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Treatment of intermediate-risk prostate cancer with active surveillance in the routine care—Long-term outcomes of a prospective noninterventional study(HAROW)

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Current Urology 2024年第2期18卷 115-121页

作者： Lothar Weissbach Andreas Schwarte Edith A.Boedefeld Jan Herden Health Research for Men GmbH BerlinGermany Urological practice Borken BorkenGermany Department of Urology Uro-OncologyRobot-Assisted and Reconstructive UrologyFaculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany PAN clinic Urological practiceCologneGermany

Background:We report here the long-term outcomes of patients with intermediate-risk prostate cancer(PCa)treated with active surveillance(AS)in a daily routine *** andmethods:HAROW(2008–2013)was a noninterventional,health service research study investigating themanagement of localized PCa in a community setting.A substantial proportion of the study centers were office-based urologists.A follow-up examination of all intermediate-risk patients with AS was ***,cancer-specific,metastasis-free,and treatment-free survival rates,as well as reasons for discontinuation,were determined and ***:Of the 2957 patients enrolled,52 with intermediate-risk PCa were managed with AS and were available for *** median follow-up was 6.8 years(interquartile range,3.4–8.6 years).Seven patients(13.5%)died of causes unrelated to PCa,of whom 4 were under AS or under watchful *** patients(3.8%)developed *** estimated 8-year overall,cancer-specific,metastasis-free,and treatment-free survival rates were 85%(95%confidence interval[CI],72%–96%),100%,93%(95%CI,82%–100%),and 31%(95%CI,17%–45%),*** analysis,prostate-specific antigen density of≥0.2 ng/mL2 was significantly predictive of receiving invasive treatment(hazard ratio,3.29;p=0.006).Reasons for discontinuation were more often due to patient's or physician's concerns(36%)than due to observed clinical ***:Although survival outcome data for intermediate-risk patients managed with AS in real-life health care conditions were promising,rates of discontinuation were high,and discontinuation was often a patient's decision,even when the signs of disease progression were *** might be an indication of higher levels of mental burden and anxiety in this specific subgroup of patients,which should be considered when making treatment *** a psychological perspective,not all intermediate-risk patients are optimal candidates for A

关键词： Active surveillance Intermediate-risk prostate cancer HAROW study Conservative management Outcomes research

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Mechanisms behind elevated serum levels of plasminogen activator inhibitor-1 in frontotemporal lobar degeneration

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Neural Regeneration Research 2025年第8期20卷 2317-2318页

作者： Francesco Angelucci Jakub Hort Memory clinic Department of NeurologySecond Faculty of MedicineCharles University and Motol University HospitalPragueCzech Republic International clinical Research Centre St.Anne’s University HospitalBrnoCzech Republic

Frontotemporal lobar degeneration(FTLD)is a form of progressive dementia characterized by degeneration of the frontal and temporal lobes of the *** pathology involves a series of cognitive,behavioral,and neurological ... 详细信息

关键词： degeneration elevated pathology

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Advances in clinical applications of bioceramics in the new regenerative medicine era

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World Journal of clinical Cases 2024年第11期12卷 1863-1869页

作者： Noha Elshazly Fayza Eid Nasr Ayat Hamdy Safa Saied Mohamed Elshazly Tissue Engineering Laboratory Faculty of DentistryAlexandria UniversityAlexandria 21526Egypt Department of Biochemistry Faculty of ScienceAlexandria UniversityAlexandria 21526Egypt Public Dental clinic Central Administration of DentistryMinistry of Health and PopulationAlexandria 21554Egypt Department of Surgery Faculty of Veterinary MedicineAlexandria 21526Egypt

