scholarly journals Duration of lead time in screening for gastric cancer

2021 ◽  
Vol 8 (10) ◽  
pp. 563-566
Author(s):  
Jochanan Benbassat
Keyword(s):  
Gastric Cancer ◽  
Lead Time ◽  
Doubling Time ◽  
Randomized Clinical Trials ◽  
Tumor Doubling Time ◽  
Patients With Cancer ◽  
Reference Sections ◽  
Populations At Risk ◽  
Wide Variability

Objective: Estimates of lead time (LT), i.e., from detection of cancer in asymptomatic persons to manifestations of the disease, can be obtained by follow-up of populations at risk, reviews of the past histories of patients with cancer, estimates of tumor doubling time, and from the ratio between the prevalence of cancer at the first round of screening and its annual incidence on subsequent screening rounds. Aim of this study is to derive the LT of gastric cancer (GC) from published studies. Material and Methods: An overview of longitudinal studies and screening trials of GC; search of the reference sections of the retrieved papers for additional relevant studies; and calculation of the LT derived from these studies. Results: LT was 2.8 – 7.3 years if derived from prospective follow-up studies; 1.0 - 4.0 years if derived from retrospective reviews of the patients' histories before the clinical diagnosis of GC; 5.9 - 8.6 years if derived from tumor doubling time; and 1.8 - 4.3 years if derived from prevalence / /incidence ratios. Conclusions: There is wide variability in estimates of the LT of GC. Since an LT exceeding 6 six years may explain the improved survival of patients with screen-detected GS, the present survey does not obviate the need for randomized clinical trials of the effect of screening on gastric cancer mortality.

scholarly journals Duration of lead time in screening for lung cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jochanan Benbassat
Keyword(s):  
Lung Cancer ◽  
Longitudinal Studies ◽  
Squamous Cell ◽  
Lead Time ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Tumor Doubling Time ◽  
Probability Modeling ◽  
Populations At Risk ◽  
Screening Trials

Abstract Background Screening for lung cancer has used chest radiography (CR), low dose computed tomography (LDCT) and sputum cytology (SC). Estimates of the lead time (LT), i.e., the time interval from detection of lung cancer by screening to the development of symptoms, have been derived from longitudinal studies of populations at risk, tumor doubling time (DT), the ratio between its prevalence at the first round of screening and its annual incidence during follow-up, and by probability modeling derived from the results of screening trials. Objective To review and update the estimates of LT of lung cancer. Methods A non-systematic search of the literature for estimates of LT and screening trials. Search of the reference sections of the retrieved papers for additional relevant studies. Calculation of LTs derived from these studies. Results LT since detection by CR was 0.8–1.1 years if derived from longitudinal studies; 0.6–2.1 years if derived from prevalence / incidence ratios; 0.2 years if derived from the average tumor DT; and 0.2–1.0 if derived from probability modeling. LT since detection by LDCT was 1.1–3.5 if derived from prevalence / incidence ratios; 3.9 if derived from DT; and 0.9 if derived from probability modeling. LT since detection of squamous cell cancer by SC in persons with normal CR was 1.3–1.5 if derived from prevalence/incidence ratios; and 2.1 years if derived from the DT of squamous cell cancer. Conclusions Most estimates of the LT yield values of 0.2–1.5 years for detection by CR; of 0.9–3.5 years for detection by LDCT; and about 2 years or less for detection of squamous cell cancer by SC in persons with normal CR. The heterogeneity of the screening trials and methods of derivation may account for the variability of LT estimates.

L-arginine effect on inflammatory mediators: A systematic review of randomized controlled clinical trials

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Seyed Reza Mirhafez ◽  
Mitra Hariri
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Inflammatory Mediators ◽  
Randomized Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Patients With Cancer ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Human Adults ◽  
Factor Α

Abstract. L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.

Audio Stories as Incidental Language Teachers

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Ute Ritterfeld ◽  
Timo Lüke
Keyword(s):  
Language Learning ◽  
Low Socioeconomic Status ◽  
Language Teachers ◽  
Control Group ◽  
Low Socioeconomic ◽  
Migrant Families ◽  
Populations At Risk ◽  
Grammatical Skills ◽  
Entertainment Value

Abstract. Audio stories offer a unique blend of narrative entertainment with language learning opportunities as a user’s enjoyment is dependent on their processing of the linguistic content. A total of 138 third- and fourth-graders from low socioeconomic status and migrant families recruited from a metropolitan area in Germany participated in a randomized pre–post follow-up intervention study with a control group. Children listened to a tailored crime story of approximately 90 min over a period of 3 days within the classroom setting. Entertainment value for the age group was established in a pilot study. Outcome variables included semantic and grammatical skills in German and were administered before (pretest), shortly after intervention (posttest), and 2 weeks later (follow-up). We used nonverbal intelligence, reading, comprehension skills, age and sex as control variables. Results indicate a strong positive effect of media reception on language skills. The effectiveness of the intervention is discussed with reference to different linguistic domains, entertainment value, and compensatory effects in populations at risk of language learning deficits.

