Pub Date : 2022-06-01DOI: 10.1080/08941939.2022.2084189
Z. K. Kıraz, Ezgi Kar, F. Kar, E. Kocatürk, M. Kebapçı, İ. Ö. Alatas, S. Uslu
Abstract Background Oral glucose loading may affect oxidative status during oral glucose tolerance test (OGTT). We aimed to investigate how oxidant and antioxidant markers and thiol/disulfide parameters change during OGTT. Methods OGTT was performed to 42 volunteers who were considered risk of type 2 diabetes and were divided into three groups (normoglycemic, prediabetes, diabetes) according glucose levels during OGTT. Glucose, insulin, c-peptide, total antioxidant status (TAS), total oxidant status (TOS), total thiol and native thiol were investigated with auto-anaylzer for five-hours period. Results Decrease of TAS and increase of TOS levels began with the increase in glucose and insulin levels. The increase of TAS started at third hour and reached the highest levels at fifth hour. OSI levels were higher at fourth hour than fasting and first hours in normoglycemic and diabetes groups. In the prediabetic group, TAS were higher than the other groups, TOS peak was at the second hour (p < 0.05). Native thiol and total thiol levels showed variable course during OGTT, both parameters increased at the end of the process (p < 0.05). Disulfide levels showed an increase trend but it was not statistically different in normoglycemic and diabetes groups. In prediabetes group, second hour disulfide level was lower than fasting state and disulfide was significantly increased at third, fourth and fifth hours and fifth hour disulfide level was also higher than fasting. Conclusion Oxidative stress parameters and thiol/disulfide balance were found to deteriorate within five-hours after glucose loading in all groups. These results indicates that oxidative stress occurs during OGTT.
背景口服葡萄糖负荷可能影响口服葡萄糖耐量试验(OGTT)中的氧化状态。我们的目的是研究氧化和抗氧化标志物和硫醇/二硫参数在OGTT过程中的变化。方法对42例有2型糖尿病危险的志愿者进行OGTT，根据OGTT期间血糖水平分为血糖正常组、糖尿病前期组和糖尿病组。葡萄糖、胰岛素、c肽、总抗氧化状态(TAS)、总氧化状态(TOS)、总硫醇和天然硫醇用自动分析仪测定5小时。结果TAS降低，TOS升高始于葡萄糖和胰岛素水平升高。TAS在第3小时开始增加，第5小时达到最高水平。在血糖正常和糖尿病组中，第4小时的OSI水平高于空腹和第1小时。糖尿病前期组TAS明显高于其他各组，TOS峰值出现在第2 h (p < 0.05)。天然硫醇和总硫醇水平在OGTT过程中呈变化过程，在过程结束时两者均升高(p < 0.05)。二硫化物水平呈上升趋势，但在血糖正常组和糖尿病组中无统计学差异。前驱糖尿病组第2小时二硫化物水平低于空腹，第3、4、5小时二硫化物水平显著升高，第5小时二硫化物水平也高于空腹。结论各组小鼠在葡萄糖负荷后5h内氧化应激参数和硫醇/二硫平衡均出现恶化。这些结果表明氧化应激在OGTT过程中发生。
{"title":"Oxidative Status and Thiol/Disulfide Homeostasis Are Changed During 75 g Oral Glucose Tolerance Test over a Five-Hour Period","authors":"Z. K. Kıraz, Ezgi Kar, F. Kar, E. Kocatürk, M. Kebapçı, İ. Ö. Alatas, S. Uslu","doi":"10.1080/08941939.2022.2084189","DOIUrl":"https://doi.org/10.1080/08941939.2022.2084189","url":null,"abstract":"Abstract Background Oral glucose loading may affect oxidative status during oral glucose tolerance test (OGTT). We aimed to investigate how oxidant and antioxidant markers and thiol/disulfide parameters change during OGTT. Methods OGTT was performed to 42 volunteers who were considered risk of type 2 diabetes and were divided into three groups (normoglycemic, prediabetes, diabetes) according glucose levels during OGTT. Glucose, insulin, c-peptide, total antioxidant status (TAS), total oxidant status (TOS), total thiol and native thiol were investigated with auto-anaylzer for five-hours period. Results Decrease of TAS and increase of TOS levels began with the increase in glucose and insulin levels. The increase of TAS started at third hour and reached the highest levels at fifth hour. OSI levels were higher at fourth hour than fasting and first hours in normoglycemic and diabetes groups. In the prediabetic group, TAS were higher than the other groups, TOS peak was at the second hour (p < 0.05). Native thiol and total thiol levels showed variable course during OGTT, both parameters increased at the end of the process (p < 0.05). Disulfide levels showed an increase trend but it was not statistically different in normoglycemic and diabetes groups. In prediabetes group, second hour disulfide level was lower than fasting state and disulfide was significantly increased at third, fourth and fifth hours and fifth hour disulfide level was also higher than fasting. Conclusion Oxidative stress parameters and thiol/disulfide balance were found to deteriorate within five-hours after glucose loading in all groups. These results indicates that oxidative stress occurs during OGTT.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1626 - 1634"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47141914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-30DOI: 10.1080/08941939.2022.2081389
U. K. Ozturk, S. Acar, S. Akış, E. Keleş, C. Alınca, M. Api
