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[PMID]: 24778086
[Au] Autor:Arvold ND; Wang Y; Zigler C; Schrag D; Dominici F
[Ad] Address:Department of Radiation Oncology, Dana-Farber/Brigham & Women's Hospital, Boston, Massachusetts (N.D.A.); Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts (Y.W., C.Z., F.D.); Department of Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts (D.S.)....
[Ti] Title:Hospitalization burden and survival among older glioblastoma patients†.
[So] Source:Neuro Oncol;16(11):1530-40, 2014 Nov.
[Is] ISSN:1523-5866
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Half of all glioblastoma patients are at least 65 years old. The frequency and duration of hospitalization from disease- and treatment-related morbidity in this population are unknown. METHODS: We performed a retrospective cohort study among patients aged 65 years and older with glioblastoma diagnosed between 1999 and 2007 using SEER-Medicare linked data. Diagnoses and procedures were identified using administrative claims data. Logistic regression was performed to identify predictors of high hospitalization burden. RESULTS: Among the 5029 patients in the cohort, 52% were ages 65-74, and 52% were male. Twenty-six percent of patients underwent extensive resection, 72% received radiotherapy, and 18% received temozolomide. Median survival was 4.9 months. Among all patients, 21% were hospitalized at least 30 cumulative days between diagnosis and death, and 22% of all patients spent at least one-fourth of their remaining lives as inpatients. Higher comorbidity score (adjusted hazard ratio [AHR], 1.72; 95% CI, 1.42-2.07) and black race (AHR, 1.56; 95% CI, 1.11-2.18) were associated with an increased risk of being hospitalized for at least 25% of remaining life, whereas radiation (AHR, 0.49; 95% CI, 0.42-0.58), temozolomide (AHR, 0.31; 95% CI, 0.23-0.42), and extensive surgery (AHR, 0.83; 95% CI, 0.69-0.99) were associated with a decreased risk. CONCLUSIONS: These data highlight the burden of hospitalization faced by a large proportion of older glioblastoma patients. In the setting of short survival, strategies to reduce the amount of time these patients spend hospitalized are urgently needed, to help maintain quality of life at the end of life.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1093/neuonc/nou060

  2 / 1409917 MEDLINE  
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[PMID]: 25267975
[Au] Autor:Wen Z; Fan L; Li Y; Zou Z; Scott MJ; Xiao G; Li S; Billiar TR; Wilson MA; Shi X; Fan J
[Ad] Address:Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China; Department of Anesthesiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China; Department of Surgery, University of Pittsburgh School of Medicine, ...
[Ti] Title:Neutrophils counteract autophagy-mediated anti-inflammatory mechanisms in alveolar macrophage: role in posthemorrhagic shock acute lung inflammation.
[So] Source:J Immunol;193(9):4623-33, 2014 Nov 1.
[Is] ISSN:1550-6606
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Acute lung injury (ALI) is a major component of multiple organ dysfunction syndrome after hemorrhagic shock (HS) resulting from major surgery and trauma. The increased susceptibility in HS patients to the development of ALI suggests not yet fully elucidated mechanisms that enhance proinflammatory responses and/or suppress anti-inflammatory responses in the lung. Alveolar macrophages (AMϕ) are at the center of the pathogenesis of ALI after HS. We have previously reported that HS-activated polymorphonuclear neutrophils (PMNs) interact with macrophages to influence inflammation progress. In this study, we explore a novel function of PMNs regulating AMϕ anti-inflammatory mechanisms involving autophagy. Using a mouse "two-hit" model of HS/resuscitation followed by intratracheal injection of muramyl dipeptide, we demonstrate that HS initiates high mobility group box 1/TLR4 signaling, which upregulates NOD2 expression in AMϕ and sensitizes them to subsequent NOD2 ligand muramyl dipeptide to augment lung inflammation. In addition, upregulated NOD2 signaling induces autophagy in AMϕ, which negatively regulates lung inflammation through feedback suppression of NOD2-RIP2 signaling and inflammasome activation. Importantly, we further demonstrate that HS-activated PMNs that migrate in alveoli counteract the anti-inflammatory effect of autophagy in AMϕ, possibly through NAD(P)H oxidase-mediated signaling to enhance I-κB kinase γ phosphorylation, NF-κB activation, and nucleotide-binding oligomerization domain protein 3 inflammasome activation, and therefore augment post-HS lung inflammation. These findings explore a previously unidentified complexity in the mechanisms of ALI, which involves cell-cell interaction and receptor cross talk.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.4049/jimmunol.1400899

