RESUMEN
This study conducted a comparative proteomic analysis to identify potential genetic markers for the biological function of chemolithoautotrophic iron oxidation in the marine bacterium Ghiorsea bivora. To date, this is the only characterized species in the class Zetaproteobacteria that is not an obligate iron-oxidizer, providing a unique opportunity to investigate differential protein expression to identify key genes involved in iron-oxidation at circumneutral pH. Over 1000 proteins were identified under both iron- and hydrogen-oxidizing conditions, with differentially expressed proteins found in both treatments. Notably, a gene cluster upregulated during iron oxidation was identified. This cluster contains genes encoding for cytochromes that share sequence similarity with the known iron-oxidase, Cyc2. Interestingly, these cytochromes, conserved in both Bacteria and Archaea, do not exhibit the typical ß-barrel structure of Cyc2. This cluster potentially encodes a biological nanowire-like transmembrane complex containing multiple redox proteins spanning the inner membrane, periplasm, outer membrane, and extracellular space. The upregulation of key genes associated with this complex during iron-oxidizing conditions was confirmed by quantitative reverse transcription-PCR. These findings were further supported by electromicrobiological methods, which demonstrated negative current production by G. bivora in a three-electrode system poised at a cathodic potential. This research provides significant insights into the biological function of chemolithoautotrophic iron oxidation.
Asunto(s)
Proteínas Bacterianas , Hierro , Oxidación-Reducción , Proteómica , Hierro/metabolismo , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Crecimiento Quimioautotrófico , Familia de Multigenes , Regulación Bacteriana de la Expresión Génica , Agua de Mar/microbiologíaRESUMEN
OBJECTIVE: In this study, we aimed to assess the predictive value of Intermountain Risk Score (IMRS) in intensive care unit (ICU) patients with COVID-19. PATIENTS AND METHODS: Our retrospective study included the data of 194 patients who were admitted to the COVID-19 ICU of a tertiary care center. COVID-19 diagnoses were made by a positive result from a real-time reverse-transcriptase (RT) polymerase chain reaction (PCR) assay of nasal and pharyngeal swab specimens. Patients who had negative RT-PCR results or who were not admitted to ICU and patients under 18 years old were excluded from the study. Complete blood count, biochemistry panel, and blood gas analysis results were gathered and compiled. RESULTS: 194 ICU patients with COVID-19 (PCR positive) were included in the study. The patients were divided into two groups according to IMRS (if IMRS was <15 in women and <17 in men, patients were included in the non-high-risk group, while patients with IMRS ≥15 in women and ≥17 in men were defined as a high-risk group). Multivariate regression analysis was performed to predict in-hospital mortality. The IMRS [OR: 1.17 (1.08-1.27) p<0.001)] was found to predict in-hospital mortality. CONCLUSIONS: In this study, we showed that the IMRS score at admission can predict in-hospital mortality in intensive care unit patients with a diagnosis of COVID-19.
Asunto(s)
COVID-19 , Masculino , Humanos , Femenino , Adolescente , Pronóstico , COVID-19/diagnóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Unidades de Cuidados Intensivos , Prueba de COVID-19RESUMEN
OBJECTIVE: In this study, we measured the levels of Kelch-like ECH-associated protein 1 (KEAP1), which has the potential antioxidant capacity, among non-ST elevation myocardial infarction (NSTEMI) patients compared with healthy controls. We also investigated the possible association between KEAP1 levels and the GRACE score, which is a universal risk score commonly used for patients with acute myocardial infarction. PATIENTS AND METHODS: As the patient group, 78 patients admitted to our center with a diagnosis of NSTEMI were included in the study. As the control group, 77 individuals found to have normal coronary arteries after coronary arteriography were included (155 patients in total). GRACE risk scores and left ventricular ejection fractions (LVEFs) were calculated, KEAP1 levels were measured, and the usual blood tests were performed. RESULTS: KEAP1 levels were significantly higher among the NSTEMI patients compared to the healthy control group (671.1 ± 120.7 vs. 262.7 ± 105.7, p < 0.001). We also found a moderate positive correlation between KEAP1 levels and GRACE risk scores among patients with NSTEMI (r = +0.521, p < 0.001). Additionally, a negative correlation between KEAP1 levels and LVEFs was detected (r = -0.264, p < 0.001). CONCLUSIONS: Elevated KEAP1 levels have the potential to be used as a risk factor for NSTEMI in terms of clinical adverse events and poor prognosis at admission.
