Display omitted
The aim of this study was to analyze the clinical and genetic characteristics of young lung cancer cases, and to compare them with those of older cases.
We used the Thoracic Tumors ...Registry (TTR) as a data source representative of lung cancer cases diagnosed in Spain, and included all cases registered until 9/01/2023 which had information on age at diagnosis or the data needed to calculate it. We performed a descriptive statistical analysis and fitted logistic regressions to analyze how different characteristics influenced being a younger lung cancer patient.
A total of 26,336 subjects were included. Lung cancer cases <50 years old had a higher probability of being women (OR: 1.38; 95% CI: 1.21–1.57), being in stage III or IV (OR: 1.32; 95% CI: 1.08–1.62), not having comorbidities (OR: 5.21; 95% CI: 4.59–5.91), presenting with symptoms at diagnosis (OR: 1.53; 95% CI: 1.29–1.81), and having ALK translocation (OR: 7.61; 95% CI: 1.25–46.32) and HER2 mutation (OR: 5.71; 95% CI: 1.34–24.33), compared with subjects ≥50 years. Among subjects <35 years old (n=61), our study observed a higher proportion of women (59.0% vs. 26.6%; p<0.001), never smokers (45.8% vs. 10.3%; p<0.001), no comorbidities (21.3% vs. 74.0%; p<0.001); ALK translocation (33.3% vs. 4.4%; p<0.001) and ROS1 mutation (14.3% vs. 2.3%; p=0.01), compared with subjects ≥35 years.
Lung cancer displays differences by age at diagnosis which may have important implications for its clinical management.
Third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) have shown impressive results in EGFR mutant lung cancer (LC) patients in terms of disease control rate with ...a positive impact on overall survival. Nevertheless, after months of treatment with targeted therapy, progression inevitably occurs. Some patients develop oligoprogression and local treatment is required for optimal disease control while maintaining EGFR-TKIs. This work features a clinical case of a patient harboring an EGFR mutant LC undergoing oligoprogression to EGFR-TKIs, first into the brain and afterward to the primary tumor, requiring local ablative strategies, including primary tumor resection three years after the start of osimertinib. Currently, the patient is still alive and continues with a complete response upon EGFR-TKIs maintenance. Hence, oligoprogression, even in driven oncogenic tumors, represents a distinct biological entity and potential curative disease that deserves particular consideration in multidisciplinary tumor boards. In this case, tumor primary resection after three years of the initial diagnosis represents a paradigm shift in the treatment of EGFR mutant patients.
Lacunarity transition in a chaotic dynamical system Cucurull, Bartomeu; Pradas, Marc; Wilkinson, Michael
Journal of physics. A, Mathematical and theoretical,
08/2022, Letnik:
55, Številka:
33
Journal Article
Recenzirano
Odprti dostop
Abstract
Experiments investigating particles floating on a randomly stirred fluid show regions of very low density, which are not well understood. We introduce a simplified model for understanding ...sparsely occupied regions of the phase space of non-autonomous, chaotic dynamical systems, based upon an extension of the skinny bakers’ map. We show how the distribution of the sizes of voids in the phase space can be mapped to the statistics of the running maximum of a Wiener process. We find that the model exhibits a
lacunarity transition
, which is characterised by regions of the phase space remaining empty as the number of trajectories is increased.
Flux-conserving directed percolation Cucurull, Barto; Huber, Greg; Kawagoe, Kyle ...
Journal of physics. A, Mathematical and theoretical,
02/2024, Letnik:
57, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Abstract
We discuss a model for directed percolation in which the flux of material along each bond is a dynamical variable. The model includes a physically significant limiting case where the total ...flux of material is conserved. We show that the distribution of fluxes is asymptotic to a power law at small fluxes. We give an implicit equation for the exponent, in terms of probabilities characterising site occupations. In one dimension the site occupations are exactly independent, and the model is exactly solvable. In two dimensions, the independent-occupation assumption gives a good approximation. We explore the relationship between this model and traditional models for directed percolation.
Substance-induced psychosis (SIP) is frequent in substance use disorder patients. However, little is known about the presence of SIP in Borderline Personality Disorder (BPD) and what the risk factors ...for the development of SIP in this population would be. A sample of 91 BPD drug-dependent patients attending an outpatient substance use disorder unit was evaluated. Comorbidity with Axis I and II was assessed using SCID-I and SCID-II. Psychoactive drug related variables were registered as well as the presence of the ninth criterion of DSM-IV-TR as a code of psychotic symptoms. A total of 50.5% of the sample were women. The most prevalent drug consumed was cocaine (67%) followed by cannabis (47.3%) and then alcohol (39.6%). A total of 62.8% people with BPD registered substance-induced psychosis symptoms in their lifetime. Notably, this study found these symptoms were not associated with the presence of psychotic symptoms registered in ninth criterion. Cocaine and cannabis consumption are associated with the presence of SIP in SUD-BPD patients. No other clinical variables were related in this sample. Further research studies are needed to find other risk factors for SIP in this patient group.
