scholarly journals Immunotherapy in gastroesophageal cancers: Current state and future directions

2020 ◽  
pp. 107815522096353
Author(s):  
Hira Shaikh ◽  
Amir Kamran ◽  
Dulabh K Monga

While gastroesophageal (GE) cancers are one of the most common cancers worldwide, unfortunately, the mortality remains high. Commonly used treatment options include surgical resection, chemotherapy, radiotherapy, and molecular targeted therapy, which improve survival only minimally; thus, affirming the dire need for exploring alternative strategies to improve patient outcomes. Immunotherapy, which has revolutionized the world of oncology, has somewhat lagged behind in GE malignancies. Tumor-associated microenvironment and regulatory T cells, alongside cell cycle checkpoints, have been proposed by various studies as the mediators of carcinogenesis in GE cancers. Thus, inhibition of each of these could serve as a possible target of treatment. While the approval of pembrolizumab has provided some hope, it is not enough to override the dismal prognosis that this disease confers. Herein, we discuss the prospects of immunotherapy in this variety of cancer.

2019 ◽  
Vol 4 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Rita Grazina ◽  
Sérgio Teixeira ◽  
Renato Ramos ◽  
Henrique Sousa ◽  
Andreia Ferreira ◽  
...  

Dupuytren’s disease is a fibroproliferative disease that involves collagen deposition, leading to hand contractures that ultimately affect hand mobility and grip strength. It is a benign disorder but can cause high morbidity by limiting daily activities. Many factors have been proposed for its aetiology: namely genetics, smoking, alcohol intake and diabetes. However, there is still controversy as to the main aetiological cause of the disease. Treatment is not yet uniform around the world and still varies with the surgeon’s experience and preference. In this review, the authors review the pathogenesis and treatment options for Dupuytren’s disease in an attempt to summarize the current state of the art. Cite this article: EFORT Open Rev 2019;4:63-69. DOI: 10.1302/2058-5241.4.180021.


2018 ◽  
Vol 29 (04) ◽  
pp. 313-336 ◽  
Author(s):  
Fatima T. Husain ◽  
Phillip E. Gander ◽  
Jaclyn N. Jansen ◽  
Sa Shen

AbstractRoughly 10–15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling.This study compared audiologists’ and patients’ responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients. The surveys included several related questions, such that comparison of the two could reveal where patients’ and audiologists’ expectations for tinnitus care were in agreement and areas in which they differed.The surveys for audiologists and adults with tinnitus were 31- and 38-item questionnaires, respectively. Both surveys comprised demographic questions followed by several tinnitus-related questions in either multiple-choice or Likert-scale format.We received 230 completed Patient Surveys and 68 completed Audiologist Surveys.All survey recruitment was completed online. Responses were collected via the Survey Monkey web tool (http://www.surveymonkey.com/). Responses were analyzed within and between surveys and grouped into topical categories (assessment, counseling, current available tinnitus information, satisfaction and expectations, improving tinnitus management). For data within each survey, descriptive statistics and correlation analyses were used. For selected comparisons between surveys, cross-tabulations were used. Hierarchical regression modeling was conducted to further explore (1) the perceived effectiveness of treatment received, and (2) how each group defined treatment success.Differences were noted between the two groups’ responses to the question on the definition of treatment success; audiologists reported decreased awareness (77%), stress/anxiety relief (63%), and increased knowledge of tinnitus (63%) most commonly, whereas patients reported reduction of tinnitus loudness (63%) and complete elimination of tinnitus (57%) most often. The topic of greatest agreement was the desire for more information on tinnitus; 62% of patients felt more information from their healthcare provider would be the most important factor for improved tinnitus management, and 67% of audiologists reported currently having “some access” or less to appropriate resources for tinnitus treatment. Modeling results for effective tinnitus management and definitions of treatment success highlighted the importance of resource access and information sharing for both audiologists and patients.Patients and audiologists differed in terms of their expectations for successful treatment, with the patients focusing on perceptual factors and the audiologists on the reaction to the sound. Patient satisfaction with tinnitus treatment may be improved through access to more information, specifically, more information about current tinnitus treatment options and how these focus on the patient’s reaction to the tinnitus rather than the percept itself. Providing credible tinnitus information resources to audiologists, and focusing resources on training a small number of tinnitus specialist audiologists could greatly improve patient satisfaction with the current state of tinnitus palliative care.


