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How to select elderly colorectal cancer patients for surgery: a pilot study in an Italian academic medical center

Cancer Biology & Medicine 2015年第4期12卷 302-307页

作者： Giampaolo Ugolini Francesco Pasini Federico Ghignone Davide Zattoni Maria Letizia Bacchi Reggiani Daniele Parlanti Isacco Montroni Department of medical and Surgical Sciences University of Bologna S.Orsola Malpighi Hospital

Objective: Cancer is one of the most common diagnoses in elderly patients. Of all types of abdominal cancer, colorectal cancer(CRC) is undoubtedly the most frequent. Median age at diagnosis is approximately 70 years old worldwide. Due to the multiple comorbidities affecting elderly people, frailty evaluation is very important in order to avoid over- or undertreatment. This pilot study was designed to investigate the variables capable of predicting the long-term risk of mortality and living situation after surgery for ***: Patients with 70 years old and older undergoing elective surgery for CRC were prospectively enrolled in the study. The patients were preoperatively screened using 11 internationally-validated-frailty-assessment tests. The endpoints of the study were long-term mortality and living situation. The data were analyzed using univariate Cox proportional-hazard regression analysis to verify the predictive value of score indices in order to identify possible risk ***: Forty-six patients were studied. The median follow-up time after surgery was 4.6 years(range, 2.9-5.7 years) and no patients were lost to follow-up. The overall mortality rate was 39%. Four of the patients who survived(4/28, 14%) lost their functional autonomy. The preoperative impaired Timed Up and Go(TUG), Eastern Cooperative Group Performance Status(ECOG PS), Instrumental Activities of Daily Living(IADLs), Vulnerable Elders Survey(VES-13) scoring systems were significantly associated with increased long term mortality ***: Simplified frailty-assessing tools should be routinely used in elderly cancer patients before treatment in order to stratify patient risk. The TUG, ECOG-PS, IADLs and VES-13 scoring systems are potentially able to predict long-term mortality and disability. Additional studies will be needed to confirm the preliminary data in order to improve management strategies for oncogeriatric surgical patients.

关键词： Elderly geriatric assessment surgical oncology risk assessment screening tools colorectal cancer(CRC)

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Intra-operative consult for cystic struma ovarii—An experience in an academic medical center: A study of 53 cases over 21 years

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Open Journal of Obstetrics and Gynecology 2013年第7期3卷 1-6页

作者： M. Ruhul Quddus Jinjun Xiong S. M. K. Nahar Begum Michele Lomme Katrine Hansen C. James Sung W. Dwayne Lawrence Department of Pathology Women & Infants’ Hospital and the Warren Alpert Medical School of Brown University Providence USA

Struma ovarii often escapes recognition during intraoperative consultation because of its rarity, subtle characteristic gross appearance, and lack of clinical suspicion. An intraoperative diagnosis of benign struma ovarii enables the general gynecologic surgeon to continue the planned surgery. However, a diagnosis of malignnancy in a struma ovarii would alter the course of surgery with the involvement of a gynecologic oncology surgeon. We present here that our experience with intraoperative consultation for preoperatively undiagnosed struma ovarii presenting as an adnexal cystic or solid mass at our teaching hospital. Fifty-three cases of struma ovarii, 5.2% of all cystic teratoma of the same period, were diagnosed between January 1991 and March 2011. All intraoperative consultation reports, gross descriptions and final pathology reports were reviewed. The H&E stained slides and in selected cases, immunohistochemistry stained slides, were reviewed. Of the 53 cases of struma ovarii, intraoperative consultation was requested on 48 cases. Frozen section was done on 24 cases and only gross examination was felt appropriate in remaining 24 cases. 83% cases were diagnosed when a frozen section was done. None of the remaining 24 cases were recognized as struma by gross inspection. Our findings reveal that in a large number of cases the diagnosis of struma ovarii remained unrecognized during intraoperative consultation, indicating its often subtle/deceptive gross morphologic appearance. However, the purpose of the intraoperative consultation was served, as appropriate information was provided to the surgeon to guide the surgical management.

