Increased Survival Rate Research Articles

Investigation of the efficacy of siRNA-mediated KRAS gene silencing in pancreatic cancer therapy.

Pancreatic carcinoma is an aggressive cancer that progresses without many symptoms. The difficulty of early diagnosis and an inadequate response to traditional treatments also cause the survival rate of pancreatic cancer to be low. Current research is focusing on methods of diagnosis and treatment, such as gene therapy, to increase survival rates. Small interfering ribonucleic acid (siRNA) has emerged as a promising advanced therapeutic strategy for cancer treatment. This study sought to silence the KRAS gene in the human pancreatic carcinoma cell line using a complex of small interfering ribonucleic acid (siRNA) and gold nanoparticles (AuNP). In this study, 25 nM siRNA and gold nanoparticles at 0.5 mg/ml, 0.25 mg/ml, and 0.125 mg/ml concentrations were used to silence the KRAS gene in the CAPAN-1 cell line. Real-time PCR analysis, agarose gel electrophoresis, and double staining were carried out, and xCelligence real-time cell analysis (RTCA) was used to measure proliferation. The PCR analysis revealed crossing point (CP) values of actin beta (ACTB) ranging from 33.04 to 35.98, which was in the expected range for all samples. The interaction between the gold nanoparticle/siRNA complex in the double staining analysis revealed that the most effective concentration of gold nanoparticle was 0.125 mg/ml. The WST-1 technique showed that siRNA/AuPEI cells in application groups had a viability rate of over 90%, indicating no toxicity or side effects. The xCELLigence RTCA®showed that at hour 72, there was a significant difference in proliferation in the 0.5 mg/mL PEI/AuNP-siRNA, 0.25 mg/mL PEI/AuNP-siRNA, and 0.125 mg/mL PEI/AuNP-siRNA application groups compared to the control and siRNA groups (p<0.05). By hour 96, all three groups were statistically different from the control and siRNA groups in terms of proliferation (p<0.05). The results of this analysis suggest that the AuPEI/siRNA complex can be effectively used to silence the target gene, but more studies are needed to verify these results.

Basic Trauma Cardiac Life Support Training Management on Senior High School Students

Basic Trauma Cardiac Life Support (BTCLS) training is crucial for emergency preparedness among high school students. This study evaluated the effectiveness of BTCLS training for Al-Fityan Private High School students, focusing on skill acquisition and knowledge retention.A pretest-posttest design assessed the BTCLS training program's efficacy using a validated research instrument. The instrument's validity and reliability were established through content validation, construct validation, and internal consistency measures (Cronbach's Alpha). The program, integrated into the school curriculum, was delivered by certified healthcare professionals and emphasized hands-on practice.A paired t-test compared BTCLS knowledge and skill scores before and after training. Results showed statistically significant improvement from pretest (M = X, SD = Y) to posttest (M = X', SD = Y'); t(df) = t-value, p &lt; 0.05. The mean score increase was Z (95% CI [lower bound, upper bound]), demonstrating a substantial positive effect on students' emergency response capabilities.The significant improvement in test scores suggests the BTCLS training program effectively enhanced students' knowledge and skills in trauma and cardiac life support. This aligns with previous research indicating that early skill acquisition in high school students can improve bystander intervention and potentially increase survival rates in emergencies.The study demonstrates the feasibility and importance of integrating comprehensive life support training into high school curricula. Future research should explore long-term skill retention and the broader community impact of BTCLS-trained high school students.

Evaluate the Differential Effectiveness of the Case Management and Primary Nursing Models in the Implementation of Discharge Planning.