Asunto(s)
Infarto del Miocardio , Infarto del Miocardio sin Elevación del ST , Humanos , Infarto del Miocardio sin Elevación del ST/diagnóstico por imagen , Proteína 1 Asociada A ECH Tipo Kelch , Medición de Riesgo , Factor 2 Relacionado con NF-E2 , Factores de Riesgo , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/complicaciones , PronósticoRESUMEN
Objetivo: El objetivo de la presente investigación es evaluar nuestra experiencia inicial en la implementación de la mamografía con inyección de contraste (MCIC) y realizar una revisión de la literatura actual respecto de sus indicaciones. Los estudios se realizaron utilizando mamógrafo con capacidad de realizar MCIC, inyección de contraste iodado endovenoso y posterior toma de las imágenes mamográficas habituales (baja y alta energía). Se incluyeron 20 pacientes, invitadas a participar entre quienes concurrieron a realizar biopsias por punción histológicas. Una paciente realizó un segundo estudio al finalizar la terapia neoadyuvante. Dos de 20 (10%) pacientes tuvieron solo lesiones benignas que no realzaron y 18/20 (90%) lesiones malignas que realzaron. Se biopsiaron 27 lesiones, 4 (15%) fueron benignas y 23 (85%) malignas. La extensión del realce coincidió con la lesión visible en imágenes de baja energía en 9/18 (50%) pacientes, en 1/18 (5%) parte del realce mayor a la imagen de baja energía correspondió a una lesión benigna (falso positivo) y en 8/18 (45%) el realce mayor a la imagen de baja energía se corroboró histológicamente. En 4 (22%) pacientes se modificó la estrategia quirúrgica. En el examen post neoadyuvancia se observó respuesta imagenológica completa, reportándose en la cirugía, lesión residual invasora de 2mm. No se presentaron reacciones alérgicas ni otras complicaciones. Se realizó revisión de indicaciones en la literatura. Conclusiones: Nuestra experiencia inicial y curva de aprendizaje muestran que la MCIC es segura y con buenos resultados(AU)
Objetive The purpose of the investigation is to evaluate our initial experience with the implementation of contrast enhanced mammography (CEM) and a review of the current publications regarding its indications. The study was performed with a mammographic unit with CEM capability and iodine-based contrast medium injection. Low and high energy images (recombined image) were obtained in standard incidences. Twenty patients were invited to participate among those that came to undergo breast core biopsies. One patient had two studies, the second after neoadjuvant therapy. Two of 20 (10%) patients had only benign lesions that did not enhanced and 18/20 (90%) had malignant lesions that enhanced. Twenty-seven lesions were biopsied, 4 (15%) were benign and 23 (85%) were malignant. Enhancement was coincident with low energy images size in 9/18 (50%) patients, in 1/8 (5%) part of the enhancement, larger than the lesion in low energy images was due to a benign lesion (false positive) and 8/18 (45%) the size of the lesion that enhanced was truly larger than low energy images (histology proved). Because of this, surgery strategy was modified in 4 (22%) patients. There was radiologic complete response after neoadjuvant therapy and the surgical path report described a 2mm residual invasive carcinoma. There were no allergic reactions or other complications. A review of the published indications of the method was performed. Conclusions: Our initial experience and learning curve shows that CEM is safe with good clinical outcome (AU)
RESUMEN
PURPOSE: The aim of this study was to investigate the effect of the body fat mass ratio on survival and prognosis in advanced non-small-cell lung cancer patients. METHODS: The study includes 200 patients who were diagnosed with advanced non-small-cell lung cancer between 2014 and 2018 and whose body fat mass percentage and body mass index (BMI) were determined using the Tanita Body Composition Analyzer during admission. RESULTS: All patients had advanced incurable non-small-cell lung cancer (30% had locally advanced disease, 70% were stage IV). In the univariate and multivariate analyses, age, gender, histopathological type, smoking history, comorbidities, weight loss in the last six months and body mass index had no statistically significant effect on survival (p > 0.05). However, the performance status (p = 0.008), metastatic status (p = 0.003) and body fat mass ratio (p = 0.01) were found to have a significant effect on overall survival (OS): the median OS was 16.4 mo, in patients with the BFM ratio ≤ 22% and 29.2 mo, in those with > 22% (p = 0.01). CONCLUSION: In this study, it was found that the body fat mass ratio was an important prognostic factor in patients with advanced non-small-cell lung cancer.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Tejido Adiposo , Carcinoma de Pulmón de Células no Pequeñas/patología , Humanos , Lactante , Neoplasias Pulmonares/patología , Estadificación de Neoplasias , Pronóstico , Estudios RetrospectivosRESUMEN
In patients with type 1 neurofibromatosis (NF1), there is an increased susceptibility to tumor development in the central nervous system due to the loss of neurofibromin, an inactivator of the protooncogene Ras. NF1 has a broad clinical spectrum,which includes spinal tumors. Although the most common intramedullary tumor of the spinal cord in adults is ependymoma, few patients with NF1 accompanied by spinal ependymoma have been reported to date, and the localization of the tumors is cervical and thoracic in these cases. In this study, we report the case of a patient with NF1 presenting to our clinic with low back pain and gait disturbance. The patient had an intradural extramedullary ependymoma at the L2-3 vertebra level. This report is the first case of NF1 with spinal ependymoma localized in the lumbar region.
