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Κυριακή 27 Νοεμβρίου 2022

Καρκίνος του Στομάχου – Νεώτερα Δεδομένα

[PDF] Καρκίνος του στομάχου


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Αλέξανδρος Γ. Σφακιανάκης
Αναπαύσεως 5 Άγιος Νικόλαος Λασιθίου 72100
2841026182

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Τομογραφία Εκπομπής Ποζιτρονίων (PET) και υβριδικά συστήματα PET-ΜRI

[PDF] Τομογραφία εκπομπής ποζιτρονίων (PET) και υβριδικά συστήματα PET-MRI


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Αλέξανδρος Γ. Σφακιανάκης
Αναπαύσεως 5 Άγιος Νικόλαος Λασιθίου 72100
2841026182
00306932607174
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Early warning signals for Omicron outbreaks

alexandrossfakianakis shared this article with you from Inoreader

Abstract

The Omicron variant has become the dominant COVID-19 variant worldwide due to its rapid and cryptic spread; therefore, successful early warning is of great importance to be able to control epidemics in their early phase, before developing into large outbreaks. COVID-19-related Baidu search index, which reflects human behavior to a certain degree, was used to retrospectively detect the warning signs for Omicron variant outbreaks in China in 2022. The characteristics and effects of warning signs were analyzed in detail. We detected the presence of early warning signs (both high and low thresholds) and found that these occurred 4–7 days earlier than traditional epidemiological surveillance and >20 days earlier than the implementation of the local "lockdown" policy. Compared with the "high threshold" warning, the early warning effect of the "low threshold" is also vital because it indicates a complacency about epidemic prevention and control. Ho wever, there is obvious heterogeneity in the optimal threshold for detecting early warning signs and their distribution in different cities. Multi-source and multi-point early warning systems should be established via combining internet-based big data in the future to conduct effective and early real-time warning. This would create precious time for the early control of COVID-19 outbreaks.

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Salvage treatments for locally recurrent nasopharyngeal cancer: A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader

Abstract

The present study aimed to evaluate the effectiveness and safety of various salvage treatments to treat locally recurrent nasopharyngeal carcinoma (IrNPC). A comprehensive search was conducted to gather relevant research publications on salvage treatment for IrNPC. Specifically, 2-, 3-, and 5-year overall survival were the primary outcome. A total of 89 studies with 101 cohorts were collected. Endoscopic nasopharyngectomy was found to be associated with a significantly improved 5-year OS compared with CRT (p = 0.027) and IMRT (p = 0.016). Moreover, based on recurrence T classification, the 2-, 3-, and 5-year OS were similar across different treatments. Endoscopic nasopharyngectomy was associated with a significant reduction in treatment-related complications (grade ≥ 3) compared with IMRT (p < 0.001) and open nasopharyngectomy (p = 0.028). Endoscopic nasopharyngectomy may provide comparable treatment outcomes t o re-irradiation, while offering a better safety profile for selective patients with resectable IrNPC.
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Hepatic Artery Infusion Pumps: A Surgical Toolkit for Intraoperative Decision-Making and Management of Hepatic Artery Infusion-Specific Complications

alexandrossfakianakis shared this article with you from Inoreader
imageBackground: Hepatic artery infusion (HAI) is a liver-directed therapy that delivers high-dose chemotherapy to the liver through the hepatic arterial system for colorectal liver metastases and intrahepatic cholangiocarcinoma. Utilization of HAI is rapidly expanding worldwide. Objective and Methods: This review describes the conduct of HAI pump implantation, with focus on common technical pitfalls and their associated solutions. Perioperative identification and management of common postoperative complications is also described. Results: HAI therapy is most commonly performed with the surgical implantation of a subcutaneous pump, and placement of its catheter into the hepatic arterial system for inline flow of pump chemotherapy directly to the liver. Intraoperative challenges and abnormal hepatic perfusion can arise due to aberrant anatomy, vascular disease, technical or patient factors. However, solutions to prevent or overcome technical pitfalls are present for the majority of cases. Postoperative HAI-specific complications arise in 22% to 28% of patients in the form of pump pocket (8%–18%), catheter (10%–26%), vascular (5%–10%), or biliary (2%–8%) complications. The majority of patients can be rescued from these complications with early identification and aggressive intervention to continue to deliver safe and effective HAI therapy. Conclusions: This HAI toolkit provides the HAI team a reference to manage commonly encountered HAI-specific perioperative obstacles and complications. Overcoming these challenges is critical to ensure safe and effective pump implantation and delivery of HAI therapy, and key to successful implementation of new programs and expansion of HAI to patients who may benefit from such a highly specialized treatment strategy.
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Enteral nutrition support and treatment toxicities in patients with head and neck cancer receiving definitive or adjuvant helical intensity‐modulated radiotherapy with concurrent chemotherapy

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Enteral nutrition (EN) is often required in patients with head and neck cancer (HNSCC); however, initiation criteria is limited or inconsistent. This study aimed to describe the relationship of treatment toxicities and requirement for EN and investigate toxicity and baseline characteristics association with EN duration.

