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Liu Q, Yang J, Zhang J. Factors affecting the time interval of endoscopic ultrasound-guided endoscopic necrosectomy of walled-off pancreatic necrosis: A retrospective single-center study in China. Pancreatology 2024; 24:357-362. [PMID: 38369393 DOI: 10.1016/j.pan.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND AIM Endoscopic ultrasound (EUS)-guided endoscopic necrosectomy is an effective and minimally invasive treatment for walled-off pancreatic necrosis (WON). This study investigated the factors affecting the time interval of EUS-guided WON necrosectomy. METHODS Patients who received EUS-guided necrosectomy in the Endoscopy Center of the First Affiliated Hospital of Chongqing Medical University in the past 5 years were retrospectively analyzed. Data including general information, etiology, blood biochemical indexes, physical signs, CT severity grade, location, size, solid necrotic ratio, type and number of stents, and immediate necrosectomy were collected to explore the relationships between these factors and the interval of endoscopic necrosectomy. RESULTS A total of 51 WON patients were included. No significant correlation has been noted between the endoscopic debridement interval and the following indexes, including the patients' general information, the etiology of pancreatitis, blood biochemical indexes (leukocyte count, neutrophil percentage, C-reactive protein), preoperative fever, and WON's location and size, type and number of stents, and whether immediate necrosectomy. However, there were significant differences between the debridement interval and the modified CT Severity Index (MCTSI) (p < 0.001), the solid necrotic ratio of WON (p < 0.001) before the intervention, postoperative fever (p = 0.038), C-reactive protein increasing (p = 0.012) and fever before reintervention (p = 0.024). CONCLUSIONS The EUS-measured solid necrotic ratio, the MCTSI, postoperative fever, C-reactive protein increase, and fever before reintervention in patients affect the time interval of EUS-guided endoscopic necrosectomy in WON patients. These five indicators may be promisingly effective in predicting and managing endoscopic necrosectomy intervals.
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Affiliation(s)
- Qing Liu
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jian Yang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Junwen Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Orvieto R, Shimon C, Dratviman-Storobinsky O, Noach-Hirsh M, Aizer A. What is the maximal timeframe between sperm acquisition to sperm cryopreservation, in different "culture" conditions? J Assist Reprod Genet 2024; 41:515-518. [PMID: 38177973 PMCID: PMC10894794 DOI: 10.1007/s10815-023-03017-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
OBJECTIVE Most of the literature about postmortem sperm retrieval (PMSR) deals with the controversies surrounding ethical and legal aspects, while the optimal time interval between the death and viable sperm acquisition is indefinite. In an attempt to aid fertility specialists, while counseling whether to pursue and adopt PMSR, we aim to explore the maximal time frame from ejaculated sperm acquisition to sperm cryopreservation in different "culture" conditions, observations that might be extrapolated to PMSR requests. PATIENTS AND METHODS Five healthy men with normal semen analysis were enrolled. The sperm specimen from each man was diluted to 6.5 mL. After extracting 0.5 mL for cryopreservation, the remaining 6 mL were divided into three tubes: one was maintained in room temperature (23-25 °C), the second in an incubator (37 °C), and the third in a refrigerator (4 °C). Thereafter, every day, a 0.5 mL of each sample was extracted, examined, and cryopreserved. A week later, all the cryopreserved samples were thawed and tested for sperm motility and viability. RESULTS While at room temperature, frozen/thawed sperm were still motile (6.5%) and viable (9.9%) up to 96 h; those maintained in the refrigerator, following freezing/thawing were immotile already at 48 h in culture, but still viable (6.0%) up to 72 h in culture. Those maintained in the incubator demonstrated the worse results with negligible motility (1.5%) and viability (3.7%) following freezing/thawing, already after 48 h in culture. CONCLUSIONS The timeframe cut-off between ejaculated sperm acquisition and cryopreservation should be 72 h, unless sperm was maintained at room temperature, where it might be longer. It would be prudent to check for sperm vitality prior to freezing in cases where only immotile sperms are present.
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Affiliation(s)
- Raoul Orvieto
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, at the Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
| | - Chen Shimon
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
| | | | - Meirav Noach-Hirsh
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
| | - Adva Aizer
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Piccarreta M, Lazzari M, Bentivenga M. The influence in rainfall erosivity calculation by using different temporal resolution in Mediterranean area. Sci Total Environ 2024; 906:167411. [PMID: 37769721 DOI: 10.1016/j.scitotenv.2023.167411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
Rainfall erosivity (EI30) is crucial to characterize the rainfall effect on soil erosion based on storm intensity. Its calculation is highly sensitive to the time resolution used, in which using rainfall data at fixed time intervals (ΔΤ) >30-min results in large underestimation. Therefore, there is a need to explore the difference and correlation between EI30 calculated at different ΔΤ. One-minute rainfall data from 2006 to 2022 were collected from 6 stations over the Basilicata region in southern Italy to compute the maximum 30-min rainfall intensity (I30), total kinetic energy of storm (KE), EI30 and erosivity density values, for a total of 2516 storm events. These data constitute the actual values of I30, KE and EI30 and will be used as reference data. Underestimation of all the considered parameters were systematically evaluated using data aggregated at 5-, 10-, 15-, 30- and 60-min fixed interval. For ΔΤ ≤ 15 min the parameter responsible of the greatest underestimation turns out to be KE, whereas for coarser temporal resolution (ΔΤ > 30 min) I30 plays a dominant role in underestimating EI30. The use of coarse temporal resolutions also leads to >5 % loss of erosive events, especially those characterized by middle to high intensity/low duration (ΔΤ ≤ 45 min) events, as well as to an underestimation higher than 30 % in the estimated rainfall erosivity. The results show that an accurate estimation of the rainfall erosivity requires the use of rainfall data with a fixed time interval of length lower than 10 min.
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Affiliation(s)
| | - Maurizio Lazzari
- CNR ISPC, C/da S. Loja, Zona Industriale, 85050 Tito Scalo, PZ, Italy
| | - Mario Bentivenga
- Department of Sciences, University of Basilicata, via Ateneo lucano, 10, 85100 Potenza, Italy; ExtraGEO, Polo di Macchia Romana, via Ateneo lucano, 10, 85100 Potenza, Italy
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Yang Z, Chen H, Jin T, Sun L, Li L, Zhang S, Wu B, Jin K, Zou Y, Sun C, Xia L. The Impact of Time Interval on Prognosis in Patients with Non-Small Cell Lung Cancer Brain Metastases After Metastases Surgery. World Neurosurg 2023; 180:e171-e182. [PMID: 37704036 DOI: 10.1016/j.wneu.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) is a prominent malignancy often linked to the development of brain metastases (BM), which commonly appear at diverse time intervals (TI) following the lung cancer diagnosis. This study endeavors to determine the prognostic significance of the time interval in patients with NSCLC who undergo BM surgery. Through this investigation, we aim to improve our understanding of the factors impacting the prognosis of BM cases originating from NSCLC. METHODS We analyzed data from 74 patients (2011-2021) who underwent BM surgery at our institution. The relationship between various clinical, radiological, and histopathological factors, as well as TI and overall survival (OS), was examined. RESULTS The median TI from initial NSCLC diagnosis to BM surgery was 19 months (range: 9-36 months). Notably, a shorter TI of less than 23 months was found to be independently associated with postoperative survival (adjusted odds ratio [aOR] 2.87, 95% confidence interval [CI] 1.03-8.02, P = 0.045). Additionally, a shorter TI was independently correlated with the absence of adjuvant chemotherapy for NSCLC (aOR 0.25, 95% CI 0.07-0.83, P = 0.023) and lack of targeted therapy (aOR 0.02, 95% CI 0.00-0.16, P < 0.001). Late-onset BM (TI ≥ 36 months) was observed in 15 cases (20.3%), in this subgroup, patients aged 60 years or older at the time of lung cancer diagnosis exhibited a significant independent correlation with late-onset BM (aOR 7.24, 95% CI 1.59-32.95, P = 0.011). NSCLC patients who underwent adjuvant chemotherapy displayed a notable correlation with late-onset BM (aOR 6.46, 95% CI 1.52-27.43, P = 0.011), while those who received targeted therapy also exhibited an independent association (aOR 2.27, 95% CI 1.70-3.03, P < 0.001). CONCLUSIONS Multiple factors contribute to the variability in the onset interval of BM subsequent to NSCLC diagnosis. The occurrence of BM within TI < 23 months following the initial diagnosis of NSCLC was demonstrated as an independent factor associated with an unfavorable prognosis following BM surgery. Furthermore, patients with NSCLC who did not receive adjuvant chemotherapy and lacked targeted therapy were shown to have an elevated likelihood of developing BM after a long progression-free survival.
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Affiliation(s)
- Zhi Yang
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Haibin Chen
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Tao Jin
- Department of Neurosurgery, The Second Affiliated Hospital of Mudanjiang Medical University, Mudanjiang, Helongjiang Province, China
| | - Liang Sun
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Liwen Li
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Shuyuan Zhang
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Bin Wu
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Kai Jin
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Yangfan Zou
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
| | - Caixing Sun
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China
| | - Liang Xia
- Department of Neurosurgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China; Postgraduate Training Base Alliance of Wenzhou Medical University, WenZhou, Zhejiang Province, China.
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Yang J, Li Y, Meng L. Combination of Bifidobacterium breve and antibiotics against Clostridioides difficile: effect of the time interval of combination on antagonistic activity. Int Microbiol 2023; 26:833-840. [PMID: 36808573 DOI: 10.1007/s10123-023-00340-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/21/2023]
Abstract
Co-administration of probiotics and antibiotics has been used to prevent or treat primary Clostridioides difficile (pCDI), and the closer the interval between the combination, the more effective it is, but the reason behind this is unknown. In this study, the cell-free culture supernatant (CFCS) of Bifidobacterium breve YH68 was used in combination with vancomycin (VAN) and metronidazole (MTR) to treat C. difficile cells. The growth and biofilm production of C. difficile under different co-administration time interval treatments were determined by optical density and crystalline violet staining, respectively. The toxin production of C. difficile was determined by enzyme immunoassay, and the relative expressions of C. difficile virulence genes tcdA and tcdB were determined by real-time qPCR method. Meanwhile, the types and contents of organic acids in YH68-CFCS were investigated by LC-MS/MS. The results showed that YH68-CFCS in combination with VAN or MTR significantly inhibited the growth, biofilm production, and toxin production of C. difficile in the effective time interval range (0-12 h) but did not affect the expression level of C. difficile virulence genes. In addition, the effective antibacterial component of YH68-CFCS is lactic acid (LA).
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Affiliation(s)
- Jingpeng Yang
- School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Nanjing, China.
| | - Yanan Li
- School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Nanjing, China
| | - Lingtong Meng
- School of Food Science and Pharmaceutical Engineering, Nanjing Normal University, Nanjing, China.
