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1.
Rev. Flum. Odontol. (Online) ; 1(66): 1-11, jan-abr.2025. tab, ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1570439

RESUMO

Introduction: This case report presents the intentional periodontal maintenance of two periodontal hopeless lower central incisors with a multidisciplinary approach and 20-year follow-up. Case presentation: A 36-year-old male, in 2001, was diagnosed with aggressive periodontitis, gingival swelling, bleeding, and mandibular central incisors with mobility and poor prognosis. Following periodontal therapy (phase I), root canal treatment, and occlusal adjustment, #31 and #41 were gently extracted to remove the granulation tissues, calculus, and infected cementum from the root surface. Then, tetracycline-HCl was applied for 5 minutes on the root surfaces. The teeth were repositioned into the sockets and splinted with a lingual bar. At 3 months, the bar was removed, and a free gingival autogenous graft was done to improve the local keratinized tissue width. Mobility scores, pocket depths, and clinical attachment levels were recorded, and radiographs were taken at 1, 5, and 20 years. The 5-year follow-up showed that the teeth were clinically and radiographically in function. There was a reduction in probing depth and a gain in clinical attachment and radiographic alveolar bone levels. After 20 years, #41 was stable, but #31 had external root resorption, leading to a new treatment plan (dental implants) and extraction. Conclusion: The clinical result of this case was satisfactory for 20 years. Intentional periodontal maintenance of the teeth may be an alternative treatment, even considering the high level of complexity.


Assuntos
Humanos , Masculino , Adulto , Planejamento de Assistência ao Paciente , Periodontia , Procedimentos Cirúrgicos Operatórios , Tempo , Perda da Inserção Periodontal
2.
Rev. Flum. Odontol. (Online) ; 1(66): 12-25, jan-abr.2025. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1570470

RESUMO

A hiperplasia hemimandibular é responsável por prejuízos estéticos, funcionais, motores e psicossociais. Com etiologia incerta, ocorre frente ao desequilíbrio de fatores regulatórios de crescimento presentes na camada cartilaginosa do côndilo. O relato objetiva descrever a tomada de decisões baseada em exames complementares específicos aliados à adequada intervenção cirúrgica da lesão. Paciente gênero feminino, 33 anos de idade, compareceu à clínica particular com queixa principal de "face assimétrica", foi requerido uma avaliação cintilográfica objetivando e confirmando a interrupção do crescimento condilar, descartando a hipótese de Osteocondroma e condilectomia. Após preparo ortodôntico prévio, os exames tomográficos foram utilizados na criação de um protótipo que foi impresso após a realização dos movimentos ósseos planejados. Mediante à reconstrução, foi concluído que a assimetria presente não seria totalmente corrigida somente através da intervenção ortognática, sendo necessária também uma osteotomia removendo parte da base do corpo e ângulo mandibular, através da confecção de um guia de corte, promovendo à reanatomização sem a necessidade de acesso extra oral submandibular, evitando uma cicatriz em face feminina. Paciente encontra-se em pós-operatório de 60 meses, sem queixas e satisfeita. Portanto, é evidenciado cada vez mais a influência positiva que o planejamento virtual pode trazer aos profissionais na otimização dos resultados cirúrgicos.


Hemimandibular hyperplasia is responsible for aesthetic, functional, motor, and psychosocial impairments. With an uncertain etiology, it occurs due to the imbalance of regulatory growth factors present in the cartilaginous layer of the condyle. The report aims to describe decision-making based on specific complementary exams combined with the appropriate surgical intervention for the condition. A 33-year-old female patient presented at a private clinic with the main complaint of "asymmetric face." A scintigraphic evaluation was requested to objectively confirm the interruption of condylar growth, ruling out the hypothesis of Osteochondroma and condylectomy. After prior orthodontic preparation, tomographic exams were used to create a prototype that was printed after planned bone movements. Through the reconstruction, it was concluded that the existing asymmetry would not be entirely corrected through orthognathic intervention alone, necessitating also an osteotomy to remove part of the base of the body and mandibular angle. This was done through the creation of a cutting guide, allowing for reanatomization without the need for submandibular extraoral access, thus avoiding a scar on the female face. The patient is 60 months postoperative, with no complaints and satisfied. Therefore, the increasingly positive influence of virtual planning on optimizing surgical outcomes for professionals is evident.


Assuntos
Humanos , Feminino , Adulto , Procedimentos Cirúrgicos Operatórios , Cintilografia , Planejamento , Assimetria Facial , Tomada de Decisão Clínica , Hiperplasia , Côndilo Mandibular
3.
Asian J Endosc Surg ; 18(1): e13397, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39428321

