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Background: Melanoma is a highly malignant form of skin cancer that exhibits remarkable metabolic adaptability. Melanoma cells exhibit the capacity to adapt to specific conditions of the tumor microenvironment through the utilization of diverse energy sources, thereby facilitating the growth and advancement of the tumor. One of the notable characteristics of metabolic reprogramming is the heightened rate of lipid synthesis. This review was conducted to illustrate how the integration of whole exom and transcriptome sequencing will enhance the detection of the effect of cholesterol metabolism in melanoma. Methods: The Cochrane database, Embase, PubMed, SCOPUS, Google Scholar, Ovid, and other databases were thoroughly searched for works addressing integrated whole exome and transcriptome sequencing in cholesterol metabolism in melanoma. Skin malignancy, melanoma progression, transcriptome sequencing, whole exome sequencing, transcriptome sequencing by RNA sequencing, and integrated transcriptome and whole exome sequencing were the key phrases employed. This article underwent a phased search for pertinent literature using a staged literature search methodology. Each section's relevant papers were identified and summarized independently. The results have been condensed and narratively given in the pertinent sections of this thorough assessment. Results: DNA-based analysis has proven to be ineffective in identifying numerous mutations that have an impact on splicing or gene expression. RNA-Sequencing, when combined with suitable bioinformatics, offers a reliable method for detecting supplementary mutations that aid in the genetic diagnosis of geno-dermatoses. Therefore, clinical RNA-Sequencing expands the scope of molecular diagnostics for rare genodermatoses, and it has the potential to serve as a dependable initial diagnostic method for expanding mutation databases in individuals with inheritable skin conditions. Conclusion: The integration of patient-specific tumor RNA-sequencing and tumor DNA whole-exome sequencing (WES) would potentially enhance mutation detection capabilities compared to relying solely on DNA-WES.
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Neoplasms , DNA Tumor Viruses , Exome Sequencing , MelanomaABSTRACT
Objective To investigate the difference of the disease progression in patients with chronic obstructive pulmonary disease (COPD) with different muscle mass levels and the influence of related factors on the disease progression. Methods A total of 308 newly diagnosed patients with COPD from February 2021 to February 2022 were selected for this study. All patients were below moderate COPD. The patients were divided into two groups according to their muscle mass levels: sarcopenia group (98 cases) and control group (210 cases). The diagnostic criteria for sarcopenia were based on sarcopenia diagnostic thresholds: RSMI 2 in men and 2 for women. All subjects were followed up for 4 months to observe the progress of the patient's condition. The correlation between the muscle mass level and pulmonary function level, as well as the results of 6-minute walking test and CAT score was evaluated, and the influence of muscle mass level on the patient's disease progress was analyzed. At the same time, the potential influence of related factors (body fat rate, vitamin D level, etc.) on the condition of patients with different muscle mass levels was discussed. SPSS 19.0 software was used to perform statistical analysis. Results Under the same treatment intervention, the baseline and follow-up lung function improvement levels of patients in the sarcopenia group were lower than those in the control group, and the difference was statistically significant (P<0.05). At the same time, the baseline and follow-up 6-minute walk test results of the patients in the sarcopenia group were also worse than those of the control group, and the difference was statistically significant (P<0.05). Further correlation analysis was carried out between the patient's muscle mass level and the post-treatment pulmonary function indicators and 6MWD test level. The results showed that the muscle mass level was positively correlated with several pulmonary function indicators (FEV1, FEV1% predict) and 6MWD (both P<0.05). Considering the possible influence of other factors on the control and progress of the patient's condition, the present study used follow-up CAT score results to distinguish the prognosis of the patient's condition improvement, and used improvement and non-improvement as dependent variables to analyze the influence of various potential influencing factors. The results of regression model analysis showed that lower baseline muscle mass, women, lower body fat percentage, and lower vitamin D level were the main risk factors. Conclusion Under the same treatment condition, COPD patients with different muscle mass levels improve more slowly when complicated with sarcopenia and have poor prognosis. Women, lower body fat percentage and lower vitamin D level are potential risk factors for poor prognosis.
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La miopía constituye un problema de salud pública a nivel mundial, y se espera que afecte a un número cada vez mayor de personas en las próximas décadas. El control de la progresión de este defecto refractivo se ha convertido en una parte importante de la práctica clínica, ante la ausencia de un tratamiento protocolizado con el objetivo de disminuirla, se han valorado varias opciones terapéuticas. El objetivo del estudio fue proporcionar información actualizada sobre el tratamiento óptico en niños miopes. Para su realización se revisaron publicaciones, en idioma español e inglés, disponibles en bases de datos como PubMed, Ebsco, Google Académico, SciELO entre otras.