In this editorial,we comment on the hard and soft tissue applications of different ceramic-based scaffolds prepared by different mechanisms such as 3D printing,sol-gel,and *** new concept of regenerative medicine relies on biomaterials that can trigger in situ tissue regeneration and stem cell recruitment at the defect site.A large percentage of these biomaterials is ceramic-based as they provide the essential requirements of biomaterial principles such as tailored multisize porosity,antibacterial properties,and angiogenic *** these previously mentioned properties put bioceramics on top of the hierarchy of biomaterials utilized to stimulate tissue regeneration in soft and hard tissue *** clinical applications registered the use of these materials in triggering soft tissue regeneration in healthy and diabetic patients such as bioactive glass *** results were promising and opened new frontiers for utilizing these materials on a larger *** same results were mentioned when using different forms and formulas of bioceramics in hard defect *** bioceramics were used in combination with other polymers and biological scaffolds to improve their regenerative and mechanical *** this progress will enable a larger scale of patients to receive such services with ease and decrease the financial burden on the government.

关键词： Regenerative medicine Bioceramics Chronic wounds Bone defects clinical applications

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Emergency physicians’ occupational risks in China

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World Journal of Emergency Medicine 2024年第3期15卷 232-234页

作者： Huaying Jiang Jia Chang Rong Huang Xiayi Liang Manning Song Hejing Yuan Shuo Wang School of Chinese Materia Medica Beijing University of Chinese MedicineBeijing 100105China Operation Room Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China School of Marxism Beijing University of Chinese MedicineBeijing 100105China Department of Infectious Diseases(Fever clinic) Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing 100010China

With the rapid development of emergency medicine,emergency physicians are working around the clock,[1]including additional workloads due to sudden public health emergencies and *** risks for emergency physicians are s... 详细信息

关键词： physician acute occupational

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Comparative Quantitative Analysis of Retinal Superficial Capillary Plexus in Patients with Retinal Vein Occlusion and Unaffected Fellow Eyes

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Open Journal of Ophthalmology 2024年第3期14卷 218-228页

作者： Sinan Aptikadir Nelly Sivkova Department of Ophthalmology Faculty of Medicine Medical University of Plovdiv Plovdiv Bulgaria University Eye clinic St. George University Hospital Plovdiv Bulgaria

Purpose: To evaluate optical coherence tomography angiography (OCT-A) data obtained from the superficial retinal capillary plexus of patients with retinal vein occlusion and comparative analysis with data registered from unaffected fellow eyes. Methods: The examined patients were classified into 2 groups: group 1—eyes with established retinal vein occlusion (n = 29) and group 2—unaffected fellow eyes of patients with retinal vein occlusion (n = 24). The scanning protocol “Angiography 3 × 3 mm” of Zeiss Cirrus HD-OCT 6000, AngioPlex Metrix was used to evaluate the retinal superficial capillary plexus. The analyzed parameters were vascular density and perfusion density, as well as the area, perimeter, and circularity of the foveolar avascular zone (FAZ). Results: The comparative analysis of FAZ parameters at the superficial capillary plexus (SCP) between group 1 (eyes with retinal vein occlusion) and group 2 (unaffected fellow eyes) showed significant results for the three parameters, respectively area (p = 0.003), perimeter (p ≤ 0.001), and circularity (p = 0.011) of FAZ. The comparative analysis of the vascular network at SCP in patients with diagnosed retinal vein occlusion and unaffected fellow eyes showed significant results for vascular density (VD) in the central (p = 0.038) and inner (p ≤ 0.001) zones as well as total VD (p ≤ 0.001) were statistically significant. Moreover, the results obtained in the study of vascular perfusion (VP) indicated significant results in the inner zone (p ≤ 0.001) and total VP (p = 0.001). Vascular perfusion in the central zone (p = 0.116) was the only parameter not to meet significant results. Conclusion: The current study observed a significant enlargement of the FAZ and loss of its circularity, along with a reduction in vascular network parameters at the superficial retinal capillary plexus level.

