Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Κυριακή 11 Δεκεμβρίου 2022

Efficacy and safety of camrelizumab plus apatinib compared to apatinib monotherapy as third‐line or above therapy for metastatic colorectal cancer patients: A retrospective cohort study

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Efficacy and safety of camrelizumab plus apatinib compared to apatinib monotherapy as third-line or above therapy for metastatic colorectal cancer patients: A retrospective cohort study

This study aimed to investigate the treatment efficacy and safety of camrelizumab (programmed cell death protein-1 (PD-1) inhibitor) plus apatinib as third-line or above therapy in metastatic colorectal cancer (mCRC) patients. Totally, 64 unresectable mCRC patients receiving camrelizumab plus apatinib (N = 31) and apatinib (N = 33) were retrospectively enrolled. It was found that disease control rate and objective response rate (ORR) were increased in camrelizumab plus apatinib group compared to apatinib group, but ORR did not achieve statistical significance. Besides, the median (95% confidence interval [CI]) progressive-free survival (PFS) and overall survival (OS) were 6.9 (3.7–10.1) and 11.5 (7.7–15.3) months in camrelizumab plus apatinib group, as well as 3.6 (1.7–5.5) and 6.7 (5.0–8.4) months in apatinib group. Additionally, PFS and OS were prolonged in camrelizumab plus apatinib group compared with apatinib group. The incidence of a dverse events did not differ between groups. Conclusively, camrelizumab (PD-1 inhibitor) plus apatinib achieves a better treatment efficacy than apatinib as third-line or above therapy with a good safety profile in mCRC patients.


Abstract

What Is Known and Objective

Programmed cell death protein-1 (PD-1) inhibitors synergize apatinib for anti-tumour effect by regulating tumour microenvironment, vascular endothelial growth factor, hypoxia condition, immune response, etc. This study aimed to investigate the treatment efficacy and safety of camrelizumab (PD-1 inhibitor) plus apatinib as third-line or above therapy in metastatic colorectal cancer (mCRC) patients.

Methods

Totally, 64 unresectable mCRC patients receiving camrelizumab plus apatinib (N = 31) and apatinib (N = 33) were retrospectively enrolled.

Results

Disease control rate (80.6% vs. 57.6%) (P = 0.047) was elevated in camrelizumab plus apatinib group compared to apatinib group; however, objective response rate (22.6% vs. 6.1%) (P = 0.078) only showed an increasing trend but did not achieve statistical significance. Besides, the median (95% confidence interval [CI]) progressive-free survival (PFS) and overall survival (OS) were 6.9 (3.7–10.1) and 11.5 (7.7–15.3) months in camrelizumab plus apatinib group; meanwhile, the median (95% CI) PFS and OS were 3.6 (1.7–5.5) and 6.7 (5.0–8.4) months in the apatinib group. Additionally, PFS (P = 0.017) and OS (P = 0.006) were prolonged in camrelizumab plus apatinib group compared with apatinib group, which was confirmed by further multivariate Cox's proportional hazards regression analysis (hazard ratio [HR] = 0.340, P < 0.001 for PFS; HR = 0.271, P < 0.001 for OS). Th e incidence of total, grade 1–2, and grade 3–4 adverse events did not differ between groups (all P > 0.05).

Conclusion

Camrelizumab (PD-1 inhibitor) plus apatinib achieves a better treatment efficacy than apatinib as third-line or above therapy with a good safety profile in mCRC patients.