RESUMO

PURPOSE: Although laparoscopic pancreaticoduodenectomy (LPD) and robot-assisted pancreaticoduodenectomy (RPD) are gradually gaining popularity, their advantages over open pancreaticoduodenectomy (OPD) remain controversial. This study aimed to compare the short-term outcomes of OPD, LPD, and RPD to elucidate the advantages and disadvantages of each procedure. METHODS: We retrospectively analyzed 16 LPD, 43 RPD, and 36 OPD procedures performed at a single center between April 2020 and May 2024. Clinical data, including operative time, estimated blood loss, postoperative complications, length of hospital stay, and hospitalization costs, were retrospectively collected and analyzed. RESULTS: RPD demonstrated a significantly longer operative time (553 min) than OPD (446 min) and LPD (453 min) but a significantly lower estimated blood loss than OPD (150 mL vs. 400 mL, p < .001). Postoperative complication rates (Clavien-Dindo grade ≥3) were lower for RPD (24.4%) than those for OPD (50.0%) and LPD (68.8%). RPD also showed a significantly lower rate of clinically relevant postoperative pancreatic fistula (14.6% vs. 38.9% for OPD and 43.8% for LPD) and a shorter duration of hospitalization (11 vs. 28 days for OPD and 21 days for LPD, p < .001). Hospitalization costs were higher for RPD (20 109 USD) than for OPD (18 487 USD, p < .001), with LPD (20 496 USD) and RPD costs being similar. CONCLUSIONS: RPD appears to offer advantages in terms of reduced blood loss and postoperative complications and shortened hospital stay despite longer operative times and higher hospitalization costs. Therefore, RPD may be a more beneficial approach than OPD or LPD in pancreatic surgery.


Assuntos
Laparoscopia , Tempo de Internação , Duração da Cirurgia , Pancreaticoduodenectomia , Complicações Pós-Operatórias , Procedimentos Cirúrgicos Robóticos , Humanos , Pancreaticoduodenectomia/métodos , Pancreaticoduodenectomia/economia , Estudos Retrospectivos , Masculino , Feminino , Laparoscopia/economia , Laparoscopia/métodos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Robóticos/economia , Idoso , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento , Tempo de Internação/estatística & dados numéricos , Adulto , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Fatores de Tempo , Neoplasias Pancreáticas/cirurgia
4.
J Pharm Biomed Anal ; 252: 116477, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39321489

RESUMO

Breast cancer is strongly connected with elevated oxidative stress. Oxidative modifications of hemoglobin can serve as biomarkers for monitoring oxidative stress status in vivo. The structure of hemoglobin modifications derived from malondialdehyde (MDA) in human blood hemoglobin exists as N-propenal and dihydropyridine (DHP). This study reports the simultaneous quantification of eleven modified peptides in hemoglobin derived from MDA and advanced histidine oxidation in 16 breast cancer patients and 16 healthy women using nanoflow liquid chromatography nanoelectrospray ionization tandem mass spectrometry. The results reveal statistically significant increases in the formation of MDA-derived N-propenal and DHP of lysine and advanced oxidation of histidine in hemoglobin of breast cancer patients with the Mann-Whitney U-test p values < 0.0001 and the AUC of ROC between 0.9277 and 1.0. Furthermore, the elevation in modified peptides is significant in patients with early stages of breast cancer. By measuring these oxidative modifications in hemoglobin from a drop of blood, the role of lipid peroxidation and oxidative stress in breast cancer can be assessed using this sensitive assay.


Assuntos
Neoplasias da Mama , Hemoglobinas , Malondialdeído , Oxirredução , Estresse Oxidativo , Espectrometria de Massas em Tandem , Humanos , Neoplasias da Mama/sangue , Neoplasias da Mama/metabolismo , Feminino , Hemoglobinas/análise , Hemoglobinas/metabolismo , Espectrometria de Massas em Tandem/métodos , Pessoa de Meia-Idade , Adulto , Malondialdeído/sangue , Cromatografia Líquida/métodos , Peroxidação de Lipídeos , Peptídeos/química , Peptídeos/sangue , Idoso
5.
J Pharm Biomed Anal ; 252: 116492, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39366306

RESUMO

Oxapliplatin-induced peripheral neuropathy (OIPN) is a significant adverse effect encountered in patients with colorectal cancer undergoing oxaliplatin therapy. However, the pathogenesis of OIPN remains unclear. This study aimed to identify potential diagnostic biomarkers for OIPN and discover the metabolic pathways associated with the disease. Serum samples were collected from 218 subjects, including patients with OIPN and control (CONT). The metabolite profiles were analyzed using nontargeted liquid chromatography-mass spectrometry (LC-MS) serum metabolomics method. Subsequently, differentially altered metabolites were identified and evaluated through multivariate statistical analyses. In this study, patients with OIPN and CONT were distinguished by ten significant metabolites. The levels of racemethionine, O-acetylcarnitine, stearolic acid, aminoadipic acid, iminoarginine, galactaric acid, and all-trans-retinoic acid were increased, whereas the levels of 3-methyl-L-tyrosine, 5-aminopentanoic acid, and erythritol compared were found to be diminished in patients with OIPN when compared to the CONT. Through receiver operating characteristic (ROC) curve analysis, racemethionine, stearolic acid, 5-aminopentanoic acid, erythritol, aminoadipic acid, and all-trans-retinoic acid were pinpointed as promising biomarkers for OIPN. Significantly altered pathways included amino acids (arginine biosynthesis, beta-alanine metabolism, arginine and proline metabolism, alanine, aspartate and glutamate metabolism, lysine degradation, and phenylalanine, tyrosine and tryptophan biosynthesis), lipid (linoleic acid metabolism and the biosynthesis of unsaturated fatty acids), and energy metabolism. This study, by identifying serum biomarkers and dissecting metabolic pathways, offers a groundbreaking perspective on the susceptibility mechanisms underlying OIPN. It stands as an invaluable resource for the adjunctive diagnosis of OIPN, with the potential to diminish the incidence of adverse reactions and to enhance the objectivity and reliability of clinical diagnoses of OIPN.