关键词： Retinal Vein Occlusion Optical Coherence Tomography Angiography Superficial Retinal Capillary Plexus

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Isolated Lumbar Extension Resistance Training Is Effective at Improving Extension Power and Disability in Subjects with Diagnosed Lumbar Multifidus Dysfunction

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Open Journal of Therapy and Rehabilitation 2024年第3期12卷 245-255页

作者： William Roger Peters James Thomas Ernest Smith Mario Guiseppe Zotti Adam Leslie Lincoln Benjamin James Enser Faculty of Medicine & Health Sciences Bond University Queensland Australia Back Neck clinic Bundall Queensland Australia Kieser Australia Bundall Queensland Australia

Background: Lumbar multifidus dysfunction is a prevalent cause of disability in individuals with lower back pain. Previous research highlights the benefits of isolated lumbar extension training for non-specific lower back pain, however, studies examining its efficacy in lumbar multifidus dysfunction are lacking. Objective: To evaluate the effectiveness of isolated lumbar extension resistance training on disability and strength in individuals with lumbar multifidus dysfunction. Methods: Subjects underwent a physiotherapy led structured rehabilitation program incorporating isolated lumbar extension. Sessions were conducted twice weekly targeting momentary muscular failure with time under load 90 - 120 seconds and progressions aimed at 5 - 10 lbs increments. Outcomes were assessed using the Oswestry Disability Index and lumbar extension strength testing at baseline and after 12 weeks, with statistical analysis using t-test and chi-squared 2 × 2. Results: Forty-five subjects (24 male, 21 female) with a median age of 48 completed the intervention. Improvements were noted in Oswestry Disability Index scores (median pre: 24, post: 15) and maximal lumbar extension strength (median pre: 122 lb, post: 186 lb), with p ≤ 0.05. Overall, 89% showed improvement in disability scores, 67% moved to a better disability category, and 51% saw at least a 50% increase in strength. No significant gender differences were observed. Conclusions: Isolated lumbar extension resistance training is effective at improving extension power and disability in subjects with lumbar multifidus dysfunction.

关键词： Low Back Pain Multifidus Muscle Strength Rehabilitation Resistance Training

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Discharging patients home from the intensive care unit:A new trend

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World Journal of clinical Cases 2024年第23期12卷 5313-5319页

作者： Esraa M Hassan Abbas B Jama Ahmed Sharaf Asim Shaikh Mohamad El Labban Salim Surani Syed A Khan Department of Critical Care Medicine Mayo Clinic Health systemMankatoMN 56001United States Department of Internal Medicine Baptist Hospital of Southeast TexasBeaumontTX 77701United States Department of Medicine Aga Khan UniversityKarachi 74200SindhPakistan Department of Internal Medicine Mayo Clinic Health SystemMankatoMN 56001United States Department of Medicine and Pharmacology Texas A&M UniversityCollege StationTX 77843United States Department of Anaesthesiology Mayo Clinic Health SystemRochesterMN 55905United States

Discharging patients directly to home from the intensive care unit(ICU)is becoming a new *** review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU *** analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare *** practice of direct discharge from the ICU presents both opportunities and *** it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support *** this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the *** critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal *** insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare ***,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.

关键词： Intensive care unit Critical care Early discharge Cost effective critical care Patient comfort Early recovery

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Impact of D-dimer on in-hospital mortality following aortic dissection:A systematic review and meta-analysis

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World Journal of Cardiology 2024年第6期16卷 355-362页

作者： Sashwath Srikanth Shabnam Abrishami Lakshmi Subramanian Ashwini Mahadevaiah Ankit Vyas Akhil Jain Sangeetha Nathaniel Subramanian Gnanaguruparan Rupak Desai Department of Medicine ECU Health Medical CenterGreenvilleNC 27834United States Department of Research Independent Outcomes ResearchLos AngelesCA 90036United States Harvard T.H.Chan School of Public Health Harvard UniversityBostonMA 02115United States Department of Vascular Medicine Ochsner Clinic FoundationNew OrleansLA 70121United States Department of Leukemia The University of Texas MD Anderson Cancer CenterHoustonTX 77079United States Department of Cardiology Heart and Vascular ClinicNewarkDE 19713United States Independent Researcher AtlantaGA 30079United States

