during a thromboembolic event.Thromboembolic events occurred in 5 (86%) of the 7 patients with thrombophilia, and 1 in a patient without thrombophilia.In addition, 4 ischaemic strokes, 1 central retinal artery thrombosis, 1 venous sinus thrombosis, 1 jugular venous thrombosis, and 1 transient ischaemic attack were recorded.In addition, 1 patient showed positive anti-β2 microglobulin antibody; 3 showed positive lupus anticoagulant with MTHFR C677T homozygosity; 1 MTHFR C677T homozygosity, 1 positive lupus anticoagulant with MTHFR C677T heterozygosity; and 1 with positive lupus anticoagulant and MTHFR A1298C and C677T heterozygosity.Amongst the patients with thromboembolic events, 5 had Crohn's disease and 1 ulcerative colitis.The average age was 45.6 years with an average disease-evolution time of 61.2 months.The average Harvey-Bradshaw score was 5.4, and Mayo score was 11.Average erythrocyte sedimentation rate was 23 mm, and C-reactive protein was 2.97 mg/dL.It was necessary to optimise therapeutic in 2 patients.Conclusions: In our study, most of the patients with IBD and thrombophilias presented a thromboembolic event.Thromboembolic events were more frequent in Crohn's disease, with highest clinical activity scores.
Asthma is a common airway disease associated with allergic inflammation. Environmental factors, such as pollens, pollution, insect-borne antigens, or commercial chemicals, cause this disease. The common symptoms of this airway allergic reaction are increasing mucus, narrowing of the airway wall, coughing, and chest tightness. Medications, such as steroids, alleviate the disease but with severe side effects. Several studies have reported the anti-inflammatory effects of tree-based essential oil components, particularly 3-carene. Therefore, this study used 3-carene to determine if it alleviates asthmatic symptoms in the murine model. First, BALB/c mice were sensitized to an ovalbumin and aluminium hydroxide mixture on day 7
Purpose: Hilar and mediastinal lymph node staging is a crucial prognostic factor and treatment indicator in patients with non-small-cell lung cancer.This study aims to access the accuracy of 18F-fluro-2-deoxy-D-glucose (FDG) integrated positron emission tomography and computed tomography (FDG-PET/CT) in detection of intrathoracic lymph nodes.Methods and materials: Single institution retrospective study of preoperative patients with suspected or pathologically proven potentially resectable NSCLC undergoing FDG-PET/CT.Nodal stations identified according to American Joint committee on cancer 7th edition.Lymph nodes were reported as positive, negative or suspicious based on visual FDG-PET assessment and CT characteristics.Lymph node staging was pathologically confirmed with tissue specimens collected with endobronchial ultrasound FNA, mediastinoscopy and/or thoracotomy.Statistical evaluation performed on a per-patient basis.Results: A total of 30 patients included in the study.Integrated FDG-PET/CT sensitivity and specificity were 80 ± 35% and 90 ± 13%, respectively.The positive and negative predictive values were 66.7 ± 10% and 94.7 ± 38%, respectively.FDG-PET/CT accurately staged nodal status in 22/25 patients (88%).Five patients were classified on FDG-PET/CT as indeterminate/low level suspicion with histological confirmation either prior to or at the time of surgery recommended.False positive (2 cases) and negative cases (1 case) involved lymph nodes <12 mm in size with FDG-avidity similar or only slightly greater than the mediastinal blood pool.True positive cases involved nodes greater than 10 mm with FDG-avidity significantly greater than the surrounding mediastinal blood pool (SUV > 11.0).Conclusion: Our data show FDG-PET/CT has high specificity but low sensitivity in accuracy of intrathoracic nodal staging of NSCLC patients.Negative PET-CT results are reassuring given the high negative predictive value, however positive PET-CT still require confirmation with nodal sampling particularly given the low sensitivity and positive predictive value.An integrated approach to reporting is required assessing nodal FDG-PET avidity as well as CT nodal characteristics.
The results provide evidence for the assumptions of the CSM and suggest the importance of addressing illness perceptions and the coping strategy 'decreasing activity' in quality health care for IBD.
