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Systemic Inflammation Response Index and weight loss as prognostic factors in metastatic pancreatic cancer: A concept study from the PANTHEIA-SEOM trial

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 386-397页

作者： Vilma Pacheco-Barcia Sara Custodio-Cabello Fatima Carrasco-Valero Magda Palka-Kotlowska Axel Mariño-Mendez Alberto Carmona-Bayonas Javier Gallego A J Muñoz Martín Paula Jimenez-Fonseca Luis Cabezon-Gutierrez Department of Medical Oncology Hospital Universitario de TorrejonMadrid 28850Spain Department of Internal Medicine Hospital Universitario de TorrejonMadrid 28850Spain Department of Medical Oncology Hospital Universitario Central de AsturiasOviedo 33011Spain Department of Medical Oncology Hospital Universitario Morales MeseguerUniversity of MurciaMurcia 30001Spain Department of Medical Oncology Hospital General Universitario de ElcheElche 03202Spain Department of Medical Oncology Hospital General Universitario Gregorio MarañónUniversidad Complutense MadridMadrid 28007Spain Universidad Francisco de Vitoria Madrid 28223Spain

BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains *** To study the prognostic significance of SIRI and weight loss in metastatic pancreatic *** The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work *** pilot study sought to analyze the association between weight loss and inflammatory status as defined by *** cohort stems from a proof-of-concept pilot study conducted at one of the coordinating *** with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were *** index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation *** study evaluated associations between overall survival(OS),SIRI and weight *** A total of 50 patients were included.66%of these patients were male and the median age was 66 *** sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple *** the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI *** difference was statistically significant(P<0.000).For pat

关键词： Pancreatic cancer Nutrition Prognostic factor Inflammation Advanced cancer Systemic inflammatory response index Weight loss

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Mixed neuroendocrine non-neuroendocrine neoplasms in gastroenteropancreatic tract

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1166-1179页

作者： Sebastián Díaz-López Jerónimo Jiménez-Castro Carlos Enrique Robles-Barraza Carlos Ayala-de Miguel Manuel Chaves-Conde Medical Oncology Department Hospital Universitario ValmeSeville 41014AndalucíaSpain

Mixed neuroendocrine non-neuroendocrine neoplasms(MiNENs)are a hetero-geneous group of malignant neoplasms that can settle in the gastroenteropan-creatic *** are composed of a neuroendocrine(NE)and a non-NE compo-nent in at least 30%of each *** non-NE component can include different histological combinations of glandular,squamous,mucinous and sarcomatoid phenotypes,and one or both of the components can be low-or high grade *** changes in the nomenclature of these neoplasms might lead to great deal of confusion,and the lack of specific clinical trials is the main reason why their management is *** review aims to clarify the definition of MiNEN and analyze available evidence about their diagnosis and treatment options according to their location and extension through careful analysis of the available *** would be important to reach a general consensus on their diagnosis in order to construct a classification that remains stable over time and facilitates the design of clinical trials that,due to their low incidence,will require long recruitment periods.

关键词： Mixed neuroendocrine non-neuroendocrine neoplasms Mixed adenoneuroendocrine carcinomas Mixed tumours Gastroenteropancreatic Treatment Etiology Diagnosis

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Present and future of new systemic therapies for early and intermediate stages of hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第19期30卷 2512-2522页

作者： Juan Jose Urquijo-Ponce Carlos Alventosa-Mateu Mercedes Latorre-Sánchez Inmaculada Castelló-Miralles Moisés Diago Hepatology Unit Department of Digestive Diseases Consorcio Hospital General Universitario of ValenciaValencia 46014Spain

Hepatocellular carcinoma(HCC)is a high mortality neoplasm which usually appears on a cirrhotic *** therapeutic arsenal and subsequent prognostic outlook are intrinsically linked to the HCC stage at *** the current deployment of treatments with curative intent(liver resection/local ablation and liver transplantation)in early and intermediate stages,a high rate of HCC recurrence persists,underscoring a pivotal clinical *** systemic therapies(ST),particularly immunotherapy,have demonstrate promising outcomes in terms of increase overall survival,but they are currently bound to the advanced stage of *** review provides a comprehensive analysis of the literature,encompassing studies up to March 10,2024,evaluating the impact of novel ST in the early and intermediate HCC stages,specially focusing on the findings of neoadjuvant and adjuvant regimens,aimed at increasing significantly overall survival and recurrence-free survival after a treatment with curative *** also investigate the potential role of ST in enhancing the downstaging rate for the intermediate-stage HCC initially deemed ineligible for treatment with curative ***,we critically discuss about the current relevance of the results of these studies and the encouraging future implications of ST in the treatment schedules of early and intermediate HCC stages.

