence of multiple comorbidities, adverse drug events and functional decline. Low-dose oral administration of cytotoxic agents such as vinorelbine, a semisynthetic vinca alkaloid that interferes with microtubule assembly, leading to arrest of cell division, is usually effective and well tolerated. Methods From February 2010 to February 2014, 32 patients with MBC, median age 76 years (range 69-83) were treated with oral vinorelbine 30 mg (total dose), one day on and one day off, until disease progression or unacceptable toxicity levels were reported. Toxicity, quality of life and clinical benefit were evaluated. Matched t-tests were conducted to discern whether quality-of-life indicator (p<0.05 was considered significant) differed before and 6 months after treatment. Statistical analysis was performed using Graph Pad Prism 5.0 (GraphPad Software Inc., San Diego, CA, USA). Results No grade 3 and 4 adverse events were reported. A clinical benefit of 50% was found in our cohort. On and off metronomic vinorelbine oral administration resulted in good tolerability and safe profile in our selected elderly population, and improved patient adherence to therapy. Conclusions The present study demonstrated that metronomic vinorelbine might be a potential treatment in elderly patients by reducing adverse effects and increasing quality of life, setting the stage for future extensive clinical trials.
Bleeding after Bevacizumab Treatment in Patients with Metastatic Colorectal Cancer
Authors: Cao Dan , Guo Chun-hong , Liu Jie-wei , Yang Xi , Li Qiu 
Published: February 2015

Aims and Background To evaluate the adverse events (AEs) of bleeding caused by bevacizumab/5-fluorouracil/ leucovorin (5-FU/LV) combination chemotherapy with addition of irinotecan or oxaliplatin in patients with metastatic colorectal cancer (mCRC). Methods A retrospective study was conducted to evaluate the bleeding AEs associated with bevacizumab and to explore potential associations between bleeding and baseline patient characteristics. The National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 were used to classify the severity of AEs. AEs were divided into five grades: grade 1, mild: intervention not indicated; grade 2, moderate: medical intervention or minor cauterization indicated; grade 3, severe: transfusion, radiological, endoscopic or elective surgical intervention indicated; grade 4, life threatening: urgent intervention indicated; and grade 5, death. Results Sixty-two patients were evaluated. Bleeding occurred in 26 (41%) patients; the incidence of grade 3 bleeding was 1.6% while no grade 4-5 bleeding occurred. Grade 1 epistaxis and grade 2 hemoptysis events were observed in 25.8% and 3.2% of patients, respectively. Hematochezia events occurred in 12 (19.4%) patients, one (1.6%) of whom required bevacizumab discontinuation. The incidence of hematochezia was higher in patients with unresected primary tumors, prior intestinal bleeding, and tumor response (p<0.05). Conclusions These data provide important information about the incidence of clinically significant bleeding AEs, including minor mucocutaneous hemorrhage and major tumor-related bleeding such as hemoptysis and hematochezia in bevacizumab-treated mCRC patients. In addition, unresected primary tumor, prior bleeding, and tumor response were significant risk factors for hematochezia.
Efficacy of Bronchoscopic Therapies for Bronchial Mucoepidermoid Carcinoma in Children: Results from Six Patients
Authors: Wang Hongwu , Zhang Jieli , Li Dongmei , Zhang Nan , Li Jing , Mao Jiangfeng 
Published: February 2015

Aims and Background Bronchial mucoepidermoid carcinoma is a rare disease in children, and lobectomy is traditionally considered as a first-line treatment. As the tumor is characterized by intraluminal growth, low malignancy and superficial infiltration of bronchial walls, bronchoscopic interventional therapy may provide an alternative treatment with favorable results. The aim of the study was to evaluate the efficacy and safety of bronchoscopic therapies for bronchial mucoepidermoid carcinoma in children. Methods and Study design Clinical manifestations, multiple bronchoscopic interventions and outcomes in 6 children with bronchial mucoepidermoid carcinoma were retrospectively analyzed. Results The median age was 8.7 years (range 4 to 12 years). All the tumors were located in the lobar bronchus and were detected by computerized tomography. Diagnoses of low-grade mucoepidermoid carcinoma were made based on biopsies obtained via bronchoscopy. Five tumors were classified as intraluminal type and successfully eradicated by carbon dioxide cryotherapy and argon plasma coagulation under bronchoscopy. The other tumor in patient 3 was classified as the mixture type and could not be removed by a bronchoscopic, so left upper lobectomy was performed. For each patient, interventional procedures were conducted on the average for 6 times. No recurrence was detected by bronchoscopic inspections or computed tomography scans during follow-ups for 16-72 months. Conclusions Multiple bronchoscopic procedures, as alternative treatments, are effective in removing bronchial mucoepidermoid carcinoma mucoepidermoid carcinoma in children without any major complications.
The Anal Canal as a Risk Organ in Cervical Cancer Patients with Hemorrhoids Undergoing Whole Pelvic Radiotherapy
Authors: Jang Hyunsoo , Baek Jong Geun , Jo Sunmi 
Published: February 2015