Assuntos
Biomarcadores , Neoplasias Colorretais , Metabolômica , Oxaliplatina , Humanos , Oxaliplatina/efeitos adversos , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/sangue , Metabolômica/métodos , Masculino , Pessoa de Meia-Idade , Feminino , Biomarcadores/sangue , Cromatografia Líquida/métodos , Idoso , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/sangue , Doenças do Sistema Nervoso Periférico/diagnóstico , Síndromes Neurotóxicas/sangue , Síndromes Neurotóxicas/etiologia , Síndromes Neurotóxicas/diagnóstico , Antineoplásicos/efeitos adversos , Adulto , Espectrometria de Massas/métodos , Espectrometria de Massa com Cromatografia Líquida
6.
J Pharm Biomed Anal ; 252: 116500, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39383543

RESUMO

Sepsis is a life-threatening immune response to infection in the body, eventually resulting in fatal organ failure. Current methods utilize blood cultures and quick-Sequential-Organ-Failure-Assessment (qSOFA), but there is a need for more accurate and time-sensitive diagnostic methods to improve survival rates. We present a 3D-printed microfluidic chip that bioconjugates antibodies CD69, CD64, and CD25 to channel surfaces to capture sepsis cells in blood samples and validate it with clinical samples (n = 125 septic, n = 10 healthy). Other variables were taken such as healthy volunteer blood samples and patient demographics to validate and confirm our device's diagnostic ability. Statistical differences were found between healthy volunteer and sepsis patient antigen cell counts (CD69 p-value < 0.001, CD64 p-value < 0.004, CD25 p-value < 0.0009), and were confirmed using principal component analysis. Demographics such as length of stay, age, culture results, and need for surgery also factored into sepsis detection on a smaller scale than the antigen cell counts. The receiver operating characteristic (ROC) analysis showed an area under the curve (AUC) of 0.989, 0.988, and 0.992 for CD69, CD64, and CD25, respectively, and a combined biomarker panel of 0.997. Overall, the device performed within a shorter time frame of 4 h compared to standard blood culture tests and was validated for use in detecting sepsis in patients.


Assuntos
Antígenos CD , Antígenos de Diferenciação de Linfócitos T , Subunidade alfa de Receptor de Interleucina-2 , Dispositivos Lab-On-A-Chip , Lectinas Tipo C , Impressão Tridimensional , Receptores de IgG , Sepse , Humanos , Sepse/diagnóstico , Sepse/sangue , Sepse/microbiologia , Antígenos CD/sangue , Antígenos CD/imunologia , Receptores de IgG/sangue , Receptores de IgG/metabolismo , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Curva ROC , Biomarcadores/sangue
7.
Mol Med Rep ; 31(1)2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39450557

RESUMO

In ß­thalassemia, excessive α­globin chain impedes the normal development of red blood cells resulting in anemia. Numerous miRNAs, including miR­6747­3p, are aberrantly expressed in ß­thalassemia major (ß­TM), but there are no reports on the mechanism of miR­6747­3p in regulating red blood cell lineage development and fetal hemoglobin (HbF) expression. In the present study, RT­qPCR was utilized to confirm miR­6747­3p expression in patients with ß­TM and the healthy controls. Electrotransfection was employed to introduce the miR­6747­3p mimic and inhibitor in both HUDEP­2 and K562 cells, and red blood cell lineage development was evaluated by CCK­8 assay, flow cytometry, Wright­Giemsa staining and Benzidine blue staining. B­cell lymphoma/leukemia 11A (BCL11A) was selected as a candidate target gene of miR­6747­3p for further validation through FISH assay, dual luciferase assay and Western blotting. The results indicated that miR­6747­3p expression was notably higher in patients with ß­TM compared with healthy controls and was positively related to HbF levels. Functionally, miR­6747­3p overexpression resulted in the hindrance of cell proliferation, promotion of cell apoptosis, facilitation of cellular erythroid differentiation and γ­globin expression in HUDEP­2 and K562 cells. Mechanistically, miR­6747­3p could specifically bind to the 546­552 loci of BCL11A 3'­UTR and induce γ­globin expression. These data indicate that upregulation of miR­6747­3p affects red blood cell lineage development and induces HbF expression by targeting BCL11A in ß­thalassemia, highlighting miR­6747­3p as a potential molecular target for ß­thalassemia therapy.


Assuntos
Hemoglobina Fetal , MicroRNAs , Proteínas Repressoras , Talassemia beta , Humanos , Hemoglobina Fetal/genética , Hemoglobina Fetal/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Talassemia beta/genética , Talassemia beta/metabolismo , Proteínas Repressoras/metabolismo , Proteínas Repressoras/genética , Células K562 , Masculino , Feminino , Eritrócitos/metabolismo , Linhagem da Célula/genética , Regulação para Cima , Apoptose/genética , Adulto , Proliferação de Células/genética , Regulação da Expressão Gênica , Regiões 3' não Traduzidas , Diferenciação Celular/genética , Adolescente
8.
Int J Cancer ; 156(1): 201-215, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39146488

