Sleep Disturbances in Lung Cancer Patients Assigned to Definitive or Adjuvant Irradiation

xlomafota13 shared this article with you from Inoreader Sleep Disturbances in Lung Cancer Patients Assigned to Definitive or Adjuvant Irradiation Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3333-3337. doi: 10.21873/invivo.12630. ABSTRACT BACKGROUND/AIM: A considerable number of patients with lung cancer are scheduled for definitive or adjuvant radiotherapy. Prevalence and potential risk factors of pre-radiotherapy sleep disturbances were evaluated. PATIENTS AND METHODS: Nineteen factors were retrospectively investigated for associations with pre-radiotherapy sleep disturbances in 77 lung cancer patients. Factors included COVID-19 pandemic; age; gender; performance score; comorbidity index; history of another malignancy; distress score; number of emotional, physical or practical problems; patient's request for psychological support; histology; tumor stage; upfront surgery; chemotherapy; and type of radiotherapy. RESULTS: Thirty-one patients (40.3%) reported sleep disturbances that were significantly associated with distress score 6-10 (p=0.019), ≥2 emotional problems (p=0.001), ≥ 5 physical problems (p<0.001), and request for psychological support (p=0.006). Trends were found for female gender (p=0.064) and stereotactic body radiation therapy (p=0.057). CONCLUSION: Many lung cancer patients assigned to radiotherapy reported sleep disturbances. Risk factors can be used to identify patients in need of psychological support already before treatment. PMID:34697166 | DOI:10.21873/invivo.12630 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of a Specialized Outpatient Clinic on Bone Metastasis and Its Burden on Spine Surgeons

xlomafota13 shared this article with you from Inoreader Impact of a Specialized Outpatient Clinic on Bone Metastasis and Its Burden on Spine Surgeons Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3575-3579. doi: 10.21873/invivo.12661. ABSTRACT BACKGROUND/AIM: It is important to perform early intervention on bone metastases using multidisciplinary approaches, however it is difficult to hold frequent meetings between patients and clinicians. We aimed to evaluate the usefulness of a specialized outpatient clinic on bone metastasis, instead of the multidisciplinary approach currently in practice. PATIENTS AND METHODS: We included 31 patients with vertebral metastases of various carcinomas, undergoing surgical treatment by spine surgeons. We divided the patients into two groups before and after their visit to the specialized outpatient clinic (pre and post groups), and compared their clinical characteristics. RESULTS: The post group demonstrated a longer period from consulting the spine surgeon to the surgery than the pre group (p=0.0129). A multivariate logistic regression analysis revealed t hat the period from spine surgeon consultation to surgery was significantly associated with a specialized outpatient clinic visit (p=0.0460). CONCLUSION: Specialized outpatient clinics on bone metastasis could possibly reduce the burden on spinal surgeons. PMID:34697197 | DOI:10.21873/invivo.12661 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tumour Markers in the Differential Diagnosis of Patients With Isolated Involuntary Weight Loss

xlomafota13 shared this article with you from Inoreader Tumour Markers in the Differential Diagnosis of Patients With Isolated Involuntary Weight Loss Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3361-3367. doi: 10.21873/invivo.12634. ABSTRACT BACKGROUND/AIM: Paraneoplastic syndrome symptoms include isolated involuntary weight loss (IIWL). The differential diagnosis of cancer from other diseases may require a significant number of tests. Tumour markers (TMs) can be used for the diagnosis and stratification of patients according to cancer risk. PATIENTS AND METHODS: This study included 606 patients (48% females) seen at the rapid diagnostic unit for IIWL. We determined the levels of TMs carcinoembryonic antigen, carbohydrate antigen 19-9, soluble fragments of cytokeratin 19, carbohydrate antigen 15-3, carbohydrate antigen 125, neuron specific enolase, alpha-fetoprotein, prostatic specific antigen using the multiparametric analyser COBAS 601. Two cut-off points were established, the upper reference limit described by the manufacturer and a high cut-off point suggested by Molina et al., to stratif y patients according to cancer risk. RESULTS: Patients were classified according to TM levels as follows: I) all TMs below the upper reference limit; II) highest number of TMs between the two cut-offs; III) at least one TM above the higher cut-off. The odds ratio for malignancy was 4.3 for group II and 248 for group III. These results indicate that when at least one TM is above the higher cut-off, neoplasia is highly probable. CONCLUSION: TM determination allowed to establish cancer risk in patients with IIWL. PMID:34697170 | DOI:10.21873/invivo.12634 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sella Turcica Shape in Fragile X Syndrome

