Different Types Of Therapy Research Articles

Revealing the impact of social circumstances on the selection of cancer therapy through natural language processing of social work notes.

We aimed to investigate the impact of social circumstances on cancer therapy selection using natural language processing to derive insights from social worker documentation. We developed and employed a Bidirectional Encoder Representations from Transformers (BERT) based approach, using a hierarchical multi-step BERT model (BERT-MS), to predict the prescription of targeted cancer therapy to patients based solely on documentation by clinical social workers. Our corpus included free-text clinical social work notes, combined with medication prescription information, for all patients treated for breast cancer at UCSF between 2012 and 2021. We conducted a feature importance analysis to identify the specific social circumstances that impact cancer therapy regimen. Using only social work notes, we consistently predicted the administration of targeted therapies, suggesting systematic differences in treatment selection exist due to non-clinical factors. The findings were confirmed by several language models, with GatorTron achieving the best performance with an area under the receiver operating characteristic curve (AUROC) of 0.721 and a Macro F1 score of 0.616. The UCSF BERT-MS model, capable of leveraging multiple pieces of notes, surpassed the UCSF-BERT model in both AUROC and Macro-F1. Our feature importance analysis identified several clinically intuitive social determinants of health that potentially contribute to disparities in treatment. Leveraging social work notes can be instrumental in identifying disparities in clinical decision-making. Hypotheses generated in an automated way could be used to guide patient-specific quality improvement interventions. Further validation with diverse clinical outcomes and prospective studies is essential. Our findings indicate that significant disparities exist among breast cancer patients receiving different types of therapies based on social determinants of health. Social work reports play a crucial role in understanding these disparities in clinical decision-making.

Myeloid-derived suppressor cells in axial spondyloarthritis patients with different types of therapy

Myeloid-derived suppressor cells in axial spondyloarthritis patients with different types of therapy

Implications of Chemotherapy, Radiation therapy, and Surgical treatment in Oral Cancer

Oral cancer includes both the cancers of the mouth and back of the throat. This literature review investigates viable treatment modalities for adult patients diagnosed with oral cancer including the comparison of chemo/radiation therapy, surgery, and new treatment modalities. Surgical interventions are often the initial treatment, depending on tumor characteristics, and may require reconstructive procedures. Chemotherapy and radiation therapy, while effective, present challenges such as side effects such as nausea, vomiting, hair loss, and fatigue. With surgery, there is the consideration of different types of therapies. Post-operative care, lifestyle implications, and treatment success vary among these modalities. New treatments such as gene therapy and immunotherapy are also starting to appear. Findings suggest the drawbacks and the advantages of different treatments and possible preventive measures.

Different Types of Therapies in Corneal Regeneration

Different Types of Therapies in Corneal Regeneration

Therapeutic challenges in temporomandibular disorders.

This study aimed at evaluating the etiology and treatment challenges of temporomandibular disorders (TMDs). 160 subjects with TMDs, 38 males (23.8%) and 122 females (76.3%) were studied. A personalized coefficient was designated, which included the resolution of the main symptom, correction of secondary symptoms, patient collaboration (emotional parameter), treatment duration, and cost. The most frequent cause for consultation was muscle impairment (42.5%), or limitation of mouth opening, followed by joint impairment (23.1%). Muscle pain was noticed, particularly in the masseter (57.5%) and lateral pterygoid muscles (51.9%). Tooth pain or gingival retraction was frequently associated with tooth wear (48.1%) and dental abfraction (31.3%). Remote symptomatology was dominated by otologic symptomatology. Iatrogenic etiology was highest (69.4%), followed by untreated missing teeth (66.9%). Treatment options included muscle relaxation, occlusal balancing (equilibration), kinesitherapy, medication, and swallowing re-education. Most patients benefited from four to seven different types of therapy, which resulted in a higher cost and a longer and more uncomfortable treatment. The primary symptom was relieved in 82.3% of cases, with recurrence occurring in 15.7%. The treatment of temporomandibular joint dysfunction is time-consuming, demanding, and intricate. Most patients required four to seven different types of therapy, which increased the expense, treatment duration, and suffering.

