Effects Of Long-term Treatment Research Articles

Long-term Urinary and Sexual Outcomes in Pediatric Genitourinary Rhabdomyosarcoma Survivors: A Qualitative Study.

Genitourinary rhabdomyosarcoma (GU-RMS) often requires multimodal therapy treatment including radiation, chemotherapy, and radical surgery for disease control. The long-term effects of the disease and associated treatments are unclear. We sought to investigate the long-term genitourinary quality of life for adult survivors of pediatric GU-RMS. In total, 14 subjects (43% female, median age = 32.5 years [IQR = 23.25 - 39.25], range = 20 - 52 years, 2 bladder, 1 cervical, 5 paratesticular, 3 vaginal, 2 pelvic, 1 prostate RMS) agreed to interview about impact of GU-RMS treatment during childhood on quality of life. A semi-structured interview guide based on the Long-Term Service and Support quality of life model, and grounded in known GU-RMS experiences was created. Two coders independently coded using thematic analysis methodology. Six themes emerged: (i) unknown fertility status, (ii) lack of education, (iii) relationships and difficult communication, (iv) incontinence, clean intermittent catheterization, and a bag, (v) lifestyle and learned adaptation, and (vi) threats to body image. Across these themes, participants reported insufficient knowledge regarding GU-RMS treatment and its impact on function. Participants were principally concerned with anatomical changes, fertility, pregnancy expectations, and survivorship challenges such as communication with romantic partners. Survivors of GU-RMS have significant urinary and sexual function concerns that are important to address in long-term survivorship. Clinicians can potentially improve survivors' quality of life through open and honest age-appropriate education on expectations for treatment, fertility preservation options, and long-term effects of treatment.

Long-term effects of medication-assisted treatment in opioid using offenders in German prisoners—treatment outcomes in prison and after release

Abstract Objectives The aim of this study was to examine the long-term effects of medication-assisted treatment after release from prison. We compared prisoners receiving medications for opioid use disorder (MOUD) to prisoners receiving no MOUD, on a number of outcome variables. Self-reported drug use was confirmed with laboratory tests. Methods A sample of 247 prisoners in German prisons completed the European Addiction Severity Index shortly before release. Subjects were contacted again at 1, 3–6, and 12 months after release for telephone interviews. Results Compared to no-MOUD subjects, MOUD subjects reported fewer illegal opioids and significantly fewer non-prescribed substitution medications. MOUD participants showed high treatment continuity through 12 months. Benefits of MOUD peaked at 3–6 months; effects were reduced at 12 months. Convergent validity of the self-report measure of drug use with laboratory drug screenings was satisfactorily high (~ 71% convergence). Conclusions For long-term sustainability of MOUD effects, additional psychosocial interventions are recommended.

Effectiveness of spinal cord stimulation in diabetic patients with chronic limb-threatening ischemia: small cohort study

BackgroundChronic limb-threatening ischemia (CLTI) is the most severe form of peripheral artery disease (PAD). Patients with diabetes mellitus (DM) have a faster progression of PAD and a fourfold increased risk of CLTI compared to patients without DM. Epidural spinal cord stimulation (SCS) has been used as a method to improve microcirculation, relieve ischemic pain and reduce the number of amputations in patients with PAD. This is a retrospective small cohort analysis of patients with diabetes and the long-term treatment effect of spinal cord stimulation.MethodsAs the main outcome of the study, we evaluated the survival and amputation of 13 diabetic patients with chronic lower-limb ischemia who were not eligible for surgical or interventional therapy. Secondary outcomes included ankle-brachial index (ABI), ischemic pain intensity, quality of life, use of analgesic medications and skin wound outcomes analyzed during long-term follow-up.ResultsBetween January 2010 and January 2017, 13 patients underwent SCS implantation in our vascular center. At 1-year follow-up, the limb salvage rate was 92.3% (12 of 13 patients), and limb ulcers healed in 75% of patients (6/8). No patient died during the one-year follow-up. A total of 4 of patients (31%) experienced major amputation during long-term follow-up, all of them were Fontaine stage IV. Pain intensity and quality of life improved significantly at 6-month follow-up (p < 0.05). ABI measurements were unaffected by SCS treatment. There were no complications related to the procedure or device.ConclusionsSCS is a promising treatment option for diabetic patients unsuitable for endovascular or surgical revascularization. The method improves limb survival in diabetic patients with critical limb ischemia, provides significant pain control, and improves patients' quality of life. However, more studies are needed to clarify the indications for SCS and clarify its effects on the vascular system.