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Yang Z, Zhong W, Luo Y, Wu C. The timing of durvalumab administration affects the risk of pneumonitis in patients with locally advanced non-small cell lung cancer: a systematic review and meta-analysis. BMC Cancer 2023; 23:962. [PMID: 37817073 PMCID: PMC10566123 DOI: 10.1186/s12885-023-11472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
Abstract
PURPOSE The PACIFIC study has demonstrated that the administration of durvalumab following concurrent chemoradiotherapy can significantly improve both overall survival and progression-free survival rates in patients with locally advanced unresectable non-small cell lung cancer. While the latest NCCN guidelines recommend this combination regimen, they do not specify the optimal timing for administering durvalumab after completing radiotherapy. The PACIFIC study suggested initiating durvalumab within 42 days of completing radiotherapy, but early administration of the drug may increase the incidence of pneumonitis. Therefore, we conducted this study to investigate whether the time interval between completion of radiotherapy and initiation of durvalumab treatment is associated with the risk of pneumonitis (Grade ≥ 3), which is the primary endpoint, as well as progression-free survival, which is the secondary endpoint. METHODS A comprehensive search of clinical trials in PubMed and EMBASE was conducted up to March 2023 to identify clinical trials involving locally advanced unresectable non-small cell lung cancer patients who were treated with durvalumab following chemoradiotherapy. Meta-analysis was performed on single-arm studies to estimate the incidence of pneumonitis (Grade ≥ 3) and progression-free survival in all studies, as well as in studies that administered durvalumab within 42 days after completion of radiotherapy. RESULTS This meta-analysis consisted of nine studies with a total of 2560 patients. The analysis showed that the incidence of pneumonitis (Grade ≥ 3) was 5.36% [95%CI (0.03, 0.08), I2 = 18.41%, p = 0.29], while the 1-year progression-free survival rate was 57.91% [95%CI (0.53, 0.63), I2 = 10.57%, p = 0.35]. Furthermore, when the duration between completion of radiotherapy and initiation of durvalumab treatment was shorter than 42 days, the incidence of pneumonitis (Grade ≥ 3) was 4.12% [95%CI (0.02, 0.06), I2 = 0.00%, p = 0.56], with a 1-year progression-free survival rate of 61.03% [95%CI (0.51, 0.71), I2 = 59.06%, p = 0.09]. CONCLUSION Overall, based on the available evidence, it appears that there is no significant increase in pneumonitis or decrease in progression-free survival (PFS) when the time interval is less than 42 days and a shorter interval between treatment sessions does not necessarily have a detrimental effect on the rate of pneumonitis. We recommend that clinicians carefully evaluate the specific circumstances of each patient to determine the optimal timing for initiating immunotherapy.
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Affiliation(s)
- Zhenyi Yang
- The Fourth Affiliated Hospital of China Medical University, Chongshan East Road #4, Huanggu District, Liaoning, 110032, China
| | - Wen Zhong
- The Fourth Affiliated Hospital of China Medical University, Chongshan East Road #4, Huanggu District, Liaoning, 110032, China
| | - Yixuan Luo
- The Fourth Affiliated Hospital of China Medical University, Chongshan East Road #4, Huanggu District, Liaoning, 110032, China
| | - Chunli Wu
- The Fourth Affiliated Hospital of China Medical University, Chongshan East Road #4, Huanggu District, Liaoning, 110032, China.
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Zhang B, Qi J, Chen P, Sun B, Ling Y, Wu Q, Xu S, Wu P, Shi H. Deliberately Staged Combined Endovascular Embolization and Subsequent Microsurgery Resection for the Treatment of Cerebral Arteriovenous Malformations. World Neurosurg 2023; 178:e254-e264. [PMID: 37467953 DOI: 10.1016/j.wneu.2023.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Complex cerebral arteriovenous malformations (AVMs) require a combined therapy of endovascular embolization and microsurgical resection to eliminate the lesion and maximize neurological protection, while a deliberate time interval might contribute to optimal clinical outcomes. The present study aimed to explore the feasibility of this paradigm. METHODS All patients who underwent deliberately planned presurgery embolization and microsurgery resection between 2015 and 2023 were reviewed, with baseline data, postoperative complications, and follow-up outcomes recorded. The modified Rankin scale (mRS) was used to evaluate clinical outcomes, with mRS 0-2 defined as good. RESULTS A total of 30 patients were included in the study (15 were ruptured AVMs). The median Spetzler-Martin grade of baseline AVMs was 3 (interquartile range: 2-3). The median interval between the last embolization and microsurgery was 5 days (interquartile range: 2.25-7). The complete removal rate was 100%, and the overall permanent complication rate was 16.67%. At the last follow-up, 26 patients achieved mRS 0-2, while 28 had improved or unaltered mRS. The last follow-up mRS significantly improved from baseline and discharge (P = 0.0006 and P = 0.006). The last follow-up mRS decreased by 0.65 for each additional day of time interval before the 4.4-day inflection point (β = -0.65, P = 0.02) in the AVM ruptured cohort. CONCLUSIONS The deliberately staged combined procedure of embolization and microsurgery might be a safe and efficacious strategy for Spetzler-Martin grade 2-5 AVMs, 4-5 days might be an appropriate staged time interval for ruptured AVMs, although further studies are needed to substantiate these findings.
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Affiliation(s)
- Bohan Zhang
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jingtao Qi
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Pingbo Chen
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Bowen Sun
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yeping Ling
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qiaowei Wu
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shancai Xu
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Pei Wu
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Huaizhang Shi
- Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, China.
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Yuh WT, Han J, Lee CH, Kim CH, Kang HS, Chung CK. The Optimal Time between Embolization and Surgery for Hypervascular Spinal Metastatic Tumors : A Systematic Review and Meta-Analysis. J Korean Neurosurg Soc 2023:jkns.2022.0204. [PMID: 37315576 DOI: 10.3340/jkns.2022.0204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 03/06/2023] [Indexed: 06/16/2023] Open
Abstract
Objective Preoperative transarterial embolization (TAE) of tumor feeders in hypervascular spine metastasis is known to reduce intraoperative estimated blood loss (EBL) during surgery. The effect of TAE varies for several reasons, and one controllable factor is the timing between embolization and surgery. However, the adequate timing remains unclear. This study aimed to evaluate the timing and other factors that reduce EBL in spinal metastasis surgery through a meta-analysis. Methods A comprehensive database search was performed to identify direct comparative studies of EBL stratified by the timing of surgery after TAE for spinal metastasis. EBL was analyzed according to the timing of surgery and other factors. Subgroup analyses were also performed. The difference in EBL was calculated as the mean difference (MD) and 95% confidence interval (CI). Results Among seven studies, 196 and 194 patients underwent early and late surgery after TAE, respectively. The early surgery was defined as within 1-2 days after TAE, while the late surgery group received surgery at least 1 day after TAE. Overall, the MD in EBL was not different according to the timing of surgery (MD, 86.3 mL; 95% CI, -95.5 to 268.1 mL; p=0.35). A subgroup analysis of the complete embolization group demonstrated that patients who underwent early surgery within 24 hours after TAE had significantly less bleeding (MD, 233.3 mL; 95% CI, 76.0 to 390.5 mL; p=0.004). In cases of partial embolization, EBL was not significantly different regardless of the time interval. Conclusion Complete embolization followed by early spinal surgery within 24 hours may reduce intraoperative bleeding for the patients with hypervascular spinal metastasis.
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Affiliation(s)
- Woon Tak Yuh
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Junghoon Han
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
| | - Chang-Hyun Lee
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chi Heon Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Medical Device Development, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun-Seung Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chun Kee Chung
- Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Sciences, College of Natural Science, Seoul National University, Seoul, Korea
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Liao J, Qi Z, Chen B, Lei P. Association between early ambulation exercise and short-term postoperative recovery after open transforaminal lumbar interbody fusion: a single center retrospective analysis. BMC Musculoskelet Disord 2023; 24:345. [PMID: 37143006 PMCID: PMC10158157 DOI: 10.1186/s12891-023-06395-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Early ambulation in patients undergoing transforaminal lumbar interbody fusion (TLIF) surgery is recommended, however, the precise time interval after open surgery has never been specified. Current retrospective analysis was conducted aiming to clarify an accurate time interval. METHODS A retrospective analysis of eligible patients was conducted using the databases of the Bone Surgery Department, Third Affiliated Hospital of Sun Yat-sen University from 2016 to 2021. Data pertaining to postoperative hospital stay length, expenses, incidence of complications were extracted and compared using Pearson's χ2 or Student's t-tests. A multivariate linear regression model was conducted to identify the relationship between length of hospital stay (LOS) and other outcomes of interest. A propensity analysis was conducted to minimize bias and to evaluate the reliability of results. RESULTS A total of 303 patients met the criteria and were included for the data analysis. Multivariate linear regression results demonstrated that a high ASA grade (p = 0.016), increased blood loss (p = 0.003), cardiac disease (p < 0.001), occurrence of postoperative complications(p < 0.001) and longer ambulatory interval (p < 0.001) was significantly associated with an increased LOS. The cut-off analysis manifested that patients should start mobilization within 3 days after open TLIF surgery (B = 2.843, [1.395-4.292], p = 0.0001). Further comparative analysis indicated that patients who start ambulatory exercise within 3 days have shorter LOS (8.52 ± 3.28d vs 12.24 ± 5.88d, p < 0.001), total expenses ( 9398.12 ± 2790.82vs 10701.03 ± 2994.03 [USD], p = 0.002). Propensity analysis revealed such superiority was stable along with lower incidence of postoperative complications (2/61 vs 8/61, p = 0.0048). CONCLUSIONS The current analysis suggested that ambulatory exercise within 3 days for patients who underwent open TLIF surgery was significantly associated with reduced LOS, total hospital expenses, and postoperative complications. Further causal relationship would be confirmed by future randomized controlled trials.
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Affiliation(s)
- Jingwen Liao
- Department of Bone Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhou Qi
- Department of Bone Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Biying Chen
- Department of Bone Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
| | - Purun Lei
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
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Zhao D, Shi Y, Cheng L, Li H, Zhang L, Guo H. Time interval uncertainty-aware and text-enhanced based disease prediction. J Biomed Inform 2023; 139:104239. [PMID: 36356933 DOI: 10.1016/j.jbi.2022.104239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/14/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
Deep learning methods have achieved success in disease prediction using electronic health records (EHR) data. Most of the existing methods have some limitations. First, most of the methods adopt a homogeneous decay way to deal with the effect of time interval on patient's previous visits information. However, the effect of the time interval between patient's visits is not always negative. For example, although the time interval between visits for patients with chronic diseases is relatively long, the importance of the previous visit to the next visit is high, and we may not be able to consider the effect of the time interval as negative at this point. That is, the effect of the time interval on previous visits is exerted in a nonmonotonic manner, and it is either positive, negative, or neutral. In addition, the effect of text information on prediction results is not taken into account in most of methods. The text in EHR contains a description of the patient's past medical history and current symptoms of the disease, which is important for prediction results. In order to solve these issues, we propose a Time Interval Uncertainty-Aware and Text-Enhanced Based Disease Prediction Model, which utilizes the uncertain effects of time intervals and patient's text information for disease prediction. Firstly, we apply a cross-attention mechanism to generate a global representation of the patient using the patient's disease and text information from the EHR. Then, we use the key-query attention mechanism to obtain the two importance weights of the two visit sequences with and without time intervals, respectively. Furthermore, we achieve disease prediction by making slight adjustments to the encode part of the Transformer, a deep learning model based on a self-attention mechanism. We compare with various state-of-the-art models on two publicly available datasets, MIMIC-III and MIMIC-IV, and select the top 10 diseases with the highest frequency in the dataset as the target diseases. On the MIMIC-III dataset, our model is up to three percent higher than the optimal baseline in terms of evaluation metrics.
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Affiliation(s)
- Dan Zhao
- School of Software, Shandong University, China.
| | - Yuliang Shi
- School of Software, Shandong University, China; Dareway Software Co., Ltd, China.
| | - Lin Cheng
- School of Software, Shandong University, China.
| | - Hui Li
- School of Software, Shandong University, China.
| | - Liguo Zhang
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, China; Shandong Key Laboratory of Oral Tissue Regeneration, China; Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, China.
| | - Hongmei Guo
- Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, China; Shandong Key Laboratory of Oral Tissue Regeneration, China; Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, China.
