scholarly journals A48 USE OF ENDOSCOPIC ULTRASOUND FINE NEEDLE ASPIRATE AND ENDOSCOPIC ULTRASOUND FINE NEEDLE BIOPSY FOR DETECTION OF GATA6 EXPRESSON IN PANCREATIC DUCTAL ADENOCARINCOMA

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 297-299
Author(s):  
C Law ◽  
S Fischer ◽  
J Knox ◽  
S Gallinger ◽  
S Ramotar ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Statistical Significance ◽  
Pancreatic Head ◽  
Primary Objective ◽  
The Body ◽  
Ductal Adenocarcinoma ◽  
P Value ◽  
Fine Needle Aspirate ◽  
Fine Needle ◽  
The Impact

Abstract Background GATA6 is a transcription factor that can be used to distinguish between the basal-like and classical subtypes of pancreatic ductal adenocarcinoma (PDAC). The basal-like subtype has been demonstrated to be less responsive to modified FOLFIRINOX chemotherapy and thus can be used to predict response to specific chemotherapies. To date, GATA6 expression has only been evaluated in surgically resected PDAC specimens. Less than 15% of patients with PDAC are eligible for surgery. Endoscopic ultrasound guided fine-needle aspirate (EUS-FNA) and biopsy (EUS-FNB) can potentially help assess GATA6 expression in PDAC and in turn, help guide personalized treatment selection in all cases of PDAC. Aims The primary objective of this study was to explore the yield of EUS-FNA and EUS-FNB for the detection of GATA6 among patients with PDAC. The study also aimed to explore the impact of lesion location on sample adequacy and type of fixative on validity of GATA6 staining. Methods This study was conducted from November 2017 to October 2019. Consecutive patients with a diagnosis of PDAC confirmed by biopsy were included. Patients underwent either EUS-FNB or EUS-FNA to obtain tissues samples. Samples were fixed in either neutral buffered formalin (NBF) or a methanol based buffered solution (Cytolyt) and evaluated by a specialized cytopathology team. Fisher’s exact test was used and a p-value ≤0.05 was considered to indicate statistical significance. Results Forty-four patients were included in the study. Twenty-three (52%) patients were male and the median age of patients was 67.5 years. Twenty-five lesions were located in the head and neck of the pancreas, 14 were located in the body, and 4 were located in the tail. One patient was found to have a local recurrence of PDAC at the surgical bed of a previous Whipple procedure. Eighteen lesions were sampled by EUS-FNA and 26 were sampled using EUS-FNB. Thirty-eight (86%) samples were adequate for assessment of GATA6. Sampling technique (p=0.68) and fixative type (p=1.00) did not appear to affect sample adequacy. Compared to pancreatic body or tail specimens, samples obtained from the head or neck of the pancreas were more likely to be inadequate for analysis (p=0.03). Conclusions EUS-FNA and EUS-FNB samples are efficacious methods of assessing GATA6 expression in PDAC. This is the first predictor of treatment response that has been demonstrated to be obtained without surgical resection. Neither EUS needle type or alcohol fixation before cell block preparation appear to impact GATA6 detection. Lesions in the pancreatic head or neck appear to be associated with higher rates of sample inadequacy. Larger, prospective studies are required to confirm our findings. Funding Agencies None

617 Who Benefits the Most from Burn Camps?

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S162-S163
Author(s):  
Jennifer B Radics-Johnson ◽  
Daniel W Chacon ◽  
Li Zhang
Keyword(s):  
Retrospective Review ◽  
Burn Injury ◽  
Statistical Significance ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Self Evaluation ◽  
Significant Difference ◽  
Return Home ◽  
The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value< 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

scholarly journals Estado nutricional e desfechos clínicos em pacientes críticos internados em hospital universitário

2020 ◽  
Vol 34 (4) ◽  
pp. 361-366
Author(s):  
Edcleide Oliveira dos Santos Olinto ◽  
Gina Araújo Martins Feitosa ◽  
Izaura Odir Lima Gomes da Costa ◽  
Janine Maciel Barbosa ◽  
Ericka Vilar Bôtto Targino ◽  
...  
Keyword(s):  
Body Mass ◽  
Statistical Significance ◽  
Strong Relationship ◽  
The Body ◽  
University Hospital ◽  
Nutritional Risk ◽  
World Health ◽  
P Value ◽  
Chi Square ◽  
Length Of Hospitalization

