Dosimetric effect of the intestinal gas of on-line adaptive stereotactic body radiotherapy on target and critical organs without on-line electron density correction for pancreatic cancer

Objective: This study aimed to assess the dosimetric effect of intestinal gas of stereotactic magnetic resonance (MR)-guided adaptive radiation therapy (SMART) on target and critical organs for pancreatic cancer without on-line electron density correction (EDC). Methods: Thirty pancreatic cancer patients who underwent on-line SMART were selected for this study. The treatment time of each stage and the total treatment time were recorded and analyzed. The concerned dose-volume parameters of target and organs at risk (OAR) were compared with and without an intestinal gas EDC using the Wilcoxon signed rank test. Analysis items with p value < 0.05 were considered statistically significant. The relationships between dosimetric difference and intestinal gas volume variation were investigated using the Spearman test. Results: The average treatment time was 82 min, and the average EDC time was 8 min, which accounted for 10% of the overall treatment time. There were no significant differences in CTV (GTV), PTV, bowel, stomach, duodenum, and skin (p > 0.05) with respect to dose volume parameters. For the Dmax of gastrointestinal organs (p = 0.03), the mean dose of the liver (p = 0.002) and kidneys (p = 0.03 and p = 0.04 for the left and right kidneys, respectively), there may be a risk of slight overestimation compared with EDC, and for the Dmax of the spinal cord (p = 0.02), there may be a risk of slight underestimation compared with EDC. A weak correlation for D95 in the PTV and D0.5 cc in the duodenum was observed. Conclusion: For patients with similar inter fractional intestinal gas distribution, EDC had little dosimetric effects on the D0.5 cc of all GI organs and dose volume parameters of target in most plans. Advances in knowledge: By omitting the EDC of intestinal gas, the online SMART treatment time can be shortened.

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Vital Tooth Whitening Techniques. A literature Review

Current Dentistry ◽

10.2174/2542579x02999200812130854 ◽

2020 ◽

Vol 02 ◽

Author(s):

Pia Chatterjee Kirk

Keyword(s):

Soft Tissues ◽

Treatment Time ◽

Tooth Bleaching ◽

Tooth Whitening ◽

Easy Method ◽

Tooth Structure ◽

Dental Esthetics ◽

Total Treatment Time ◽

Restorative Materials ◽

Total Treatment

Background: Vital tooth whitening has become an integral part of esthetic dentistry and remains one of the safest and most economic options today to improve dental esthetics without removing tooth structure. The tooth whitening materials have evolved into three categories: dentist-prescribed/dispensed (in office and patient home-use), and over-thecounter purchased and applied by patients. Objective: This review outlines the latest advances in dentist prescribed vital teeth whitening techniques, effects on tooth structure, soft tissues, and dental restoratives. Areas requiring additional research are also discussed. Methods: Electronic and manual literature search was conducted for key words such as tooth bleaching, and dental bleaching techniques using PubMed/MEDLINE, followed by manual selection of the studies that included whitening procedures in vital teeth. Results: The two main whitening agents are carbamide peroxide (CP) and hydrogen peroxide (HP or H2O2) whose concentration, duration of contact, and total treatment time can alter results. In addition, factors including the type of stain, and age of patient can affect results. Although whitening agents can affect tooth structure, restorative materials, and gingival tissues, the changes are temporary or can be treated using minimally invasive techniques. Conclusion: Areas requiring further research include the actual mechanism of whitening, its effect on tooth structure and restorative materials, and the development of an easy method to quantitate the degree of whitening in the dental office.

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Correlation of AGR2 expression with the incidence of metastasis in luminal breast cancer

Breast Disease ◽

10.3233/bd-219015 ◽

2021 ◽

pp. 1-5

Author(s):

David Samuel Kereh ◽

John Pieter ◽

William Hamdani ◽

Haryasena Haryasena ◽

Daniel Sampepajung ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Mean Value ◽