Abstract Purpose To evaluate the effects of mechanical bowel preparation (MBP) on the intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery in patients undergoing elective laparoscopic gynecological surgeries. Methods The patients randomized to a MBP group and a no preparation (NMBP) group. The senior surgeon remained blinded to the bowel regimen used by the patient. Intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery were evaluated using a numeric rating scale (NRS). Results We enrolled 120 patients, of whom 109 completed the study, with 51 and 58 patients in the MBP and NMBP groups, respectively. The intraoperative visualization of the surgical field, intestinal load, and NRS scores for overall ease of surgery were better in the NMBP group (p = .03, p = .048, and p = .022, respectively). The results of the assessments also revealed no significant differences in surgical field visualization, ease of bowel handling, overall ease of surgery, or the time that patients experienced passage of flatus between obese (BMI > 30 kg/m2) and non-obese (BMI ≤ 30 kg/m2) patients in the two groups. Conclusions The current study revealed that MBP did not improve the intraoperative visualization of the surgical field or the overall ease of surgery. Moreover, MBP had no benefit when operating on patients who had a high BMI. Therefore, we do not recommend routine MBP before laparoscopic gynecological surgeries.
{"title":"The Effect of Mechanical Bowel Preparation on the Surgical Field in Laparoscopic Gynecologic Surgeries: A Prospective Randomized Controlled Trial","authors":"U. K. Ozturk, S. Acar, S. Akış, E. Keleş, C. Alınca, M. Api","doi":"10.1080/08941939.2022.2081389","DOIUrl":"https://doi.org/10.1080/08941939.2022.2081389","url":null,"abstract":"Abstract Purpose To evaluate the effects of mechanical bowel preparation (MBP) on the intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery in patients undergoing elective laparoscopic gynecological surgeries. Methods The patients randomized to a MBP group and a no preparation (NMBP) group. The senior surgeon remained blinded to the bowel regimen used by the patient. Intraoperative visualization of the surgical field, bowel handling, intestinal load, and overall ease of surgery were evaluated using a numeric rating scale (NRS). Results We enrolled 120 patients, of whom 109 completed the study, with 51 and 58 patients in the MBP and NMBP groups, respectively. The intraoperative visualization of the surgical field, intestinal load, and NRS scores for overall ease of surgery were better in the NMBP group (p = .03, p = .048, and p = .022, respectively). The results of the assessments also revealed no significant differences in surgical field visualization, ease of bowel handling, overall ease of surgery, or the time that patients experienced passage of flatus between obese (BMI > 30 kg/m2) and non-obese (BMI ≤ 30 kg/m2) patients in the two groups. Conclusions The current study revealed that MBP did not improve the intraoperative visualization of the surgical field or the overall ease of surgery. Moreover, MBP had no benefit when operating on patients who had a high BMI. Therefore, we do not recommend routine MBP before laparoscopic gynecological surgeries.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1604 - 1608"},"PeriodicalIF":1.9,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42267094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-30DOI: 10.1080/08941939.2022.2080308
Kayhan Ozdemir, Ismail Zengin, G. Guney Eskiler, H. Kocer, A. Ozkan, T. Demiray, Elif Özözen Şahin
Abstract Objective We investigated the serum levels of MMPs and TIMPs in breast cancer (BC) patients to predict the response rate to/after treatment with or without neoadjuvant chemotherapy. BC is the most common cancer in women and MMPs are responsible for the breakdown of ECM proteins during organogenesis and TIMPs are restricted the ECM destruction by MMPs. However, the predictive role of MMPs and TIMPs in the treatment response of BC patients has not identified. Methods This study consisted of 96 BC patients (34 neoadjuvant treatment and 62 surgically treated) and 35 healthy individuals. ELISA was used to determine the level of MMP-2, MMP-9, TIMP-1, and TIMP-2 from serum samples of BC patients. Results The mean levels of MMP-9 and TIMP-2 were significantly increased in all BC patients at diagnosis and after chemotherapy, but MMP-2 was considerably lower at diagnosis. There was only a significant difference in the TIMP-1 levels after chemotherapy as well as HER2 and ER status in the neoadjuvant and surgically treated group. Additionally, MMP-2 and MMP-9 serum levels negatively correlated with tumor size and metastatic lymph nodes in BC patients after chemotherapy. Conclusions BC patients with high levels of MMP-9 and TIMP-2 can be used to predict the stage of the tumor and CR to chemotherapy and higher TIMP-1 serum level after chemotherapy could be related to better response to chemotherapy.