Differentiation therapy as a new multidisciplinary approach to the treatment of human brain glioma

Differentiation therapy as a new multidisciplinary approach to the treatment of human brain glioma

Diabetes technology and sexual health: which role?

The aim of this review is to evaluate the effects of new technology used in the management of diabetes mellitus (DM), including the use of continuous glucose monitoring (CGM) and the administration of insulin through continuous subcutaneous insulin infusion (CSII), on male and female sexual function. This narrative review was performed for all available prospective, retrospective and review articles, published up to June 2023 in PubMed. Data were extracted from the text and from the tables of the manuscript. Sexual dysfunctions are an underestimated comorbidity of DM in both male and female. Although erectile dysfunction (ED) is recognized by the guidelines as a complication of DM, female sexual dysfunction (FSD) is poorly investigated in clinical setting. In addition to the complications of DM, the different types of therapies can also influence male and female sexual response. Furthermore, insulin therapy can be administered through multiple-daily injections (MDI) or a CSII. The new technologies in the field of DM allow better glycemic control which results in a reduction in the occurrence or aggravation of complications of DM. Despite this evidence, few data are available on the impact of new technologies on sexual dysfunctions. The use of DM technology might affect sexual function due to the risk of a worse body image, as well as discomfort related to CSII disconnection during sexual activity. However, the use is related to an improved metabolic control, which, in the long-term associates to a reduction in all diabetes complications, including sexual function.

Lunch Symposium

The overall objectives of this session are to understand the patient burden of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) and to reflect on the role of tailored treatment strategies in the management of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). The presentation will initially, for each of the 3 diseases, describe key disease characteristics and the clinical responses to different types of therapy, with emphasis on biological and targeted synthetic disease modifying antirheumatic drugs (b/tsDMARDs). Subsequently, the focus will be the gap between patients’ and physicians’ perspectives on the most important aspects of the diseases, and on the main goals of treatment. Thereafter, current international recommendations for RA, PsA and axSpA and the treat-to-target concept will be introduced and discussed, followed by a discussion, disease by disease, of whether prevention of radiographic progression should be an important the goal of treatment. Finally, it will be discussed how the strategy for treating patients RA, PsA, and axSpA should be in the future, including the role of therapeutic strategies tailored for the individual patients.

Contemporaneous and upcoming trends in immunotherapy for prostate cancer: review.

Prostate cancer (PCa) is the most common cancer in men worldwide. It affects more than 1.4 million men worldwide and kills up to 375000 people. PCa is routinely managed with chemotherapy and androgen deprivation therapy, but the success rate of these treatments is unsatisfactory. Immunotherapy is a novel method of treating different types of cancers, and it utilizes the body's own immune system to fight cancer. Different types of cancer respond differently to immunotherapy, with some showing excellent responses, while others do not show very satisfactory responses. PCa is known to be an immunologically cold tumor, such that conventional immunotherapy does not work as effectively as it works in other cancers. In the past decade, multiple studies and trials have been conducted to test different types of therapies, ranging from immune checkpoint inhibitors to anticancer vaccines to anticancer cytokines. Even after many studies, there is still a drug to be discovered that can completely cure any stage of PCa. Recent immunotherapeutic drug trials have started using immunotherapy in conjunction with chemotherapy and radiotherapy and have shown promising results. In this paper, the authors present a comprehensive overview of the currently used immunotherapeutic drugs as well as emerging immunotherapies, including modalities of combination immunotherapy with radiotherapy and chemotherapy. This review can help readers gain the latest knowledge about emerging trends in the current immunotherapy landscape for the treatment of PCa, as well as a general overview of the already used immunotherapy drugs for PCa.