Long-term effects of treatment of acute lymphoblastic leukemia in childhood on the part of the musculoskeletal system

Effective treatment of leukemia in children has improved both the five-year and long-term survival of patients. An increase in life expectancy requires an assessment of the long-term effects of treatment. The use of antitumor drugs such as mercaptopurin, methotrexate, tyrosine kinase inhibitors, as well as glucocorticosteroids often negatively affect the musculoskeletal system, including bone mineralization, which can lead to fractures, necrosis, arthropathy and other lesions of the musculoskeletal system, Side effects of anticancer drugs, glucocorticosteroids on bone tissue are especially important in childhood, when the skeleton is being formed and their long-term negative effect on the musculoskeletal system is no less important. The assessment of long-term consequences will make it possible to develop timely preventive measures. KEYWORDS: bone tissue, antitumor therapy, leukemia, long-term effects of treatment.

Effects of One-Year Anti-seizure Treatment with Add-On Cenobamate on Bone Density and Bone Turnover in Adults with Drug-Resistant Focal Epilepsy: An Observational Study.

Cenobamate is a novel anti-seizure medication (ASM) with unusually high responder rates even in patients with refractory epilepsy. Due to its enzyme-inducing properties, cenobamate could negatively affect bone metabolism, similar to other ASMs; however, effects of long-term cenobamate treatment on bone health have not yet been investigated. The aim of this longitudinal observational study was to assess the effects of 1 year of continuous, adjunctive cenobamate treatment on bone health in patients with drug-resistant, focal epilepsy. Adult patients from a tertiary epilepsy centre received cenobamate add-on to their concomitant anti-seizure medication. Bone mineral density at femoral neck and lumbar spine, as well as bone formation biomarkers, electrolytes and liver enzymes in serum were assessed at baseline and after 12 months of continuous cenobamate therapy. Forty-seven patients (29 male, median age 40 years) were included in the study. Median daily dose of cenobamate at 12 months was 250 mg. Moderate, yet statistically significant reduction of the T-score at femoral neck but not lumbar spine was found after 1 year of cenobamate treatment, also in a subgroup of patients (n = 37) without enzyme inducers in the comedication. Additionally, we observed statistically significant changes in bone formation biomarkers: decreased serum level of osteocalcin and increased bone-specific alkaline phosphatase. Bone minerals (calcium and phosphorus) as well as vitamin D3 remained unchanged. Parathormone was statistically significantly reduced. There was a highly statistically significant increase in serum gamma-glutamyl transferase (GGT) levels after 12 months of treatment, reflecting an underlying hepatic enzyme induction by cenobamate. A statistically significant decrease of the T-score at femoral neck, as well as prominent alterations in the bone formation biomarkers, suggest an increase in bone turnover after 1 year of cenobamate treatment. The underlying mechanism is most likely attributed to the hepatic enzyme activation, indicated by a prominent elevation of serum GGT. The results alert for bone density control in susceptible patient groups. DRKS00027568, March 2, 2022 retrospectively registered.

Therapeutic Efficacy of the Inositol D-Pinitol as a Multi-Faceted Disease Modifier in the 5×FAD Humanized Mouse Model of Alzheimer’s Amyloidosis