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Mendelian randomization suggests a potential causal effect of eosinophil count on influenza vaccination responsiveness

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Abstract

Currently, the clinical factors affecting immune responses to influenza vaccines have not been systematically explored. The mechanism of low responsiveness to influenza vaccination (LRIV) is complicated and not thoroughly elucidated. Thus, we integrate our in-house genome-wide association studies (GWAS) analysis result of LRIV (N = 111, Ncase [Low Responders] = 34, Ncontrol [Responders] = 77) with the GWAS summary of 10 blood-based biomarkers (sample size ranging from 62,076 to 108,794) deposited in BioBank Japan (BBJ) to comprehensively explore the shared genetics between LRIV and blood-based biomarkers to investigate the causal relationships between blood-based biomarkers and LRIV by Mendelian randomization (MR). The applications of four MR approaches (inverse-variance-weighted (IVW), weighted median, weighted mode, and generalized summary-data-based Mendelian randomization (GSMR)) suggested that the genetically instrumented LRIV was associated with decreased eosinophil count (� � = -5.517 to -4.422, p-value = 0.004 to 0.039). Finally, we conclude that the low level of eosinophil count is a suggestive risk factor for LRIV.

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The prognostic significance of hematogones in childhood B‐cell acute lymphoblastic leukemia

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Abstract

Background

Recent studies have demonstrated hematogones (HGs) expansion to be associated with favorable outcomes in hematological diseases, especially in patients with acute myeloid leukemia and patients undergoing hematopoietic stem cell transplantation. Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children. As of now, minimal residual disease (MRD) remains the most compelling independent prognostic factor in childhood ALL. There is need for more prognostic tools for evaluating relapse risk.

Procedure

The goal of this study was to assess the prognostic value of HGs on relapse-free survival (RFS) and overall survival (OS) in childhood ALL. In this prospective cohort study, a total of 122 subjects with definitive diagnosis of precursor B lymphoblastic leukemia were evaluated. Flow cytometric HG detection was performed in bone marrow aspirates after induction and consolidation therapy.

Results

The median follow-up period of patients was 35.5 ± 9.4 (SD) months. Patients who had at least 1.0% HGs had a significantly better RFS (p = .023). Moreover, univariate and multivariate analyses confirmed that positive HGs were independently associated with longer RFS (unadjusted model: hazard ratio = 0.33, 95% CI = 0.12–0.91, p = .031; adjusted model: hazard ratio = 0.30, 95% CI = 0.11–0.82, p = .020).

Conclusions

Along with the role of MRD, our study shows the significance of HGs as an independent prognostic factor. The results indicate the independent prognostic value of HGs on RFS after adjustment for other prognostic factors, and can be beneficial for risk stratification and treatment modifications amongst pediatric B-cell ALL patients.

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Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care?

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Duration of antibiotic treatment for acute graft pyelonephritis: What's the standard of care?


Abstract

Background

Limited evidence is available to inform the duration of antibiotic treatment in kidney transplant recipients with bacterial acute graft pyelonephritis. Guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation suggest a 14–21 day duration.

Methods

A four-question survey was constructed to determine the current standard of practice for the duration of treatment for acute graft pyelonephritis. The survey was distributed among members of the Infectious Diseases and the Kidney Pancreas Communities of Practice of the American Society of Transplantation.

Results

Among 144 survey respondents, 87 (60%) were infectious disease physicians, and 36 (25%) were transplant nephrologists. Although most (55%) respondents preferred a 14-day duration, a spread between 7 and 28 days was observed. Goals of treatment and drivers for longer duration differed between infectious disease physicians and transplant nephrologists.

Conclusions

Although most respondents prefer a 14-day duration of treatment for acute graft pyelonephritis, a wide range of responses was seen between 7 and 28 days. More evidence is needed to inform optimal treatment duration in this common infectious complication after transplantation.

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Πέμπτη 8 Δεκεμβρίου 2022

Design of customized soft tissue substitutes for anterior single‐tooth and posterior double‐tooth defects: An in vitro study

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Abstract

Objective

This study aims to validate the standardized procedure for designing soft tissue substitutes (STS) adapted to optimally fit single-tooth defects in the anterior jaws and double-tooth defects in the posterior jaw and to compare mathematically modeled average shapes.