xlomafota13 shared this article with you from Inoreader <em>Sella Turcica</em> Shape in Fragile X Syndrome Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3581-3584. doi: 10.21873/invivo.12662. ABSTRACT BACKGROUND: Fragile X syndrome (FXS) is a relatively common syndrome with numerous, multifaceted, and often unremarkable findings. Psychic alterations are at the forefront of treatment needs. Previous studies have provided evidence for an unusual sella turcica in some patients with FXS. This report adds to the up to now sparse findings on sella morphology in FXS. CASE REPORT: The young patient with genetically confirmed FXS was treated for a mandibular tumor. Cone beam tomography of the skull revealed a prominent sella turcica with flat tuberculum sellae and steep clivus. CONCLUSION: Unusual sella turcica formations can be observed in FXS. A correlation with other discreet changes of FXS-related skeletal development is likely. PMID:34697198 | DOI:10.21873/invivo.12662 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Paclitaxel and Carboplatin Versus Cisplatin and 5-Fluorouracil in Concurrent Chemoradiotherapy in Patients With Esophageal Cancer

xlomafota13 shared this article with you from Inoreader Paclitaxel and Carboplatin <em>Versus</em> Cisplatin and 5-Fluorouracil in Concurrent Chemoradiotherapy in Patients With Esophageal Cancer Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3391-3399. doi: 10.21873/invivo.12638. ABSTRACT BACKGROUND/AIM: Cisplatin with 5-fluouracil (Cis/5Fu) and paclitaxel with carboplatin (Pac/Car) are common regimens used in concurrent chemoradiotherapy (CCRT) for patients with locally advanced esophageal cancer (EC). Here, we aimed to compare the survival outcomes and treatment-related toxicities between these regimens in neoadjuvant CCRT in patients with locally advanced EC. PATIENTS AND METHODS: One hundred and thirty-six patients with locally advanced EC (98% squamous cell carcinoma) were prospectively recruited between 2016 and 2017 in a non-randomized manner. Patients were categorized into two groups according to the chemotherapeutic agents administered (Pac/Car group, n=87; Cis/5Fu group, n=47) in CCRT to compare the survival outcome and severe adverse event (sAE) incidence. RESULTS: Forty-two patients (85.7%) and 80 patients (91.4%) in the Cis/5Fu and Pac/Car groups completed pre-planned CCRT (p=0.26), respectively. The Cis/5Fu group presented a higher incidence of non-hematological sAE than the Pac/Car group (69.45% vs. 51.7%, p=0.049). Patients in the Pac/Car group showed a higher rate of surgical resection than those in the Cis/5Fu group (49.4% vs. 22.4%, p<0.001). After a median follow-up duration of 22.0 months (range=1.9-31.8), the 2-year survival rate was 56.9% for patients in the Pac/Car group and 28.7% for the Cis/5Fu group. The hazard ratio (HR) of overall survival was 0.45 (95%CI=0.28-0.72, p=0.001) in the comparison between the groups. CONCLUSION: Overall, neoadjuvant CCRT with Pac/Car is associated with a better survival outcome, higher surgical resection rate, and better safety profiles than Cis/5Fu in patients with locally advanced EC. PMID:34697174 | DOI:10.21873/invivo.12638 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three Cases of Nivolumab Plus Ipilimumab Therapy in Haemodialysis Patients With Metastatic Renal Cell Carcinoma