Methods

Acute toxicities and baseline characteristics were collected from patients with HNSCC (n = 110) undergoing H-IMRT. Percentage EN contributing to estimated requirements and EN duration were measured.

Results

The threshold for patients needing ≥50% of estimated requirements via EN increased from week 3 to 4 for grade ≥2 oral/pharyngeal mucositis, dysgeusia, thick saliva and nausea, and for grade 3 dysphagia. Patients with grade 2–3 dysphagia had a reduced risk of ceasing EN compared to those with grade 0–1 dysphagia.

Conclusions

Using acute toxicities in clinical practice may be a useful tool to inform prompt initiation of EN prior to decline in nutritional status and anticipate EN duration.
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Preferential looking to eyes versus mouth in early infancy: heritability and link to concurrent and later development

alexandrossfakianakis shared this article with you from Inoreader

Background

From birth, infants orient preferentially to faces, and when looking at the face, they attend primarily to eyes and mouth. These areas convey different types of information, and earlier research suggests that genetic factors influence the preference for one or the other in young children.

Methods

In a sample of 535 5-month-old infant twins, we assessed eye (relative to mouth) preference in early infancy, i.e., before neural systems for social communication and language are fully developed. We investigated the contribution of genetic and environmental factors to the preference for looking at eyes, and the association with concurrent traits and follow-up measures.

Results

Eye preference was independent from all other concurrent traits measured, and had a moderate-to-high contribution from genetic influences (A = 0.57; 95% CI: 0.45, 0.66). Preference for eyes at 5 months was associated with higher parent ratings of receptive vocabulary at 14 months. No statistically significant association with later autistic traits was found. Preference for eyes was strikingly stable across different stimulus types (e.g., dynamic vs. still), suggesting that infants' preference at this age does not reflect sensitivity to low-level visual cues.

Conclusions

These results suggest that individual differences in infants' preferential looking to eyes versus mouth to a substantial degree reflect genetic variation. The findings provide new leads on both the perceptual basis and the developmental consequences of these attentional biases.
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Three‐dimensional evaluation of sleep bruxism‐related splint wear using a dental laboratory scanner: a preliminary clinical study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background:

The wear depth on the occlusal splint (OS) is reportedly associated with the sleep bruxism (SB) level, as evaluated using portable polysomnography (PSG) recordings. However, the OS is deformed owing to SB forces, possibly preventing the accurate quantification of the wear facets.

Objectives:

To introduce a newly developed system to quantify the wear facets on the OS using a dental laboratory scanner (D810) and investigate the association between the wear facets, as evaluated with this system, and the SB level.

Methods:

Ten healthy individuals who were diagnosed with SB based on portable PSG recordings participated in this study. They were asked to wear the OS for 2 months. The first day after a 2-week adaptation period was defined as the reference day, and sequential scanning of the OS surface was performed on days 15, 30, and 45. Changes in the OS surface from the reference day allowed dimensional evaluation of the wear facets in terms of the maximum wear depth, wear area, and wear volume. Multiple regression analyses were conducted to test whether each of these variables could be predicted by any of the SB-related variables.

Results:

The total duration of SB episodes per hour of sleep and the maximum muscle activity were significantly associated with the wear area, as measured with our system (adjusted R-squared was 0.78, p < 0.01).

Conclusion:

Our system allows dimensional analysis of the wear facets on the OS surface in association with the SB level.
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Splith mouth randomized control trial comparison of T‐PRF and subepithelial connective tissue graft in the treatment of maxillar multiple gingival recessions

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

The aim of this study is to compare the treatment efficacy of the bilateral multiple gingival recession areas with a titanium-platelet-rich-fibrin (T-PRF) and subepithelial connective tissue graft (SCTG) combined with a modified coronal advanced flap (MCAF) and the clinical results.

Method

In the study, 118 maxillary bilateral multiple Miller I recessions were treated. Gingival index, plaque index, probing pocket depth, gingival thickness, recession height, recession width, keratinized gingival width and open root surface area were measured at baseline and at 6 months. Postoperative pain levels Visual Analog Scale, healing status, wound healing index evaluated with. The results of both groups pre and postoperative were compared.

