Secondary diabetes associated with principal endocrinopathies: the impact of new treatment modalities

2009 ◽  
Vol 46 (2) ◽  
pp. 85-95 ◽  
Author(s):  
Eugenia Resmini ◽  
Francesco Minuto ◽  
Annamaria Colao ◽  
Diego Ferone
Keyword(s):  
Treatment Modalities ◽  
Secondary Diabetes ◽  
New Treatment ◽  
The Impact

The impact of the creation of a venous surgical centre within the department of cardiovascular surgery at a university hospital

2007 ◽  
Vol 22 (2) ◽  
pp. 70-74 ◽  
Author(s):  
J T Christenson
Keyword(s):  
Surgical Procedures ◽  
Cardiovascular Surgery ◽  
Physician Satisfaction ◽  
University Hospital ◽  
Treatment Modalities ◽  
Clinical Activity ◽  
Patient Volume ◽  
The Creation ◽  
New Treatment ◽  
The Impact

Background: The establishment of specialty vein clinics has proven beneficial in terms of expansion of clinical volume. Depending on the local situation, the creation of a venous surgical centre may, in addition, result in better collaboration between various specialties, enable active participation in the development and evaluation of new treatment modalities, offer better training/education and provide venues for more complex treatment modalities such as reconstructive surgery of the deep venous system. Objectives: The aim of this study was to analyse the impact of the creation of a venous surgical centre under the auspices of a department of cardiovascular surgery at a university hospital. Methods: A venous surgical centre was established on 1 October 2003, under the direction of one senior surgeon. The impact on clinical activity was measured in terms of patient volume, percentage distribution between venous and arterial surgery and surgical procedures performed, complications following venous surgery as well as evaluation of patient and referring physician satisfaction. Data, from the department's databank, on all patients evaluated and surgically treated for venous and arterial problems from 1 January 2000 to 30 June 2006 were analysed. Number of outpatient clinic visits and operations (patients and surgical procedures) were calculated. Results: The establishment of the venous surgical centre, without additional funding, led to a significant increase in clinical volume. There was a 433% increase in vein surgical procedures and a 774% increase in outpatient clinic visits (comparing 2002 with 2004). Endovenous laser treatment of varicose veins and reconstructive surgery for the deep venous system was started, and a program for training surgeons was established. Complication rate following varicose vein surgery decreased from 5.8% to 1.2% (hematomas and groin infection). Patient and referring physician satisfaction was documented in 2004 and 2006 using questionnaires. Conclusions: The establishment of an academic venous surgical centre has proven useful in increasing clinical activity in terms of patient volume, providing more efficient and better continuity of care, ensuring less complications following varicose vein surgery, allowing the introduction of new treatment modalities, and resulting in overwhelming patient and treating physician satisfaction.

The impact of immune responses on lung cancer and the development of new treatment modalities

Lung Cancer ◽  
2001 ◽  
Vol 34 ◽  
pp. S71-S77 ◽  
Author(s):  
Eric Pluygers ◽  
Ala Sadowska ◽  
Lech Chyczewski ◽  
Jacek Nikliński ◽  
Wiesława Niklińska ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Immune Responses ◽  
Treatment Modalities ◽  
New Treatment ◽  
The Impact

Management of thoracic aortic lesions - the future is endovascular

VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 163-176 ◽  
Author(s):  
Weidenhagen ◽  
Bombien ◽  
Meimarakis ◽  
Geisler ◽  
A. Koeppel
Keyword(s):  
Thoracic Aorta ◽  
Clinical Decision Making ◽  
Treatment Options ◽  
Clinical Decision ◽  
Clinical Results ◽  
Treatment Modalities ◽  
Traumatic Rupture ◽  
Descending Thoracic Aorta ◽  
New Treatment ◽  
Aneurysm Dissection

Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the “state-of-the-art” treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates. However, due to a lack of randomized trials, the level of reliability of these new treatment modalities remains a matter of discussion. Clinical decision-making is generally based on the experience of the vascular center as well as on individual factors, such as life expectancy, comorbidity, aneurysm aetiology, aortic diameter and morphology. This article will review and discuss recent publications of open surgical, hybrid thoracic aortic (in case of aortic arch involvement) and endovascular repair in complex pathologies of the descending thoracic aorta.

U.S. Regulatory Approaches: A Critical Appraisal

1992 ◽  
Vol 25 (3) ◽  
pp. 13-21
Author(s):  
R. L. Williamson
Keyword(s):  
Decision Making ◽  
Command And Control ◽  
Regulatory System ◽  
Federal Agencies ◽  
Toxic Substances ◽  
Use Of Technology ◽  
Treatment Technologies ◽  
New Treatment ◽  
And Control ◽  
The Impact

The American approach to environmental regulation is characterized by fragmentation of responsibilities, primary reliance on command and control regulations, extraordinary complexity, a preference for identifiable standards, and heavy resort to litigation. This system has provided important benefits, including significant reduction of environmental contamination, substantial use of science in decision-making, broad participatory rights, and the stimulation of new treatment technologies. However, these gains have been achieved at excessive cost. Too much reliance is placed on command and control methods and especially on technology-based standards. There is too much resort to litigation, and inadequate input from science. Participatory rights are being undermined, and there is a poor allocation of decision-making among the federal agencies and the states. Over-regulation sometimes leads to under-regulation, and insufficient attention is given to the impact on small entities. The responsibility for these difficulties rests with everyone, including the federal agencies, the Congress, the general public and the courts. Changes in the regulatory system are needed. We should abandon the use of technology-based standards to control toxic substances under the Clean Water Act in favor of strong health- and environmentally based standards, coupled with taxes on toxic substances in wastewater.