  3 / 1409917 MEDLINE  
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[PMID]: 25304935
[Au] Autor:Bytniewski P; Machala W; Romanowski L; Wisniewski W; Kosowski K
[Ti] Title:The dynamics of D-dimer level fluctuation in patients after the cemented and cementless total hip and total knee replacement.
[So] Source:J Orthop Surg Res;9(1):89, 2014.
[Is] ISSN:1749-799X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: The number of total hip and total knee replacement procedures performed worldwide has tended to surge in recent years, due to the combination of such factors as the increased life expectancy, improved quality of life, advances in medical technology as well as pre-operative and post-operative patient management.Numerous studies confirm that patients undergoing major orthopaedics procedures involving lower extremities, for instance total hip and total knee replacement, constitute the highest risk group for the development of post-operative venous thromboembolism (VTE), primarily manifested as deep vein thrombosis (DVT). PURPOSE: The purpose of the research was to assess the dynamics of D-dimer level fluctuation during the post-operative period in patients after the cemented or cementless total hip replacement (THR) or total knee replacement (TKR), in order to prove or reject the thesis that the cemented and cementless THR or TKR affects the post-operative D-dimer levels. MATERIAL AND METHODS: The study group consisted of 47 patients aged 29-82 years. Of them, 23 had the cementless THR, 12 subjects had the cemented THR and another 12 patients had the TKR. All of the patients performed to measure the concentration of D-dimers in the peri-operative period at predetermined time points. For the peri-operative period was adopted from time 1 day before surgery to 10-day hospitalization. The subarachnoid block (SAB) was performed in all patients. RESULTS: The distribution of D-dimer values throughout the entire post-operative period (up to 10th post-operative day) followed the sinusoid pattern with two peaks in all patients. It was not specific in any group. CONCLUSIONS: 1. The D-dimer level almost doubles during the post-operative period in patients after THR or TKR.2. Higher level of D-dimers in post-operative period in the research group of patients does not relate to higher risk of thromboembolic disease.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/s13018-014-0089-0

  4 / 1409917 MEDLINE  
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[PMID]: 25303779
[Au] Autor:Mekaj AY; Morina AA; Bytyqi CI; Mekaj YH; Duci SB
[Ti] Title:Application of topical pharmacological agents at the site of peripheral nerve injury and methods used for evaluating the success of the regenerative process.
[So] Source:J Orthop Surg Res;9(1):94, 2014.
[Is] ISSN:1749-799X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Traumatic injuries of the peripheral nerves are very common. Surgical repair of the damaged nerve is often complicated by scar tissue formation around the damaged nerve itself. The main objective of this study is to present the recent data from animal experimental studies where pharmacological topical agents are used at the site of peripheral nerve repair. Some of the most commonly topical agents used are tacrolimus (FK506), hyaluronic acid and its derivatives, and melatonin, whereas methylprednisolone and vitamin B12 have been used less. These studies have shown that the abovementioned substances have neuroprotective and neuroregenerative properties though different mechanisms. The successes of the regenerative process of the nerve repair in experimental research, using topical agents, can be evaluated using variety of methods such as morphological, electrophysiologic, and functional evaluation. However, most authors agree that despite good microsurgical repair and topical application of these substances, full regeneration and functional recovery of the nerve injured are almost never achieved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/s13018-014-0094-3

  5 / 1409917 MEDLINE  
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[PMID]: 25316373
[Au] Autor:Risch O; Alfidja A; Mulliez A; Amani AH; Boyer L; Camilleri L; Azarnoush K
[Ti] Title:Severe non-traumatic bleeding events detected by computed tomography: do anticoagulants and antiplatelet agents have a role?
[So] Source:J Cardiothorac Surg;9:166, 2014.
[Is] ISSN:1749-8090
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:PURPOSE: Bleeding is the most common and most serious complication of anticoagulant (AC) and antiplatelet agents (APA) which are increasingly used in every day practice. The aim of this study was to enlist and analyze the most severe bleeding events revealed during computed tomography scanner (CT scan) examinations over a 1-year period at our University Hospital and to evaluate the role of ACs and APAs in their occurrence. METHODS: This descriptive monocentric retrospective study included all patients who benefited from an emergency CT scan with a diagnosis of severe non-traumatic bleeding. Patients were divided into two groups: those treated with ACs and/or APAs, and those not treated with ACs or APAs. RESULTS: After applying the inclusion criteria, 93 patients were enrolled. Sixty-one patients received an anticoagulant or antiplatelet treatment, and 32 did not receive any AC or APA therapy. Seventy nine percent presented with an intracranial hemorrhage, 17% with a rectus sheath or iliopsoas bleeding or hematoma, and 4% with a quadriceps hematoma. Only patients who received ACs or APAs suffered a muscular hematoma (p <0.0001). Among patients treated with vitamin K antagonists, 6/43 (14%), had an international normalized ratio (INR) higher than the therapeutic range (INR >3). CONCLUSIONS: In our series, intracranial hemorrhage was preponderant and muscular hematomas occurred exclusively in patients treated with ACs and/or APAs. This study needs to be extended to evaluate the impact of new anticoagulant and antiplatelet agents.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/s13019-014-0166-9