Myopia constitutes a worldwide public health problem, and is expected to affect an increasing number of people in the coming decades. The control of the progression of this refractive defect has become an important part of clinical practice, and in the absence of a protocolized treatment with the aim of reducing it, several therapeutic options have been evaluated. The aim of the study was to provide updated information on optical treatment in myopic children. For its realization, publications were reviewed, in Spanish and English, available in databases such as PubMed, Ebsco, Google Scholar, SciELO, among others.
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Background: Studies evaluating chronic kidney disease in older adults are scarce despite the high prevalence of the disease in this age group. In this study we have tried to determine the factors associated with the progression of chronic kidney disease in a group of patients over 65 years old. Methods: An analytical observational study of a prospective non-concurrent cohort was performed. We included patients older than 65 years belonging to a nephroprotection program and then, we followed them for 12 months. The variables of interest were age, sex, history of diabetes mellitus, serum creatinine at baseline and at 12-month follow-up, blood pressure and use of antihypertensive drugs, high density lipoprotein and low density lipoprotein, cholesterol levels, proteinuria, and use of antiplatelet agents. The estimated glomerular filtration rate (eGFR) was calculated at baseline and at 12-month follow-up, lastly the progression of chronic kidney disease was established. Results: 200 patients were included with an average age of 78.9 + 7.6 years, 51 % (102) females, 33 % (66) with a history of diabetes mellitus, with a mean initial eGFR 38.8 + 12.1 mL/min/1.73 m2. The mean of the final eGFR was 36.4 + 11.0 mL/min/ 1.73 m2 ; 17.5 % (35) presented a decrease > 25 % of the initial eGFR (progression) and 37.5 % (75) showed a decrease > 5mL/min/1.73m2/ year (rapid progression). Progression and rapid progression were significantly associated with age (p = 0.03 and p = 0.001, respectively), male sex (p < 0.001 and p < 0.001, respectively) and proteinuria (p < 0.001 and p < 0.001, respectively). There were no significant associations with other variables of interest. Conclusion: In our study, the progression of chronic kidney disease in patients older than 65 years in a nephroprotection program was significantly associated with the increased age, male sex, and presence of proteinuria.
Antecedentes: los estudios que evalúan la enfermedad renal crónica en adultos mayores son escasos, a pesar de la alta prevalencia de esta enfermedad en este grupo de edad. En este estudio hemos intentado determinar los factores asociados a la progresión de la enfermedad renal crónica en un grupo de pacientes mayores de 65 años. Métodos: se realizó un estudio observacional analítico de una cohorte prospectiva no concurrente. Se incluyeron pacientes mayores de 65 años pertenecientes a un programa de nefroprotección y se les siguió durante 12 meses. Las variables de interés fueron edad, sexo, antecedentes de diabetes mellitus, creatinina sérica al inicio y a los 12 meses de seguimiento, presión arterial y uso de fármacos antihipertensivos, niveles de colesterol, lipoproteínas de alta densidad y lipoproteínas de baja densidad, proteinuria y uso de antiagregantes plaquetarios. La tasa de filtración glomerular estimada (TFGe) se calculó tanto al inicio como a los 12 meses de seguimiento y se estableció la progresión de la enfermedad renal crónica. Resultados: se incluyeron 200 pacientes con una edad promedio de 78,9 + 7,6 años, 51 % (102) mujeres, 33 % (66) con antecedentes de diabetes mellitus, con TFGe inicial promedio 38,8 + 12,1 mL/min/1,73 m2. La media del TFGe final fue de 36,4 + 11,0 mL/min/ 1,73 m2; El 17,5 % (35) presentó una disminución > 25 % del TFGe inicial (progresión) y el 37,5 % (75) presentó una disminución > 5mL/min/1,73m2/año (progresión rápida). La progresión y la progresión rápida se asociaron significativamente con la edad (p = 0,03 y p = 0,001, respectivamente), el sexo masculino (p < 0,001 y p < 0,001, respectivamente) y la proteinuria (p < 0,001 y p < 0,001, respectivamente). No hubo asociaciones significativas con otras variables de interés. Conclusión: en nuestro estudio, la progresión de la enfermedad renal crónica en pacientes mayores de 65 años en programa de nefroprotección se asoció significativamente con el aumento de la edad, el sexo masculino y la presencia de proteinuria.