Abstract Background Endoscopic submucosal dissection (ESD) has gained traction as an effective therapy for ulcerative colitis (UC)-associated dysplasia, yet identifying fitting ESD candidates is challenging by substantial submucosal (SM) fibrosis from chronic inflammation. We report our experience utilising endoscopic ultrasonography (EUS) to assess ESD eligibility by measuring SM cushion thickness. Methods Retrospective case-series includes nine patients who were diagnosed or referred to as UC-associated dysplasia in surveillance colonoscopies between August 2017 and October 2023. After scanning dysplastic lesions (Fig A-B), hyaluronic acid solution was injected into the SM layer (Fig C). EUS with a mini-probe quantified SM cushion beneath the dysplastic lesion (Fig D), and ESD was performed in cases with at least 2.0 mm of SM cushion thickness (Fig E-F). Results Among ten cases from nine patients, eight cases met the criteria and underwent ESD, while two cases (Patient 3, Patient 7) were regarded as unsuitable for ESD with SM cushion thickness less than 2.0 mm. Median disease duration was 19 years, and median age at diagnosis of UC-associated dysplasia was 50 years. Median SM cushion thickness ranged from 4.2 to 6.9 mm. Median procedure time was 50 minutes, and median size of resected specimens and lesions were 31.5 x 24.5 mm and 16.0 x 12.5 mm, respectively. en bloc resection was achieved in all cases, with an 87.5% R0 resection rate. No perforation occurred; only one required post-discharge endoscopic bleeding control after four days post-discharge. Conclusion EUS-measured SM cushion thickness may be a valid approach that provides an objective criterion for determining ESD eligibility in UC-associated dysplasia. This would help guide individualised treatment in UC-associated dysplasia, reducing unnecessary procedures or surgery.
Abstract Backgrounds Pericardial effusion (PE) is often an obstacle to cancer treatment and a life-threatening factor. Although cancer survival has improved over the past two decades, an appropriate treatment method for PE in cancer patients has not yet been established. The purpose of this study was to investigate the temporal trends and clinical results in the method of drainage of PE. Methods Between 2003 and 2022, 744 consecutive patients with malignant PE who underwent pericardial drainage were retrospectively analyzed. The patients were divided according to the time of pericardial drainage (Period 1: 2003-2012, Period 2: 2013-2022) and initial drainage method (pericardiocentesis vs. window surgery). The rates of all-cause death and redo pericardial drainage for recurrent PE were compared according to the drainage methods. Results In comparison with Period 1, there was an increasing number of patients who underwent pericardial drainage in Period 2 (235 vs. 509). However, the proportion of window surgery decreased (21.7 vs. 14.9%, P=0.029). The median survival time of patients was improved (4.4 vs. 6.3 months, log-rank P<0.001). There was no significant difference in all-cause death and 30-day mortality (24.4 vs. 18.6%, P=0.171) after drainage between surgery and pericardiocentesis groups. The window surgery group had a significantly lower incidence of redo pericardial drainage than the pericardiocentesis group (hazard ratio [HR]: 0.49, 95% confidence interval [CI]: 0.26–0.91, P=0.022). In Period 1, there was no significant difference in redo pericardial drainage between window surgery and pericardiocentesis (HR: 0.78, 95% CI: 0.35–1.74, P=0.540). However, the window surgery group had significantly lower redo pericardial drainage than the pericardiocentesis group in Period 2(HR: 0.33, 95% CI: 0.12–0.91, P=0.024). Conclusions The window surgery was safe in cancer patients. As cancer survival rates improve, surgery showed benefits in reducing redo pericardial drainage. Pericardial window surgery could be preferred over pericardiocentesis in patients who expected longer life expectancy.
Abstract Background Atrial fibrillation catheter ablation (AFCA) is an effective rhythm control method for patients with AF, but AF recurrence is higher in patients with a large left atrium (LA). We explored whether pre-procedural LA strain has incremental prognostic value for the long-term rhythm outcomes of AFCA in patients with AF and moderately enlarged LA size (45≤LA diameter<50mm). Methods We included 2,269 patients who underwent de novo AF catheter ablation (men 72.2%, 59.1[±10.7] years, paroxysmal AF 64.0%). We divided grouped into 5 mm increments and determined the appropriate cut-off of LA diameter (45mm) predicting the difference in long-term rhythm outcome by the log-likelihood values of multivariate Cox proportional hazard models. Patients with moderately enlarged LA size (45≤LA diameter<50mm, n=413) with borderline rhythm outcomes were used for analysis. Results In the cohort of 413 patients who underwent AFCA with moderately enlarged LA size, AF was recurred in 208 patients (43.7%) after AFCA. We determined the appropriate cut-off of LA strain (12.5) predicting the difference in long-term rhythm outcome by the log-likelihood values of multivariate Cox proportional hazard models. During 24 months [10-50] follow-up, patients with low LA strain (<12.5) were showed worsen rhythm outcome than high LA strain (Log-rank p<0.001). Patients with AF recurrence after AFCA were independently associated with low LA strain (HR 1.539 [1.130-2.094], p=0.006), and paroxysmal AF (OR 0.651 [0.469-0.905], p=0.011). Furthermore, the likelihood ratio test demonstrated a significant influence of adding LA strain by TTE (χ2 = 13.90 [P < 0.001]). Conclusions LA strain using baseline echocardiography has a predictive power for AF recurrence after AFCA in patients with moderately enlarged LA size (45≤LA diameter<50mm).
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