Non-smoking Male Patients Research Articles

Japanese patients need slower, personalized clozapine titrations: A comment on the case described by Kikuchi et al.

Japanese patients need slower, personalized clozapine titrations: A comment on the case described by Kikuchi et al.

PS-BPC02-3: EVALUATION OF VASCULAR FUNCTION FOR PREDICTION OF RENAL PROGNOSIS IN JAPANESE PATIENTS WITH LIFESTYLE-RELATED DISEASES.

Background: Since chronic kidney disease (CKD) is associated with the development of serious cardiovascular diseases such as stroke, coronary artery disease and heart failure, prevention and early diagnosis of CKD are important clinical issues. Many risk factors including diabetes, hypertension, dyslipidemia, obesity, and cigarette smoking are known to be involved in the development of CKD; however, there is no available biomarker that can predict the progression of CKD at an early stage. Although it has been reported that glomerular endothelial injury causes development of CKD, it remains unclear whether evaluation of vascular endothelial function can predict renal prognosis. Therefore, in the present study, we examined the association between vascular endothelial function and longitudinal eGFR change in patients with lifestyle-related diseases. Methods: We retrospectively evaluated 341 Japanese patients (176 males and 165 females; mean age, 63.87 ± 12.02 years) with lifestyle-related diseases in whom baseline vascular function was evaluated by flow-mediated dilation (FMD) and brachial-ankle pulse wave velocity (baPWV) and in whom 24-month longitudinal eGFR values were recorded after vascular testing at Tokushima University Hospital and Anan Medical Center, Tokushima Japan. The association between values of FMD and eGFR slope and the association between values of baPWV and eGFR slope were statistically analyzed. Statistical significance was set at p < 0.05. Results: Single regression analysis showed that value of FMD was positively associated with eGFR slope in females (p < 0.001) and non-smoking males (p = 0.033) but not in smoking males (p = 0.133). Multiple regression analysis including confounding factors demonstrated that the value of FMD remained a contributor against annual eGFR decline in females (p = 0.002) and non-smoking males (p = 0.046) but not in smoking males (p = 0.266). On the other hand, the value of baPWV had no significant association with eGFR slope regardless of sex and smoking. Conclusions: In patients with lifestyle-related diseases, FMD value can be used for prediction of renal prognosis represented by the eGFR slope in females and non-smoking males. Thus, early comprehensive intervention for improving vascular endothelial function might lead to a better renal prognosis in female and non-smoking male patients with lifestyle-related diseases.

Afatinib combined with anlotinib in the treatment of lung adenocarcinoma patient with novel HER2 mutation: a case report and review of the literature

BackgroundHER2 is a member of the ERBB family of receptor tyrosine kinases, and HER2 mutations occur in 1–4% of non-small cell lung cancer (NSCLC) as an oncogenic driver mutation. We found a rare mutation of HER2 p.Asp769Tyr in NSCLC.Case presentationWe presented a case of a 68-year-old nonsmoking male patient with brain metastasis from lung adenocarcinoma harboring a rare mutation of HER2 p.Asp769Tyr. After multiple lines of treatment, he obtained a durable response (10 months) to afatinib and anlotinib.ConclusionWe reported for the first time that afatinib and anlotinib have successfully treated lung adenocarcinoma with HER2 p.Asp769Tyr mutation. This finding can provide an insight into the optimal treatment of lung adenocarcinoma patients with novel mutations. Additionally, we summarized the efficacy of targeted therapy for HER2 mutant lung cancer in this article.