Asunto(s)
Ependimoma , Neurofibromatosis , Neurofibromatosis 1 , Adulto , Ependimoma/cirugía , Humanos , Vértebras Lumbares/diagnóstico por imagen , Región Lumbosacra , Imagen por Resonancia Magnética , Neurofibromatosis 1/complicacionesRESUMEN
BACKGROUND: In the phase III CheckMate 743 study (NCT02899299), first-line nivolumab plus ipilimumab significantly improved overall survival (OS) versus chemotherapy in patients with unresectable malignant pleural mesothelioma (MPM). We report updated data with 3-year minimum follow-up. PATIENTS AND METHODS: Adults with previously untreated, histologically confirmed, unresectable MPM and Eastern Cooperative Oncology Group performance status of ≤1 were randomized 1 : 1 to nivolumab (3 mg/kg every 2 weeks) plus ipilimumab (1 mg/kg every 6 weeks) for up to 2 years, or six cycles of platinum plus pemetrexed chemotherapy. This report includes updated efficacy and safety outcomes, exploratory biomarker analyses including four-gene inflammatory expression signature score, and a post hoc efficacy analysis in patients who discontinued treatment due to treatment-related adverse events (TRAEs). RESULTS: With a median follow-up of 43.1 months, nivolumab plus ipilimumab continued to prolong OS versus chemotherapy. Median OS was 18.1 versus 14.1 months [hazard ratio (95% confidence interval), 0.73 (0.61-0.87)], and 3-year OS rates were 23% versus 15%, respectively. Three-year progression-free survival rates were 14% versus 1%, and objective response rates were 40% versus 44%. At 3 years, 28% versus 0% of responders had an ongoing response. Improved survival benefit with nivolumab plus ipilimumab versus chemotherapy was observed across subgroups, including histology. A high score of the four-gene inflammatory signature appeared to correlate with improved survival benefit with nivolumab plus ipilimumab. No new safety signals were observed with nivolumab plus ipilimumab, despite patients being off therapy for 1 year. In patients who discontinued nivolumab plus ipilimumab due to TRAEs, median OS was 25.4 months, and 34% of responders maintained their responses for ≥3 years after discontinuation. CONCLUSIONS: With 3 years' minimum follow-up, nivolumab plus ipilimumab continued to provide long-term survival benefit over chemotherapy and a manageable safety profile, supporting the regimen as standard-of-care treatment for unresectable MPM, regardless of histology.
Asunto(s)
Mesotelioma Maligno , Nivolumab , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Humanos , Ipilimumab/efectos adversos , Nivolumab/uso terapéutico , Supervivencia sin ProgresiónRESUMEN
The efficacy of a new photosensitizer of chlorin E6 conjugated with a prostate-specific membrane antigen (PSMA) in photodynamic therapy of murine melanoma B16 was studied in in vivo experiments. The dynamics of photosensitizer accumulation in the tumor and surrounding tissues was evaluated and antitumor efficacy of photodynamic therapy was assessed by parameters of regression and morphological characteristics of experimental transplanted melanoma B16. The inhibitory effect of photodynamic therapy on melanoma was evaluated by complete regression of the tumor, absolute tumor growth coefficient in animals with continuation of tumor growth, and the increase in life span in comparison with the control; the criterion of cure was the absence of signs of tumor recurrence in mice within 90 days after therapy. The therapeutic potential of photodynamic therapy was determined by devitalization of tumor cells (histological examination of the zones of laser exposure on day 21 after treatment). The photosensitizer with PSMA-ligand exhibited high antitumor activity in photodynamic therapy for melanoma B16. Photodynamic therapy carried out at the optimum time after photosensitizer injection with experimentally determined parameters of laser exposure allows achieving the maximum inhibitory effect on melanoma. Pathomorphological study in the zones of exposure detected no survived tumor cells.
