asymptomatic stage
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Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 388
Author(s):  
Nobuaki Fujikuni ◽  
Kazuaki Tanabe ◽  
Minoru Hattori ◽  
Yuji Yamamoto ◽  
Hirofumi Tazawa ◽  
...  

Background: The prognostic prolongation effect of reduction surgery for asymptomatic stage IV gastric cancer (GC) is unfavorable; however, its prognostic effect for symptomatic stage IV GC remains unclear. We aimed to compare the prognosis of gastrectomy and gastrojejunostomy for symptomatic stage IV GC. Methods: This multicenter retrospective study analyzed record-based data of patients undergoing palliative surgery for symptomatic stage IV GC in the middle or lower-third regions between January 2015 and December 2019. Patients were divided into distal gastrectomy and gastrojejunostomy groups. We compared clinicopathological features and outcomes after propensity score matching (PSM). Results: Among the 126 patients studied, 46 and 80 underwent distal gastrectomy and gastrojejunostomy, respectively. There was no difference in postoperative complications between the groups. Regarding prognostic factors, surgical procedures and postoperative chemotherapy were significantly different in multivariate analysis. Each group was further subdivided into groups with and without postoperative chemotherapy. After PSM, the data of 21 well-matched patients with postoperative chemotherapy and 8 without postoperative chemotherapy were evaluated. Overall survival was significantly longer in the distal gastrectomy group (p = 0.007 [group with postoperative chemotherapy], p = 0.02 [group without postoperative chemotherapy]). Conclusions: Distal gastrectomy for symptomatic stage IV GC contributes to prognosis with acceptable safety compared to gastrojejunostomy.


Author(s):  
Masahito Watanabe ◽  
Kazuhiro Umeyama ◽  
Kazuaki Nakano ◽  
Hitomi Matsunari ◽  
Toru Fukuda ◽  
...  

AbstractAutosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease, manifesting as the progressive development of fluid-filled renal cysts. In approximately half of all patients with ADPKD, end-stage renal disease results in decreased renal function. In this study, we used CRISPR-Cas9 and somatic cell cloning to produce pigs with the unique mutation c.152_153insG (PKD1insG/+). Pathological analysis of founder cloned animals and progeny revealed that PKD1insG/+ pigs developed many pathological conditions similar to those of patients with heterozygous mutations in PKD1. Pathological similarities included the formation of macroscopic renal cysts at the neonatal stage, number and cystogenic dynamics of the renal cysts formed, interstitial fibrosis of the renal tissue, and presence of a premature asymptomatic stage. Our findings demonstrate that PKD1insG/+ pigs recapitulate the characteristic symptoms of ADPKD.


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
James Halle-Smith ◽  
Lewis Hall ◽  
Lois Daamen ◽  
James Hodson ◽  
Rupaly Pande ◽  
...  

Abstract Background The clinical benefit and acceptability to patients of routine surveillance after resection of pancreatic ductal adenocarcinoma (PDAC) remains unclear. Furthermore, expert guidelines around the world offer conflicting recommendations. This study is a systematic review of evidence for surveillance programs. Methods A systematic review of studies evaluating different surveillance methods was undertaken. Meta-analyses were performed for those studies reporting rates of asymptomatic recurrence, treatment of recurrence and overall survival, according to different surveillance methods. Results There were ten studies included in the literature review. Five studies were appropriate for meta-analysis (1,596 patients). If enrolled in an active surveillance program, patients were more likely to have recurrence detected at an asymptomatic stage (Pooled Rate: 49.3% vs. 19.1%, p = 0.043). In terms of clinical outcomes, patients with asymptomatic recurrence were more likely to receive treatment for recurrence (Odds Ratio 3.49; 95% CI: 1.73-7.07; p < 0.001) and had longer overall survival (Mean Difference: 9.5 months; 95% CI: 4.1-14.8; p < 0.001) than those with symptoms at time of recurrence. Conclusions From this systematic review and meta-analysis of early data it appears that routine surveillance after surgery for PDAC detects more patients at the asymptomatic stage. Data from these non-randomised trials also suggest that treatment rates and survival may be superior in patients were recurrence is detected when asymptomatic. As such, these data suggest that routine surveillance may improve patient outcomes, however an appropriately conducted trial would be required to address concerns that various sources of bias may be affecting these results.