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11
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Ademaj A, Veltsista PD, Marder D, Hälg RA, Puric E, Brunner TB, Crezee H, Gabrys D, Franckena M, Gani C, Horsman MR, Krempien R, Lindner LH, Maluta S, Notter M, Petzold G, Abdel-Rahman S, Richetti A, Thomsen AR, Tsoutsou P, Fietkau R, Ott OJ, Ghadjar P, Riesterer O. A patterns of care analysis of hyperthermia in combination with radio(chemo)therapy or chemotherapy in European clinical centers. Strahlenther Onkol 2022. [PMID: 36038671 DOI: 10.1007/s00066-022-01980-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/07/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The combination of hyperthermia (HT) with radio(chemo)therapy or chemotherapy (CT) is an established treatment strategy for specific indications. Its application in routine clinical practice in Europe depends on regulatory and local conditions. We conducted a survey among European clinical centers to determine current practice of HT. METHODS A questionnaire with 22 questions was sent to 24 European HT centers. The questions were divided into two main categories. The first category assessed how many patients are treated with HT in combination with radio(chemo)therapy or CT for specific indications per year. The second category addressed which hyperthermia parameters are recorded. Analysis was performed using descriptive methods. RESULTS The response rate was 71% (17/24) and 16 centers were included in this evaluation. Annually, these 16 centers treat approximately 637 patients using HT in combination with radio(chemo)therapy or CT. On average, 34% (range: 3-100%) of patients are treated in clinical study protocols. Temperature readings and the time interval between HT and radio(chemo)therapy or CT are recorded in 13 (81%) and 9 (56%) centers, respectively. The thermal dose quality parameter "cumulative equivalent minutes at 43 °C" (CEM43°C) is only evaluated in five (31%) centers for each HT session. With regard to treatment sequence, 8 (50%) centers administer HT before radio(chemo)therapy and the other 8 in the reverse order. CONCLUSION There is a significant heterogeneity among European HT centers as to the indications treated and the recording of thermometric parameters. More evidence from clinical studies is necessary to achieve standardization of HT practice.
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12
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Sugimoto F, Kimura M, Takeda Y. Investigation of the optimal time interval between task-irrelevant auditory probes for evaluating mental workload in the shortest possible time. Int J Psychophysiol 2022; 177:103-110. [PMID: 35513137 DOI: 10.1016/j.ijpsycho.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/27/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
Event-related brain potentials (ERPs) elicited by auditory stimuli unrelated to a current visual-cognitive task (i.e., task-irrelevant auditory probes) can be used to evaluate the level of mental workload. Towards the evaluation of workload in the shortest possible time, the present study with a multiple-stimulus paradigm (Takeda and Kimura, 2014, Int. J. Psychophysiol.) examined whether manipulating time intervals between probes could improve the temporal resolution in evaluating workload. Probes were presented in four interval conditions as a combination of two mean interval lengths [long (600 ms) vs. short (300 ms)] and two interval variabilities [variable (five levels) vs. fixed], while participants were performing a driving game at slow and fast speeds (i.e., imposing low and high workload, respectively). For each interval condition, the minimum data length required to obtain a significant difference in the amplitude of ERPs (i.e., auditory N1 and P2) between the slow and fast driving tasks was estimated. The N1 difference was significant in all four interval conditions but the required minimum data lengths to observe this difference did not greatly differ across the interval conditions (about 60-90 s). The P2 difference was significant only in the long-variable condition and the required minimum data length was about 120 s. These results suggest that, at least with a multiple-stimulus paradigm, manipulations of time intervals between probes did not greatly improve the temporal resolution in evaluating mental workload; at present, long-variable intervals would be optimal for evaluating mental workload in detail.
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Affiliation(s)
- Fumie Sugimoto
- National Institute of Advanced Industrial Science and Technology (AIST), Japan.
| | - Motohiro Kimura
- National Institute of Advanced Industrial Science and Technology (AIST), Japan
| | - Yuji Takeda
- National Institute of Advanced Industrial Science and Technology (AIST), Japan
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13
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Hassanin AS, El-Shahawy HF, Hussain SH, Bahaa Eldin AM, Elhawary MM, Elbakery M, Elsafty MSE. Impact of interval between induction of spinal anesthesia to delivery on umbilical arterial cord ph of neonates delivered by elective cesarean section. BMC Pregnancy Childbirth 2022; 22:216. [PMID: 35300620 PMCID: PMC8932063 DOI: 10.1186/s12884-022-04536-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate the impact of interval between induction of spinal anesthesia to delivery of the fetus by elective cesarean section on umbilical arterial pH and neonatal outcome. Patients and methods Two hundred and twenty pregnant women who were planned for elective cesarean section at term under spinal anesthesia were recruited. Minimum systolic, diastolic and mean arterial blood pressures (SBP, DBP, MAP) and largest pressure decrease (SBP, DBP, MPA) were also recorded. Induction of spinal anesthesia to delivery interval was measured. Following delivery, umbilical arterial cord analysis for pH and base deficit were done. Apgar scores at 1 min and at 5 min, neonatal intensive care unit (NICU) admission, need for mechanical ventilation and incidence of hypoxemic-ischemic encephalopathy were recorded. Results Induction of spinal anesthesia to delivery interval was 25.7 ± 5.6 min. Lowest SBP and MAP reached during cesarean delivery were 88.9 ± 7.3 mmHg and 60.4 ± 5.6 mmHg, respectively. MAP < 65 mmHg was reached in 136 (62%) patients with a decrease of MAP of > 20% in 149 (68%) patients. Duration of the longest hypotension episode was 3.3 ± 2.2 min. All patients required ephedrine administration for hypotensive episodes with an average dosage of 11.4 ± 3.2 mg. Umbilical pH of 7.3 ± 0.1 and base deficit of 8.3 ± 4.4 mmol/l were recorded. Apgar scores at 5 min were 8.5 ± 1.2. Eight (3.6%) neonates were admitted in the NICU. One neonate needed mechanical ventilation. There were no cases of hypoxemic-ischemic encephalopathy. There were inverse correlations between induction of spinal anesthesia to delivery interval, body mass index (BMI) and duration of longest hypotension episode in relation to umbilical pH (r = -0.817, -0.395 and -0.268, respectively). Cut off value for induction of spinal anesthesia to delivery interval greater than 27 min predicted an umbilical pH of < 7.2. Cut off value for the duration of the longest hypotension episode greater than 5 min predicted an umbilical pH of < 7.2. Cut off value for BMI greater than 35 kg/m2 predicted an umbilical pH of < 7.2. Conclusion Prolonged interval between induction of spinal anesthesia to delivery could be associated with neonatal acidosis. This could be aggravated by maternal obesity and prolonged duration of hypotension episodes during cesarean delivery.
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Affiliation(s)
- Alaa S Hassanin
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, 38 Ramsis Street, Abbasiya, 11591, Cairo, Egypt.
| | - Hazem F El-Shahawy
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, 38 Ramsis Street, Abbasiya, 11591, Cairo, Egypt
| | - Sherif Hanafi Hussain
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, 38 Ramsis Street, Abbasiya, 11591, Cairo, Egypt
| | - Ahmed M Bahaa Eldin
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, 38 Ramsis Street, Abbasiya, 11591, Cairo, Egypt
| | - Marwa Mohammed Elhawary
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, 38 Ramsis Street, Abbasiya, 11591, Cairo, Egypt
| | - Mohamed Elbakery
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Azhar University, Cairo, Egypt
| | - Mohammed S E Elsafty
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, 38 Ramsis Street, Abbasiya, 11591, Cairo, Egypt
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14
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Piva C, Panier Suffat L, Petrucci ETF, Manuguerra G, Vittone F, Cante D, Ferrario S, Paolini M, Radici L, Vellani G, La Porta MR. Effect of delaying surgery by more than 10 weeks after neoadjuvant therapy in rectal cancer: a single institution experience. Updates Surg 2021; 74:145-151. [PMID: 34661871 DOI: 10.1007/s13304-021-01189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/01/2021] [Indexed: 10/20/2022]
Abstract
The optimal timing of surgery after neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer is still controversial. Aim of this study was to evaluate the effect of increasing time interval between the end of CRT and surgery on pathological outcomes. This is a retrospective analysis on 114 patients treated with long-course neoadjuvant RT with or without chemotherapy between January 2005 and September 2020. 43 patients underwent surgery within 10 weeks from the end of CRT (1st group), whereas 71 patients underwent total mesorectal excision with a time interval equal or greater than 10 weeks (2nd group). Primary endpoint was pCR (pathological complete response). Secondary endpoints were near pCR (ypT0-1 N0), tumor downstaging (ypT less than cT), nodal downstaging (ypN less than cN), and overall response comparing clinical with pathological TN stage. Overall, the pCR rate was 8.8%, whereas we observed no significantly difference in primary endpoint between the two groups. Considering near pCR, a trend toward significant difference in favor of 2nd group was seen (p = 0.072). Tumor and nodal downstaging rates were 39.5%, 41.9%, 59.2%, and 56.3% in the 1st and 2nd group, respectively, with a statistically significant difference for T category (p = 0.042). Overall response rates (TN stage) showed a trend toward significant difference in favor of patients of the ≥ 10 week group (p = 0.059). Our study suggests that a prolonged time interval between the end of CRT and surgery (≥ 10 weeks) increases pathological response rates.
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Affiliation(s)
- Cristina Piva
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Luca Panier Suffat
- Department of Surgery, ASL TO4, Ivrea Community Hospital, Piazza Credenza 2, 10015, Ivrea, Italy.
| | | | | | - Federico Vittone
- Department of Pathology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Domenico Cante
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Silvia Ferrario
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Marina Paolini
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Lorenzo Radici
- Department of Medical Physics, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Giorgio Vellani
- Department of Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
| | - Maria R La Porta
- Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, Italy
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15
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Yu L, Yang B, Xu Q, Teng Y, Xue Z. A study on the timing of uterine artery embolization followed by pregnancy excision for cesarean scar pregnancy: a prospective study in China. BMC Pregnancy Childbirth 2021; 21:697. [PMID: 34654394 PMCID: PMC8518328 DOI: 10.1186/s12884-021-04180-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 10/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cesarean scar pregnancy (CSP) remains a sporadic and special form of ectopic pregnancy in which the fertilized ovum is implanted on a previous cesarean scar within 12 weeks. This study aims to evaluate the optimal time interval between uterine artery embolization (UAE) and curettage modalities in order to provide the best clinical outcomes. METHODS From January 2018 to December 2020, we recruited 61 patients with CSP. They were randomly divided into two groups depending on whether the time interval between UAE and dilatation and curettage (D&C) requires additional hospitalization: 31 patients received prophylactic UAE followed by D&C on the same day (0-12 h; group A) and 30 patients need hospitalization (12-72 h; group B). The clinical characteristics, diagnostic data, and outcomes of the two groups were compared and analyzed. RESULTS A total of 59 (96.72%) cases had responded well to the first treatment. One patient in each arm undergone retreatment, but none of the 61 patients needed additional hysterectomy. There was no considerable relationship between the two groups with respect to the intraoperative hemorrhage during D&C, serum index (containing β-hCG, hemoglobin, CRP, and D-dimer) on the first day after D&C, side effects (containing fever and abdominal pain), renal, hepatic, and coagulation function, time of CSP residual mass disappearance, and hospitalization cost. The time of serum β-hCG resolution after surgery was 41.22 ± 14.97 days in group A and 66.67 ± 36.64 days in group B (P = 0.027), and group A treatment resulted in a shorten hospital stay as compared with group B (4.81 ± 2.74 days vs. 6.80 ± 2.14 days, P < 0.001). However, the average hourly serum β-hCG decrease rate within 24 h and the leukocytes on the first day after D&C in group B were superior than in group A (P < 0.050). CONCLUSION For patients with CSP, UAE followed by D&C on the same day (0-12 h) appears to have more advantages in hospitalization and recovery time, while the long time interval (12-72 h) may have a lower risk of inflammation and a more rapid decrease in serum β-hCG level within 24 h after D&C surgery. The treatment of CSP should be individualized based on the conditions of patients.