Asunto(s)
Clorofilidas/uso terapéutico , Melanoma Experimental/tratamiento farmacológico , Fotoquimioterapia/métodos , Neoplasias Cutáneas/tratamiento farmacológico , Urea/análogos & derivados , Animales , Línea Celular Tumoral , Clorofilidas/química , Clorofilidas/farmacocinética , Femenino , Ligandos , Melanoma Experimental/diagnóstico por imagen , Melanoma Experimental/metabolismo , Melanoma Experimental/patología , Ratones , Ratones Endogámicos C57BL , Recurrencia Local de Neoplasia/diagnóstico , Recurrencia Local de Neoplasia/metabolismo , Recurrencia Local de Neoplasia/patología , Fármacos Fotosensibilizantes/química , Fármacos Fotosensibilizantes/farmacocinética , Fármacos Fotosensibilizantes/uso terapéutico , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/metabolismo , Neoplasias Cutáneas/patología , Urea/química , Urea/farmacocinética , Urea/uso terapéuticoRESUMEN
Severe coronavirus disease 2019 (COVID-19) pneumonia survivors often exhibit long-term pulmonary sequelae, but the underlying mechanisms or associated local and systemic immune correlates are not known. Here, we have performed high-dimensional characterization of the pathophysiological and immune traits of aged COVID-19 convalescents, and correlated the local and systemic immune profiles with pulmonary function and lung imaging. We found that chronic lung impairment was accompanied by persistent respiratory immune alterations. We showed that functional severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)specific memory T and B cells were enriched at the site of infection compared with those of blood. Detailed evaluation of the lung immune compartment revealed that dysregulated respiratory CD8+ T cell responses were associated with the impaired lung function after acute COVID-19. Single-cell transcriptomic analysis identified the potential pathogenic subsets of respiratory CD8+ T cells contributing to persistent tissue conditions after COVID-19. Our results have revealed pathophysiological and immune traits that may support the development of lung sequelae after SARS-CoV-2 pneumonia in older individuals, with implications for the treatment of chronic COVID-19 symptoms.
Asunto(s)
Linfocitos B/inmunología , Linfocitos T CD8-positivos/inmunología , COVID-19/microbiología , Memoria Inmunológica , Pulmón/inmunología , SARS-CoV-2/inmunología , Linfocitos B/patología , Linfocitos T CD8-positivos/patología , COVID-19/patología , Femenino , Humanos , Pulmón/patología , Pulmón/virología , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: The geriatric nutritional risk index (GNRI) is a simple and objective nutritional assessment tool for elderly patients. Lower GNRI values are associated with a worse prognosis in heart failure with reduced ejection fraction (HFrEF). Our aim is to investigate the relationship between malnutrition and follow-up cardiovascular (CV) events in HFrEF. METHODS: A retrospective study was performed on 362 patients with HFrEF. The baseline GNRI was calculated at the first visit. The patients were divided into three groups according to the GNRI: >98, no-risk group; 92 to ≤98, low risk group; 82 to <92, moderatetohighrisk group. The study endpoint was a composite of follow-upCV events, including all-cause mortality, non-valvular atrial fibrillation (NVAF) , need for cardioverter defibrillator (ICD) therapy, HfrEFrelated hospitalizations and need for percutaneous coronary interventions (PCIs). RESULTS: Follow-up data showed that the group with moderate-to-high risk had a significantly higher incidence of NVAF, PCIs and all-cause mortality compared to other groups (p<0.001, p: 0.026 and p0.05). Mean GNRI value was 83.3 in NVAF patients and 101.1 in patients without NVAFâ (p<0.001). Kaplan Meier survival analysis showed that patients from the group with moderate-to-high risk had a significantly worse survival rate (p < 0.001). In the multivariate Cox regression analysis, the group with moderate-tohigh risk (HR=3.872) and ICD implantations (HR=4.045) were associated with increased mortality. CONCLUSION: The GNRI value may have a potential role for predicting future events, especially NVAF in patients with HfrEF (Tab. 4, Fig. 2, Ref. 27).
