scholarly journals The influence of plastic techniques in surgery of primary skin melanoma on patient survival

2020 ◽  
Vol 25 (1) ◽  
pp. 27-36
Author(s):  
S. A. Yargunin ◽  
Y. N. Shoyhet ◽  
A. F. Lazarev

Objective. To analyze the feasibility of performing plastic surgery in patients with primary skin melanoma (SM). Material and methods. We studied patients with primary MK treated in our institution in 2013 (n = 333), who were randomized to a group of 2 blind selection methods to the main one (n = 168), in which the tumor removal operation in patients ended with a tissue defect repair and a comparison group ( n = 165) (after removal of the tumor, simple linear suturing of the wound was performed). A statistically significant difference was found in the comparison groups in the occurrence of negative dynamics (ND), progression-free survival (PFS) and overall survival (OS) in patients with MK 0-IIA st during the follow-up period up to 36 months. Results. It was found that patients with 0-IIA st who underwent plastic surgery to close the defect when removing primary SM have a statistically proven advantage in ND, PFS, and OS compared with patients without plastic surgery for up to 36 months. In general, the use of plastics has a statistical tendency towards the dynamics of an increase in PFS and OS in the early stages of SM. Discussion. In the early stages (0-IIA) up to 36 months, cases of negative dynamics (4.2%) were observed 2.3 times less frequently than in the comparison group (9.7%) (p = 0.048), and fatal outcomes in the main group (1.8%) were observed 3.7 times less than in the comparison group (6.7%) (p = 0.028). The analysis also shows that in patients who underwent surgery using plastic surgery statistically significantly reduces the risk of distant metastasis by 3 times (p = 0.05), but significantly more often (in every third patient) (p = 0.022) than in the control group (without plastic surgery) met transient metastases. The appearance of ND, as well as an increase in PFS, OS depended on the plastic replacement of the defect after excision of the primary SM in patients with SM 0-IIA st during the observation period up to 36 months. Conclusion. The use of plastic methods for closing a wound defect reduces the risk of distant metastasis by 3 times compared with linear suturing, provides a reduction in mortality in patients with SM 0 IIA st for 60 months, prolongs the patients life by an average of 10 months and is the operation of choice in this category.

Author(s):  
INARAH FAJRIATY ◽  
HAFRIZAL RIZA ◽  
FAJAR NUGRAHA ◽  
FRENGKI FRIANTO

Objectives: Drugs can cause undesired effects on the fetus during pregnancy, especially embryonic/organogenesis which could lead to defects in the fetus because some types of drugs can penetrate the placenta and will undergo biotransformation into a highly reactive compound that has the potential to become a teratogenic compound. The aim of this research was to examine the teratogenic effect of bintangur leaves (Calophyllum soulattri Burm. F) ethanol extract to Sprague Dawley strain white rats. Methods: The white rats are divided into four treatment groups: Control group was given carboxymethyl cellulose Na 1%, comparison group was given trimethoprim 360 mg/kg BW, C. soulattri leaves ethanol extract (CLE) 100 mg/kg BW, and CLE 500 mg/kg BW. The treatment was administrated since organogenesis period. Cesarian section was performed to pregnant rat at the 20th day to separate the fetuses. Observation covered body weight of pregnant rats, fetal biometric, morphological malformation, and skeletal formation. Results: CLE 100 mg/kg BW and 500 mg/kg BW did not cause any change in the number of a living fetus, body weight, and length of fetuses like the comparison group. Both doses of CLE shown have a normal skeletal formation. Resorption was found in the comparison group and CLE 100 mg/kg BW with the percentage was 65.21% and 6.67%. It was found that there is no significant difference (p<0.05) between both doses of CLE compared to control group. Conclusion: From the results, it is concluded that CLE did not have the teratogenic effect.


2007 ◽  
Vol 336-338 ◽  
pp. 1662-1665
Author(s):  
Guo Hua Xu ◽  
Xiao Jian Ye ◽  
Wen Yuan ◽  
Shu Cai ◽  
Jian Gang Shi ◽  
...  