MULTIPLE LUNG NODULES AND AN UNCOMMON FINDING: TWO DISTINCT PULMONARY METASTASIS

TOPIC: Lung Cancer TYPE: Global Case Reports INTRODUCTION: The solitary lung nodule is a classical entity usually described under solid guidelines and strong scientific evidence, with well-known management and follow-up. However, dual or multiple pulmonary nodules might be a propedeutic challenge, although they are usually linked to a single nosological agent and when related to a tumoral origin are habitually provenient from breast, colorectal, renal cell, head and neck cancer. More uncommon primary tumors with frequent lung metastasis are pancreatic, testicular and thyroid cancer followed by osteosarcoma. This case report demonstrates the management of a patient with double main pulmonary nodules with distinct causes. CASE PRESENTATION: A 69 year old, non-smoker male patient from Rio de Janeiro, Brazil presented on a scheduled follow-up for a nephrectomy in 2009 caused by a renal clear cell carcinoma with a chest tomography with two lung nodules in lingula, both measuring about 1,5 cm and clinically asymptomatic. Further investigation revealed nodule enlargement but low avidity on PET-CT 2 months later. Patient underwent exploratory thoracotomy and lobectomy which revealed both nodules to be a clear renal cell carcinoma metastasis, but surprisingly, a third nodule of 1,5 mm was found on the procedure and consisted of a papillary thyroid carcinoma. On sequence, in 2021 his thyroid was surgically removed, revealing a malignant nodule, corroborating the previous diagnosis. DISCUSSION: Thyroid cancer is the most common subsequent tumor related to a previous renal cell carcinoma and some scientific research proposes a BRAF mutation being linked to this finding. That being said, renal cell carcinoma has as risk factor a history of thyroid carcinoma. Being both tumors with slow onset and poor clinical presentation and low metabolic profile, they are usually difficult to diagnose at early stages. CONCLUSIONS: This case demonstrates that a high suspicion level and thorough management can achieve reasonable levels of diagnosis and high survival rates even when two rare entities are bound in the same case. REFERENCE #1: Immunotargets Ther . 2013; 2: 73 90. Jul 22 REFERENCE #2: Thyroid cancer : Coexisting papillary thyroid carcinoma and renal cell carcinoma: 4 cases ( Mehmet Celik1, Semra Ayturk1, Buket Yilmaz Bulbul1, Nuray Can2, Ebru Tastekin2, Atakan Sezer3, Funda Ustun4 & Sibel Guldiken1) : Endocrine Abstracts (2016) 41 EP1146 DISCLOSURES: no disclosure on file for Barbara Bracarense; No relevant relationships by Michelle Cailleaux-Cezar, source=Web Response No relevant relationships by Fábio Kunita, source=Web Response

Effective Management of Hypothyroidism by Using Ayurvedic Interventions: A Case Report

Hypothyroidism is an endocrine disorder that mainly occurs due to insufficient thyroid gland stimulation or primary gland failure by the pituitary or hypothalamus gland. Symptoms of hypothyroidism include fatigue, gastric trouble, face puffiness with edematous eyelids, retarded nail growth, weight gain, hoarseness of voice, decreased libido, pallor, dry skin, dry hair, alopecia, constipation, abnormal menstrual cycle, muscle cramps, myalgia etc. A 30-year-old married Hindu, non-alcoholic, non-smoking male patient visited OPD of Shuddhi Ayurveda Clinic, Jeena Sikho Lifecare Pvt. Ltd. Noida on 18 November 2020 with known case of subclinical hypothyroidism. On the basis of clinical diagnosis and laboratory investigations, ayurvedic medicines having action on thyroid gland and digestion improvement were prescribed for over a period of six months. After this ayurvedic medicinal treatment for four months i.e. from November 2020 to February 2021, significant results were noted in terms of reduction in level of increased TSH. TSH level was significantly reduced from 181µIU/ml to 0.11 µIU/ml within two months of ayurvedic treatment. Then, there was a mild increase in the TSH level when patient was tested for TFT after four months i.e. on 21st of June 2021, investigated level of TSH was 5.59 µIU/ml. Overall, a satisfactory result was observed in patient clinical conditions proving significant efficacy of ayurvedic treatment.