关键词： Hepatocellular carcinoma Early stage Intermediate stage Neoadjuvant Adjuvant Systemic therapy

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The challenging management of malignant ureteral obstruction:Analysis of a series of 188 cases

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Current Urology 2024年第1期18卷 34-42页

作者： Alberto Artiles Medina Inés Laso García Fernando González Tello Sara Álvarez Rodríguez Manuel Hevia Palacios Marina Mata Alcaraz César Mínguez Ojeda Fernando Arias Funez Victoria Gómez Dos santos Francisco Javier Burgos Revilla Department of Urology Hospital Universitario Ramón y CajalMadridSpain Department of Radiology Hospital Universitario Ramón y CajalMadridSpain

Background:Malignant ureteral obstruction(MUO)is a common condition that complicates the course of advanced *** aims of this study are to analyze the causes,management,and survival of patients with obstructive nephropathy due to malignant ureteric obstruction and to determine prognostic ***,we studied the complications and outcomes in patients who underwent urinary *** and methods:A retrospective study was conducted on patients with computed tomography-confirmed MUO between January 2016 and November ***,clinical,radiological,laboratory,and management data were *** curves were estimated using the Kaplan-Meier method,and univariate and multivariate Cox proportional hazards models were used to test the association between parameters and ***:A total of 188 patients were *** mean age was 69.01 years(SD,14.95 years),and the majority(54.8%)were *** most common mechanism leading to MUO was compression by a pelvic mass(36.9%),and the 3 most frequent tumors causing MUO were prostate(17.6%),bladder(16.5%),and rectal cancer(11.7%).Forty-seven patients(25%)underwent urinary diversion:23(48.9%)underwent double-J stenting and 21(44.7%)underwent percutaneous *** most common reason for urinary diversion was acute kidney injury(53.3%).Recovery of renal function was observed in 55.8%of the patients after urinary *** most frequently identified complications after urinary diversion were urinary tract infection(24.4%),hematuria(17.0%),and urinary sepsis(14.9%).The median survival after hydronephrosis diagnosis was 6.43 months(interquartile range,1.91-14.81 months).In patients who underwent urinary decompression,the median survival after urinary diversion was 8.67 months(interquartile range,2.99-17.28 months).In the multivariate analysis,a lower grade of hydronephrosis and cancer cachexia negatively impacted ***:Cancer patients with MUO have a poor pro

关键词： Hydronephrosis Ureteral obstruction Neoplasms Urinary diversion Survival Prognosis

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Fungal infections in immunocompromised critically ill patients

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Journal of Intensive Medicine 2024年第3期4卷 299-306页

作者： JoséGarnacho-Montero Irene Barrero-García Cristina León-Moya Unidad Clínica de Cuidados Intensivos Hospital Universitario Virgen MacarenaSevillaSpain

Diverse pathogenic fungi can produce severe infections in immunocompromised patients, thereby justifying intensive care unit (ICU) admissions. In some cases, the infections can develop in immunocompromised patients who were previously admitted to the ICU. Aspergillus spp., Pneumocystis jirovecii, Candida spp., and Mucorales are the fungi that are most frequently involved in these infections. Diagnosis continues to be challenging because symptoms and signs are unspecific. Herein, we provide an in-depth review about the diagnosis, with emphasis on recent advances, and treatment of these invasive fungal infections in the ICU setting.