Aims and Background Tolerance of the anal canal tends to be ignored in patients with cervical cancer undergoing whole pelvic radiotherapy. However, patients with hemorrhoids may be troubled with low radiation dose. We tried to analyze the dose-volume statistics of the anal canal in patients undergoing whole pelvic radiotherapy. Methods The records of 31 patients with cervical cancer who received definite or postoperative radiotherapy at one institution were reviewed. Acute anal symptoms, such as anal pain and bleeding, were evaluated from radiotherapy start to 1 month after radiotherapy completion. Various clinical and dosimetric factors were analyzed to characterize relations with acute anal complications. Results The anal verge was located an average of 1.2 cm (range −0.6~3.9) below the lower border of the ischial tuberosity and an average of 2.7 cm (range −0.6~5.7) behind the sacral promontory level. The presence of hemorrhoids before radiotherapy was found to be significantly associated with acute radiation-induced anal symptoms (p = 0.001), and the mean induction dose for anal symptoms was 36.9 Gy. No patient without hemorrhoids developed an anal symptom during radiotherapy. Dosimetric analyses of V30 and V40 showed marginal correlations with anal symptoms (p = 0.07). Conclusions The present study suggests a relation between acute anal symptoms following radiotherapy and acute hemorrhoid aggravation. Furthermore, the location of the anal verge was found to be variable, and consequently doses administered to the anal canal also varied substantially. Our results caution careful radiation treatment planning for whole pelvic radiotherapy, and that proper clinical management be afforded patients with hemorrhoids during radiotherapy.
Predictive Factors for Additional Non-Sentinel Lymph Node Involvement in Breast Cancer Patients with One Positive Sentinel Node
Authors: Meattini Icro , Saieva Calogero , Bertocci Silvia , Francolini Giulio , Zei Giacomo , De Luca Cardillo Carla , Scotti Vieri , Greto Daniela , Bonomo Pierluigi , Orzalesi Lorenzo , Bianchi Simonetta , Livi Lorenzo 
Published: February 2015

Aim The aim of this study was to identify a subgroup of breast cancer patients in whom it is possible to avoid axillary lymph node dissection (ALND) when the sentinel lymph node (SLN) is positive. Methods A series of 292 patients treated with breast-conserving surgery or mastectomy underwent ALND after positive SLN detection. To correlate SLN metastasis with the chances of finding additional metastasis in non-SLNs we evaluated the main clinicopathological characteristics. No patients received adjuvant radiotherapy to the axillary region. Results Fifty-six patients (35.4%) with positive SLNs for macrometastases (n = 158) had additional metastases upon completion ALND compared with 7 patients (5.2%) with micrometastases in the SLN (n = 132). Cases with a higher number of positive axillary lymph nodes tended to have higher pT stage (p = 0.004). In multivariate analysis, pT was confirmed as an independent predictor of non-SLN metastases (OR = 2.40; 95% CI = 1.16-4.99). No patients with micrometastases in SLN and cancer <10 mm had additional positive non-SLNs. Conclusions Our results, in agreement with the major published studies, suggest that ALND can be avoided in selected patients without the need for additional treatment to the axillary region.
Adaptive Splenic Radiotherapy for Symptomatic Splenomegaly Management in Myeloproliferative Disorders
Authors: Sager Omer , Beyzadeoglu Murat , Dincoglan Ferrat , Demiral Selcuk , Uysal Bora , Gamsiz Hakan , Akin Mustafa , Gundem Esin , Dirican Bahar 
Published: February 2015

