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Metabolomic changes in children with autism

World j.urnal of Clinical Pediatrics 2024年第2期13卷 171-197页

作者： Mohammed Al-Beltagi Nermin kamal Saeed adel Salah Bediwy Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Pediatric University Medical CenterDr.Sulaiman Al Habib Medical GroupManamaBahrainManama 26671Bahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12Bahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBahrainBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Chest Disease University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Chest Disease University Medical CenterDr.Sulaiman Al Habib Medical GroupManamaManama 26671Bahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain

BACKGROUND Autism spectrum disorder(ASD)is a neurodevelopmental condition characterized by deficits in social communication and repetitive *** profiling has emerged as a valuable tool for understanding the underlying metabolic dysregulations associated with *** To comprehensively explore metabolomic changes in children with ASD,integrating findings from various research articles,reviews,systematic reviews,meta-analyses,case reports,editorials,and a book *** A systematic search was conducted in electronic databases,including PubMed,PubMed Central,Cochrane Library,Embase,Web of Science,CINAHL,Scopus,LISA,and NLM catalog up until j.nuary *** criteria encompassed research articles(83),review articles(145),meta-analyses(6),systematic reviews(6),case reports(2),editorials(2),and a book chapter(1)related to metabolomic changes in children with *** criteria were applied to ensure the relevance and quality of included *** The systematic review identified specific metabolites and metabolic pathways showing consistent differences in children with ASD compared to typically developing *** metabolic biomarkers may serve as obj.ctive measures to support clinical assessments,improve diagnostic accuracy,and inform personalized treatment *** profiling also offers insights into the metabolic alterations associated with comorbid conditions commonly observed in individuals with *** Integration of metabolomic changes in children with ASD holds promise for enhancing diagnostic accuracy,guiding personalized treatment approaches,monitoring treatment response,and improving *** research is needed to validate findings,establish standardized protocols,and overcome technical challenges in metabolomic *** advancing our understanding of metabolic dysregulations in ASD,clinicians can improve the lives of affected individuals and their families.

关键词： Autism spectrum disorder Metabolic dysregulations Metabolomic changes Children Mitochondrial dysfunction Oxidative stress Amino acids

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Fecal calprotectin in pediatric gastrointestinal diseases:Pros and cons

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World j.urnal of Clinical Pediatrics 2024年第2期13卷 198-220页

作者： Mohammed Al-Beltagi Nermin kamal Saeed adel Salah Bediwy Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatrics University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain Department of Pediatrics University Medical CenterDr.Sulaiman Al Habib Medical GroupBahrainManama 26671ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBahrainBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain Department of Pulmonology University Medical CenterKing Abdulla Medical CityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain

BACKGROUND Fecal calprotectin is a valuable biomarker for assessing intestinal inflammation in pediatric gastrointestinal ***,its role,pros,and cons in various conditions must be comprehensively *** To explore the role of fecal calprotectin in pediatric gastrointestinal diseases,including its advantages and *** A comprehensive search was conducted on PubMed,PubMed Central,Google Scholar,and other scientific research engines until February 24,*** review included 88 research articles,56 review articles,six metaanalyses,two systematic reviews,two consensus papers,and two letters to the *** Fecal calprotectin is a non-invasive marker for detecting intestinal inflammation and monitoring disease activity in pediatric conditions such as functional gastrointestinal disorders,inflammatory bowel disease,coeliac disease,coronavirus disease 2019-induced gastrointestinal disorders,gastroenteritis,and cystic fibrosis-associated intestinal ***,its lack of specificity and susceptibility to various confounding factors pose challenges in *** these limitations,fecal calprotectin offers significant advantages in diagnosing,monitoring,and managing pediatric gastrointestinal *** Fecal calprotectin holds promise as a valuable tool in pediatric gastroenterology,offering insights into disease activity,treatment response,and *** protocols and guidelines are needed to optimize its clinical utility and mitigate interpretation *** research is warranted to address the identified limitations and enhance our understanding of fecal calprotectin in pediatric gastrointestinal diseases.