The Girl Who Wants to Get Rid of Her Left Leg—Body Identity Dysphoria

Introduction: One of the strangest kinds of misperceptions of the body is “Body Integrity Dysphoria” (BID), formerly named as “Body Identity Integrity Disorder” (BIID). The affected people have the feeling that a limb is not part of their body. They can feel it, they can use it, they can move it, but they cannot get along with the fact that it is a part of their own body. Most feel the need for an amputation of a leg, others of both legs, some want a palsy and use a wheelchair. Still discussed is whether other disablements such as blindness, dumbness, deafness or a desire to have an incontinency can be included in this diagnosis. This review discusses parallels and differences to transgender/trans identity, body dysmorphic disorder, alien limb syndrome, hemineglect, and self-induced amputations in schizophrenic patients. The cause for the need to be disabled is still unknown; the review gives an overview about psychological and neurological theories of explanation and what kind of therapy may help. Methods: This is a narrative review of about 20 years of research about Body Integrity Dysphoria by the author. Results: Overall, no psychopathological deviations were found, none of the affected persons examined by us were actually delusional or schizophrenic, which underlines that there is a neurological malfunction in the brain that has existed since birth. However, psychological mechanisms intensify the symptoms. There are clear parallels to other forms of interference between the external body and mental body representation. Different types of therapies have been able to provide help to better deal with BID, but there has been little to bring about a real cure. In contrast, BID-affected persons who achieved amputation (or other desired forms of disability) were satisfied and able to return to work. Conclusions: BID remains an enigmatic disorder. We have learned a lot over the past 20 years that the mental and physical bodies do not have to match.

Оценка параметров иммунного статуса в качестве факторов прогнозирования эффективности терапии в контексте механизмов развития противоопухолевого иммунного ответа

The purpose of the study was to evaluate the prognostic and predictive value of lymphocyte subpopulations estimation in the peripheral blood during systemic therapy in patients with solid tumors. Material and methods. We performed a pooled analysis of a series of phase I–II or IV prospective trials conducted in the N.N. Petrov National Medical Research Center of Oncology since 1998 to 2017. Immune system condition (immune status) was assessed 2932 times in 532 patients. 64.5% of patients had melanoma, 16.5% – kidney cancer, 11.4% – soft tissue sarcoma, 7.6% – primary multiple tumors with inclusion of above mentioned diseases. Stages I–II was diagnosed in 12.1% of cases, stage III in 27.5%, stage IV in 60.5%. We present results of the complex assessment of immune factors as predictors of objective response, time to progression or overall survival. Results. We confirmed predictive role of the anergy for efficacy of anticancer vaccines in melanoma. We found several factors that have change their prognostic and predictive value to the opposite in relation to primary tumor, therapy setting (adjuvant or therapeutic), type of therapy. We have shown the efficacy of chemotherapy and targeted therapy in patients with high CD3+CD4+CD24highCD127low lymphocytes level. We have shown favorable prognostic value of elevated CD3+CD4+CD8+ cells level. We demonstrated relation between immune response evaluation and mechanism of action in different types of vaccines. Features of immunological profiles of predictive factors for different diseases, different types of therapy are presented. Conclusion. Evaluation of the main parts of the immune system and allocation of different syndromes is essential for the prediction do the therapy efficacy based on immune system parameters.

Chemical Composition, Antioxidant, Antimicrobial, and Immunomodulatory Activity of Mandragora autumnalis Grown in Jordan