The tumor doubling time is a useful parameter for predicting the histological type of thymic epithelial tumors

Surgery Today ◽  
2019 ◽  
Vol 49 (8) ◽  
pp. 656-660 ◽  
Author(s):  
Koichi Fukumoto ◽  
Takayuki Fukui ◽  
Koji Kawaguchi ◽  
Shota Nakamura ◽  
Shuhei Hakiri ◽  
...  
Keyword(s):  
Doubling Time ◽  
Histological Type ◽  
Tumor Doubling Time ◽  
Thymic Epithelial Tumors ◽  
Epithelial Tumors

scholarly journals An Emulation of Randomized Trials of Administrating Antipsychotics in PTSD Patients for Outcomes of Suicide-Related Events

2021 ◽  
Vol 11 (3) ◽  
pp. 178
Author(s):  
Noah R. Delapaz ◽  
William K. Hor ◽  
Michael Gilbert ◽  
Andrew D. La ◽  
Feiran Liang ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Previous History ◽  
Current Treatment ◽  
Careful Consideration ◽  
P Value ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
History Of ◽  
Almost All

Post-traumatic stress disorder (PTSD) is a prevalent mental disorder marked by psychological and behavioral changes. Currently, there is no consensus of preferred antipsychotics to be used for the treatment of PTSD. We aim to discover whether certain antipsychotics have decreased suicide risk in the PTSD population, as these patients may be at higher risk. A total of 38,807 patients were identified with a diagnosis of PTSD through the ICD9 or ICD10 codes from January 2004 to October 2019. An emulation of randomized clinical trials was conducted to compare the outcomes of suicide-related events (SREs) among PTSD patients who ever used one of eight individual antipsychotics after the diagnosis of PTSD. Exclusion criteria included patients with a history of SREs and a previous history of antipsychotic use within one year before enrollment. Eligible individuals were assigned to a treatment group according to the antipsychotic initiated and followed until stopping current treatment, switching to another same class of drugs, death, or loss to follow up. The primary outcome was to identify the frequency of SREs associated with each antipsychotic. SREs were defined as ideation, attempts, and death by suicide. Pooled logistic regression methods with the Firth option were conducted to compare two drugs for their outcomes using SAS version 9.4 (SAS Institute, Cary, NC, USA). The results were adjusted for baseline characteristics and post-baseline, time-varying confounders. A total of 5294 patients were eligible for enrollment with an average follow up of 7.86 months. A total of 157 SREs were recorded throughout this study. Lurasidone showed a statistically significant decrease in SREs when compared head to head to almost all the other antipsychotics: aripiprazole, haloperidol, olanzapine, quetiapine, risperidone, and ziprasidone (p < 0.0001 and false discovery rate-adjusted p value < 0.0004). In addition, olanzapine was associated with higher SREs than quetiapine and risperidone, and ziprasidone was associated with higher SREs than risperidone. The results of this study suggest that certain antipsychotics may put individuals within the PTSD population at an increased risk of SREs, and that careful consideration may need to be taken when prescribed.

scholarly journals Accuracy of upper endoscopies with random biopsies to identify patients with gastric premalignant lesions who can safely be exempt from surveillance

2021 ◽  
Vol 24 (3) ◽  
pp. 680-690
Author(s):  
Michiel C. Mommersteeg ◽  
Stella A. V. Nieuwenburg ◽  
Wouter J. den Hollander ◽  
Lisanne Holster ◽  
Caroline M. den Hoed ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Low Risk ◽  
Premalignant Lesions ◽  
High Risk Patients ◽  
European Guidelines ◽  
Progression Of Disease ◽  
Risk Patients ◽  
Progression Risk