{"title":"The Predictive Role of MMP-2, MMP-9, TIMP-1 and TIMP-2 Serum Levels in the Complete Response of the Tumor to Chemotherapy in Breast Cancer Patients","authors":"Kayhan Ozdemir, Ismail Zengin, G. Guney Eskiler, H. Kocer, A. Ozkan, T. Demiray, Elif Özözen Şahin","doi":"10.1080/08941939.2022.2080308","DOIUrl":"https://doi.org/10.1080/08941939.2022.2080308","url":null,"abstract":"Abstract Objective We investigated the serum levels of MMPs and TIMPs in breast cancer (BC) patients to predict the response rate to/after treatment with or without neoadjuvant chemotherapy. BC is the most common cancer in women and MMPs are responsible for the breakdown of ECM proteins during organogenesis and TIMPs are restricted the ECM destruction by MMPs. However, the predictive role of MMPs and TIMPs in the treatment response of BC patients has not identified. Methods This study consisted of 96 BC patients (34 neoadjuvant treatment and 62 surgically treated) and 35 healthy individuals. ELISA was used to determine the level of MMP-2, MMP-9, TIMP-1, and TIMP-2 from serum samples of BC patients. Results The mean levels of MMP-9 and TIMP-2 were significantly increased in all BC patients at diagnosis and after chemotherapy, but MMP-2 was considerably lower at diagnosis. There was only a significant difference in the TIMP-1 levels after chemotherapy as well as HER2 and ER status in the neoadjuvant and surgically treated group. Additionally, MMP-2 and MMP-9 serum levels negatively correlated with tumor size and metastatic lymph nodes in BC patients after chemotherapy. Conclusions BC patients with high levels of MMP-9 and TIMP-2 can be used to predict the stage of the tumor and CR to chemotherapy and higher TIMP-1 serum level after chemotherapy could be related to better response to chemotherapy.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1544 - 1550"},"PeriodicalIF":1.9,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44731426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-29DOI: 10.1080/08941939.2022.2078022
Dong-Ze Ji, Ziyi Wu, H. Dai, Jing Yang, Xun E Zhang, J. Jin, Qingguo Li, Hao Yao
Abstract Objective The aim of the study was to analyze perioperative complications and postoperative mortality in patients of acute Stanford type A aortic dissection(ATAAD)combined with cardiac tamponade (TMP). Methods In this study, we identified a total of 242 ATAAD patients who underwent surgery from January 2016 to December 2020. Of the 242 patients, 44(18.2%) patients were combined with TMP and 198(81.8%) patients without TMP. We compared perioperative complications and postoperative mortality between the two groups. Results The postoperative mortality was significantly higher in patients with TMP (29.5% vs 14.1%, p = 0.014). The incidence of postoperative acute kidney injury (75.0% vs 51.5%, p = 0.005), acute hepatic injury (45.5% vs 20.7%, p = 0.001), cerebral infarction (27.3% vs 13.1%, p = 0.020), low cardiac output syndrome (50.0% vs 33.3%, p = 0.038) and respiratory failure (36.4% vs 22.2%, p = 0.049) in patients with TMP was significantly higher than those without TMP. Binary logistic regression analysis showed that age [odds ratio(OR) 1.063, 95% confidence interval (CI) 1.023∼1.105; p = 0.002], surgical time[odds ratio(OR)1.393, 95% confidence interval (CI) 1.006∼1.929; p = 0.046], cardiac tamponade[odds ratio(OR)3.010, 95% confidence interval (CI) 1.166∼7.767; p = 0.023], circulatory arrest time[odds ratio(OR)1.044, 95% confidence interval (CI) 1.001∼1.088; p = 0.045] were independent risk factors for postoperative mortality in ATAAD patients. Conclusions Cardiac tamponade increases the difficulty of perioperative management in ATAAD patients, the incidence of postoperative complications and postoperative mortality, which requires the cooperation of anesthesiologists, intensivists and surgeons to save and improve patients’ lives.