  6 / 1409917 MEDLINE  
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[PMID]: 25239775
[Au] Autor:Harling L; Ashrafian H; Casula RP; Athanasiou T
[Ti] Title:Late surgical repair of a traumatic ventricular septal defect.
[So] Source:J Cardiothorac Surg;9:145, 2014.
[Is] ISSN:1749-8090
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Ventricular Septal Defect (VSD) complicates approximately 1-5% of patients presenting with penetrating chest trauma, however not all VSDs are evident at the time of initial presentation to the emergency department. Acute closure of traumatic VSDs is indicated in patients with a large defect and haemodynamic compromise, however closure may be delayed in smaller defects in order to minimise operative time, reduce operative mortality and allow for recovery from the initial trauma. We describe the case of a previously healthy 23 year-old Caucasian man who presented in extremis following stab wounds to the precordium. After emergency cardiopulmonary bypass and closure of lacerations to both the left and right ventricles, postoperative trans-thoracic echocardiography (TTE) noted a restrictive intramuscular VSD with a high velocity left to right shunt, initially managed conservatively. Elective surgical closure was performed 10 months after the initial injury through a right ventriculotomy using 4-0 Proline sutures reinforced with Teflon pledgets. Despite excellent clinical recovery, 3-month follow-up TTE noted a residual VSD in the mid apical septum. However, given the presence of minimal left to right shunt and the small size of the defect, the patient was managed conservatively with annual review and repeat transthoracic echo. This case highlights the potential pitfalls in both the diagnosis and management of traumatic VSDs particularly where the patient presents in extremis with other life-threatening injuries. Furthermore, it exemplifies the importance of a multidisciplinary approach when planning any elective intervention. Regardless of the management strategy, repeated re-assessment and re-evaluation is vital following penetrating cardiac trauma, and vigilant long-term follow-up is of paramount importance in these cases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/s13019-014-0145-1

  7 / 1409917 MEDLINE  
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[PMID]: 24890385
[Au] Autor:Sato M; Kadota M; Tang B; Yang HH; Yang YA; Shan M; Weng J; Welsh MA; Flanders KC; Nagano Y; Michalowski AM; Clifford RJ; Lee MP; Wakefield LM
[Ti] Title:An integrated genomic approach identifies persistent tumor suppressive effects of transforming growth factor-ß in human breast cancer.
[So] Source:Breast Cancer Res;16(3):R57, 2014.
[Is] ISSN:1465-542X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Transforming growth factor-ßs (TGF-ßs) play a dual role in breast cancer, with context-dependent tumor-suppressive or pro-oncogenic effects. TGF-ß antagonists are showing promise in early-phase clinical oncology trials to neutralize the pro-oncogenic effects. However, there is currently no way to determine whether the tumor-suppressive effects of TGF-ß are still active in human breast tumors at the time of surgery and treatment, a situation that could lead to adverse therapeutic responses. METHODS: Using a breast cancer progression model that exemplifies the dual role of TGF-ß, promoter-wide chromatin immunoprecipitation and transcriptomic approaches were applied to identify a core set of TGF-ß-regulated genes that specifically reflect only the tumor-suppressor arm of the pathway. The clinical significance of this signature and the underlying biology were investigated using bioinformatic analyses in clinical breast cancer datasets, and knockdown validation approaches in tumor xenografts. RESULTS: TGF-ß-driven tumor suppression was highly dependent on Smad3, and Smad3 target genes that were specifically enriched for involvement in tumor suppression were identified. Patterns of Smad3 binding reflected the preexisting active chromatin landscape, and target genes were frequently regulated in opposite directions in vitro and in vivo, highlighting the strong contextuality of TGF-ß action. An in vivo-weighted TGF-ß/Smad3 tumor-suppressor signature was associated with good outcome in estrogen receptor-positive breast cancer cohorts. TGF-ß/Smad3 effects on cell proliferation, differentiation and ephrin signaling contributed to the observed tumor suppression. CONCLUSIONS: Tumor-suppressive effects of TGF-ß persist in some breast cancer patients at the time of surgery and affect clinical outcome. Carefully tailored in vitro/in vivo genomic approaches can identify such patients for exclusion from treatment with TGF-ß antagonists.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1410
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1186/bcr3668

