scholarly journals Retinoblastoma and vision

Eye ◽  
2022 ◽  
Author(s):  
Omar Warda ◽  
Zishan Naeem ◽  
Kelsey A. Roelofs ◽  
Mandeep S. Sagoo ◽  
M. Ashwin Reddy
Keyword(s):  
Survival Rates ◽  
Treatment Strategies ◽  
Visual Outcomes ◽  
The Impact

AbstractThe assessment of vision has a growing importance in the management of retinoblastoma in the era of globe-conserving therapy, both prior to and after treatment. As survival rates approach 98–99% and globe salvage rates reach ever-higher levels, it is important to provide families with information regarding the visual outcomes of different treatments. We present an overview of the role of vision in determining the treatment given and the impact of complications of treatment. We also discuss screening and treatment strategies that can be used to maximise vision.

Sarcoligo: Impact of local ablative treatment of oligometastatic sarcomas on overall survival.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10042-10042
Author(s):  
Juliette Thariat ◽  
Laurence Moureau-Zabotto ◽  
Nicolas Penel ◽  
Antoine Italiano ◽  
Jacques-Olivier Bay ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lung Metastases ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Locoregional Treatment ◽  
Metastatic Sites ◽  
The Impact

10042 Background: 40-50% of sarcomas become metastatic. Median survival of metastatic patients has improved over time. The probably multifactorial reasons for such improvement are not fully clear. Noteworthy, for patients with a controlled primary and a limited number of lung metastases, complete resection of their metastases yields survival rates of up to 40% at three years. Advances in surgery, radiotherapy and radiofrequency have fostered the use of local treatments for various metastatic sites (lung, liver, spine...). Methods: A multicentric retrospective study of the Groupe Sarcome Francais (GSF-GETO); approved by the nationally-review board and ethical committee, was conducted to assess the impact of local ablative treatment on overall survival. Patients who had had oligometastases (any site, 1-5 synchronous metastases) at diagnostic or during the course of disease between 2000 and 2010 were included. Results: Median age of the 243 oligometastatic sarcoma patients was 53 years-old (11-86). Patients had grade I, II and III in 7.5%, 29.6% and 63.3% of cases, respectively with various histologies. 69% of patients underwent local ablative treatment of metastases. Median follow-up was 59 months (4-212) for living patients. Median overall survival was 51 months (1-348). On univariate analysis, grade, histology, absence of chemotherapy, local ablative treatment (surgery, irradiation, radiofrequency or chemoembolisation) correlated with survival but not age or site of oligometastasis. On multivariate analyses, grade (hazard ratio HR 0.12 [CI95 0.3-0.6]) and local ablative treatment (HR 3.8 [CI95 2.1-7.1]) remained significant. Conclusions: Local ablative treatment of metastases is associated with better survival in sarcoma patients with oligometastatic disease. The role of the locoregional treatment of metastases and its impact on quality of life should be assessed prospectively.

scholarly journals The Role of the Immune Response in Chronic Marginal and Apical Periodontitis

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 238-243
Author(s):  
Teodora Karteva ◽  
Neshka Manchorova-Veleva
Keyword(s):  
Immune Response ◽  
Treatment Strategies ◽  
Apical Periodontitis ◽  
Scientific Models ◽  
Comprehensive Understanding ◽  
Host Reaction ◽  
Complex Dynamic ◽  
The Impact ◽  
Marginal Periodontitis

The immune response is a complex, dynamic and strongly individual biologic network that plays an essential role in the pathogenesis of chronic apical and marginal periodontitis. Recent research in the field of periodontology has indicated that the major determinant of susceptibility to disease is the nature of the immunoinflammatory response as marginal periodontal tissue damage is thought to be primarily mediated by the host reaction. Whether the same rules apply for the development of apical periodontitis, however, remains largely unexplored. This review aims to draw parallels between the pathogenesis of chronic periodontitis of endodontic and marginal origin, outline the evidence for the destructive role of immune response in chronic marginal periodontitis and raise questions about its role in chronic apical periodontitis. It would be worthy to further explore the impact of the immune system on the characteristics and progress of these diseases and transfer some of the scientific models from the field of periodontology to the field of endodontics. Research in this area could lead to a more comprehensive understanding of the dynamics of apical and marginal periodontitis and lay the foundation of new personalized treatment strategies. 