•The presence of SIP among people with BPD has not previously been deeply analyzed.•SIP evaluation is difficult in BPD because of other cognitive disturbances associated with the disorder.•SIP symptoms are described in 62.8% of a sample of SUD-BPD.•Cocaine and cannabis dependence is a risk factor for the development of SIP in patients with BPD.•Early diagnosis of SIP in BPD is a challenge for clinicians.
New direct-acting antiviral agents (DAAs) have shown great efficacy and tolerability in clinical trials and real-life cohorts. However, data are scarce regarding efficacy and safety in cirrhotic ...HCV/HIV-coinfected patients.
A multicentre prospective analysis was performed in 13 Spanish hospitals, including all cirrhotic HCV/HIV-coinfected patients starting DAA combinations from January to December 2015. Sustained virological response 12 weeks after treatment (SVR12) was analysed. Withdrawal due to toxicity and/or hepatic decompensation and change in liver stiffness measurement (LSM) after HCV treatment were evaluated.
Patients (n = 170) were mostly male (n = 125; 74.3%) with the following HCV genotype (Gt) distribution: Gt-1a, 68 (40%); Gt-1b, 21 (12.4%); Gt-4, 47 (27.6%); and Gt-3, 26 (15.3%). Baseline median LSM was 20.6 kPa (IQR 16.1-33.7) and log10 HCV-RNA 6.1 IU/mL (IQR 5.7-6.5). Most patients had a Child-Pugh class A score (n = 127; 74.7%) and 28 (16.5%) had prior hepatic decompensation. There were 89 (52.4%) pretreated patients with 40.4% (n = 36) of null responders. Preferred regimens were as follows: sofosbuvir/ledipasvir + ribavirin, 43 (25.3%) patients; sofosbuvir + simeprevir + ribavirin, 34 (20%); sofosbuvir/ledipasvir, 26 (15.3%) and sofosbuvir + daclatasvir + ribavirin, 25 (14.7%). Overall SVR12 was 92.9% (158/170), without differences between genotypes. Pretreated patients had lower SVR12 rates compared with naive (88.8% versus 97.5%; P = 0.026). Treatment failures were as follows: 7 (4.1%) relapses; 2 (1.2%) lost to follow-up; 1 (0.6%) toxicity-related discontinuation; 1 (0.6%) hepatic decompensation; and 1 (0.6%) viral breakthrough. On-treatment hepatic decompensation was recorded in four (2.4%) patients (encephalopathy and ascites, two each). Paired LSM in 33 patients showed a decrease of 5.6 kPa (95% CI 1.8-9.2; P = 0.004).
In our cohort of cirrhotic HCV/HIV-coinfected patients, DAAs were highly safe and efficacious. Viral eradication was associated with a significant decrease in liver stiffness.
The comorbidity between substance-use disorders and borderline personality disorder (SUD-BPD) with other psychiatric disorders has been little studied. A total of 937 drug-dependent patients were ...evaluated using semistructured interviews and 13.7% were SUD-BPD patients. After multivariate analysis, gender, Affective Disorder (OR 2.59), Anxiety Disorder (OR 1.90), Eating Disorders (OR 4.29), Cocaine (OR 2.16), benzodiazepine dependence (OR 1.90), early age of onset of drug consumption (OR 0.94), and dependent (OR 4.04), paranoid (OR 3.70) and antisocial personality disorders (OR 3.46) were associated with SUD-BPD. Several psychiatric comorbidities are the norm in SUD-BPD patients; therefore these patients are a challenge for clinicians.
We discuss a model for directed percolation in which the flux of material along each bond is a dynamical variable. The model includes a physically significant limiting case where the total flux of ...material is conserved. We show that the distribution of fluxes is asymptotic to a power law at small fluxes. We give an implicit equation for the exponent, in terms of probabilities characterising site occupations. In one dimension the site occupations are exactly independent, and the model is exactly solvable. In two dimensions, the independent-occupation assumption gives a good approximation. We explore the relationship between this model and traditional models for directed percolation.
Experiments investigating particles floating on a randomly stirred fluid show regions of very low density, which are not well understood. We introduce a simplified model for understanding sparsely ...occupied regions of the phase space of non-autonomous, chaotic dynamical systems, based upon an extension of the skinny bakers' map. We show how the distribution of the sizes of voids in the phase space can be mapped to the statistics of the running maximum of a Wiener process. We find that the model exhibits a lacunarity transition, which is characterised by regions of the phase space remaining empty as the number of trajectories is increased.
PDF