Results

The initial recession height was 2.15 ± 1.0 mm in the T-PRF group; 2.04 ± 0.80 mm in the SCTG group. After 6 months, the mean root closure rate was 61.77%, 75.31% in T-PRF and SCTG group, respectively. Clinical attachment gain was achieved in both groups compared to baseline. When the results were compared, the gains achieved in the SCTG group were statistically significantly higher. İt was determined that patient satisfaction was higher in T-PRF group and wound healing was faster.

Conclusion

Considering the advantages of T-PRF such as providing effective results in the treatment of defects, patient satisfaction and rapid recovery; It can be applied as an alternative to SCTG.

Clinical Significance

T-PRF can be an alternative to SCTG in the treatment of gingival recessions.
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Human Endogenous Retroviruses in Cancer: Oncogenesis mechanisms and Clinical Implications

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Human Endogenous Retroviruses (HERVs) are viral sequences integrated into the human genome, resulting from the infection of human germ-line cells by ancient exogenous retroviruses. Despite losing their replication and retrotransposition abilities, HERVs appear to have been co-opted in human physiological functions while their aberrant expression is linked to human disease. The role of HERVs in multiple malignancies has been demonstrated, however, the extent to which HERV activation and expression participate in the development of cancer is not yet fully comprehended. In this review article, we discuss the presumed role of HERVs in carcinogenesis and their promising diagnostic and prognostic implications. Additionally, we explore recent data on the HERVs in cancer therapeutics, either through the manipulation of their expression, to induce anti-tumor innate immunity responses or as cancer immunotherapy targets. Finally, more precise and higher resolution high -throughput sequencing approaches will further elucidate HERV participation in human physiological and pathological processes.

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Prognostic significance of circulating Epstein‐Barr virus DNA in pulmonary lymphoepithelioma‐like carcinoma: a meta‐analysis and validation study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

In small-scale studies, circulating Epstein-Barr virus (EBV) DNA levels have prognostic value in patients with pulmonary lymphoepithelioma-like carcinoma (LELC). Therefore, we performed a comprehensive meta-analysis to evaluate the prognostic significance of circulating EBV DNA levels in patients with pulmonary LELC.

Methods

Studies that discussed the prognostic significance of circulating EBV DNA detection in pulmonary LELC were eligible for inclusion in this study. The overall survival (OS) and progression-free survival (PFS) were the primary outcomes. Pooled hazard ratio (HR), 95% confidence intervals (CIs), and P-value were calculated to estimate the prognostic significance of EBV DNA levels. Additionally, we conducted a further observation using an independent cohort.

Results

The pooled HR and 95% CI of pre-treatment EBV DNA levels for OS and PFS were 3.63 (95% CI: 2.90–4.55) and 2.88 (95% CI: 1.90–4.38), respectively. The pooled HR and 95% CI for post-treatment EBV DNA levels for OS and PFS were 3.77 (95% CI: 2.96–4.80) and 3.52 (95% CI: 1.91–6.51, P<0.001), respectively. The independent cohort showed similar results that patients with high pre-treatment EBV DNA or positive post-treatment EBV DNA had significantly inferior PFS.

Conclusion

Circulating EBV DNA levels provide prognostic values of survival and treatment response in pulmonary LELC patients.

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Survival outcomes for patients with T3N0M0 squamous cell carcinoma of the glottis treated with definitive radiation alone versus chemoradiation

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Given the poor lymphatics of the glottis, we evaluated omission of chemotherapy in patients treated definitely for T3N0M0 squamous cell carcinoma (SCC) of the glottis.

Methods

We performed survival analysis of patients with T3N0M0 SCC of the glottis identified in the National Cancer Database treated with radiation alone versus chemoradiation.

Results

A total of 3785 patients were identified. Patients age ≥70 and those with comorbidities were less likely to receive chemotherapy (odds ratio [OR] 0.30, 95% CI [0.25–0.37] and 0.48 [0.31–0.76], respectively). Five-year OS was lower in patients treated with radiation versus chemoradiation (33.8% [30.3%–37.2%] vs. 58.0% [55.8%–60.0%]). In patients <70 with no comorbidities this difference persisted (51.0% [44.5%–57.0%] versus 66.7% [64.0%–69.3%]).

Conclusion

Overall survival was higher in patients treated with chemoradiation compared to radiation alone, even when controlling for age and comorbidities. Radiotherapy with chemotherapy omission is not appropriate in patients with T3N0M0 SCC of the glottis.
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