RESUMO

Intrabdominal dissemination of malignant mesothelioma (MM) and pseudomyxoma peritonei (PMP) is poorly characterized with respect to the stemness window which malignant cells activate during their reshaping on the epithelial-mesenchymal (E/M) axis. To gain insights into stemness properties and their prognostic significance in these rarer forms of peritoneal metastases (PM), primary tumor cultures from 55 patients selected for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy were analyzed for cancer stem cells (CSC) by aldehyde dehydrogenase 1 (ALDH1) and spheroid formation assays, and for expression of a set of plasticity-related genes to measure E/M transition (EMT) score. Intratumor heterogeneity was also analyzed. Samples from PM of colorectal cancer were included for comparison. Molecular data were confirmed using principal component and cluster analyses. Associations with survival were evaluated using Kaplan-Meier and Cox regression models. The activity of acetylsalicylic acid (ASA), a stemness modifier, was tested in five cultures. Significantly increased amounts of ALDH1bright-cells identified high-grade PMP, and discriminated solid masses from ascitic/mucin-embedded tumor cells in both forms of PM. Epithelial/early hybrid EMT scores and an early hybrid expression pattern correlated with pluripotency factors were significantly associated with early peritoneal progression (p = .0343 and p = .0339, respectively, log-rank test) in multivariable models. ASA impaired spheroid formation and increased cisplatin sensitivity in all five cultures. These data suggest that CSC subpopulations and hybrid E/M states may guide peritoneal spread of MM and PMP. Stemness could be exploited as targetable vulnerability to increase chemosensitivity and improve patient outcomes. Additional research is needed to confirm these preliminary data.


Assuntos
Transição Epitelial-Mesenquimal , Mesotelioma Maligno , Células-Tronco Neoplásicas , Neoplasias Peritoneais , Pseudomixoma Peritoneal , Humanos , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/patologia , Células-Tronco Neoplásicas/patologia , Células-Tronco Neoplásicas/metabolismo , Mesotelioma Maligno/patologia , Masculino , Feminino , Pseudomixoma Peritoneal/patologia , Pseudomixoma Peritoneal/metabolismo , Pessoa de Meia-Idade , Idoso , Família Aldeído Desidrogenase 1/metabolismo , Família Aldeído Desidrogenase 1/genética , Mesotelioma/patologia , Mesotelioma/genética , Prognóstico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/genética , Quimioterapia Intraperitoneal Hipertérmica , Células Tumorais Cultivadas , Retinal Desidrogenase/metabolismo , Retinal Desidrogenase/genética , Adulto
9.
Int J Cancer ; 156(1): 91-103, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39150415

RESUMO

Gallbladder cancer (GBC) mortality in Chile is among the highest worldwide. In 2006, the Chilean government launched a programme guaranteeing access to gallbladder surgery (cholecystectomy) for patients aged 35-49 years. We evaluated the impact of this programme on digestive cancer mortality. After conducting an interrupted time series analysis of hospitalisation and mortality data from 2002 to 2018 publicly available from the Chilean Department of Health Statistics and Information, we calculated the change in the proportion of individuals without gallbladder since 10 years. We then estimated age, gender, region, and calendar-year standardised mortality ratios (SMRs) as a function of the change in the proportion of individuals without gallbladder. The cholecystectomy rate increased by 45 operations per 100,000 persons per year (95%CI 19-72) after the introduction of the health programme. Each 1% increase in the proportion of individuals without gallbladder since 10 years was associated with a 0.73% decrease in GBC mortality (95% CI -1.05% to -0.38%), but the negative correlation was limited to women, southern Chile and age over 60. We also found decreasing mortality rates for extrahepatic bile duct, liver, oesophageal and stomach cancer with increasing proportions of individuals without gallbladder. To conclude, 12 years after its inception, the Chilean cholecystectomy programme has markedly and heterogeneously changed cholecystectomy rates. Results based on aggregate data indicate a negative correlation between the proportion of individuals without gallbladder and mortality due to gallbladder and other digestive cancers, which requires validation using individual-level longitudinal data to reduce the potential impact of ecological bias.


Assuntos
Colecistectomia , Neoplasias da Vesícula Biliar , Análise de Séries Temporais Interrompida , Humanos , Chile/epidemiologia , Colecistectomia/estatística & dados numéricos , Colecistectomia/métodos , Feminino , Pessoa de Meia-Idade , Masculino , Adulto , Neoplasias da Vesícula Biliar/mortalidade , Neoplasias da Vesícula Biliar/cirurgia , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias do Sistema Digestório/cirurgia , Neoplasias do Sistema Digestório/mortalidade , Idoso , Análise de Dados
10.
Int J Cancer ; 156(1): 104-113, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39177481