关键词： Struma Ovarii Intraoperative Consult Ovarian Cyst

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Understanding the link between type 2 diabetes mellitus and Parkinson's disease:role of brain insulin resistance

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Neural Regeneration Research 2025年第11期20卷 3113-3123页

作者： Theodora Ntetsika Sergiu-Bogdan Catrina Ioanna Markaki Department of Clinical Neuroscience Karolinska InstituteStockholmSweden Department of Neurology Karolinska University HospitalStockholmSweden Department of Molecular Medicine and Surgery Karolinska InstituteStockholmSweden center for Diabetes Academic Specialist CenterStockholmSweden center for Neurology Academic Specialist CenterStockholmSweden

Type 2 diabetes mellitus and Parkinson's disease are chronic diseases linked to a growing pandemic that affects older adults and causes significant socio-economic *** data supporting a close relationship between these two aging-related diseases have resulted in the investigation of shared pathophysiological molecular *** insulin signaling in the brain has gained increasing attention during the last decade and has been suggested to contribute to the development of Parkinson's disease through the dysregulation of several pathological *** contribution of type 2 diabetes mellitus and insulin resistance in neurodegeneration in Parkinson's disease,with emphasis on brain insulin resistance,is extensively discussed in this article and new therapeutic strategies targeting this pathological link are presented and reviewed.

关键词： brain insulin resistance brain insulin signaling diabetes type 2 GLP-1 receptor agonists GLP-1 signaling insulin resistance insulin signaling neurodegeneration Parkinson's disease targeted therapy

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Return to work in young and middle-aged colorectal cancer survivors:Factors influencing self-efficacy,fear,resilience,and financial toxicity

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World Journal of Gastroenterology 2025年第1期31卷 79-92页

作者： Dan Hu Yue Li Hua Zhang Lian-Lian Wang Wen-Wen Liu Xin Yang Ming-Zhao Xiao Hao-Ling Zhang Juan Li Department of Nursing The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Nursing National Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChildren’s Hospital of Chongqing Medical UniversityChongqing 400014China Department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Biomedical Science Advanced Medical and Dental InstituteUniversity Sains MalaysiaPenang 13200Malaysia academic Affairs Office The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social ***,these survivors encounter significant challenges during their RTW ***,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC *** To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW *** A cross-sectional investigation was adopted in this *** September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in *** investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and *** analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were *** A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 *** regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further *** levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC *** professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.

关键词： Return to work Colorectal neoplasms Return-to-work self-efficacy Fear of progression Family resilience Financial toxicity

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Interconnections between diabetic corneal neuropathy and diabetic retinopathy:diagnostic and therapeutic implications

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Neural Regeneration Research 2025年第8期20卷 2169-2180页

作者： Mingyi Yu Faith Teo En Ning Chang Liu Yu-Chi Liu Tissue Engineering and Stem Cell Group Singapore Eye Research InstituteSingapore Yong Loo Lin School of Medicine National University of SingaporeSingapore Department of Cornea and External Eye Disease Singapore National Eye CenterSingapore Ophthalmology and Visual Sciences academic Clinical Program Duke-NUS Medical SchoolSingapore

Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes *** corneal neuropathy refers to the progressive damage of corneal *** retinopathy has traditionally been considered as damage to the retinal ***,growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit,which includes both the retinal vascular structures and neural *** retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular ***,diabetic corneal neuropathy is commonly overlooked and underdiagnosed,leading to severe ocular surface *** studies have found that these two conditions tend to occur together,and they share similarities in their pathogenesis pathways,being triggered by a status of chronic *** review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy,whether diabetic corneal neuropathy precedes diabetic retinopathy,as well as the relation between the stage of diabetic retinopathy and the severity of corneal *** also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.