Background: The activity of phytochemicals has a huge impact on pharmaceutical research and developing new drugs. Hence, numerous studies have been conducted to investigate the efficacy of different natural products and their potential to be used in different types of therapy. Objective: This study was carried out to investigate the biological activity of M. autumnalis crude extract and fractions, and the assessment included antimicrobial activity, radical scavenging potential, and their effect on the immune system. The work also emphasizes determining the chemical constituents and the main bioactive compounds in M. autumnalis leaves. Methods: Ethanol crude extract was prepared by maceration method, followed by solvents fractionation using n-hexane, aqueous/methanol, and water. Phytochemical analysis of ethanol extract using LC-MS and total phenolic and flavonoid content were conducted. The immunomodulatory activity was also evaluated by measuring the effect of M. autumnalis on splenocyte proliferation in the presence and absence of mitogens. Nitro blue tetrazolium assay and neutral red method have been used to determine the effect of M. autumnalis on the phagocytic activity of macrophages and the function of pinocytosis, respectively. Antibacterial assay was applied using the microtiter plate dilution method, and DPPH assay was used to determine the antioxidant activity. Results: The phytochemical analysis has shown the presence of flavonoids, polyphenolic compounds, and other organic acids like quinic and chlorogenic acids. M. autumnalis aqueous fraction exhibited high antioxidant activity with an IC₅₀ value of 23.67±0.3 μg/ml. Ethanol extract and n-hexane fraction inhibited the bacterial growth of P. auriginosa with an MIC value of 25 mg/ml, while n-hexane fraction was more active against C. albicans with an MIC value of 12.5 mg/ml. On the other hand, the immune assay revealed a slight modulation of the lymphocyte and macrophage activity compared to the control results. Conclusion: The results suggested that M. autumnalis leaves are rich in polyphenolic compounds and its crude extract and fractions exhibited antimicrobial and antioxidant potential. However, further research is needed to understand the effect of M. autumnalis on the immune parameters.

Modern possibilities of intensive treatment of dyslipidemia and gaps in its control: literature review

The article discusses modern approaches to screening for dyslipidemia and its control, target levels of low-density lipoproteins (LDL), initiation of lipid-lowering therapy depending on the total risk on the Systematic Coronary Risk Evaluation (SCORE) scale, considering the effects of age, gender, smoking, blood pressure, lipid levels, which are of crucial importance for selecting preventive and therapeutic strategies in patients with several risk factors. Different types of therapy for dyslipidemia are discussed as of monotherapy with statins and, in combination with ezetimibe, inhibitors of the enzyme proprotein convertase subtilisin-kexin type 9 (PCSK9). New lipid-lowering drugs are highlighted: bempedoic acid and inclisiran, a synthetic small interfering RNA (siRNA) conjugated with a hydrocarbon of three-antennary N-acetylgalactosamine, which activates the natural RNA interference mechanism to cleave the mRNA of the PCSK9 enzyme and prevent its translation into a protein molecule. This increases the number of receptors for LDL and reducing their amount in the blood. We present our results of assessing the use of lipid-lowering therapy and achievement of the target LDL value in very high-risk patients. Innovative biotechnological drugs based on human monoclonal antibodies or antisense oligonucleodins create additional opportunities for improving the treatment of statin-resistant forms of dyslipidemia in patients with a very high cardiovascular risk. The article aims to increase the level of knowledge about modern approaches to lipid-lowering therapy of general practitioners, cardiologists of the primary care settings and will be of interest to other specialists.

The impact of central stabilization exercises and classical massage on the quality of life of people suffering from cervical spine pain

Introduction. Pain in the cervical spine affects about 22-70% of the population and the incidence of pain increases with age. Out of different types of therapies, most patients prefer a massage aimed at normalizing muscle tension and reducing pain. However, a comprehensive approach to a patient according to the Kinetic Control concept allows for the assessment of uncontrolled motion and enables the analysis of motion and its function. The assessment of motor errors as well as the re-education of muscle function is an important element in improving the range of motion and reducing pain in the cervical part of the spine. Aim. Assessment of the impact of classical massage and central stabilization exercises on the quality of life of people with cervical spine pain. Material and methods. The study covered 40 people (62,5% women, 37,5% men) aged 20 – 70 year who suffered from pain in the cervical spine. Two groups of 20 were formed. Group I was subjected to a series of classical massage, Group II performed exercises of central stabilization. The impact of both therapies was assessed by means of: the author's own survey, the VAS scale, the NDI-PL form, and the measurement of the range of motion in the cervical spine. Quality of life was assessed using a 100-degree scale. Results. VAS and NDI scores in both groups are significantly lower after treatment (p < 0,01), but it cannot be concluded that one form of therapy has had a better effect. The range of spine motion which was evaluated in the cervical segment significantly increased (p < 0,01) in both groups. It was noted that in terms of extension, central stabilization exercises proved to be more effective - the scope of extension increased on average by 1,3 units after exercises, whereas after massages only by 0,7 units (p = 0,045). Both therapies demonstrated effectiveness in the domain of general health (p = 0,54) – both massages and exercises (p = 0,01) brought patients a significant improvement. Conclusions. Both therapies are effective in fighting cervical spine pain, however, better results were obtained in the group performing central stabilization exercises. The quality of life increased significantly in both groups of patients.