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Purpose: To find out the mean rate of progression (MROP) of visual fields (VF) in patients with primary open?angle glaucoma (POAG) and ocular hypertension (OHT) using FORUM® Glaucoma Workplace. Methods: Two hundred and one eyes of 105 patients were included in this prospective cohort study. Patients with POAG and OHT were recruited, and VF analysis with 24?2 and or 10?2 was done using SITA standard strategy in Zeiss Humphrey Visual Field Analyzer (HFA). All the previous VFs were identified from FORUM software, and the baseline indices were recorded from the first reliable VF analysis. The present VF analysis was compared to the previous one using FORUM software, and the rate of progression (ROP) in VF was obtained by Guided Progression Analysis. Results: MROP of VF in the POAG group was ? 0.085 dB/ year, ranging from ?2.8 to 2.8 dB/year with a standard deviation (SD) of 0.69. In the OHT group, the MROP of VF was ?0.003 dB/year, ranging from ? 0.8 to 0.5 dB/year with an SD of 0.27. The MROP of VF in medically treated eyes with POAG was ?0.14 dB/year with an SD of 0.61 and in surgically treated eyes was ?0.02 dB/year with an SD of 0.78. The overall baseline mean VF index (VFI) was 83.19% and the final mean VFI was 79.80%. There was a statistically significant decrease in the mean VFI value from baseline to the final visit (P?value 0.0005). Conclusion: The mean ROP of VF in the POAG group was ?0.085 dB/year and in the OHT group was ? 0.003 dB/year
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Purpose: The purpose of this study was to identify and analyze the clinical and ocular surface risk factors influencing the progression of keratoconus (KC) using an artificial intelligence (AI) model. Methods: This was a prospective analysis in which 450 KC patients were included. We used the random forest (RF) classifier model from our previous study (which evaluated longitudinal changes in tomographic parameters to predict “progression” and “no progression”) to classify these patients. Clinical and ocular surface risk factors were determined through a questionnaire, which included presence of eye rubbing, duration of indoor activity, usage of lubricants and immunomodulator topical medications, duration of computer use, hormonal disturbances, use of hand sanitizers, immunoglobulin E (IgE), and vitamins D and B12 from blood investigations. An AI model was then built to assess whether these risk factors were linked to the future progression versus no progression of KC. The area under the curve (AUC) and other metrics were evaluated. Results: The tomographic AI model classified 322 eyes as progression and 128 eyes as no progression. Also, 76% of the cases that were classified as progression (from tomographic changes) were correctly predicted as progression and 67% of cases that were classified as no progression were predicted as no progression based on clinical risk factors at the first visit. IgE had the highest information gain, followed by presence of systemic allergies, vitamin D, and eye rubbing. The clinical risk factors AI model achieved an AUC of 0.812. Conclusion: This study demonstrated the importance of using AI for risk stratification and profiling of patients based on clinical risk factors, which could impact the progression in KC eyes and help manage them better
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Purpose: The current study was carried out to evaluate the clinical features and management outcomes of dry eye disease (DED) in chronic ocular GvHD following allogenic hematopoietic stem cell transplantation (HSCT). Methods: A retrospective review of consecutive patients diagnosed with chronic ocular GvHD between 2011 and 2020 was performed at a tertiary eye care network. Multi?variate regression analysis was carried out for identifying risk factors associated with progressive disease. Results: A total of 34 patients (68 eyes) with a median age of 33 years [inter?quartile range (IQR) 23–40.5] were studied. The most common indication for HSCT was acute lymphocytic leukemia (26%). Ocular GvHD developed at a median of 2 years (IQR 1–5.5 years) after HSCT. Aqueous tear deficiency was present in 71% of the eyes, of which 84% had a Schirmer value of <5 mm. The median visual acuity at presentation and that after a median follow? up of 6.9 months were comparable at 0.1 log minimum angle of resolution (logMAR) (P = 0.97). Topical immunosuppression was required in 88% of cases, and with this, improvement in corneal (53%, P = 0.003) and conjunctival staining scores (45%, P = 0.43) was noted. A progressive disease was present in 32% with persistent epithelial defects being the most common complication. Grade 2 conjunctival hyperemia [odds ratio (OR): 2.6; P = 0.01] and Schirmer’s value <5 mm (OR: 2.7; P = 0.03) were found to be associated with progressive disease. Conclusion: Aqueous deficient DED is the most common ocular manifestation of chronic ocular GvHD, and the risk of the disease progression is greater in eyes with conjunctival hyperemia and severe aqueous deficiency. Awareness among ophthalmologists of this entity is essential for its timely detection and optimal management.