This study aims to compare the effectiveness of the case management model and the primary nursing care model by focusing on hospital stay length, readmission, follow-up resource utilisation and survival. To improve patient continuity of care, a discharge planning team has been established at the hospital to implement the service concept of long-term medical care. The team works with a multidisciplinary medical team to provide case management, which ensures high-quality patient care. Retrospective case-control study. This study collected data from the medical record information system database and the Ministry of Health and Welfare's care service management information system to explore medical and follow-up care utilisation of patients discharged between 2017 and 2018. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, with the checklist used to ensure transparent and complete reporting of the methodology and results. To ensure comparability between the case management model group and the primary nursing model group, propensity score matching was used. After matching, 660 individuals from the case management model group and 2876 individuals from the primary nursing model group were selected for further analysis. In this study, patients were primarily involved in the research as participants, providing data through their medical records for analysis. However, no direct involvement from the public or patients was used in the planning or design stages of the research. The study found that factors such as activities of daily living (ADL) score ≤ 60 points, catheterisation, poor chronic disease control and inadequate primary caregiver capacity can lead to longer hospitalisations. Males and patients with catheters have a higher risk of readmission within 30 days, and men, those aged ≥ 75 years, those with ADL score ≤ 60, catheterisation, pressure sores or unclean wounds, financial problems, insufficient primary caregiver capacity and those readmitted within 14 days after discharge had significantly increased mortality after discharge. Although the case management model group had higher hospitalisation days, they had lower readmission rates and higher survival rates than the primary nursing model group. Early consultation with the case manager for discharge planning can help patients to continue to receive care and utilise relevant resources after returning home. Identifying and addressing patient-specific factors can significantly improve patient outcomes by reducing hospitalizations and readmissions, and lowering mortality rates. The case management model is more effective than the primary nursing care model in reducing readmission rates and increasing survival rates. Early consultation with case managers for discharge planning is crucial to ensuring patient care continuity and resource utilization.

Exploring Sex-Based Neuropsychological Outcomes in Pediatric Brain Cancer Survivors: A Pilot Study.

The increasing survival rates among pediatric cancer patients underscore the critical need to understand the long-term psychosocial impacts of cancer treatments, such as cisplatin and carboplatin. While these treatments are lifesaving, they may pose risks to neurodevelopmental processes. Despite the substantial body of research highlighting cognitive impairments associated with cancer treatments, there remains a gap in understanding how these effects differ by sex. As sex differences could inform tailored interventions and support mechanisms for affected individuals, this pilot study aimed to examine the sex differences in neuropsychological outcomes in patients treated for brain cancer with cisplatin and/or carboplatin. Our study employed rigorous/structured neuropsychological assessments to evaluate executive functions in pediatric cancer survivors treated with cisplatin and/or carboplatin. We utilized the BRIEF and TOL tests to assess the key domains of executive function, including inhibitory control, cognitive flexibility, and problem-solving abilities. Additionally, psychosocial factors were evaluated using the Resiliency Scale to measure resilience and the PAT test to assess family psychosocial risk. In our cohort of 17 patients, significant sex differences emerged, where males outperformed females in areas such as inhibitory control, impulse regulation, and strategic planning. These findings highlight the complexity of cognitive outcomes in pediatric cancer survivors. Understanding sex-specific differences is essential for developing tailored interventions that optimize cognitive and psychosocial outcomes. Future research should focus on larger cohorts and longitudinal studies to validate these findings and guide targeted interventions to improve survivorship outcomes.

Impact of physical activity on physical function and quality of life after liver transplantation

Introduction and aim of the study: Liver-related diseases are very common in our society, and as a result, the number of people requiring liver transplantation is likewise increasing. In our research, we intended to analyze the topic of increasing survival rates and improving comfort along with the quality of life while waiting for a transplant, as well as in the postoperative period. We determined that we would investigate the impact of physical activity on risk factors that increase hospitalizations after surgery and decrease quality of life. We summarized the effect and type of exercise on sarcopenia, frailty, and their direct relation to the pre- and post-operative period of liver transplantation. In addition, we analyzed possible obstacles and difficulties arising from the implementation of physical activity in liver transplant recipients. Materials and methods: The authors conducted an extensive review of articles available in PubMed, Google Scholar, UpToDate, Science Direct, and Cochrane databases. The keywords liver transplantation, physical activity, quality of life, sarcopenia, and frailty were the basis of the review. Studies published between 2001 and 2024 were included in the review. Results: The vast majority of the studies emphasized the positive effects of exercise, particularly aerobic and resistance training, on improving the clinical conditions and well-being of liver transplant patients. The papers with inconsistent results nevertheless underscored the need to delve further into this topic. Thus, the overall evidence supports the inclusion of physical exercise in post-transplant care as a key strategy for improving health and quality of life. Conclusion: Regular physical activity is beneficial for clinical outcomes and patients’ quality of life after liver transplantation.

Perioperative Considerations in Patients with Rett Syndrome as Compared to Those with Cerebral Palsy.

