scholarly journals Novel Concepts of Glioblastoma Therapy Concerning Its Heterogeneity

2021 ◽  
Vol 22 (18) ◽  
pp. 10005
Author(s):  
Gábor Hutóczki ◽  
József Virga ◽  
Zsuzsanna Birkó ◽  
Almos Klekner
Keyword(s):  
Tumor Heterogeneity ◽  
Diagnostic Methods ◽  
Dynamic Heterogeneity ◽  
Histological Subtypes ◽  
Prognostic Information ◽  
The Past ◽  
Specific Tumor ◽  
Extracellular Matrix Components ◽  
Prognostic Groups ◽  
Target Treatment

Although treatment outcomes of glioblastoma, the most malignant central nervous system (CNS) tumor, has improved in the past decades, it is still incurable, and survival has only slightly improved. Advances in molecular biology and genetics have completely transformed our understanding of glioblastoma. Multiple classifications and different diagnostic methods were made according to novel molecular markers. Discovering tumor heterogeneity only partially explains the ineffectiveness of current anti-proliferative therapies. Dynamic heterogeneity secures resistance to combined oncotherapy. As tumor growth proceeds, new therapy-resistant sub clones emerge. Liquid biopsy is a new and promising diagnostic tool that can step up with the dynamic genetic change. Getting a ’real-time’ picture of a specific tumor, anti-invasion and multi-target treatment can be designed. During invasion to the peri-tumoral brain tissue, glioma cells interact with the extracellular matrix components. The expressional levels of these matrix molecules give a characteristic pattern, the invasion spectrum, which possess vast diagnostical, predictive and prognostic information. It is a huge leap forward combating tumor heterogeneity and searching for novel therapies. Using the invasion spectrum of a tumor sample is a novel tool to distinguish between histological subtypes, specifying the tumor grades or different prognostic groups. Moreover, new therapeutic methods and their combinations are under trial. These are crucial steps towards personalized oncotherapy.

HPV-associated cervical diseases: screening, methods of examination, principles of treatment

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 6-8
Author(s):  
Vera N Prilepskaya
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Prevention ◽  
Mortality Rates ◽  
Diagnostic Methods ◽  
Screening Methods ◽  
The Past ◽  
Associated Diseases ◽  
Principles Of Treatment ◽  
Cervical Diseases

This article presents information about modern principles of diagnosis and treatment of HPV-associated diseases. Behind cervical cancer morbidity and mortality rates over the past 10 years increase significantly. Examination and observation of patients with human papillomavirus persistence of highly oncogenic types is important a link in cancer prevention. The article presents diagnostic methods, treatment of cervical diseases, as well as the possibility of pharmacotherapy in HPV-associated diseases.

scholarly journals Toward Resolving the Challenges of Sepsis Diagnosis

2004 ◽  
Vol 50 (8) ◽  
pp. 1301-1314 ◽  
Author(s):  
Shawn D Carrigan ◽  
George Scott ◽  
Maryam Tabrizian
Keyword(s):  
Medical Diagnosis ◽  
Delayed Diagnosis ◽  
High Sensitivity ◽  
The United States ◽  
Immune Monitoring ◽  
Diagnostic Methods ◽  
Magic Bullet ◽  
Sepsis Diagnosis ◽  
The Past ◽  
Related Mortality

Abstract Sepsis in the United States has an estimated annual healthcare cost of $16.7 billion and leads to 120 000 deaths. Insufficient development in both medical diagnosis and treatment of sepsis has led to continued growth in reported cases of sepsis over the past two decades with little improvement in mortality statistics. Efforts over the last decade to improve diagnosis have unsuccessfully sought to identify a “magic bullet” proteic biomarker that provides high sensitivity and specificity for infectious inflammation. More recently, genetic methods have made tracking regulation of the genes responsible for these biomarkers possible, giving current research new direction in the search to understand how host immune response combats infection. Despite the breadth of research, inadequate treatment as a result of delayed diagnosis continues to affect approximately one fourth of septic patients. In this report we review past and present diagnostic methods for sepsis and their respective limitations, and discuss the requirements for more timely diagnosis as the next step in curtailing sepsis-related mortality. We also present a proposal toward revision of the current diagnostic paradigm to include real-time immune monitoring.