摘要目的分析急性Stanford A型主动脉夹层(ATAAD)合并心包填塞(TMP)患者围手术期并发症及术后死亡率。方法在本研究中，我们共确定了242例2016年1月至2020年12月接受手术治疗的ATAAD患者。242例患者中，合并TMP 44例(18.2%)，不合并TMP 198例(81.8%)。比较两组患者围手术期并发症及术后死亡率。结果TMP组患者术后死亡率明显高于对照组(29.5% vs 14.1%， p = 0.014)。术后急性肾损伤(75.0% vs 51.5%， p = 0.005)、急性肝损伤(45.5% vs 20.7%， p = 0.001)、脑梗死(27.3% vs 13.1%， p = 0.020)、低心输出量综合征(50.0% vs 33.3%， p = 0.038)、呼吸衰竭(36.4% vs 22.2%， p = 0.049)发生率均显著高于非TMP组。二元logistic回归分析显示年龄[比值比(OR) 1.063, 95%可信区间(CI) 1.023 ~ 1.105;p = 0.002]，手术时间[优势比(OR)1.393, 95%可信区间(CI) 1.006 ~ 1.929;p = 0.046]，心包填塞[优势比(OR)3.010, 95%可信区间(CI) 1.166 ~ 7.767;p = 0.023]，循环停止时间[优势比(OR)1.044, 95%可信区间(CI) 1.001 ~ 1.088;p = 0.045]是ATAAD患者术后死亡的独立危险因素。结论心包填塞增加了ATAAD患者围手术期管理的难度，增加了术后并发症的发生率和术后死亡率，需要麻醉医师、重症监护医师和外科医师的共同努力才能挽救和改善患者的生命。
{"title":"Perioperative Complications and Postoperative Mortality in Patients of Acute Stanford Type a Aortic Dissection with Cardiac Tamponade","authors":"Dong-Ze Ji, Ziyi Wu, H. Dai, Jing Yang, Xun E Zhang, J. Jin, Qingguo Li, Hao Yao","doi":"10.1080/08941939.2022.2078022","DOIUrl":"https://doi.org/10.1080/08941939.2022.2078022","url":null,"abstract":"Abstract Objective The aim of the study was to analyze perioperative complications and postoperative mortality in patients of acute Stanford type A aortic dissection(ATAAD)combined with cardiac tamponade (TMP). Methods In this study, we identified a total of 242 ATAAD patients who underwent surgery from January 2016 to December 2020. Of the 242 patients, 44(18.2%) patients were combined with TMP and 198(81.8%) patients without TMP. We compared perioperative complications and postoperative mortality between the two groups. Results The postoperative mortality was significantly higher in patients with TMP (29.5% vs 14.1%, p = 0.014). The incidence of postoperative acute kidney injury (75.0% vs 51.5%, p = 0.005), acute hepatic injury (45.5% vs 20.7%, p = 0.001), cerebral infarction (27.3% vs 13.1%, p = 0.020), low cardiac output syndrome (50.0% vs 33.3%, p = 0.038) and respiratory failure (36.4% vs 22.2%, p = 0.049) in patients with TMP was significantly higher than those without TMP. Binary logistic regression analysis showed that age [odds ratio(OR) 1.063, 95% confidence interval (CI) 1.023∼1.105; p = 0.002], surgical time[odds ratio(OR)1.393, 95% confidence interval (CI) 1.006∼1.929; p = 0.046], cardiac tamponade[odds ratio(OR)3.010, 95% confidence interval (CI) 1.166∼7.767; p = 0.023], circulatory arrest time[odds ratio(OR)1.044, 95% confidence interval (CI) 1.001∼1.088; p = 0.045] were independent risk factors for postoperative mortality in ATAAD patients. Conclusions Cardiac tamponade increases the difficulty of perioperative management in ATAAD patients, the incidence of postoperative complications and postoperative mortality, which requires the cooperation of anesthesiologists, intensivists and surgeons to save and improve patients’ lives.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1536 - 1543"},"PeriodicalIF":1.9,"publicationDate":"2022-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48358207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-26DOI: 10.1080/08941939.2022.2078021
Yunjie Shi, Xinxing Li, Xukun Zhang, Shengyun Wang, Jun Pu, Lihua Zhang, Zhiqian Hu
Abstract Background A predictive tool is required to identify the cancer-specific survival in rectal cancer (RC) patients who have opted to receive preoperative radiotherapy. Methods A database containing the data on RC patients’ records of Surveillance, Epidemiology, and End Results (SEER) receiving surgery during 2000–2014 was selected. All patients received neoadjuvant radiotherapy (NR). The correlation of clinicopathological parameters was analyzed using the Chi-square test and the survival risk factors were analyzed using the Cox proportional hazards analysis (univariate and multivariate). Finally, the nomogram was developed and validated to visually represent an accurate prediction of the probability of 3- and 5-year cancer-specific survival (CSS) based on the screened variables of the cohort. Results 11,499 rectal cancer patients were included in our cohort. Patients’ records were randomly allocated to either the development or validation cohorts based on an equal ratio (1:1). Performing the multivariate Cox regression analysis incorporating these variables in the development cohort determined 11 independent prognostic factors. Statistically significant differences were recorded among subgroups using log-rank tests, which confirmed the appropriateness and acceptability of factor stratifications. Then, the nomogram was constructed and its concordance index (C-index) values in the development cohort (0.720) and validation cohort (0.717) were evaluated to be higher (P<0.05) than those of the AJCC stage (0.631 and 0.633 respectively). Also, the 3-year AUC values of this nomogram were higher than those of the AJCC stage in both the development cohort (0.746 vs. 0.631) and the validation cohort (0.745 vs. 0.640). Using DCA curves, the predictive potential of the currently developed nomogram outperformed the conventional AJCC staging system. Conclusion The nomogram model might be a more reliable tool to predict prognosis accurately in rectal cancer patients receiving preoperative radiotherapy.