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Contexto: la enfermedad renal crónica (ERC) es un problema de salud pública mundial, con una prevalencia creciente y una carga sustancial sobre los sistemas de salud. Las características de los pacientes progresores rápidos junto con los factores que podrían predecir la progresión acelerada requieren una mayor exploración, sobre todo porque en Colombia no hay estudios publicados de este tipo. Objetivo: identificar los factores clínicos y sociodemográficos asociados con la progresión rápida de la ERC en una gran cohorte de pacientes de la costa norte colombiana. Metodología: este estudio observacional retrospectivo incluyó dos cohortes de pacientes de la costa norte colombiana con estadios de G1 a G4 sin diálisis. El seguimiento se realizó durante 18 meses (n = 14.420) y 24 meses (n = 10.042) y los pacientes se dividieron en progresores rápidos y progresores estables, según la pendiente de la tasa de filtración glomerular (TFGe) < -5 ml/min/1,73 m2/año o ≥ -5 mL/min/1,73 m2/año, respectivamente. Resultados: el 37,68 % de la cohorte se clasificó como progresión rápida a los 24 meses y el 28,41 % a los 18 meses. Se encontró un R2 = 0,77 en ambas cohortes para las mediciones de la TFGe, lo que indica una tendencia hacia una pérdida lineal. Además, la progresión acelerada se observó en pacientes más jóvenes y con valores más altos de tensión arterial diastólica. Conclusiones: en dos grandes cohortes de pacientes renales, aproximadamente 4 de cada 10 pacientes se clasificaron como progresores rápidos a los 24 meses de seguimiento y 3 de cada 10 a los 18 meses de seguimiento. Es importante identificar a los pacientes con mayor riesgo de progresión acelerada de la ERC en el corto plazo, para brindarles una atención personalizada y efectiva.
Background: Chronic Kidney Disease (CKD) is a global public health problem with increasing prevalence and a substantial burden on healthcare systems. The characteristics of rapid progressors and factors that may predict accelerated CKD progression require further exploration, especially since there are no published studies about this topic in Colombia. Purpose: To identify the clinical and sociodemographic factors associated with the rapid progression of CKD in a large cohort of Colombian patients. Methods: This retrospective observational study included two cohorts of G1 to G4 stage CKD patients without dialysis from the Colombian North Coast. Follow-up was conducted for 18 months (n=14,420) and 24 months (n=10,042). Patients were divided into rapid progressors and stable progressors based on the glomerular filtration rate (GFR) slope <−5 mL/min/1.73m2/year or ≥-5 mL/min/1.73 m2/year, respectively. Results: 37.68% of the cohort was classified as rapid progressors at 24 months and 28.41% at 18 months. An R2=0.77 was found in both cohorts for GFR measurements, indicating a linear trend toward loss. Furthermore, accelerated progression was observed in younger patients and those with higher diastolic blood pressure values. Conclusion: In two large cohorts of renal patients, approximately 4 out of 10 patients were classified as rapid progressors at 24 months of follow-up and 3 out of 10 at 18 months of follow-up. It is important to identify patients at higher risk of accelerated CKD progression in the short term to provide them with personalized and effective care.
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Introducción: La presencia de hipertensión arterial en población joven aumenta el riesgo de eventos cardiovasculares en la mediana edad y como consecuencia una morbimortalidad prematura. El propósito de este estudio es evaluar la progresión de los componentes de la presión arterial y la correlación con las medidas antropométricas y laboratoriales en estudiantes de la Universidad Nacional de Asunción- Paraguay. Materiales y métodos: Se realizó un estudio descriptivo correlacional, longitudinal, prospectivo, desde el año 2013 hasta el año 2017 evaluando al inicio 284 universitarios y 240 al final de las carreras. Se midieron variables sociodemográficas, antropométricas, presión arterial, determinaciones bioquímicas. La progresión de los componentes de la presión arterial, de las variables antropométricas y clínicas se calcularon mediante la prueba T de muestras relacionadas. La correlación de la presión arterial sistólica y presión arterial diastólica con las variables antropométricas y laboratoriales con la correlación de Pearson. Resultados: La progresión de los componentes de la presión arterial presentó una diferencia estadísticamente significativa en la presión arterial sistólica, presión arterial diastólica y presión de pulso. En relación con las características antropométricas y clínicas de los estudiantes se encontró una diferencia estadísticamente significativa entre la medición inicial y final en el peso, perímetro abdominal, glicemia, insulina, colesterol total, colesterol de alta densidad, colesterol de baja densidad, triglicéridos y proteína C reactiva. La correlación más importante encontrada entre las medidas antropométricas con la presión arterial sistólica y presión arterial diastólica fue la circunferencia abdominal. Conclusión: Se encontró aumento de la tendencia de la presión arterial y de otros factores de riesgo cardiovascular en universitarios.