In this paper, we study the effect of repairing the dog's femoral defects with the artificial bone integrating the nano-calcium phosphates/zirconia porous artificial bone scaffold with the autologous osteoblasts. We transplanted the artificial bone to the femoral defect of the dog, and at the same time, simple scaffold and the autologous cancellous bone were implanted as the control group. 3 months after the transplantation, the specimen was taken out with complete integration with the bone in these 3 groups and the bone defect got the complete bone union. The mechanics strength test showed that the group of the artificial bone was the strongest, followed by the cancellous bone group, and the simple material group was lower, but the strength was stronger than that before the transplantation. In the sixth month, the complete femoral defect repair was found in each group and the complete formation of the Haversian canal can be found on the histology examination. According to the mechanics strength test, there was no significant difference (P<0.05).


2019 ◽  
Vol 9 (22) ◽  
Author(s):  
Patrick Ayodeji Akinyemi ◽  
Caleb Aderemi Adegbenro ◽  
Temitope Olumuyiwa Ojo ◽  
Olanrewaju Elugbaju

Background. Furniture making industries are small scale businesses that commonly use organic solvents. There has been minimal focus on the health effects of this chemical hazard on the nervous system among furniture makers in Nigeria. Objectives. The present study aimed to assess the association between organic solvents exposure and neurobehavioral status of furniture makers, using electronic technicians as a comparison group. Methods. A comparative cross-sectional study design was employed. A sample size of 108 was calculated for each group. A semi-structured interviewer-administered questionnaire was used to obtain data on the socio-demographic variables and use of personal protective equipment (PPE). A proforma was developed to collect neurobehavioral assessment data. A checklist was used to assess the furniture makers' workshops. Air was sampled from all of the workshops in both the study and comparison groups to determine the concentration of total volatile organic compounds (TVOCs). Results. The use of PPE was poor in both the study and comparison groups, with no significant difference between them (34.4% and 37.7% respectively). Total volatile organic compound and formaldehyde (HCHO) concentrations were significantly higher at the furniture makers' workshops compared with electronic technicians (p&lt;0.001) for both chemicals. The 8-hour time-weighted average of TVOC was also higher in the furniture makers' workshops (4.4±0.6 mg/m3) compared with the control group (0.3±0.3 mg/m3). The neurobehavioral symptoms score was significantly higher among the study group relative to the comparison group (p&lt;0.001). There was a significant difference in the outcome of the auditory verbal learning test, total recall (p=0.005), and delayed recall (p=0.003). There was no significant association between solvent exposure index and findings from the simple reaction time test Conclusions. Poor compliance with the use of PPE among furniture makers may increase their exposure to organic solvents. There were more neurobehavioral changes in the furniture makers with a higher exposure index. Measures are needed to educate artisans about workrelated chemical hazards and ensure compliance with basic occupational safety and hygiene standards. Participant Consent. Obtained Ethics Approval. Ethics approval was obtained from the Health Research and Ethics Committee of the Institute of Public Health, Obafemi Awolowo University (IPH/OAU/12/1049). Competing Interests. The authors declare no competing financial interests.


2019 ◽  
Author(s):  
Zhimin Zhang ◽  
Ge Wang ◽  
Feng Jin ◽  
Jijun Zheng ◽  
He Xiao ◽  
...  