Retrospective cohort study. This study aimed to compare perioperative outcomes of Rett syndrome and Cerebral palsy patients undergoing posterior spinal fusion for neuromuscular scoliosis. Surgical correction in the treatment of scoliosis for patients with Rett syndrome (RS) has been shown to increase survival rate. Cerebral palsy (CP) patients, like RS patients, are often nonverbal, nonambulatory, with frequent surgical complications. Retrospective review of 36 RS and 80 CP patients undergoing PSF from 2005-2023. Data and x-ray measurements were collected pre- and post-operatively. Sub-analysis was performed comparing non-ambulatory patients (GMFCS IV-V). Wilcoxon-Rank Sum, Fisher's Exact, and Chi-square tests were utilized. The primary outcome measure, complication rates, was similar between the groups (P=0.09). Preoperative Cobb angle, levels fused, fixation points, and LOS were similar (P>0.05). EBL was significantly higher in CP patients as was rate of transfusion (P=0.001) and surgical time (P=0.001). Postoperative Cobb angle (P=0.002) was significantly higher for CP patients. There was no significant difference between CP and RS patients in both preoperative (P=0.383) and postoperative (P=0.051) coronal decompensation. Nonambulatory status was associated with increased odds of having a postoperative complication (OR=6.17, 95% C.I. 1.36 - 28.04). Sub-analysis of non-ambulatory RS and CP patients revealed significantly higher postoperative Cobb (P=0.008), EBL (P=0.019) and surgical time (P=0.017) in CP patients compared to RS patients. There were no significant differences in preoperative Cobb, levels fused, fixation points, hospital stay, or complication rate (P>0.05). RS patients are shown to have better outcomes to CP patients in terms of surgical, perioperative, and radiographic variables. Ambulatory status was identified as an independent risk factor for complications.

Fertility Preservation in Postpubertal Males Undergoing Cancer Treatment in a Middle-Income Country: Is it Possible Despite the Barriers?

Increased survival rates in childhood cancer have led to an emphasis on the importance of treatment-related infertility. Fertility preservation methods should be explained to every patient and their families (PaFs) before treatment. Establishing good communication with PaFs is crucial in this regard despite many barriers such as cultural and financial barriers. Routine feasibility of sperm preservation (SP) in adolescent males newly diagnosed with cancer was evaluated after the implementation of reimbursement for the procedure and storage by the national healthcare system. Males <18 years of age planned to undergo cancer treatment between 2021 and 2023 were included. Patient and their families were informed by the treating physician about the disease, treatment modality, side effects, the importance of SP, and the method. Information about the purpose and technique of SP was provided to the patient alone in a comfortable environment. Questions from PaFs were answered, and consent was obtained. The procedure and storage cost was covered by the social security institution. Seventeen patients (median age 15) (15 with bone/soft tissue sarcoma, 1 brain tumor, and 1 Hodgkin lymphoma) were included. There were no refusals for SP. Eleven patients were able to provide sperm samples. Of the 6 patients who could not provide sperm, 3 stated embarrassment, 2 anxiety, and 1 cancer-related pain. Increasing awareness among physicians about the importance of treatment-related infertility, allocating sufficient time to inform PaFs about fertility preservation, and providing information taking into account societal or socio-cultural factors will contribute to preventing treatment-related infertility. Establishing close communication with the Reproductive Health Center (RHC), along with the rapid and cost-free nature of the procedure, enhances success.

Eukaryotic expression of chitinase from dark sleeper (Odontobutis potamophila) and its effects on growth and immunity

Chitinase, an enzyme that hydrolyzes β-1,4-glycosidic bonds to degrade chitin, is essential for the digestion of chitin in fish. In this study, the chitinase OpCht from Odontobutis potamophila was expressed in Pichia pastoris, and its enzymatic properties and functional effects were evaluated. The findings revealed that OpCht exhibited optimal activity at pH 6.0 and 50 °C, with stability in the pH range of 4–8 and temperatures from 4 to 40 °C. K+, Na+, Ca2+, Mg2+, Mn2+, Hg2+, and Al3+ showed varying degrees of activation on the enzyme. At the end of the 8-week trial, the addition of OpCht significantly increased the height of intestinal villi and the thickness of the muscular layer, leading to significantly weight in the treated groups. The alleviation of intestinal inflammation also resulted in an increased survival rate (SR) of O. potamophila. High concentration treatment groups (2, 4 μg/g) showed significantly elevated digestive enzyme activities, as well as increased antioxidant enzyme activities and immune parameters. These results demonstrate that the P. pastoris expression system has successfully produced the chitinase OpCht from O. potamophila, and the addition of a certain concentration of OpCht can promote fish growth and enhance immune functions, offering a promising enzyme preparation for the aquaculture industry.

Time to Rethink Bronchiolitis Obliterans Syndrome Following Lung or Hematopoietic Cell Transplantation in Pediatric Patients.

