scholarly journals CLINICAL MANIFESTATIONS AND INCIDENCE OF GLOBE SALVAGE AND PATIENT SURVIVAL IN THE CASES OF RETINOBLASTOMA

2019 ◽  
pp. 1-3
Author(s):  
Bansari Sorathiya

PURPOSE: To study clinical characteristics of Retinoblastoma and analyze the occurrences of patient survival and globe salvation. METHODS: This is a prospective and non-randomized study involving retinoblastoma patients at a tertiary institute from May, 2017 to May, 2019. All patients underwent comprehensive medical assessment and illness management investigations. The given treatment was recorded, including focal therapy, enucleation and chemotherapy. RESULTS: Leukocoria was the foremost common presentation (60.68%) followed by proptosis (12.3%). The patient survival rate was 87.7% whereas globe salvation was at 23.2% (19 eyes). CONCLUSION: Most patients came for clinical examination for rst time at a later stage of disease, having high risk clinical features such as positive family history, hyphema, and large tumor volume. More awareness and early stage diagnosis are of prime importance in order to achieve globe salvation in retinoblastoma.

2018 ◽  
Vol 5 (3) ◽  
pp. 175-187 ◽  
Author(s):  
O. V. Gorovtsova ◽  
T. L. Ushakova ◽  
V. G. Polyakov

Retinoblastoma is one of highly curable diseases; today the total 5-year survival rate in patients with retinoblastoma exceeds 95%. The article summarizes the current world experience on treatment of patients with intraocular retinoblastoma. The treating skills of intraocular malignant tumor in children are a balance between the patient’s life and the preservation of an eye and its visual functions. The complex and challenging task is the treatment of common intraocular retinoblastoma groups «C», «D», «E» when the large size or localization of the tumor does not allow performing the local (focal) destruction of the tumor. As a rule, in such cases neoadjuvant chemotherapy (CT) is performed at the first stage in order to reduce the size of the tumor for further focal therapy. However, the analysed data on the effectiveness of neoadjuvant CT in combination with focal or radiotherapy demonstrated the limited possibilities of the proposed therapy. Local drug delivery in cancer therapy became a real breakthrough in the organ-preserving treatment of children with large intraocular retinoblastoma. The most widely used current methods of local drug delivery are intravitreal (IVitC) and selective intra-arterial chemotherapy (SIAC) as monotherapy or in combination with neoadjuvant CT and focal therapy which significantly increased the percentage of preserved eyes without radiotherapy administration or damage to the patient survival. The review discusses the different IVitC and SIAC techniques, chemotherapy schemes, dosages of chemotherapy, immediate and long-term complications of treatment.


2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Yuexin Wu ◽  
Yuyan Cao ◽  
Keren Xu ◽  
Yue Zhu ◽  
Yuemei Qiao ◽  
...  

AbstractLiver cirrhosis remains major health problem. Despite the progress in diagnosis of asymptomatic early-stage cirrhosis, prognostic biomarkers are needed to identify cirrhotic patients at high risk developing advanced stage disease. Liver cirrhosis is the result of deregulated wound healing and is featured by aberrant extracellular matrix (ECM) remodeling. However, it is not comprehensively understood how ECM is dynamically remodeled in the progressive development of liver cirrhosis. It is yet unknown whether ECM signature is of predictive value in determining prognosis of early-stage liver cirrhosis. In this study, we systematically analyzed proteomics of decellularized hepatic matrix and identified four unique clusters of ECM proteins at tissue damage/inflammation, transitional ECM remodeling or fibrogenesis stage in carbon tetrachloride-induced liver fibrosis. In particular, basement membrane (BM) was heavily deposited at the fibrogenesis stage. BM component minor type IV collagen α5 chain expression was increased in activated hepatic stellate cells. Knockout of minor type IV collagen α5 chain ameliorated liver fibrosis by hampering hepatic stellate cell activation and promoting hepatocyte proliferation. ECM signatures were differentially enriched in the biopsies of good and poor prognosis early-stage liver cirrhosis patients. Clusters of ECM proteins responsible for homeostatic remodeling and tissue fibrogenesis, as well as basement membrane signature were significantly associated with disease progression and patient survival. In particular, a 14-gene signature consisting of basement membrane proteins is potent in predicting disease progression and patient survival. Thus, the ECM signatures are potential prognostic biomarkers to identify cirrhotic patients at high risk developing advanced stage disease.


2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Jyoti Verma ◽  
Sumit Lal ◽  
Cornelis J.F. Van Noorden

AbstractTheranostics are a multifunctional approach using nanoparticles for combined diagnostic and therapeutic purposes. The hybrid nanoparticles that are applied for these purposes are composed of an inorganic core and an organic shell. The inorganic core acts as a contrast enhancer and the organic shell acts as a drug releaser. Hybrid nanoparticles can be conjugated with targeting moieties and systematically administered to patients to direct the nanoparticles to specific cells such as cancer cells. Theranostics have the potential to significantly improve early stage cancer diagnostics and patient survival. This review discusses preclinical and clinical advances in applications of inorganic nanoparticles for the theranostics of cancer.