关键词： Invasive aspergillosis Immunocompromised patient Critically ill patient Antifungal Invasive candidiasis Pneumocystis jirovecii

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Exclusive breastfeeding greater than 50%, success of education in a university hospital in Bogotá: Case-control study

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World Journal of Clinical Pediatrics 2024年第1期13卷 23-30页

作者： Marcela Murillo Galvis Sofia Ortegon Ochoa Clara Eugenia Plata García Maria Paula Valderrama Junca Dayanna Alejandra Inga Ceballos Daniel Mauricio Mora Gómez Claudia M Granados Martin Rondón Department of Pediatrics Hospital Universitario San IgnacioBogotá110111Colombia Department of Clinical Epidemiology and Biostatistics Pontifica Universidad JaverianaBogotá110111Colombia

BACKGROUND Maintenance rates of exclusive breastfeeding(EBF)worldwide are low,thus,one of the objectives of the summary of policies on breastfeeding(BF)in world nutrition goals for 2025 are that at least 50%of infants under six months of age receive EBF that *** Objective of this study is to document the rates of EBF in children born in san ignacio University hospital(HUSI)and identify factors associated with *** To document the percentages of EBF in those that were born at HUSI and identify factors associated to their *** This is a study of cases and controls in an analytic,retrospective cohort that took children born alive between January 2016 and January 2019 at HUSI located in the city of Bogotá,*** Receiving information about BF at HUSI was able to maintain EBF up until 4 mo(OR=1.65;95%CI:1.02-2.66).The presence of gynecologic and obstetric comorbidities(OR=0.32;95%CI:0.12-0.83),having mastitis(OR=0.56;95%CI:0.33-0.94),and receiving information from mass media(OR=0.52;95%CI:0.31-0.84)are factors associated with not maintaining *** Receiving education at a Women-and Child-Friendly Institution was the only significant factor to achieve EBF until 4 mo,with a frequency greater than the one reported in the country,which matches multiple studies where counseling and individualized support on BF achieve this *** about BF and early detection of obstetric/gynecologic complications must be strengthened among the healthcare staff in charge of mothers during ***,strategies must be promoted to continue BF such as creating milk banks with the objective of increasing BF rates even when mothers return to work.

关键词： Breastfeeding Women-and Child-Friendly Institutional Strategy Strategies Adherence Education

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SARS-CoV-2 variants are associated with different clinical courses in children with MIS-C

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World Journal of Pediatrics 2024年第2期20卷 143-152页

作者： Andres F.Moreno Rojas Emelia Bainto Helen Harvey Adriana H.Tremoulet Jane C.Burns Kirsten B.Dummer Department of Pediatrics Division of Pediatric CardiologyUniversity of California San Diegoand Rady Children’s Hospital3020 Children’s Way MC 5004San DiegoCA 92123USA Kawasaki Disease Research Center La JollaCAUSA Department of Pediatrics Division of Pediatric Critical CareUniversity of California San Diegoand Rady Children’s HospitalSan DiegoCAUSA Department of Pediatrics University of California San Diegoand Rady Children’s HospitalSan DiegoCAUSA

Background Recent infection with SARS‑CoV-2 in children has been associated with multisystem inflammatory syndrome in children(MIS-C).SARS‑CoV-2 has undergone different *** publications exist about specific variants and their correlation with the severity of *** This was a single-center,retrospective study including all patients admitted with MIS-C at Rady Children’s hospital-san Diego between May 2020 and March *** epidemiologic data,including viral genomic information,were obtained from public ***,clinical presentation,laboratory values,and outcomes were obtained from electronic medical *** The analysis included 104 pediatric *** MIS-C waves were *** variants in san Diego during the first wave included clades 20A to *** the second wave,there were variants from clades 20A to C,20G,21C(Epsilon),20I(Alpha),and 20J(Gamma).The third wave had Delta strains(clades 21A,21I,and 21J),and the fourth had Omicron variants(clades 21K,21L,and 22C).MIS-C presented with similar symptoms and laboratory findings across all *** patients were admitted to the pediatric intensive care unit(PICU)(74%)and required inotropic support(63%)during the second *** of the patients required mechanical circulatory support,and only two required invasive ventilatory *** was no *** The various strains of SARS-CoV-2 triggered MIS-C with differing severities,with the second wave having a more severe clinical *** the differences in disease severity across variants were due to changes in the virus or other factors remains unknown.

关键词： Complications COVID-19 MIS-C SARS-CoV-2 variants

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Prevention of complications in endourological management of stones:What are the basic measures needed before,during,and after interventions?