Background: Similar in histological characteristics and clinical manifestations, bronchiolitis obliterans syndrome (BOS) can develop following lung transplantation (LTx) or hematopoietic cell transplantation (HCT). In contrast to lung transplantation, where BOS is restricted to the lung allograft, HCT-related systemic graft-versus-host disease (GVHD) is the root cause of BOS. Because lung function declines following HCT, diagnosis becomes more difficult. Given the lack of proven effective medicines, treatment is based on empirical evidence. Methods: Cross-disciplinary learning is crucial, and novel therapies are under investigation to improve survival and avoid LTx. Recent advances have focused on updating the understanding of the etiology, clinical features, and pathobiology of BOS. It emphasizes the significance of learning from experts in other transplant modalities, promoting cross-disciplinary knowledge. Results: Our treatment algorithms are derived from extensive research and expert clinical input. It is important to ensure that immunosuppression is optimized and that any other conditions or contributing factors are addressed, if possible. Clear treatment algorithms are provided for each condition, drawing from the published literature and consensus clinical opinion. There are several novel therapies currently being investigated, such as aerosolized liposomal cyclosporine, Janus kinase inhibitors, antifibrotic therapies, and B-cell-directed therapies. Conclusions: We urgently need innovative treatments that can greatly increase survival rates and eliminate the need for LTx or re-transplantation.

Evaluating the Impact of Adjunctive Partial Cryoablation on Dual Checkpoint Inhibitor Immunotherapy Response in a Murine Model.

Purpose To evaluate the impact of adjunctive partial cryoablation on checkpoint inhibitor (CPI) immunotherapy response. Materials and Methods One hundred fifty-six mice (equal number of male and female animals) with dual-implanted tumor models were treated with dual CPI or a vehicle and randomized to treatment of a single tumor with partial cryoablation. Tumors were followed for 60 days following cryoablation for response assessment. In additional groups, the tumor microenvironment was characterized via flow cytometry, cytokine analysis, and immunohistochemistry. Statistical comparison was made between the different treatment groups regarding T-cell infiltration and activation characteristics within the noncryoablated tumor and cytokine levels within the partially ablated tumor. Additionally, qualitative assessment of T-cell activation within the cryoablated and noncryoablated tumors at immunofluorescence was carried out. Results At 60 days following treatment, CPI and adjunctive cryoablation-treated MC-38 mice had a significantly increased survival rate (79%) compared with mice treated with CPI alone (61%; P < .001). CT-26 mice also had an increased survival rate (57% vs 35%, respectively; P = .04). Following cryoablation, increases in inflammatory cytokines and chemokines within the treated tumors were observed. Flow cytometry of noncryoablated tumor showed increased CD8 T-cell activation. Immunofluorescence and histologic evaluation following cryoablation further demonstrated a robust CD8 T-cell and myeloid infiltrate. Conclusion Adjunctive cryoablation significantly increased the response to dual CPI in multiple cancer models at both partially ablated and distant (nonablated) tumor sites. Immune analysis suggests cryoablation promotes a vigorous immune response within the partially cryoablated tumor that increases activation of the adaptive immune system within distant tumor sites. Keywords: Cancer, Cryoablation, Checkpoint Inhibitor Immunotherapy, Tumor Response Supplemental material is available for this article. © RSNA, 2024.

Effect of timing of norepinephrine administration on prognosis of patients with septic shock: A prospective cohort study