Introduction: The presence of arterial hypertension in young population increases the risk of cardiovascular events in middle age and as a consequence premature morbimortality. The purpose of this study was to evaluate the progression of blood pressure components and the correlation with anthropometric and laboratory measurements in students of the National University of Asuncion, Paraguay. Materials and methods: A descriptive correlational, longitudinal, prospective, descriptive study was conducted from 2013 to 2017 evaluating at the beginning 284 undergraduates and 240 at the end of the careers. Sociodemographic variables, anthropometric variables, blood pressure, biochemical determinations were measured. The progression of blood pressure components, anthropometric and clinical variables were calculated using the related samples t-test. The correlation of systolic blood pressure and diastolic blood pressure with anthropometric and laboratory variables was correlated with Pearson's correlation. Results: The progression of blood pressure components presented a statistically significant difference in systolic blood pressure, diastolic blood pressure and pulse pressure. In relation to the anthropometric and clinical characteristics of the students, a statistically significant difference was found between the initial and final measurements in weight, abdominal perimeter, glycemia, insulin, total cholesterol, high-density cholesterol, low-density cholesterol, triglycerides, and C-reactive protein. The most important correlation found between anthropometric measurements with systolic blood pressure and diastolic blood pressure was abdominal circumference. Conclusion: An increase in the trend of blood pressure and other cardiovascular risk factors was found in university students.
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Arterial Pressure , Pressure , HypertensionABSTRACT
Introducción: la enfermedad renal crónica representa un significativo problema de salud en el siglo XXI. Se han identificado diversos factores asociados a un incremento del daño renal y a la consecuente progresión de la enfermedad. Objetivo: analizar el comportamiento de los factores de progresión de la enfermedad renal crónica en pacientes atendidos en una consulta de Nefrología comunitaria. Materiales y métodos: estudio observacional, descriptivo y prospectivo. Se incluyeron 65 pacientes con enfermedad renal crónica, que tuvieron seguimiento estable durante un período de 12 meses en la consulta de Nefrología comunitaria, del municipio Pedro Betancourt, de la provincia Matanzas. Fueron analizadas variables sociodemográficas y las relacionadas con la enfermedad renal crónica (etiología, estadio, factores de progresión y marcadores de daño renal). Resultados: se constató una edad promedio de 68,79 años; el 64,6 % de los enfermos eran blancos; diabéticos el 46,15 %; se expusieron a nefrotóxicos el 93,8 %; el 56,9 % presentó proteinuria; el 66,1 % mostró estabilidad en la función renal, y seis factores de progresión concurrieron en pacientes con estadio 3b. Conclusiones: predominaron los pacientes blancos, longevos y con diabetes como enfermedad de base. Hubo una distribución equitativa en cuanto a sexo. El empleo de fármacos nefrotóxicos, y la proteinuria, hiperuricemia e hiperlipidemia, se destacaron como los principales factores de progresión; no obstante, sola la proteinuria, la anemia y la acidosis estuvieron asociadas estadísticamente con la posible progresión de la enfermedad, que no fue constatada en ningún paciente.
Introduction: chronic kidney disease represents a significant health problem in the 21st century. Various factors associated to kidney damage increase and to the consequent progression of the disease have been identified. Objective: to analyze the behavior of chronic kidney disease progression factors in patients treated in a community nephrology consultation. Materials and methods: observational, descriptive and prospective study. Sixty-five patients with chronic kidney disease that were stably followed up during a twelve-month period in the community nephrology consultation of the Pedro Betancourt municipality, province of Matanzas, were included. Socio-demographic variables and those related to chronic kidney disease (etiology, stage, progression factors, and kidney damage markers) were analyzed. Results: an average age of 68.79 years was found; 64.6% of the patients were white; 46.15% were diabetics; 93.8% were exposed to nephrotoxics; 56.9% presented proteinuria; 66.1% showed renal function stability, and six progression factors concurred in 3b stage patients. Conclusions: white, aged patients predominated, with diabetes as underlying disease. There was an equitable distribution in terms of gender. The use of nephrotoxic drugs, and proteinuria, hyperuricemia, and hyperlipidemia stood out as the main progression factors. However, only proteinuria, anemia and acidosis were statistically associated to the possible disease progression, which was not found in any patient.