Asunto(s)
Fibrilación Atrial , Insuficiencia Cardíaca , Anciano , Fibrilación Atrial/complicaciones , Fibrilación Atrial/epidemiología , Fibrilación Atrial/terapia , Evaluación Geriátrica , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/epidemiología , Insuficiencia Cardíaca/terapia , Humanos , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Volumen SistólicoRESUMEN
BACKGROUND AND STUDY AIMS: Percutaneous endoscopic gastrostomy (PEG) is a procedure that provides long term enteral nutrition. To investigate the predictors of PEG-related complications and 30-day mortality rates and evaluate the indicators for deciding whether to recommend elective PEG insertions, we sought to determine the complications and early mortality rates of patients who underwent PEG. PATIENTS AND METHODS: We performed a retrospective analysis of consecutive adult patients who had undergone PEG for the first time between October 2016 and January 2019. The predictors of complications and 30-day mortality were analyzed with receiver operating characteristic (ROC) and logistic regression analysis. RESULTS: This study included 309 patients. Patients were excluded from the study if they were < 18 years of age or there were missing data about them. Out of 253 patients, 33 (13%) had complications and 32 (12.6%) died within one month after PEG insertion. A higher C-reactive protein (CRP) to albumin ratio was the only independent factor predicting the complications (odds ratio (OR) : 3.17 ; 95% CI : 1.26-8.00 ; p = 0.014). The independent predictive factors for 30-day mortality after PEG placement included higher urea levels and higher CRP to albumin ratios (OR : 3.78 ; 95% CI : 1.41-10.17 ; p = 0.008) (OR : 6.67 ; 95% CI : 1.87- 23.75 ; p = 0.003). The only predictor for both complications and 30-day mortality was the CRP to albumin ratio. CONCLUSIONS: When appropriate, the PEG procedure can provide a safe and effective method for enteral feeding. The CRP to albumin ratio can be used to predict complications and early mortality after PEG insertion. Because PEG is elective, higher CRP to albumin ratios can be helpful in deciding to select patients for the procedure.
Asunto(s)
Proteína C-Reactiva , Gastrostomía , Adulto , Proteína C-Reactiva/análisis , Nutrición Enteral , Humanos , Estudios Retrospectivos , Factores de RiesgoRESUMEN
We studied the effectiveness of photodynamic therapy with the photosensitizer Photoran E6 on the model of rat sarcoma M-1 positive for mutant p53 gene. Experiments showed that Photoran E6 exhibits high antitumor activity in photodynamic therapy of solid tumor of the connective tissue. Photodynamic therapy carried out during the optimal period after injections of Photoran E6 with the determined parameters of laser exposure allows achieving the maximum inhibitory effect on sarcoma M-1: 100% cured animals. Immunohistochemical study revealed no live tumor cells with expression of the mutant p53 protein in areas of photodynamic exposure.
Asunto(s)
Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Sarcoma/terapia , Animales , Inmunohistoquímica , Ratas , Proteína p53 Supresora de Tumor/metabolismoRESUMEN
Aim: To assess the efficacy and tolerability of the first-line treatment options for hormone-refractory prostate cancer patients with visceral metastases. Materials & methods: The records of 191 patients diagnosed with hormone-refractory prostate cancer with visceral metastases were analyzed retrospectively. Results: Docetaxel was administered to 61.2% (n = 117), abiraterone to 14.2% (n = 27) and enzalutamide to 9.4% (n = 18) as the first-line treatment. The median survival of the patients receiving docetaxel, abiraterone and enzalutamide as the first-line treatment during the hormone-refractory period was 15 (95% Cl: 12.9-17) months, 6 (95% Cl: 1.8-10.1) months and 11 (95% Cl: 0.9-23.1) months (p = 0.038), respectively. Conclusion: The present study established a statistically significant difference in favor of docetaxel in terms of overall survival and progression-free survival.
Lay abstract The optimal therapeutic option for castration-resistant prostate cancer (CRPC) patients with visceral metastases is unknown. We assessed the efficacy and tolerability of the first-line treatment options for CRPC patients with visceral metastasis. One hundred ninety-one patients diagnosed with CRPC with visceral metastases were included in the study. The present study established a statistically significant difference in favor of docetaxel in terms of overall survival and progression-free survival between first-line docetaxel, abiraterone and enzalutamide treatments in CRPC patients with visceral metastases. For patients who cannot undergo chemotherapy, enzalutamide, among novel androgen pathway inhibitors, may be the most appropriate option, given its numerical, although statistically insignificant, difference in overall survival and its fewer side effects compared with abiraterone.