Prognostic Mutational Signatures of NSCLC Patients treated with chemotherapy, immunotherapy and chemoimmunotherapy

Different types of therapy are currently being used to treat non-small cell lung cancer (NSCLC) depending on the stage of tumor and the presence of potentially druggable mutations. However, few biomarkers are available to guide clinicians in selecting the most effective therapy for all patients with various genetic backgrounds. To examine whether patients’ mutation profiles are associated with the response to a specific treatment, we collected comprehensive clinical characteristics and sequencing data from 524 patients with stage III and IV NSCLC treated at Atrium Health Wake Forest Baptist. Overall survival based Cox-proportional hazard regression models were applied to identify mutations that were “beneficial” (HR < 1) or “detrimental” (HR > 1) for patients treated with chemotherapy (chemo), immune checkpoint inhibitor (ICI) and chemo+ICI combination therapy (Chemo+ICI) followed by the generation of mutation composite scores (MCS) for each treatment. We also found that MCS is highly treatment specific that MCS derived from one treatment group failed to predict the response in others. Receiver operating characteristics (ROC) analyses showed a superior predictive power of MCS compared to TMB and PD-L1 status for immune therapy-treated patients. Mutation interaction analysis also identified novel co-occurring and mutually exclusive mutations in each treatment group. Our work highlights how patients’ sequencing data facilitates the clinical selection of optimized treatment strategies.

Neoadjuvant therapy for pancreatic cancer.

Patients with localized pancreatic ductal adenocarcinoma (PDAC) are best treated with surgical resection of the primary tumour and systemic chemotherapy, which provides considerably longer overall survival (OS) durations than either modality alone. Regardless, most patients will have disease relapse owing to micrometastatic disease. Although currently a matter of some debate, considerable research interest has been focused on the role of neoadjuvant therapy for all forms of resectable PDAC. Whilst adjuvant combination chemotherapy remains the standard of care for patients with resectable PDAC, neoadjuvant chemotherapy seems to improve OS without necessarily increasing the resection rate in those with borderline-resectable disease. Furthermore, around 20% of patients with unresectable non-metastatic PDAC might undergo resection following 4-6 months of induction combination chemotherapy with or without radiotherapy, even in the absence of a clear radiological response, leading to improved OS outcomes in this group. Distinct molecular and biological responses to different types of therapies need to be better understood in order to enable the optimal sequencing of specific treatment modalities to further improve OS. In this Review, we describe current treatment strategies for the various clinical stages of PDAC and discuss developments that are likely to determine the optimal sequence of multimodality therapies by integrating the fundamental clinical and molecular features of the cancer.

Synergistic Combination of Irinotecan and Rapamycin Orally Delivered by Nanoemulsion for Enhancing Therapeutic Efficacy of Pancreatic Cancer

In recent years, combining different types of therapy has emerged as an advanced strategy for cancer treatment. In these combination therapies, oral delivery of anticancer drugs is more convenient and compliant. This study developed an irinotecan/rapamycin-loaded oral lecithin-based self-nanoemulsifying nanoemulsion preconcentrate (LBSNENPir/ra) and evaluated its synergistic combination effects on pancreatic cancer. LBSNENP loaded with irinotecan and rapamycin at a ratio of 1:1 (LBSNENPir10/ra10) had a better drug release profile and smaller particle size (<200 nm) than the drug powder. Moreover, LBSNENPir10/ra10 exhibited a strong synergistic effect (combination index [CI] < 1.0) in cell viability and combination effect studies. In the tumor inhibition study, the antitumor activity of LBSNENPir10/ra10/sily20 against MIA PaCa-2 (a human pancreatic cancer cell line) was significantly increased compared with the other groups. When administered with rapamycin and silymarin, the area under the curve and the maximum concentration of irinotecan significantly improved compared with the control. We successfully developed an irinotecan/rapamycin-loaded oral self-nanoemulsifying nanoemulsion system to achieve treatment efficacy for pancreatic cancer.