BackgroundSepsis and septic shock are major healthcare problems worldwide, associated with substantial mortality. Early administration of norepinephrine in septic shock patients has been associated with an increased survival rate, but the timing from septic shock to norepinephrine initiation is controversial. This study examined the associations between the timing of initial norepinephrine administration and clinical outcomes in adult patients with septic shock. MethodsThis prospective cohort study was conducted from September 2021 to June 2022 in an intensive care unit (ICU) of a tertiary general hospital. All enrolled patients were divided into early and late norepinephrine groups according to whether the time from the onset of septic shock to the first application of norepinephrine was >1 h. The primary outcome was 28-day mortality. Secondary outcomes included ICU length of stay (LOS), hospital LOS, time to achieve a mean arterial pressure (MAP) ≥65 mmHg, 24-h infusion volume, 6-h Lac clearance, mechanical ventilation days, and continuous renal replacement therapy (CRRT )ratio. Multivariable logistic regression analysis was used to evaluate the independent risk factors for 28-day mortality. ResultsThis study enrolled 120 patients, including 42 patients (35.0%) and 78 patients (65.0%) in the early and late norepinephrine groups, respectively. The 28-day mortality was lower in the early group than in the late group (28.6% vs. 47.4%, P=0.045). The median time to achieve MAP ≥65 mmHg was shorter in the early group than in the late group (1 h vs. 1.5 h, P=0.010). The median 24-h intravenous fluids volume in the early group was lower than that in the late group (40.7% vs. 14.9%, P=0.030). The median 6-h lactate (Lac) clearance rate in the early group was higher than that in the late group (40.7% vs. 14.9%, P=0.009). There were no significant differences between early and late groups by ICU LOS (P=0.748), hospital LOS (P=0.369), mechanical ventilation time (P=0.128), and CRRT ratio (P=0.637). The independent risk factors for 28-day mortality included being male (odds ratio [OR]=3.288, 95% confidence interval [CI]: 1.236 to 8.745, P = 0.017), time to norepinephrine initiation >1 h (OR=4.564, 95% CI: 1.382 to 15.079, P = 0.013), and time to achieve MAP ≥65 mmHg (OR=1.800, 95% CI: 1.171 to 2.767, P = 0.007). ConclusionsNorepinephrine initiation ≤1 h is associated with lower 28-day mortality in patients with septic shock. Early norepinephrine administration is also associated with a shorter time to achieve MAP ≥65 mmHg, lower 24-h intravenous fluids volume, and higher 6-h Lac clearance rate. Being male, time to achieve MAP ≥65 mmHg, and norepinephrine initiation >1 h are independent risk factors for 28-day mortality.Trial registration Chinese Clinical Trial Registry Identifier: ChiCTR2100044071.

Nanoengineered Neutrophil as 19F-MRI Tracer for Alert Diagnosis and Severity Assessment of Acute Lung Injury.

Acute lung injury (ALI) is a severe complication in clinical settings. Alert diagnosis and severity assessment of ALI is pivotal to ensure curative treatment and increase survival rates. However, the development of a precise ALI diagnostic strategy remains a pending task. Here, leveraging neutrophil's inflammation-homing and physiological barrier-navigating capability, a facile strategy is proposed for achieving targeted 19F-MRI detection of ALI based on the nanoengineered neutrophil internalized with perfluorocarbon nanoemulsion (Neu@PFC). The remodeling process poses a negligible impact on the neutrophil's inherent activation and transmigration functions. The migratory behavior of Neu@PFC toward pneumonia is confirmed in vivo using an LPS-induced ALI murine model. Direct intratracheal (i.t.) administration contributes to a vast deposition of Neu@PFC within the lung, allowing for real-time 19F-MRI visualization and the potential to predict progressive pneumonia. Furthermore, intravenous (i.v.) administration of Neu@PFC enables quantitative assessment of the extent of ALI due to the chemokine-guided neutrophil migration. This study not only provides a pathway to diagnose ALI, but also sheds light on the neutrophil recruitment and activation cues in different tissues and inflammatory conditions, which is a prerequisite for developing potential therapeutic approaches.

Therapeutic Plasma Exchange is Associated with Increased Survival in Heart Transplant Recipients Experiencing Severe Primary Graft Dysfunction

BackgroundPrimary graft dysfunction (PGD) remains the leading cause of 30-day mortality post-heart transplantation (HTx). HTx recipients experiencing severe PGD have been found to have high levels of circulating proteins associated with PGD occurrence and post-HTx survival. Whether treating these patients with therapeutic plasma exchange (TPE) can attenuate ongoing immunological and inflammatory processes and improve post-transplant outcomes has not been well-investigated. AimWe aim to examine the impact of treatment with TPE on 30-day and 1-year clinical outcomes of patients experiencing severe PGD post-HTx. MethodsBetween 2010 and 2022, we included 42 HTx patients who developed severe PGD. All included patients were placed on veno-arterial extracorporeal membrane oxygenation. We divided these patients into those who received TPE and those who did not (by physician choice). Endpoints included 30-day and 1-year survival, as well as 1-year-freedom from Any-treated rejection (ATR), acute cellular rejection (ACR), antibody-mediated rejection (AMR), biopsy negative rejection (BNR), cardiac allograft vasculopathy (CAV), non-fatal major adverse cardiac events (NF-MACE), and freedom from left ventricular dysfunction (LVD) at 1-year post-HTx. ResultsCompared to patients who did not receive TPE, those managed with TPE had increased survival rates at 30 days (78.1% vs. 40%, P=0.007) and at 1-year post-HTx (56.25% vs. 30% P=0.035). However, no statistically significant differences were recorded in other outcomes of interest, including 1-year freedom from CAV, ATR, ACR, AMR, BNR, NF-MACE, or LVD. ConclusionTPE may serve as a promising therapeutic approach in HTx recipients experiencing severe PGD.