{"title":"Constructing and Validating a Prognosis Predictive Nomogram for Cancer-Specific Survival in Rectal Cancer Patients Receiving Preoperative Radiotherapy","authors":"Yunjie Shi, Xinxing Li, Xukun Zhang, Shengyun Wang, Jun Pu, Lihua Zhang, Zhiqian Hu","doi":"10.1080/08941939.2022.2078021","DOIUrl":"https://doi.org/10.1080/08941939.2022.2078021","url":null,"abstract":"Abstract Background A predictive tool is required to identify the cancer-specific survival in rectal cancer (RC) patients who have opted to receive preoperative radiotherapy. Methods A database containing the data on RC patients’ records of Surveillance, Epidemiology, and End Results (SEER) receiving surgery during 2000–2014 was selected. All patients received neoadjuvant radiotherapy (NR). The correlation of clinicopathological parameters was analyzed using the Chi-square test and the survival risk factors were analyzed using the Cox proportional hazards analysis (univariate and multivariate). Finally, the nomogram was developed and validated to visually represent an accurate prediction of the probability of 3- and 5-year cancer-specific survival (CSS) based on the screened variables of the cohort. Results 11,499 rectal cancer patients were included in our cohort. Patients’ records were randomly allocated to either the development or validation cohorts based on an equal ratio (1:1). Performing the multivariate Cox regression analysis incorporating these variables in the development cohort determined 11 independent prognostic factors. Statistically significant differences were recorded among subgroups using log-rank tests, which confirmed the appropriateness and acceptability of factor stratifications. Then, the nomogram was constructed and its concordance index (C-index) values in the development cohort (0.720) and validation cohort (0.717) were evaluated to be higher (P<0.05) than those of the AJCC stage (0.631 and 0.633 respectively). Also, the 3-year AUC values of this nomogram were higher than those of the AJCC stage in both the development cohort (0.746 vs. 0.631) and the validation cohort (0.745 vs. 0.640). Using DCA curves, the predictive potential of the currently developed nomogram outperformed the conventional AJCC staging system. Conclusion The nomogram model might be a more reliable tool to predict prognosis accurately in rectal cancer patients receiving preoperative radiotherapy.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1526 - 1535"},"PeriodicalIF":1.9,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41463486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose To identify candidate factors for predicting high-volume lateral lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC). Methods We retrospectively studied 2981 patients with PTMC who underwent thyroidectomy from 2013 to 2016. LLNM was identified by histopathology. Patients with different LLNM statuses were compared according to clinical, sonographic and pathological parameters. A multivariate logistic model was established to predict high-volume LLNM (number of metastatic lymph nodes >5). Results High-volume LLNM of PTMC was independently associated with age < 40 years (OR = 1.791, P = 0.023), male sex (OR = 2.401, p = 0.001), tumor size > 0.5 cm (OR = 4.839, p < 0.001), extrathyroidal extension (OR = 2.097, p = 0.007) and microcalcification (OR = 2.894, p = 0.002). These five factors were incorporated together to develop a multivariate analysis, which showed good predictive ability (AUC = 0.78, 95% CI 0.72–0.83), with a sensitivity of 80.0% and a specificity of 61.4%. Moreover, more level II or V lateral regions were involved in patients with high-volume LLNM than in those with small-volume LLNM (69.2% vs. 25.0%, p < 0.001; 10.8% vs. 4.7%, p < 0.001). Conclusion Multilevel LLNM tended to be more common in patients with PTMC who had high-volume LLNM. The high-volume LLNM rates of patients with PTMC with age < 40 years, male sex, tumor size > 0.5 cm, extrathyroidal extension and microcalcification were relatively higher than those without. These findings may be useful for identifying patients at higher high-volume LLNM risk who may require more aggressive treatment or intensive follow-up management.