The analysis of mortality age between smoker and non-smoker male patients from the point of the prevalence COPD and malignant tumor

The analysis of mortality age between smoker and non-smoker male patients from the point of the prevalence COPD and malignant tumor

Tumor fibroso solitario pleural. Aspectos clínico-patológicos a propósito de un caso

El tumor fibroso pleural es una entidad médica poco frecuente, considerado una tumoración benigna. Representa entre el 5-8 % de los tumores primarios de pleural. Reportamos el caso de un paciente de sexo masculino de 59 años, no fumador con historia de 3 meses de deposiciones líquidas, asociadas a astenia, pérdida de peso y dolor en parrilla costal. Fue ingresado en el servicio de Gastroenterología del Hospital Clínico Quirúrgico Hermanos Ameijeiras, La Habana, Cuba. Se le realizó una radiografía de tórax, observándose como hallazgo accidental una masa tumoral en región para cardiaca, por lo que decide interconsultar con el servicio de Neumología. La tomografía de tórax evidenció una masa tumoral en el tercio inferior del hemitórax izquierdo, el estudio histológico e inmunohistoquímico fue compatible con un tumor fibroso solitario pleural. Conclusiones de este trabajo apuntan a que para el diagnóstico preciso de este tipo de tumor es necesario realizar una tomografía axial de tórax y un análisis histopatológico detallado.

Elemental Concentrations in Biological Samples of Coronavirus Disease (COVID-19) and Other Pulmonary Disease Patients

Background: Recently, Coronavirus Disease 2019 (COVID-19) has been affected by the extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has developed important global health anxiety. At this time, the treatment options for this disease are only moderately successful. Smoking has been related to COVID-19 and its mortality, and it has the potential to affect bacteriological and viral conversion, clinical effects, and treatment outcomes. Methods: The aim of this study was to determine the relationship between critical essential trace {zinc (Zn), iron (Fe), and copper (Cu)} and toxic {cadmium (Cd) and nickel (Ni)} elements in human biological samples such as scalp hair, serum, saliva, blood, nasal fluid, and sputum of smoking and nonsmoking male COVID-19 patients (n = 139, age range 25 - 38 years) from Hyderabad, Pakistan. For comparative purposes, the biological specimens of referent persons (n = 83), pulmonary Tuberculosis (T.B) patients (n = 67), Pneumonia (n = 56) of the same age groups were also be analyzed. Microwave oven mediated digestion method was employed, and digestion of samples was carried out with the help of 2:1 mixture solution of HNO3 (65%) and H2O2 (30%). Atomic absorption spectrometry was employed for the determination of elemental concentrations from the microwave oven employed digested samples. Results: The found average of essential elements (Zn, Fe, and Cu) in biological specimens of smoker and nonsmoker male COVID-19, T.B, and Pneumonia patients was found to lower, whilst cadmium and nickel were found to be higher when compared with samples from referents (p S. pneumoniae. Our findings also suggest that higher Cd and Ni concentrations are linked to cigarette smoking, which could lead to COVID-19 and other lung-infected diseased recurrences. However, further clinical and experimental research is required.

Hiperplasia Nodular Histiocítica: Uma Manifestação Rara à Exposição ao Asbesto

A hiperplasia nodular histiocítica (HNH) consiste em uma condição rara, sem predileção por sexo ou idade, marcada por um processo proliferativo benigno, por vezes confundido com neoplasia maligna, constituído majoritariamente por histiócitos (1, 2). Inflamação crônica local e irritação mecânica estão entre as principais causas postuladas para essa entidade. Patologias malignas, por outro lado, representam os principais diagnósticos diferenciais, o que evidencia a importância clínica de seu diagnóstico assertivo sendo a imunohistoquímica uma importante ferramenta diagnóstica (3). Nesse artigo, os autores descrevem um relato de caso de hiperplasia nodular histiocítica pleuro-pulmonar em um paciente do sexo masculino, não tabagista, com história de exposição ao asbesto o qual provavelmente incitou um processo inflamatório crônico com proliferação de histiócitos. O paciente apresentava dispnéia, dor pleurítica e hemoptise além de derrame pleural hemorrágico recorrente evoluindo a óbito por exacerbação dos sintomas. Apesar da entidade ser descrita na literatura como uma proliferação celular benigna histiocitária, há raros casos relatados sobre a evolução e tratamento da doença.
 Palavras chaves: Hiperplasia nodular histiocítica, asbesto, pleura, pulmão.