关键词： Fecal calprotectin Pediatric gastrointestinal diseases Functional gastrointestinal disorders Inflammatory bowel disease Coeliac disease COVID-19-induced gastrointestinal disorders Infectious gastroenteritis Cystic fibrosis

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Microphallus early management in infancy saves adulthood sensual life:A comprehensive review

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World j.urnal of Clinical Pediatrics 2024年第2期13卷 16-37页

作者： Mohammed Al-Beltagi Nermin kamal Saeed adel Salah Bediwy Maj.d A Shaikh Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511Egypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Pediatric University Medical CenterSulaiman Al Habib Medical GroupManama 26671Bahrain Department of Medical Microbiology Section and Pathology Salmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12Bahrain Department of Medical Microbiology Section and Pathology Irish Royal College of SurgeonBusaiteen 15503Bahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Department of Pulmonology University Medical CenterSulaiman Al Habib Medical GroupManama 26671Bahrain Department of Pediatrics Ibn Al Nafees HospitalManama 54533Bahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503Bahrain

Microphallus/Micropenis is a rare condition with significant physical and psychological implications for affected *** article comprehensively reviews micropenis,its etiology,epidemiology,and various treatment *** conducted a thorough literature review to collect relevant information on micropenis and microphallus,as well as related *** primary databases were PubMed,Medline,and Google *** searched for articles published in English between 2000 and *** analysis included 67 review articles,56 research studies,11 case reports,one guideline,and one *** search terms included"microphallus","micropenis","congenital hypogonadotropic hypogonadism","androgen insensitivity syndrome","pediatric management of micropenis","testosterone therapy",and"psychosocial implications of micropenis".We focused on diagnosing micropenis and related conditions,including hormonal assessments,medical and surgical treatment options,psychosocial and psychological well-being,sexual development of adolescents,and sociocultural influences on men's perceptions of penile ***,we explored parenting and family dynamics in cases of micropenis and disorders of sex development,implications of hormonal treatment in neonates,and studies related to penile augmentation procedures and their *** article highlights the importance of early diagnosis and intervention in addressing the physical and psychological well-being of individuals with *** procedures,such as penile lengthening and girth enhancement,and non-surgical approaches like hormonal therapy are *** significance of psychological support,education,and lifestyle modifications is *** management and comprehensive care are crucial for individuals with micropenis,from infancy to adolescence and beyond.A multidisciplinary approach involving urologists,endocrinologists,and mental health professionals is *** assessment of treatment e

关键词： Microphallus Micropenis Hypogonadism Children Adults Sensual life Testosterone therapy

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Gastrointestinal tolerability of organic infant formula compared to traditional infant formula: A systematic review

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World j.urnal of Clinical Pediatrics 2024年第1期13卷 125-140页

作者： Mohammed Al-Beltagi Nermin kamal Saeed adel Salah Bediwy Reem Elbeltagi Mohamed Basiony Hamza Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671ManamaBahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlgahrbiaEgypt

BACKGROUND Infants'nutrition significantly influences their growth,development,and overall *** the increasing demand for organic infant formula driven by the perception of health benefits and growing awareness of natural feeding options,it is crucial to conduct a comparative analysis of the gastrointestinal tolerability between organic and traditional infant *** To provide a concise and precise analysis of the gastrointestinal tolerability of organic infant formula compared to traditional infant *** to limited direct comparisons,the review synthesizes available literature on each formula type,presenting insights into their potential effects on infants'digestive *** An extensive literature search was conducted,compiling studies on organic and traditional infant formulas,their compositions,and reported effects on gastrointestinal *** searched academic databases such as PubMed and Google Scholar and specialized nutrition,paediatrics,and infant health j.urnals using relevant keywords till October 1,*** Although specific comparative studies are scarce and formula heterogeneity is a significant limitation,this systematic review provides an in-depth understanding of organic infant formulas'composition and potential *** scientific evidence directly comparing gastrointestinal tolerability is limited,organic formulas strive to use carefully selected organic ingredients to imitate breast milk *** benefits include improved lipid profiles,higher methionine content,and decreased antibiotic-resistant bacteria *** the gastrointestinal tolerability of organic and traditional infant formulas is crucial for parents and healthcare providers to make informed *** Despite limitations in direct comparisons,this systematic review provides insights into the composition and potential benefits of organic infant *** emphasizes the need for further research to eluci