Abstract Background: Serum miRNA was once found as potential disease survival index,thus we investigated the role of miRNA in predicting prognosis in loco-regionally advanced NPC patients treated with CCRT. Methods: This study included two phases: (i) We enrolled 3 NPC patients with recurrence or distant metastasis (experimental group, EG) and 3 NPC patients in clinical remission (control group, CG) , who were treated with CCRT within 5 years.The paired serum was collected before and after treatment and biomarkers were discovered by TaqMan Human MicroRNA Arrays. (ii) we used the bioinformatic analysis, marker selection and an independent validation by qRT-PCR to analyse the serums of 29 NPC patients with recurrent disease or distant metastasis and 19 NPC patients in clinical remission treated with CCRT. We used the Kaplan-Meier method, log-rank test and Cox regression model to estimate the accuracy of the miRNAs to predict PFS and OS, and identified factors significantly associated with prognosis, respectively. Results: Using fold change≥2.0 or ≤0.5 and p≤0.05 as cutoff levels, we identified 1 up-regulated and 9 down-regulated miRNAs, 1 up-regulated and 6 down-regulated miRNAs in EG versus CG before and after CCRT, respectively. After significantly down-regulated miRNAs from EG versus CG were removed, only 9 different miRNAs were significantly reduced. In the serum samples of 48 NPC patients, there were no significant difference in the expression of miRNA-26b, miRNA-29a and miRNA-125b before CCRT, and the expression of miRNA-143 and miRNA-29b after CCRT. We calculated a risk score with the expression of miRNA-26b、miRNA-29a、miRNA-125b、miRNA-29b、miRNA-143 and then classified patients as high or low risk group. Cox regression model suggested that combining miRNA-29a and miRNA-125b before CCRT with miRNA-26b after CCRT was independent prognostic factors for PFS (HR=3.149, 95%CI:1.018-9.115, p=0.034), whereas combining the former two is independent for OS (HR=5.146, 95%CI:1.674-15.817, p=004). Conclusions: For loco-regionally advanced NPC patients treated with CCRT, especially high-risk patients- serum miRNAs such as miRNA-29a, miRNA-125b and miRNA-26b etc, play an important role in predicting prognosis factors for PFS and OS, which will contribute to the strategic direction of future research.


2019 ◽  
Vol 122 (3) ◽  
pp. 333-339 ◽  
Author(s):  
Max M. Wattenberg ◽  
Daniella Asch ◽  
Shun Yu ◽  
Peter J. O’Dwyer ◽  
Susan M. Domchek ◽  
...  

Abstract Background Retrospective studies suggest a survival benefit when platinum-based chemotherapy is administered to patients with pancreatic cancer harbouring a germline mutation in BRCA1, BRCA2 or PALB2 (mut-positive PDAC). However, the objective response rate (ORR) and real-world progression free survival (rwPFS) achieved with such treatment remain ill-defined. Methods Twenty-six patients with advanced-stage mut-positive PDAC who had been treated with platinum-based therapy were matched by age, race and sex to 52 platinum-treated control PDAC patients. Responses to therapy were determined by RECIST v1.1, performed by blinded radiology review. Measured outcomes included ORR and rwPFS. Results The ORR in mut-positive patients was 58% compared to 21% in the control group (p = 0.0022). There was no significant difference in ORR between platinum regimens in mut-positive patients (p = 0.814), whereas in control patients, the only observed responses were to FOLFIRINOX. rwPFS was 10.1 mo. for mut-positive patients and 6.9 mo. for controls (HR 0.43; 95% CI 0.25–0.74; 0.0068). Conclusion Mut-positive PDAC has a high ORR and prolonged rwPFS to platinum-based chemotherapy. These findings may have implications particularly in the neoadjuvant setting, and for future clinical trial design, and highlight the importance of early germline testing in patients with PDAC.


2020 ◽  
pp. 175045892091263
Author(s):  
Yanipan Chungsamarnyart ◽  
Jiranun Pairart ◽  
Sithapan Munjupong

Background Coughing and laryngospasm are undesirable consequences occurring when patients awaken from general anaesthesia. The objective of the study aimed to compare the effects of intravenous propofol and propofol with low-dose ketamine on preventing postextubation cough and laryngospasm. Methods In all, 120 patients scheduled surgery under general anaesthesia were randomly assigned into three groups. Patients in the control group (C-group) obtained intravenous 0.9% NaCl, while patients in the propofol group (P-group) obtained intravenous 0.25mg/kg propofol and patients in the propofol combined with ketamine group (PK-group) obtained intravenous 0.25mg/kg of propofol plus 0.15mg/kg of ketamine. Drugs were administered before extubation. Incidence and severity of coughing and laryngospasm were recorded by a blinded anaesthesiologist. Results Subjects of the PK-group (25%) experienced significantly reduced incidence of postoperative cough than that in the P-group (55%) and C-group (72.5%) (all P < 0.05). The severity of cough in the PK-group was significantly less than that in the P-group and C-group (P = 0.039 and P < 0.001, respectively). No significant difference was found in the incidence and severity of laryngospasm between comparison groups. Conclusion Intravenous combination of propofol and low-dose ketamine significantly reduced the incidence and severity among patients awakening from general anaesthesia.