Background/Objectives: Alzheimer’s disease (AD), a leading cause of dementia, lacks effective long-term treatments. Current therapies offer temporary relief or fail to halt its progression and are often inaccessible due to cost. AD involves multiple pathological processes, including amyloid beta (Aβ) deposition, insulin resistance, tau protein hyperphosphorylation, and systemic inflammation accelerated by gut microbiota dysbiosis originating from a leaky gut. Given this context, exploring alternative therapeutic interventions capable of addressing the multifaceted components of AD etiology is essential. Methods: This study suggests D-Pinitol (DPIN) as a potential treatment modifier for AD. DPIN, derived from carob pods, demonstrates insulin-sensitizing, tau hyperphosphorylation inhibition, and antioxidant properties. To test this hypothesis, we studied whether chronic oral administration of DPIN (200 mg/kg/day) could reverse the AD-like disease progression in the 5×FAD mice. Results: Results showed that treatment of 5×FAD mice with DPIN improved cognition, reduced hippocampal Aβ and hyperphosphorylated tau levels, increased insulin-degrading enzyme (IDE) expression, enhanced pro-cognitive hormone circulation (such as ghrelin and leptin), and normalized the PI3K/Akt insulin pathway. This enhancement may be mediated through the modulation of cyclin-dependent kinase 5 (CDK5). DPIN also protected the gut barrier and microbiota, reducing the pro-inflammatory impact of the leaky gut observed in 5×FAD mice. DPIN reduced bacterial lipopolysaccharide (LPS) and LPS-associated inflammation, as well as restored intestinal proteins such as Claudin-3. This effect was associated with a modulation of gut microbiota towards a more balanced bacterial composition. Conclusions: These findings underscore DPIN’s promise in mitigating cognitive decline in the early AD stages, positioning it as a potential disease modifier.

Effects of long-term treatment with low concentration butylparaben on prostate organoids.

Endocrine-disrupting compounds (EDCs), such as butylparaben (BP), which are used as preservatives in food and cosmetics, have been shown to negatively affect male reproductive health. Organs under the control of hormones such as androgens and estrogens, such as the prostate, are vulnerable to EDC stimulation. It is well known that BP can cause hormonal imbalances in the prostate and lead to various prostate diseases. However, studies on the long-term exposure of low-dose BP, which is common in daily life, are lacking, and existing studies rely heavily on in vitro tests to assess the risk of EDCs. Therefore, in this study, we investigated the long-term exposure effects of low-dose BP using a prostate organoid model that more closely resembles the target organ. When prostate organoids were treated with BP for a long period, hormonal imbalance was confirmed through differences in the expression of hormone receptors. In addition, reactive oxygen species (ROS) production was confirmed by DCFDA staining, and the protective effect of prostate organoids against stimulation was confirmed by increased protein levels of antioxidant factors. Through transcriptome analysis, we confirmed the occurrence of reproductive toxicity caused by BP. The long-term treatment of prostate organoids with BP causes hormonal imbalance and increased ROS exhibits reproductive toxicity and exerts a protective mechanism against BP through the expression of antioxidant factors. Our results highlight the potential of prostrate organoids as an alternative to animal experimental model and the need for further research on the effects of low EDC concentrations on male reproductive function.

Natural Nano-emulsions: A Sustainable Solution for Rice Weevil Control in Stored Paddy Rice

Nanoemulsion technology offers a promising method to enhance the absorption and effectiveness of various active compounds. This study specifically developed nanoemulsions of frankincense, turmeric, and sesame oil to assess their impact on paddy rice. Notably, there is a lack of research examining both the efficacy and long-term effects of nanoemulsion treatments on rice quality, as most existing studies focus primarily on immediate harmful effects or repellent capabilities without considering prolonged impacts. This research is pioneering in exploring how nanoemulsion treatments influence the physical and chemical properties, nutritional value, and overall quality of paddy rice, as well as their effects on the rice weevil, (Sitophilus oryzae L., Coleoptera: Curculionidae). Nanoemulsions were prepared using a high-energy ultrasonication process and characterized by transmission electron microscopy, revealing spherical particles ranging from 27-34 nm in diameter. The formulations exhibited kinetic stability, slight acidity (pH 5.0–6.33), and favorable physicochemical properties including zeta potential (-31.6 to -15.2 mV), viscosity (27-34 cP), and surface tension (28.12-53.59 dyne/cm). The nanoemulsions were applied to paddy rice of the Sakha 108 cultivar at concentrations of 500, 1500, and 2000 μL/kg. Over 9 months of storage, the sesame nanoemulsion at 2000 μL/kg significantly improved milling quality (71.78% vs 70.23% in controls), hardness (7.25 N vs 5.40 N), and cooking properties. It also enhanced nutritional content, increasing vitamin B3 to 51.12 mg/kg (vs 44.63 mg/kg in controls), potassium to 1149 mg/kg (vs 1113 mg/kg), and phosphorus to 1133 mg/kg (vs 1064 mg/kg). The nanoemulsions demonstrated robust insecticidal effects against S. oryzae. The turmeric formulation at 2000 μL/kg achieved 100% adult mortality after two weeks and complete inhibition of progeny emergence over 9 months. Sesame and frankincense nanoemulsions at the same concentration resulted in 90% and 83.33% mortality, respectively, after two weeks. These findings demonstrate the potential of nanoemulsion technology as an environmentally friendly alternative to conventional chemical treatments for maintaining rice quality and providing effective pest control during long-term storage.