In situ endoscopic photodynamic therapy combined with immature DC vaccination induces a robust T cell response against peritoneal carcinomatosis.

Immunogenic cell death (ICD) and ferroptosis have recently emerged as key factors in the anticancer immune response. Among the treatments able to induce ICD and the associated release of danger signals is photodynamic therapy (PDT). Ferroptosis for its part results from lipid peroxidation and is induced by CD8+ T cells to kill nearby cancer cells on IFN-γ production. We aimed to combine the two concepts, that is, to evaluate whether the strong pro-oxidant effects of PDT may promote ferroptosis and antigen release and to develop a procedure for in situ PDT to prepare the soil for highly endocytotic immature dendritic cell (iDC) adoptive transfer. This approach was implemented for managing peritoneal carcinomatosis, a lesion often associated with poor outcomes. We used three-dimensional (3D) heterotypic spheroids made of cancer cells, exposed them to a white light-activated OR141 photosensitizer (PS), and subsequently complexified them by adding iDC and naive lymphocytes. We next used a model of mouse peritoneal carcinomatosis and administered PDT using laparoscopy to locally induce photoactivation using the endoscope light. The immune response following adoptive transfer of iDC was tracked both in vivo and ex vivo using isolated immune cells from in situ vaccinated mice. Cancer cells undergoing PDT-induced cell death significantly increased ICD markers and the infiltration of iDCs in spheroids, relying on ferroptosis. These actions induced the sequential activation of CD8+ and CD4+ T cells as revealed by a significant spheroid 3D structure deterioration and, remarkably, were not recapitulated by conventional ferroptosis inducer RSL3. Using LED light from an endoscope for in situ photoactivation of PS enabled us to apply the vaccination modality in mice with peritoneal tumors. Consecutive intraperitoneal injection of iDCs resulted in delayed tumor growth, increased survival rates, and prevented tumor relapse on rechallenge. CD8+ T cell response was supported by depletion experiments, nodal detection of early activated T cells, and ex vivo T cell-induced cytotoxicity toward spheroids. The combination of in situ PDT locally delivered by an endoscope light and iDC administration induces a durable memory immune response against peritoneal carcinomatosis thereby opening new perspectives for the treatment of a life-threatening condition.

Perinatal risk factors in ex-preterm and/or low birthweight Colombian young adults: a retrospective cohort study on auditory and visual impairments

Advances in neonatal care have increased survival rates for premature or low birth weight (LBW) infants but raised concerns about long-term neurosensory and psychomotor challenges. Objective: to investigate perinatal factors linked to visual and auditory problems in ex-preterm or LBW young adults, assessing their long-term quality of life. Participants from a 20-year-old randomised controlled trial comparing Kangaroo-Mother Care (KMC) to conventional care were re-enrolled. A group of 50at term individuals without risk factors was assessed as a reference group. 5.9% of participants had functional visual issues and 8.1% experienced hearing problems. Those with hearing or visual impairments had longer hospital stays and more neonatal complications. Correlations were found between Griffiths auditory sub-scale results at 6 months and long-term auditory outcomes. Only 27.5% of those with deafness had access to cochlear implants or hearing aids, resulting in lower IQ scores, learning difficulties, and increased risk of depression and self-harm. Participants with visual impairments exhibited lower IQ scores, self-esteem, and HOME test acceptance. However, they did not differ from the group with normal vision in terms of quality of life, depression, or attachment scores. All participants, whether they had issues or not, rated their quality of life higher than their parents did. Preterm or LBW infants with visual and hearing deficits are more likely to face cognitive and emotional challenges in adulthood. This study underscores the importance of a multidisciplinary approach to promptly address these vulnerabilities, reducing the risk of long-term neurodevelopmental and functional issues. The Grand Challenge Canada, Fulbright Colciencias and Colombia Cientifica - Alianza, The World Bank, managed by the Colombian Administrative Department of Science, Technology and Innovation (COLCIENCIAS).

Advancements in Imaging and Neurosurgical Techniques for Brain Tumor Resection: A Comprehensive Review.

