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Background: Transformation of endometriosis to malignancy is a rare occurrence. Clear cell ovarian cancer and endometrioid ovarian cancer are the two histotypes most consistently linked to endometriosis. The exact pathways leading to malignant transformation of endometriosis remain elusive. Case presentation: A 41-year-old woman presented to our hospital with a ten days history of abdominal pain which was not responsive to medication. Pathological examination revealed an unexpected finding of bilateral endometriosis associated with distinct malignancies: a clear cell carcinoma in the right ovary and a well-differentiated endometrioid carcinoma in the left ovary. Molecular analysis indicated a shared somatic driver mutation in ING1 in the eutopic endometrium and the bilateral ovaries while simultaneously exhibiting specific genetic alterations unique to each carcinoma. Notably, several common mutation sites were also identified, including previously reported common oncogenes (KRAS, PIK3CA, ARID1A). This finding prompts the hypothesis of a possible monoclonal origin of the two tumours. Conclusion: This case represents an exceedingly rare occurrence of two different histotypes of ovarian endometriosis-associated cancer manifesting simultaneously in bilateral ovaries. Based on genetic analysis, we hypothesize that these malignancies may have a monoclonal origin, providing insights into understanding the different biological mechanisms underlying carcinogenesis.
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Chronic hepatitis B (CHB) is a common chronic viral infectious disease that requires long-term treatment to control the condition and prevent complications. To standardize treatment regimens for CHB, professional associations have established relevant guidelines, but they have often overlooked patient preferences. Historically, in the treatment process, medical decisions were predominantly made by physicians or health care administrators, with limited patient involvement, leading to the neglect of patient preferences. Patient attitudes, expectations, and needs are all influenced by their preferences, and patient preferences have a direct impact on treatment adherence. Understanding and respecting patient preferences are crucial to ensuring treatment effectiveness. This article will explore patient preferences in the treatment of CHB and elucidate the influence of patient preferences on treatment adherence, aiming to provide insights for the development of a more personalized and effective health care process.
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Background: Although a large number of studies have demonstrated the effectiveness of cardiac rehabilitation(CR), patient preferences for CR remain unclear. Knowing patient preferences may contribute to increasing patient participation and adherence, thus improving patient prognosis. Methods: A systematic search was carried out using electronic databases and manual reference checks from inception until 15th June 2022. Quantitative studies, qualitative studies and mixed methods studies assessing patient preferences for CR were included. Two researchers independently conducted study selectionand data extraction. CR preferences were divided into three categories: CR settings, CR components, and CR contents. A narrative synthesis was applied to integrate the results of the included studies. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of included studies. Results: Ultimately, 17 publications were included in this study. Regarding CR settings, most patients preferred the hospital to home, some considered both, and a few were willing to accept the local CR club as an alternative setting to the hospital. For CR components, regardless of age and gender, patients considered exercise training and nutrition counseling to be the most important and smoking cessation to be the least important. In exercise intervention of CR contents, progress discussion and encouragement were rated as most critical, and non-conflicting with other activities was rated as least critical. In psychological intervention of CR contents, most patients were willing to accept psychological intervention, and a few patients wanted to heal the trauma with the passage of time. Conclusion: This systematic review provides important insights into patient preferences for CR, clarifying patient preferences for CR settings, components, and contents, along with possible influencing factors. Patient preferences may change due to the COVID-19 epidemic, and there is still a need to focus on patient preferences for CR and conduct more relevant primary research to validate the findings of this paper in the future.
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Background: This study aims to assess whether sarcopenia can be used to predict prognosis in patients with heart failure (HF) and if different diagnostic criteria for sarcopenia and diverse regions where studies were conducted could affect prognostic outcomes, thus providing a preliminary basis for early identification and prediction of poor prognosis in HF. Methods: The PubMed, Cochrane, Embase, and CNKI (China National Knowledge Infrastructure) databases were searched from inception until March 2023. Cohort studies evaluating the prognostic effect of sarcopenia in patients with HF were included. Two authors independently assessed the studies according to the Newcastle-Ottawa Scale. The meta-analyses were performed using RevMan 5.3 software. The study results were reported using a checklist of Preferred Reporting Items for Systematic Reviews and Meta-analyses were used to report the study results. Results: A total of 12 studies with 3696 HF patients were included. The results showed that the sarcopenia population had a higher risk of all-cause mortality (HR (hazard ratio) = 1.98, 95% CI (confidence interval): 1.61-2.44) and major adverse cardiovascular events (MACE) (HR = 1.24, 95% CI: 1.06-1.45) compared to the non-sarcopenia population. Moreover, the subgroup analysis reported that different diagnostic criteria for sarcopenia and diverse regions were statistically significant for all-cause mortality, except for the Europe subgroup (HR = 1.34, 95% CI: 0.89-2.02). In the subgroup analysis of MACE, all subgroups were statistically significant except for the European Working Group on Sarcopenia in Older People (EWGSOP) (HR = 1.39, 95% CI: 0.86-2.25) and European subgroups (HR = 1.39, 95% CI: 0.86-2.25). Conclusions: Sarcopenia is associated with poor prognosis, including all-cause mortality and MACE, in patients with HF. However, due to the adoption of various diagnostic criteria in different regions of the world, these results need further validation.
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INTRODUCTION: Exercise interventions are important non-pharmacological interventions for patients with mild cognitive impairment (MCI), but patients with MCI have poor compliance and there is no consistent strategy for exercise interventions. Understanding the needs and preferences of MCI patients allows for the development of effective and acceptable exercise intervention programmes that achieve the goals of patient-centred care. This study uses a discrete choice experiment (DCE) to measure and quantify MCI patients' preferences for exercise interventions, and aims at (1) identifying and exploring which elements of exercise intervention programmes are essential for MCI patients; (2) measuring MCI patients' preferences for exercise interventions and summarising relevant characteristics that may influence preference choices and (3) determining whether these preferences vary by participant characteristics and classifying the population types based on the sociodemographic characteristics of the participants. METHODS AND ANALYSIS: A DCE will be conducted to explore MCI patients' preferences for exercise interventions. We conducted a systematic literature review and extensive qualitative work to select the best attributes to develop the design of DCE. A partial factorial survey design was generated through an orthogonal experimental design. We will conduct a questionnaire survey in one city each in the eastern (Nanjing), western (Xining), southern (Zhuhai) and northern (Beijing) parts of China and reach the planned sample size (n=278). Final data will be analysed using a mixed logit model and a latent class model. ETHICS AND DISSEMINATION: This study was approved by the Ethics Committee of Nanjing Medical University (2021-666). All participants will be required to provide informed consent. Our findings will be disseminated and shared with interested patient groups and the general public through online blogs, policy briefs, national and international conferences and peer-reviewed journals.