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Purpose: To investigate the knowledge of myopia and its natural history including complications and clinical approaches for management adopted by optometrists across India. Methods: An online survey was distributed to Indian optometrists. A pre?validated questionnaire was adopted from previous literature. Respondents provided information about their demographics (gender, age, practice location, and modality), myopia knowledge, self?reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Results: A total of 302 responses were collected from different regions of the country. Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open?angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non?cycloplegic refractive measures. The most common approaches to management were single?vision distance despite most optometrists identifying orthokeratology and low?dose (0.01%) topical atropine as two potentially more effective therapeutic interventions for controlling childhood myopia progression. Almost 90% of respondents considered increasing the time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences, seminars, research articles, and workshops. Conclusion: Indian optometrists appear to be aware of emerging evidence and practices, but are not routinely adopting measures. Clinical guidelines, regulatory approval, and sufficient consultation time may be of value for assisting practitioners in making clinical decisions based on the current available research evidence
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Purpose: To compare central visual field progression using mean deviation and pointwise linear regression (PLR) analysis. Methods: We analyzed the 10?2 Humphrey visual field (HVF) tests for moderate and advanced primary glaucoma who had undergone at least five reliable 10?2 visual field tests with a minimum follow?up of at least two years and best?corrected visual acuity better than 6/12. Regression slope less than ?1 dB/year at P < 0.01 at a point was defined as an individual threshold point progression. Results: Ninety?six eyes of 74 patients were included. The median follow?up duration was of 4 years (±1.97). Median 10?2 mean deviation (MD) at inclusion was ?19.01 dB (interquartile range [IQR] ?13.2, ?24.14) and ?21.90 (IQR ? 13.4, ?27.8) on 24?2 HVF. The median rate of MD change was ?0.13 dB/year (IQR ? 0.46, 0.08) for 10?2. The median rate for visual field index (VFI) change was 0.9% per year (IQR ? 1.5, 0.4). Twenty?eight percent of eyes (27 eyes) showed progression. Twelve percent (12 eyes) showed progression of two or more points in the same hemifield on pointwise linear regression (PLR) analysis, and 16% of eyes (15 eyes) showed progression of one point. The median rate of MD change was significantly more in progressing eyes based on PLR analysis than eyes with no progression (?0.5 vs. ?0.06 dB/year P < 0.001). One patient had likely and the second had possible progression on 24?2. In 24 eyes, event analysis did not show any change; the rest mean deviation was out of range. Conclusion: Central visual field PLR analysis is useful in detecting progression in advanced glaucomatous damage.
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Introducción: La Organización Mundial de la Salud considera a la miopía un problema de salud mundial debido a su prevalencia creciente. Se espera que afecte al 52 % de la población mundial en 2050. Objetivo: Determinar la progresión de la miopía durante la pandemia de COVID-19 con respecto al período previo al confinamiento. Métodos: Se realizó un estudio descriptivo y ambispectivo de una serie de 12 pacientes atendidos en la Consulta de Oftalmología Pediátrica del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" antes de la pandemia y que acudieron en el período de confinamiento por la COVID-19 para su seguimiento. Las variables evaluadas fueron edad, género, antecedentes patológicos familiares de miopía, horas pantalla, equivalente esférico y biometría. Resultados: El promedio de edad fue de 9,7 años y el 58,3 por ciento correspondió al sexo femenino. El 75 por ciento de los pacientes tenían antecedentes patológicos familiares de miopía y el tiempo estimado frente a pantalla fue de 5,3 ± 0,8 h diarias. La media de la biometría se incrementó en el tiempo de 23 mm en 2019 a 25,5 mm en 2021. La diferencia de la media del equivalente esférico previo a la COVID-19 fue -0,89 y -0,84 para ojo derecho y el ojo izquierdo, respectivamente. En la etapa epidémica se percibió un aumento hasta -1,97 y -1,72. Conclusiones: El incremento del uso de los medios digitales debido al confinamiento ha causado la progresión de la miopía(AU)
Introduction: Myopia is considered a global health problem by the World Health Organization due to its increasing prevalence and is expected to affect 52 percent of the world's population by 2050. Objective: To determine the progression of myopia during the COVID-19 pandemic with respect to the pre-confinement period. Methods: A descriptive and ambispective study of a series of 12 patients treated at the Pediatric Ophthalmology Clinic of the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" before the pandemic and who visited the hospital during the COVID-19 confinement period for follow-up, was carried out. The variables evaluated were age, gender, family history of myopia, screen hours, spherical equivalent and biometry. Results: The average age was 9.7 years and 58.3 percent of the patients were females. Seventy-five percent of the patients had a family history of myopia and the estimated time in front of the screen was 5.3 ± 0.8 h per day. The medium biometry increased over time from 23 mm in 2019 to 25.5 mm in 2021. The difference in medium pre-COVID-19 spherical equivalent was -0.89 and -0.84 for right eye and left eye, respectively. In the epidemic stage, an increase to -1.97 and -1.72 was perceived. Conclusions: Increased use of digital media due to confinement has caused myopia progression(AU)
