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Endoscopic balloon dilation for management of stricturing Crohn’s disease in children

World journal of Gastrointestinal Endoscopy 2021年第9期13卷 382-390页

作者： Brianna McSorley Robert A Cina Candi jump johanna Palmadottir j antonio quiros Department of Pediatrics Medical University of South CarolinaCharlestonSC 29425United States Department of Surgery Medical University of South CarolinaCharlestonSC 29425United States Department of Pediatric Gastroenterology Medical University of South CarolinaCharlestonSC 29425United States Department of Pediatric Gastroenterology MUSC Children's HospitalCharlestonSC 29425United States Department of Pediatric Gastroenterology and Nutrition Mount Sinai Kravis Children's HospitalNew YorkNY 10029United States

BACKGROUND Crohn’s disease(CD)has a multitude of complications including intestinal strictures from fibrostenotic *** disease has been reported in 10%-17%of children at presentation and leads to surgery in 20%-50%of cases within ten years of *** symptoms develop from these strictures,the treatment in children has primarily been surgical *** balloon dilation(EBD)has been shown to be a safe and efficacious alternative to surgery in adults,but evidence is poor in the literature regarding its safety and efficacy in *** To evaluate the outcomes of children with fibrostenosing CD who underwent EBD vs surgery as a *** In a single-center retrospective study,we looked at pediatric patients(ages 0-18)who carry the diagnosis of CD,who were diagnosed after opening a dedicated Inflammatory Bowel Disease clinic on july 1,2012 through May 1,*** used diagnostic codes through our electronic medical record to identify patients with CD with a stricturing *** type of intervention for patients’strictures was then identified through procedural and surgical billing *** evaluated their demographics,clinical variables,whether they underwent EBD vs surgery or both,and their clinical *** Of the 139 patients with CD,25(18%)developed *** initial intervention for a stricture was surgical resection in 12 patients(48%)and EBD in 13 patients(52%).However,4(33%)patients whom initially had surgical resection required follow up EBD,and thus 17 total patients(68%)underwent EBD at some point in their treatment *** those 8 patients who underwent successful surgical resection alone,4 of these patients(50%)had a fistula present near the stricture site and 4(50%)had strictures greater than 5 cm in *** patients who underwent EBD had no procedural complications,such as a ***-two(88%)of the treated strictures were successfully managed by EBD and did not require any furth

关键词： Crohn’s disease Intestinal strictures Endoscopic dilation Pediatrics Endoscopic balloon dilation

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Update on the treatment of metastatic renal cell carcinoma

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World journal of Clinical Oncology 2022年第1期13卷 1-8页

作者： Rafael antonio Medina Lopez Ines Rivero Belenchon javier Mazuecos-quiros Carmen Belen Congregado-Ruiz Felipe Counago Department of Urology and Nephrology Virgen del Rocio University HospitalBiomedical Institute of Seville/CSIC/University of SevilleSevilla 41013Spain Department of Urology and Nephrology Virgen del Rocio University HospitalSeville 41005Spain Radiation Oncology Hospital Universitario QuironsaludHospital La LuzUniversidad Europea de MadridMadrid 28223Spain

Metastatic renal cell cancer(mRCC)management has undergone a paradigm shift in recent *** first revolution came with the emergence of vascular endothelial growth factor inhibitors;there was a second wave with the unprecedented success of checkpoint inhibitors,and then the latest approach,which is becoming the new care standard in mRCC,of combining these two strategies in different *** results of Checkmate-214 after 42 mo of follow-up were consistent with previously published results showing the superiority of nivolumab/ipilimumab over sunitinib in progression free survival(PFS),overall survival(OS),and objective response rate(ORR)in intermediate and high-risk ***,several studies presented at the American Society of Clinical Oncology 2020 suggested that the best place,and so far,the only one for nivolumab/ipilimumab is the frontline *** update on Keynote-426 after 23 mo of follow-up showed no superiority of pembrolizumab/axitinib over sunitinib in favorable-risk mRCC,suggesting that it should no longer be the first line of choice in low-risk ***,the phase III Checkmate 9ER trial results revealed the superiority of nivolumab/cabozantinib vs sunitinib in PFS,OS,and ORR,providing a new first-line option among all International Metastatic RCC Database Consortium risk *** phase II clinical trials also presented this year showed promising results with new combination therapies such as nivolumab/sitravatinib,cabozantinib/atezolizumab,and lenvatinib/pembrolizumab,providing promising grounds upon which to start phase III *** addition,other works are using novel therapeutic agents with different mechanisms of action,including telaglenastat(a glutaminase inhibitor),entinostat[an inhibitor of histone deacetylases(HDACs)],and olaparib and talazoparib,poly(ADP-ribose)polymerase inhibitors widely used in other ***,some questions regarding mRCC management still need to be addressed,such as head-to-head co

关键词： Metastatic renal cell carcinoma Systemic treatment Immune checkpoint inhibitors Antiangiogenic Update Biomarkers

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