关键词： cornea corneal nerves diabetes diabetic corneal neuropathy diabetic retinopathy retina

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Azathioprine does not reduce adenoma formation in a mouse model of sporadic intestinal tumorigenesis

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World Journal of Gastroenterology 2014年第44期20卷 16683-16689页

作者： Mattheus CB Wielenga Jooske F van Lidth de Jeude Sanne L Rosekrans Alon D Levin Monique Schukking Geert RAM D'Haens Jarom Heijmans Marnix Jansen Vanesa Muncan Gijs R van den Brink Tytgat Institute for Liver and Intestinal Research and Department of Gastroenterology and Hepatology Academic Medical Center Department of Pathology Academic Medical Center

AIM: To investigate if azathioprine could reduce adenoma formation in ApcMin/+, a mouse model of sporadic intestinal tumorigenesis.

关键词： Azathioprine Thiopurine Intestinal adenoma Polyp ApcMin Chemoprevention Lymphoma Colon cancer

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Self-expandable metal stents for malignant gastric outlet obstruction: A pooled analysis of prospective literature

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World Journal of Gastroenterology 2015年第43期21卷 12468-12481页

作者： Emo E van Halsema Erik AJ Rauws Paul Fockens Jeanin E van Hooft Department of Gastroenterology and Hepatology Academic Medical Center

AIM: To provide an overview of the clinical outcomes of self-expandable metal stent(SEMS) placement for malignant gastric outlet obstruction(MGOO).METHODS: A systematic literature search was performed in Pub Med of the literature published between January 2009 and March 2015. Only prospective studies that reported on the clinical success of stent placement for MGOO were included. The primary endpoint was clinical success,defined according to the definition used in the original article. Data were pooled and analyzed using descriptive statistics. Subgroup analyses were performed for partially covered SEMSs(PCSEMSs) and uncovered SEMSs(UCSEMSs) using Fisher's exact ***: A total of 19 studies,including 1281 patients,were included in the final analysis. Gastric(42%) and pancreatic(37%) cancer were the main causes of MGOO. UCSEMSs were used in 76% of patients and PCSEMSs in 24%. The overall pooled technical success rate was 97.3% and the clinical success rate was 85.7%. Stent dysfunction occurred in 19.6% of patients,mainly caused by re-obstruction(12.6%) and stent migration(4.3%),and was comparable between PCSEMSs and UCSEMSs(21.2% vs 19.1%,respectively,P = 0.412). Re-obstruction was more common with UCSEMSs(14.9% vs 5.1%,P < 0.001) and stent migration was more frequent after PCSEMS placement(10.9% vs 2.2%,P < 0.001). The overall perforation rate was 1.2%. Bleeding was reported in 4.1% of patients,including major bleeding in 0.8%. The median stent patency ranged from 68 to 307 d in five studies. The median overall survival ranged from 49 to 183 d in 13 ***: The clinical outcomes in this large population showed that enteral stent placement was feasible,effective and safe. Therefore,stent placement is a valid treatment option for the palliation of MGOO.

关键词： Stents Gastric outlet obstruction Stomach neoplasm

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Non-specific anti-viral approach towards Ebola virus infection: a comment on “Against Ebola: type I interferon guard risk and mesenchymal stromal cell combat sepsis”

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2015年第3期16卷 251-252页

作者： Beuy JOOB Viroj WIWANITKIT Sanitation 1 medical academic center Hainan medical University Patil medical University

The recent"Viewpoint"by Zhang et al.(2015)entitled"Against Ebola:type I interferon guard risk and mesenchymal stromal cell combat sepsis",published in Journal of Zhejiang University-SCIENCE B(Biomedicine&Biotechnology),is very interesting,which mentioned the possible role of non-specific anti-viral approach towards Ebola virus *** noted the role of interferon and"applying a non-specific anti-viral approach during the incubation period of virus infection as an essential protection to put the host’s immune system into an alert state and henceforth to slow down the viral replication."In previous report,Zhang and Wang(2014)

关键词：基质细胞病毒感染非特异性干扰素败血症抗病毒作战风险

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Herpes simplex induced necrotizing tonsillitis in an immunocompromised patient with ulcerative colitis