RESUMO

Gastric cancer (GC) remains a significant health concern in Gansu province, China, with morbidity and mortality rates surpassing national averages. Despite the recognized health risks associated with ambient particulate matter with an aerodynamic diameter <1 µm (PM1), the relationship between PM1 exposure and GC incidence has not been extensively studied. Data on GC cases from 2013 to 2021 were gathered from 262 hospitals in Gansu, China. Concurrently, data on the normalized vegetation index (NDVI), gross domestic product (GDP), drinking and smoking behavioral index (DSBI), PM1, PM2.5, and PM2.5-1 were collected. Utilizing a Bayesian conditional autoregressive (CAR) combined generalized linear model (GLM) with quasi-Poisson regression, we evaluated the impact of PM1, PM2.5, PM2.5-1, NDVI, DSBI, and GDP on GC morbidity while adjusting for potential confounders. Our analysis indicated that exposure to PM1 (µg/m3) is significantly positively correlated with GC incidence in regions with an overall age-standardized incidence rate (ASIR) >40 (relative risks [RR]: 1.023, 95% confidence intervals [CI, 1.007, 1.039]), male ASIR >50 (RR: 1.014, 95% CI [1.009, 1.019]), and female ASIR >20 (RR: 1.010, 95% CI [1.002, 1.018]). PM2.5, PM2.5-1, DSBI, and GDP were positively correlated with GC incidence, while NDVI was negatively correlated in the study regions. Our findings provided evidence of a positive correlation between PM1 exposure and GC incidence in high-risk areas of GC within arid regions. Further research is warranted to elucidate the complex nonlinear relationships between environmental factors and GC. These insights could inform strategies for improving the control and prevention of GC in Gansu and similar regions.


Assuntos
Exposição Ambiental , Material Particulado , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/induzido quimicamente , China/epidemiologia , Material Particulado/efeitos adversos , Material Particulado/análise , Masculino , Feminino , Incidência , Pessoa de Meia-Idade , Exposição Ambiental/efeitos adversos , Idoso , Adulto , Fatores de Risco , Teorema de Bayes , Poluição do Ar/efeitos adversos , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise
11.
Int J Cancer ; 156(1): 174-185, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39187950

RESUMO

Hepatic metachronous oligometastatic nasopharyngeal carcinoma (hmoNPC) exhibits distinct clinical characteristics compared to other types of metastatic NPC. We investigated the optimal therapy for hmoNPC. 160 patients with hmoNPC treated in Sun Yat-sen University Cancer Center between 2010 and 2021 were retrospectively recruited. A total of 56 patients were classified into the local therapy (LT) cohort, 23 into the systemic therapy (ST) cohort and 81 into the combination therapy (LT + ST) cohort. The median PFS was 7.9 months (95% confidence interval [CI]: 4.1-11.9 months) in the LT cohort, 15.5 months (95% CI: 10.5-32.3 months) in the ST cohort, and 31.3 months (95% CI: 20.3 to NA months) in the LT + ST cohort. The median OS was 41.1 months (95% CI: 30.0-54.0 months) in the LT cohort, 50.4 months (95% CI: 41.5 to NA months) in the ST cohort and not reached (NR) (95% CI: 77.3 to NA months) in the LT + ST cohort. Cox analysis was used to construct nomograms to predict patient outcomes. Among patients with no evidence of disease status after LT, the prognosis was significantly better in the LT + ST cohort than LT cohort (median PFS: NR [95% CI: 29.0 to NA months] vs. 20.0 months [95% CI: 10.4 to NA months]). More survival benefits were achieved with platinum-based chemotherapy than oral monotherapy (median PFS: NR [95% CI: 21.7 to NA months] vs. 17.2 months [95% CI: 10.2 to NA months]). Fewer postoperative early progression events were observed in neoadjuvant chemotherapy cohort than in adjuvant chemotherapy cohort (2.78% vs. 18.81%, P = .013). In conclusion, combining neoadjuvant platinum-based chemotherapy and local therapy was the best strategy for patients with hmoNPC.


Assuntos
Neoplasias Hepáticas , Carcinoma Nasofaríngeo , Humanos , Masculino , Feminino , Estudos Retrospectivos , Carcinoma Nasofaríngeo/terapia , Carcinoma Nasofaríngeo/mortalidade , Carcinoma Nasofaríngeo/patologia , Carcinoma Nasofaríngeo/tratamento farmacológico , Pessoa de Meia-Idade , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/terapia , Adulto , Idoso , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/terapia , Neoplasias Nasofaríngeas/mortalidade , Neoplasias Nasofaríngeas/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Segunda Neoplasia Primária/terapia , Segunda Neoplasia Primária/patologia , Adulto Jovem
12.
Int J Cancer ; 156(1): 154-163, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39198970

RESUMO

Over 40% stage-III non-small-cell lung cancer (NSCLC) patients (pts) experience 5-year survival following multimodality treatment. Nevertheless, little is known about relevant late toxicities and quality-of-life (QoL) in the further long-term follow-up. Therefore, we invited pts from our randomized phase-III trial (Eberhardt et al., Journal of Clinical Oncology 2015) after 10 years from diagnosis to participate within a structured survivorship program (SSP) including follow-up imaging, laboratory parameters, cardio-pulmonary investigations, long-term toxicity evaluations and QoL questionnaires. Of 246 pts initially accrued, 161 were considered potentially resectable following the induction therapy and were randomized (80 to arm A: definitive chemoradiation; 81 to arm B: definitive surgery; 85 not randomized for different reasons; group C). 31 from 37 pts still alive after 10 years agreed to the SSP (13 in A; 12 in B; 6 in C). Clinically relevant long-term toxicities (grade 3 and 4) were rarely observed with no signal favoring any of the randomization arms. Furthermore, available data from the global QoL analysis did not show a signal favoring any definitive locoregional approach (Mean QoL in SSP A pts: 56.41/100, B pts: 64.39/100) and no late decline in comparison to baseline and early 1-year follow-up. This is the first comprehensive SSP of very late survival follow-up reported in stage-III NSCLC treated within a randomized multimodality trial and it may serve as important baseline information for physicians and pts deciding for a locoregional treatment option.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Qualidade de Vida , Humanos , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/terapia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Feminino , Masculino , Idoso , Pessoa de Meia-Idade , Sobrevivência , Estadiamento de Neoplasias , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/métodos , Seguimentos , Adulto
13.
Int J Cancer ; 156(1): 130-144, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39251783