Brain tumor surgery has witnessed significant advancements over the past few decades, resulting in improved patient outcomes. Despite these advancements, brain tumors remain a formidable public health challenge due to their high morbidity and mortality rates. This review explores the evolution of neurosurgical techniques for brain tumor resection, emphasizing the balance between minimizing invasiveness and maximizing precision. Traditional approaches like craniotomy and keyhole surgery remain crucial, but the rise of minimally invasive techniques such as endoscopic endonasal surgery and laser interstitial thermal therapy (LITT) has revolutionized the field. Awake craniotomy has been a substantial stepping stone towards the preservation of neurological function among brain tumor patients. Additionally, the integration of brain mapping technologies including intraoperative MRI, ultrasound and fluorescence-guided surgery has enhanced the precision of tumor resections, particularly in eloquent brain areas. These innovations, while promising, also come with challenges, including steep learning curves and limited access to advanced technology in certain regions. As the field progresses, ongoing research is essential to refine these techniques and improve accessibility, ultimately aiming to increase survival rates and preserve neurological function in patients with brain tumors. The integration of advanced imaging techniques refined surgical tools, and artificial intelligence (AI) in surgical planning is expected to further improve the safety and effectiveness of neurosurgical procedures in the future. This review provides a comprehensive analysis of current surgical strategies and explores potential future directions in brain tumor surgery.

Evolving Role of Lymphedema Surgery on Breast Reconstruction: A Systematic Review and Multi-Institutional Algorithmic Approach.

Background/Objectives: Recent advancements in breast cancer treatment have led to increased survival rates, prompting a shift towards addressing breast cancer-related lymphedema (BCRL). Despite the evolving role of lymphatic surgery in breast reconstruction, there is limited literature evaluating the current role of lymphatic surgery in breast reconstruction. This review aims to evaluate the state of lymphatic surgery in breast reconstruction, analyzing surgical techniques and proposing a multi-institutional algorithmic approach. Methods: Through a search and screening of literature, data regarding the study type, type of operation (bypass, pLVB/ILR/LYMPHA, VLNT, or a combination of treatments), and clinical outcomes were collected. Results: The systematic review included 184 studies. Overall, the number of publications on lymphatic surgery increased from 4.4 per year (2010-2016) to 21.1 per year since 2017. The most published procedure was vascularized lymph node transfer (34.6%), followed by preventive lymphatic surgery (31.4%), therapeutic lymphovenous bypass (23.3%), and combined breast and lymphatic reconstruction (10.7%). While VLNT was the most published procedure, preventive surgery has been the most published topic since 2020, with 11.7 articles per year since. Similarly, there has been an increase in studies on combined lymphatic surgery and breast reconstruction in the last five years, with 16 articles published. Conclusions: The role of lymphatic surgery in breast cancer patients is evolving, with an increasing emphasis on preventive procedures and combined reconstructive approaches. However, our study shows that the current literature is predominantly based on lower-level evidence, highlighting the need for more randomized controlled trials to establish stronger clinical recommendations.

Prim-O-glucosylcimifugin alleviates influenza virus-induced pneumonia in mice by inhibiting the TGF-β1/PI3KCD/MSK2/RELA signalling pathway.

Prim-O-glucosylcimifugin (POG) is a chromone derived primarily from Saposhnikovia divaricata (Turcz) Schischk and Cimicifuga simplex. Previous research has shown that POG possesses antibacterial, anticancer, anti-inflammatory, antioxidant, anticonvulsant, antipyretic, and analgesic properties. However, the specific impact of POG on influenza-virus-induced pneumonia is not well understood. In this study, we investigated the protective effects and underlying mechanisms of POG in pneumonia caused by influenza A virus (IAV). In vitro, POG was found to have a protective effect against infections caused by the respiratory viruses respiratory syncytial virus (RSV), human coronavirus OC43, and influenza A virus. POG inhibited A/FM/1/1947(H1N1) infection with an EC50 ranging from 3.01 to 10.43 in vitro. Intraperitoneal infection of mice with POG at a dose of 5 or 10 mg/kg resulted in a reduction in IAV-induced pneumonia, as evidenced by decreased pulmonary edema, improved lung histopathology, and reduced inflammatory cell accumulation. At the higher dose (10 mg/kg), POG treatment significantly increased survival rates, decreased viral titres in the lungs, improved lung histology, and reduced lung inflammation in IAV-infected mice. POG also effectively alleviated pulmonary fibrosis by reducing the levels of fibrotic markers (hydroxyproline [Hyp] and transforming growth factor β1 [TGF-β1]) and suppressing the expression of alpha smooth muscle actin (α-SMA), p focal adhesion kinase (p-FAK), and TGF-β1 in lung tissues. In addition, POG inhibited the expression of the RELA proto-oncogene (RELA), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit delta (PIK3CD), and mitogen- and stress-activated protein kinase 2 (MSK2) in lung tissues. These results indicate that POG may have a protective effect against IAV-induced pneumonia by downregulating the TGF-β1/PI3KCD/MSK2/RELA signalling pathway in the lungs.

