The current study suggests that a high pretreatment neutrophil to lymphocyte ratio and presence of low muscle mass (sarcopenia) are potential risk factors for the development of hyperprogressive ...disease and shorter survival upon treatment with Pembrolizumab.
Summary
The aim of this multi‐center retrospective study was to evaluate the incidence of hyperprogressive disease (HPD) after second‐line treatment with pembrolizumab in patients (n = 167) with metastatic non‐small‐cell lung cancer (NSCLC) whose tumors expressed programmed cell death ligand 1 (PD‐L1) in ≥ 1% and to search for hematological and imaging biomarkers associated with its development. Prior to chemotherapy, neutrophil : lymphocyte ratio (NLR1) and platelet : lymphocyte ratio (PLR1), and prior to immunotherapy, NLR2 and PLR2 were retrospectively analyzed. The psoas major muscle area (PMMA) was calculated at the L3 position on computed tomography before chemotherapy (PMMA1) and before immunotherapy (PMMA2) (n = 112). Patients with ∆PMMA (1‐PMMA2/PMMA1) × 100 ≥ 10% were considered to have sarcopenia (low muscle mass). After treatment with pembrolizumab on the first computerized tomography (CT) scan evaluation, patients were subdivided as follows as: hyperprogressors (HPs), progressors (Ps), non‐progressors (NPs) and pseudoprogressors (PPs). HPs had significantly higher ∆PMMA levels, NLR2 and PLR2 than the other patients. Moreover, in multinomial logistic regression analysis, higher levels of ∆PMMA were associated with a decreased likelihood of being a P odds ratio (OR) = 0·81; 95% confidence interval (CI) = 0·65–0·99; P = 0·047 or an NP (OR = 0·76; 95% CI = 0·62–0·94; P = 0·012) versus an HP. Higher NLRs tended to decrease the likelihood of being a P versus an HP (OR = 0·66; 95% CI = 0·42–1·06; P = 0·09) and significantly decreased the likelihood of being an NP versus an HP (OR = 0·44; 95% CI = 0·28–0·69; P < 0·0001). Our data suggest that a high pre‐immunotherapy NLR2 and the presence of sarcopenia are potential risk factors for the development of HPD.
Intervertebral disc degeneration often is a cause of low back pain (LBP) and radicular pain even without severe compression of the nerve root by hernial material. Thermodiscoplasty, or intradiscal ...electrothermal therapy (IDET) is used for minimally invasive treatment of discogenic pain. Pulsed radiofrequency (PRF) of the dorsal root ganglion (DRG) is used as an interventional method for radicular pain elimination. For the first time we have proposed the simultaneous combined use of these techniques. Our research's aim - to study the dynamics of pain syndrome and disability in patients undergone simultaneous combined treatment with the IDET and PRF DRG for pain associated with moderate disc herniation without spinal root severe compression, which confirmed motor and sensitive deficit absence. A retrospective analysis of 22 patients treated at the Neurospine clinic (Kyiv) from 2019 to 2020 was carried out. All patients had degenerative-dystrophic disease of the intervertebral discs L4-L5 and L5-S1 with therapeutically resistant radicular pain. The standard examination included two-plane spondylography and magnetic resonance imaging, as well as an assessment of neurological status. The discogenic origin of pain is confirmed by provocative contrasting discography. The interest of the corresponding spinal root was confirmed by performing selective radicular blockade.The treatment results were assessed using the Numerical rating scale (NRS) and the Oswestry disability index (ODI); statistical processing was carried out using Microsoft Excel and Statistica-10 program tools. There were no complications detected. All patients noted a significant reduction in pain and decrease of disability: VAS (Me) before treatment = 7.77±1.02, ODI (Ме) before treatment = 70.45±7.85; VAS (Me) immediately after surgery = 2.18±1.13. This trend persisted for six months: VAS (Me) 6 months after surgery = 2.0±0.75, ODI (Me) 6 months after surgery = 30.45±9.98. The simultaneous combined use of IDET and PRF DRG is an effective and safe treatment for therapeutically resistant chronic lumbosacral radicular pain associated with moderate disc herniation.
Methods for assessing the current state and forecasting critical events are developed in order to reduce the stress load on the pilot of an aircraft. These methods are based on the energy approach to ...flight control. Algorithms for forecasting the possibility of safe takeoff in the presence of high-rise obstacles on the trajectory are obtained. Forecast correction algorithms are introduced. Algorithms for calculating the braking distance depending on the runway condition are found in the modes of landing or emergency braking at takeoff. Some ways to correct forecasts considering the sequence and operation time of all braking devices are proposed. Model tests are carried out for the algorithms in the entire range of operating conditions.
Cerebral arterial air embolism (CAE) is a serious and potentially dangerous condition that can interrupt the blood supply to the brain and cause stroke. One of the promising gas mixtures for ...emergency treatment of air embolism is an oxygen-helium mixture.
We modeled CAE in awake rats by injecting air into the common carotid artery. Immediately after CAE, animals were either untreated or underwent hyperbaria, oxygen inhalation, heated air inhalation, or helium-oxygen mixture inhalation. Body temperature, locomotor activity, respiratory and cardiovascular parameters were monitored in the animals before CAE modeling, and 3 and 24 h after CAE modeling.
After 3 hours of CAE modeling in awake rats, depression of the nervous, cardiovascular and respiratory systems, as well as decreased body temperature were observed. 24 h after CAE modeling multifocal cerebral ischemia was observed. Normobaric helium-oxygen mixture inhalation, on par with hyperbaric treatment, restored body temperature, locomotor activity, respiratory volume, respiratory rate, and blood pressure 3 hours after CAE, and prevented the formation of ischemic brain damage lesions 24 h after CAE.