Zonulin as a marker of intestinal permeability in patients with acne associated with celiac disease

The intestinal barrier plays an important role in maintaining gut and whole body immune homeostasis. The role of the gastrointestinal microbiota is significant in maintaining intestinal tightness as the latter affects the intestinal barrier. Shifting the balance of the gut microbiota composition towards opportunistic microorganisms is known to lead to increased secretion of the recently discovered protein zonulin. The level of zonulin in patients with various diseases makes it possible to judge the change in intestinal wall permeability during pathological processes or different types of therapy. The present study examined for the first time the effect of a gluten-free diet on the course of acne in patients with and without celiac disease. The given study was the first to investigate the effect of a gluten-free diet on the course of acne in patients with and without celiac disease.

Stochasticity and Drug Effects in Dynamical Model for Cancer Stem Cells.

The Cancer Stem Model allows for a dynamical description of cancer colonies which accounts for the existence of different families of cells, namely stem cells, highly proliferating and quasi-immortal, and differentiated cells, both undergoing cellular processes under numerous activated pathways. In the present work, we investigate a dynamical model numerically, as a system of coupled differential equations, and include a plasticity mechanism, of differentiated cells turning into a stem state if the stem concentration drops low. We are particularly interested in the stability of the model once we introduce stochastically evolving parameters, associated with environmental and cellular intrinsic variabilities, as well as the response of the model after introducing a drug therapy. As long as we stay within the characteristic time scale of the system, defined on the base of the needed time for the trajectories to converge on stable states, we observe that the system remains stable for the main parameters evolving stochastically according to white noise. As for the drug treatments, we discuss a model both for the kinetics and the dynamics of the substance in the organism, and then consider the impact of different types of therapies in a few particular examples, outlining some interesting mechanisms, such as the tumor growth paradox, that possibly impact the outcome of therapy significantly.

Heterogeneity in hormone-dependent breast cancer and therapy: Steroid hormones, HER2, melanoma antigens, and cannabinoid receptors

Breast cancer is the most frequently diagnosed cancer and the leading cause of death by cancer among women worldwide. The prognosis of the disease and patients’ response to different types of therapies varies in different subgroups of this heterogeneous disease. The subgroups are based on histological and molecular characteristics of the tumor, especially the expression of estrogen (ER) and progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Hormone-dependent breast cancer, determined predominantly by the presence of ER, is the most common type of breast cancer. Patients with hormone-dependent breast cancer have an available targeted therapy, however, tumor cells can develop resistance to the therapy, which is a major obstacle limiting the success of treatment and enabling relapse to metastatic disease. The complicated crosstalk of both tumor-intrinsic and exogenous factors may contribute to endocrine resistance, although the underlying molecular details are still enigmatic. For example, the expression of the melanoma antigen genes (MAGE) correlates with a worse clinical prognosis and therapy resistance in many types of cancers, including breast cancer. Recent studies suggested that cancers co-opt MAGEs’ physiological functions to promote therapy resistance and potentially metastasis development. The response to the therapy can be also affected by the concurrent use of alternative therapy, e.g., cannabinoid use is popular among breast cancer patients. Cannabinoids interact with endogenous estrogen function, however, how they interfere with breast cancer therapy is still poorly understood. In this review, we summarize the role of ER, PR, and HER2 in hormone-dependent breast cancer; provide current knowledge of MAGEs and cannabinoid receptors in breast cancer; ultimately discuss the potential interlacement of their signaling paths which may underlay diverse responses to therapies in breast cancer patients simultaneously using cannabinoids. These interactions are poorly understood but critical for the advancement of conventional and complementary treatment options for patients, particularly the ones with metastatic disease.