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Humans , Female , Child , Myopia/epidemiology , Epidemiology, DescriptiveABSTRACT
Objective:To investigate the risk factors of early neurological deterioration (END) in patients with minor ischemic stroke caused by large vessel occlusion (LVO) and the impact of rescue endovascular thromboectomy (REVT) on clinical outcomes of patients with END at discharge.Methods:Consecutive patients with acute minor ischemic stroke caused by LVO within 24 h of onset in the Third Affiliated Hospital, Soochow University from January 2021 to March 2023 were retrospectively enrolled. Minor ischemic stroke was defined as baseline National Institute of Health Stroke Scale (NIHSS) score ≤5 at admission. END was defined as an increase of ≥4 in the NIHSS score within 24 h after the best medical management. The modified Rankin Scale was used to evaluate the clinical outcomes of patients with END at discharge. 0-2 was defined as a good outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for END and the impact of REVT on clinical outcomes in patients with END. Results:A total of 75 patients with minor ischemic stroke caused by LVO were included, of which 31 (41.3%) developed END and 13 (41.9%) underwent REVT after END. Multivariate logistic regression analysis showed that internal carotid artery occlusion was an independent risk factor for END (odds ratio 4.304, 95% confidence interval 1.213-15.270; P=0.024), and REVT was an independent protective factor for good outcomes in patients with END (odds ratio 0.068, 95% confidence interval 0.006-0.774; P=0.030). Conclusions:The incidence of END is higher in patients with minor ischemic stroke caused by LVO, and internal carotid artery occlusion is an independent risk factor for the occurrence of END. Providing REVT after END may improve the clinical outcomes of patients with END at discharge.
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Objective:To investigate the effectiveness and safety of endovascular therapy for acute progressive stroke caused by large vessel occlusion (LVO).Methods:Patients with progressive stroke caused by LVO admitted to the Department of Neurology, Yueyang Central Hospital from January 2019 to February 2022 were retrospective included. Patients with an Alberta Stroke Program Early CT Score (ASPECTS) or posterior circulation ASPECTS (pc-ASPECTS) ≥6 after progression were selected for endovascular therapy, including mechanical thromboectomy, thrombus aspiration, balloon angioplasty, stenting, or a combination of the above methods. Patients in the time window (anterior circulation within 12 h and posterior circulation within 24 h) and outside the time window (anterior circulation >12 h, posterior circulation >24 h) as well as those in the anterior and posterior circulation were compared.Results:A total of 20 patients with progressive stroke caused by LVO received endovascular treatment were included. There were 17 males and 3 females, aged 59.45±12.06 years. Three patients (15%) developed asymptomatic intracranial hemorrhage, and 12 (60%) had a good outcome 3 months after procedure. There were no statistically significant differences in the rate of successful vascular recanalization, incidence of intracranial hemorrhage, and the rate of poor outcomes between patients within and outside the time window and between the patients with anterior and posterior circulation.Conclusion:Endovascular therapy may be safe and effective for patients with progressive stroke caused by LVO with ASPECTS or pc-ASPECTS scores ≥6.
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Objective:To investigate the predictive value of monocyte-to-high-density lipoprotein cholesterol ratio (MHR) for early neurological deterioration (END) and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke (AIS).Methods:Patients with AIS received IVT in Hefei Second People's Hospital from May 2020 to January 2022 were retrospectively enrolled. Blood collection was completed and MHR was calculated before intravenous thrombolysis. END was defined as an increase of ≥2 from the baseline in the National Institutes of Health Stroke Scale (NIHSS) score or ≥1 from the baseline in motor function score at any time within 7 d after admission. HT was defined as intracranial hemorrhage newly found by CT/MRI within 24 h after intravenous thrombolysis. Multivariate logistic regression analysis was used to determine the independent predictors of END and HT, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of MHR for END and HT. Results:A total of 186 patients with AIS treated with IVT were included, of which 50 (26.9%) had END and 31 (16.7%) had HT. The median MHR was 0.43. The MHR in the END group was significantly higher than that in the non-END group (0.49 vs. 0.40; P=0.008), and the MHR in the HT group was significantly higher than that in the non-HT group (0.52 vs. 0.40; P=0.013). All patients were divided into 4 groups (MHR1, MHR2, MHR3 and MHR4) according to the MHR quartile from low to high. Multivariate logistic regression analysis showed that after adjusting for confounding factors, taking MHR1 as a reference, MHR3 (odds ratio [ OR] 6.317, 95% confidence interval [ CI] 1.465-27.237; P=0.013) and MHR4 ( OR 8.064, 95% CI 1.910-34.051; P=0.005) were the significant independent predictors of END; Taking MHR1 as a reference, MHR4 ( OR 5.147, 95% CI 1.194-22.182; P=0.028) was the significant independent predictor of HT. The ROC curve analysis showed that the area under the curve of MHR for predicting END was 0.628 (95% CI 0.554-0.698; P=0.008). When the optimal MHR cutoff value was 0.41, its sensitivity and specificity for predicting END was 74.0% and 53.7% respectively. The area under the curve of MHR for predicting HT was 0.642 (95% CI 0.569-0.711; P=0.013). When the best cutoff value was 0.44, the sensitivity and specificity of MHR for predicting HT were 77.4% and 58.1% respectively. Conclusion:Higher MHR is a risk factor for END and HT after intravenous thrombolysis in patients with AIS, but the predictive value of MHR for END and HT is limited.