{"title":"What Are the Characteristics of Papillary Thyroid Microcarcinoma Prone to High-Volume Lateral Lymph Node Metastasis? - An Analysis of 2981 Consecutive Cases","authors":"Luying Gao, Xiaoyi Li, Chunhao Liu, Ruifeng Liu, Xinlong Shi, Liyuan Ma, Hao Zhao, Yu Xia, Yuxin Jiang","doi":"10.1080/08941939.2022.2075494","DOIUrl":"https://doi.org/10.1080/08941939.2022.2075494","url":null,"abstract":"Abstract Purpose To identify candidate factors for predicting high-volume lateral lymph node metastasis (LLNM) in papillary thyroid microcarcinoma (PTMC). Methods We retrospectively studied 2981 patients with PTMC who underwent thyroidectomy from 2013 to 2016. LLNM was identified by histopathology. Patients with different LLNM statuses were compared according to clinical, sonographic and pathological parameters. A multivariate logistic model was established to predict high-volume LLNM (number of metastatic lymph nodes >5). Results High-volume LLNM of PTMC was independently associated with age < 40 years (OR = 1.791, P = 0.023), male sex (OR = 2.401, p = 0.001), tumor size > 0.5 cm (OR = 4.839, p < 0.001), extrathyroidal extension (OR = 2.097, p = 0.007) and microcalcification (OR = 2.894, p = 0.002). These five factors were incorporated together to develop a multivariate analysis, which showed good predictive ability (AUC = 0.78, 95% CI 0.72–0.83), with a sensitivity of 80.0% and a specificity of 61.4%. Moreover, more level II or V lateral regions were involved in patients with high-volume LLNM than in those with small-volume LLNM (69.2% vs. 25.0%, p < 0.001; 10.8% vs. 4.7%, p < 0.001). Conclusion Multilevel LLNM tended to be more common in patients with PTMC who had high-volume LLNM. The high-volume LLNM rates of patients with PTMC with age < 40 years, male sex, tumor size > 0.5 cm, extrathyroidal extension and microcalcification were relatively higher than those without. These findings may be useful for identifying patients at higher high-volume LLNM risk who may require more aggressive treatment or intensive follow-up management.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1519 - 1525"},"PeriodicalIF":1.9,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41818432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.
{"title":"Elevated Serum Procalcitonin to Predict Severity and Prognosis of Extensive Burns","authors":"Zhaoxing Liu, Dawei Li, Xinzhu Liu, Bohan Zhang, Yu Zang, Jinglong Ma, Wen Zhang, Yuezeng Niu, Chuan'an Shen","doi":"10.1080/08941939.2022.2073489","DOIUrl":"https://doi.org/10.1080/08941939.2022.2073489","url":null,"abstract":"Abstract Purpose To analyze the factors affecting the elevation of serum procalcitonin (PCT) in patients with extensive burns, and explore its potential value in evaluating the severity and prognosis. Methods Clinical data of 139 patients with extensive burns admitted to our burn center from January 2014 to December 2019 were retrospectively analyzed. Spearman’s Rank correlation coefficient was used to analyze the factors influencing the elevated PCT levels. The predictive power of PCT for death was evaluated by receiver operating characteristic (ROC) and multiple logistic regression analysis. Results 72 cases exhibited elevated serum PCT concentrations during the shock phase, but none of them had obvious signs of infection. PCT level in the shock phase was positively correlated with burn area, depth, degree of inhalation injury, delay in fluid resuscitation, APACHE II, and SOFA scores. The peak values of PCT during shock and infection phases were significantly higher in the non-survivors than in the survivors. The areas under the ROC curve for predicting death were 0.788 and 0.926, respectively, and 5.4 ng/mL (OR = 5.33) and 8.5 ng/mL (OR = 14.49) were the high-risk thresholds for death prediction. Conclusions Serum PCT level in the shock phase is a potential indicator for evaluating the severity of burns, while the PCT level during the infection period can be used as an early warning indicator for severe systemic infection. High levels of PCT peaks during the shock and infection periods indicate an increased risk of poor prognosis, and targeted treatment is required accordingly.","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1510 - 1518"},"PeriodicalIF":1.9,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43705090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1080/08941939.2022.2075495
A. Giannini, O. D’Oria, V. Chiantera, C. Margioula-Siarkou, M. C. Di Donna, S. Terzic, Z. Sleiman, A. Laganà