Mitigating rainfall induced soil erosion through bio-approach: From laboratory test to field trail

Extreme rainfall events exacerbated by global warming can pose great threats to soil stability, causing severe soil erosion and triggering various disasters, such as landslide, debris flow, and land degradation. This study explores the efficacy and critical influence factors of a bio-approach utilizing microbially induced calcite precipitation (MICP) for soil erosion control by conducting a series of laboratory tests. The field trial was also performed to explore the long-term effectiveness of MICP treatment on soil slope under natural rainfall. The laboratory tests results indicate that the peak penetration strength increased 4.43 times, and the soil slaking index and soil loss during rainfall decreased by up to 65.7 % and 92.6 % after MICP treatment. The optimal concentration of cementation solution was found to be 1.0 M. Both the one-phase and two-phase MICP methods proved effective in enhancing soil erosion resistance. However, the two-phase MICP method demonstrated a more pronounced impact on surface soil improvement, while the one-phase MICP method achieved a more uniform treatment effect. The 11-months field erosion trials validated the remarkbale durability of MICP treatment in controlling soil erosion. Additionally, more cycles of MICP treatment further enhanced the soil erosion resistance to rainfall. The bonding and filling effect of MICP-produced CaCO3 precipitates played a crucial role in the improvement of soil water stability and mechnical strength, thereby significantly mitigating soil erosion caused by raindrop and surface runoff during natural rainfall. This study provides valuable suggestions for the pratical application of MICP approch on soil erosion control against increasing extreme rainfall, which is also expected to offer a controllable and sustainable soil improvement solution under the climate change.

A multicenter, single-group, open feasibility study of a new individual cognitive behavioral therapy program for adult Japanese patients with attention-deficit/hyperactivity disorder: Study protocol.

Attention-deficit/hyperactivity disorder (ADHD) symptoms, including executive function, emotional regulation, and motivation, can persist into adulthood and are often associated with mental illnesses. Cognitive behavioral therapy (CBT) may help ADHD adults in Japan, but the lack of studies and the variability in group CBT approaches make its effects unclear. Japan lacks unified CBT programs and adult ADHD guidelines, making it difficult to implement international individual CBT recommendations due to cultural differences. This study will assess the feasibility of a novel CBT program for Japanese adult ADHD patients. This feasibility study will be open, nonrandomized, single-arm, multicenter study. Twelve ADHD patients aged 20-65 years who are currently receiving treatment will be included based on Conners' Adult ADHD Rating Scale (CAARS) clinical severity threshold. An intervention phase of 12-16 weeks and a 12-week follow-up will total 24-28 weeks for all participants. The intervention will use a new CBT program tailored to individual assessments. The primary objective is to determine feasibility using dropout rates, adverse events, and CAARS score changes between Weeks 1 and 16. The secondary outcomes will assess long-term effects of treatment beyond the intervention period and provide descriptive statistics on sex, depression, quality of life, and autistic scores in relation to the intervention outcomes. The full analysis set and per protocol set will be used for statistical analysis. This study is essential for the development of CBT interventions in accordance with Japan's healthcare system that are tailored to the unique needs of its population.

Long-term treatments of osteomyelitis caused by metatarsal traumatic infections in Japanese black heifer and calf.

There are few reports on long-term treatment of bovine osteomyelitis. In this study, two cattle (Japanese black heifer and calf) suffered damage to the dorsal metatarsal below the tarsus due to their hind limbs becoming caught in a metal fence, with consequent struggling and thrashing, causing osteomyelitis of the metatarsal. We present these two cases of osteomyelitis of the metatarsal and compare their: clinical conditions, effects of long-term treatment, and clinical outcomes. In Case 1, the heifer underwent surgical removal of the sequestrum, followed by washing the wound with antibiotics, and was cured within 130 days of treatment. In case 2, treatment for the calf was focused on washing the osteomyelitis and controlling the inflammation with antibiotics without surgical treatment, thereby reducing the cost of treatment, and was cured within 155 days of treatment. As a result, the hospital stay in Case 1 was shorter than in Case 2. In conclusion, in this case report with an adult cow and a calf, long-term washing of the wound and surgical removal of the sequestrum are effective measures against bovine osteomyelitis caused by metatarsal contusion involving a hind limb.