Author(s):  
Mayank Yadav ◽  

Acute Pulmonary embolism is one of the major preventable causes of in hospital mortality. It is commonly seen in ICU setting in chronic bed ridden patients [1]. It has wide spectrum of clinical presentation ranging from asymptomatic stage to severe hemodynamic decompensation so diagnosis requires high degree of suspicion. In majority of cases detailed history and physical examination along with ECG and 2D transthoracic echocardiography is enough the diagnosis. CT pulmonary angiography is done to confirm the diagnosis or when diagnosis is not possible by other non-invasive tests. A 45-year-old army person presented to ER with breathlessness for 3 days. There was no complaint of chest pain, giddiness, palpitation, swelling or pain of legs. Patient does not have any other comorbidities.


2021 ◽  
Vol 8 (1) ◽  
pp. 15
Author(s):  
Kiran Sankar Maiti ◽  
Susmita Roy ◽  
Renée Lampe ◽  
Alexander Apolonski

Many life-threatening diseases at an early stage remain unrecognized due to a lack of pronounced symptoms. It is also accepted that the early detection of disease is a key ingredient for saving many lives. Unfortunately, in most of the cases, diagnostics implies an invasive sample collection, being problematic at the asymptomatic stage. Infrared spectroscopy of breath offers reliable noninvasive diagnostics at every stage and has already been tested for several diseases. This approach offers not only the detection of specific metabolites, but also the analysis of their imbalance and transportation. In this article, the power of infrared spectroscopy is demonstrated for diabetes, cerebral palsy, acute gastritis caused by bacterial infection, and prostate cancer.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fabian Cuypers ◽  
Alexander Schäfer ◽  
Sebastian B. Skorka ◽  
Surabhi Surabhi ◽  
Lea A. Tölken ◽  
...  

AbstractSeasonal Influenza A virus (IAV) infections can promote dissemination of upper respiratory tract commensals such as Streptococcus pneumoniae to the lower respiratory tract resulting in severe life-threatening pneumonia. Here, we aimed to compare innate immune responses in the lungs of healthy colonized and non-colonized mice after IAV challenge at the initial asymptomatic stage of infection. Responses during a severe bacterial pneumonia were profiled for comparison. Cytokine and innate immune cell imprints of the lungs were analyzed. Irrespective of the colonization status, mild H1N1 IAV infection was characterized by a bi-phasic disease progression resulting in full recovery of the animals. Already at the asymptomatic stage of viral infection, the pro-inflammatory cytokine response was as high as in pneumococcal pneumonia. Flow cytometry analyses revealed an early influx of inflammatory monocytes into the lungs. Neutrophil influx was mostly limited to bacterial infections. The majority of cells, except monocytes, displayed an activated phenotype characterized by elevated CCR2 and MHCII expression. In conclusion, we show that IAV challenge of colonized healthy mice does not automatically result in severe co-infection. However, a general local inflammatory response was noted at the asymptomatic stage of infection irrespective of the infection type.


Author(s):  
Inmaculada Gómez ◽  
M. Carmen Thomas ◽  
Génesis Palacios ◽  
Adriana Egui ◽  
Bartolomé Carrilero ◽  
...  

Infection by the Trypanosoma cruzi parasite causes Chagas disease and triggers multiple immune mechanisms in the host to combat the pathogen. Chagas disease has a variable clinical presentation and progression, producing in the chronic phase a fragile balance between the host immune response and parasite replication that keeps patients in a clinically silent asymptomatic stage for years. Since the parasite is intracellular and replicates within cells, the cell-mediated response of the host adaptive immunity plays a critical role. This function is mainly orchestrated by T lymphocytes, which recognize parasite antigens and promote specific functions to control the infection. However, little is known about the immunological markers associated with this asymptomatic stage of the disease. In this large-scale analysis, the differential expression of 106 immune system-related genes has been analyzed using high-throughput qPCR in T. cruzi antigen-stimulated PBMC from chronic Chagas disease patients with indeterminate form (IND) and healthy donors (HD) from endemic and non-endemic areas of Chagas disease. This analysis revealed that there were no differences in the expression level of most genes under study between healthy donors from endemic and non-endemic areas determined by PCA and differential gene expression analysis. Instead, PCA revealed the existence of different expression profiles between IND patients and HD (p < 0.0001), dependent on the 32 genes included in PC1. Differential gene expression analysis also revealed 23 upregulated genes (expression fold change > 2) and 11 downregulated genes (expression fold change < 0.5) in IND patients versus HD. Enrichment analysis showed that several upregulated genes in IND patients participate in relevant immunological pathways such as antigen-dependent B cell activation, stress induction of HSP regulation, NO2-dependent IL12 pathway in NK cells, and cytokine-inflammatory response. The antigen-specific differential gene expression profile detected in these patients and the relevant immunological pathways that seem to be activated could represent potential biomarkers of the asymptomatic form of Chagas disease, helpful to diagnosis and infection control.