Materials and Methods

Casts from 35 patients with 17 single-tooth defects in anterior region and 21 double-tooth defects in posterior region were scanned. STS were designed and sectioned in 3D slices meshes. Thickness values were documented respecting mesial-distal and buccal-lingual orientations. Graphs were embedded into images, and hierarchical clustering was applied to group STS according to shape and thickness.

Results

STS clustered into two groups per defect type. For anterior single defects, STS (n = 4) were either a small and thin oval: 7 mm buccal-lingual, 4–5 mm mesial-distal direction and 1.1–1.5 mm thick or a larger oval (n = 13): 9 mm buccal-lingual, 5–7 mm mesial-distal and 1.6 m thick. For posterior double tooth defects, STS (n = 10) were either narrow, long and thick: 6–7 mm buccal-lingual, 16–20 mm mesial-distal and 2.2 thick or a wide, thinner rectangle (n = 11): 9–11 mm buccal-lingual, 12–14 mm mesial-distal and 1.1–1.5 mm thick.

Conclusions

The study validated the standardized digital method to design grafts for soft tissue volume augmentation and identified four average shapes for anterior single-tooth and posterior double-tooth soft tissue defects.

Clinical Significance

We developed and validated a standardized digital method to design an optimal geometrical shape of a soft tissue substitute for oral volume augmentation and combined it with mathematical modeling to identify average shapes for single-interior, and double-posterior tooth defects. The identified average shapes offer the possibility to produce better-fitted xenografts or synthetic STS blocks requiring minimal chair-side adaptation leading to reduced clinical time and patient discomfort and potentially improving soft tissue volume augmentation outcomes.

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Tonsillectomy vs Modified Uvulopalatopharyngoplasty for Hypertrophy and Obstructive Sleep Apnea

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This randomized clinical trial examines whether modified uvulopalatopharyngoplasty is more effective than tonsillectomy alone for treating adults with tonsillar hypertrophy and moderate to severe obstructive sleep apnea.
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Berichtetes und gemessenes Riech- und Schmeckvermögen in einer Long-COVID-Kohorte

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Laryngorhinootologie
DOI: 10.1055/a-1970-6510

Einleitung Störungen des Riech- und Schmecksinns werden häufig zahlenmäßig übereinstimmend als Long-COVID-Symptom beklagt. Anhand von Befunden einer Spezialsprechstunde (HNO-LCS) soll geklärt werden, wie groß tatsächlich der Anteil pathologischer olfaktorischer bzw. gustatorischer Diagnosen in dieser Kohorte ist. Methodik 48 erwachsene Patienten, die die HNO-LCS aus eigenem Leidensdruck aufsuchten, wurden nach ihrer Anamnese befragt, sie schätzten ihr Riech- (SER) und Schmeckvermögen (SES) mit Schulnoten ein und absolvierten als Riechtest den erweiterten Sniffin'Sticks-Test und als Schmecktest den 3-Tropfen-Test. Aus dem SDI-Riechscore und dem totalen Schmeckscore (SScore-total) wurden anhand von Normwerten Diagnosen erstellt. Zwischen den gemessenen Scores und der Selbsteinschätzung und zwischen SER und SES wurden Korrelationen berechnet. Ergebnisse Tatsächliche pathologische chemosensorische Diagnosen bestanden bei 90% der Patienten. Pathologische olfaktorische Diagnosen waren doppelt so häufig wie gustatorische. Bei 10% der Kohorte war keine pathologische Diagnose verifizierbar. Bei 6 Patienten wurde ein Anosmie-Ageusie-Syndrom diagnostiziert. SER korrelierte stark mit SDI. SES korrelierte moderat mit SScore-total. SER korrelierte stark mit SES. Schlussfolgerungen Bei der Interpretation berichteter chemosensorischer Symptome besteht die Gefahr einer Konfusion von Riechen und Schmecken durch die Betroffenen. Deshalb ist die Überprüfung der chemischen Sinne mit validierten Tests in Long-COVID-Ambulanzen wichtig.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
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