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Asian Journal of Urology 2024年第2期11卷 180-190页

作者： Eric Edison Giorgio Mazzon Vimoshan Arumuham Simon Choong Department of Urology University College Hospital LondonLondonUK Department of Urology San Bassiano HospitalVicenzaItaly

Objective:This narrative review aims to describe measures to minimise the risk of complications during percutaneous nephrolithotomy(PCNL),ureteroscopy,and retrograde intrarenal ***:A literature search was conducted from the PubMed/PMC database for papers published within the last 10 years(January 2012 to December 2022).Search terms included“ureteroscopy”,“retrograde intrarenal surgery”,“PCNL”,“percutaneous nephrolithotomy”,“complications”,“sepsis”,“infection”,“bleed”,“haemorrhage”,and“hemorrhage”.Key papers were identified and included meta-analyses,systematic reviews,guidelines,and primary *** references of these papers were searched to identify any further relevant papers not included ***:The evidence is assimilated with the opinions of the authors to provide *** practice pathways for patient care in the pre-operative,intra-operative,and post-operative periods are described,including the identification and management of residual *** complications(sepsis and stent issues)that are relevant for any endourological procedure are then be ***-specific considerations are then *** measures for PCNL include optimising access to minimise the chance of bleeding or visceral *** role of endoscopic combined intrarenal surgery in this regard is *** measures for ureteroscopy and retrograde intrarenal surgery include planning and technique to minimise the risk of ureteric *** role of anaesthetic assessment is *** importance of specific comorbidities on each step of the pathway is highlighted as ***:This review demonstrates that the principles of meticulous planning,interdisciplinary teamworking,and good operative technique can minimise the risk of complications in endourology.

关键词： Endourology Ureteroscopy Retrogradeintrarenal surgery Percutaneous nephrolithotomy Complications Sepsis Stent

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Liquid biopsy for gastric cancer:Techniques,applications,and future directions

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World Journal of Gastroenterology 2024年第12期30卷 1680-1705页

作者： Cristina Díaz del Arco M Jesús Fernández Aceñero Luis Ortega Medina Department of Surgical Pathology Health Research Institute of the Hospital Clínico San CarlosHospital Clínico San CarlosMadrid 28040Spain Department of Legal Medicine Psychiatry and PathologyUniversidad Complutense de MadridMadrid 28040Spain

After the study of circulating tumor cells in blood through liquid biopsy(LB),this technique has evolved to encompass the analysis of multiple materials originating from the tumor,such as nucleic acids,extracellular vesicles,tumor-educated platelets,and other ***,research has extended to include the examination of samples other than blood or plasma,such as saliva,gastric juice,urine,or *** techniques are diverse,intricate,and *** must be highly sensitive,and pre-analytical,patient,and tumor-related factors significantly influence the detection threshold,diagnostic method selection,and potential ***,the implementation of LB in clinical practice still faces several *** potential applications of LB range from early cancer detection to guiding targeted therapy or immunotherapy in both early and advanced cancer cases,monitoring treatment response,early identification of relapses,or assessing patient *** the other hand,gastric cancer(GC)is a disease often diagnosed at advanced *** recent advances in molecular understanding,the currently available treatment options have not substantially improved the prognosis for many of these *** application of LB in GC could be highly valuable as a non-invasive method for early diagnosis and for enhancing the management and outcomes of these *** this comprehensive review,from a pathologist’s perspective,we provide an overview of the main options available in LB,delve into the fundamental principles of the most studied techniques,explore the potential utility of LB application in the context of GC,and address the obstacles that need to be overcome in the future to make this innovative technique a game-changer in cancer diagnosis and treatment within clinical practice.

关键词： Liquid biopsy Gastric cancer Circulating tumor cells Cell-free DNA Circulating tumor DNA Molecular

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Machine learning in liver surgery:Benefits and pitfalls

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World Journal of Clinical Cases 2024年第12期12卷 2134-2137页

作者： Rafael Calleja Manuel Durán María Dolores Ayllón Ruben Ciria Javier Briceño Hepatobiliary Surgery and Liver Transplantation Unit Hospital Universitario Reina SofíaMaimonides Biomedical Research Institute of CordobaCórdoba 14004Spain

The application of machine learning(ML)algorithms in various fields of hepatology is an issue of ***,we must be cautious with the *** this letter,based on a published ML prediction model for acute kidney injury after liver surgery,we discuss some limitations of ML models and how they may be addressed in the *** the future faces significant challenges,it also holds a great potential.

关键词： Machine learning Liver surgery Artificial intelligence Random forest Prediction model

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