Aims and Background Symptomatic, massive splenomegaly is a debilitating complication of myeloproliferative disorders. In the study, we evaluated the use of a contemporary, individualized radiotherapeutic approach for splenic irradiation, including 3-dimensional computed tomography-based treatment planning, individualized treatment margins based on splenic motion assessment, online setup verification with volumetric image guidance at each fraction, and adaptive radiation treatment planning to account for changes in splenic size during the fractionated radiotherapy course. Methods and Study design Between December 2008 and January 2014, 18 patients (13 males, 5 females) with myeloproliferative disorders referred to Gulhane Military Medical Academy Radiation Oncology Department underwent 22 courses of splenic irradiation using 3-dimensional computed tomography-based treatment planning and volumetric image guidance for palliation of symptomatic splenomegaly. Results Median age was 64 years (range 28-79). Significant pain relief was achieved in 20 of the 22 splenic irradiation courses (90.9%). Improvement in hematological parameters was achieved in 8 of the 11 splenic irradiation courses applied for cytopenia (72.7%). At least a 50% reduction in splenic size was achieved in 18 of the 22 splenic irradiation courses (81.8%). Toxicity was manageable with supportive treatment including antiemetics and platelet or red blood cell transfusions. Conclusions Splenic irradiation with a contemporary radiotherapeutic approach offers safe and effective palliation of symptomatic splenomegaly in myeloproliferative disorders.
Evaluation of Stereotactic Body Radiation Therapy in the Management of Adrenal Metastases from Non-Small Cell Lung Cancer
Authors: Gamsiz Hakan , Beyzadeoglu Murat , Sager Omer , Demiral Selcuk , Dincoglan Ferrat , Uysal Bora , Onal Elif , Dirican Bahar 
Published: February 2015

Aims and Background In this retrospective analysis, we evaluated the use of stereotactic body radiation therapy in the management of adrenal metastases from non-small cell lung cancer and report our single center experience. Methods and Study design Fifteen non-small cell lung cancer patients (9 male, 6 female) with 17 adrenal metastases referred to Gulhane Military Medical Academy Radiation Oncology Department were treated using active breathing control-guided stereotactic body radiation therapy between December 2009 and October 2013. Dose per fraction was 10 Gy to deliver a total dose of 30 Gy over 3 consecutive days for all metastatic adrenal lesions. The mean gross tumor volume was 28.4 cc (range 6.6-101.5) and mean planning target volume was 57.4 cc (range 16.5-143.8). Results At a median follow-up of 16 months, local control was 86.7% and overall survival was 33.3%. Median disease-free survival was 10 months. Treatment response according to RECIST was categorized as complete response in 3 patients (20%), partial response in 5 patients (33.3%), stable disease in 5 patients (33.3%), and progressive disease in 2 patients (13.3%). Most common acute toxicity was grade 1 nausea (n = 7) and grade 1 fatigue (n = 12). There was no case of grade ≥3 acute or late toxicity. Conclusions Stereotactic body radiation therapy offers a safe and efficacious management strategy for adrenal metastases from non-small cell lung cancer by providing excellent local control with negligible treatment related toxicity.
Analysis of MicroRNA Expression Profile Identifies Novel Biomarkers for Non-small Cell Lung Cancer
Authors: Xu Chi , Zheng Yisheng , Lian Duohuang , Ye Shixin , Yang Jinrong , Zeng Zhiyong 
Published: February 2015

Background Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer mortality. MicroRNAs (miRNAs), small noncoding RNAs, regulate the expression of genes that play roles in human cancer via posttranscriptional inhibition. Methods To identify the potential miRNA biomarkers in NSCLC, we downloaded the miRNA expression profile (ID: GSE29248) of NSCLC from the Gene Expression Omnibus (GEO) database and analyzed the differentially expressed miRNAs in NSCLC tissue compared with normal control tissue. Then the targets of these differentially expressed miRNAs were screened and used in network construction and functional enrichment analysis. Results We identified a total of 17 miRNAs that showed a significantly differential expression in NSCLC tissue. We found that miR-34b and miR-520h might play important roles in the regulation of NSCLC, miR-22 might be a novel biomarker as an oncogene, and miR-448 might promote, while miR-654-3p prevents, NSCLC progression. Conclusions Our study may provide the groundwork for further clinical molecular target therapy experiments in NSCLC.
Pathway Crosstalk Analysis of Non-Small Cell Lung Cancer Based on Microarray Gene Expression Profiling
Authors: Xing Chunyan , Zhang Ronghua , Cui Jiyun , Li Yonghong , Li Guanhua , Yang Yanna , Pang Longbin , Ruan Xiaoyun , Li Jun 
Published: February 2015