Author(s):  
М.М. Тлиш ◽  
Ж.Ю. Наатыж ◽  
Т.Г. Кузнецова ◽  
Д.И. Масько ◽  
Я.В. Козырь

К паранеопластическим синдромам относят заболевания, возникающие вследствие развития злокачественного новообразования и проявляющиеся симптомами, отдаленными от локализации самой опухоли и ее метастазов. Паранеопластические дерматозы – это многочисленная группа различных кожных проявлений, указывающих на возможность наличия опухоли, в том числе на ранней бессимптомной стадии развития. Одним из таких дерматозов является некролитическая мигрирующая эритема – патология кожи, имеющая ассоциацию с глюкагономой – альфа-клеточной опухолью поджелудочной железы, продуцирующей глюкагон. Представленное в статье описание клинического случая поможет улучшить понимание общности патогенетических аспектов между новообразованием и дерматозом, повысить онкологическую настороженность смежных специалистов и организовать эффективное междисциплинарное взаимодействие, улучшив качество жизни больных с опухоль-ассоциированными дерматозами. Paraneoplastic syndromes include diseases that arise as a result of the development of a malignant neoplasm, manifested by symptoms that are remote from the localization of the tumor itself and its metastases. Paraneoplastic dermatoses are a large group of various skin manifestations that indicate the possibility of the presence of a tumor, including at an early asymptomatic stage of development. One of these dermatoses is necrolytic migrating erythema, a skin pathology associated with glucagonoma, an alpha – cell tumor of the pancreas that produces glucagon. The description of the clinical case presented in the article will help to improve the understanding of the common pathogenetic aspects between neoplasm and dermatosis, increase the oncological alertness of related specialists and organize effective interdisciplinary interaction, as a result, improving the quality of life of patients with tumor-associated dermatoses.


2021 ◽  
Vol 22 (16) ◽  
pp. 9039
Author(s):  
Giuseppe Murdaca ◽  
Alessandro Allegra ◽  
Francesca Paladin ◽  
Fabrizio Calapai ◽  
Caterina Musolino ◽  
...  

Objective: Multiple Myeloma (MM) is a haematological disease resulting from the neoplastic transformation of plasma cells. The uncontrolled growth of plasma cells in the bone marrow and the delivery of several cytokines causes bone erosion that often does not regress, even in the event of disease remission. MM is characterised by a multi-step evolutionary path, which starts with an early asymptomatic stage defined as monoclonal gammopathy of undetermined significance (MGUS) evolving to overt disease. Data Sources and Study Selection: We have selected scientific publications on the specific topics “alarmis, MGUS, and MM”, drawing from PubMed. The keywords we used were alarmines, MGUS, MM, and immune system. Results: The analysis confirms the pivotal role of molecules such as high-mobility group box-1, heat shock proteins, and S100 proteins in the induction of neoangiogenesis, which represents a milestone in the negative evolution of MM as well as other haematological and non-haematological tumours. Conclusions: Modulation of the host immune system and the inhibition of neoangiogenesis may represent the therapeutic target for the treatment of MM that is capable of promoting better survival and reducing the risk of RRMM.


2021 ◽  
Author(s):  
Michaela A McCown ◽  
Carolyn Allen ◽  
Daniel D Machado ◽  
Hannah Boekweg ◽  
Yiran Liang ◽  
...  

Chronic Lymphocytic Leukemia (CLL) is a slow progressing disease, characterized by a long asymptomatic stage followed by a symptomatic stage during which patients receive treatment. While proteomic studies have discovered differential pathways in CLL, the proteomic evolution of CLL during the asymptomatic stage has not been studied. In this pilot study, we show that by using small sample sizes comprising ~145 cells, we can detect important features of CLL necessary for studying tumor evolution. Our small samples are collected at two time points and reveal large proteomic changes in healthy individuals over time. A meta-analysis of two CLL proteomic papers showed little commonality in differentially expressed proteins and demonstrates the need for larger control populations sampled over time. To account for proteomic variability between time points and individuals, large control populations sampled at multiple time points are necessary for understanding CLL progression. Data is available via ProteomeXchange with identifier PXD027429.


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