xlomafota13 shared this article with you from Inoreader Three Cases of Nivolumab Plus Ipilimumab Therapy in Haemodialysis Patients With Metastatic Renal Cell Carcinoma Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3585-3589. doi: 10.21873/invivo.12663. ABSTRACT BACKGROUND: Although the CheckMate 214 trial affirmed the effectiveness of nivolumab-ipilimumab combination therapy in advanced or metastatic renal cell carcinoma (mRCC), its safety and efficacy in patients with end-stage renal disease (ESRD) on haemodialysis remains unexplored. CASE REPORT: All patients were male and underwent mRCC treatment with partial nephrectomy or nephrectomy. They had ESRD and were undergoing haemodialysis. Cases 1 and 2 showed lymph node and lung metastases after initial surgery and received nivolumab-ipilimumab therapy. Case 1 had grade 3 adrenal insufficiency after four courses, which was controlled with steroids. Case 2 did not experience adverse events. Both were well controlled with complete (CR) or partial response (PR). Case 3 suffered local recurrence after nephrectomy and received combination therapy. Grade 3 adrenal insu fficiency occurred following three courses, and tumour size did not change remarkably. CONCLUSION: Nivolumab-ipilimumab combination therapy can effectively treat mRCC patients with ESRD undergoing haemodialysis. PMID:34697199 | DOI:10.21873/invivo.12663 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Malignant Struma Ovarii Τreated With Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

xlomafota13 shared this article with you from Inoreader Malignant Struma Ovarii Τreated With Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3591-3596. doi: 10.21873/invivo.12664. ABSTRACT BACKGROUND/AIM: Malignant struma ovarii is an extremely rare tumor entity among ovarian tumors. In the presence of ascites and peritoneal metastases, the preoperative appearance may resemble the most common epithelial ovarian carcinoma (EOC) and accordingly, the surgical therapy may be identical if a preoperative histology diagnosis is not possible. The objective of this case report is to present a patient with histopathologically confirmed malignant struma ovarii who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) with the aim of complete tumor resection. CASE REPORT: This study reports on a patient with preoperatively proven peritoneal metastasis of an 18 cm ovarian tumor with large struma ovarii and papillary thyroid carcinoma within the struma, who was treated with CRS and HIPEC after neoadjuvant chemother apy. CONCLUSION: This disease has a significantly better prognosis than EOC, however, HIPEC could provide an additional effect in examining the presence of peritoneal metastasis. PMID:34697200 | DOI:10.21873/invivo.12664 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Cause of Massive Hematuria: Placenta Percreta With Bladder Invasion

xlomafota13 shared this article with you from Inoreader A Rare Cause of Massive Hematuria: Placenta Percreta With Bladder Invasion Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3633-3639. doi: 10.21873/invivo.12670. ABSTRACT BACKGROUND/AIM: Placenta percreta is a rare event, but it poses serious problems due to potential hemorrhagic events. We report a particular case of placenta percreta with massive hematuria due to maternal bladder invasion, and describe the surgical protocol performed that resulted in an excellent outcome. CASE REPORT: A 33-year-old patient, at 27th weeks gestational age, presented in the emergency room of the Urology Department with urinary blood clot acute retention, because of massive hematuria from a placenta percreta with bladder invasion. After extracting the clots from the bladder, and coagulation of an area of venous ectasies of the posterior wall, hematuria ceased, but appeared after two days, necessitating again the bladder clots removal and coagulation. A surgical team with gynecologists, urologists, anesthesiologists and a neonatolo gist was composed, and after bilateral ureteral double J insertion, cesarean section was performed followed by hemostatic hysterectomy and partial cystectomy, bilateral internal iliac artery ligature and repair of the bladder wall. The postoperative evolution was without incidents; the Foley catheter was removed in the 14th postoperative day. CONCLUSION: In the context of a massive hematuria of a pregnant woman, the urologist must always consider a diagnosis of complicated placenta percreta. PMID:34697206 | DOI:10.21873/invivo.12670 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Supraclavicular Artery Flap for Oral Reconstruction Prior to Esophagectomy During the COVID-19 Pandemic: A Case Report