2021 ◽  
Author(s):  
Alexandr S. Golota ◽  
Sergey G. Sherbak ◽  
Stanislav V. Makarenko ◽  
Andrey M. Sarana ◽  
Tatyana A. Kamilova

The article is devoted to the analysis of the current state of regenerative and rehabilitative treatments of skeletal muscles, the possibilities of restoring the functioning of tissue lost due to aging, injuries or diseases. The study of the molecular genetic basis of mechanotransduction and mechanotherapy will allow the identification of genes and molecules, the expression levels of which can serve as biomarkers of the effectiveness of regenerative-rehabilitation measures. These mechanisms are potential therapeutic targets for stimulating of regeneration of skeletal muscles. The focus of the article is on the choice of an individual approach, both when conducting basic scientific research and developing rehabilitation programs. All this will significantly improve patient outcomes.


Cephalalgia ◽  
2020 ◽  
pp. 033310242097435
Author(s):  
Patricia Pozo-Rosich ◽  
Gianluca Coppola ◽  
Julio Pascual ◽  
Todd J Schwedt

Background Validated chronic migraine biomarkers could improve diagnostic, prognostic, and predictive abilities for clinicians and researchers, as well as increase knowledge on migraine pathophysiology. Objective The objective of this narrative review is to summarise and interpret the published literature regarding the current state of development of chronic migraine biomarkers. Findings Data from functional and structural imaging, neurophysiological, and biochemical studies have been utilised towards the development of chronic migraine biomarkers. These biomarkers could contribute to chronic migraine classification/diagnosis, prognosticating patient outcomes, predicting response to treatment, and measuring treatment responses early after initiation. Results show promise for using measures of brain structure and function, evoked potentials, and sensory neuropeptide concentrations for the development of chronic migraine biomarkers, yet further optimisation and validation are still required. Conclusions Imaging, neurophysiological, and biochemical changes that occur with the progression from episodic to chronic migraine could be utilised for developing chronic migraine biomarkers that might assist with diagnosis, prognosticating individual patient outcomes, and predicting responses to migraine therapies. Ultimately, validated biomarkers could move us closer to being able to practice precision medicine in the field and thus improve patient care.


The Oxford Handbook of the Apocrypha is meant to be a premier reference work for the study of the so-called Old Testament Apocrypha, important early Jewish texts that have become deutero-canonical for some Christian churches and non-canonical for other churches and that are of lasting cultural significance. In addition to the place given to the classical literary, historical, and tradition-historical introductory questions, this Handbook will focus on the major social and theological themes of each individual book. Special attention will be given to the Apocrypha’s portrayal of gender and sexuality, their ethics, and their reception history. Several chapters will deal with overarching topics, such as genre and historicity, Jewish practices and beliefs, and the relation of the Apocrypha to the Septuagint, Qumran, Pseudepigrapha, and New Testament, thus also offering important insights on the place of the Apocrypha in Second Temple (or early) Judaism. With contributions from leading scholars from around the world, the Handbook provides the authoritative reference work on the current state of Apocrypha research, and at the same time, carves out future directions of study.


2016 ◽  
pp. 1707-1717
Author(s):  
Judith W. Dexheimer ◽  
Elizabeth M. Borycki

Hand-held and mobile technology is steadily expanding in popularity throughout the world. Mobile technologies (e.g. mobile phones, tablets, and smart phones) are increasingly being used in Emergency Departments (ED) around the world. As part of this international trend towards introducing mobile technologies into the ED, health professionals (e.g. physicians, nurses) are now being afforded opportunities to access patient information and decision supports anywhere and anytime in the ED. In this chapter, the authors present a model that describes the current state of the research involving mobile device use in the ED, and they identify key future directions where mobile technology use is concerned.