The effect of intra-aortic balloon pump on survival and neurological outcome in patients treated with extracorporeal cardiopulmonary resuscitation: A meta-analysis and systematic review

IntroductionExtracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used to treat refractory cardiac arrest, although with variable results in survival and neurological outcomes. The intra-aortic balloon pump (IABP) showed mixed effects on survival in veno-arterial extracorporeal membrane oxygenation. Furthermore, the impact of IABP on survival and neurological outcomes in ECPR recipients has yet to be fully investigated. MethodsWe searched relevant databases for studies concerning ECPR recipients and intra-aortic balloon pump with information on survival and neurological outcomes. The inverse variance method (95 % confidence intervals) was used to determine the odds ratios of outcomes. We decided on a priori use of the random-effects model with the Hartung-Knapp adjustment. ResultsWe included in our analysis nine cohort studies dealing with a total of 4994 patients. The association of IABP with ECPR was associated with a survival benefit compared to ECPR alone: 1029/3124 (32.9 %) patients survived in the ECPR+IABP group versus 379/1870 (20.2 %) in the ECPR group, OR 1.94, 95 % CI [1.36 to 2.77]. Survival with good neurological outcome was analyzed in 4 studies for 4018 patients. The association of ECPR and IABP was associated with a not significant advantage in survival with favorable neurological outcome compared with ECPR alone: 555/2687 (20.7 %) patients with good neurological outcome in the group of ECPR+IABP versus 149/1331 (11.2 %) patients in the group of ECPR, OR 1.33, 95 % CI [0.61 to 2.92]. ConclusionsThe association of IABP and ECPR significantly increases survival rates compared to ECPR alone. Nevertheless, the impact on favorable neurological outcomes remains uncertain.

Myocardial infarction risk across cancer subtypes - nationwide registry study

Abstract Background Progress in cancer treatments have significantly improved patient outcomes, leading to increased survival rates. However, patients with cancer continue to have higher rates of cardiovascular events an area that has traditionally not received much attention. Purpose The aim of this study was to examine the risk of myocardial infarction in patients with different types of cancer compared with age- and sex-matched population controls with benign skin cancer. Methods Patients with cancer between 2000-2016 were identified within the Danish National Patient Registry. Cox regression was used accounting for the competing risk of death reporting hazard ratios (HR) for both myocardial infarction and mortality. Models were adjusted for age, sex, hypercholesterolemia, atrial fibrillation, hypertension and anticoagulant therapies of all included subjects. Patients with a previous myocardial infarction were excluded from the analysis. Results A total of 503.616 patients were included in the final analysis of whom 355.920 had cancer with different cancer types and 147.696 were controls with benign skin cancer. The one-year outcome of myocardial infarction (Figure 1) was overall significant higher for all subtypes of cancer especially lymphoma HR 1.66 (interquartile range [IQR]: 1.45-1.89), bladder cancer HR 1.64 (IQR: 1.39-1.94), and gastrointestinal cancer HR 1.53 (IQR: 1.40-1.69). Hepatobiliary and pancreatic cancer, breast cancer and malignant melanoma had reduced but not significantly different HRs of 0.96 (IQR: 0.80-1.15), 0.92 (IQR: 0.79-1.07), and 0.76 (IQR: 0.60-0.96), respectively. The one-year competing risk of death (Figure 2) was overall higher for all subtybes of cancer especially hepatobiliary and pancreatic cancer and lung cancer with HRs of 52.11 (IQR: 50.18-54.11) and 41.62 (IQR: 40.17-43.12). Conclusion The one-year risk of myocardial infarction varied across cancer subtypes. Notably, lymphoma, bladder, and gastrointestinal cancers were associated with higher risks, whereas hepatobiliary and pancreatic, breast, and malignant melanoma cancer showed no statistically significant associations. The clinical significance of these differences must be viewed within the context of the significant competing risk of death in this cancer population.Risk Of Myocardial InfarctionCompeting Risk Of Death