aDepartment of Medical and surgical sciences and translational Medicine, PhD Course in “translational Medicine and oncology”, sapienza university, rome, Italy; bunit of gynecologic oncology, arnas "Civico – Di Cristina – Benfratelli", Palermo, Italy; cDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical specialties (ProMIse), university of Palermo, Palermo, Italy; d2nd academic Department of obstetrics and gynaecology, Hippokration general Hospital, aristotle university of thessaloniki, thessaloníki, greece; eDepartment of surgical, oncological and oral sciences (Di.Chir.on.s.), university of Palermo, Palermo, Italy; fDepartment of Medicine, school of Medicine, nazarbayev university, nur-sultan, Kazakhstan; gDepartment of obstetrics and gynecology, lebanese american university, Beirut, lebanon
{"title":"Minimally Invasive Surgery for Cervical Cancer: Should We Look beyond Squamous Cell Carcinoma?","authors":"A. Giannini, O. D’Oria, V. Chiantera, C. Margioula-Siarkou, M. C. Di Donna, S. Terzic, Z. Sleiman, A. Laganà","doi":"10.1080/08941939.2022.2075495","DOIUrl":"https://doi.org/10.1080/08941939.2022.2075495","url":null,"abstract":"aDepartment of Medical and surgical sciences and translational Medicine, PhD Course in “translational Medicine and oncology”, sapienza university, rome, Italy; bunit of gynecologic oncology, arnas \"Civico – Di Cristina – Benfratelli\", Palermo, Italy; cDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical specialties (ProMIse), university of Palermo, Palermo, Italy; d2nd academic Department of obstetrics and gynaecology, Hippokration general Hospital, aristotle university of thessaloniki, thessaloníki, greece; eDepartment of surgical, oncological and oral sciences (Di.Chir.on.s.), university of Palermo, Palermo, Italy; fDepartment of Medicine, school of Medicine, nazarbayev university, nur-sultan, Kazakhstan; gDepartment of obstetrics and gynecology, lebanese american university, Beirut, lebanon","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1602 - 1603"},"PeriodicalIF":1.9,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47997388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1080/08941939.2022.2071507
K. Tsapakidis, M. Liontos, M. Tolia, N. Tsoukalas
aDepartment of oncology, university Hospital of larissa, Medical school, university of thessaly, larissa, greece; bDepartment of Clinical therapeutics, “alexandra” Hospital, national and Kapodistrian university of athens, athens, greece; cDepartment of radiotherapy, school of Medicine, university of Crete, Heraklion, greece; dDepartment of oncology, 401 general Military Hospital of athens, athens, greece
{"title":"A Proposed Nomogram Model for Recurrence of Non-Muscle Invasive Bladder Carcinoma","authors":"K. Tsapakidis, M. Liontos, M. Tolia, N. Tsoukalas","doi":"10.1080/08941939.2022.2071507","DOIUrl":"https://doi.org/10.1080/08941939.2022.2071507","url":null,"abstract":"aDepartment of oncology, university Hospital of larissa, Medical school, university of thessaly, larissa, greece; bDepartment of Clinical therapeutics, “alexandra” Hospital, national and Kapodistrian university of athens, athens, greece; cDepartment of radiotherapy, school of Medicine, university of Crete, Heraklion, greece; dDepartment of oncology, 401 general Military Hospital of athens, athens, greece","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1610 - 1611"},"PeriodicalIF":1.9,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42015404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-09DOI: 10.1080/08941939.2022.2071508
D. Castellani
Prostate cancer (PCa) is the second most common cancer worldwide, with an estimated incidence of 30.7 new cases per 100,000 men in 2020 [1]. The highest incidence rates were reported in Northern and Western Europe, the Caribbean, Australia, and New Zealand [2]. PCa shows a steady increase with age but a non-neglectable number of men aged 20–50 years are currently diagnosed and die of PCa, with an estimated worldwide number of deaths of 2770 men in 2020 in this range of age [1]. Li et. al established nomograms to predict overall and cancer-specific survival in PCa patients aged <50 years at diagnosis [3]. The authors used data from The Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. 8259 patients were included and randomly divided into two groups (training and validation group) at a ratio of 7:3. In multivariate analysis, race, marital status, summary stage, American Joint Committee on Cancer (AJCC) stage, lymph node stage, biopsy Gleason score, and treatment were significantly associated with overall survival, whereas AJCC stage, lymph node stage, biopsy Gleason score, and treatment were associated with cancer-specific survival. The above variables were used to build nomograms aiming to predict 5-, 8-, and 10-year overall and cancer-specific survival. Using receiver operating characteristic curve analysis, the authors found that the discriminative ability of their nomograms was moderately accurate in predicting overall survival and highly accurate in predicting cancer-specific survival. The performance of nomograms was confirmed by