Rank Test ◽

Luminal Breast Cancer ◽

P Value ◽

Strong Positive Correlation ◽

Breast Cancer Patients ◽

The Mean ◽

Spearman Test

BACKGROUND: AGR2 expression is associated with luminal breast cancer. Overexpression of AGR2 is a predictor of poor prognosis. Several studies have found correlations between AGR2 in disseminated tumor cells (DTCs) in breast cancer patients. OBJECTIVE: This study aims to determine the correlation between anterior Gradient2 (AGR2) expression with the incidence of distant metastases in luminal breast cancer. METHODS: This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and the network. ELISA methods examine AGR2 expression from blood serum of breast cancer patients. To compare the AGR2 expression in metastatic patients and the non-metastatic patient was tested with Mann Whitney test. The correlation of AGR2 expression and metastasis was tested with the Rank Spearman test. RESULTS: The mean value of AGR2 antibody expression on ELISA in this study was 2.90 ± 1.82 ng/dl, and its cut-off point was 2.1 ng/dl. Based on this cut-off point value, 14 subjects (66.7%) had overexpression of AGR2 serum ELISA, and 7 subjects (33.3%) had not. The mean value AGR2 was significantly higher in metastatic than not metastatic, 3.77 versus 1.76 (p < 0.01). The Spearman rank test obtained a p-value for the 2 tail test of 0.003 (p < 0.05), which showed a significant correlation of both, while the correlation coefficient of 0.612 showed a strong positive correlation of AGR2 overexpression and metastasis. CONCLUSIONS: AGR2 expression is correlated with metastasis in Luminal breast cancer.

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Cohort study of the overall survival of patients with pancreatic cancer in a hospital of specialties of Quito-Ecuador in the period 2007–2017

Innovative Surgical Sciences ◽

10.1515/iss-2020-0030 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Andrés Moreno Roca ◽

Luciana Armijos Acurio ◽

Ruth Jimbo Sotomayor ◽

Carlos Céspedes Rivadeneira ◽

Carlos Rosero Reyes ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cohort Study ◽

Survival Time ◽

Univariate Analysis ◽

Rank Test ◽

Kaplan Meier ◽

Significant Difference ◽

Icd 10 ◽

The Difference ◽

Clinical Records

Abstract Objectives Pancreatic cancers in most patients in Ecuador are diagnosed at an advanced stage of the disease, which is associated with lower survival. To determine the characteristics and global survival of pancreatic cancer patients in a social security hospital in Ecuador between 2007 and 2017. Methods A retrospective cohort study and a survival analysis were performed using all the available data in the electronic clinical records of patients with a diagnosis of pancreatic cancer in a Hospital of Specialties of Quito-Ecuador between 2007 and 2017. The included patients were those coded according to the ICD 10 between C25.0 and C25.9. Our univariate analysis calculated frequencies, measures of central tendency and dispersion. Through the Kaplan-Meier method we estimated the median time of survival and analyzed the difference in survival time among the different categories of our included variables. These differences were shown through the log rank test. Results A total of 357 patients diagnosed with pancreatic cancer between 2007 and 2017 were included in the study. More than two-thirds (69.9%) of the patients were diagnosed in late stages of the disease. The median survival time for all patients was of 4 months (P25: 2, P75: 8). Conclusions The statistically significant difference of survival time between types of treatment is the most relevant finding in this study, when comparing to all other types of treatments.

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Proposition of Splenic Dose-Volume Constraints to Prevent Severe Lymphopenia after Chemoradiation for Pancreatic Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2018.07.410 ◽

2018 ◽

Vol 102 (3) ◽

pp. e69

Author(s):

E. Blais ◽

R. Bourdais ◽

J.M. Simon ◽

P. Sargos ◽

I. Troussier ◽

...

Keyword(s):

Pancreatic Cancer ◽

Dose Volume

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Development and Validation of a Hypoglycemia Risk Model for Intensive Insulin Therapy in Patients with Type 2 Diabetes

Journal of Diabetes Research ◽

10.1155/2020/7292108 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Xiling Hu ◽

Weiran Xu ◽

Shuo Lin ◽

Cang Zhang ◽

Cong Ling ◽

...