BACKGROUND The utility of D-dimer(DD)as a biomarker for acute aortic dissection(AD)is ***,its predictive value for in-hospital mortality remains uncertain and subject to conflicting *** To conduct a meta-analysis of AD-related in-hospital mortality(ADIM)with elevated DD *** We searched PubMed,Scopus,Embase,and Google Scholar for AD and ADIM literature through May *** was assessed using I2 statistics and effect size(hazard or odds ratio)analysis with random-effects *** size,study type,and patients’mean age were used for subgroup *** significance threshold was P60 *** and larger sample size studies(n>250)demonstrated a heightened likelihood of ADIM associated with elevated DD levels(effect size:2.57,95%CI:1.30-5.08,P<0.01 vs effect size:1.05,95%CI:1.00-1.11,P=0.05,respectively).CONCLUSION Our meta-analysis shows elevated DD increases in-hospital mortality risk in AD patients,highlighting the need for larger,prospective studies to improve risk prediction models.

关键词： D-dimer Aortic dissection Mortality Biomarker Systematic review Meta-analysis

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Corneal collagen cross-linking in patients with keratoconus from the Dresden protocol to customized solutions:theoretical basis

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 951-962页

作者： Ciro Caruso Luca D’Andrea Mario Troisi Michele Rinaldi Raffaele Piscopo Salvatore Troisi Ciro Costagliola Corneal Transplant Center Pellegrini HospitalVia Portamedina alla Pignasecca 41Napoli 80127Italy Eye clinic Department of NeurosciencesReproductive and Odontostomatological SciencesUniversity of Naples Federico IINaples 80131Italy Public Health Department University of Naples Federico IINaples 80131Italy Salerno Hospital University Ophthalmologic UnitBaronissiCampania 84131Italy

Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual *** therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced *** keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe *** consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks *** aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment ***,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.

关键词： corneal collagen cross linking keratoconus custom fast protocol Dresden protocol lambert-beer law Bunsen-roscoe law

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Impact of PD-1/PD-L1 inhibitors on survival in stage Ⅲ non-small-cell lung cancer:A systematic review

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Cancer Pathogenesis and Therapy 2024年第3期2卷 155-163页

作者： Petros Roussos Magdalini Migkou National and Kapodistrian University of Athens Medical SchoolAlexandra HospitalTherapeutic ClinicLeof.Vasilissis Sofias 80Athens 11528Greece

Background:Lung cancer is the leading cause of cancer-related death,and non-small-cell lung cancer(NSCLC)is the predominant *** death 1(PD-1)and programmed death-ligand 1(PD-L1)inhibitors are widely used to treat stage IV *** study systematically reviewed the literature to clarify the impact of PD1/PD-L1 inhibitor treatment on the survival of patients with stage Ⅲ ***:Randomized phase Ⅲ clinical trials of PD-1/PD-L1 inhibitors administered to patients with stage Ⅲ NSCLC that were written in English and published between November 2012 and November 2022 were eligible for *** sources of information were the MEDLINE database(last consulted on December 26,2022),ScienceDirect website(last consulted on December 26,2022),and CENTRAL register(last consulted on December 27,2022).The outcomes of interest were overall survival(OS),progression-free survival(PFS),disease-free survival(DFS),and event-free survival(EFS).Risk of bias assessments were performed according to the Cochrane Handbook for Systematic Reviews of Interventions version *** findings have been assessed for certainty according to the Grading of Recommendations,Assessment,Development,and Evaluations(GRADE)***:Fourteen eligible studies and 2788 participants were included in the *** key characteristics used to group the participants were disease histology,percentage of PD-L1 expression in cancer cells,and timeline of *** and PFS were improved(risk ratio[RR]:0.85;95%confidence interval[CI]:0.75–0.96 and RR:0.75;95%CI:0.70–0.86,respectively)based on the use of PD-L1 inhibitors after chemoradiation and OS was improved using first-line PD-1 inhibitors plus chemotherapy in non-squamous NSCLC(RR:0.40;95%CI:0.17–0.95),with the GRADE results indicating moderate quality of evidence.

关键词： Non-small cell lung cancer PD-1 inhibitors PD-L1 inhibitors Immunotherapy Systematic review

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