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World Journal of Clinical Cases 2016年第2期4卷 60-62页

作者： Laura Jansen Xander G Vos Mark L?wenberg Department of Infectious diseases Academic Medical Center Department of Gastroenterology and Hepatology Westfries Gasthuis Department of Gastroenterology and Hepatology Academic Medical Center

We here present the case of a 22-year-old female of Suriname ethnicity with ulcerative colitis who received treatment with mercaptopurine and *** presented herself with a severe necrotizing tonsillitis due to herpes simplex virus type-1(HSV-1).Combination therapy consisting of immunomodulators and anti-tumor necrosis factor(TNF) agents is increasingly being ***-TNF therapy is associated with an increased risk of developing serious infections,and especially patients receiving combination treatment with thiopurines are at an increased *** here show that HSV infections can cause a severe tonsillitis in immunocompromised *** recognition is essential when there is no improvement with initial antibiotic therapy within the first 24 to 72 *** infections should be in the differential diagnosis of immunocompromised patients presenting with a necrotizing tonsillitis and can be confirmed by polymerase chain *** treatment with antiviral agents should be considered especially if antibiotic treatment fails in such patients.

关键词： Herpes simplex virus Tonsillitis Ulcerative colitis Immunosuppression Anti-tumor necrosis factor agents

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Human small intestine is capable of restoring barrier function after short ischemic periods

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World Journal of Gastroenterology 2017年第48期23卷 8452-8464页

作者： Dirk HSM Schellekens Inca HR Hundscheid Claire AJI Leenarts Joep Grootjans Kaatje Lenaerts Wim A Buurman Cornelis HC Dejong Joep PM Derikx Department of Surgery Maastricht University Medical Center NUTRIM School for Nutrition and Translational Research in MetabolismMaastricht University Department of Gastroenterology Academic Medical Center MHeNs School of Mental Health and Neuroscience Maastricht University Medical Center Pediatric Surgical center of Amsterdam Emma Children’s Hospital Academic Medical Center and VU University Medical Center

AIM To assess intestinal barrier function during human intestinal ischemia and reperfusion(IR).METHODS In a human experimental model,6 cm of jejunum was selectively exposed to 30 min of ischemia(I) followed by 30 and 120 min of reperfusion(R). A sham procedure was also performed. Blood and tissue was sampled at all-time points. Functional barrier function was assessed using dual-sugar absorption tests with lactulose(L) and rhamnose(R). Plasma concentrations of citrulline,an amino acid described as marker for enterocyte function were measured as marker of metabolic enterocytes restoration. Damage to the epithelial lining was assessed by immunohistochemistry for tight junctions( TJs),by plasma marker for enterocytes damage(I-FABP) and analyzed by electron microscopy(EM) using lanthanum nitrate as an electrondense *** Plasma L/R ratio's were significantly increased after 30 min of ischemia(30 I) followed by 30 min of reperfusion(30 R) compared to control(0.75 ± 0.10 vs 0.20 ± 0.09,P < 0.05). At 120 min of reperfusion(120 R),ratio's normalized(0.17 ± 0.06) and were not significantly different from control. Plasma levels of I-FABP correlated with plasma L/R ratios measured at the same time points(correlation: 0.467,P < 0.01). TJs staining shows distortion of staining at 30 I. An intact lining of TJs was again observed at 30 I120 R. Electron microscopy analysis revealed disrupted TJs after 30 I with paracellular leakage of lanthanum nitrate,which restored after 30 I120 R. Furthermore,citrulline concentrations closely paralleled the histological perturbations during intestinal *** This study directly correlates histological data with intestinal permeability tests,revealing that the human gut has the ability of to withstand short episodes of ischemia,with morphological and functional recovery of the intestinal barrier within 120 min of reperfusion.

关键词： Intestinal ischemia-reperfusion Intestinal barrier function Intestinal permeability Human Dualsugar absorption test Tight Junctions Citrulline

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