关键词： Organic infant formula Traditional infant formula Gastrointestinal tolerability Formula ingredients Digestive health Infant nutrition Organic farming

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Serum ferritin and the risk of early-onset colorectal cancer

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World j.urnal of Gastrointestinal Oncology 2024年第8期16卷 3496-3506页

作者： Adam L Urback Kylee Martens Hannah Stowe McMurry Emerson Y Chen Caitlin Citti Anil Sharma adel Kardosh j.seph j.Shatzel Division of Internal Medicine Oregon Health&Science UniversityPortlandOR 97239United States Division of Hematology and Medical Oncology Knight Cancer InstituteOregon Health&Science UniversityPortlandOR 97239United States Division of Gastroenterology&Hepatology Oregon Health&Science UniversityPortlandOR 97239United States

BACKGROUND The incidence of early-onset colorectal cancer(EO-CRC)is rising in the United States,and is often diagnosed at advanced *** serum ferritin is often incidentally discovered in young adults,however,the indication for endoscopy in EO-CRC is *** To compare serum ferritin between patients with EO-CRC and healthy controls(HCs),and examine the association of serum ferritin in EO-CRC with patient-and disease-specific *** A retrospective study of patients<50 years with newly-diagnosed EO-CRC was conducted from 1/2013-12/*** were included if serum ferritin was measured within 2 years prior to 1 year following CRC histologic *** supplement the analysis,a cohort of HCs meeting similar inclusion and exclusion criteria were identified for comparison.A sensitivity analysis including only patients with serum ferritin obtained at or before diagnosis was separately performed to minimize risk of *** Among 85 patients identified with EO-CRC(48 females),the median serum ferritin level was 26 ng/mL(range<1-2759 ng/mL).Compared to HCs(n=80211),there were a higher proportion of individuals with EO-CRC with serum ferritin<20 ng/mL(female 65%,male 40%)versus HCs(female 32.1%,male 7.2%)age 29-39 years(P=0.002 and P<0.00001,respectively).Stage IV disease was associated with significantly higher serum ferritin compared to less advanced stages(P<0.001).Serum ferritin obtained before or at the time of diagnosis was lower than levels obtained after *** findings were confirmed in the sensitivity *** Severe iron deficiency may indicate an increased risk of EO-CRC,particularly at earlier *** studies defining the optimal serum ferritin threshold and routine incorporation of serum ferritin in screening algorithms is essential to develop more effective screening strategies for EO-CRC.

关键词： Early-onset Young-onset Colorectal cancer Age Ferritin Iron deficiency

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Pulse oximetry in pediatric care:Balancing advantages and limitations

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World j.urnal of Clinical Pediatrics 2024年第3期13卷 69-97页

作者： Mohammed Al-Beltagi Nermin kamal Saeed adel Salah Bediwy Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityTanta 31511AlghrabiaEgypt Department of Pediatrics University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 26671ManamaBahrain Medical Microbiology Section Department of PathologyIrish Royal College of Surgeon in BahrainBusaiteen 15503MuharraqBahrain Department of Pulmonology Faculty of MedicineTanta UniversityTanta 31527AlghrabiaEgypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain Department of Medicine The Royal College of Surgeons in Ireland-BahrainBusiateen 15503MuharraqBahrain