Role of Dermatologists in Advanced Cutaneous Melanoma Treatment: A Call for Action (Preprint)

2021 ◽  
Author(s):  
Louay Samir Abdulkarim
Keyword(s):  
Adverse Events ◽  
Health Care Professionals ◽  
Cutaneous Melanoma ◽  
Detrimental Effect ◽  
Survival Rates ◽  
Melanoma Treatment ◽  
Melanoma Patients ◽  
The Impact ◽  
Fragmentation Of Care

UNSTRUCTURED Advanced cutaneous melanoma has always been a dreaded diagnosis, but with the introduction of a number of practice-changing agents, namely targeted therapy and immunotherapy, considerable strides have been achieved in terms of survival rates. However, the introduction of these agents was associated with a variety of dermatological adverse event, some of which have shown a detrimental effect on the continuity of treatment. This holds especially true in the light of the current fragmentation of care provided by the managing health care professionals. This article sheds light on the impact of the scarcity of dermatology specialist input in the management of dermatological adverse events associated with advanced melanoma treatment. Furthermore, it looks into the potential avenues where dermatological input can bridge the gap in the care provided by oncologists, hence standardising the care provided to melanoma patients with dermatological adverse events.

Modelling population viability in fragmented environments: contribution to the conservation of an endangered percid (Zingel asper)

2006 ◽  
Vol 63 (3) ◽  
pp. 650-659 ◽  
Author(s):  
Jacques Labonne ◽  
Philippe Gaudin
Keyword(s):  
Survival Rates ◽  
Dispersal Rate ◽  
Population Extinction ◽  
Extinction Rates ◽  
Random Events ◽  
Extinction Probabilities ◽  
Scale Population ◽  
Riverine Habitat ◽  
The Impact

Zingel asper is an endemic percid of the Rhône catchment. The demography and habitat use of this endangered benthic species have been studied in previous works. The species exhibits natural low densities and clumped distribution related to habitat distribution. Based on these results, the authors build a stochastic equations network model, integrating spatial structure at intrapopulation level and vague density dependence. Calculation of density, growth rates, and local extinction rates globally match the field results. The numerical sensitivity analysis on extinction probabilities shows that adult and juvenile survival rates and spawning success (due to random events) are the key parameters of intrapatch dynamics. Low negative variations in these parameters increase extinction probabilities. The number of available connected patches and the dispersal rate drive the population persistence at the interpatch scale. Population extinction probability over 100 years is at least 0.4 for dispersal rate below 0.2, or when the number of connected patches is below 15. These results enlighten the role of dispersal in nonmigratory fish populations and should be useful in assessing the impact of riverine habitat fragmentation through river-damming and habitat loss.

Impact of immune checkpoint inhibitor (CPI) and EGFR tyrosine kinase inhibitor (TKI) sequence on time to treatment failure (TTF) among EGFR plus NSCLC treated in a community-based cancer research network.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9099-9099
Author(s):  
Carissa Jones ◽  
Rebecca Lachs ◽  
Emma Sturgill ◽  
Amanda Misch ◽  
Caressa Lietman ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Survival Rates ◽  
Research Network ◽  
Sample Sizes ◽  
Loss To Follow Up ◽  
Kaplan Meier ◽  
Oncogenic Driver ◽  
The Impact