Changing Profile of Congenital Heart Disease

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 790-791
Author(s):  
D. WOODROW BENSON ◽  
James Moller ◽  
Donald C. Fyler ◽  
David E. Fixler
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Surgical Treatment ◽  
Congenital Heart ◽  
Considerable Change ◽  
Diagnostic Methods ◽  
Younger Patients ◽  
The Past ◽  
Steady Improvement ◽  
Complex Lesions

In the past 20 years, considerable change has occurred in the profile of congenital heart disease regarding both diagnosis and treatment. The profile has changed from older to younger patients; the essence of this change has been from pediatric to infant to neonatal cardiology. There has been a shift from palliative to more definitive surgical procedures and a change from invasive (cardiac catheterization) to noninvasive (echocardiography) diagnostic methods. The profile has changed from definitive surgical treatment limited to simple lesions to surgical treatment of the most complex lesions. There has been steady improvement in the recognition of cases of congenital heart disease. Of all children admitted to hospitals for treatment of congenital heart disease, the portion less than three days of age has increased from 24% in 1969 to 1972 to 33% in 1982 to 1986.

scholarly journals Multimodality imaging in arrhythmogenic cardiomyopathy

2021 ◽  
Vol 31 (1) ◽  
pp. 10-16
Author(s):  
Laura Tapoi ◽  
Alexandra Clement ◽  
Rodica Radu ◽  
Radu Sascau
Keyword(s):  
Cardiac Death ◽  
Multimodality Imaging ◽  
Imaging Techniques ◽  
Left Ventricular ◽  
Arrhythmogenic Cardiomyopathy ◽  
Prognostic Information ◽  
Care Community ◽  
The Past ◽  
Widespread Availability ◽  
Made In

Arrhythmogenic cardiomyopathy, as it has been recently redefi ned, is characterized by progressive myocyte loss with fibrosis and fat infiltration of the myocardium, which finally leads to a broad clinical spectrum ranging from heart failure symptoms to sudden cardiac death. The diagnosis of arrhythmogenic cardiomyopathy is challenging particularly because of its heterogeneity in presentation, which varies from focal right ventricular involvement to biventricular or prominent left ventricular phenotype. In the past decades, the development of new electrocardiographic and imaging diagnostic criteria for arrhythmogenic cardiomyopathy constituted an important area of research and resulted in the elaboration of the Padua criteria. However, even with the widespread availability of modern imaging techniques, there is still a lack of awareness in the health care community and this pathology persist in being under-or misdiagnosed. Given the limited indication of endomyocardial biopsy for the diagnosis of arrhythmogenic cardiomyopathy, one can conclude that the progress that has been made in the last few years in the multimodality imaging field is of utmost importance for the early detection and proper treatment of patients with arrhythmogenic cardiomyopathy, providing valuable prognostic information.

Group B Streptococcal Infections in Neonates

1979 ◽  
Vol 1 (1) ◽  
pp. 5-15
Author(s):  
Carol J. Baker
Keyword(s):  
Group B Streptococcus ◽  
Newborn Infants ◽  
Neonatal Infection ◽  
Etiologic Agent ◽  
Diagnostic Methods ◽  
Bacterial Disease ◽  
Absolute Increase ◽  
Mortality And Morbidity ◽  
The Past ◽  
Group B

β-Hemolytic streptococci of Lancefield group B have been causally linked to neonatal disease since 1938, but only in the last decade has the group B Streptococcus become the leading etiologic agent for bacteremia and/or meningitis occurring during the first two months of life. Neither the reasons for the emergence of this organism nor the shifts over the past 40 years in the prevalence of various bacteria responsible for neonatal infection has been adequately explained. However, the importance of the group B Streptococcus as a frequent cause of neonatal mortality and morbidity demands a thorough understanding of the epidemiology and pathogenesis, clinical features, diagnostic methods, and management of these infections by physicians caring for newborn infants. INCIDENCE The common occurrence of neonatal group B streptococcal septicemia and meningitis in several geographically distant centers since 1970 has allowed the relatively precise determination of attack rates for early onset type (≤5 days) infection. Reported attack rates have been surprisingly uniform, varying from 1.3/1,000 to 4.0/1,000 live births (Table 1). Because the attack rates for serious neonatal infections associated with Escherichia coli and other maternally acquired coliform organisms have been constant since 1960, the appearance of the group B Streptococcus resulted in an absolute increase in the incidence of neonatal bacterial disease during the past decade in many hospitals in this country.