BACKGROUND Pulse oximetry has become a cornerstone technology in healthcare,providing non-invasive monitoring of oxygen saturation levels and pulse *** its widespread use,the technology has inherent limitations and challenges that must be addressed to ensure accurate and reliable patient *** To comprehensively evaluate the advantages,limitations,and challenges of pulse oximetry in clinical practice,as well as to propose recommendations for optimizing its *** A systematic literature review was conducted to identify studies related to pulse oximetry and its applications in various clinical *** articles were selected based on predefined inclusion and exclusion criteria,and data were synthesized to provide a comprehensive overview of the *** Pulse oximetry offers numerous advantages,including non-invasiveness,real-time feedback,portability,and ***,several limitations and challenges were identified,including motion artifacts,poor peripheral perfusion,ambient light interference,and patient-specific factors such as skin pigmentation and hemoglobin *** for optimizing pulse oximetry use include technological advancements,education and training initiatives,quality assurance protocols,and interdisciplinary *** Pulse oximetry is crucial in modern healthcare,offering invaluable insights into patients’oxygenation *** its limitations,pulse oximetry remains an indispensable tool for monitoring patients in diverse clinical *** implementing the recommendations outlined in this review,healthcare providers can enhance the effectiveness,accessibility,and safety of pulse oximetry monitoring,ultimately improving patient outcomes and quality of care.

关键词： Pulse oximetry Oxygen saturation Monitoring Advantages Limitations Challenges Recommendations Clinical practice Non-invasive Children

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Decoding the genetic landscape of autism:A comprehensive review

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World j.urnal of Clinical Pediatrics 2024年第3期13卷 98-136页

作者： Mohammed Al-Beltagi Nermin kamal Saeed adel Salah Bediwy Eman A Bediwy Reem Elbeltagi Department of Pediatric Faculty of MedicineTanta UniversityAlghrabiaTanta 31511Egypt Department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthKingdom of BahrainManama 12Bahrain Medical Microbiology Section Department of PathologyIrish Royal College of SurgeonMuharraqBusaiteen 15503Bahrain Department of Pulmonology Faculty of MedicineTanta UniversityAlghrabiaTanta 31527Egypt Department of Pulmonology University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671Bahrain Internal Medicine Faculty of MedicineTanta UniversityAlgharbiaTanta 31527Egypt Department of Medicine The Royal College of Surgeons in Ireland-BahrainMuharraqBusiateen 15503Bahrain

BACKGROUND Autism spectrum disorder(ASD)is a complex neurodevelopmental condition characterized by heterogeneous symptoms and genetic *** advancements in genetic and epigenetic research have provided insights into the intricate mechanisms contributing to ASD,influencing both diagnosis and therapeutic *** To explore the genetic architecture of ASD,elucidate mechanistic insights into genetic mutations,and examine gene-environment *** A comprehensive systematic review was conducted,integrating findings from studies on genetic variations,epigenetic mechanisms(such as DNA methylation and histone modifications),and emerging technologies[including Clustered Regularly Interspaced Short Palindromic Repeats(CRISPR)-Cas9 and single-cell RNA sequencing].Relevant articles were identified through systematic searches of databases such as PubMed and Google *** Genetic studies have identified numerous risk genes and mutations associated with ASD,yet many cases remain unexplained by known factors,suggesting undiscovered genetic *** insights into how these genetic mutations impact neural development and brain connectivity are still *** modifications,particularly DNA methylation and non-coding RNAs,also play significant roles in ASD *** technologies like CRISPR-Cas9 and advanced bioinformatics are advancing our understanding by enabling precise genetic editing and analysis of complex genomic *** Continued research into the genetic and epigenetic underpinnings of ASD is crucial for developing personalized and effective *** efforts integrating multidisciplinary expertise and international collaborations are essential to address the complexity of ASD and translate genetic discoveries into clinical *** unresolved questions and ethical considerations surrounding genetic research will pave the way for improved diagnostic tools and targ

关键词： Autism spectrum disorder Genetics Epigenetics Clustered Regularly Interspaced Short Palindromic Repeats-Cas9 Gene-environment interactions Personalized medicine