Keyword(s):

Type 2 Diabetes ◽

Insulin Therapy ◽

Intensive Insulin Therapy ◽

Risk Model ◽

Treatment Time ◽

Fasting Blood Glucose ◽

Prediction Rule ◽

Derivation Cohort ◽

Total Treatment Time

Aims. To develop a simple hypoglycemic prediction model to evaluate the risk of hypoglycemia during hospitalization in patients with type 2 diabetes treated with intensive insulin therapy. Methods. We performed a cross-sectional chart review study utilizing the electronic database of the Third Affiliated Hospital of Sun Yat-sen University, and included 257 patients with type 2 diabetes undergoing intensive insulin therapy in the Department of Endocrinology and Metabolism. Logistic regression analysis was used to derive the clinical prediction rule with hypoglycemia (blood glucose≤3.9 mmol/L) as the main result, and internal verification was performed. Results. In the derivation cohort, the incidence of hypoglycemia was 51%. The final model selected included three variables: fasting insulin, fasting blood glucose, and total treatment time. The area under the curve (AUC) of this model was 0.666 (95% CI: 0.594–0.738, P<0.001). Conclusions. The model’s hypoglycemia prediction and the actual occurrence are in good agreement. The variable data was easy to obtain and the evaluation method was simple, which could provide a reference for the prevention and treatment of hypoglycemia and screen patients with a high risk of hypoglycemia.

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Correlation of Clinical Findings and Autopsy Results after Fatal Injury from Motor Vehicular-Related Crashes

The American Surgeon ◽

10.1177/000313480607200317 ◽

2006 ◽

Vol 72 (3) ◽

pp. 282-287 ◽

Cited By ~ 1

Author(s):

Luke Y. Shen ◽

Kendra N. Marcotte ◽

Stephen D. Helmer ◽

Mary H. Dudley ◽

R. Stephen Smith

Keyword(s):

Injury Severity ◽

Motor Vehicle ◽

Treatment Time ◽

Clinical Findings ◽

Trauma Patients ◽

Additional Information ◽

Total Treatment Time ◽

Glascow Coma Scale ◽

American College Of Surgeons ◽

Level I

In the past, autopsy served as the gold standard to document diagnostic accuracy. Although a valuable contributor to medical education, information collected from autopsies is frequently delayed and poorly used. The purpose of this study was to determine the degree of concordance between clinical findings and autopsy results of trauma patients involved in fatal vehicular-related crashes. A 10-year retrospective review of trauma patients involved in fatal vehicular-related crashes who subsequently had an autopsy performed was conducted at an American College of Surgeons-verified Level I trauma center. The clinical record, trauma registry data, and autopsy results were reviewed. Degree of concordance was evaluated using the Goldman Type Errors Criteria. A total of 207 decedents were included (mean age, 41; 63% male; median Glascow Coma Scale score, 3; median Injury Severity Score, 37). The majority (69.6%) of decedents were injured in motor vehicle crashes. Total treatment time was <15 minutes in 29.0 per cent of cases, <6 hours in 59.4 per cent of cases, and <24 hours in 73.9 per cent of cases. Location of death was the emergency department (43.0%), the intensive care unit (49.8%), the operating room (5.4%), and the nursing floor (1.0%). There were no Goldman Class I or IV type errors, (i.e., no major or minor discrepancies, respectively, that may have altered therapy or survival of the patient). Following ATLS-based protocols results in appropriate identification of clinically significant injuries in patients involved in motor vehicular-related crashes. The routine use of autopsy results offers little additional information to a mature American College of Surgeons-verified Level I trauma program.

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Bimaxillary Protrusion - A Case Report

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v7i1.24697 ◽

2019 ◽

Vol 7 (1) ◽

pp. 70-73

Author(s):

Hemant Kumar Halwa ◽

Sumit Kumar Yadav ◽

Kishor Dutta ◽

Sandeep Kumar Gupta ◽

Raju Shrestha ◽

...

Keyword(s):

Case Report ◽

Orthodontic Treatment ◽

Treatment Time ◽

Facial Appearance ◽

Total Treatment Time ◽

Total Treatment ◽

Bimaxillary Protrusion ◽

Maximum Anchorage

Correction of a severe bimaxillary protrusion with maximum anchorage can be challenging. This case report describes the treatment of a girl with a bimaxillary protrusion. Orthodontic treatment included extraction of her 4 first premolars. The total treatment time was 18 months. Her dental proclination and facial appearance was significantly improved.

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