In the U.S., lung cancer accounts for 14% of cancer diagnoses and 28% of cancer deaths annually. Since no cure exists for advanced lung cancer, the main treatment goal is to prolong survival. ...Chemotherapy regimens produce side effects with different profiles. Coupling this with individual patient's preferred side effects could result in patient-centered choices leading to better treatment outcomes. There are apparently no previous studies of or tools for assessing and utilizing patient chemotherapy preferences in clinical settings. The long-term goal of the study was to facilitate patients' treatment choices for advanced-stage lung cancer. A primary aim was to determine how preferences for chemotherapy side effects relate to chemotherapy choices.
An observational, longitudinal, open cohort study of patients with advanced-stage non-small cell lung cancer (NSCLC) was conducted. Data sources included patient medical records and from one to three interviews per subject. Data were analyzed using Chi-square, Fisher's Exact and McNamara's test, and logistic regression.
Patients identified the top three chemotherapy side effects that they would most like to avoid: shortness of breath, bleeding, and fatigue. These side effects were similar between first and last interviews, although the rank order changed after patients experienced chemotherapy.
Patients ranked drug side effects that they would most like to avoid. Patient-centered clinical care and patient-centered outcomes research are feasible and may be enhanced by stakeholder commitment. The study results are limited to patients with advanced NSCLC. Most of the subjects were White, since patients were drawn from the U.S. Midwest, a predominantly White population.
The limited effectiveness of therapy for patients with advanced stage head and neck squamous cell carcinoma (HNSCC) or recurrent disease is a reflection of an incomplete understanding of the ...molecular basis of HNSCC pathogenesis. MUC4, a high molecular weight glycoprotein, is differentially overexpressed in many human cancers and implicated in cancer progression and resistance to several chemotherapies. However, its clinical relevance and the molecular mechanisms through which it mediates HNSCC progression are not well understood. This study revealed a significant upregulation of MUC4 in 78% (68/87) of HNSCC tissues compared with 10% positivity (1/10) in benign samples (P=0.006, odds ratio (95% confidence interval)=10.74 (2.0-57.56). MUC4 knockdown (KD) in SCC1 and SCC10B HNSCC cell lines resulted in significant inhibition of growth in vitro and in vivo, increased senescence as indicated by an increase in the number of flat, enlarged and senescence-associated β-galactosidase (SA-β-Gal)-positive cells. Decreased cellular proliferation was associated with G0/G1 cell cycle arrest and decrease expression of cell cycle regulatory proteins like cyclin E, cyclin D1 and decrease in BrdU incorporation. Mechanistic studies revealed upregulation of p16, pRb dephosphorylation and its interaction with histone deacetylase 1/2. This resulted in decreased histone acetylation (H3K9) at cyclin E promoter leading to its downregulation. Orthotopic implantation of MUC4 KD SCC1 cells into the floor of the mouth in nude mice resulted in the formation of significantly smaller tumors (170±18.30 mg) compared to those (375±17.29 mg) formed by control cells (P=0.00007). In conclusion, our findings showed that MUC4 overexpression has a critical role by regulating proliferation and cellular senescence of HNSCC cells. Downregulation of MUC4 may be a promising therapeutic approach for treating HNSCC patients.
Acute coronary syndrome in the presence of an allergic reaction is known as Kounis syndrome, which is an underdiagnosed disorder and has nuances regarding management.
We present a patient brought ...into the hospital as a STEMI alert in the setting of an allergic reaction triggered by food.
During the course of the emergency department stay, the patient went into anaphylactic shock requiring epinephrine and adjunctive therapies, with improvement in allergic symptoms and resolution of ST elevations.
Inflammatory mediators released during an allergic reaction can lead to coronary vasospasm, known as Kounis syndrome, which has implications regarding management of a typical allergic reaction and acute coronary syndrome.
GEM detector development for CBM experiment at FAIR Dubey, A.K.; Prakash, A.; Chattopadhyay, S. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
08/2013, Volume:
718
Journal Article
Peer reviewed
A GEM-based detector system is being developed at VECC, Kolkata, to be used for muon tracking in the proposed Compressed Baryonic Experiment (CBM) at the upcoming FAIR facility at GSI, Darmstadt. We ...have built and successfully tested several multi-GEM prototypes with radioactive sources and cosmic muons. We report the details of the R&D at VECC in terms of fabrication, assembly and the subsequent tests of the prototype chambers.
In this paper, the authors review the verbatim comments from patients’ post-emergency department discharge survey results and highlight the impact that doctors and nurses have on the patient's ...experience. This paper also explores the benefits of delivering a positive experience on patients, clinicians, and healthcare systems. Many interventions that have worked are simple to implement and do not tend to require significant capital investment while having the potential of improving emergency department encounters for all those involved. There are always limitations, selection biases, and issues with generalizability in reviewing retrospective and subjective survey response data.
A Morel-Lavallée lesion (MLL) is a rare, closed traumatic soft-tissue degloving injury that is often misdiagnosed. The mechanism that results in this lesion involves a shearing force that separates ...the hypodermis from underlying fascia, thereby disrupting perforating vascular and lymphatic vessels and resulting in a hemolymphatic fluid collection prone to infection and pseudocyst formation. We describe a case of a 70-year-old male with an initially missed MLL despite CT imaging that was ultimately diagnosed on point-of-care ultrasound (POCUS) on a second emergency department visit. Although an MLL is often misdiagnosed on radiography and CT imaging, POCUS is an expeditious imaging modality that can facilitate diagnosis of an MLL by visualizing specific sonographic characteristics.
This case report details the symptoms, diagnostic results, and surgical treatment of a 66-year-old woman who presented to the emergency department complaining of excruciating pain in her right leg ...after being injured while doing Pilates. After an accident involving a ball during a Pilates exercise, the patient reported feeling pain. Upon physical examination, the right leg was found to be shortened and externally rotated, with the foot's sensation and mobility unaffected. A displaced proximal subtrochanteric femur fracture was detected via plain film radiography.
PDF