Invasive aspergillosis in an immunocompetent patient: A retrospective case report and review of the literature.

Invasive aspergillosis (IA) is rare in immunocompetent patients. We present the case of a 44-year-old female with IA invading the lungs, mediastinum, heart, and brain, with a disease duration of 11 years. The patient was initially diagnosed with lung aspergillosis that had invaded the mediastinum on October 8, 2008. Irregular uptake of itraconazole led to the aggravation of lung lesions. Echocardiography and enhanced magnetic resonance imaging revealed a large irregular mass in the left atrium and an enhanced 1-cm nodular lesion in the right frontal lobe respectively in 2016. The patient refused to undergo a biopsy of the cardiac mass. Oral itraconazole (200 mg, twice daily) was recommended for subsequent days. The intracranial lesion gradually enlarged, and a complete tumor resection of the right frontal lobe was performed on February 23, 2017. The patient`s condition was well controlled with oral voriconazole by the end of follow-up until April 11, 2019. We conducted a search across multiple databases, including PubMed, Web of Science, Scopus, and Science Direct. We aimed to identify cases of aspergillosis that simultaneously invaded the lungs, heart, and brain. The details of these cases are summarized. Fourteen cases with available data met the requirements, and the mortality rate of these 14 cases was 100%. IA can occur even in immunocompetent patients receiving antifungal therapy. Therefore, timely diagnosis and effective long-term antifungal treatments are crucial. Voriconazole is an effective antifungal drug that is used to treat cerebral aspergillosis.

Safety and Efficacy of Deucravacitinib in Moderate to Severe Plaque Psoriasis For Up to 3 Years

Safe and effective long-term treatments for moderate to severe plaque psoriasis are needed. To evaluate the long-term safety and efficacy of deucravacitinib through 3 years (week 148) in the randomized POETYK PSO-1, PSO-2, and nonrandomized long-term extension (LTE) trials. PSO-1/PSO-2 were global, 52-week, randomized, double-blinded phase 3 trials in patients with moderate to severe plaque psoriasis. After completing 52 weeks of treatment in PSO-1/PSO-2, patients could enroll in the prespecified, ongoing, nonrandomized LTE trial. The peak of the global COVID-19 pandemic coincided with the LTE trial. Patient enrollment in the LTE started August 12, 2019; safety and efficacy were assessed through June 15, 2022; and these data were analyzed through June 28, 2024. The PSO-1/PSO-2 trials randomized patients 1:2:1 to oral placebo, deucravacitinib, 6 mg once daily, or apremilast, 30 mg twice daily. Patients enrolling in the LTE trial received open-label deucravacitinib, 6 mg once daily. Safety outcomes were evaluated in patients who received 1 or more doses of deucravacitinib. Efficacy outcomes included 75% or greater or 90% or greater reduction from baseline in Psoriasis Area and Severity Index (PASI 75/90) and static Physician Global Assessment scores of 0 (clear) or 1 (almost clear) (sPGA 0/1) and were assessed in patients who received deucravacitinib treatment from day 1 of the parent trials who continued in the LTE trial. Of 1519 patients who received 1 or more doses of deucravacitinib, 513 received continuous deucravacitinib treatment from day 1 and entered the LTE trial. Exposure-adjusted incidence rates (EAIRs) per 100 person-years were decreased or similar in the 1-year vs 3-year cumulative periods, respectively, for adverse events (AEs) (229.2 vs 144.8; 95% CI, 215.4-243.9 vs 137.1-153.0), serious AEs (5.7 vs 5.5; 95% CI, 4.4-7.4 vs 4.7-6.4), discontinuations due to AEs (4.4 vs 2.4; 95% CI, 3.3-5.9 vs 2.0-3.0), and deaths (0.2 vs 0.3; 95% CI, 0.1-0.8 vs 0.2-0.6). Incidence rates of the most common AEs (EAIR per 100 person-years ≥5) during the 1-year and 3-year cumulative periods, respectively, were nasopharyngitis (26.1 vs 11.4; 95% CI, 23.0-29.8 vs 10.2-12.7), COVID-19 (0.5 vs 8.0; 95% CI, 0.2-1.2 vs 7.1-9.1), and upper respiratory tract infection (13.4 vs 6.2; 95% CI, 11.3-16.0 vs 5.4-7.2). EAIRs for AEs of interest, including herpes zoster, major adverse cardiovascular events, and malignant diseases, remained low and were decreased or comparable between the 1-year and 3-year cumulative periods. Clinical response rates were maintained through 3 years. The findings of this integrated analysis of the phase 3 POETYK PSO-1, PSO-2, and nonrandomized LTE trials demonstrate a consistent safety profile and durable clinical response of continuous treatment with deucravacitinib through 3 years of treatment in patients with psoriasis. ClinicalTrials.gov Identifiers: NCT03624127, NCT03611751, and NCT04036435.

