treatment protocols
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Bilal Asaad Mubdir ◽  
Hassan Mohammed Ali Bayram

<span>Coronavirus disease (COVID-19) altered the way of caregiving and the new pandemic forced the health systems to adopt new treatment protocols in which remote follow-up is essential. This paper introduces a proposed system to link a remote healthcare unit as it is inside the hospital. Two different network protocols; a global system for mobile communication (GSM) and Wi-Fi were used to simulate the heath data transfer from the two different geographical locations, using Raspberry Pi development board and Microcontroller units. Message queuing telemetry transport (MQTT) protocol was employed to transfer the measured data from the healthcare unit to the hospital’s Gateway. The gateway is used to route the aggregated health data from healthcare units to the hospital server, doctors’ dashboards, and the further processing. The system was successfully implemented and tested, where the experimental tests show that the remote healthcare units using a GSM network consumed about 900 mWh. A high percentage of success data packets transfer was recorded within the network framework as it reaches 99.89% with an average round trip time (RTT) of 7.5 milliseconds and a data transfer rate up to 12.3 kbps.</span>

2022 ◽  
Vol 11 (2) ◽  
pp. 369
Harrison Sicheng Lin ◽  
Qiang Ding ◽  
Zsuzsanna Lichner ◽  
Sung Sun Kim ◽  
Rola Saleeb ◽  

With sunitinib treatment of metastatic renal cell carcinoma, most patients end up developing resistance over time. Recent clinical trials have shown that individualizing treatment protocols could delay resistance and result in better outcomes. We developed an in vivo xenograft tumor model and compared tumor growth rate, morphological, and transcriptomic differences between alternative and traditional treatment schedules. Our results show that the alternative treatment regime could delay/postpone cancer progression. Additionally, we identified distinct morphological changes in the tumor with alternative and traditional treatments, likely due to the significantly dysregulated signaling pathways between the protocols. Further investigation of the signaling pathways underlying these morphological changes may lead potential therapeutic targets to be used in a combined treatment with sunitinib, which offers promise in postponing/reversing the resistance of sunitinib.

2022 ◽  
Vol 17 (6) ◽  
pp. 900-907
Yu. A. Vasyuk ◽  
E. Yu. Shupenina ◽  
D. A. Vyzhigin ◽  
E. O. Novosel ◽  
K. V. Gallinger

Cancer is the second leading cause of mortality in the world, second only to cardiovascular diseases. Simultaneously cancer mortality has been steadily decreasing due to the development  of new chemotherapy and targeted  drugs  and the improvement  of existing  treatment protocols.  Improving the prognosis of treatment of cancer patients leads to an unexpected  result - more patients are faced with side effects of cancer treatment. Cardiotoxicity, including  arrhythmia, has  become  a significant  factor  to reduce  the effectiveness  of cancer  patient’s  treatment.  Atrial  fibrillation  is frequent  and persistent a rhythm disorder, affecting  all categories  of patients, especially the elderly. An association  between these two conditions  can be expected, considering the fact that in old age the prevalence of malignant neoplasms  and comorbid pathology predisposing to the onset of AF is high. Therefore, AF may be an additional  factor negatively  influencing the prognosis and treatment tactics in patients with malignant neoplasms. A comprehensive search was conducted  using the keywords  “cancer”, “atrial fibrillation” and “cardiotoxicity” using the PubMed,  Scopus and Cohrane  databases. We reviewed publications having the relationship between AF and cancer. The literature review considered 61 publications on the prevalence of AF in cancer patients, classification, mechanisms of development, the effect of anticancer drugs and other treatment methods on this group of patients. Analyzed articles include clinical guidelines, consensus  expert opinions,  systematic  reviews,  meta-analyzes, and previously  published  reviews of the literature. The problem of cardiotoxic  complications diagnostics is evaluated separately,  incl. arrhythmias, and their monitoring in cancer patients. Therefore, the direction of medicine named "Cardio-oncology" comes to the fore. Interdisciplinary interaction will allow identify cardiotoxic  manifestations at the subclinical stage and optimize anticancer treatment.