Current methods of radiological diagnosis of kidney neoplasms (literature review)

2021 ◽  
pp. 14-22
Author(s):  
Oleg N. YAMSHIKOV ◽  
Natalia V. YEMELYANOVA ◽  
Daria S. ZAGORODNOVA
Keyword(s):  
Kidney Neoplasms ◽  
Diagnostic Methods ◽  
Malignant Neoplasms ◽  
Kidney Tumors ◽  
The Past ◽  
New Methods ◽  
Total Incidence ◽  
Oncological Diseases ◽  
Working Age ◽  
Medical Disciplines

We presented an overview of domestic and foreign studies on the diagnosis of renal malignancies published in publicly available electronic specialized medical publications. Taking into account that every year the share of oncological diseases in the structure of the total incidence is constantly growing, and that cancer is one of the main causes of death and disability in the working age population, currently, the search for new diagnostic methods to detect kidney tumors still remains a pressing problem located at the junction of several medical disciplines, in particular, oncology, urology, radiation diagnostics and radiation therapy. Over the past decade, the diagnosis of malignant kidney neoplasms has undergone significant changes and has stepped far forward. Because of that the ability to detect the disease in the early stages of development increases. In the study, we examined the most widespread methods, methods that have already lost relevance, as well as new methods, such as magnetic resonance imaging, computed tomography ultrasonography, radiography, etc. We also considered the possibilities of differential diagnosis of benign and malignant neoplasms.

scholarly journals Lyme Disease Biosensors: A Potential Solution to a Diagnostic Dilemma

Biosensors ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 137
Author(s):  
Connor Flynn ◽  
Anna Ignaszak
Keyword(s):  
Lyme Disease ◽  
Large Degree ◽  
Diagnostic Methods ◽  
Diagnostic Dilemma ◽  
The Past ◽  
Current State ◽  
The World ◽  
Chemical Techniques ◽  
Late Stages ◽  
Current Standards

Over the past four decades, Lyme disease has remained a virulent and pervasive illness, persisting throughout North America and many other regions of the world. Recent increases in illness in many countries has sparked a renewed interest in improved Lyme diagnostics. While current standards of diagnosis are acceptable for the late stages of the disease, it remains difficult to accurately diagnose early forms of the illness. In addition, current diagnostic methods tend to be relatively expensive and require a large degree of laboratory-based analysis. Biosensors represent the fusion of biological materials with chemical techniques to provide simple, inexpensive alternatives to traditional diagnostic methods. Lyme disease biosensors have the potential to better diagnose early stages of the illness and provide possible patients with an inexpensive, commercially available test. This review examines the current state of Lyme disease biosensing, with a focus on previous biosensor development and essential future considerations.

scholarly journals Diagnosis and Planning in the Management of Musculoskeletal Tumors - A Review

2017 ◽  
Vol 11 (2) ◽  
pp. 81-85
Author(s):  
Md Hafizur Rahman ◽  
Md Maiyeen Uddin
Keyword(s):  
Soft Tissue ◽  
Imaging Techniques ◽  
Surgical Techniques ◽  
Soft Tissue Tumors ◽  
Chemotherapeutic Drugs ◽  
Prognostic Information ◽  
Image Guided ◽  
Musculoskeletal Tumors ◽  
The Past ◽  
Appropriate Treatment

The prognosis of patients with musculoskeletal tumors has improved markedly because of the advent of new chemotherapeutic drugs and regimens and as a result of advances in imaging and surgical techniques. Limb-salvage operations can currently be performed with better outcomes, while in the past; limbs with tumors were treated only with amputation. Accurate preoperative surgical staging of musculoskeletal tumors is currently possible because imaging techniques provide prognostic information and aid clinicians in choosing the most appropriate treatment option for the patient. The aim of this article is to outline the presentation, imaging, and staging of the primary and metastatic bone and soft tissue tumors. Some of the image-guided interventions for these tumors are also presented.Faridpur Med. Coll. J. Jul 2016;11(2): 81-85

scholarly journals Overcoming Shellfish Allergy: How Far Have We Come?

2020 ◽  
Vol 21 (6) ◽  
pp. 2234 ◽  
Author(s):  
Christine Y.Y. Wai ◽  
Nicki Y.H. Leung ◽  
Ka Hou Chu ◽  
Patrick S.C. Leung ◽  
Agnes S.Y. Leung ◽  
...  
Keyword(s):  
Treatment Options ◽  
Standard Of Care ◽  
Specific Ige ◽  
Diagnostic Methods ◽  
Asia Pacific ◽  
Prick Test ◽  
Immunological Responses ◽  
The Past ◽  
Molecular Features ◽  
Shellfish Allergy

Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. Such a standard of care is unsatisfactory to both patients and healthcare practitioners. There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy. In this review, we will discuss the epidemiology, the molecular identification of shellfish allergens, recent progress in various diagnostic methods, as well as current development in immunotherapeutic approaches including the use of unmodified allergens, hypoallergens, immunoregulatory peptides and DNA vaccines for the prevention and treatment of shellfish allergy. The prospect of a “cure “for shellfish allergy is within reach.