Versatile inulin/trans-ferulic acid/silk sericin nanoparticles-nourished probiotic complex with prolonged intestinal retention for synergistic therapy of inflammatory bowel disease

To achieve effective long-term synergistic treatment of inflammatory bowel disease (IBD) with probiotics, we developed a versatile inulin/trans-ferulic acid/silk sericin nanoparticles-nourished probiotic complex. Inulin/TFA/SS nanoparticles were fabricated by inulin, trans-ferulic acid (TFA), and silk sericin (SS), and then loaded onto the surface of poly-l-lysine (PLL) and poly-glutamic acid (PGA)-coated Bifidobacterium longum (BL) to obtain BL@PLL-PGA-Inulin/TFA/SS NPs (BL@PP-NPs). This design simultaneously endowed the complex with excellent gastrointestinal resistance, antioxidant, and anti-inflammation abilities. Moreover, the inulin in the nanoparticles acts as a prebiotic, promoting the Bifidobacterium's rapid proliferation to exert effects within a short period. Compared with uncoated BL, BL@PP-NPs exhibited excellent gastric acid tolerance and up to 31.32-fold colonic colonization, and the ROS scavenging and proliferative capacity were increased by 5.61- and 1.39-fold, respectively. In a mouse model of dextran sulfate sodium (DSS)- and trinitrobenzene sulfonic acid (TNBS)-induced colitis, the components of Inulin/TFA/SS NPs synergized with probiotics to efficiently treat IBD by attenuating oxidative stress, decreasing inflammation, repairing intestinal barrier, and promoting the rapid proliferation of probiotics to reverse gut microbial disorders. Collectively, food-grade BL@PP-NPs represent a novel approach to probiotic modification that offers an effective, safe, and synergistic therapy for IBD.

Long-term effects of sirolimus treatment for slow-flow vascular malformations: Real-world evidence from the French observational multicentre SIROLO study.

Sirolimus is a treatment for slow-flow vascular malformations (SFVMs). However, the long-term management remains challenging. The SIROLO study assessed the long-term effects and real-life management of oral sirolimus for SFVMs by investigating data from 15 French tertiary centres for vascular anomalies. Participants were retrospectively included if they had a SFVM that was being/had been treated with sirolimus for at least 3 years in total. Data were collected on treatment goals when initiating sirolimus, investigator-reported efficacy, safety, dosages and treatment withdrawal. The cohort involved 67 patients with various SFVM entities (mean [±SD] age 19.6 ± 12.5 years, 35 children, 52.2%). We found a heterogeneity of predefined treatment goals, the most frequent being cessation of pain. The investigators considered that sirolimus had persistent efficacy for bleeding, ulceration and pain but only slight efficacy for reducing volume. It was reported to be well-tolerated, although serious adverse events (mainly infections and also two ovarian cysts) were reported in 6 patients (9.0%) and required definitive sirolimus discontinuation for one. Overall, 11 patients (16.4%) had at least one temporary withdrawal period, leading to symptom recurrence and sirolimus resumption at a mean of 6.4 ± 9.6 months. The mean sirolimus concentration was 6.4 ± 3.7 ng/mL during the first 6 months and decreased over time (mean concentration during the last 6 months: 4.2 ± 3.2 ng/mL), probably to target the minimal efficient dosage. Eight patients (11.9%) switched to alpelisib because of insufficient efficacy of sirolimus. This real-life study gives answers to frequent questions patients and parents ask before sirolimus initiation for SFVMs, such as persistence of efficacy over time, long-term side effects and time to recurrence in case of withdrawal.