2011 ◽  
Vol 07 (02) ◽  
pp. 143
Author(s):  
Hillary Prescott ◽  
Elias Jabbour ◽  
Jeffrey Bryan ◽  
Hagop Kantarjian ◽  
◽  
...  

Myelodysplastic syndromes (MDS) are a group of heterogeneous hematopoietic stem cell disorders characterized by peripheral blood cytopenias and a risk of transformation to acute myeloid leukaemia. Until recently, treatment of MDS predominately consisted of supportive care measures. However, three agents for the treatment of MDS have recently been approved: lenalidomide, decitabine, and azacitidine. These agents have dramatically improved the outcomes for patients with MDS. To date, azacitidine is the only agent that has demonstrated a survival advantage when compared with conventional care. Novel agents and combination regimens including lenalidomide, decitabine and azacitidine are being explored in an effort to further improve patient outcomes.


2020 ◽  
Vol 39 (1) ◽  
pp. 83-103
Author(s):  
J. Cedar Wang ◽  
Lori Podlinski

This chapter discusses the current state of hospital-based simulation, including the unprecedented events of 2020's global COVID-19 pandemic. Hospital-based simulation training requires a new approach. The realities of social distancing and the operational demands of hospital staffing ratios warrant creative adaptations of traditional simulation training methods. Hospitals used simulation to improve patient outcomes by training healthcare staff and students through telesimulation, and tested systems and equipment using in situ simulation (ISS). Latent safety threats (LSTs) were identified and corrected to improve patient outcomes. Hospital-based simulation has been incorporated into newly licensed registered nurses (NLRNs) residency programs to prepare them for competent practice. Simulations are also used for preparing staff for low-incidence, high-risk medical emergencies or disasters, such as active shooter events. Hospital-based simulation training adds value to healthcare systems, but requires more evidence of its quantitative and qualitative impacts.


2017 ◽  
Vol 30 (6) ◽  
pp. 278-282 ◽  
Author(s):  
Rakesh Calton ◽  
Kim de Haan ◽  
Kerrie Dewachter ◽  
Susan Komhyr Smith

Value in healthcare is a challenge that is faced all over the world; costs continue to rise despite efforts to increase quality and efficient healthcare delivery. Heart failure is a progressive chronic condition that has been demonstrated to benefit from close monitoring with positive effects on mortality and morbidity when well managed. This article will review the Porter model for value in healthcare by comparing the current state of heart failure management in Ontario, Canada, with the six key concepts of the value agenda. The Ontario quality-based procedure model has been implemented for heart failure management and will be applied against the Porter model to provide an increased understanding of how managers can think differently about patient outcomes. An examination as to how the quality and value of the treatment of this condition can be improved will be conducted using the principles of the value agenda.


2018 ◽  
Vol 19 (7) ◽  
pp. 2139 ◽  
Author(s):  
David Bartlett ◽  
Richard Miller ◽  
Scott Thiesfeldt ◽  
Hari Lakhani ◽  
Joseph Shapiro ◽  
...  

Aging has been associated with a series of pathophysiological processes causing general decline in the overall health of the afflicted population. The cumulative line of evidence suggests an important role of oxidative stress in the development and progression of the aging process and metabolic abnormalities, exacerbating adipocyte dysfunction, cardiovascular diseases, and associated complications at the same time. In recent years, robust have established the implication of Na/K-ATPase signaling in causing oxidative stress and alterations in cellular mechanisms, in addition to its distinct pumping function. Understanding the underlying molecular mechanisms and exploring the possible sources of pro-oxidants may allow for developing therapeutic targets in these processes and formulate novel intervention strategies for patients susceptible to aging and associated complications, such as obesity and cardiovascular disease. The attenuation of oxidative stress with targeted treatment options can improve patient outcomes and significantly reduce economic burden.


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