Exploring the Immune Microenvironment of Diffuse Large B Cell Lymphoma in a Tissue Microarray: Predicting Survival with a Score That Incorporates Macrophages, Cytotoxic and Regulatory T Cells

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 951-951 ◽  
Author(s):  
Rita Coutinho ◽  
Andrew James Clear ◽  
David Andrew Owen ◽  
Paul Greaves ◽  
Simon L. Hallam ◽  
...  
Keyword(s):  
T Cells ◽  
Immune Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Single Centre ◽  
Immune Microenvironment ◽  
Prognostic Information ◽  
Large B Cell Lymphoma ◽  
Prognostic Groups ◽  
Large B Cell

Abstract Abstract 951 Gene expression profiling studies in Diffuse Large B cell Lymphoma (DLBCL) have described signatures enriched in genes representing the immune microenvironment. These signatures, together with the cell of origin classification have prognostic significance. However, a comprehensive functional understanding of the role of inflammation and the immune response in DLBCL is still lacking. The use of immunohistochemistry (IHC) to validate and elaborate upon molecular results is appealing. Our objective was to assess the cellular composition of the non-malignant population in DLBCL quantitatively and thoroughly in a single centre TMA of patients with DLBCL with corresponding clinical and survival data. Based on reported findings and known functional interactions a panel of antibodies were selected that included CD68, FOXP3 and TIA-1. IHC was performed on TMAs from high quality formalin-fixed paraffin-embedded diagnostic tissue biopsies of DLBCL from 1977 to 2009. Triplicate cores were made from areas of representative tumour tissue, arrayed onto glass slides and stained for a panel of antibodies, aiming to characterize immune cell subsets. The TMA included tissue from 218 patients: 128 males, 90 females, with a median age of 55 (18-94) years; 23.2% high-int/high risk IPI; with median follow up of 3,1 years. 33% of patients were treated in the rituximab era. Absolute numbers of positive cells were counted across all intact cores using an automated image analysis system (Ariol), confirmed by histopathologists, and means calculated and corrected to a 1 mm2 area. A training-validation set method was used to generate optimal cutoff values discriminating prognostic groups and comparisons performed using the chi-square test. Among nine antibodies examined, statistically significant prognostic information was provided using staining for FOXP3, TIA-1 and CD68. Using single cut-offs of positive cells/mm2 to define low and high marker density, two prognostic groups were defined for each marker. Patients with a more favourable prognosis had the highest cell density for FOXP3, TIA-1 and CD68. To clarify whether there was an additive prognostic relationship we developed a score that incorporated these three markers. This scoring system allowed us to discriminate two subgroups of patients with divergent survival parameters (fig 1).Marker (cutoff value high vs low)Overall Survival at 3yr (high vs low)Progression Free Survival at 3yr (high vs low)Disease Specific Survival at 3yr (high vs low)FOXP3 (450+ cells/mm2)64% vs 44% (p 0.005)55% vs 36% (p 0.001)69% vs 54% (0.01)CD68 (900+ cells/mm2)58% vs 28% (p 0.023)50% vs 20% (p 0.05)66% vs 36% (p 0.005)TIA-1 (2500+ cells/mm2)76% vs 45% (p 0.002)66% vs 41% (p 0.01)80% vs 56% (p 0.005)Combined Score68% vs 39% (p 0.0002)60% vs 32% (p 0.0003)73% vs 49% (p 0.0008) A Cox regression model was developed, incorporating age, IPI, rituximab treatment and IHC score. The score results were validated as independent prognostic markers for OS, PFS and DSS, together with age, IPI (for OS and DSS) and rituximab (for PFS). We confirm that there is heterogeneity in immune cell infiltration at diagnosis in DLBCL, and we provide correlative prognostic data to suggest a corresponding biological relevance. Attributing single cut-off values for immune cell markers is feasible, attractive as a clinical tool, and appears to provide robust prognostic information. In our single centre cohort we found that higher numbers of macrophages, Tregs and cytotoxic T cells correlate independently with improved patient survival. CD68 has been associated with an adverse prognosis in lymphoid malignancies but phenotypic diversity of macrophages may account for this study's finding and will be explored using macrophage subset specific markers. Our multivariate analysis revealed that the IHC results have an independent impact on survival on this cohort of DLBCL patients. We are currently validating this approach in an independent TMA of R-CHOP treated patients. Combining these three different immune cell parameters allowed us to discriminate prognostic subgroups providing further evidence of the impact of the non-malignant immune cells in the biology of DLBCL and validating their role as potential therapeutic targets for intervention. Disclosures: Gribben: Gilead: Honoraria; Mundipharma: Honoraria; GSK: Honoraria; Celgene: Honoraria; Roche: Honoraria; Pharmacyclics: Honoraria.

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