Systematic literature review of clinical outcomes in adults with metastatic or advanced synovial sarcoma

2020 ◽  
Vol 16 (35) ◽  
pp. 2997-3013
Author(s):  
Kentaro Kogushi ◽  
Michael LoPresti ◽  
Shunya Ikeda
Keyword(s):  
Synovial Sarcoma ◽  
High Frequency ◽  
Clinical Evidence ◽  
Systemic Treatment ◽  
Progression Free Survival ◽  
Treatment Modalities ◽  
Free Survival ◽  
New Treatment ◽  
Poor Outcomes

Background: Synovial sarcoma (SS) is a rare, aggressive soft tissue sarcoma with a poor prognosis after metastasis. The objective of this study was to conduct a systematic review of the clinical evidence for therapeutic options for adults with metastatic or advanced SS. Materials & methods: Relevant databases were searched with predefined keywords. Results: Thirty-nine publications reported clinical data for systemic treatment and other interventions. Data on survival outcomes varied but were generally poor (progression-free survival: 1.0–7.7 months; overall survival: 6.7–29.2 months) for adults with metastatic and advanced SS. A high frequency of neutropenia with systemic treatment and low quality of life post-progression were reported. Conclusion: Reported evidence suggests poor outcomes in adults with metastatic and advanced SS and the need for the development of new treatment modalities.

scholarly journals Inhibitory Effects of a Reengineered Anthrax Toxin on Canine Oral Mucosal Melanomas

Toxins ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 157 ◽  
Author(s):  
Adriana Tomoko Nishiya ◽  
Marcia Kazumi Nagamine ◽  
Ivone Izabel Mackowiak da Fonseca ◽  
Andrea Caringi Miraldo ◽  
Nayra Villar Scattone ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Evaluation Criteria ◽  
Anthrax Toxin ◽  
Treatment Modalities ◽  
Inhibitory Effects ◽  
Upa Receptor ◽  
New Treatment ◽  
Oral Malignancy

Canine oral mucosal melanomas (OMM) are the most common oral malignancy in dogs and few treatments are available. Thus, new treatment modalities are needed for this disease. Bacillus anthracis (anthrax) toxin has been reengineered to target tumor cells that express urokinase plasminogen activator (uPA) and metalloproteinases (MMP-2), and has shown antineoplastic effects both, in vitro and in vivo. This study aimed to evaluate the effects of a reengineered anthrax toxin on canine OMM. Five dogs bearing OMM without lung metastasis were included in the clinical study. Tumor tissue was analyzed by immunohistochemistry for expression of uPA, uPA receptor, MMP-2, MT1-MMP and TIMP-2. Animals received either three or six intratumoral injections of the reengineered anthrax toxin prior to surgical tumor excision. OMM samples from the five dogs were positive for all antibodies. After intratumoral treatment, all dogs showed stable disease according to the canine Response Evaluation Criteria in Solid Tumors (cRECIST), and tumors had decreased bleeding. Histopathology has shown necrosis of tumor cells and blood vessel walls after treatment. No significant systemic side effects were noted. In conclusion, the reengineered anthrax toxin exerted inhibitory effects when administered intratumorally, and systemic administration of this toxin is a promising therapy for canine OMM.

scholarly journals Genetic variations influence brain changes in patients with attention-deficit hyperactivity disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Santosh K. Yadav ◽  
Ajaz A. Bhat ◽  
Sheema Hashem ◽  
Sabah Nisar ◽  
Madeeha Kamal ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Brain Imaging ◽  
Attention Deficit ◽  
Genetic Variations ◽  
Imaging Genetics ◽  
Treatment Modalities ◽  
Genetic Studies ◽  
Hyperactivity Disorder ◽  
Clinical Biomarkers ◽  
The Impact