Christian M. Meerwein ◽  
Muriel D. Brada ◽  
Michael B. Soyka ◽  
David Holzmann ◽  
Niels J. Rupp

AbstractSince sinonasal intestinal-type adenocarcinomas (ITAC) show resemblance to colorectal adenocarcinomas, we aimed to investigate novel prognostic factors of outcome, with particular focus on the role of tumor budding (TB). Retrospective clinico-pathological single-institution study on consecutive ITAC patients between 1996 and 2020. Histopathological parameters including conventional subtypes and TB features (low, intermediate, high) were evaluated with the aid of pancytokeratin (AE1/AE3) immunohistochemical staining. Parameters were correlated to clinical data and outcome. A total of 31 ITAC patients were included. Overall, 19/31 patients (61.3%) presented with stage III/IV disease. Presence of lymph node or distant metastases was rare (1/31 patient, 3.2%). Treatment protocols consisted of tumor resection in 30/31 patients (96.8%) and primary radiochemotherapy in 1/31 patient (3.2%). Adjuvant radiation therapy was conducted in 20/30 surgically treated patients (66.7%). The 3- and 5-year overall survival (OS) was 83.9% and 78.3% and the 3- and 5-years disease-specific survival (DSS) 83.7% % and 78.5%, respectively. The presence of intermediate/high TB (defined as ≥ 5 buds) was associated with both, worse DSS (log rank p = 0.03) and OS (log rank p = 0.006). No patient with low TB revealed progressive disease or died of the disease. No association between TB and tumor stage or conventional tumor subtype was found. Tumor budding seems to be an independent prognostic factor of worse outcome in ITAC.

2022 ◽  
Camilla Astley ◽  
Maria Fernanda Badue ◽  
Marcos Santos Lima ◽  
Carlos Alberto Buchpiguel ◽  
Camila G. Carneiro ◽  

Abstract Objective To perform an in-depth assessment of cardiovascular and pulmonary outcomes in a series of 5 post discharged multisystem inflammatory syndrome (MIS-C) survivors. Methods Data were collected ≅1.9 month after hospital discharge at a tertiary hospital in São Paulo, Brazil. All patients (7-18 years; 3 females) fulfilled the MIS-C diagnosis according to CDC. The battery of tests included: 13 N-ammonia PET-CT imaging, standard echocardiography, brachial flow-mediated dilation using a Doppler ultrasound, cardiopulmonary exercise test, and blood markers. Results Upon PET-CT scans, two patients exhibited severe perfusion defect developed in the left ventricular cavity suggesting extensive myocardial ischemia, and one patient showed persistent mild pericardial effusion. Other two patients had endothelial dysfunction. All patients exhibited abnormal cardiopulmonary reserve during exercise (e.g., low VO2peak). Three patients had abnormal values for D-dimer and fibrinogen. Conclusion This study reveals novel pathological findings in MIS-C patients, which may help optimize treatment protocols in this condition.

Pharmaceutics ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 148
Woo Tak Lee ◽  
Johyun Yoon ◽  
Sung Soo Kim ◽  
Hanju Kim ◽  
Nguyen Thi Nguyen ◽  

Combined therapy using photothermal and photodynamic treatments together with chemotherapeutic agents is considered one of the most synergistic treatment protocols to ablate hypoxic tumors. Herein, we sought to fabricate an in situ-injectable PEG hydrogel system having such multifunctional effects. This PEG hydrogel was prepared with (i) nabTM-technique-based paclitaxel (PTX)-bound albumin nanoparticles with chlorin-e6 (Ce6)-conjugated bovine serum albumin (BSA-Ce6) and indocyanine green (ICG), named ICG/PTX/BSA-Ce6-NPs (~175 nm), and (ii) an albumin-stabilized perfluorocarbon (PFC) nano-emulsion (BSA-PFC-NEs; ~320 nm). This multifunctional PEG hydrogel induced moderate and severe hyperthermia (41−42 °C and >48 °C, respectively) at the target site under two different 808 nm laser irradiation protocols, and also induced efficient singlet oxygen (1O2) generation under 660 nm laser irradiation supplemented by oxygen produced by ultrasound-triggered PFC. Due to such multifunctionality, our PEG hydrogel formula displayed significantly enhanced killing of three-dimensional 4T1 cell spheroids and also suppressed the growth of xenografted 4T1 cell tumors in mice (tumor volume: 47.7 ± 11.6 and 63.4 ± 13.0 mm3 for photothermal and photodynamic treatment, respectively, vs. PBS group (805.9 ± 138.5 mm3), presumably based on sufficient generation of moderate heat as well as 1O2/O2 even under hypoxic conditions. Our PEG hydrogel formula also showed excellent hyperthermal efficacy (>50 °C), ablating the 4T1 tumors when the irradiation duration was extended and output intensity was increased. We expect that our multifunctional PEG hydrogel formula will become a prototype for ablation of otherwise poorly responsive hypoxic tumors.