xlomafota13 shared this article with you from Inoreader Supraclavicular Artery Flap for Oral Reconstruction Prior to Esophagectomy During the COVID-19 Pandemic: A Case Report Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3597-3601. doi: 10.21873/invivo.12665. ABSTRACT BACKGROUND: During the coronavirus disease 2019 (COVID19) pandemic, pedicle flaps (instead of free flaps) were recommended for reconstruction following wide resection for patients with head and neck cancer, in order to reduce the use of medical resources. Currently, there are no established treatment guidelines for patients with head and neck cancer with synchronous esophageal cancer. CASE REPORT: We present a 68-year-old male with cT4aN2cM0 oral floor and synchronous cT1bN1M0 esophageal cancers who had defective reconstruction following oral tumor resection before esophagectomy during the pandemic. At the initial surgery, the oral resected defect was reconstructed using supraclavicular artery flap. The subsequent esophagectomy was reconstructed by gastric tube reconstruction. Both postoperative courses were successful, without the need for postoperative ventilator use. The days from initial or second surgery to discharge were 14 or 16 days, respectively. CONCLUSION: This case had achieved negative surgical margins and recovered oral intake with tracheostomy decannulation. Further case accruement using supraclavicular artery flap is required for patients with head and neck cancer and synchronous esophageal cancer. PMID:34697201 | DOI:10.21873/invivo.12665 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Role of Diagnostic Management in COVID-19 Screening of Asymptomatic Patients Admitted for Elective Surgery

xlomafota13 shared this article with you from Inoreader The Role of Diagnostic Management in COVID-19 Screening of Asymptomatic Patients Admitted for Elective Surgery Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3321-3323. doi: 10.21873/invivo.12628. ABSTRACT BACKGROUND: Due to the high risk of COVID-19 transmission by asymptomatic patients, the aim of this study was to evaluate chest computed tomography (CT) and blood differential test as an additional COVID-19 screening tool for patients undergoing elective or urgent surgery. PATIENTS AND METHODS: The preoperative assessment of 118 patients hospitalized from June to July 2020 included real-time reverse transcriptase polymerase chain reaction RNA test before elective surgery or rapid antigen test in emergency patients. The diagnostics were supplemented by chest CT and a complete blood count with a blood smear in all patients. RESULTS: None of the hospitalized patients had molecular, serological or radiographic symptoms of COVID-19 infection. The chest CT revealed non-COVID-19 pathologies in a total of 48 patients. Leukocytosis and lymphopenia were typic al of emergency patients. CONCLUSION: Routine chest CT scans have no benefit in screening for potential COVID-19 changes in asymptomatic patients. Blood differential tests are readily available, which makes them more helpful in COVID-19 screening. PMID:34697164 | DOI:10.21873/invivo.12628 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epidermal Growth Factor Is Increased in Conjunctival Malignant Melanoma

xlomafota13 shared this article with you from Inoreader Epidermal Growth Factor Is Increased in Conjunctival Malignant Melanoma Via In vivo (Athens, Greece) In Vivo. 2021 Nov-Dec;35(6):3603-3612. doi: 10.21873/invivo.12666. ABSTRACT BACKGROUND/AIM: Conjunctival malignant melanoma (CMM) is a rare, but very aggressive tumor with a high metastasis rate. Not much is known about the CMM metastasis mechanisms. So far, epidermal growth factor (EGF) and its receptor (EGF-R) as well as macrophages and matrix metalloproteinase 9 (MMP-9) have been reported to lead to metastasis by epithelial-mesenchymal-transition and tumor migration in different solid tumors. Therefore, we evaluated whether EGF and EGF-R, CD68 and MMP-9 are altered in CMM samples in comparison to conjunctival nevi and healthy conjunctiva. PATIENTS AND METHODS: EGF, EGF-R, the macrophage marker CD68 and MMP-9 expression were analyzed in human conjunctival melanoma (CMM, n=16), human conjunctival nevi (n=13) and disease-free human conjunctiva (controls, n=14) by immunohistology. Staining of each sample was evaluated using a stan dardized score ranging from negative (0) to triple positive (3). The groups were then compared by ANOVA, followed by Tukey's post-hoc test. RESULTS: A statistically significant increase of EGF was seen in CMM samples in comparison to conjunctival nevi (p=0.03). In contrast, no statistically significant differences in EGF-R expression were noted between the three groups. A statistically significant increase of CD68 was only seen in conjunctival nevi compared to controls (p=0.04). MMP-9 expression was similar in all groups. CONCLUSION: In CMM, the study data demonstrated an up-regulation of EGF in comparison to conjunctival nevi. Hence, EGF might promote proliferation of CMM cells and induce the epithelial-mesenchymal transition. Therefore, our data suggest that an interplay between EGF and CMM might have a critical role in the developing CMM tumors and metastasis. PMID:34697202 | DOI:10.21873/invivo.12666 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.