Head and neck squamous cell carcinomas (HNSCCs) are the sixth most common cancers worldwide. More than half of patients with HNSCC eventually experience disease recurrence and/or metastasis, which ...can threaten their long-term survival. HNSCCs located in the oral cavity and larynx are usually associated with tobacco and/or alcohol use, whereas human papillomavirus (HPV) infection, particularly HPV16 infection, is increasingly recognized as a cause of oropharyngeal HNSCC. Despite clinical, histologic, and molecular differences between HPV-positive and HPV-negative HNSCCs, current treatment approaches are the same. For recurrent disease, these strategies include chemotherapy, immunotherapy with PD-1-inhibitors, or a monoclonal antibody, cetuximab, that targets epidermal growth factor; these therapies can be administered either as single agents or in combination. However, these treatment strategies carry a high risk of toxic side effects; therefore, more effective and less toxic treatments are needed. The landscape of HNSCC therapy is changing significantly; numerous clinical trials are underway to test novel therapeutic options like adaptive cellular therapy, antibody-drug conjugates, new targeted therapy agents, novel immunotherapy combinations, and therapeutic vaccines. This review helps in understanding the various developments in HNSCC therapy and sheds light on the path ahead in terms of further research in this field.
Keywords: Effective dose, Dose Length Product, Computed Tomography Dose Indexvolume, Dose Reference Level
AbstractAim: The aim of this study was to estimate the effective doses from CT scans using ...DoseLength Product (DLP) in a Nepalese hospital.Materials and methods: This prospective study was conducted in 150 patients above 18years of age who were referred for CT scan of head, chest and abdomen. The CT scan wasperformed on a 128 slice multi detector scanner. All the subjects who met the inclusioncriteria were included in the study. Following the non-contrast imaging phases of the head,chest and abdomen CTDIvol, DLP, kVp and pitch were recorded for each patient from theconsole display of the scanner. The effective dose was calculated for each examination usingDLP which were graphically analyzed and correlated with the age of the patient.Results: The study showed the mean CTDIvol for head, chest and abdomen to be 53.95±4.83mGy, 5.28±1.17 mGy and 11.15±2.71 mGy respectively along with mean DLP to be923.52±71.11 mGycm, 229.32±48.70 mGycm and 517.02±148.32 mGycm respectively. Usingthese values, the mean effective doses were calculated and found to be 1.93±0.14 mSv,3.20±0.68 mSv and 7.75±2.19 mSv respectively.Conclusion: The calculated effective dose values were lower than in other studies for CTexaminations of chest and abdomen while higher or similar for CT examination of head. Theresults of this survey could motivate other researchers to investigate the radiation doses inother hospitals and help establish national diagnostic reference levels.
Essential oils: How safe? How effective? Shah, Pooja Amy; Killeen, David; Meninno, Erica ...
The Journal of family practice,
11/2023, Volume:
72, Issue:
9
Journal Article
Peer reviewed
Open access
Given the ubiquity of these plant-based oils, your patients might ask about using them. Here's the evidence on safety and efficacy to guide your response.
Older individuals with chronic health conditions are at highest risk of adverse clinical outcomes from COVID-19, but there is widespread belief that risk to younger, relatively lower-risk individuals ...is negligible. We assessed the rate and predictors of life-threatening complications among relatively lower-risk adults hospitalized with COVID-19. Of 3766 adults hospitalized with COVID-19 to three hospitals in New York City from March to May 2020, 963 were relatively lower-risk based on absence of preexisting health conditions. Multivariable logistic regression models examined in-hospital development of life-threatening complications (major medical events, intubation, or death). Covariates included age, sex, race/ethnicity, hypertension, weight, insurance type, and area-level sociodemographic factors (poverty, crowdedness, and limited English proficiency). In individuals ≥55 years old (n = 522), 33.3% experienced a life-threatening complication, 17.4% were intubated, and 22.6% died. Among those <55 years (n = 441), 15.0% experienced a life-threatening complication, 11.1% were intubated, and 5.9% died. In multivariable analyses among those ≥55 years, age (OR 1.03 95%CI 1.01-1.06), male sex (OR 1.72 95%CI 1.14-2.64), being publicly insured (versus commercial insurance: Medicare, OR 2.02 95%CI 1.22-3.38, Medicaid, OR 1.87 95%CI 1.10-3.20) and living in areas with relatively high limited English proficiency (highest versus lowest quartile: OR 3.50 95%CI 1.74-7.13) predicted life-threatening complications. In those <55 years, no sociodemographic factors significantly predicted life-threatening complications. A substantial proportion of relatively lower-risk patients hospitalized with COVID-19 experienced life-threatening complications and more than 1 in 20 died. Public messaging needs to effectively convey that relatively lower-risk individuals are still at risk of serious complications.
