Role of exosomes in non-small cell lung cancer and EGFR-mutated lung cancer.

As an important mediator of information transfer between cells, exosomes play a unique role in regulating tumor growth, supporting vascular proliferation, tumor invasion, and metastasis. Exosomes are widely present in various body fluids, and therefore they can be used as a potential tool for non-invasive liquid biopsy. The present study reviews the role of exosomes in liquid biopsy, tumor microenvironment formation, and epithelial-mesenchymal transition in non-small cell lung cancer (NSCLC). By targeting epidermal growth factor receptor (EGFR) therapy as a first-line treatment for patients with NSCLC, this study also briefly describes the occurrence of EGRF+ exosomes and the role of exosomes and their contents in non-invasive detection and potential therapeutic targets in EGFR-mutated lung cancer.

BONE FRAGILITY, FRACTURE RISK AND TRAUMA:A COMPLICATED TRIANGLE IN CHILDREN.

OBJECTIVE: To analyze whether association between bone fragility and risk of fracture depends on the trauma level. METHOD: All participants along with their mothers underwent DXA scan and body measurements. The subjects answered a self-report questionnaire about their physical activities and the precipitating causes. The questionnaire results were associated with DXA performed at the baseline visit. RESULTS: A total 374 children with available DXA scan and complete follow-up of 5 years were included in the final analysis. Of the 374 children, 53 (14.2%) had one fracture, and 11 (20.7%) had more than one fracture. Based on the modified Landin classification, the trauma level was determined. Of the 53 (14.2%) children who had one fracture, 39 (73.6%) were classified, namely 19 (48.7%) with mild trauma, 16 (41%) with moderate trauma and four (10.2%) with severe trauma. Trauma level could not be assigned to 14 (26.4%) children due to limited information. Children without fractures had significantly higher values in all bone parameters compared to those with fractures caused by mild trauma. CONCLUSION: Subjects with mild trauma fractures had an inversely proportional ratio between bone fragility parameters and fracture risk compared with subjects without fractures. Level of Evidence IV, Case Series.

OBJETIVO: Analisar se a associação entre fragilidade óssea e risco de fratura depende do nível de trauma. MÉTODO: Todos os participantes, juntamente com suas mães, foram submetidos à DEXA e medições corporais. Os participantes responderam um questionário de autorrelato sobre atividades físicas e descrição de como o trauma ocorreu. Os resultados do questionário foram associados à DEXA realizada na primeira visita do estudo. RESULTADOS: Um total de 374 crianças com DEXA disponível e acompanhamento completo de 5 anos foi incluído na análise final. Das 374 crianças, 53 (14,2%) tiveram uma fratura e 11 (20,7%) tiveram mais de uma fratura. Com base na classificação de Landin modificada, foi determinado o nível de trauma. Das 53 (14,2%) crianças que tiveram uma fratura, 39 (73,6%) foram classificadas, sendo 19 (48,7%) com trauma leve, 16 (41%) com trauma moderado e quatro (10,2%) com trauma grave. O nível de trauma não pôde ser atribuído a 14 (26,4%) crianças, devido a informações limitadas. As crianças sem fraturas apresentaram valores significantemente mais altos em todos os parâmetros ósseos, em comparação com os que tinham fraturas causadas por trauma leve. CONCLUSÃO: Os indivíduos com fraturas por trauma leve apresentaram relação inversamente proporcional entre os parâmetros fragilidade óssea e o risco de fratura em comparação com indivíduos sem fratura. Nível de Evidência IV, Série de Casos .

Arthroscopic fixation of acute acromioclavicular joint disruption with TightRope™: Outcome and complications after minimum 2 (2-5) years follow-up.

PURPOSE: To evaluate the midterm results of arthroscopic reconstruction of acute acromioclavicular (AC) joint disruption using TightRope™ system. METHODS AND MATERIAL: We retrospectively assess the results of 24 patients of acute AC joint dislocation who were operated using TightRope system. Constant and University of California, Los Angeles (UCLA) scores and coracoclavicular distance were calculated pre- and postoperatively. Data was entered into MS excel and analyzed using the SPSS version 17. RESULTS: The mean follow-up was 39.45 months. Constant and UCLA scores were significantly increased postoperatively. Six patients had partial loss of reduction within 3-6 months and two patients had a failure of construct. Constant score was significantly lower in these patients. CONCLUSION: TightRope reconstruction of the AC joint is a reproducible and safe alternative to many other techniques of AC joint reconstruction. Early subluxation remains a concern and may reflect the need for technique modification.

BONE FRAGILITY, FRACTURE RISK AND TRAUMA:A COMPLICATED TRIANGLE IN CHILDREN / FRAGILIDADE ÓSSEA, RISCO DE FRATURA E TRAUMA:UM TRIÂNGULO COMPLICADO EM CRIANÇAS

ABSTRACT Objective: To analyze whether association between bone fragility and risk of fracture depends on the trauma level. Method: All participants along with their mothers underwent DXA scan and body measurements. The subjects answered a self-report questionnaire about their physical activities and the precipitating causes. The questionnaire results were associated with DXA performed at the baseline visit. Results: A total 374 children with available DXA scan and complete follow-up of 5 years were included in the final analysis. Of the 374 children, 53 (14.2%) had one fracture, and 11 (20.7%) had more than one fracture. Based on the modified Landin classification, the trauma level was determined. Of the 53 (14.2%) children who had one fracture, 39 (73.6%) were classified, namely 19 (48.7%) with mild trauma, 16 (41%) with moderate trauma and four (10.2%) with severe trauma. Trauma level could not be assigned to 14 (26.4%) children due to limited information. Children without fractures had significantly higher values in all bone parameters compared to those with fractures caused by mild trauma. Conclusion: Subjects with mild trauma fractures had an inversely proportional ratio between bone fragility parameters and fracture risk compared with subjects without fractures. Level of Evidence IV, Case Series.

RESUMO Objetivo: Analisar se a associação entre fragilidade óssea e risco de fratura depende do nível de trauma. Método: Todos os participantes, juntamente com suas mães, foram submetidos à DEXA e medições corporais. Os participantes responderam um questionário de autorrelato sobre atividades físicas e descrição de como o trauma ocorreu. Os resultados do questionário foram associados à DEXA realizada na primeira visita do estudo. Resultados: Um total de 374 crianças com DEXA disponível e acompanhamento completo de 5 anos foi incluído na análise final. Das 374 crianças, 53 (14,2%) tiveram uma fratura e 11 (20,7%) tiveram mais de uma fratura. Com base na classificação de Landin modificada, foi determinado o nível de trauma. Das 53 (14,2%) crianças que tiveram uma fratura, 39 (73,6%) foram classificadas, sendo 19 (48,7%) com trauma leve, 16 (41%) com trauma moderado e quatro (10,2%) com trauma grave. O nível de trauma não pôde ser atribuído a 14 (26,4%) crianças, devido a informações limitadas. As crianças sem fraturas apresentaram valores significantemente mais altos em todos os parâmetros ósseos, em comparação com os que tinham fraturas causadas por trauma leve. Conclusão: Os indivíduos com fraturas por trauma leve apresentaram relação inversamente proporcional entre os parâmetros fragilidade óssea e o risco de fratura em comparação com indivíduos sem fratura. Nível de Evidência IV, Série de Casos .