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2.
Front Oncol ; 13: 1310106, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38192624

RESUMO

As the prognosis for squamous cell carcinoma of the head and neck remains unsatisfactory when compared to other malignancies, novel therapies targeting specific biomarkers are a critical emerging area of great promise. One particular class of drugs that has been developed to impede tumor angiogenesis is vascular endothelial growth factor-tyrosine kinase inhibitors. As current data is primarily limited to preclinical and phase I/II trials, this review summarizes the current and future prospects of these agents in squamous cell carcinoma of the head and neck. In particular, the combination of these agents with immunotherapy is an exciting area that may be a promising option for patients with recurrent or metastatic disease, evidenced in recent trials such as the combination immune checkpoint inhibitors with lenvatinib and cabozantinib. In addition, the use of such combination therapy preoperatively in locally advanced disease is another area of interest.

3.
Front Immunol ; 14: 1230049, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37795086

RESUMO

Iatrogenic vascular air embolism is a relatively infrequent event but is associated with significant morbidity and mortality. These emboli can arise in many clinical settings such as neurosurgery, cardiac surgery, and liver transplantation, but more recently, endoscopy, hemodialysis, thoracentesis, tissue biopsy, angiography, and central and peripheral venous access and removal have overtaken surgery and trauma as significant causes of vascular air embolism. The true incidence may be greater since many of these air emboli are asymptomatic and frequently go undiagnosed or unreported. Due to the rarity of vascular air embolism and because of the many manifestations, diagnoses can be difficult and require immediate therapeutic intervention. An iatrogenic air embolism can result in both venous and arterial emboli whose anatomic locations dictate the clinical course. Most clinically significant iatrogenic air emboli are caused by arterial obstruction of small vessels because the pulmonary gas exchange filters the more frequent, smaller volume bubbles that gain access to the venous circulation. However, there is a subset of patients with venous air emboli caused by larger volumes of air who present with more protean manifestations. There have been significant gains in the understanding of the interactions of fluid dynamics, hemostasis, and inflammation caused by air emboli due to in vitro and in vivo studies on flow dynamics of bubbles in small vessels. Intensive research regarding the thromboinflammatory changes at the level of the endothelium has been described recently. The obstruction of vessels by air emboli causes immediate pathoanatomic and immunologic and thromboinflammatory responses at the level of the endothelium. In this review, we describe those immunologic and thromboinflammatory responses at the level of the endothelium as well as evaluate traditional and novel forms of therapy for this rare and often unrecognized clinical condition.


Assuntos
Embolia Aérea , Trombose , Humanos , Embolia Aérea/diagnóstico , Embolia Aérea/etiologia , Embolia Aérea/terapia , Tromboinflamação , Inflamação/terapia , Inflamação/complicações , Trombose/complicações , Doença Iatrogênica
4.
Am J Ophthalmol ; 243: 28-33, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35809658

RESUMO

PURPOSE: To evaluate whether orientation of the optic-haptic junction of an intraocular lens (IOL) during cataract surgery could decrease the incidence and/or severity of positive and negative dysphotopsia. DESIGN: Prospective, randomized controlled trial. METHODS: A total of 163 patients (326 eyes) in a private practice scheduled to have bilateral implantation of a Tecnis monofocal IOL (ZCB00) (Johnson & Johnson Vision) were randomly assigned to have the optic-haptic junction positioned vertically, horizontally, superonasally, or inferonasally. Patients with known visual field defects or best-corrected vision less than 20/80 were excluded. Patients were surveyed for positive and negative dysphotopsia symptoms at 1 week and 4-6 weeks after surgery. Patients were blinded to the orientation whereas researchers were not. Data were analyzed to compare the differences in positive and negative dysphotopsia incidence and severity. RESULTS: IOL oriented vertically in 82 eyes (25.2%), horizontally in 72 eyes (22.1%), superonasally in 94 eyes (28.8%), and inferonasally in 78 eyes (23.9%). Significant differences were noted between orientations in incidence of negative dysphotopsia at 1 week postoperatively (P = .019) and 4-6 weeks postoperatively (P = .002). Patients in the superonasal group had the worst outcome at both time periods, and the horizontal group had the best outcome at 4-6 weeks. No differences were noted for positive dysphotopsia incidence or severity. CONCLUSIONS: The orientation of the optic-haptic junction of a monofocal IOL was significantly associated with incidence of negative dysphotopsia after surgery, with the horizontal orientation performing best at 4-6 weeks.


Assuntos
Lentes Intraoculares , Facoemulsificação , Humanos , Implante de Lente Intraocular/efeitos adversos , Pseudofacia/complicações , Facoemulsificação/efeitos adversos , Estudos Prospectivos , Lentes Intraoculares/efeitos adversos , Transtornos da Visão/etiologia , Desenho de Prótese
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