2021 ◽  
Vol 100 (2) ◽  
pp. 49-57
Author(s):  
M.N. Guseva ◽  
◽  
E.I. Zinina ◽  
E.N. Suspitsyn ◽  
M.M. Kostik ◽  
...  

Hereditary angioedema (HAE) is a rare autosomal dominant disease characterized by isolated recurrent angioedema (AE) of various localizations: skin, the submucosa in the gastrointestinale tract, the respiratory tract. The characteristic features of edema in HAE are the absence of itching, skin flushing, accompanying urticaria, as well as the absence of pronounced effect of systemic corticosteroid therapy, systemic antihistamines therapy and adrenaline. The aim of our study was to present a descriptive characteristics of the group of patients with HAE and to access efficacy and safety of treatment. Materials and methods: the retrospective multicenter continuous nonrandomized uncontrolled study included data on 34 patients: 19 men (56%) and 15 women (44%) with HAE. The diagnosis of HAE was based on clinical and laboratorial data, according to the clinical guidelines of the Russian Association of allergologists and clinical immunologists on HAE (2014). Results The age range of patients at the time of inclusion in the study was 5–82 years, median – 38,8 (20,6; 46,9) years. Median age of first HAE episode was 12,5 (5,8; 16,3) years, ranged from 2 to 40, 22/28 (79%) of the patients manifested before 18 years. HAE was diagnosed at the median age of 30 years (17,5; 44,8) years, in 14,0 (9,0; 25,0) years after onset of the clinical manifestations. Most of the observations described have a positive family history of HAE (91%), in total 9 families were described. In 67% of families the disease manifested itself in two generations and in 33% of families – in three generations. At the onset of HAE peripheral edema was in 29/31 (94%) of the patients, and 22/31 (71%) had edema confined to the distal extremities. 7/31 (29%) patients had peripheral edema combined with edema of other locations. Abdominal attacks were in 6/31 (19%), head, neck and upper airways edema were in 7/31 (23%). The frequency of swelling of head, neck, upper respiratory tract increased statistically significantly from 23% (7/31) to 35% (7/20, p=0,003). 24 patients have recieved Icatibant treatment. No deaths were recorded against the background of this treatment. Conclusions HAE is diagnosed with significant time delays. Icatibant treatment is safe and effective.


1997 ◽  
Vol 10 (3) ◽  
pp. 419-443 ◽  
Author(s):  
E K Wagner ◽  
D C Bloom

The clinical manifestations of herpes simplex virus infection generally involve a mild and localized primary infection followed by asymptomatic (latent) infection interrupted sporadically by periods of recrudescence (reactivation) where virus replication and associated cytopathologic findings are manifest at the site of initial infection. During the latent phase of infection, viral genomes, but not infectious virus itself, can be detected in sensory and autonomic neurons. The process of latent infection and reactivation has been subject to continuing investigation in animal models and, more recently, in cultured cells. The initiation and maintenance of latent infection in neurons are apparently passive phenomena in that no virus gene products need be expressed or are required. Despite this, a single latency-associated transcript (LAT) encoded by DNA encompassing about 6% of the viral genome is expressed during latent infection in a minority of neurons containing viral DNA. This transcript is spliced, and the intron derived from this splicing is stably maintained in the nucleus of neurons expressing it. Reactivation, which can be induced by stress and assayed in several animal models, is facilitated by the expression of LAT. Although the mechanism of action of LAT-mediated facilitation of reactivation is not clear, all available evidence argues against its involving the expression of a protein. Rather, the most consistent models of action involve LAT expression playing a cis-acting role in a very early stage of the reactivation process.


2020 ◽  
pp. 67-73
Author(s):  
P.I. Tkachenko ◽  
I.I. Starchenko ◽  
S.O. Bilokon ◽  
N.V. Lokhmatova ◽  
N.P. Bilokon ◽  
...  