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Metabolic reprogramming by Syntenin-1 directs RA FLS and endothelial cell-mediated inflammation and angiogenesis

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Cellular & Molecular Immunology 2024年第1期21卷 33-46页

作者： Anj. Meyer Stephanie R.Zack Wes Nij.m adel Burgos Vishwa Patel Brian Zanotti Michael V.Volin M.Asif Amin Myles j.Lewis Costantino Pitzalis Shiva Arami j.seph A.Karam Nadera j.Sweiss Shiva Shahrara j.sse Brown VA Medical Center ChicagoILUSA Department of Medicine Division of RheumatologyThe University of Illinois at ChicagoChicagoILUSA Department of Microbiology and Immunology Midwestern UniversityDowners GroveILUSA Division of Rheumatology and Clinical Autoimmunity Center of Excellence University of MichiganAnn ArborMIUSA Centre for Experimental Medicine and Rheumatology William Harvey Research InstituteBarts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUnited Kingdom Centre for Experimental Medicine&Rheumatology William Harvey Research InstituteQueen Mary University of London and Barts NIHR BRC&NHS TrustLondonUK Department of Biomedical Sciences Humanitas Universityand Humanitas Research HospitalMilanItaly Department of Orthopedic Surgery the University of Illinois at ChicagoChicagoILUSA

A novel rheumatoid arthritis(RA)synovial fluid protein,Syntenin-1,and its receptor,Syndecan-1(SDC-1),are colocalized on RA synovial tissue endothelial cells and fibroblast-like synoviocytes(FLS).Syntenin-1 exacerbates the inflammatory landscape of endothelial cells and RA FLS by upregulating transcription of IRF1/5/7/9,IL-1β,IL-6,and CCL2 through SDC-1 ligation and HIF1α,or mTOR ***,Syntenin-1 orchestrates RA FLS and endothelial cell invasion via SDC-1 and/or mTOR *** Syntenin-1 reprogrammed endothelial cells,the dynamic expression of metabolic intermediates coincides with escalated glycolysis along with unchanged oxidative factors,AMPK,PGC-1α,citrate,and inactive oxidative ***,RA FLS rewired by Syntenin-1 displayed a modest glycolytic-ATP accompanied by a robust mitochondrial-ATP *** enriched mitochondrial-ATP detected in Syntenin-1 reprogrammed RA FLS was coupled with mitochondrial fusion and fission recapitulated by escalated Mitofusin-2 and DRP1 *** found that VEGFR1/2 and Notch1 networks are responsible for the crosstalk between Syntenin-1 rewired endothelial cells and RA FLS,which are also represented in RA *** to RA explants,morphological and transcriptome studies authenticated the importance of VEGFR1/2,Notch1,RAPTOR,and HIF1αpathways in Syntenin-1 arthritic mice and their obstruction in SDC-1 deficient ***,dysregulation of SDC-1,mTOR,and HIF1αnegated Syntenin-1 inflammatory phenotype in RA explants,while inhibition of HIF1αimpaired synovial angiogenic imprint amplified by *** conclusion,since the current therapies are ineffective on Syntenin-1 and SDC-1 expression in RA synovial tissue and blood,targeting this pathway and its interconnected metabolic intermediates may provide a novel therapeutic strategy.

关键词： Syntenin-1 Syndecan-1 RA FLS RA explants immunometabolism

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Prognostic model of survival outcomes in non-small cell lung cancer patients initiated on afatinib: pooled analysis of clinical trial data

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Cancer Biology & Medicine 2019年第2期16卷 341-349页

作者： Ashley M. Hopkins adel Shahnam Sasha Zhang Chris S. Karapetis Andrew Rowland Michael j. Sorich Flinders Centre for Innovation in Cancer Department of Clinical Pharmacology College of Medicine and Public Health Flinders University Adelaide 5042 Australia The Canberra Hospital Garran 2605 Australia