Asunto(s)
Androstenos/administración & dosificación , Benzamidas/administración & dosificación , Docetaxel/administración & dosificación , Nitrilos/administración & dosificación , Feniltiohidantoína/administración & dosificación , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Androstenos/efectos adversos , Benzamidas/efectos adversos , Docetaxel/efectos adversos , Esquema de Medicación , Humanos , Masculino , Persona de Mediana Edad , Nitrilos/efectos adversos , Feniltiohidantoína/efectos adversos , Supervivencia sin Progresión , Neoplasias de la Próstata Resistentes a la Castración/mortalidad , Neoplasias de la Próstata Resistentes a la Castración/patología , Estudios RetrospectivosRESUMEN
INTRODUCTION AND OBJECTIVES: As well as increased susceptibility to infections, autoimmune and inflammatory manifestations also eventuate due to dysregulation of immune system in a substantial proportion of patients with primary immunodeficiency (PID). Autoimmune and inflammatory manifestations can occur prior or after diagnosis of PID. This study aimed to evaluate autoimmune and inflammatory complications among all types of PID patients in childhood and to emphasize the importance of these findings as a warning sign to diagnose PIDs. METHODS: Medical records of 1036 patients with PID, followed up between 2003 and 2019, were retrospectively screened for occurrence of autoimmunity and inflammation. During this time, demographic features, autoimmune/inflammatory findings and initial time, genetic mutations, laboratory and clinical follow up findings, treatment regimens and outcomes were recorded. RESULTS: Autoimmune and inflammatory manifestations were observed in 83 patients (10.1%). The median age of autoimmunity initial time was 61.3 ± 53 months. Sixty-seven (80.7%) patients presented with autoimmune and inflammatory manifestations, and these findings had occurred during 16 patients' (19.3%) follow-up. The most common autoimmune manifestations were autoimmune hematologic (51.8%) and endocrine diseases (26.5%). Fifty patients (60.2%) had a single autoimmune/inflammatory manifestation, however 23 patients (27.7%) had two, eight patients (9.6%) had three and two patients (2.4%) had four different types of autoimmune/inflammatory manifestations. The frequency of autoimmune and inflammatory manifestations in phagocyte defects (56%), combined immune deficiencies (53%) and immune dysregulation diseases (52%) were observed higher than other forms of PIDs. During follow-up 13 (15.7%) patients died. CONCLUSION: Autoimmune/inflammatory manifestations are associated with high morbidity in patients with PIDs and may precede the diagnosis of PID in childhood. Therefore, physicians must be aware of underlying possible immune deficiency and patients with known PIDs should be evaluated for autoimmune and inflammatory complications
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Síndromes de Inmunodeficiencia/epidemiología , Enfermedades Autoinmunes/epidemiología , Inflamación/epidemiología , Estudios Retrospectivos , Síndromes de Inmunodeficiencia/patología , Enfermedades Autoinmunes/patología , Inflamación/patología , Prevalencia , Factores de Edad , Estadísticas no Paramétricas , Mutación , Estudios de Seguimiento , Turquía/epidemiologíaRESUMEN
Rare tumours of the testis includes a wide variety of tumours. We aim to present clinical and histological characteristics of our patients with rare tumours of the testis. The medical records of 33 patients who were treated and followed-up for testicular rare tumours in our center between 2007 and 2020 were retrospectively reviewed. Of all the 243 testicular tumours, 222 cases (91.4%) were germ cell tumours and 21 cases (8.6%) were non-germ cell tumours. Thirty-three rare tumours of the testis including rare germ cell tumours and non-germ cell tumours were detected. The mean age of the patients at diagnosis was 34 years (range 18-68 years). The histological types of rare testicular tumours were as follows: teratoma 4.5% (n=11), sex-cord stromal tumours 4.5% (n=11), paratesticular tumours 3.2% (n=8), and the others [lymphoma 0.4% (n=1), mesothelioma 0.4% (n=1) and choriocarcinoma 0.4% (n=1)]. The median duration of follow-up was 32 months (range 1 to 256 months). None of the patients with non-metastatic disease stage developed recurrence after having received appropriate therapy. Metastatic disease was documented in 9 cases at the time of diagnosis (five patients with teratomas, two patients with Leydig cell tumour, one patient with choriocarcinoma and rhabdomyosarcoma). The most common subtypes of testicular rare tumours in our center was teratoma and sex-cord stromal tumours. Because of testicular rare tumours have different biological features and different clinical outcomes, the management of each tumour requires a different approach.