Abstract Introduction Guidelines recommend endoscopy with biopsies to stratify patients with gastric premalignant lesions (GPL) to high and low progression risk. High-risk patients are recommended to undergo surveillance. We aimed to assess the accuracy of guideline recommendations to identify low-risk patients, who can safely be discharged from surveillance. Methods This study includes patients with GPL. Patients underwent at least two endoscopies with an interval of 1–6 years. Patients were defined ‘low risk’ if they fulfilled requirements for discharge, and ‘high risk’ if they fulfilled requirements for surveillance, according to European guidelines (MAPS-2012, updated MAPS-2019, BSG). Patients defined ‘low risk’ with progression of disease during follow-up (FU) were considered ‘misclassified’ as low risk. Results 334 patients (median age 60 years IQR11; 48.7% male) were included and followed for a median of 48 months. At baseline, 181/334 (54%) patients were defined low risk. Of these, 32.6% were ‘misclassified’, showing progression of disease during FU. If MAPS-2019 were followed, 169/334 (51%) patients were defined low risk, of which 32.5% were ‘misclassified’. If BSG were followed, 174/334 (51%) patients were defined low risk, of which 32.2% were ‘misclassified’. Seven patients developed gastric cancer (GC) or dysplasia, four patients were ‘misclassified’ based on MAPS-2012 and three on MAPS-2019 and BSG. By performing one additional endoscopy 72.9% (95% CI 62.4–83.3) of high-risk patients and all patients who developed GC or dysplasia were identified. Conclusion One-third of patients that would have been discharged from GC surveillance, appeared to be ‘misclassified’ as low risk. One additional endoscopy will reduce this risk by 70%.

scholarly journals Update and clinical management of anti-DNA auto-antibodies

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Concepción González Rodríguez ◽  
MªBelén Aparicio Hernández ◽  
Inmaculada Alarcón Torres
Keyword(s):  
Lupus Erythematosus ◽  
Analytical Methods ◽  
Clinical Laboratory ◽  
Meta Analysis ◽  
Laboratory Methods ◽  
Wide Variability ◽  
Diagnostic Usefulness ◽  
Dna Antibodies ◽  
Editorial Review

Abstract Objectives Anti-deoxyribonucleic acid (DNA) antibodies in the clinical laboratory are intimately linked to the diagnosis and monitoring of systemic lupus erythematosus (SLE); however, the characteristics of the analytical methods and the properties of the antibodies themselves are heterogeneous. To review the definition and properties of anti-double-stranded anti-DNA (anti-dsDNA) antibodies, the adequacy of analytical methods, and the clinical requirements for this biomarker. Content Through PubMed we searched the existing literature with the terms anti-dsDNA, editorial, review, guideline, meta-analysis and SLE. The last search, anti-dsDNA and SLE restricted to the last two years. Information was expanded through related articles and those published in official state bodies related to anti-dsDNA and SLE. Summary Clinical laboratory methods for anti-dsDNA analysis and their characteristics are analyze. The clinical utility of anti-dsDNA in its diagnostic, clinical association and follow-up aspects of SLE is reviewed. Outlook There is wide variability in analytical methods and deficits in standardization persist. They are part of the current SLE classification criteria and are used as markers in the follow-up of the disease. Their diagnostic usefulness improves when they are determined in antinuclear antibody (ANA)-positive patients. In follow-up, quantification is of interest, preferably with the same analytical method (given the deficits in standardization).

scholarly journals Potential of biomarkers during pharmacological therapy setting for postmenopausal osteoporosis: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Filippo Migliorini ◽  
Nicola Maffulli ◽  
Filippo Spiezia ◽  
Giuseppe Maria Peretti ◽  
Markus Tingart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Postmenopausal Osteoporosis ◽  
Randomized Clinical Trials ◽  
Type I Collagen ◽  
Therapy Monitoring ◽  
Pharmacological Therapy ◽  
Type I ◽  
Gastrointestinal Adverse Events

Abstract Background Biochemical markers of bone turnover (BTMs), such as the bone alkaline phosphatase (bALP), procollagen type I N propeptide (PINP), serum cross-linked C-telopeptides of type I collagen (bCTx), and urinary cross-linked N-telopeptides of type I collagen (NTx), are used to manage therapy monitoring in osteoporotic patients. This systematic review analyzed the potential of these BMTs in predicting the clinical outcomes in terms of BMD, t-score, rate of fractures, and adverse events during the therapy setting in postmenopausal osteoporosis. Methods All randomized clinical trials (RCTs) reporting data on biomarkers for postmenopausal osteoporosis were accessed. Only articles reporting quantitative data on the level of biomarkers at baseline and on the outcomes of interest at the last follow-up were eligible. Results A total of 36,706 patients were retrieved. Greater values of bALP were associated with a greater rate of vertebral (P = 0.001) and non-vertebral fractures (P = 0.0001). Greater values of NTx at baseline were associated with a greater rate of adverse events at the last follow-up (P = 0.02). Greater values of CTx at baseline were associated with a greater rate of adverse events leading to discontinuation (P = 0.04), gastrointestinal adverse events (P = 0.0001), musculoskeletal adverse events (P = 0.04), and mortality (P = 0.04). Greater values of PINP at baseline were associated with greater rates of gastrointestinal adverse events (P = 0.02) at the last follow-up. Conclusion The present analysis supports the adoption of BMTs during pharmacological therapy setting of patients suffering from osteoporosis. Level of evidence I, systematic review of RCTs

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