Comparative analysis of primary versus secondary paranasal sinus mucoceles: a case control study

Abstract Background Paranasal sinus mucoceles are benign cystic lesions characterized by mucous accumulation that can lead to significant complications due to erosion of sinus walls and compression of adjacent structures. This retrospective study aims to compare the clinical characteristics and treatment outcomes of primary and secondary mucoceles. Methods We reviewed medical records of 68 patients treated for mucoceles at the Ear, Nose, and Throat Hospital in Ho Chi Minh City, Vietnam, from June 2022 to June 2024. Advanced diagnostic imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), were utilized in the management of these lesions. Statistical analysis was conducted using chi-square and t-tests to compare the characteristics and outcomes between the two groups. Results The study found that primary mucoceles often presented with less severe symptoms compared to secondary mucoceles, which occur post-surgery or post-trauma and are associated with more severe symptoms and complications. Primary mucoceles were most frequently located in the frontal-ethmoid region (47.4%), while secondary mucoceles had a similar distribution but were more prevalent following previous surgical interventions. Endoscopic sinus surgery was the primary treatment for both groups, with secondary mucoceles frequently requiring more complex surgical interventions. Postoperative improvement was significant in both groups, though secondary mucoceles exhibited slower recovery and higher rates of residual minor visual impairments. Conclusion The comparison between primary and secondary paranasal sinus mucoceles reveals critical differences in clinical profiles and treatment outcomes. Understanding these differences is essential for optimizing management strategies and improving prognosis for patients with these challenging conditions. Further research is needed to explore long-term treatment effects and the efficacy of different surgical approaches.

Group medical visits in cancer survivorship care: a scoping review

Abstract Background More than 60% of cancer survivors report unmet physical, psychosocial, and informational needs. The care of cancer survivors includes surveillance, health maintenance monitoring, referral for long-term adverse effects of cancer treatment, and coordination of care. Group medical visits (GMV) include medical care, education, and peer support and can be used to facilitate the delivery of multidisciplinary survivorship care. We aimed to characterize the current state of related research describing the role of GMV in cancer survivorship care. Methods For this scoping review, we searched for published literature using PubMed, Embase, and other resources. We included intervention studies of multidisciplinary care involving GMVs of adult patients with a history of cancer requiring the presence of medical personnel, physicians, advanced practitioners, or oncology nurses. We included studies that focused on broad cancer survivorship care, rather than those using specific modalities, such as yoga, or limited to specific aspects of cancer survivorship care, such as weight loss. We characterized the studies by cancer type, structure of GMVs, and reported outcomes. Results We identified 2311 studies (2122 from PubMed and 189 from Embase). We excluded 1524 duplicates and screened 787 studies for title and abstract review. Finally, 63 studies were retrieved for full-text review, and six were included in this scoping review. Of the included studies, four were non-randomized, and two were randomized. Breast cancer was the most common site (4); other studies included breast and other cancers (1) and hematopoietic transplant cancer survivors (1). There was heterogeneity in the structure and frequency of sessions and the survivorship domains addressed. The outcomes studied included quality of life, healthcare utilization, and costs. Conclusions Limited high-quality research exists on the role of GMV in cancer survivorship. Though shown to be effective in chronic disease, the evidence for the effectiveness of this important and widely used approach in multidisciplinary survivorship care remains inconsistent and preliminary; the literature to date provides a starting point for larger-scale studies of GMV in cancer survivorship care. Implications for Cancer Survivors While Group medical visits are a promising intervention to provide multidisciplinary care, larger studies are needed to support their benefit in the care of cancer survivors.

Abstract 4144574: Cardiovascular Risk in Cancer Survivor Patients: A Systematic Review and Meta-analysis of 1.2 Million Cancer Survivors.