Millions of individuals live longer and healthier lives due to modern medical innovations. The advancement of modern medicine to combat numerous ailments has benefited humanity a lot. Breast cancer ...is one of the most fatal diseases affecting women globally. Early detection is essential for lowering the fatality rate. The objective of the paper is to create a computer-aided diagnostic model that helps in the early detection of breast cancer and hence decreases the death rate. The study introduces a hybrid strategy for effectively diagnosing breast cancer by using a Novel Relief algorithm for feature selection with an Adaptive Neuro-Fuzzy Inference System (ANFIS). The efficiency of this proposed hybrid model and the ANFIS model without using any feature selection technique is estimated using the Wisconsin Breast Cancer Data set (WBCD). The study finds that the new hybrid model has attained the highest accuracy of 99.30% and is ideal for detecting breast cancer.
The cell of origin of colon cancer is typically thought to be the resident somatic stem cells, which are immortal and escape the continual cellular turnover characteristic of the intestinal ...epithelium. However, recent studies have identified certain conditions in which differentiated cells can acquire stem-like properties and give rise to tumors. Defining the origins of tumors will inform cancer prevention efforts as well as cancer therapies, as cancers with distinct origins often respond differently to treatments. We report here a new condition in which tumors arise from the differentiated intestinal epithelium. Inactivation of the differentiation-promoting transcription factor SMAD4 in the intestinal epithelium was surprisingly well tolerated in the short term. However, after several months, adenomas developed with characteristics of activated WNT signaling. Simultaneous loss of SMAD4 and activation of the WNT pathway led to dedifferentiation and rapid adenoma formation in differentiated tissue. Transcriptional profiling revealed acquisition of stem cell characteristics, and colabeling indicated that cells expressing differentiated enterocyte markers entered the cell cycle and reexpressed stem cell genes upon simultaneous loss of SMAD4 and activation of the WNT pathway. These results indicate that SMAD4 functions to maintain differentiated enterocytes in the presence of oncogenic WNT signaling, thus preventing dedifferentiation and tumor formation in the differentiated intestinal epithelium.
This work identifies a mechanism through which differentiated cells prevent tumor formation by suppressing oncogenic plasticity.
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ntroduction: Identifying trauma patients with shock is crucial, as early intervention and prompt treatment improve patient prognosis and survival. To address this, the ratio of Systolic Blood ...Pressure (SBP) and Heart Rate (HR), known as the Reverse Shock Index (RSI), is measured. Aim: To evaluate the effectiveness of RSI calculation in assessing prognosis. Materials and Methods: This was a retrospective observational study in which data were retrospectively collected on trauma patients treated in the Emergency Room (ER) at Dhiraj Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India, from January 2021 to December 2022. Patients involved in road traffic accidents, fall from a height of ≥6 m, assault, and machinery injuries were included. Upon arrival, vital signs such as HR, SBP, Respiratory Rate (RR), Glasgow Coma Scale (GCS), associated injuries, and in-hospital mortality were documented. Any resuscitative procedures required, such as Cardiopulmonary Resuscitation (CPR), intubation, oxygen therapy, chest tube insertion, and blood transfusion, were also recorded. The RSI was calculated for all trauma patients and divided into two groups (RSI <1 and RSI ≥1). The t-test was performed with a 95% Confidence Interval (CI). Results: Out of 363 patients, data from 320 patients were included. Among them, 55 patients (17.2%) had RSI <1, and 265 patients (82.8%) had RSI ≥1. Patients with RSI <1 exhibited lower GCS scores, tachypnoea (RR >29), or bradypnoea (RR <10), along with higher mortality rates. These patients also required resuscitative interventions. Those with RSI <1 experienced more head injuries, thoracic trauma, and maxillofacial injuries (p<0.001). Conclusion: The RSI <1 in trauma patients demonstrated significantly higher predictive accuracy for adverse outcomes, serving as a primary tool for early intervention and aggressive care in the ER.
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