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Affiliation(s)
- Liping Yu
- The Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Bikang Yang
- The Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Qinyang Xu
- The Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Yincheng Teng
- The Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Zhuowei Xue
- The Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
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16
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Suekane T, Tachibana D, Kurihara Y, Yokoi N, Seo N, Kitada K, Tahara M, Hamuro A, Misugi T, Nakano A, Koyama M. Time interval analysis of ductus venosus and cardiac cycles in relation with umbilical artery pH at birth in fetal growth restriction. BMC Pregnancy Childbirth 2021; 21:671. [PMID: 34602049 PMCID: PMC8489040 DOI: 10.1186/s12884-021-04115-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 09/09/2021] [Indexed: 12/27/2022] Open
Abstract
Background The aims of this study were to evaluate the time intervals of flow velocity waveforms (FVW) of ductus venosus (DV) and cardiac cycles, as well as the pulsatility index of DV-FVW (DV-PI), in correlation with umbilical artery (UA) pH at birth in fetal growth restriction (FGR) complicated with placental insufficiency. Methods Data were retrospectively retrieved from pregnancies complicated by FGR. FGR was defined as an estimated fetal weight below − 2.0 S.D. with an elevated UA-PI. Time interval assessments of DV-FVW were as follows: the duration of systolic wave was divided by the duration of diastolic wave and defined as DV-S/D. We also measured the following time intervals of ventricular inflow through tricuspid valve (TV) and mitral valve (MV): (iii), from the second peak of ventricular inflow caused by atrial contraction (A-wave) to the opening of atrio-ventricular valves and: (iv), from the opening of atrio-ventricular valves to the peak of A-wave. (iii)/(iv) was expressed as TV-S/D and MV-S/D, for TV and MV, respectively. The time interval data were transformed into z-scores. Results Thirty-one FGR fetuses were included in this study. Both DV-PI and DV-S/D showed significant correlation with UA-pH (r = − 0.677, p = < 0.001 and r = 0.489, p = 0.005 for DV-PI and z-score of DV-S/D, respectively) and more significances were observed in FGR ≤ 28 + 6 gestational weeks (r = − 0.819, p < 0.001 and r = 0.726, p = 0.005, for DV-PI and z-score of DV-S/D, respectively) than in FGR > 28 + 6 gestational weeks (r = − 0.634, p = 0.007 and r = 0.635, p = 0.020, for DV-PI and z-score of DV-S/D, respectively). On the other hand, TV-S/D and MV-S/D showed no significant correlation with UA-pH, although these z-scores indicated significant decreases compared with normal references. Conclusions Time interval analysis of DV-FVW might be a valuable parameter, as well as DV-PI, for the antenatal prediction of fetal acidemia in the management of FGR fetuses. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04115-7.
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Affiliation(s)
- Tomoki Suekane
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Daisuke Tachibana
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan.
| | - Yasushi Kurihara
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Natsuko Yokoi
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Naomi Seo
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Kohei Kitada
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan.,Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan
| | - Mie Tahara
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Akihiro Hamuro
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Takuya Misugi
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Akemi Nakano
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
| | - Masayasu Koyama
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku Osaka, Osaka, 545-8585, Japan
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17
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Wang X, Zheng Z, Zhu H, Yu Q, Huang S, Lu X, Huang Y, Chi P. Timing to achieve the best recurrence-free survival after neoadjuvant chemoradiotherapy in locally advanced rectal cancer: experience in a large-volume center in China. Int J Colorectal Dis 2021; 36:1007-16. [PMID: 33398511 DOI: 10.1007/s00384-020-03829-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/25/2020] [Indexed: 02/07/2023]
Abstract
AIM To identify the optimal interval from the end of neoadjuvant chemoradiotherapy to surgery (CRT-surgery interval) based on long-term oncological outcome of locally advanced rectal cancer (LARC). METHODS Retrospective data analysis is reported from patients diagnosed with cT3 or T4 or TxN+ rectal cancer who underwent neoadjuvant treatment and curative-intent surgery between January 2010 and December 2018. With a priority focus on the effect of interval on oncological prognosis, we used recurrence-free survival (RFS) as the primary endpoint to determine the best cutoff point of time intervals. Then, the short-term and long-term outcomes of patients from longer and shorter interval groups were compared. RESULTS Data from 910 patients were analyzed, with 185 patients who achieved pCR (20.3%). The trend for increased rates of pCR for groups with a prolonged time interval was not observed (P = 0.808). X-tile determined a cutoff value of 10.5 weeks, and the population was divided into longer (> 10 weeks) and shorter (≤ 10 weeks) interval groups. The shorter interval was associated with a higher wound infection rate (4.7% vs. 1.1%, P = 0.031), but other postoperative complications did not differ between the groups. The 5-year RFS rate was significantly higher in patients in a longer group than those in the shorter weeks group (86.8% vs. 77.8%, P = 0.016). The 5-year OS rates between groups were similar (84.1% vs. 82.5%, P = 0.257). Local recurrence and lung metastases rates were higher in shorter interval group than those of longer group (local recurrence rate: 1.7% vs. 5.1%, P = 0.049; lung metastases rate: 5.7% vs. 10.7%, P = 0.047). Cox multivariate regression analysis confirmed the CRT-surgery interval (HR = 0.599, P = 0.045) to be an independent prognostic factor of RFS. CONCLUSION This study is the first, to the best of our knowledge, to define the optimal CRT-surgery interval based on RFS as the primary endpoint. Prolonging the waiting period to 10 weeks after the completion of CRT with additional chemotherapy cycles during the interval period might be a promising option to improve oncological survival in LARC patients treated with CRT and TME without compromising the surgical safety. Further randomized controlled trials investigating this are warranted to prove a clearly causality.
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Gong Y, Zhuang H, Chong S, Shi Q, Wei F, Liu Z, Ouyang H, Liu X, Jiang L. Delayed postoperative radiotherapy increases the incidence of radiographic local tumor progression before radiotherapy and leads to poor prognosis in spinal metastases. Radiat Oncol 2021; 16:21. [PMID: 33482844 PMCID: PMC7825226 DOI: 10.1186/s13014-020-01740-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/26/2020] [Indexed: 12/28/2022] Open
Abstract
Background Most previous studies focused on the minimum interval between surgery and radiotherapy in spinal metastases, leaving the maximum interval under-investigated. However, in real world, limited radiotherapist and equipment cannot meet the needs of a large patient population to obtain timely radiotherapy after the index spine surgery in developing countries. This study aimed to estimate the clinical risks of delayed radiotherapy after surgery in patients with spinal metastases in developing country. Methods Data from 89 patients who underwent surgery and postoperative radiotherapy at a single site in a developing country were retrospectively reviewed. Patients were divided into the progression before radiotherapy (PBR) and no progression before radiotherapy (NPBR) groups. Kaplan–Meier analysis and log-rank tests were used to compare the local control (LC) and overall survival (OS) between groups. Results Within 1 month after surgery, only 20.2% of patients underwent radiotherapy. Risk of local progression before radiotherapy at 1, 3, and 6 months was 1.2%, 24.1%, and 45.1%, respectively. The LC rate at 1 year was lower in the PBR group than in the NPBR group (53.3% vs. 76.3%, P = 0.040). The OS rate at 1 year was 61.9% and 79.6% in the PBR and NPBR groups, respectively (P = 0.001). The Karnofsky performance status significantly improved only in the NPBR group (52.5 ± 17.6 vs. 66.8 ± 26.3, P < 0.001). The sphincter dysfunction significantly improved in the NPBR group (0.3 ± 0.5 vs. 0.1 ± 0.3, P = 0.007) but it tended to be deteriorated in the PBR group (0.1 ± 0.4 vs. 0.3 ± 0.5, P = 0.500). Conclusions In real world, about 80% of patients had delayed radiotherapy 1 month after spine surgery for metastases in our developing country. Patients had a higher risk for radiographic local progression before radiotherapy and poorer LC, OS, and quality of life as time to radiotherapy increased.
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Affiliation(s)
- Yining Gong
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.,Health Science Center, Peking University, Beijing, China
| | - Hongqing Zhuang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Shan Chong
- Health Science Center, Peking University, Beijing, China
| | - Qianyu Shi
- Health Science Center, Peking University, Beijing, China
| | - Feng Wei
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Hanqiang Ouyang
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China. .,The Institute of Traumatology and Orthopaedics, Beijing Jishuitan Hospital, Beijing, China.
| | - Liang Jiang
- Department of Orthopedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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19
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Somanna SN, Murthy SN, Chaluvarayaswamy R, Malila N. Time from Self-Detection of Symptoms to Seeking Definitive Care among Cervical Cancer Patients. Asian Pac J Cancer Prev 2020; 21:3301-3307. [PMID: 33247688 PMCID: PMC8033105 DOI: 10.31557/apjcp.2020.21.11.3301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Indexed: 12/24/2022] Open
Abstract
Background: India had the burden of 97,000 new cases of cervical cancer with 60,000 deaths accounting nearly one-third of global cervical cancer deaths during the year 2018. Cervical cancer is the leading cause of cancer mortality in India. The present study aims to estimate the time interval between self-detection of cervical cancer symptoms and seeking care and different barriers for the possible time lag in seeking care. Methods: A cross-sectional study was undertaken from April 2017 to September 2017 in a regional cancer centre in the south of India. The centre has both a population and a hospital-based cancer registry. Cervical cancer cases (N= 210) with histological confirmation were interviewed at the hospital using a pre-tested semi-structured questionnaire. Results: The median time interval between the self-detection of cervical cancer symptoms and first contact with the general physician was 80 [IQR 45-150] days. The overall median time interval between the self-detection of symptoms to the initiation of primary treatment was 123[IQR 83-205] days. The major perceived reason for not seeking medical care was a lack of awareness in identifying cervical cancer symptoms in 183(92.9%) women. Conclusion: The median time of 80 days was observed from the self-detection of cervical cancer symptoms to the first contact with a general physician. Lack of awareness of patients pertaining to cancer symptoms was the major concern in seeking cancer care.
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Shang QX, Yang YS, Gu YM, Zeng XX, Zhang HL, Hu WP, Wang WP, Chen LQ, Yuan Y. Timing of surgery after neoadjuvant chemoradiotherapy affects oncologic outcomes in patients with esophageal cancer. World J Gastrointest Oncol 2020; 12:687-698. [PMID: 32699583 PMCID: PMC7340997 DOI: 10.4251/wjgo.v12.i6.687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/09/2020] [Accepted: 04/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The optimal time interval between neoadjuvant chemoradiotherapy (nCRT) and esophagectomy in esophageal cancer has not been defined.
AIM To evaluate whether a prolonged time interval between the end of nCRT and surgery has an effect on survival outcome in esophageal cancer patients.
METHODS We searched PubMed, Embase, Web of Science, the Cochrane Library, Wanfang and China National Knowledge Infrastructure databases for relevant articles published before November 16, 2019, to identify potential studies that evaluated the prognostic role of different time intervals between nCRT and surgery in esophageal cancer. The hazard ratios and 95% confidence intervals (95%CI) were merged to estimate the correlation between the time intervals and survival outcomes in esophageal cancer, esophageal squamous cell carcinoma and adenocarcinoma using fixed- and random-effect models.
RESULTS This meta-analysis included 12621 patients from 16 studies. The results demonstrated that esophageal cancer patients with a prolonged time interval between the end of nCRT and surgery had significantly worse overall survival (OS) [hazard ratio (HR): 1.107, 95%CI: 1.014-1.208, P = 0.023] than those with a shorter time interval. Subgroup analysis showed that poor OS with a prolonged interval was observed based on both the sample size and HRs. There was also significant association between a prolonged time interval and decreased OS in Asian, but not Caucasian patients. In addition, a longer wait time indicated worse OS (HR: 1.385, 95%CI: 1.186-1.616, P < 0.001) in patients with adenocarcinoma.
CONCLUSION A prolonged time interval from the completion of nCRT to surgery is associated with a significant decrease in OS. Thus, esophagectomy should be performed within 7-8 wk after nCRT.