the validation group. Nomograms are currently widely used in urologic oncology, particularly in the decision-making process and patient counseling [4]. In the diagnostic phase, nomograms using clinical parameters are useful to assess the risk of clinically significant PCa at biopsy [4], and nomograms that include multiparametric magnetic resonance imaging data have been recently introduced [5,6]. Post-diagnosis decision-making is a crucial aspect in PCa patients, mostly to stratify the risk of progression and to offer advice on the possible management of clinically localized disease [4]. Post-treatment prognostic nomograms were also developed for detecting patients at risk of lymph node invasion, presence of positive surgical, margin, extracapsular extension, and biochemical recurrence after radical prostatectomy [7]. Prognostic nomograms are more accurate than staging systems in predicting the progression of PCa. Being continuous prediction methods, nomograms are more appropriate to predict progression compared with staging systems, because grouping patients predisposes to reduce the predictive accuracy of a prognostic model [8]. In fact, Liu et al. confirmed that the constructed nomograms demonstrated to have a better predictive ability in predicting overall and cancer-specific survival than AJCC TNM and Gleason score [3]. Notably, their analysis failed to show any influence of base
{"title":"Prostate Cancer Nomograms Are Still Alive","authors":"D. Castellani","doi":"10.1080/08941939.2022.2071508","DOIUrl":"https://doi.org/10.1080/08941939.2022.2071508","url":null,"abstract":"Prostate cancer (PCa) is the second most common cancer worldwide, with an estimated incidence of 30.7 new cases per 100,000 men in 2020 [1]. The highest incidence rates were reported in Northern and Western Europe, the Caribbean, Australia, and New Zealand [2]. PCa shows a steady increase with age but a non-neglectable number of men aged 20–50 years are currently diagnosed and die of PCa, with an estimated worldwide number of deaths of 2770 men in 2020 in this range of age [1]. Li et. al established nomograms to predict overall and cancer-specific survival in PCa patients aged <50 years at diagnosis [3]. The authors used data from The Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. 8259 patients were included and randomly divided into two groups (training and validation group) at a ratio of 7:3. In multivariate analysis, race, marital status, summary stage, American Joint Committee on Cancer (AJCC) stage, lymph node stage, biopsy Gleason score, and treatment were significantly associated with overall survival, whereas AJCC stage, lymph node stage, biopsy Gleason score, and treatment were associated with cancer-specific survival. The above variables were used to build nomograms aiming to predict 5-, 8-, and 10-year overall and cancer-specific survival. Using receiver operating characteristic curve analysis, the authors found that the discriminative ability of their nomograms was moderately accurate in predicting overall survival and highly accurate in predicting cancer-specific survival. The performance of nomograms was confirmed by the validation group. Nomograms are currently widely used in urologic oncology, particularly in the decision-making process and patient counseling [4]. In the diagnostic phase, nomograms using clinical parameters are useful to assess the risk of clinically significant PCa at biopsy [4], and nomograms that include multiparametric magnetic resonance imaging data have been recently introduced [5,6]. Post-diagnosis decision-making is a crucial aspect in PCa patients, mostly to stratify the risk of progression and to offer advice on the possible management of clinically localized disease [4]. Post-treatment prognostic nomograms were also developed for detecting patients at risk of lymph node invasion, presence of positive surgical, margin, extracapsular extension, and biochemical recurrence after radical prostatectomy [7]. Prognostic nomograms are more accurate than staging systems in predicting the progression of PCa. Being continuous prediction methods, nomograms are more appropriate to predict progression compared with staging systems, because grouping patients predisposes to reduce the predictive accuracy of a prognostic model [8]. In fact, Liu et al. confirmed that the constructed nomograms demonstrated to have a better predictive ability in predicting overall and cancer-specific survival than AJCC TNM and Gleason score [3]. Notably, their analysis failed to show any influence of base","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"35 1","pages":"1591 - 1592"},"PeriodicalIF":1.9,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45984728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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