RESUMO

The genetic basis of nonsyndromic familial nonmedullary thyroid carcinoma (FNMTC) is still poorly understood, as the susceptibility genes identified so far only account for a small percentage of the genetic burden. Recently, germline mutations in DNA repair-related genes have been reported in cases with thyroid cancer. In order to clarify the genetic basis of FNMTC, 94 genes involved in hereditary cancer predisposition, including DNA repair genes, were analyzed in 48 probands from FNMTC families, through targeted next-generation sequencing (NGS). Genetic variants were selected upon bioinformatics analysis and in silico studies. Structural modeling and network analysis were also performed. In silico results of NGS data unveiled likely pathogenic germline variants in 15 families with FNMTC, in genes encoding proteins involved in DNA repair (ATM, CHEK2, ERCC2, BRCA2, ERCC4, FANCA, FANCD2, FANCF, and PALB2) and in the DICER1, FLCN, PTCH1, BUB1B, and RHBDF2 genes. Structural modeling predicted that most missense variants resulted in the disruption of networks of interactions between residues, with implications for local secondary and tertiary structure elements. Functional annotation and network analyses showed that the involved DNA repair proteins functionally interact with each other, within the same DNA repair pathway and across different pathways. MAPK activation was a common event in tumor progression. This study supports that rare germline variants in DNA repair genes may be accountable for FNMTC susceptibility, with potential future utility in patients' clinical management, and reinforces the relevance of DICER1 in disease etiology.


Assuntos
Reparo do DNA , Predisposição Genética para Doença , Mutação em Linhagem Germinativa , Neoplasias da Glândula Tireoide , Humanos , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Reparo do DNA/genética , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Sequenciamento de Nucleotídeos em Larga Escala , Dano ao DNA/genética , Linhagem , Idoso , Adulto Jovem
14.
Int J Cancer ; 156(1): 40-51, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39016032

RESUMO

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease globally, and can lead to hepatocellular carcinoma (HCC), a leading cause of cancer-related death. We aimed to determine the extent to which MASLD is an increasing cause of HCC in Sweden and to determine clinical characteristics associated with underlying MASLD. Using the Swedish quality registry for liver cancer (SweLiv), we identified all adults with a diagnosis of HCC in Sweden between 2012 and 2018. Baseline data were retrieved from SweLiv and other nationwide registers. Totally, 3494 patients with HCC were identified. Of them, 757 patients (22%) had MASLD-HCC. The proportion with MASLD-HCC increased from 19% in 2012 to 25% in 2018 (ptrend = 0.012), and MASLD was since 2017 the leading cause of HCC, surpassing hepatitis C. MASLD was the fastest growing cause of HCC with a 33% increment during the study period. Compared to other patients with HCC, those with MASLD-HCC were older (75 vs. 67 years, p < .001), less commonly had cirrhosis (61% vs. 82%, p < .001), had larger tumours (median 5.5 vs. 4.3 cm, p < .001), and more often extrahepatic metastasis (22% vs. 16%, p < .001). Patients with HCC caused by MASLD or by other causes were equally likely to be diagnosed in an early stage (Barcelona Clinic Liver Cancer 0-A, 27% vs. 30%, p = .129). MASLD is now the leading cause of HCC in Sweden.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/etiologia , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/patologia , Suécia/epidemiologia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Estudos de Coortes , Fígado Gorduroso/epidemiologia , Fígado Gorduroso/complicações , Fígado Gorduroso/patologia , Idoso de 80 Anos ou mais , Sistema de Registros , Adulto
15.
Int J Cancer ; 156(1): 145-153, 2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-39032035

RESUMO

It is known, that different metastatic organ systems respond differently to immune checkpoint inhibitors (ICIs). In this study, we aimed to investigate the extent to which skin/subcutaneous metastases respond to ICI or targeted therapies (TTs) and whether the response rate differs from that of distant metastases in the same patient. Patients with melanoma diagnosed between January 2021 and September 2023 with at least one skin/subcutaneous metastasis who had received therapy with ICI or TT in an advanced setting were included in the analysis. Best overall response (BOR) was classified according to the revised response evaluation criteria in solid tumors (RECIST). The BOR of skin metastases and visceral metastases to ICI and TT was compared using the chi-square test. Skin metastases treated with ICI a first-line setting showed an overall response rate (ORR) of 44.1%. In contrast, visceral metastases had a higher ORR of 51.1%. However, the difference was not statistically significant (p = .77). Regarding TT, the ORR for skin metastases was 57.1%, compared to 38.5% for visceral metastases (p = .59). Interestingly, the ORR for skin/subcutaneous metastases was notably lower with ICI compared to visceral metastases, in contrast to patients who underwent TT. Skin metastases showed a poorer response to ICI than visceral metastases. Therefore, careful monitoring is recommended to detect non-response early in patients with skin metastases as skin metastases may have a worse response than TT. A larger cohort is needed for a comprehensive analysis and confirmation of our results.