9099 Background: The development of CPIs and driver-targeted TKIs has transformed the treatment of NSCLC and increased survival rates. However, the role of CPIs in patients with oncogenic-driven NSCLC remains an area of investigation. We sought to examine the impact of CPI sequence on treatment response among patients with oncogenic-driver mutation-positive NSCLC. Methods: Patients with NSCLC being treated within the Sarah Cannon Research Institute network were identified through Genospace, Sarah Cannon’s clinico-genomic analytics platform. Advanced stage oncogenic-driven tumors (driver+) were defined as those with a record of receiving an FDA-approved TKI targeting EGFR, ALK, RET, ROS1, NTRK, MET, or BRAF. Kaplan-Meier estimates were used to examine TTF (defined as time from therapy start to start of next therapy, death, or loss to follow-up) and overall survival (OS). Results: We identified 12,352 patients with lung cancer and available therapy data (2005-2020), including 2,270 (18%) driver+ patients. Eleven percent (N=245) of driver+ patients received a CPI, including 120 (49%) with CPI prior to TKI, 122 (50%) with CPI post TKI, and 3 (1%) who received CPI both pre and post TKI. The CPI TTF was significantly longer for those who received CPI post TKI compared to those who received it prior (Table). EGFR+ tumors accounted for 82% (N=1,867) of driver+ patients, 10% of whom (N=188) received a CPI. Of the EGFR+/CPI+ patients, 78 patients (41%) received CPI prior to TKI, 107 (57%) received CPI post TKI, and 3 (2%) received CPI both pre and post TKI. EGFR+ tumors exposed to a CPI post TKI had a longer CPI TTF compared to patients who received it prior (Table). In contrast, there was no difference in length of benefit from TKI if it was received pre vs. post CPI (Table). There was also no difference in OS based on sequence of TKI and CPI (p=0.88). Larger sample sizes are needed for analysis of additional driver-stratified cohorts. Conclusions: Patients with oncogenic-driven NSCLC benefited from CPI longer when it was administered after TKI compared to before. Importantly, therapy sequence only affected length of benefit from CPIs and did not affect length of benefit from TKIs. This effect was present in EGFR+ NSCLC, but sample sizes were too small to determine if the same is true for other oncogenic-drivers. Therapy sequence had no impact on OS, indicating the presence of additional clinical, therapeutic, and/or genomic factors contributing to disease progression. Continued research is needed to better understand markers of CPI response in driver+ NSCLC.[Table: see text]

Prognosis in Acute Myeloid Leukemia: A Population-Based Study on 5,809 Patients Diagnosed in Sweden 1973–2001.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1845-1845 ◽  
Author(s):  
Asa R. Derolf ◽  
Ola Landgren ◽  
Paul Dickman ◽  
Sigurdur Y. Kristinsson ◽  
Magnus Bjorkholm
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Survival Rates ◽  
Age Groups ◽  
Treatment Strategies ◽  
Relative Survival ◽  
Age Group ◽  
Calendar Period ◽  
The Impact

Abstract Background AML is an aggressive disease, which is rapidly fatal without specific therapy. Such treatment was not available until the early 1970’s when combinations of anthracyclines and cytarabine were introduced. Since then major improvements have been made in chemotherapy, stem cell transplantation (SCT) and supportive care. The aim of this study was to define the impact of modern AML treatment strategies on outcome. Extrapolation of results from clinical trials may not be appropriate for estimation of outcome in the whole population because of a varying degree of patient selection. In this study relative survival rates (RSR) were estimated in relation to age, sex, calendar period and region of residence in a cohort of 5,809 AML patients. Methods Records on all patients with AML reported to the Swedish Cancer Register between 1973 and 2001 were linked to the nationwide Cause of Death Register. Information on the number of SCT in AML patients in Sweden during the study period was obtained from the EBMT register. Survival analysis were performed by computing relative survival rates (RSR), defined as the ratio of observed survival of the patients in the cohort versus the expected survival among individuals of the same age, sex, and calendar year of observation. Results 5809 AML patients diagnosed between January 1, 1973 and December 31, 2001 were identified. The cases were divided into six age groups; 0–18, 19–40, 41–60, 61–70, 71–80, and 80+ years. The study period was arbitrarily divided into 7-year intervals. Improvement was seen in all age groups but the eldest. However, patients < 60 years benefited most from new treatment strategies (table 1). There was a marked increase in SCT during the study period with allogeneic SCT dominating in the last period (fig 1). A comparison between regions (with different therapeutical traditions) was made. The regions of Stockholm, Uppsala and Örebro have cooperated since 1971 within the Leukemia Group of Middle Sweden (LGMS) and was therefore considered as one region and compared with the rest of the country. During the first calendar period the 5-year RSR of residents with AML in LGMS counties was significantly higher than that of patients in remaining regions. However, this difference has disappeared with time. Conclusion Improvement in overall survival of AML patients was mainly confined to young patients (<60 years). However, among patients 60–71 years at diagnosis, a slightly improved RSR was observed. For patients above the age of 70 years, the prognosis remains very poor stressing the fact that the decision to use aggressive chemotherapy for this group of patients should consider the risk of iatrogenic morbidity and mortality as well as projected benefit. The early creation of a cooperative clinical AML group probably explains the improved RSR rates during the first study period (1973–1979). Table 1. Five-year RSR (%) according to age group and calendar period calendar period/age group (years) 1973–1979 1980–1986 1987–1993 1994–2000 0–18 17 31 52 68 19–40 14 17 38 58 41–60 7 13 22 36 61–70 6 8 12 15 71–80 3 3 7 6 81+ 1 0 0 1 Fig. 1 Number of stem cell transplantation in Sweden 1973–2001 Fig. 1. Number of stem cell transplantation in Sweden 1973–2001