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Diffuse large B-cell lymphoma (DLBCL) is a common, highly aggressive and heterogeneous hematologic malignancy in adults. Patients with DLBCL have substantially differences in molecular biological characteristics, clinical manifestations, and prognosis. Increasing evidence shows that the tumor microenvironment plays an important role in the occurrence and development of DLBCL. CD47, an integrin related protein, is overexpressed in DLBCL cells and plays a key role in immune escape of lymphoma. This work reviews the research progress of CD47 in DLBCL TME in terms of CD47-related signal pathway, CD47 role in DLBCL TME, and therapeutic strategies targeting CD47 in DLBCL TME.
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The continuous development of high-throughput and single-cell sequencing technologies and the emergence of spatial transcriptome sequencing have allowed the continuous discovery of temporal and spatial molecular events in the progression of colorectal cancer (CRC) to better understand its mechanism of malignant progression. Genetic variations (mutation of APC and P53, etc.) and mismatch repair of DNA, posttranscriptional regulation, such as epigenetic alteration, and dynamic alteration of complex molecular networks have their own special molecules that play key roles. Drug resistance and metastasis in the late stage of CRC progression are closely related to these key molecular events. This article reviews the research progress and explores key molecular events in the malignant progression of CRC to provide scientific basis and ideas for elucidating the regulatory mechanism of CRC and evaluating its prognosis prediction and treatment.
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Drug-induced bile duct injury is a specific kind of drug-induced liver injury that has two main pathological types, namely ductopenia, or vanishing bile duct syndrome, and secondary sclerosing cholangitis. However, in recent years, the reports of new drugs that cause bile duct injury have been constantly increasing, and these drugs have different clinicopathological features and a novel pathogenesis. Therefore, this paper summarizes and analyzes the progress and challenges in the etiology, pathogenesis, diagnosis and treatment, and other aspects of drug-induced bile duct injury.
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Humans , Cholestasis/chemically induced , Cholangitis, Sclerosing/diagnosis , Chemical and Drug Induced Liver Injury/pathology , Bile Ducts/pathologyABSTRACT
ObjectivesBased on the changes of lung lesions in patients with COVID-19 at different stages， a nomogram model describing CT image features was established by radiomics method to explore its efficacy in predicting the progression of the disease. MethodsThis retrospective study enrolled 136 patients with COVID-19 pneumonia who received at least two CTs including three cohorts （training cohort and validation cohort 1 and 2）. Patients in the training cohort were divided into three groups according to time between onset of fever symptoms and the first CT. The clinical manifestations and CT features of each group were analyzed and compared. A nomogram to predict disease progression was constructed according to the CT features of the patients， and its performance was evaluated. ResultsThe training cohort consisted of 41 patients.A nomogram was generated to predict disease progression based on three CT features： irregular strip shadow， air bronchial sign， and the proportion of lesions with irregular shape ≥50%. AUC（95%CI）=0.906（0.817，0.995）.The C index of the training cohort was 0.906， and the C index of the internal verification was 0.892. AUC（95%CI）of the validation cohort 1 （34 cases） =0.889（0.793，0.984）；AUC（95%CI）of the validation cohort 2 （61 cases）=0.876（0.706，1.000）.The calibration curves show that the predicted values of the nomogram are in good agreement with the observed values. ConclusionThe nomogram model based on CT radiomics can predict the outcome of lung lesions in patients with high sensitivity and specificity.According to the changes of CT image characteristics of patients with COVID-19， lung lesions will be improved when the proportion of irregular cable shadow， air bronchogram and irregular lesions is greater than 50%.