Assuntos
Inibidores de Checkpoint Imunológico , Melanoma , Neoplasias Cutâneas , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Melanoma/tratamento farmacológico , Melanoma/secundário , Melanoma/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Adulto , Idoso de 80 Anos ou mais , Estudos Retrospectivos , Resultado do Tratamento
16.
J Environ Pathol Toxicol Oncol ; 44(1): 37-45, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39462448

RESUMO

The prevalent histological variant within differentiated thyroid carcinoma is papillary thyroid carcinoma, also known as PTC. The study investigated the clinical performance of serum hsa_circ_0001955 in predicting the prognosis of PTC treated with radical thyroidectomy and iodine 131 nail clearance. The relative expression of serum circ_0001955 of PTC patients was detected before and after accepting radical thyroidectomy combined with 131I thyroid remnant ablation by RT-qPCR. Serum thyroglobulin (Tg) and thyroglobulin antibody (TgAb) levels were quantified by an automatic chemiluminescence immunoassay analyzer. Multivariate logistic regression analysis was employed to investigate the risk factors associated with the prognosis of PTC patients with postoperative 131I therapy. The serum circ_0001955 levels in 127 PTC patients were higher than that in 96 multinodular goiter patients and 110 healthy controls before treatment and had diagnostic values for PTC patients. After 131I treatment, serum circ_0001955 levels and Tg value have a correlation with potential recurrence (WBS positive). Serum circ_0001955, Tg, and TgAb value, and their combination may have diagnostic value in predicting recurrence. Serum circ_0001955 levels in patients with PTC after radical thyroidectomy and iodine 131 thyroidectomy may help predict recurrence.


Assuntos
Radioisótopos do Iodo , Tireoglobulina , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Tireoidectomia , Humanos , Radioisótopos do Iodo/uso terapêutico , Câncer Papilífero da Tireoide/terapia , Câncer Papilífero da Tireoide/sangue , Câncer Papilífero da Tireoide/genética , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Neoplasias da Glândula Tireoide/terapia , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/radioterapia , Tireoglobulina/sangue , RNA Circular/genética , RNA Circular/sangue , Prognóstico , Idoso
17.
Behav Brain Res ; 476: 115248, 2025 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-39260584

RESUMO

Despite earlier research demonstrating the immunomodulatory effects of acute and chronic exercise in many medical illnesses, there is a lack of literature evaluating the acute and chronic effects of exercise on the cytokine levels in individuals with bipolar disorder (BD) or schizophrenia (SCH). This study aims to examine the acute effects of resistance exercise on cytokines and the chronic effects of resistance exercise by 10 weeks on cytokine levels, symptoms of disease, and muscular strength in individuals with BD and SCH. The included individuals (N=10) performed a single session of band-elastic resistance exercises (six exercises, 3 sets of 12-15 repetitions, 60 seconds of interval between sets). A sub-sample (N=6) of individuals performed a supervised band-elastic resistance exercise program (2 times a week, for 10 weeks, 6 exercises, 3 sets of 12-15 repetitions, 60 seconds of interval). We verified for acute effects: IL-2 (P=0.0085) and IL-4 (P=0.0253) levels increased, while IL-6 decreased (P=0.0435), and for chronic effects: increased IL-2 and IL-4 levels (significant effect size - Pre vs Post), a decrease in disease symptoms, and an increase in muscular strength. This study adds to what is already known about how resistance exercises affect people with BD and SCH in both short-term (systemic cytokines levels) and long-term (symptoms of disease, muscular strength, and systemic cytokines levels).


Assuntos
Transtorno Bipolar , Citocinas , Força Muscular , Treinamento Resistido , Esquizofrenia , Humanos , Transtorno Bipolar/fisiopatologia , Transtorno Bipolar/sangue , Treinamento Resistido/métodos , Projetos Piloto , Esquizofrenia/fisiopatologia , Esquizofrenia/sangue , Masculino , Adulto , Feminino , Citocinas/sangue , Força Muscular/fisiologia , Pessoa de Meia-Idade , Interleucina-6/sangue , Interleucina-4/sangue , Interleucina-2/sangue , Adulto Jovem
18.
Magn Reson Med ; 93(1): 261-275, 2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39221478

RESUMO

PURPOSE: To enable diffusion weighted imaging in prostate patients with metallic total hip replacements in clinically feasible scan times for prostate cancer screening, and avoid distortion and dropout artifacts present in the conventionally used Echo Planar Imaging (EPI). METHODS: A reduced field of view (FOV) diffusion-prepared sequence that is robust to the B 0 $$ {\kern0em }_0 $$ inhomogeneities produced by total hip replacements was achieved using high radiofrequency (RF) bandwidth pulses and manipulation for stimulated echo pathways. The reduced FOV along the A/P direction was obtained using slice-select gradient reversal, and the prepared magnetization was imaged with a three-dimensional RF-spoiled gradient echo readout. The sequence was validated in phantom experiments, in vivo in healthy volunteers with and without total hip replacements, and in vivo in patients undergoing a standard MRI prostate exam. RESULTS: The proposed sequence is robust to shading and distortion artifacts that are encountered by standard diffusion-weighted EPI in the presence of moderate off-resonance. Apparent diffusion coefficient estimates obtained by the proposed sequence were comparable to those obtained with diffusion-weighted EPI. CONCLUSION: Acquisition of distortionless diffusion weighted images of the prostate is feasible in patients with total hip replacements on conventional, whole-body 3T MRI, using a b-value of 800 s / mm 2 $$ \mathrm{s}/{\mathrm{mm}}^2 $$ and nominal resolution of 1.7 × $$ \times $$ 1.7 × $$ \times $$ 4 mm3 in scan times of 6 min.