Thus, inhalation of a heated oxygen-helium gas mixture (O2 30% and He 70%) immediately after CAE improves the physiological condition of the animals and prevents the foci of ischemic brain damage formation.
This paper conceptualizes the main principles of comprehensive software verification for an onboard spacecraft control system. An optimal comprehensive verification strategy for onboard software is ...selected by rigorously stating and solving the corresponding optimization problem. Software verification methods with functional correctness indicators are proposed.
The paper is devoted to solving the problem of determining the relative spatial arrangement and orientation of objects. The task was set: to show the fundamental possibility of spatial and angular ...relative positioning when using the parameters of the magnetic field gradient in tensor form and in the form of gradient of an absolute value vector as measurement information for the magnetic field of a local dipole source. The solution of the problem is presented along with the features and limitations for both forms of representation are considered. The principles of construction of magnetic gradiometry measurement systems are briefly described, the limitations of technical implementation are considered, and the benefits of using an alternating magnetic field source is outlined. The results of modelling are presented, proving the possibility of using the proposed positioning method for various engineering problems.
Abstract
The article discusses the results of processing some catalysts used in the chemical industry using plasma technologies. The catalysts already used in production were treated in vacuum with a ...beam of argon ions with the addition of oxygen. The experiments were carried out with different values of the ion beam current and the energy of its ions. As a result of the experiments, it turned out that the characteristics of plasma-treated catalysts already used turned out to be close to those of fresh catalysts.
This paper considers control of the magnetic field of a moving object based on indications of onboard magnetic gradiometers to minimize the object’s magnetic interference. This problem is solved by ...mounting magnetic dipoles with variable dipole moments. The feedback signal in the magnetic field control loop is formed using two gradiometers located at different distances to the carrier’s body. Two types of control are studied as follows. The first type involves the difference between the indications of gradiometers taking into account their arrangement. The second type relies on the assumption that the object’s interference is negligibly small on large distances, and hence an external magnetic field can be estimated using a remote magnetic gradiometer. Simulation results are also presented.
Currently, wound treatment is an urgent task of medicine around the world. In the process of wound healing, various types of cells are involved under the control and regulation of cytokines and ...growth factors. Disruption of the synchronization process between the various types of cells and intercellular mediators involved in the restoration of tissue damage can lead to impaired healing and the development of chronic wounds. Photobiomodulation (PBM) therapy promotes platelet activation and aggregation, reduces inflammation and oxidative stress, and accelerates cell migration and proliferation. PBM also induces the production of the extracellular matrix and the release of key growth factors, thereby improving tissue regeneration and accelerating wound healing. The aim of our work was to study the effect of photobiomodulation therapy on the regulation of reparative processes in chronic wounds monitored by biomarkers and platelet aggregation activity. 54 Wistar rats were divided into three groups. Intact animals were not manipulated. In animals of the control and experimental groups, a chronic wound was simulated by reproducing the conditions of local hypoxia and microcirculation disorders. The wounds of the experimental group received PBM therapy. The device Lika-therapist M (Ukraine) was used in a continuous mode at a wavelength of 660 nm, an output power of 10 mW, and an energy density of 1 J/cm2. The wounds of the animals in the control group were treated with sham. The animals were euthanized on days 3, 7, 14, and 28 after the surgery (6 animals, each from the control and experimental groups). Measurements of the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor alpha (TNF-α), the basic fibroblast growth factor (bFGF), and reactive oxygen species (ROS) were carried out by ELISA. Results revealed the multidirectional effect of PBM therapy on the expression of the studied biomarkers. The results of the histological examination indicated a positive effect of PBM therapy with the applied parameters on the repair processes of chronic wounds. We concluded that the use of PBM therapy made it possible to regulate disturbances in reparative processes by modulating ROS, cytokines, and platelet aggregation activity.
Хроническая тестикулярная боль, или “хроническая орхиалгия”, определяется как боль в яичках длительностью более 3 месяцев, которая существенно мешает всем видам активности пациента. Хроническая ...орхиалгия как клинический симптом может быть проявлением множества заболеваний мужской половой сферы. Наиболее ярко она проявляется при орхите, орхоэпидидимите. Нередко орхиалгия может быть проявлением простатита, фуникулита, везикулита. Эта линейка патологий находится в сфере профессиональной заинтересованности урологов. Для её лечения применяются консервативные и хирургические методы. Тупиковая ситуация возникает в случае необнаружения органической патологии после детального обследования больного. Вниманию читателей предлагается опыт лечения 34-летнего пациента, обратившегося по поводу жалоб на боли в яичках после пятилетней безуспешной курации неврологами, урологами и андрологами. Данные обследования (МРТ, УЗИ, бактериологическое исследование) патологии не выявили. Был установлен рабочий диагноз “хроническая тестикулярная боль”. Под радиологическим контролем произведена диагностическая блокада S3 корешков с двух сторон с использованием нейролокации с пороговым значением 0,03V. Введено 5 мг бупивакаина с каждой стороны. Получен положительный эффект – боли купировались на время действия анестезии. Спустя несколько дней проведена радиочастотная абляция S3 с двух сторон в режиме 70 °С, 120 сек. Процедура завершена введением смеси анестетика и кортикостероида. Трёхмесячное постпроцедурное наблюдение показывает значительное снижение болевого синдрома (с 8/10 до 1/10 по ВАШ). Этот случай довольно убедительно демонстрирует успешность применения интервенционных радиочастотных методов в лечении нейропатической тестикулярной боли.
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