scholarly journals Role of chemotherapy in nasopharyngeal carcinoma

2012 ◽  
Vol 6 (1) ◽  
pp. 1 ◽  
Author(s):  
Fabiola Paiar ◽  
Vanessa Di Cataldo ◽  
Giacomo Zei ◽  
Eleonora Monteleone Pasquetti ◽  
Sara Cecchini ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Head And Neck ◽  
Locally Advanced ◽  
Survival Rates ◽  
Treatment Strategies ◽  
High Sensitivity ◽  
Chemotherapeutic Agents ◽  
High Response Rate ◽  
Poorly Differentiated

Nasopharyngeal carcinoma (NPC) is a unique malignant head and neck cancer with clinical, demographic, and geographic features distinct from other head and neck epithelial malignancies. Non-keratinizing, poorly differentiated, and undifferentiated WHO types 2 and 3 is the most common subtypes of NPC. NPC is also characterized by its relatively high sensitivity to radiation, so that in the last decades radiotherapy (RT) has been the cornerstone of treatment. However, in the majority of cases NPC is discovered at locally advanced stage. The results are disappointing when RT alone is offered. The 5-year survival rates have been reported to be about 34-52%. The poor prognosis for advanced NPC led to increasing interests in exploring the use of chemotherapy (CT). NPC has been considered to be not only radiosensitive but also chemo-sensitive and has shown high response rate to various chemotherapeutic agents. Certainly, the treatment strategies for NPC will continue to change and evolve as a better understanding is gained of the molecular and immune mechanisms that drive this disease. We reviewed the current literature focusing on the role of CT and new-targeted agents.

Potential Role of Lymphadenectomy in Advanced Ovarian Cancer: A Combined Exploratory Analysis of Three Prospectively Randomized Phase III Multicenter Trials

2010 ◽  
Vol 28 (10) ◽  
pp. 1733-1739 ◽  
Author(s):  
Andreas du Bois ◽  
Alexander Reuss ◽  
Philipp Harter ◽  
Eric Pujade-Lauraine ◽  
Isabelle Ray-Coquard ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Residual Disease ◽  
Survival Rates ◽  
Advanced Ovarian Cancer ◽  
Exploratory Analysis ◽  
Phase Iii ◽  
Rank Test ◽  
Primary Surgery ◽  
The Impact