  8 / 1409917 MEDLINE  
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[PMID]: 25320657
[Au] Autor:Arjona-Sánchez A; Medina-Fernández FJ; Muñoz-Casares FC; Casado-Adam A; Sánchez-Hidalgo JM; Rufián-Peña S
[Ad] Address:Alvaro Arjona-Sánchez, Francisco Javier Medina-Fernández, Francisco Cristobal Muñoz-Casares, Angela Casado-Adam, Juan Manuel Sánchez-Hidalgo, Sebastián Rufián-Peña, Unit of Oncological and Pancreatic Surgery, Department of General and Digestive Surgery, University Hospital Reina Sofia, 14004 Cordoba...
[Ti] Title:Peritoneal metastases of colorectal origin treated by cytoreduction and HIPEC: An overview.
[So] Source:World J Gastrointest Oncol;6(10):407-12, 2014 Oct 15.
[Is] ISSN:1948-5204
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Colorectal peritoneal carcinomatosis was considered a terminal condition with a merely palliative treatment that included only supportive care, palliative surgery and the best systemic chemotherapy. Since the birth of a new approach, cytoreductive surgery with peritonectomy procedures together with hyperthermic intraperitoneal chemotherapy and/or early postoperative intraperitoneal chemotherapy to treat peritoneal carcinomatosis, many research groups contributed with promising results using this procedure being up to date this strategy the only one that has shown curative benefits on colorectal peritoneal carcinomatosis achieving reported overall survival rates up to 64 mo and five-year survival rates up to 51%. The aim of this paper is to expose an updated overview of the therapeutic possibilities of these procedures in colorectal peritoneal metastases in the same way that our Unit of Oncologic Surgery has performed since 1997 with more than four hundred procedures.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1410
[Cu] Class update date: 141018
[Lr] Last revision date:141018
[Da] Date of entry for processing:141016
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4251/wjgo.v6.i10.407

  9 / 1409917 MEDLINE  
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[PMID]: 25320656
[Au] Autor:Shah RD; Cassano AD; Neifeld JP
[Ad] Address:Rachit D Shah, Anthony D Cassano, James P Neifeld, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA 23298-0068, United States.
[Ti] Title:Neoadjuvant therapy for esophageal cancer.
[So] Source:World J Gastrointest Oncol;6(10):403-6, 2014 Oct 15.
[Is] ISSN:1948-5204
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Esophageal cancer is increasing in incidence more than any other visceral malignancy in North America. Adenocarcinoma has become the most common cell type. Surgery remains the primary treatment modality for locoregional disease. Overall survival with surgery alone has been dismal, with metastatic disease the primary mode of treatment failure after an R0 surgical resection. Cure rates with chemotherapy or radiation therapy alone have been disappointing as well. For these reasons, over the last decade multi-modality treatment has gained increasing acceptance as the standard of care. This review examines the present data and role of neoadjuvant treatment using chemotherapy and radiation therapy followed by surgery for the treatment of esophageal cancer.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1410
[Cu] Class update date: 141018
[Lr] Last revision date:141018
[Da] Date of entry for processing:141016
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4251/wjgo.v6.i10.403

  10 / 1409917 MEDLINE  
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[PMID]: 25320654
[Au] Autor:Sperti C; Moletta L; Patanè G
[Ad] Address:Cosimo Sperti, Lucia Moletta, Giuseppe Patanè, Department of Surgery, Oncology and Gastroenterology, 3 Surgical Clinic, University of Padua, 35128 Padova, Italy.
[Ti] Title:Metastatic tumors to the pancreas: The role of surgery.
[So] Source:World J Gastrointest Oncol;6(10):381-92, 2014 Oct 15.
[Is] ISSN:1948-5204
[Cp] Country of publication:China
[La] Language:eng
[Ab] Abstract:Pancreatic metastases from other primary malignancies are a rare entity. By far, the most common primary cancer site resulting in an isolated pancreatic metastasis is the kidney, followed by colorectal cancer, melanoma, breast cancer, lung carcinoma and sarcoma. Only few data on the surgical outcome of pancreatic resections performed for metastases from other primary tumor have been published, and there are no guidelines to address the surgical treatment for these patients. In this study, we performed a review of the published literature, focusing on the early and long-term results of surgery for the most frequent primary tumors metastasizing to the pancreas. Results for the Literature's analysis show that in last years an increasing number of surgical resections have been performed in selected patients with limited pancreatic disease. Pancreatic resection for metastatic disease can be performed with acceptable mortality and morbidity rates. The usefulness of pancreatic resection is mainly linked to the biology of the primary tumor metastasizing to the pancreas. The benefit of metastasectomy in terms of patient survival has been observed for metastases from renal cell cancer, while for other primary tumors, such as lung and breast cancers, the role of surgery is mainly palliative.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1410
[Cu] Class update date: 141018
[Lr] Last revision date:141018
[Da] Date of entry for processing:141016
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4251/wjgo.v6.i10.381


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