Aims and background Lung cancer is characterized by uncontrolled cell growth in the lung tissue. A major challenge in cancer research is the biological interpretation of the complexity of cancer somatic mutation profiles. This study examines the role of pathway crosstalk in the metastatic process of lung cancer cells based on DNA microarray analysis. Methods We downloaded the gene expression profile GSE10096 from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified and the gene functions of selected DEGs were further analyzed. After KEGG pathway analysis, dysfunctional pathways and dysfunctional crosstalk between pathways in two types of lung cancer cells (low metastasis, M1, and high metastasis, M5) were examined. Results A total of 13433 genes were filtered as DEGs, and after pathway analysis, 108 signaling pathways related to cancer signaling pathways were screened, including a host pathway hsa05223 and 79 neighbor pathways. Dysfunctional crosstalk analysis of pathways revealed that pathway crosstalk dysfunction of M1 and M5 cells mainly occurred between hsa05223 (non-small cell lung cancer) and hsa04310 (Wnt signaling pathway), and between non-small cell lung cancer and hsa04520 (adherens junction), respectively. Significant pathway crosstalk dysfunction also existed between adherens junction and other classical signaling pathways such as hsa04110 (cell cycle), hsa04310 (Wnt signaling pathway), hsa04350 (TGF-beta signaling pathway), and hsa04630 (Jak-STAT signaling pathway). Conclusions Our discovery will help to elucidate the molecular mechanisms of the high carcinogenic and metastatic potential of lung cancer cells. In addition, it will pave the way to developing effective therapies for lung cancer.
Improving Physicians' Communication Skills and Reducing Cancer Patients' Anxiety: A Quasi-Experimental Study
Authors: Morasso Gabriella , Caruso Anita , Belbusti Valentina , Carucci Tiziana , Chiorri Carlo , Clavarezza Valentina , De Benedetta Gabriella , D'Ovidio Silvia , luvaro Maria Domenica , Piattelli Angela , Romeo Marco , Santoni Wissya , Di Leo Silvia 
Published: February 2015

Aims and Background This study is aimed at evaluating the effectiveness of a physician-centered communication skills training program on cancer patient anxiety levels. Methods and Study design In this quasi-experimental study, physicians from 9 units of 5 general hospitals and 1 cancer research institute were recruited. The unit heads chose which physicians would attend the training program (treatment group) and which would not (control group). The effectiveness of the course was evaluated by assessing the evolution of state anxiety in a sample of cancer patients before and after clinical consultations. Results Thirty-eight physicians and 339 outpatients were assessed. Patients from the treatment and control groups did not differ in pre-examination anxiety or psychological distress levels. Patients examined by physicians from the treatment group displayed a higher decrease in state-anxiety levels compared with those examined by physicians from the control group. A higher proportion of high anxiety levels was found in women, in less educated patients, and in those with a high distress level. Conclusions Our findings suggest the effectiveness of the communication skills training program with reference to patient anxiety levels. Given the potential gap between training and clinical impact, further studies investigating the effect of communication training on patient outcomes are needed.
Analytical approximation of transit time scattering due to magnetosonic waves
Authors: Bortnik J. , Thorne R. M. , Ni B. , Li J. 
Published: February 2015

AbstractRecent test particle simulations have shown that energetic electrons traveling through fast magnetosonic (MS) wave packets can experience an effect which is specifically associated with the tight equatorial confinement of these waves, known as transit time scattering. However, such test particle simulations can be computationally cumbersome and offer limited insight into the dominant physical processes controlling the wave‐particle interactions, that is, in determining the effects of the various wave parameters and equatorial confinement on the particle scattering. In this paper, we show that such nonresonant effects can be effectively captured with a straightforward analytical treatment that is made possible with a set of reasonable, simplifying assumptions. It is shown that the effect of the wave confinement, which is not captured by the standard quasi‐linear theory approach, acts in such a way as to broaden the range of particle energies and pitch angles that can effectively resonate with the wave. The resulting diffusion coefficients can be readily incorporated into global diffusion models in order to test the effects of transit time scattering on the dynamical evolution of radiation belt fluxes.