Obj.ctive: Several predictors of survival have been identified in EGFR-positive non-small cell lung cancer(NSCLC) patients treated with first generation EGFR inhibitors. Prognostic models of survival outcomes with afatinib have not been ***: A prognostic tool for overall survival(OS)/progression free survival(PFS) based on pre-treatment clinicopathological factors was developed for EGFR-positive advanced NSCLC patients treated with first-line afatinib using penalised regression of individual-participant data from LUX-Lung 3 and 6(n = 468). Favourable, intermediate and poor risk groups were identified and externally validated using LUX-Lung 1(n = 390) and LUX-Lung 2(n = 129) trials that initiated afatinib following previous chemotherapy or EGFR inhibitor ***: Discriminative performance was good in the development and validation cohorts. For patients treated with first-line afatinib, the median OS for the favourable, intermediate and poor risk groups were > 47.7, 29.3 and 16.4 months, respectively, and the median PFS were 17.3, 13.2 and 8.3 months, respectively. The improvement in median OS with afatinib use compared to chemotherapy was > 12.4 months for the favourable risk group, whereas no OS benefit was apparent for the poor risk group. The improvement in median PFS with afatinib use compared to chemotherapy was 10.2 months for the favourable risk group and 3.2 months for the poor risk ***: A prognostic tool was developed and validated to identify favourable, intermediate and poor risk groups for OS/PFS in EGFR-positive advanced NSCLC patients treated with afatinib. The prognostic groups can inform the likely absolute OS/PFS benefit expected from afatinib compared to chemotherapy in first-line treatment.

关键词： Afatinib non-small cell lung cancer prognostic model

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Insulin-resistance in paediatric age:Its magnitude and implications

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World j.urnal of Diabetes 2022年第4期13卷 282-307页

作者： Mohammed Al-Beltagi adel Salah Bediwy Nermin kamal Saeed Department of Pediatrics Faculty of MedicineTanta UniversityTanta 31511Egypt Department of Pediatrics University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Department of Chest Disease Faculty of MedicineTanta UniversityTanta 31527Egypt Department of Pulmonology University Medical CenterArabian Gulf UniversityDr.Sulaiman Al Habib Medical GroupManama 26671Bahrain Medical Microbiology Section Department of PathologySalmaniya Medical ComplexMinistry of HealthManama 12Bahrain Microbiology Section Department of PathologyIrish Royal College of SurgeonBusaiteen 15503Bahrain

Insulin resistance(IR)is insulin failure in normal plasma levels to adequately stimulate glucose uptake by the peripheral *** is becoming more common in children and adolescents than *** is a strong association between obesity in children and adolescents,IR,and the metabolic syndrome *** shows marked variation among different races,crucial to understanding the possible cardiovascular risk,specifically in high-risk races or ethnic *** causes of IR include insulin receptor mutations,mutations that stimulate autoantibody production against insulin receptors,or mutations that induce the formation of abnormal glucose transporter 4 molecules or plasma cell membrane glycoprotein-1 molecules;all induce abnormal energy pathways and end with the development of *** parallel increase of IR syndrome with the dramatic increase in the rate of obesity among children in the last few decades indicates the importance of environmental factors in increasing the rate of *** patients with IR do not develop diabetes mellitus(DM)***,IR is a crucial risk factor to develop DM type-II in *** standards for IR in children are not yet established due to various *** measures of insulin sensitivity include the hyperinsulinemia euglycemic glucose clamp and the insulin-suppression *** model analysis of frequently sampled intravenous glucose tolerance test and oral glucose tolerance test provide an indirect estimate of metabolic insulin sensitivity/*** main aim of the treatment of IR in children is to prevent the progression of compensated IR to decompensated IR,enhance insulin sensitivity,and treat possible *** are three main lines for treatment:Lifestyle and behavior modification,pharmacotherapy,and *** review will discuss the magnitude,implications,diagnosis,and treatment of IR in children。

关键词： Insulin resistance Children Diabetes mellitus Obesity Genetic Acquired

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