2019 ◽  
Vol 23 (1) ◽  
pp. 45-50
Author(s):  
R. R. Temirbulatov ◽  
V. F. Bezhenar ◽  
A. V. Smirnov

THE AIM: To assess the significance of prognostic markers of preeclampsia – sFlt-1 and PlGF in the differential diagnosis of preeclampsia and chronic kidney disease.PATIENTS AND METHODS:patients whom signed informed consent, was taken samples of blood in the third trimester of pregnancy. The study group included 36 patients with preeclampsia, the comparison group of 46 pregnant women with CKD and the control group included 40 healthy patients, with pregnancy without complication.RESULTS: Significant differences in the levels of serum sFlt-1 and PlGF were found: between the PE and the comparison group (CKD), as well as between the PE and the control group (CG), whereas no differences were found between the CG and CKD. The sFlt-1 level was significantly increased in PE compared with CKD and KG (5.12-fold and 4.25-fold higher, respectively). Serum PlGF levels were significantly reduced in PE relative to both CKD and KG (17.4 and 12.5 times lower, respectively). The sFlt-1/PlGF ratio was significantly increased in PE compared with CKD and the control group (approximately 25 times higher in both groups), but there was no significant difference between CKD and CG.CONCLUSION:Thus, the definition of the relationship sFlt-1, PlGF, sFlt-1/PlGF can be used in the differential diagnosis of preeclampsia and chronic kidney disease.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8502-8502 ◽  
Author(s):  
Theodoros Tsakiridis ◽  
Chen Hu ◽  
Heath Devin Skinner ◽  
Rafael Santana-Davila ◽  
Bo Lu ◽  
...  

8502 Background: Metformin, a diabetes agent that inhibits mitochondria complex I, enhances radiotherapy and chemotherapy responses in pre-clinical models of NSCLC. NRG-LU001 examined whether metformin can improve outcomes of curative CRT in locally advanced (LA)-NSCLC. Methods: The primary endpoint of this trial was 1-year progression free survival (PFS). Unresected, non-diabetic, stage IIIA/B NSCLC patients were randomized (1:1) to either carboplatin-paclitaxel chemotherapy concurrent with chest RT (60Gy), followed by consolidation carboplatin-paclitaxel chemotherapy (Control Arm) or the same and oral metformin (2000mg daily) during cytotoxic therapy (Experimental Arm). PFS and overall survival (OS) were estimated with the Kaplan-Meier method; time to local-regional progression (TTLRP), time to distant metastasis (TTDM) were estimated using the cumulative incidence method. Adverse events (AEs) were graded with CTCAE v.4.0. Results: Between Aug.2014 and Dec.2016, 170 patients were accrued. Analysis was planned at 102 PFS events (Feb. 2019). There was no significant difference in rates or grade of toxicity between the two arms. 1- and 2-year PFS was 60.4% (95% CI: 48.5, 70.4) and 40.1% (95% CI: 29.0, 51.0) in Control vs 51.3% (95% CI: 39.8, 61.7) and 34.5% (95% CI: 24.2, 45.1) in the Metformin arm (multivariable Cox proportional HR=1.20 (95% CI: 0.81, 1.78), p=0.36). OS at 2 years was 65.4% (95% CI: 53.5, 75.0) for Control vs 64.9% (95% CI: 53.1, 74.5) for the Metformin arm (HR=1.03 (95% CI: 0.64, 1.68)), while deaths due to disease were 90% vs 71%, respectively. No significant differences were found for TTLRP or TTDM. Conclusions: NRG-LU001 center reported outcomes show that oral daily metformin was well-tolerated in combination with CRT treatment for LA-NSCLC. However, metformin did not improve PFS and OS and did not alter the rates of local-regional failure or distant metastasis. Acknowledgements: TT and HS are Co-Principal Investigators. This project was supported by National Cancer Institute (NCI) grants: U10CA180868 (NRG Oncology Operations), U10CA180822 (NRG SDMC), UG1CA189867 (NCORP), U24CA180803 (IROC). Clinical trial information: NCT02186847.