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Affiliation(s)
- Qi-Xin Shang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Shang Yang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi-Min Gu
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Xi Zeng
- West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Han-Lu Zhang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wei-Peng Hu
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wen-Ping Wang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Long-Qi Chen
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yong Yuan
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
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21
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Bicocca MJ, Le TN, Zhang CC, Blackburn B, Blackwell SC, Sibai BM, Chauhan SP. Identification of newborns with birthweight ≥ 4,500g: Ultrasound within one- vs. two weeks of delivery. Eur J Obstet Gynecol Reprod Biol 2020; 249:47-53. [PMID: 32353616 DOI: 10.1016/j.ejogrb.2020.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Our objective was to compare the diagnostic characteristics of sonographic estimated fetal weight (SEFW) done within 7 versus 8-14 days before delivery for detection of fetal macrosomia (birthweight ≥ 4500 g). STUDY DESIGN We performed a multicenter, retrospective cohort study of all non-anomalous singletons with SEFW ≥ 4000 g by Registered Diagnostic Medical Sonographers conducted within 14 days of delivery. Cohorts were grouped by time interval between ultrasound and delivery: 0-7 days versus 8-14 days. The detection rate (DR) and false positive rate (FPR) for detection of birthweight (BW) ≥ 4500 g were compared between groups with subgroup analysis for diabetic women. Area under the receiver operator curve (AUC) was calculated to analyze all possible SEFW cutoffs within our cohort. RESULTS A total of 330 patients met inclusion criteria with 250 (75.8 %) having SEFW within 7 days and 80 (24.2 %) with SEFW 8-14 days prior to delivery. The rate of macrosomia was 15.1 % (N = 51). The DR for macrosomia was significantly higher when SEFW was performed within 7 days of delivery compared to 8-14 days among non-diabetic (73.0 % vs 7.1 %; p < 0.001) and diabetic women (76.5 % vs 16.7 %; p = 0.02). There was no significant change in FPR in either group. The AUC for detection of macrosomia was significantly higher when SEFW was performed within 7 days versus 8-14 days (0.89 vs 0.63; p < 0.01). CONCLUSION With SEFW ≥ 4000 g, the detection of BW ≥ 4500 g is significantly higher when the sonographic examination is within 7 days of birth irrespective of maternal diabetes.
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Affiliation(s)
- Matthew J Bicocca
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | - Tran N Le
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Caroline C Zhang
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Bonnie Blackburn
- Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, United States
| | - Sean C Blackwell
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Baha M Sibai
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Suneet P Chauhan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
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22
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Matsushita M, Shirakabe A, Kobayashi N, Okazaki H, Shibata Y, Goda H, Shigihara S, Asano K, Tani K, Kiuchi K, Okajima F, Hata N, Asai K, Shimizu W. Mechanisms of Urgently Presenting Acute Heart Failure. Int Heart J 2020; 61:316-324. [PMID: 32173711 DOI: 10.1536/ihj.19-523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The mechanisms of urgently presenting acute heart failure (AHF) are not clear. We evaluated the serum catecholamine values of AHF patients immediately after admission. A total of 1,475 AHF patients were screened, and 484 who were admitted from their homes and in whom serum catecholamine could be evaluated immediately after admission were analyzed. The patients were divided into three groups according to the time interval from the onset of symptoms to admission (OA): < 3 hours (early-OA group; n = 283), 3-24 hours (middle-OA group; n = 142), and ≥24 hours (late-OA group; n = 59). In the early-OA group, the systolic blood pressure (SBP) was significantly higher, orthopnea was more frequent, the pH value was significantly decreased, and the use of noninvasive positive-pressure ventilation was required significantly more often than in the other groups. The serum noradrenaline level was significantly increased in the early-OA group (1.96 [1.02-3.60] ng/mL) than in the middle-OA (1.49 [0.73-3.41] ng/mL) and late-OA (1.40 [0.91-2.42] ng/mL) groups, and the adrenaline level was significantly increased in the early-OA group (0.36 [0.13-1.17] ng/mL) than in the late-OA (0.22 [0.09-0.52] ng/mL) group. A multivariate logistic regression model indicated the early-OA group was independently associated with the SBP > 140 mmHg (odds ratio [OR]: 2.219, 95% CI: 1.375-3.581), midnight/early morning admission (OR: 3.158, 95% CI: 2.048-4.868), and high serum catecholamine value (adrenaline > 0.96 ng/mL, noradrenaline > 3.39 ng/mL, and dopamine > 0.21 ng/mL) (OR 2.091, 95% CI: 1.161-3.767). In conclusion, urgently presented AHF might be induced by an endogenous catecholamine surge, which causes an excessive rise in blood pressure leading to increased after-overload and volume-shift lung congestion.
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Affiliation(s)
- Masato Matsushita
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Akihiro Shirakabe
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Nobuaki Kobayashi
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Hirotake Okazaki
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Yusaku Shibata
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Hiroki Goda
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Shota Shigihara
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Kazuhiro Asano
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Kenichi Tani
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Kazutaka Kiuchi
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Fumitaka Okajima
- Department of Endocrinology, Nippon Medical School Chiba-Hokusoh Hospital
| | - Noritake Hata
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Kuniya Asai
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
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23
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Hu S, Xu B, Long R, Jin L. Pregnancy and perinatal outcomes in pregnancies resulting from time interval between a freeze-all cycle and a subsequent frozen-thawed single blastocyst transfer. BMC Pregnancy Childbirth 2020; 20:161. [PMID: 32169044 PMCID: PMC7071692 DOI: 10.1186/s12884-020-02858-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/06/2020] [Indexed: 12/28/2022] Open
Abstract
Background Adverse obstetric outcomes are correlated with altered circulating hormone levels at the time implantation by the trophectoderm. What’ more, embryo freezing process may also have adverse effect on perinatal outcomes. This study aims to evaluate whether increasing interval time between a freeze-all cycle and a subsequent frozen-thawed single blastocyst transfer could have any effect on pregnancy and perinatal outcomes. Methods This was a retrospective cohort study included the first single blastocyst transfer in artificially cycles of all patients who underwent a freeze-all cycle between January 1st, 2016 and September 30th, 2018. All patients were divided into two groups according to the time interval between oocyte retrieval and the day of first frozen-thawed embryo transferred (FET): Group 1 (immediate FET cycles) and Group 2 (delayed FET cycles). Results No significant differences were reported between the two groups regarding the rates of clinical pregnancy, live birth, biochemical pregnancy and pregnancy loss even after adjusting for measured confounding. When accounting for perinatal outcomes, gestational age, birth weight, delivery mode, fetus gender, preterm birth, gestational hypertension, GDM, placenta previa, fetal malformation and low birthweight also did not vary significantly between the two groups. Only the incidence of macrosomia was more frequently in the Group 2 compared with the Group 1 (AOR 3.886, 95%CI 1.153–13.103, P = 0.029) after adjusting with a multiple logistic regression model. Conclusions We found delayed FET cycles for blastocyst transfer following freeze-all cycles may not improve the pregnancy outcomes. On the contrary, postponement of FET cycles may increase the risk of macrosomia. Therefore, FET cycles for blastocyst transfer should be done immediately to avoid adverse effects of delayed time on perinatal outcomes.
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Affiliation(s)
- Shiqiao Hu
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030, People's Republic of China
| | - Bei Xu
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030, People's Republic of China
| | - Rui Long
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030, People's Republic of China
| | - Lei Jin
- Department of Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 JieFang Avenue, Wuhan, 430030, People's Republic of China.
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24
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Shen B, Liu Q, Song A, Wang X, Tang R. How long is the interval over which trial-to-trial effects on Fitts' Law task can operate? Exp Brain Res 2020; 238:851-859. [PMID: 32146503 DOI: 10.1007/s00221-020-05755-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 02/18/2020] [Indexed: 11/27/2022]
Abstract
Fitts' Law is a well-studied principle in psychology which holds that movement time (MT) varies with the size and distance of a target across a wide range of tasks. In a recent study, the authors demonstrated that performance on a current trial in a Fitts' Law paradigm is affected by what happens during the previous trial (Tang et al. in Psychon Bull Rev 25(5):1833-1839, 2018). The aim of the present study was to explore how long this trial-to-trial transfer might last and whether or not the transfer would occur between the left and right hands. A series of experiments was carried out using discrete trials, a paradigm in which the current authors and others have previously established that Fitts' Law operates (Fitts and Peterson in J Exp Psychol 67(2):103-112, 1964; Tang et al. 2018). Three inter-trial intervals (3 s, 4 s, and 5 s) were used in separate testing sessions, the order of which was counterbalanced across participants. In addition, trial-to-trial transfer was tested within a single hand and between hands. The results demonstrate that transfer from one trial to the next could bridge 4 s when either the right or the left hand was used and would disappear by 5 s. Moreover, the effect transferred between the two hands. The endpoint accuracy of the current trial was not affected by the previous trial. These findings suggest that the trial-to-trial effect reduces over time and that the transfer of sensorimotor memory or the task set is independent of the particular hand used.
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Affiliation(s)
- Bingyao Shen
- The Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Qianqian Liu
- The Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Aixia Song
- The Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Xuan Wang
- Software Institute, Nanjing University, Nanjing, Jiangsu, People's Republic of China
| | - Rixin Tang
- The Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu, People's Republic of China.
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25
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Lichthardt S, Wagner J, Löb S, Matthes N, Kastner C, Anger F, Germer CT, Wiegering A. Pathological complete response due to a prolonged time interval between preoperative chemoradiation and surgery in locally advanced rectal cancer: analysis from the German StuDoQ|Rectalcarcinoma registry. BMC Cancer 2020; 20:49. [PMID: 31959130 PMCID: PMC6971897 DOI: 10.1186/s12885-020-6538-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 01/13/2020] [Indexed: 12/27/2022] Open
Abstract
Background Preoperative chemoradiotherapy is the recommended standard of care for patients with local advanced rectal cancer. However, it remains unclear, whether a prolonged time interval to surgery results in an increased perioperative morbidity, reduced TME quality or better pathological response. Aim of this study was to determine the time interval for best pathological response and perioperative outcome compared to current recommended interval of 6 to 8 weeks. Methods This is a retrospective analysis of the German StuDoQ|Rectalcarcinoma registry. Patients were grouped for the time intervals of “less than 6 weeks”, “6 to 8 weeks”, “8 to 10 weeks” and “more than 10 weeks”. Primary endpoint was pathological response, secondary endpoint TME quality and complications according to Clavien-Dindo classification. Results Due to our inclusion criteria (preoperative chemoradiation, surgery in curative intention, M0), 1.809 of 9.560 patients were suitable for analysis. We observed a trend for increased rates of pathological complete response (pCR: ypT0ypN0) and pathological good response (pGR: ypT0-1ypN0) for groups with a prolonged time interval which was not significant. Ultimately, it led to a steady state of pCR (16.5%) and pGR (22.6%) in “8 to 10” and “more than 10” weeks. We were not able to observe any differences between the subgroups in perioperative morbidity, proportion of rectal extirpation (for cancer of the lower third) or difference in TME quality. Conclusion A prolonged time interval between neoadjuvant chemoradiation can be performed, as the rate of pCR seems to be increased without influencing perioperative morbidity.
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Affiliation(s)
- Sven Lichthardt
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - Johanna Wagner
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - Stefan Löb
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - Niels Matthes
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - Caroline Kastner
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - Friedrich Anger
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.,University of Wuerzburg, Comprehensive Cancer Center Mainfranken, Wuerzburg, Germany
| | - Armin Wiegering
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany. .,University of Wuerzburg, Comprehensive Cancer Center Mainfranken, Wuerzburg, Germany. .,Department of Biochemistry and Molecular Biology, Biocenter, University of Wuerzburg, Wuerzburg, Germany.
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Somanna SN, Nandagudi Srinivasa M, Chaluvarayaswamy R, Malila N. Time Interval between Self-Detection of Symptoms to Treatment of Breast Cancer. Asian Pac J Cancer Prev 2020; 21:169-174. [PMID: 31983180 PMCID: PMC7294006 DOI: 10.31557/apjcp.2020.21.1.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Indexed: 12/24/2022] Open
Abstract
Background: In India breast cancer is the number one cancer among females with an incidence rate of 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. India continues to have a low 5-year survival rate of breast cancer with only 66.1% as compared to 90% in developed countries. The major reason for low survival is that patients are diagnosed with cancer at high stage. The present study attempts to delineate the time interval between self-detection of breast cancer symptoms and seeking care and to find the main reasons for delay in seeking care. Methods: A cross sectional study was undertaken from October 2016 to March 2017 in a population based cancer registry (PBCR) and hospital based cancer registry (HBCR) located in south of India. Histologically confirmed breast cancer patients (N=181) were interviewed at hospital using a pre-tested semi structured questionnaire. Results: The median time interval between the self-detection of breast cancer symptoms and first contact with general physician was 60 [IQR 30-180] days. The median time to diagnosis from the first contact was 30 [IQR 10 - 60] days and the overall median time span from self-detection of symptoms to treatment was 150 [IQR 95-265] days. The major reason given for not seeking medical care in time was lack of awareness in identifying the cancer symptoms both among patients and primary care providers. Conclusion: There was considerable delay from self-detection of symptoms to cancer specific primary treatment of breast cancer. We found lack of awareness among patients as well as in primary care providers to be the major concern for delay. Awareness among the target population and health care professionals would have to be improved for early diagnostics and access to care.
