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Immunotherapy for diffuse large B-cell lymphoma: current use of immune checkpoint inhibitors therapy 弥漫性大b细胞淋巴瘤的免疫治疗:目前使用免疫检查点抑制剂治疗
Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023020
Luis Miguel Juárez-Salcedo, Luis Manuel González, Samir Dalia

Patients diagnosed with diffuse large B-cell lymphoma (DLBCL) have high cure rates with current treatment options including immuno-polychemotherapy. However, around 30% of cases do not respond or develop relapse disease. For this, it is necessary to search for new therapeutic options. In recent years, therapy using chimeric antigen receptor (CAR) T-cells has been a strategy for those patients with LBDCG in progression or relapse, although only 30–40% of cases achieve durable remissions. The programmed death-1 (PD-1) receptor regulates the T-cell-mediated immune response through binding to its ligands (PD-L1). Some tumor cells present high expression of PD-L1, which down-regulates T-cell activation. The beneficial antitumor activity of PD-1 and PD-L1 has been widely demonstrated in certain solid organ malignancies. However, their utility in the treatment of lymphomas is complex. To date, different clinical trials have demonstrated its usefulness as an innovative therapeutic alternative in these tumors. In this review article, we evaluate the literature on the role of the PD-1/PD-L1 pathway in DLBCL and describe future strategies involving these new anticancer agents in this lymphoid neoplasm.

& lt; abstract>弥漫性大b细胞淋巴瘤(DLBCL)患者的治愈率很高,目前的治疗方案包括免疫联合化疗。然而,约30%的病例没有反应或复发。为此,有必要寻找新的治疗方案。近年来,使用嵌合抗原受体(CAR) t细胞治疗已成为LBDCG进展或复发患者的一种治疗策略,尽管只有30-40%的病例获得持久缓解。程序性死亡-1 (PD-1)受体通过与其配体(PD-L1)结合来调节t细胞介导的免疫反应。部分肿瘤细胞高表达PD-L1,下调t细胞活化。PD-1和PD-L1的有益抗肿瘤活性已在某些实体器官恶性肿瘤中得到广泛证实。然而,它们在治疗淋巴瘤中的作用是复杂的。迄今为止,不同的临床试验已经证明了它作为这些肿瘤的一种创新治疗选择的有效性。在这篇综述文章中,我们评估了PD-1/PD-L1通路在DLBCL中作用的文献,并描述了这些新的抗癌药物在这种淋巴样肿瘤中的未来策略。& lt; / abstract>
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引用次数: 0
Staphylococcus aureus antimicrobial efflux pumps and their inhibitors: recent developments 金黄色葡萄球菌抗菌外排泵及其抑制剂:最新进展
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022018
M. Lekshmi, J. Stephen, M. Ojha, Sanath H. Kumar, M. Varela
The microorganism Staphylococcus aureus is a notorious causative agent of bacterial infection. The widespread presence of this pathogen has caused significant morbidity and mortality rates in clinical healthcare settings and communities. Due to its increasingly frequent recalcitrant nature towards clinically available antimicrobial agents, the bacterium poses a considerable public health crisis. A significant bacterial mechanism of antimicrobial agent resistance includes multidrug efflux pump systems. These antimicrobial efflux determinants translate into several large superfamilies of transporters that share related amino acid sequences, similarities in three-dimensional structures, modes of energization, and solute transport catalysis across the membrane. Because of their ubiquitous nature and functional role in virulence, these multidrug transporters make good targets for inhibition. This review briefly summarizes recent key findings regarding multidrug efflux activity and modulation in the MATE, SMR, and MFS transporters.
微生物金黄色葡萄球菌是一种臭名昭著的细菌感染病原体。这种病原体的广泛存在在临床卫生保健机构和社区造成了显著的发病率和死亡率。由于其对临床可用的抗微生物药物日益频繁的顽固性,这种细菌构成了相当大的公共卫生危机。抗菌药物耐药性的重要细菌机制包括多药外排泵系统。这些抗菌外排决定因子转化为几个大的转运蛋白超家族,这些转运蛋白具有相关的氨基酸序列、相似的三维结构、通电模式和跨膜的溶质转运催化。由于其普遍存在的性质和在毒力中的功能作用,这些多药转运体成为抑制的良好靶点。这篇综述简要总结了最近关于多药外排活性和在MATE、SMR和MFS转运体中的调节的主要发现。
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引用次数: 4
Bedside tests of muscle mass in older adults with Type 2 diabetes 老年2型糖尿病患者肌肉质量的床边试验
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022022
K. Madden, B. Feldman, Shane Arishenkoff, G. Meneilly
Objective

Diabetes and sarcopenia often coexist in older adults, suggesting a possible bidirectional association. Available bedside measures of muscle mass consist of bedside ultrasound (MT, quadriceps muscle thickness) and Bioelectrical Impedance Analysis (BIA). We examined the association between ultrasound measures and BIA measures of muscle in older adults with measures of strength, performance and frailty in older adults with diabetes.

Design

Cross-sectional study.

Methods

81 subjects (age ≥ 65; mean age 80.8 ± 0.6 years, 27 women, 53 men) were recruited sequentially from geriatric medicine clinics. Each subject had Lean Body Mass (LBM, by BIA, in kg), grip strength, gait speed, Cardiovascular Health Study index (frailty) and MT (in cm) measured. All initial models were adjusted for biological sex.