Introduction: There is a strong relationship between malnutrition and increased length of hospitalization and morbidity and mortality. Studies have shown that malnourished patients can have up to twenty times more complications than eutrophic ones. In critically ill patients, there is a tendency to catabolism, resulting in the loss of lean body mass, which when it reaches 40% is usually lethal. Methods: A quantitative, descriptive study was conducted on adults from both genders, admitted to the intensive care unit (ICU) of a university hospital, from March to December 2018. The following variables were collected from the evaluation and nutritional records: length of hospitalization in the ICU, date of discharge or death, nutritional risk through specific screening, height, weight and arm circumference (AC). For the screening, the Nutric score was used. For the nutritional evaluation, the body mass index (BMI) and AC indicators and the classifications recommended by the World Health Organization (2004) and Blackburn and Thornton (1979) were used. After collecting the data, they were analyzed in the Statistical Package for Social Sciences (SPSS) 13.0 and for the association of the variables the Chi-square test was used, considering statistical difference when the p value <0.05. Results: The sample consisted of 116 patients, mostly female (53.4%) whose median age was 46 years (interquartile range IQR 31-53). Regarding the frequency of nutritional risk, most patients (61.5%) had a low score. There was an important frequency of malnutrition, according to the AC indicator (73%), although BMI (43.5%) showed eutrophy. Even though most patients had low nutritional risk, those with high nutritional risk (38.5%) had a higher tendency to mortality, however, not statistically confirmed (p> 0.05). There was also a tendency of association between death and malnutrition, although no statistical significance was shown(p> 0.05). Conclusion: Patients at nutritional risk and/or malnutrition appear to be vulnerable to worse clinical outcomes.

Molecular profiling of advanced pancreatic ductal adenocarcinoma (PDAC): Role of ctDNA.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 425-425
Author(s):  
Angela Lamarca ◽  
Mairead Geraldine McNamara ◽  
Richard Hubner ◽  
Juan W. Valle
Keyword(s):  
Palliative Therapy ◽  
Progression Free Survival ◽  
Patient Characteristics ◽  
Molecular Profiling ◽  
Ductal Adenocarcinoma ◽  
P Value ◽  
Ctdna Analysis ◽  
Chemotherapy Initiation ◽  
The Impact

425 Background: Molecular profiling of tumour samples and circulating tumour DNA (ctDNA) may inform treatment of advanced cancer; the role of ctDNA to predict progression-free-survival (PFS) and overall survival (OS) in advanced PDAC is not fully understood. Methods: Eligible patients: those diagnosed with advanced PDAC undergoing molecular profiling [tumour (Foundation Medicine CDx/Caris) or ctDNA (FoundationMedicine Liquid (72 cancer-related genes))]. Baseline patient characteristics and molecular profiling outcomes, including mutant allele frequency (MAF) for pathological alterations were extracted. The primary aim was to assess the impact of presence of ctDNA at time of systemic chemotherapy initiation on PFS and OS. Results: Total of 26 samples (ctDNA 18 samples and 8 tumour samples) from 25 patients diagnosed with advanced PDAC underwent molecular profiling. When the whole population was analysed, the rate of sample analysis failure seemed to be higher when tumour tissue was tested (37.5%) compared to ctDNA (5.56%); p-value 0.072. The overall rate of identification of pathological findings was 72.73%, with 18.18% of patients having targetable findings [EGFRmut (1 patient), KRAS G12C mut (1 patient), FGFR2 fusion (1 patient), RNF43 mut (1 patient)]; these findings impacted treatment management in one patient only (RNF43 mutation; Wnt inhibitor). Variants of unknown significance were identified in 63.64% of samples. Patients with ctDNA analysis at time of palliative chemotherapy initiation (16 samples; 15 patients) were analysed [6 female (40.00%), median age 69.57 years (range 51.61-81.49), metastatic disease (66.67%), 80% first-line (80%), 20% second-line]. Pathological mutations were identified in 9/15 (60.00%) of these patients (KRAS mutation identified in 6/9). After median follow-up of 8.33 months from sample acquisition, 80% and 53.33% of patients had progressed and died, respectively. Median estimated PFS and OS were 5.65 months (95% CI 1.59-8.17) and 7.80 months (95% CI 4.13-not reached). Presence (vs absence) of pathological alterations in ctDNA showed a trend towards shorter PFS (2.91 vs 6.51 months; HR 1.38 (95% CI 0.40-4.77)) and OS (6.12 vs 9.72 months; HR 2.03 (95% CI 0.60-6.82)). Conclusions: This pilot study demonstrates the feasibility of ctDNA analysis in patients with advanced PDAC prior to initiation of palliative therapy. The presence of pathological alterations in ctDNA may prognosticate for worse PFS and OS. Larger studies are required to confirm these findings.

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