Asunto(s)
Neoplasias de Células Germinales y Embrionarias , Neoplasias Testiculares , Adolescente , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Neoplasias de Células Germinales y Embrionarias/diagnóstico , Neoplasias de Células Germinales y Embrionarias/terapia , Estudios Retrospectivos , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Adulto JovenRESUMEN
Lorlatinib is a third-generation tyrosine-kinases inhibitor (TKI) targeting ALK/ROS1 fusions. The FDA has approved lorlatinib for TKI-pretreated ALK(+) NSCLC, while its approval for ROS1(+) is still pending. Here we present the largest real-world data of NSCLC patients harboring ALK/ROS1 rearrangements treated with lorlatinib. METHODS: 123 patients were enrolled retrospectively (data cut-off 1/1/2019). Lorlatinib was administered through an early access program for patients with no other available therapy. Outcome and response were defined by each investigator upon RECIST 1.1 criteria. RESULTS: 106 ALK(+) and 17 ROS1(+) patients recruited from 8 different countries. The ALK(+) cohort included 50 % males, 73 % never-smokers and 68 % with brain metastases. Extracranial (EC) and intracranial (IC) response rates (RR) were 60 % and 62 %, with disease control rates (DCR) of 91 % and 88 % respectively. Mean duration of therapy (DoT) was 23.9⯱â¯1.6 months and median overall survival (mOS) was 89.1⯱â¯19.6 months. ROS1 cohort enrolled 53 % males, 65 % never-smokers and 65 % had brain metastases. EC and IC RR were 62 % and 67 % with DCR of 92 % and 78 % respectively. Median DoT was 18.1⯱â¯2.5 months and mOS of 90.3⯱â¯24.4 months. OS and DoT in both cohorts were not significantly correlated with line of therapy nor other parameters. The most common adverse events of any grade were peripheral edema (48 %), hyperlipidemia (47 %), weight gain (25 %) and fatigue (30 %). CNS adverse events such as cognitive effect of grade 1-2 were reported in 18 % of patients. CONCLUSION: Lorlatinib shows outstanding EC/IC efficacy in ALK/ROS1(+) NSCLC. The observed mOS of 89⯱â¯19 months in ALK(+) NSCLC supports previous reports, while mOS from of 90⯱â¯24 months is unprecedented for ROS1(+) NSCLC.
Asunto(s)
Neoplasias Pulmonares , Proteínas Tirosina Quinasas , Aminopiridinas , Femenino , Humanos , Lactamas , Lactamas Macrocíclicas , Neoplasias Pulmonares/tratamiento farmacológico , Masculino , Proteínas Proto-Oncogénicas , Pirazoles , Proteínas Tirosina Quinasas Receptoras/genética , Estudios RetrospectivosRESUMEN
OBJECTIVE: In this study, we aimed to investigate the diagnostic availability of oxidant and antioxidant parameters in ascites for spontaneous bacterial peritonitis (SBP). MATERIAL AND METHODS: This study was carried out between July and October 2018 with 25 patients with SBP and 24 patients without SBP. Patients with acute infection, those taking vitamin supplements and antioxidant medication, smoking and drinking alcohol, and patients without ascites culture were excluded from the study. RESULTS: In patients with SBP compared those without SBP median paraoxonase (3.1 vs 15.6 ; p <0.001), median stimulated paraoxonase (12.6 vs 53.1 ; p <0.001), median arylesterase (769,9 vs 857,5 ; p = 0,003) and median catalase (10 vs 22,2 ; p = 0,003) were found to be lower and median myeloperoxidase (8.1 vs 1.1 ; p <0.001) were found to be higher. There was a positive correlation between paraoxonase levels and stimulated paraoxonase levels, arylesterase levels and catalase levels, there was a negative correlation between paraoxonase levels and myeloperoxidase levels. Paraoxonase levels 3.7 and lower, stimulated paraoxonase levels 25.8 and lower, arylesterase levels 853.4 and lower, catalase levels 11.8 and lower and myeloperoxidase levels 2.7 and more predicted the the presence of SBP with high specificity and high sensitivity. Paraoxonase and stimulated paraoxo-nase levels were found to have superior performance in predicting the presence of SBP compared to arylesterase levels (p <0.05). CONCLUSION: In this study it was shown that paraoxonase, stimulated paraoxonase, arylesterase, catalase and myeloperoxidase activities can be used for the diagnosis and severity of SBP.
Asunto(s)
Ascitis , Peritonitis , Arildialquilfosfatasa , Ascitis/diagnóstico , Biomarcadores , Humanos , Estrés Oxidativo , Peritonitis/diagnósticoRESUMEN
AIM: The aim of this retrospective study is to evaluate and compare the 3-dimensional (3D) crown sizes of the left and right sides of upper and lower dental arches in patients with unilateral cleft lip and palate (UCLP). MATERIALS AND METHODS: Dental casts of 94 patients all in permanent dentition were included in this study. Dental casts were divided into three groups as 36 casts with unilateral left cleft lip and palate (ULCLP), 18 casts with unilateral right cleft lip and palate (URCLP), and 40 casts without cleft (control). Mesiodistal (MD), buccolingual (BL), and gingiva incisal (GI) values of each tooth were measured by scanning the dental models with a high-precision optical 3D scanner. Paired t-test and independent t-test were used for statistical analysis. RESULTS: U1 MD, U6 MD (P = 0.001) and BL (P = 0.01), L3 GI (P = 0.05) were greater in UCLP patients on the non-cleft side while U1 GI, L1 BL, L5 MD (P = 0.001), L4 MD, and BL (P = 0.01) values were found to be greater on the cleft side. Comparison of the cleft-sides and the control group showed that MD, BL, and GI dimensions of teeth on the cleft sides were generally found to be smaller, excluding the UR7 GI values for URCLP group (P = 0.05). CONCLUSION: In the measurements of teeth size, reliable and repeatable results were acquired through 3D software. Tooth size asymmetries can occur non-syndromic UCLP patients in both jaws. MD, BL, and GI dimensions of teeth are mostly found to be smaller in patients with CLP.