Assuntos
Artefatos , Imagem de Difusão por Ressonância Magnética , Imagem Ecoplanar , Imagens de Fantasmas , Próstata , Neoplasias da Próstata , Humanos , Masculino , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia , Próstata/diagnóstico por imagem , Imagem Ecoplanar/métodos , Metais , Pessoa de Meia-Idade , Processamento de Imagem Assistida por Computador/métodos , Algoritmos , Idoso , Adulto , Reprodutibilidade dos Testes
19.
Magn Reson Med ; 93(1): 330-340, 2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39238238

RESUMO

PURPOSE: To evaluate the repeatability and reproducibility of QSM of the liver via single breath-hold chemical shift-encoded MRI at both 1.5 T and 3 T in a multicenter, multivendor study in subjects with iron overload. METHODS: This prospective study included four academic medical centers with three different MRI vendors at 1.5 T and 3 T. Subjects with known or suspected liver iron overload underwent multi-echo spoiled gradient-recalled-echo scans at each field strength. A subset received repeatability testing at either 1.5 T or 3 T. Susceptibility and R 2 * $$ {\mathrm{R}}_2^{\ast } $$ maps were reconstructed from the multi-echo images and analyzed at a single center. QSM-measured susceptibility was compared with R 2 * $$ {\mathrm{R}}_2^{\ast } $$ and a commercial R2-based liver iron concentration method across centers and field strengths using linear regression and F-tests on the intercept and slope. Field-strength reproducibility and test/retest repeatability were evaluated using Bland-Altman analysis. RESULTS: A total of 155/80 data sets (test/retest) were available at 1.5 T, and 159/70 data sets (test/retest) were available at 3 T. Calibrations across sites were reproducible, with some variability (e.g., susceptibility slope with liver iron concentration ranged from 0.102 to 0.123 g/[mg · $$ \cdotp $$ ppm] across centers at 1.5 T). Field strength reproducibility was good (concordance correlation coefficient = 0.862), and test/retest repeatability was excellent (intraclass correlation coefficient = 0.951). CONCLUSION: QSM as an imaging biomarker of liver iron overload is feasible and repeatable across centers and MR vendors. It may be complementary with R 2 * $$ {\mathrm{R}}_2^{\ast } $$ as they are obtained from the same acquisition. Although good reproducibility was observed, liver QSM may benefit from standardization of acquisition parameters. Overall, QSM is a promising method for liver iron quantification.


Assuntos
Sobrecarga de Ferro , Fígado , Imageamento por Ressonância Magnética , Humanos , Sobrecarga de Ferro/diagnóstico por imagem , Reprodutibilidade dos Testes , Imageamento por Ressonância Magnética/métodos , Fígado/diagnóstico por imagem , Fígado/metabolismo , Feminino , Masculino , Estudos Prospectivos , Adulto , Pessoa de Meia-Idade , Ferro , Processamento de Imagem Assistida por Computador/métodos , Interpretação de Imagem Assistida por Computador/métodos
20.
Magn Reson Med ; 93(1): 301-310, 2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39270056

RESUMO

PURPOSE: To shorten CEST acquisition time by leveraging Z-spectrum undersampling combined with deep learning for CEST map construction from undersampled Z-spectra. METHODS: Fisher information gain analysis identified optimal frequency offsets (termed "Fisher offsets") for the multi-pool fitting model, maximizing information gain for the amplitude and the FWHM parameters. These offsets guided initial subsampling levels. A U-NET, trained on undersampled brain CEST images from 18 volunteers, produced CEST maps at 3 T with varied undersampling levels. Feasibility was first tested using retrospective undersampling at three levels, followed by prospective in vivo undersampling (15 of 53 offsets), reducing scan time significantly. Additionally, glioblastoma grade IV pathology was simulated to evaluate network performance in patient-like cases. RESULTS: Traditional multi-pool models failed to quantify CEST maps from undersampled images (structural similarity index [SSIM] <0.2, peak SNR <20, Pearson r <0.1). Conversely, U-NET fitting successfully addressed undersampled data challenges. The study suggests CEST scan time reduction is feasible by undersampling 15, 25, or 35 of 53 Z-spectrum offsets. Prospective undersampling cut scan time by 3.5 times, with a maximum mean squared error of 4.4e-4, r = 0.82, and SSIM = 0.84, compared to the ground truth. The network also reliably predicted CEST values for simulated glioblastoma pathology. CONCLUSION: The U-NET architecture effectively quantifies CEST maps from undersampled Z-spectra at various undersampling levels.


Assuntos
Neoplasias Encefálicas , Encéfalo , Aprendizado Profundo , Glioblastoma , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Processamento de Imagem Assistida por Computador/métodos , Glioblastoma/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Algoritmos , Estudos Retrospectivos , Adulto , Feminino , Razão Sinal-Ruído , Masculino , Estudos Prospectivos
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