Background: According to the American Cancer Society, there are currently over 18 million adult cancer survivors in the US, and by 2030, that figure is estimated to rise to over 22 million. While this is positive, more and more survivors are now at risk for cardiovascular disease (CVD). Hypothesis: This meta-analysis aims to evaluate the association between cancer survivors and cardiovascular event. Methods: A systematic search was conducted in electronic databases from inception until March 2024 using appropriate Mesh terms for ‘Cancer’, and ‘cardiovascular risk’. Pooled risk ratios (RR) with their corresponding 95% confidence intervals (CI) were calculated using random effects models. A p-value of <0.05 was considered statistically significant. Results: A total of nine studies with 1,209,168 people (Cancer survivor: 140697 and non-cancer: 1068471) were included in our study. The mean follow-up duration was 12.4 years. The risk of cardiovascular events was seen in all cancer survivors (RR: 1.69, 95%CI: 1.31-2.08, P <0.05). The cardiovascular risk was statistically significant in patients with leukemia (RR: 1.71, 95%CI: 1.54-1.88), lung cancer (RR: 1.99, 95%CI: 1.38-2.6) and lymphoma (RR: 1.65, 95%CI: 1.29-2.01), and comparable in breast cancer (RR: 1.22, 95%CI: 0.98-1.46), colorectal cancer (RR: 1.13, 95%CI: 0.89-1.37), prostate cancer (RR: 1.08, 95%CI: 0.99-1.17) and thyroid cancer (RR: 0.96, 95%CI: 0.57-1.35). Conclusion: Our study showed that overall cancer survivors had significant risk for cardiovascular events; mainly leukemia, lung cancer, and lymphoma patients had a significant result. Early identification, continuous monitoring, and proactive management strategies are essential to mitigate the long-term cardiovascular effects of cancer treatments.

The Use of Real-World Data for Estimating Relative Treatment Effects in NICE Health Technology Assessment Submissions: A Review.

This paper investigates the current use of real-world data (RWD) for estimating relative treatment effects in National Institute for Health and Care Excellence (NICE) health technology assessment (HTA) submissions. This review included 64 HTA submissions, which accounted for approximately 11% of the total NICE HTA submissions between January 2016 and December 2023. The main sources of RWD considered in the submissions were disease registries and electronic health records. RWD were primarily used to provide an external control arm to enable comparisons within single-arm trials and to inform long-term treatment effects when extrapolating survival data beyond the trial follow-up. Adjustments for potential systematic differences between treatment groups have improved over time; however, approximately one-third of the submissions still relied on unadjusted treatment comparisons. We found that approximately 10% of NICE HTA submissions used RWD to directly inform treatment effects estimation. Over one-third of the submissions relied on naïve and/or unadjusted treatment comparisons, which may have introduced biases. To ensure that RWD provide sound evidence for HTA, submissions should follow published guidelines, including the NICE real-world evidence (RWE)framework.

Aromatase inhibitors, bone microstructure, and estimated bone strength in postmenopausal women with breast cancer: a 5-year prospective study.

Aromatase inhibitors (AIs) are the standard treatment for early breast cancer (EBC) and are typical causative agents of cancer treatment-induced bone loss. However, the effects of long-term treatment with these drugs on bone microstructure remain unclear. This prospective, single-arm observational study included postmenopausal, non-osteoporotic women with hormone receptor-positive EBC. Patients who underwent dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and tartrate-resistant acid phosphatase-5b (TRACP-5b) or procollagen type I N-terminal propeptide levels were compared at baseline and at 60months after commencing AI treatment. Fifteen women were included in the study, with a median age of 58years and a quartile range of 56.5-62.5years. At 60months, HR-pQCT revealed that the cortical area and thickness decreased with increased cortical porosity in the cortical bone. In addition, the number of trabeculae decreased and trabecular separation increased trabecular bones decreases, and trabecular bone separation opens, resulting in a decrease in the trabecular bone volume fraction. Total bone mineral density (BMD), trabecular volumetric BMD, and cortical volumetric BMD, and estimated bone strength significantly decreased. DXA BMD values significantly decreased in the total hip and femoral neck but not the lumbar spine. TRACP-5b values after 5years of AI treatment showed a significant negative correlation with the rate of change in the total volumetric BMD in the distal tibia. Postmenopausal women who received AIs for 5years for EBC experienced significant deterioration in the bone microstructure, BMD, and estimated bone strength.