Purpose Primary surgery followed by platinum/taxane-based chemotherapy is the standard therapy in advanced ovarian cancer. The prognostic role of complete debulking has been well described; however, the impact of systematic pelvic and para-aortic lymphadenectomy and its interaction with biologic factors are still not fully defined. Methods This was an exploratory analysis of three prospective randomized trials (Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom trials 3, 5, and 7) investigating platinum/taxane-based chemotherapy regimens in advanced ovarian cancer conducted between 1995 and 2002. Results One thousand nine hundred twenty-four patients were analyzed. Lymphadenectomy was associated with superior survival in patients without gross residual disease. In patients with and without lymphadenectomy, the median survival time was 103 and 84 months, respectively, and 5-year survival rates were 67.% and 59.2%, respectively (P = .0166); multivariate analysis confirmed a significant impact of lymphadenectomy on overall survival (OS; hazard ratio [HR] = 0.74; 95% CI, 0.59 to 0.94; P = .0123). In patients with small residual tumors up to 1 cm, the effect of lymphadenectomy on OS barely reached significance (HR = 0.85; 95% CI, 0.72 to 1.00; P = .0497). For patients with small residual tumors and clinically suspect nodes, lymphadenectomy resulted in a 16% gain in 5-year OS (log-rank test, P = .0038). Conclusion Lymphadenectomy in advanced ovarian cancer might offer benefit mainly to patients with complete intraperitoneal debulking. However, this hypothesis should be confirmed in the context of a prospectively randomized trial.

scholarly journals Role of advanced respiratory support in acute respiratory failure in clinically frail patients with COVID-19

2021 ◽  
Author(s):  
Iftikhar Nadeem ◽  
Louise Jordon ◽  
Masood Ur Rasool ◽  
Noor Mahdi ◽  
Ritesh Kumar ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Survival Rates ◽  
Respiratory Support ◽  
Single Center Study ◽  
Significant Difference ◽  
Different Types ◽  
The Impact ◽  
Frailty Score

Background: The main aim of this study was to assess the efficacy of advanced respiratory support (ARS) for acute respiratory failure in do-not-attempt cardiopulmonary resuscitation order (DNACPR) COVID-19 patients. Methods: In this single-center study, the impact of different types of ARS modality, PaO2/FiO2 (PF) ratio, clinical frailty score (CFS) and 4C score on mortality was evaluated. Results: There was no significant difference in age, type of ARS modality, PF ratio and 4C scores between those who died and those who survived. Overall survival rates/hospital discharge of patients still requiring ARS at 5 and 7 days post admission were 20 and 17%, respectively. Conclusion: Our study showed that ARS can be a useful tool in frail, elderly and high-risk COVID-19 patients irrespective of high 4C mortality score.

scholarly journals Perimenstrual asthma: from pathophysiology to treatment strategies

2016 ◽  
Vol 11 ◽  
Author(s):  
Alessandra Graziottin ◽  
Audrey Serafini
Keyword(s):  
Hormonal Contraception ◽  
Treatment Strategies ◽  
Emergency Department Visits ◽  
Asthma Phenotype ◽  
Lung Capacity ◽  
Pubmed Database ◽  
Lower Lung ◽  
Symptomatic Asthma ◽  
The Impact

The prevalence of asthma is about 9,7 % in women and 5,5 % in men. Asthma can deteriorate during the perimenstrual period, a phenomenon known as perimenstrual asthma (PMA), which represents a unique, highly symptomatic asthma phenotype. It is distinguished from traditional allergic asthma by aspirin sensitivity, less atopy, and lower lung capacity. PMA incidence is reported to vary between 19 and 40 % of asthmatic women. The presence of PMA has been related to increases in asthma-related emergency department visits, hospitalizations and emergency treatment including intubations. It is hypothesized that hormonal status may influence asthma in women, focusing on the role of sex hormones, and specifically on the impact of estrogens’ fluctuations at ovulation and before periods. This paper will focus on the pathophysiology of hormone triggered cycle related inflammatory/allergic events and their relation with asthma. We reviewed the scientific literature on Pubmed database for studies on PMA. Key word were PMA, mastcells, estrogens, inflammation, oral contraception, hormonal replacement therapy (HRT), and hormone free interval (HFI). Special attention will be devoted to the possibility of reducing the perimenstrual worsening of asthma and associated symptoms by reducing estrogens fluctuations, with appropriate hormonal contraception and reduced HFI. This novel therapeutical approach will be finally discussed.

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