2022 ◽  
Vol 11 (1) ◽  
pp. e29111124969
Luiza Roberta Bin ◽  
Eleonor Álvaro Garbin Júnior ◽  
Geraldo Luiz Griza ◽  
Natasha Magro Érnica ◽  
Mauro Carlos Agner Busato ◽  

Cleft lip and palate is one of the most common facial deformities. During embryonic life, non-fusion of the maxillary and medial nasal plaques leads to cleft lip and palate. Fissures can produce a range of dental problems in terms of number, size, shape, and position, related to deciduous or permanent dentition. Besides this, the teeth most affected are those located in the fissure area. There are numerous treatment protocols, which, despite the lack of a consensus, start as soon as the child is born, going into adulthood, seeking functional and aesthetic rehabilitation. The surgical phases, lip repair, nasal repair, palatoplasty and alveolar bone grafting, are performed according to age. As for the bone graft, the most used option is the secondary graft, with the autogenous one being the most available. Thus, the objective of this work is to present a clinical case of secondary alveolar bone grafting in a 10-year-old female patient with an incomplete unilateral pre-foramen cleft.

Sindhu. R ◽  
H. K. Manonmani

Abstract: Microbial L-asparaginase is the most effective first-line therapeutic used in the treatment protocols of paediatric and adult leukemia. Leukemic cell’s auxotrophy for L-asparagine is exploited as a therapeutic strategy to mediate cell death through metabolic blockade of L-asparagine using L-asparaginase. Escherichia coli and Erwinia chrysanthemi serve as the major enzyme deriving sources accepted in clinical practise and the enzyme has bestowed improvements in patient outcomes over the last 40 years. However, an array of side effects generated by the native enzymes due to glutamine co-catalysis and short serum stays augmenting frequent dosages, intended a therapeutic switch towards the development of biobetter alternatives for the enzyme including the formulations resulting in sustained local depletion of L-asparagine. In addition, the treatment with L-asparaginase in few cancer types has proven to elicit drug-induced cytoprotective autophagy mechanisms and therefore warrants concern. Although the off-target glutamine hydrolysis has been viewed in contributing the drug-induced secondary responses in cells deficient with asparagine synthetase machinery, the beneficial role of glutaminase-asparaginase in proliferative regulation of asparagine prototrophic cells has been looked forward. The current review provides an overview on the enzyme’s clinical applications in leukemia and possible therapeutic implications in other solid tumours, recent advancements in drug formulations, and discusses the aspects of two-sided roles of glutaminase-asparaginases and drug-induced cytoprotective autophagy mechanisms.

Rezvan Amiri ◽  
Maryam Khalili ◽  
Saman Mohammadi ◽  
Behzad Iranmanesh ◽  
Mahin Aflatoonian

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262105
R. I. Helou ◽  
C. M. Waltmans–den Breejen ◽  
J. A. Severin ◽  
M. E. J. L. Hulscher ◽  
A. Verbon

Objective To evaluate the use of a COVID-19 app containing relevant information for healthcare workers (HCWs) in hospitals and to determine user experience. Methods A smartphone app (Firstline) was adapted to exclusively contain local COVID-19 policy documents and treatment protocols. This COVID-19 app was offered to all HCWs of a 900-bed tertiary care hospital. App use was evaluated with user analytics and user experience in an online questionnaire. Results A total number of 1168 HCWs subscribed to the COVID-19 app which was used 3903 times with an average of 1 minute and 20 seconds per session during a three-month period. The number of active users peaked in April 2020 with 1017 users. Users included medical specialists (22.3%), residents (16.5%), nurses (22.2%), management (6.2%) and other (26.5%). Information for HCWs such as when to test for SARS-CoV-2 (1214), latest updates (1181), the COVID-19 telephone list (418) and the SARS-CoV-2 / COVID-19 guideline (280) were the most frequently accessed advice. Seventy-one users with a mean age of 46.1 years from 19 different departments completed the questionnaire. Respondents considered the COVID-19 app clear (54/59; 92%), easy-to-use (46/55; 84%), fast (46/52; 88%), useful (52/56; 93%), and had faith in the information (58/70; 83%). The COVID-19 app was used to quickly look up something (43/68; 63%), when no computer was available (15/68; 22%), look up / dial COVID-related phone numbers (15/68; 22%) or when walking from A to B (11/68; 16%). Few respondents felt app use cost time (5/68; 7%). Conclusions Our COVID-19 app proved to be a relatively simple yet innovative tool that was used by HCWs from all disciplines involved in taking care of COVID-19 patients. The up-to-date app was used for different topics and had high user satisfaction amongst questionnaire respondents. An app with local hospital policy could be an invaluable tool during a pandemic.

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