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Affiliation(s)
| | | | - Ramesh Chaluvarayaswamy
- Department of Epidemiology and Biostatistics, Kidwai Memorial Institute of Oncology, Bangalore, India
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27
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Yang WC, Yen HJ, Liang ML, Chen HH, Lee YY, Wong TT, Hu YW, Chen YW. Role of early and aggressive post-operative radiation therapy in improving outcome for pediatric central nervous system atypical teratoid/rhabdoid tumor. Childs Nerv Syst 2019; 35:1013-1020. [PMID: 30982172 DOI: 10.1007/s00381-019-04126-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/11/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of the study is to evaluate possible prognostic factors and optimal management for pediatric atypical teratoid/rhabdoid tumor (AT/RT) of the central nervous system (CNS). METHODS Twenty-eight pediatric patients with CNS AT/RT who were treated with radiation therapy (RT) as part of multimodality treatment regimens at a single institution (1996-2015) were reviewed. Survival outcomes were analyzed in relation to possible prognostic factors. RESULTS The 28 patients analyzed were followed up for a median 48-month period. Median progression-free survival (PFS) was 11 months, and overall survival (OS) was 57 months. Patients < 3 years old had RT delayed for a longer period after surgery (p = 0.04), and the mean RT dose to tumor bed was lower (p < 0.01) than in patients ≥ 3 years old. In multivariate analysis, a higher primary tumor bed RT dose was identified as a favorable prognostic factor for both PFS (hazard ratio [HR] = 0.85 per gray, p < 0.01) and OS (HR = 0.92 per gray, p = 0.02). In addition, an interval between surgery and RT initiation > 2 months, with disease progression observed before RT, as compared with an interval ≤ 2 months without disease progression prior to RT, was associated with worse PFS (HR = 8.50, p < 0.01) and OS (HR = 5.27, p < 0.01). CONCLUSIONS Early and aggressive RT after surgery is critical for successful disease control in AT/RT patients. Conversely, a delay in RT until disease progression is observed that leads to unfavorable outcomes.
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Affiliation(s)
- Wan-Chin Yang
- Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, Republic of China
- National Yang-Ming University School of Medicine, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, Republic of China
| | - Hsiu-Ju Yen
- National Yang-Ming University School of Medicine, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, Republic of China
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, Republic of China
| | - Muh-Lii Liang
- National Yang-Ming University School of Medicine, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, Republic of China
- Division of Pediatric Neurosurgery, The Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, Republic of China
| | - Hsin-Hung Chen
- National Yang-Ming University School of Medicine, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, Republic of China
- Division of Pediatric Neurosurgery, The Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, Republic of China
| | - Yi-Yen Lee
- National Yang-Ming University School of Medicine, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, Republic of China
- Division of Pediatric Neurosurgery, The Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, Republic of China
| | - Tai-Tong Wong
- Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, No. 252, Wuxing St., Xinyi District, Taipei, 112, Taiwan, Republic of China
| | - Yu-Wen Hu
- Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, Republic of China
- National Yang-Ming University School of Medicine, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, Republic of China
| | - Yi-Wei Chen
- Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei, 112, Taiwan, Republic of China.
- National Yang-Ming University School of Medicine, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan, Republic of China.
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Couwenberg AM, Intven MPW, Hoendervangers S, van der Sluis FJ, van Westreenen HL, Marijnen CAM, van Grevenstein WMU, Verkooijen HM. The effect of time interval from chemoradiation to surgery on postoperative complications in patients with rectal cancer. Eur J Surg Oncol 2019; 45:1584-1591. [PMID: 31053479 DOI: 10.1016/j.ejso.2019.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/19/2019] [Accepted: 04/24/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND A prolonged time interval between chemoradiation and total mesorectal excision (TME) may render more rectal cancer patients eligible for organ-sparing approaches but may also cause more pelvic fibrosis and surgical morbidity. We estimated the effect of time interval on postoperative complications and other surgical outcomes in rectal cancer patients. METHODS This is a population-based cohort study using data of the Dutch Colorectal Audit. Rectal cancer patients treated with chemoradiation followed by TME after an interval of 3-20 weeks were selected (n = 6,268). Time interval from completion of chemoradiation to TME was categorized into 3-6, 7-8, 9-10, 11-12 and 13-20 weeks. Outcomes included postoperative complication (any, and stratified by medical and surgical complications), reintervention, intraoperative complication, incomplete resection, positive circumferential margin (CRM) and pathological complete response (pCR). The interval of 7-8 weeks was the reference group. RESULTS Prolonged time intervals were not associated with a higher risk of a postoperative complication (any, surgical or medical), reintervention, and incomplete resection. Intraoperative complications were however more common after 11-12 weeks than after 7-8 weeks (odds ratio (OR) = 1.79, 95% confidence interval (CI) = 1.20-2.69). The interval of 9-10 weeks was associated with less CRM positive resections, and 9-10 and 13-20 weeks with more pCR (relative to 7-8 weeks, OR = 0.74, 95%CI = 0.56-0.98; OR = 1.28, 95%CI = 1.04-1.58; and OR = 1.33, 95%CI = 1.04-1.71, respectively). CONCLUSIONS Compared with 7-8 weeks, longer time intervals up to 13-20 weeks between chemoradiation and TME are not associated with more postoperative complications or more positive resection margins. Accordingly, prolonging the interval aiming for organ-sparing treatment is safe.
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Affiliation(s)
- Alice M Couwenberg
- Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX Utrecht, the Netherlands.
| | - Martijn P W Intven
- Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX Utrecht, the Netherlands
| | - Sieske Hoendervangers
- Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX Utrecht, the Netherlands
| | | | | | - Corrie A M Marijnen
- Department of Radiation Oncology, Leiden University Medical Center, Albinusdreef 2, 2333, ZA Leiden, the Netherlands
| | | | - Helena M Verkooijen
- Imaging Division, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX Utrecht, the Netherlands; University of Utrecht, Utrecht, the Netherlands
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Kourlaba G, Gkiozos I, Kokkotou E, Stefanou G, Papaspiliou A, Syrigos K. Lung cancer patients' journey from first symptom to treatment: Results from a Greek registry. Cancer Epidemiol 2019; 60:193-200. [PMID: 31063908 DOI: 10.1016/j.canep.2019.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/19/2019] [Accepted: 04/26/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND To map the patients' journey from symptoms onset to treatment initiation for the most frequent histological types of lung cancer in Greece and describe the initial treatment that patients receive. METHODS The primary data source was a Greek hospital-based registry. Demographic, anthropometric, lifestyle, and diagnostic-related characteristics as well as treatment-related data were extracted from the registry for patients diagnosed with Adenocarcinoma, Squamous and Small Cell Lung Cancer (SCLC). The time intervals from symptoms onset to diagnosis (StD), diagnosis to treatment initiation (DtT), symptoms onset to treatment initiation (StT) and surgery to post-surgery treatment (SRGtT) were estimated. RESULTS 231, 120 and 122 patients were diagnosed with Adenocarcinoma, SCLC and Squamous, respectively. The percentage of patients diagnosed at stage III/IV ranged from 75% in Adenocarcinoma to 97.5% in SCLC (p < 0.001). The median (IQR) StD was 52 (28-104) days and no difference was detected across the three histological types (p = 0.301). Cough as first symptom was the only determinant of StD (p = 0.001). The median (IQR) DtT was 23 (13-36) days, with this time interval being shorter among patients with SCLC compared to patients with Adenocarcinoma and Squamous (p < 0.001). The median (IQR) StT was 81 (51-139) days. Almost one third of patients with Adenocarcinoma and Squamous were subjected first to surgery and the median (IQR) SRGtT was 42 (34-55) days. CONCLUSIONS Our results indicate that time interval from symptoms onset to treatment initiation in Greece is substantially prolonged, highlighting the need for strategies to expedite lung cancer diagnosis and access to evidence-based treatment.
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Crusell M, Nilas L, Svare J, Lauenborg J. A Time Interval of More Than 18 Months Between a Pregnancy and a Roux-en-Y Gastric Bypass Increases the Risk of Iron Deficiency and Anaemia in Pregnancy. Obes Surg 2016; 26:2457-62. [PMID: 26983748 DOI: 10.1007/s11695-016-2130-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The aim of the study is to explore the impact of time between Roux-en-Y gastric bypass (RYGB) and pregnancy on obstetrical outcome and nutritional derangements. METHODS In a retrospective cross-sectional study of pregnant women admitted for antenatal care at two tertiary hospitals, we examined 153 women with RYGB and a singleton pregnancy of at least 24 weeks. The women were stratified according to a pregnancy <18 months (40 women) or ≥18 months (113 women) after RYGB. Main outcome measures were nutritional parameters and glycated haemoglobin 1Ac (HbA1c) in second and third trimester of pregnancy, gestational hypertension, length of pregnancy, mode of delivery and foetal birth weight. RESULTS The two groups were comparable regarding age, parity and prepregnancy body mass index. The frequency of iron deficiency anaemia (ferritin <12 μg/L and haemoglobin <6.5 mmol/L/10.5 g/dL) was significantly higher in the late group, 29 vs. 8 % in the early group, p = 0.010. No differences were found for vitamin B12, vitamin D and zinc. Median HbA1c was significantly higher in the late group than in the early group (33 vs. 31 mmol/mol, p = 0.027). There were no significant differences in the risk of adverse pregnancy outcome or birth weight between the two groups. CONCLUSION A long surgery-to-pregnancy time interval after a RYGB increases the risk of iron deficiency anaemia but not of other nutritional deficits. Time interval does not seem to have an adverse effect on the obstetrical outcome, including intrauterine growth restriction. Specific attention is needed on iron deficit with increasing surgery-to-pregnancy time interval.
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Guévremont E, Lamoureux L, Généreux M, Côté C. Irrigation Water Sources and Time Intervals as Variables on the Presence of Campylobacter spp. and Listeria monocytogenes on Romaine Lettuce Grown in Muck Soil. J Food Prot 2017; 80:1182-1187. [PMID: 28604176 DOI: 10.4315/0362-028x.jfp-16-551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Irrigation water has been identified as a possible source of vegetable contamination by foodborne pathogens. Risk management for pathogens such as Campylobacter spp. and Listeria monocytogenes in fields can be influenced by the source of the irrigation water and the time interval between last irrigation and harvest. Plots of romaine lettuce were irrigated with manure-contaminated water or aerated pond water 21, 7, or 3 days prior to harvesting, and water and muck soil samples were collected at each irrigation treatment. Lettuce samples were collected at the end of the trials. The samples were tested for the presence of Campylobacter spp. and L. monocytogenes. Campylobacter coli was isolated from 33% of hog manure samples (n = 9) and from 11% of the contaminated water samples (n = 27), but no lettuce samples were positive (n = 288). L. monocytogenes was not found in manure, and only one sample of manure-contaminated irrigation water (n = 27) and one lettuce sample (n = 288) were positive. No Campylobacter or L. monocytogenes was recovered from the soil samples (n = 288). Because of the low incidence of pathogens, it was not possible to link the contamination of either soil or lettuce with the type of irrigation water. Nevertheless, experimental field trials mimicking real conditions provide new insights into the survival of two significant foodborne pathogens on romaine lettuce.