Immediate molar implant placement and the anatomic harmony abutment + a case series

Background The placement of immediate implants in the posterior sector is a widespread procedure where the success and survival rates are similar to those of traditional protocols. However, large extraction sockets are difficult to seal without mucoperiosteal flap reflection, an implant preparation sequence that considerably deviates from typical manufacturer protocols, crestal socket morphology not amenable to standard healing abutment placement. Aim/Hypothesis The purpose of this case series are to assess related technique that will allow chairside manufacturing of custom healing abutments as also called the anatomic healing abutment for immediate molar placement. Material and Methods A 55-year-old nonsmoking male patient, with no systemic condition and a 42-year female healthy with no significant medical history patient had lost her lower first molars due to nonrestorable extensive decay. According to clinical and radiographic examination on the patient detecting decayed remaining roots in molar tooth and performed an extensive restoration presenting deep, subgingival distal decay on tooth. So that, we decided to extract related tooth and then perform immediate implant placement. After minimally traumatic tooth extractions, the alveolus was carefully cleaned and washed surgically with a saline solution, and dental implants (iRES SAGL) was placed in the center of the interradicular bone, in a type A position according to the Tarnow classification. After then a temporary abutment was fabricated utilizing flowable composite, which adapted to the socket architecture, to serve as a customized healing screw. It is called the anatomic or customised healing abutment. Results Uneventful healing was observed during this time period in this cases. It is important to note that the initial contour appeared to have been maintained. The anatomic harmony abutment ultimately allows for more predictable final restorations by providing the dental laboratory a restorative profile. thus idealizing the final restoration. The soft tissue margin was stable and the esthetic appearance of the implant site was well maintained and with no clinical signs of peri-implant inflammation and bleeding on probing. Conclusion and Clinical Implications Implants may be placed in ideal restorative positions at the time of mandibular molar extraction. With the anatomic harmony abutment technique, the soft tissues upon maturation closely resemble the natural root contour, which allows for the generation of esthetic and functional implant-supported restorations.

Thalidomide-induced psoriasis in a patient with multiple myeloma

A 60-year-old non-smoker male patient with multiple myeloma (MM) in complete remission (CR) after induction treatment presented with severe psoriasis at the hands, feet, extensor surfaces of the limbs and...

Quadriceps strength in patients with chronic obstructive pulmonary disease

Background:Skeletal muscle dysfunction is well known in chronic obstructive pulmonary disease (COPD). The muscle strength is altered in various muscles variedly. Lower-limb muscle strength is very important for walking distance. Reduced lower-limb strength can affect the physical quality of life.Objectives:The aim of the study was to assess and compare the quadriceps strength in COPD patients and age-matched healthy controls and to study the correlation between lung function parameters and the quadriceps strength in patients with COPD.Methodology:Thirty nonsmoker male patients; thirty nonsmoker female patients with COPD; and sixty age-, BMI-, and gender-matched healthy controls were studied. Quadriceps muscle strength was measured using a quadriceps dynamometer. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEF 25–75, and peak expiratory flow rate were measured using Helios 702 Spirometer. The quadriceps muscle strength between the two groups was compared using the unpaired Student's t-test. Correlations between FVC and FEV1 with muscle strength were analyzed using the Pearson's coefficient.Results:The mean unilateral and bilateral quadriceps strength in both male and female COPD patients was significantly lesser than the healthy controls (P < 0.05). There was a significant positive correlation between muscle strength and FVC and muscle strength and FEV1 in patients with COPD.Conclusion:The study shows that there is quadriceps weakness in COPD patients, and pulmonary functions have a direct impact on skeletal muscle strength. Identifying those patients who have reduced strength will allow early interventions targeted at improving the quality of life of the patient.