AbstractAttention-deficit hyperactivity disorder (ADHD) is a neurological and neurodevelopmental childhood-onset disorder characterized by a persistent pattern of inattentiveness, impulsiveness, restlessness, and hyperactivity. These symptoms may continue in 55–66% of cases from childhood into adulthood. Even though the precise etiology of ADHD is not fully understood, it is considered as a multifactorial and heterogeneous disorder with several contributing factors such as heritability, auxiliary to neurodevelopmental issues, severe brain injuries, neuroinflammation, consanguineous marriages, premature birth, and exposure to environmental toxins. Neuroimaging and neurodevelopmental assessments may help to explore the possible role of genetic variations on ADHD neuropsychobiology. Multiple genetic studies have observed a strong genetic association with various aspects of neuropsychobiological functions, including neural abnormalities and delayed neurodevelopment in ADHD. The advancement in neuroimaging and molecular genomics offers the opportunity to analyze the impact of genetic variations alongside its dysregulated pathways on structural and functional derived brain imaging phenotypes in various neurological and psychiatric disorders, including ADHD. Recently, neuroimaging genomic studies observed a significant association of brain imaging phenotypes with genetic susceptibility in ADHD. Integrating the neuroimaging-derived phenotypes with genomics deciphers various neurobiological pathways that can be leveraged for the development of novel clinical biomarkers, new treatment modalities as well as therapeutic interventions for ADHD patients. In this review, we discuss the neurobiology of ADHD with particular emphasis on structural and functional changes in the ADHD brain and their interactions with complex genomic variations utilizing imaging genetics methodologies. We also highlight the genetic variants supposedly allied with the development of ADHD and how these, in turn, may affect the brain circuit function and related behaviors. In addition to reviewing imaging genetic studies, we also examine the need for complementary approaches at various levels of biological complexity and emphasize the importance of combining and integrating results to explore biological pathways involved in ADHD disorder. These approaches include animal models, computational biology, bioinformatics analyses, and multimodal imaging genetics studies.

scholarly journals Combining tissue and circulating tumor DNA increases the detection rate of a CTNNB1 mutation in hepatocellular carcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stine Karlsen Oversoe ◽  
Michelle Simone Clement ◽  
Britta Weber ◽  
Henning Grønbæk ◽  
Stephen Jacques Hamilton-Dutoit ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Mutation Rate ◽  
Detection Rate ◽  
Tumor Tissue ◽  
Circulating Tumor Dna ◽  
Treatment Modalities ◽  
Advanced Hepatocellular Carcinoma ◽  
Tissue Samples ◽  
The Impact ◽  
Tumor Dna

Abstract Background and aims Studies suggest that mutations in the CTNNB1 gene are predictive of response to immunotherapy, an emerging therapy for advanced hepatocellular carcinoma (HCC). Analysis of circulating tumor DNA (ctDNA) offers the possibility of serial non-invasive mutational profiling of tumors. Combining tumor tissue and ctDNA analysis may increase the detection rate of mutations. This study aimed to evaluate the frequency of the CTNNB1 p.T41A mutation in ctDNA and tumor samples from HCC patients and to evaluate the concordance rates between plasma and tissue. We further evaluated changes in ctDNA after various HCC treatment modalities and the impact of the CTNNB1 p.T41A mutation on the clinical course of HCC. Methods We used droplet digital PCR to analyze plasma from 95 patients and the corresponding tumor samples from 37 patients during 3 years follow up. Results In tumor tissue samples, the mutation rate was 8.1% (3/37). In ctDNA from HCC patients, the CTNNB1 mutation rate was 9.5% (9/95) in the pre-treatment samples. Adding results from plasma analysis to the subgroup of patients with available tissue samples, the mutation detection rate increased to 13.5% (5/37). There was no difference in overall survival according to CTNNB1 mutational status. Serial testing of ctDNA suggested a possible clonal evolution of HCC or arising multicentric tumors with separate genetic profiles in individual patients. Conclusion Combining analysis of ctDNA and tumor tissue increased the detection rate of CTNNB1 mutation in HCC patients. A liquid biopsy approach may be useful in a tailored therapy of HCC.

scholarly journals Tuning the network charge of biohybrid hydrogel matrices to modulate the release of SDF-1

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sebastian Kühn ◽  
Joanna Freyse ◽  
Passant Atallah ◽  
Jörg Rademann ◽  
Uwe Freudenberg ◽  
...  
Keyword(s):  
Bone Repair ◽  
Negative Charge ◽  
Polymer Networks ◽  
Signaling Molecules ◽  
Treatment Modalities ◽  
Precise Control ◽  
Integral Density ◽  
New Treatment ◽  
Two Parameters

Abstract The delivery of chemotactic signaling molecules via customized biomaterials can effectively guide the migration of cells to improve the regeneration of damaged or diseased tissues. Here, we present a novel biohybrid hydrogel system containing two different sulfated glycosaminoglycans (sGAG)/sGAG derivatives, namely either a mixture of short heparin polymers (Hep-Mal) or structurally defined nona-sulfated tetrahyaluronans (9s-HA4-SH), to precisely control the release of charged signaling molecules. The polymer networks are described in terms of their negative charge, i.e. the anionic sulfate groups on the saccharides, using two parameters, the integral density of negative charge and the local charge distribution (clustering) within the network. The modulation of both parameters was shown to govern the release characteristics of the chemotactic signaling molecule SDF-1 and allows for seamless transitions between burst and sustained release conditions as well as the precise control over the total amount of delivered protein. The obtained hydrogels with well-adjusted release profiles effectively promote MSC migration in vitro and emerge as promising candidates for new treatment modalities in the context of bone repair and wound healing.

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