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Affiliation(s)
- Evelyne Guévremont
- 1 Agriculture and Agri-Food Canada, Saint-Hyacinthe Research and Development Centre, 3600 Casavant Boulevard West, Saint-Hyacinthe, Quebec, Canada J2S 8E3; and
| | - Lisyanne Lamoureux
- 1 Agriculture and Agri-Food Canada, Saint-Hyacinthe Research and Development Centre, 3600 Casavant Boulevard West, Saint-Hyacinthe, Quebec, Canada J2S 8E3; and
| | - Mylène Généreux
- 2 Research and Development Institute for the Agri-Environment, 335 Vingt-cinq Road East, Saint-Bruno-de-Montarville, Quebec, Canada J3V 0G7
| | - Caroline Côté
- 2 Research and Development Institute for the Agri-Environment, 335 Vingt-cinq Road East, Saint-Bruno-de-Montarville, Quebec, Canada J3V 0G7
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Macchia G, Gambacorta MA, Masciocchi C, Chiloiro G, Mantello G, di Benedetto M, Lupattelli M, Palazzari E, Belgioia L, Bacigalupo A, Sainato A, Montrone S, Turri L, Caroli A, De Paoli A, Matrone F, Capirci C, Montesi G, Niespolo RM, Osti MF, Caravatta L, Galardi A, Genovesi D, Rosetto ME, Boso C, Sciacero P, Giaccherini L, Parisi S, Fontana A, Filippone FR, Picardi V, Morganti AG, Valentini V. Time to surgery and pathologic complete response after neoadjuvant chemoradiation in rectal cancer: A population study on 2094 patients. Clin Transl Radiat Oncol 2017; 4:8-14. [PMID: 29594202 PMCID: PMC5833913 DOI: 10.1016/j.ctro.2017.04.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/22/2017] [Accepted: 04/20/2017] [Indexed: 01/27/2023] Open
Abstract
A large population based analysis to evaluate pathologic response according to time of surgery. LARC patients were treated with modern techniques of radiotherapy and surgery. The rate of pCR increased according to time interval from 12.6% to 31.1%. The pCR increasing was 1.5% (about 0.2%/die) per each week of waiting. Lengthening the interval (>13 weeks) significantly improved the pathological response.
Background To retrospectively evaluate the difference in terms of pathologic complete response (pCR) according to time elapsed between chemoradiation (CRT) and total mesorectal excision (TME) on a large unselected real-life dataset of locally advanced rectal cancer (LARC) patients. Methods A multicentre retrospective cohort study of LARC patients from 21 Italian Radiotherapy Institutions was performed. Patients were stratified into 3 different time intervals from CRT. The 1st group included 300 patients who underwent TME within 6 weeks, the 2nd 1598 patients (TME within 7–12 weeks) and the 3rd 196 patients (TME within 13 or more weeks after CRT), respectively. Results Data on 2094 LARC patients treated between 1997 and 2016 were considered suitable for analysis. Overall, 578 patients had stage II while 1516 had stage III histological proven invasive rectal adenocarcinoma. A CRT schedule of one agent (N = 1585) or 2-drugs (N = 509) was administered. Overall, pCR was 22.3% (N = 468 patients). The proportion of patients achieving pCR with respect to time interval was, as follows: 12.6% (1st group), 23% (2nd group) and 31.1% (3rd group) (p < 0.001), respectively. The pCR relative risk comparison of 2nd to 1st group was 1.8, while 3rd to 2nd group was 1.3. Moreover, between the 3rd and 1st group, a pCR relative risk of 2.4 (p < 0.01) was noted. At univariate analysis, clinical stage III (p < 0.001), radiotherapy dose >5040 cGy (p = 0.002) and longer interval (p < 0.001) were significantly correlated to pCR. The positive impact of interval (p < 0.001) was confirmed at multivariate analysis as the only correlated factor. Conclusion We confirmed on a population-level that lengthening the interval (>13 weeks) from CRT to surgery improves the pathological response (pCR and pathologic partial response; pPR) in comparison to historic data. Furthermore, radiotherapy dose >5040 cGy and two drugs chemotherapy correlated with pPR rate.
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Affiliation(s)
- Gabriella Macchia
- Radiotherapy Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica S. Cuore, Campobasso, Italy
| | | | - Carlotta Masciocchi
- Department of Radiotherapy, Fondazione "Policlinico Gemelli", Università Cattolica S. Cuore, Roma, Italy
| | - Giuditta Chiloiro
- Department of Radiotherapy, Fondazione "Policlinico Gemelli", Università Cattolica S. Cuore, Roma, Italy
| | - Giovanna Mantello
- Radiotherapy Unit, Azienda Ospedaliero Universitaria, Ospedali Riuniti Ancona, Italy
| | - Maika di Benedetto
- Radiotherapy Unit, Azienda Ospedaliero Universitaria, Ospedali Riuniti Ancona, Italy
| | - Marco Lupattelli
- Radiotherapy Unit, 'S. Maria della Misericordia' Hospital, Perugia, Italy
| | - Elisa Palazzari
- Radiotherapy Unit, 'S. Maria della Misericordia' Hospital, Perugia, Italy
| | - Liliana Belgioia
- Radiotherapy Unit, AOU IRCCS San Martino, IST National Cancer Research Institute, Genova, Italy
| | - Almalina Bacigalupo
- Radiotherapy Unit, AOU IRCCS San Martino, IST National Cancer Research Institute, Genova, Italy
| | - Aldo Sainato
- Radiotherapy Unit, University Hospital, Pisa, Italy
| | | | - Lucia Turri
- Radiotherapy Unit, 'Maggiore della Carità' Hospital, Novara, Italy
| | - Angela Caroli
- Radiotherapy Unit, 'Maggiore della Carità' Hospital, Novara, Italy
| | - Antonino De Paoli
- Radiation Oncology Department, Oncological Referral Center, Aviano, Italy
| | - Fabio Matrone
- Radiation Oncology Department, Oncological Referral Center, Aviano, Italy
| | | | | | | | - Mattia Falchetto Osti
- Department of Radiation Oncology, Facoltà di Medicina e Psicologia, Università Sapienza, Roma, Italy
| | - Luciana Caravatta
- Radiation Oncology Department, 'A. Businco' Regional Oncological Hospital, Cagliari, Italy
| | | | - Domenico Genovesi
- Radiotherapy Unit, 'SS Annunziata' Hospital, 'G.D'Annunzio' University, Chieti, Italy
| | | | - Caterina Boso
- Radiotherapy and Nuclear Medicine Unit, Veneto Institute of Oncology-IRCCS, Padova, Italy
| | - Piera Sciacero
- Radiotherapy Unit, ASL TO4, General Hospital, Ivrea, Italy
| | - Lucia Giaccherini
- Radiation Oncology Center, Department of Experimental, Diagnostic and Speciality Medicine-DIMES-University of Bologna, S. Orsola-Malpighi Hospital, Italy
| | - Salvatore Parisi
- Radiotherapy Unit, Casa Sollievo della Sofferenza, IRCCS-CSS San Giovanni Rotondo, Italy
| | | | | | - Vincenzo Picardi
- Radiotherapy Unit, Fondazione di Ricerca e Cura "Giovanni Paolo II", Università Cattolica S. Cuore, Campobasso, Italy
| | - Alessio Giuseppe Morganti
- Radiation Oncology Center, Department of Experimental, Diagnostic and Speciality Medicine-DIMES-University of Bologna, S. Orsola-Malpighi Hospital, Italy
| | - Vincenzo Valentini
- Department of Radiotherapy, Fondazione "Policlinico Gemelli", Università Cattolica S. Cuore, Roma, Italy
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van Leeuwen CM, Oei AL, Chin KWTK, Crezee J, Bel A, Westermann AM, Buist MR, Franken NAP, Stalpers LJA, Kok HP. A short time interval between radiotherapy and hyperthermia reduces in-field recurrence and mortality in women with advanced cervical cancer. Radiat Oncol 2017; 12:75. [PMID: 28449703 PMCID: PMC5408439 DOI: 10.1186/s13014-017-0813-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 04/25/2017] [Indexed: 01/04/2023] Open
Abstract
Background Combined radiotherapy and hyperthermia is a well-established alternative to chemoradiotherapy for advanced stage cervical cancer patients with a contraindication for chemotherapy. Pre-clinical evidence suggests that the radiosensitizing effect of hyperthermia decreases substantially for time intervals between radiotherapy and hyperthermia as short as 1–2 h, but clinical evidence is limited. The purpose of this study is to determine the effect of the time interval between external beam radiotherapy (EBRT) and same-day hyperthermia on in-field recurrence rate, overall survival and late toxicity in women with advanced stage cervical cancer. Methods Patients with advanced stage cervical cancer who underwent a full-course of curative daily EBRT and (4–5) weekly hyperthermia sessions between 1999 and 2014 were included for retrospective analysis. The mean time interval between EBRT fractions and same-day hyperthermia was calculated for each patient; the median thereof was used to divide the cohort in a ‘short’ and ‘long’ time-interval group. Kaplan-Meier analysis and stepwise Cox regression were used to compare the in-field recurrence and overall survival. Finally, high-grade (≥3) late toxicity was compared across time-interval groups. DNA repair suppression is an important hyperthermia mechanism, DNA damage repair kinetics were therefore studied in patient biopsies to support clinical findings. Results Included were 58 patients. The 3-year in field recurrence rate was 18% and 53% in the short (≤79.2 min) and long (>79.2 min) time-interval group, respectively (p = 0.021); the 5-year overall survival was 52% and 17% respectively (p = 0.015). Differences between time-interval groups remained significant for both in-field recurrence (HR = 7.7, p = 0.007) and overall survival (HR = 2.3, p = 0.012) in multivariable Cox regression. No difference in toxicity was observed (p = 1.00), with only 6 and 5 events in the short and long group, respectively. The majority of DNA damage was repaired within 2 h, potentially explaining a reduced effectiveness of hyperthermia for long time intervals. Conclusions A short time interval between EBRT and hyperthermia is associated with a lower risk of in-field recurrence and a better overall survival. There was no evidence for difference in late toxicity.
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Affiliation(s)
- Caspar M van Leeuwen
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Arlene L Oei
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. .,Laboratory for Experimental Oncology and Radiobiology (LEXOR)/Center for Experimental Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Kenneth W T K Chin
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Johannes Crezee
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Arjan Bel
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Anneke M Westermann
- Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Marrije R Buist
- Department of Obstetrics and Gynecology, Center for Gynecologic Oncology Amsterdam, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Nicolaas A P Franken
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Laboratory for Experimental Oncology and Radiobiology (LEXOR)/Center for Experimental Molecular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Lukas J A Stalpers
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - H Petra Kok
- Department of Radiation Oncology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Zheng YR, Ye LF, Cen XJ, Lin JY, Fu JW, Wang LH. Low NT-proBNP levels: An early sign for the diagnosis of ischemic heart failure. Int J Cardiol 2017; 228:666-671. [PMID: 27883979 DOI: 10.1016/j.ijcard.2016.11.139] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/06/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND N-terminal pro-brain natriuretic peptide (NT-proBNP) is seen to be mostly elevated in patients with acute heart failure (AHF). However, cases of AHF presenting with low NT-proBNP levels have been reported. In this study designed to investigate the factors associated with low NT-proBNP levels in AHF patients, we discovered that etiology and related factors have an influence on NT-proBNP levels. METHODS In this study, 154 AHF patients met the study criteria (117 men, median age 74years; left ventricular ejection fraction [LVEF] 46±13%; New York Heart Association [NYHA] classes II-IV). We analyzed the different clinical variables of patients based on plasma NT-proBNP levels. In addition, we identified the differences in NT-proBNP levels between ischemic and non-ischemic etiologies, as well as the relationships between time from symptom onset to ED visit and NT-proBNP levels. RESULTS The group with low NT-proBNP levels showed an ischemic association, higher LVEF, lower NYHA class and shorter time from symptom onset to ED visit. Plasma NT-proBNP levels were lower in the ischemic group than in the non-ischemic group (P<0.01). Meanwhile, NT-proBNP levels were relatively low in patients during early phases of AHF hospitalization and increased with time from symptom onset to ED visit (P<0.01). CONCLUSION We inferred that low NT-proBNP levels may infer the ischemic etiology especially in patients with normal LVEF in the early phases of AHF hospitalization.