The surgical combination between functional endoscopic sinus surgery and septorhinoplasty as a procedure for nasal polyps treatment: a case report

Background: Concurrent functional endoscopic sinus surgery (FESS) and septorhinoplasty are performed either for cosmetic reasons or for a medical condition. Many patients are not satisfied with their nose shape or have breathing problem. These problems usually occur as a result of nasal fracture, obstruction, chronic sinusitis, or polyps. Case presentation: The present case was a 45-year-old non-smoker Saudi male patient, who presented to King Abdullah medical city outpatient clinic with a history of chronic right nasal obstruction for 15 years. A computerized tomography scan of a paranasal sinus with navigation protocol showed bilateral nasal polyps. Endoscopic sinus surgery was performed under general anesthesia. After FESS surgery, rhinoplasty by inverted C-shape incision, and elevation of the flap was done. The patient showed improvement and was discharged with monthly follow-up. Conclusion: These procedures are safe and cost effective. It minimizes hospital stay and can treat functional complaints, such as nasal obstruction, sinus problems, septum deviation, and polyps’ removal at the same time.

Plasma Alpha-Defensin Levels in Smoker and Non-Smoker Male Patients with Type 2 Diabetes Mellitus

Plasma Alpha-Defensin Levels in Smoker and Non-Smoker Male Patients with Type 2 Diabetes Mellitus

Plasma Alpha-defensin Levels in Smoker and Non-smoker Male Patients with Type 2 Diabetes Mellitus

Plasma Alpha-defensin Levels in Smoker and Non-smoker Male Patients with Type 2 Diabetes Mellitus

A Rare Cause of Ortner's Syndrome: Pulmonary Artery Aneurysm

A 37-year-old non-smoker male patient with a 6-month history of hoarseness admitted to our hospital. Laryngoscopic examination revealed left vocal cord paralysis with immobile vocal cord in paramedian position. The patient underwent neck and chest CT imaging. Neck CT demonstrated thickening and medial deviation of the left vocal cord, dilatation of the left piriform sinus suggesting left vocal cord palsy. Chest CT showed a fusiform aneurysmal dilatation of the proximal left pulmonary artery with 51 mm diameter. Left laryngeal nerve had been compressed between pulmonary artery aneurysm and arcus aorta.

Plasma netrin-1 levels significantly increase in smokers

ObjectivesNetrin-1 is a laminin like protein that has recently been suggested to involve in the pathophysiology of atherosclerosis and treatment targets. The relationship between netrin-1 and atherosclerosis has not been evaluated in a human research previously and the effect of smoking on plasma netrin-1 levels as well. In this study, we aimed to evaluate plasma netrin-1 levels in smokers and non-smokers and the impact of smoking on netrin-1 levels. Our second aim was to evaluate the existence of peripheral artery disease in these groups by means of ankle brachial index (ABI) measurements and the relation between plasma netrin-1 levels and peripheral artery disease. Design and MethodsSmoker and non-smoker male patients were contributed in the study, 112 males in each group. ABI of all patients was determined with an automatic device and plasma netrin-1 levels were quantified with an enzyme-linked immunosorbent assay. Netrin-1 levels were compared between smoker and non-smoker cases, and the cases with and without peripheral arterial disease. ResultsPlasma netrin-1 levels of smokers (4.54±2.87pg/mL) were significantly higher than in non-smokers (3.81±1.26pg/mL) (p=0.015). Similarly, netrin-1 levels of cases with peripheral arterial disease (6.21±2.16pg/mL) were significantly higher than the ones without peripheral arterial disease (4.07±2.16pg/mL) (p=0.002). Amount of smoking (packet⋅year) and ABI were found to be significantly related with netrin-1 levels. The relationship between PAD and netrin-1 levels remained significant after adjusting for smoking status. ConclusionWe can conclude that plasma netrin-1 levels significantly increase in smokers and peripheral artery disease is significantly related with netrin-1 levels after adjusting for smoking status.