2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 337-337
Author(s):  
Junko Tauchi ◽  
Akira Shinohara ◽  
Ken Ohashi ◽  
Taro Shibuki ◽  
Gen Kimura ◽  
...  

337 Background: Diabetes mellitus (DM) and hyperglycemia have been widely considered to be associated with the risk of pancreatic cancer. However, the aim of this study was to evaluate the relationship between glycemic control and the efficacy or safety in pancreatic cancer pts receiving treatment with nab-Paclitaxel (nab-PTX) plus Gemcitabine (GEM). Methods: We retrospectively reviewed 285 pts with unresectable pancreatic cancer with nab-PTX plus GEM as the first-line chemotherapy from December 2014 to March 2017 at the National Cancer Center Hospital East, Kashiwa, Japan. The pts were divided into two groups, average blood glucose level during the period of chemotherapy was less than 160 mg/dL (Group GC: Good glycemic control group) and more than 160 mg/dL (Group PC: Poor glycemic control group). Results: A total of 285 pts were enrolled. Median age was 66 years (range: 26-84) and males/females: 180/105, PS (0-1/2-3): 272/13, stage (III/IV): 77/208. There were 226 pts in GC group and 59 pts in PC group. No significant differences were seen in the overall survival between Group GC and PC (median: 16.1 months vs. 13.8 months, p = 0.344) and in the progression free survival between the two groups (median: 7.5 months vs. 8.2 months, p = 0.862). The incidence rate of grade 2-3 chemotherapy-induced peripheral neuropathy (CIPN) was significantly higher in Group PC compared with Group GC (Group GC 28.3%, Group PC 45.8%, p = 0.010). Univariate and multivariate analyses identified glycemic control as significant independent factors associated with the incidence of grade 2-3 of CIPN (Odds ratio 2.182, 95% CI 1.20-3.96, p = 0.010). There was no significant difference in the relative dose intensity of nab-PTX between two groups (median, 56.6% in group GC, 56.5% in group PC, p = 0.952). Conclusions: Glycemic control during the chemotherapy with nab-PTX plus GEM in unresectable pancreatic cancer was not associated with OS. The incidence of severe CIPN was higher in pts with poor glycemic control compared with good glycemic control.


2008 ◽  
Vol 29 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Swapan Kumar Roy ◽  
Farzana Bilkes ◽  
Khaleda Islam ◽  
Gulshan Ara ◽  
Phillip Tanner ◽  
...  

Background The rate of malnutrition among women in Bangladesh is high, but historically there has not been a specific program focusing on the improvement of the nutritional status of Bangladeshi women. Objective To observe changes in the nutritional status of destitute women of the Rural Maintenance Programme (RMP) by incorporating a health and nutrition intervention package with RMP ongoing activities. Methods An intervention study involving 1,275 poor destitute women was conducted from July 2004 to June 2005 in 17 districts in Bangladesh under two field offices, Mymensingh and Jessore, covering 8 and 9 districts, respectively. The respondents were divided into intervention, comparison, and control groups. All participants in the intervention and comparison groups were paid as part of the RMP and received weekly 30-minute nutrition interventions for 7 weeks in addition to routine training. The comparison group also received RMP training. The control group consisted of women with similar demographic characteristics to the intervention and comparison groups who did not receive pay or any intervention. The intervention was a unique combination of the three components of the UNICEF triangle model (food security, caring practices, and disease contol). Data on socioeconomic and anthropometric characteristics, immunization, and vitamin A capsule intake were also collected with the use of a structured questionnaire. Results After the intervention, the mean body weight had significantly increased by 1,333 g in the intervention group and had decreased by 277 g in the control group and 147 g in the comparison group. The body mass index of women in the intervention group had also significantly increased at the end of the study ( p < .001). There was a significant increase in the intake of iodized salt in the intervention group as well as increased immunization coverage in all groups. Intake of the first vitamin A capsule by children increased (from 60% to 97%) in the intervention group only. Conclusions The nutrition pilot intervention was highly effective in improving the nutritional status of women in the RMP.


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