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Affiliation(s)
- Ya-Ru Zheng
- Department of Cardiology, Zhejiang Provincial People's Hospital, China
| | - Li-Fang Ye
- Department of Cardiology, Zhejiang Provincial People's Hospital, China
| | - Xue-Jiang Cen
- Department of Cardiology, Zhejiang Provincial People's Hospital, China
| | - Jing-Yang Lin
- Department of Cardiology, Zhejiang Provincial People's Hospital, China
| | - Jian-Wei Fu
- Department of Cardiology, Zhejiang Provincial People's Hospital, China
| | - Li-Hong Wang
- Department of Cardiology, Zhejiang Provincial People's Hospital, China.
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Wang X, Mu G, Dang R, Yang Z. Up-regulation of IL-10 upon PRRSV vaccination impacts on the immune response against CSFV. Vet Microbiol 2016; 197:68-71. [PMID: 27938685 DOI: 10.1016/j.vetmic.2016.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
Abstract
Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) infection negatively impacts the efficacy of classical swine fever virus (CSFV) vaccine. This paper investigates whether the PRRSV vaccine also impacts the CSFV vaccine and if the impact is time-related. Forty-eight piglets born from four sows were divided into five groups (G1-G5). The piglets in G1 to G4 were given PRRSV vaccine at 14, 21, 28 and 35days of age. The G5 group was not vaccinated with the PRRSV. All pigs were given the CSFV vaccine at 35days of age. Immune responses to the CSFV vaccine were evaluated by testing CSFV-specific sera antibodies, lymphocyte proliferation and cytokine secretion. The results demonstrate that the PRRSV vaccine significantly reduces the immune responses of the CSFV vaccination when immunised both vaccines at the same time or with only a one week interval. The PRRSV vaccination induced higher levels of IL-10 expression in the first week and this may be why the CSFV vaccination is immunosuppressed. The findings indicate that a time interval of more than one week is necessary for vaccinated CSF after the PRRSV immunisation.
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Affiliation(s)
- Xinglong Wang
- College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China.
| | - Guohui Mu
- College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China
| | - Ruiyi Dang
- College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China
| | - Zengqi Yang
- College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China.
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Coelho S, Guerreiro M, Chester C, Silva D, Maroco J, Coelho M, Paglieri F, de Mendonça A. Time Perception in Mild Cognitive Impairment: Interval Length and Subjective Passage of Time. J Int Neuropsychol Soc 2016; 22:755-64. [PMID: 27459378 DOI: 10.1017/S1355617716000606] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Patients with mild cognitive impairment (MCI) may have difficulties in time perception, which in turn might contribute to some of their symptoms, especially memory deficits. The aim of this study was to evaluate perception of interval length and subjective passage of time in MCI patients as compared to healthy controls. METHODS Fifty-five MCI patients and 57 healthy controls underwent an experimental protocol for time perception on interval length, a questionnaire for the subjective passage of time and a neuropsychological evaluation. RESULTS MCI patients presented no changes in the perception of interval length. However, for MCI patients, time seemed to pass more slowly than it did for controls. This experience was significantly correlated with memory deficits but not with performance in executive tests, nor with complaints of depression or anxiety. CONCLUSIONS Memory deficits do not affect the perception of interval length, but are associated with alterations in the subjective passage of time. (JINS, 2016, 22, 755-764).
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Louvel G, Metellus P, Noel G, Peeters S, Guyotat J, Duntze J, Le Reste PJ, Dam Hieu P, Faillot T, Litre F, Desse N, Petit A, Emery E, Voirin J, Peltier J, Caire F, Vignes JR, Barat JL, Langlois O, Menei P, Dumont SN, Zanello M, Dezamis E, Dhermain F, Pallud J. Delaying standard combined chemoradiotherapy after surgical resection does not impact survival in newly diagnosed glioblastoma patients. Radiother Oncol 2016; 118:9-15. [PMID: 26791930 DOI: 10.1016/j.radonc.2016.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 01/02/2016] [Accepted: 01/03/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND To assess the influence of the time interval between surgical resection and standard combined chemoradiotherapy on survival in newly diagnosed and homogeneously treated (surgical resection plus standard combined chemoradiotherapy) glioblastoma patients; while controlling confounding factors (extent of resection, carmustine wafer implantation, functional status, neurological deficit, and postoperative complications). METHODS From 2005 to 2011, 692 adult patients (434 men; mean of 57.5 ± 10.8 years) with a newly diagnosed glioblastoma were enrolled in this retrospective multicentric study. All patients were treated by surgical resection (65.5% total/subtotal resection, 34.5% partial resection; 36.7% carmustine wafer implantation) followed by standard combined chemoradiotherapy (radiotherapy at a median dose of 60 Gy, with daily concomitant and adjuvant temozolomide). Time interval to standard combined chemoradiotherapy was analyzed as a continuous variable and as a dichotomized variable using median and quartiles thresholds. Multivariate analyses using Cox modeling were conducted. RESULTS The median progression-free survival was 10.3 months (95% CI, 10.0-11.0). The median overall survival was 19.7 months (95% CI, 18.5-21.0). The median time to initiation of combined chemoradiotherapy was 1.5 months (25% quartile, 1.0; 75% quartile, 2.2; range, 0.1-9.0). On univariate and multivariate analyses, OS and PFS were not significantly influenced by time intervals to adjuvant treatments. On multivariate analysis, female gender, total/subtotal resection and RTOG-RPA classes 3 and 4 were significant independent predictors of improved OS. CONCLUSIONS Delaying standard combined chemoradiotherapy following surgical resection of newly diagnosed glioblastoma in adult patients does not impact survival.
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Affiliation(s)
- Guillaume Louvel
- Department of Radiation Oncology, INSERM 1030 "Molecular Radiotherapy", Gustave Roussy, Gustave Roussy Cancer Campus, Villejuif, France.
| | - Philippe Metellus
- Department of Neurosurgery, Clairval Private Hospital, Marseille, France; UMR911, CRO2, Aix-Marseille Université, France
| | - Georges Noel
- Department of Radiotherapy, Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France; Radiobiology Laboratory, Federation of Translationnal Medicine de Strasbourg (FMTS), Strasbourg University, France
| | - Sophie Peeters
- Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, France
| | - Jacques Guyotat
- Lyon Civil Hospitals, Pierre Wertheimer Neurological and Neurosurgical Hospital, Service of Neurosurgery D, France
| | - Julien Duntze
- Department of Neurosurgery, Maison Blanche Hospital, Reims University Hospital, France
| | | | - Phong Dam Hieu
- Department of Neurosurgery, University Medical Center, Faculty of Medicine, University of Brest, France
| | - Thierry Faillot
- Department of Neurosurgery, APHP Beaujon Hospital, Clichy, France
| | - Fabien Litre
- Department of Neurosurgery, Maison Blanche Hospital, Reims University Hospital, France
| | - Nicolas Desse
- Department of Neurosurgery, Sainte Anne Military Teaching Hospital, Toulon, France
| | - Antoine Petit
- Department of Neurosurgery, University Hospital Jean Minjoz, Besançon, France
| | - Evelyne Emery
- Departement of Neurosurgery, University Hospital of Caen, University of Lower Normandy, France
| | - Jimmy Voirin
- Department of Neurosurgery, Pasteur Hospital, Colmar, France
| | - Johann Peltier
- Department of Neurosurgery, Amiens University Hospital, France
| | | | | | - Jean-Luc Barat
- Department of Neurosurgery, Clairval Private Hospital, Marseille, France
| | | | | | - Sarah N Dumont
- Department of Neurooncology, Gustave Roussy, Villejuif, France
| | - Marc Zanello
- Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, France
| | - Edouard Dezamis
- Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, France
| | - Frédéric Dhermain
- Department of Radiation Oncology, INSERM 1030 "Molecular Radiotherapy", Gustave Roussy, Gustave Roussy Cancer Campus, Villejuif, France
| | - Johan Pallud
- Department of Neurosurgery, Sainte-Anne Hospital, Paris, France; Paris Descartes University, France
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Kim TK, Kim HW, Kim SJ, Ha JK, Jang HH, Hong YM, Park SB, Choi CW, Kang DH. Importance of the time interval between bowel preparation and colonoscopy in determining the quality of bowel preparation for full-dose polyethylene glycol preparation. Gut Liver 2014; 8:625-31. [PMID: 25368750 PMCID: PMC4215448 DOI: 10.5009/gnl13228] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/30/2013] [Accepted: 10/17/2013] [Indexed: 01/14/2023] Open
Abstract
Background/Aims The quality of bowel preparation (QBP) is the important factor in performing a successful colonoscopy. Several factors influencing QBP have been reported; however, some factors, such as the optimal preparation-to-colonoscopy time interval, remain controversial. This study aimed to determine the factors influencing QBP and the optimal time interval for full-dose polyethylene glycol (PEG) preparation. Methods A total of 165 patients who underwent colonoscopy from June 2012 to August 2012 were prospectively evaluated. The QBP was assessed using the Ottawa Bowel Preparation Scale (Ottawa) score according to several factors influencing the QBP were analyzed. Results Colonoscopies with a time interval of 5 to 6 hours had the best Ottawa score in all parts of the colon. Patients with time intervals of 6 hours or less had the better QBP than those with time intervals of more than 6 hours (p=0.046). In the multivariate analysis, the time interval (odds ratio, 1.897; 95% confidence interval, 1.006 to 3.577; p=0.048) was the only significant contributor to a satisfactory bowel preparation. Conclusions The optimal time was 5 to 6 hours for the full-dose PEG method, and the time interval was the only significant contributor to a satisfactory bowel preparation.
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Affiliation(s)
- Tae Kyung Kim
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyung Wook Kim
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su Jin Kim
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jong Kun Ha
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyung Ha Jang
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young Mi Hong
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su Bum Park
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Cheol Woong Choi
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Dae Hwan Kang
- Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine, and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Tian HH, Wang HF, Zhang JR, Ayiguli·Hare, Yisikandaer·Abulimiti. Impact of interval between preoperative chemotherapy and surgery on therapeutic effects in patients with stage ⅢA and ⅢB rectal cancer. Shijie Huaren Xiaohua Zazhi 2014; 22:3918-3924. [DOI: 10.11569/wcjd.v22.i26.3918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess whether the time interval between neoadjuvant chemoradiotherapy and surgery affects the pathologic complete response (pCR) rate, disease-free survival (DFS), disease recurrence and overall survival (OS) in patients with stage ⅢA and ⅢB rectal cancer.
METHODS: We retrospectively studied 93 patients diagnosed with stage ⅢA and ⅢB rectal cancer by pathological examination who underwent neoadjuvant therapy followed by total mesorectal excision (TME) between March 2009 and March 2011 at our hospital. They were divided into two groups according to the interval between neoadjuvant therapy and surgery: A (≤7 wk, n = 49) and B (>7 wk, n = 44). The primary endpoints were reported as pCR rate, DFS, disease recurrence and OS. Secondary endpoints were type of surgery, postoperative complications, operative time and length of hospital stay.
RESULTS: The overall pCR rate was 10.75% (pCR: group A vs group B, 8.2% vs 13.6%; P = 0.027), and the overall 3-year DFS was 39.8% (DFS: group A vs group B, 28.6% vs 52.3%; P = 0.013). Disease recurrence was 20.4% in group A vs 4.5% in group B (P = 0.023). There were no significant differences in OS, type of surgery, postoperative complications, operative time or length of hospital stay between the two groups.
CONCLUSION: A neoadjuvant-surgery interval > 7 wk increases the rates of pCR and DFS and decreases disease recurrence in patients with stage ⅢA and ⅢB rectal cancer, with no effect on type of surgery, postoperative complications, operative time, length of hospital stay or oncologic outcome.
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