The great diversity of the jaw cysts makes the issues of their diagnosis, differential diagnosis, and treatment quite important, always requiring an individual approach, given the features of each clinical case. Although the jaw cysts were first mentioned by Scultetus in 1654, the researchers still have different views on the semiotics and classifying individual nosological forms and, consequently, on choosing treatment methods, preventing possible complications and recurrences, and making prognosis. Asymptomatic clinical course and absence of characteristic clear clinical manifestations of the jaw cysts and similarity of their signs at separate developmental stages regardless of the nosological form and origin site make this pathology relevant in the practice of maxillofacial surgery. Traumatic and aneurysmal pseudocysts are common in the nomenclature of tumor-like formations of the jaws. The paper is concerned with the etiology and pathogenesis, clinical morphological features, and modes of treatment of traumatic and aneurysmal jaw cysts, based on the generalization of the findings of the scientific researches, to emphasize the above nosological forms to the medical community. The study encompasses a thorough analysis of the fundamental scientific works and publications in periodicals on the above issues. The clinical part of the study concerned a comprehensive examination of 46 children with traumatic and aneurysmal jaw cysts who received treatment at the surgical unit of the Poltava Municipal Children’s Clinical Hospital during the period of 5 years. In addition, 8 adult patients with traumatic cysts were examined and received outpatient treatment at the Department’s clinic. Common clinical and additional examination methods, diagnostic puncture, EOD, radiography, CT, and MRI were used to make the clinical diagnosis in serious cases. The microscopic structure of the specimens made from the postoperative material using conventional techniques was studied. During 2014-2019, 46 children with non-odontogenic jaw cysts (NJC) were treated at the Department of Children’s Oral Surgery, including 24 patients (52.2%) with traumatic cysts (TC) and 15 patients (32.6%) with aneurysmal cysts (AC). That is, TC and AC accounted for 39 cases (84.8%) of NJC. At the same time, while the general age of patients with NJC ranged from 5 to 15 years, TC and AC were most common in children aged 10-15 years, which is consistent with other researchers’ data, who observed the highest incidence in puberty. 25 (64,1%) boys and 14 girls (35.9%) have been involved in the study. Generalized statistical analysis revealed that traumatic cysts accounted for 52.2% of children, 32.6% for aneurysmal and 15.2% for other types of non-odontogenic jaw cysts. The patients were predominantly males, and even trauma in the past medical history did not always correspond to and confirm the type of cystic formation. The presented material suggests a rather unclear diagnostic “boundary” between traumatic and aneurysmal cysts, when, in fact, the main differential diagnostic criterion is a carefully gathered anamnesis, even at the prehospital stage. The given material can be the basis for further in-depth scientific and practical studies on immunohistochemical structural features of traumatic and aneurysmal jaw cysts.


2021 ◽  
Author(s):  
Emma Ahlqvist ◽  
Rashmi B Prasad ◽  
Leif Groop

Type 2 diabetes (T2D) is one of the fastest increasing diseases worldwide. Although it is defined by a single metabolite, glucose, it is increasingly recognized as a highly heterogeneous disease with varying clinical manifestations. Identification of different subtypes at an early stage of disease when complications might still be prevented could hopefully allow for more personalized medicine. An important step towards precision medicine would be to target the right resources to the right patients, thereby improving patient health and reducing health costs for the society. More well-defined disease populations also offer increased power in experimental, genetic and clinical studies. In a recent study, we used six clinical variables (GAD autoantibodies, age at onset of diabetes, HbA1c, BMI, and simple measures of insulin resistance and insulin secretion (so called HOMA estimates) to cluster adult-onset diabetes patients into five subgroups. These subgroups have been robustly reproduced in several populations worldwide and are associated with different risks of diabetic complications and responses to treatment. Importantly, the group with severe insulin-deficient diabetes (SIDD) had increased risk of retinopathy and neuropathy, whereas the severe insulin-resistant diabetes (SIRD) group has the highest risk for diabetic kidney disease (DKD) and fatty liver. This emphasizes the key role of insulin resistance in the pathogenesis of DKD and fatty liver in T2D. In conclusion, this novel sub-classification, breaking down T2D in clinically meaningful subgroups, provides the prerequisite framework for expanded personalized medicine in diabetes beyond what is already available for monogenic and to some extent type 1 diabetes.


2002 ◽  
Vol 9 (9) ◽  
pp. 912-919 ◽  
Author(s):  
Georges Vlastos ◽  
Nadeem Q. Mirza ◽  
Funda Meric ◽  
Kelly K. Hunt ◽  
Attiqa N. Mirza ◽  
...  

2018 ◽  
Vol 15 (3) ◽  
pp. 260-262 ◽  
Author(s):  
Selthofer-Relatić K ◽  
Radić R ◽  
Stupin A ◽  
Šišljagić V ◽  
Bošnjak I ◽  
...  

Objective: Obesity-related atherosclerosis is a systemic disease with a background connected to multiple metabolic-neurohumoral pathways. The leptin/adiponectin ratio has been suggested as an atherosclerotic marker in obese patients. The aim of this study was to assess (1) the significance of the L/A ratio in overweight subjects, (2) the relation with anthropometric/metabolic parameters and (3) gender difference. Method: The study included 80 adult males and females, overweight, non-diabetic patients. Biochemical blood analysis and anthropometric and cardiovascular measurements were performed. Serum leptin levels were measured with a radioimmunoassay test and total adiponectin levels with enzyme-linked immunosorbent assay. Leptin/adiponectin ratios were calculated as ratios between total serum concentrations of leptin and adiponectin. Results: Differences between leptin, adiponectin serum levels and leptin/adiponectin ratios are presented in overweight persons, where females have a significantly higher leptin/adiponectin ratio than men ( p < 0.001). In men, the leptin/adiponectin ratio showed a positive correlation with total cholesterol levels ( p = 0.011), low-density lipoprotein ( p = 0.013) and triglycerides ( p = 0.032). In females, the leptin/adiponectin ratio correlated with anthropometric parameters of visceral obesity: waist circumference ( p = 0.001) and waist-to-hip ratio ( p = 0.025). Conclusion: The leptin/adiponectin ratio could represent an atherosclerotic risk marker of the early stage of obesity. Gender plays a significant role in pathophysiological changes, with different clinical manifestations, where sex hormones have a crucial effect on neurohumoral adipose tissue activity.


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