Asunto(s)
Labio Leporino , Imagenología Tridimensional/métodos , Odontometría/métodos , Corona del Diente/diagnóstico por imagen , Estudios de Casos y Controles , Niño , Fisura del Paladar/patología , Oclusión Dental , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Maxilar , Estudios Retrospectivos , Corona del Diente/patologíaRESUMEN
INTRODUCTION AND OBJECTIVES: As well as increased susceptibility to infections, autoimmune and inflammatory manifestations also eventuate due to dysregulation of immune system in a substantial proportion of patients with primary immunodeficiency (PID). Autoimmune and inflammatory manifestations can occur prior or after diagnosis of PID. This study aimed to evaluate autoimmune and inflammatory complications among all types of PID patients in childhood and to emphasize the importance of these findings as a warning sign to diagnose PIDs. METHODS: Medical records of 1036 patients with PID, followed up between 2003 and 2019, were retrospectively screened for occurrence of autoimmunity and inflammation. During this time, demographic features, autoimmune/inflammatory findings and initial time, genetic mutations, laboratory and clinical follow up findings, treatment regimens and outcomes were recorded. RESULTS: Autoimmune and inflammatory manifestations were observed in 83 patients (10.1%). The median age of autoimmunity initial time was 61.3±53 months. Sixty-seven (80.7%) patients presented with autoimmune and inflammatory manifestations, and these findings had occurred during 16 patients' (19.3%) follow-up. The most common autoimmune manifestations were autoimmune hematologic (51.8%) and endocrine diseases (26.5%). Fifty patients (60.2%) had a single autoimmune/inflammatory manifestation, however 23 patients (27.7%) had two, eight patients (9.6%) had three and two patients (2.4%) had four different types of autoimmune/inflammatory manifestations. The frequency of autoimmune and inflammatory manifestations in phagocyte defects (56%), combined immune deficiencies (53%) and immune dysregulation diseases (52%) were observed higher than other forms of PIDs. During follow-up 13 (15.7%) patients died. CONCLUSION: Autoimmune/inflammatory manifestations are associated with high morbidity in patients with PIDs and may precede the diagnosis of PID in childhood. Therefore, physicians must be aware of underlying possible immune deficiency and patients with known PIDs should be evaluated for autoimmune and inflammatory complications.
Asunto(s)
Enfermedades Autoinmunes/epidemiología , Enfermedades de Inmunodeficiencia Primaria/complicaciones , Edad de Inicio , Enfermedades Autoinmunes/inmunología , Niño , Preescolar , Susceptibilidad a Enfermedades/inmunología , Femenino , Estudios de Seguimiento , Humanos , Lactante , Inflamación/epidemiología , Inflamación/inmunología , Enfermedades de Inmunodeficiencia Primaria/inmunología , Estudios RetrospectivosRESUMEN
OBJECTIVE: We aimed to investigate whether a simple and easily calculated parameter such as monocyte/ HDL ratio (MHR) may be used in predicting non-dipper (NDHT)-dipper HT (DHT) end organ damage. METHODS: 70 NDHT and 73 DHT patient groups were included in the study according to ambulatory blood pressure screening results. Basic laboratory parameters and spot urine samples were evaluated. Transthoracic echocardiography and ophthalmological examination were performed for end-organ damages. RESULTS: The MHR among the groups was higher in the NDHT group; which was statistically significant (p≤0.001). In the NDHT group, albumin, creatinine, protein values, protein/creatinine ratio in the spot urine were significantly higher than in the DHT group (p≤0.05). Left ventricular hypertrophy (LVH) and retinopathy were also more frequently observed in the NDHT group (p≤0.001 and p=0.001, respectively). MHR in patients with LVH and retinopathy was significantly higher than in those without these complications (p=0.001). CONCLUSION: Easy to use, non-invasive and simple calculation, MHR can be used to predict end organ damage in hypertensive cases, and can be also used to distinguish between DHT/NDHT groups. This data supports the role of inflammation (Tab. 7, Ref. 14).