AMLODIPINE RELATED GINGIVAL OVERGROWTH IN A PATIENT WITH ASOCIATED AUTOSOMAL POLYCYSTIC KIDNEY DISEASE

Background. The paper describes the case of a 62 years non-smoking male patient who was referred to the Department of Periodontology, “Carol Davila” University of Medicine and Pharmacy, complaining of gingival overgrowth. The patient’s medical history revealed that he suffers from autosomal dominant polycystic kidney disease chronic renal failure and hypertension; the patient was under treatment with amlodipine, a calcium channel blocker for 18 months. Case presentation. The patient underwent cause-related periodontal therapy and flap surgery in areas where only partial resolution of the gingival overgrowth was obtained after completion of initial phase therapy; amlodipine was not substituted because of medical reasons. Results. We obtained complete resolution of the gingival enlargement, even without any change in the causative drug regimen; the patient was placed in a maintenance program, with regular appointments at 3 months; he successfully managed to maintain periodontal and oral health. Conclusions. If possible, all patients who are about to receive calcium channel blockers, should have a detailed periodontal assessment performed and if any periodontal disease discovered, treated properly. In case of established gingival overgrowth, non-surgical and/or surgical periodontal therapy could induce partial or complete remission of enlargement. Change of medication is also an option.

Blood Pressure is the Strongest Component Associated with Arterial Stiffness in Mexican Patients with Metabolic Syndrome

Objective: To establish which of the metabolic syndrome (MetS) components are more related to arterial stiffness. Research Design and Methods: We recruited eighty-two non-smoking male patients, 40 to 77 years old, (42 without MetS and 41 with MetS). The local ethics committee approved the study and signed informed consent forms were obtained from patients. Body mass index (BMI) was calculated as weight (in kilograms) divided by the square of height (in meters), and waist measurements were according to WHO recommendations. Blood pressure and baPWV were measured with the “Vascular Profiler 1000” device (VP-1000) (Omron®, Kyoto, Japan). All blood sample determinations were obtained after a 12-h fasting period and processed within one h. We used an oxidase technique to measure fasting plasma glucose (FPG) and enzymatic methods to obtain total cholesterol, high-density lipoprotein cholesterol (HDL-c) and triglyceride values. Low-density lipoprotein cholesterol (LDL-c) was estimated using the Friedewald formula (LDL-C = Total Cholesterol − HDL-C − Triglycerides/5). Results: We observed strong and significant correlations between SBP and baPWV (r=.753, p=&lt;0.001), and between SBP and PP (r=.853, p=&lt;0.001). The remaining components did not correlate with baPWV or PP.

EGFRgene mutations in patients with adenosquamous lung carcinoma

Adenosquamous (ADSQ) carcinoma accounts for 1-4% of non-small cell lung cancer (NSCLC). The origin of ADSQ carcinoma and its genetic background is not fully understood. Most studies concerning epidermal growth factor receptor (EGFR) mutation status are performed in adenocarcinoma, while there is limited information about the prevalence of this mutation in ADSQ-bearing Caucasian patients and the efficacy of EGFR tyrosine kinase inhibitors. EGFR gene status has been examined in 1000 non-squamous NSCLC patients of Polish origin. Polymerase chain reaction (PCR) followed by DNA fragment length analysis and allele-specific PCR as well as real-time PCR technique were used to estimate EGFR gene status. Complete clinical data were obtained for all examined patients. In the group of 1000 non-squamous NSCLC patients, ADSQ was diagnosed in 14 (1.4%) cases. Activating mutations of EGFR were observed in 28.6% (four out of 14) of ADSQ-bearing patients and included deletions of 15 base-pairs in exon 19 in three cases (one man and two women) and substitution of L861Q with coexistence of G719X mutation in one non-smoking male patient. Deletions were diagnosed in two non-smoking patients and one current-smoking female patient (50 pack-years). One non-smoking man with deletion in exon 19 of EGFR gene was successfully treated with gefitinib in first-line therapy. EGFR gene mutations in ADSQ carcinoma patients may be more common than previously thought. EGFR mutation testing is appropriate in ADSQ-bearing patients, in which response for molecular-based therapy is predictable.