Results

In our final parsimonious models, only MT (as opposed to LBM) showed a significant correlation with grip strength (Standardized β = 0.217 ± 0.078; p = 0.007) and frailty (Standardized β = 0.276 ± 0.109; p = 0.013). Neither MT or LBM showed a significant association with subject performance (gait speed).

Conclusions

Unlike BIA, bedside ultrasound measures of muscle thickness showed strong associations with both grip strength and frailty in the older adult population with diabetes, suggesting that bedside measures of MT might be a more clinically useful modality to assess muscularity in this patient population. Neither BIA or MT measures of subject muscularity showed any association with our performance indicator (gait speed).

目的糖尿病和肌肉减少症在老年人中经常共存,提示两者可能存在双向关联。可用的床边测量肌肉质量包括床边超声(MT,股四头肌厚度)和生物电阻抗分析(BIA)。我们研究了超声测量和BIA测量老年人肌肉与老年糖尿病患者的力量、表现和虚弱之间的关系。DesignCross-sectional研究。方法81例(年龄≥65岁;平均年龄80.8±0.6岁,女性27人,男性53人)依次从老年医学诊所招募。测量每位受试者的瘦体质量(LBM,通过BIA,单位为kg)、握力、步态速度、心血管健康研究指数(脆弱)和MT(单位为cm)。所有初始模型都根据生理性别进行了调整。结果在我们的最终简约模型中,只有MT(相对于LBM)与握力呈显著相关(标准化β = 0.217±0.078;p = 0.007)和虚弱(标准化β = 0.276±0.109;P = 0.013)。MT和LBM均未显示出受试者表现(步态速度)的显著相关性。结论与BIA类似,床旁超声测量的肌肉厚度与老年糖尿病患者的握力和虚弱都有很强的相关性,这表明床旁超声测量的肌肉厚度可能是评估老年糖尿病患者肌肉强度的一种更有用的临床方法。无论是BIA还是MT测量的受试者肌肉量都没有显示出与我们的表现指标(步态速度)有任何关联。
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引用次数: 0
Understanding the psychological impact of the COVID-19 pandemic on university students 了解 COVID-19 大流行对大学生的心理影响
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022001
B. Kara
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引用次数: 2
Do we trust the government? Attributes of COVID-19 vaccine hesitancy and acceptance in Nigeria 我们信任政府吗?尼日利亚COVID-19疫苗犹豫和接受的属性
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022010
Osmond C Ekwebelem, H. Onyeaka, Ismaeel Yunusa, T. Miri, Yahwedalu M. Onwuneme, Ayeni T. Eunice, A. Anyogu, Bright C Obi, N. Carol
Objectives A significant percentage of the population must be vaccinated to achieve herd immunity. Therefore the success of a vaccination program relies on the level of acceptance. This present study seeks to understand COVID-19 vaccine acceptance and hesitancy in Nigeria by assessing the public's willingness to get vaccinated. Study design This is a population-based cross-sectional study. Data were derived through a structured online survey. Methods A cross-sectional study was conducted among adult residents in Nigeria in March 2021 using a structured online questionnaire. The questionnaire surveyed participants' demographic characteristics and perception of COVID-19 and the COVID-19 vaccine. Descriptive statistics and inferential statistics using Chi-square, as well as univariable logistic regression to determine the factors associated with acceptance of COVID-19 vaccine was conducted. Results Of the 618 respondents, 272 (44%) reported being willing to get vaccinated. Interestingly, of the 346 (56%) respondents that would not take the COVID-19 vaccine, the highest marginal reasons for non-acceptance were lack of trust in the government 163 (47.1%), followed by the belief that the vaccine is not safe 67 (19.4%), and no enough information about the vaccine 49 (13.6%). In addition, male respondents and those with a university degree or above were statistically significantly more likely to accept a COVID-19 vaccine. Conclusion A considerable proportion of the study population is unwilling to receive a COVID-19 vaccine. This observation highlights the need for the government, public health officials, and advocacy groups to implement immediate awareness-raising measures to sway the public towards COVID-19 vaccine acceptance.
目的:要达到群体免疫,一定比例的人群必须接种疫苗。因此,疫苗接种计划的成功取决于接受程度。本研究旨在通过评估公众接种疫苗的意愿来了解尼日利亚对COVID-19疫苗的接受和犹豫。研究设计这是一项基于人群的横断面研究。数据是通过结构化的在线调查得出的。方法采用结构化在线问卷,于2021年3月在尼日利亚成年居民中进行了一项横断面研究。问卷调查了参与者对COVID-19和COVID-19疫苗的人口统计学特征和认知。采用卡方统计和单变量logistic回归进行描述性统计和推断性统计,以确定COVID-19疫苗接受度的相关因素。结果618名受访者中,有272人(44%)表示愿意接种疫苗。有趣的是,在346名(56%)不愿接种新冠疫苗的受访者中,不接受疫苗的最高边际原因是对政府缺乏信任163名(47.1%),其次是认为疫苗不安全67名(19.4%),疫苗信息不足49名(13.6%)。此外,男性受访者和大学及以上学历的受访者接受COVID-19疫苗的可能性在统计学上显著增加。结论相当比例的研究人群不愿接种COVID-19疫苗。这一观察结果凸显了政府、公共卫生官员和倡导团体需要立即采取提高认识措施,以说服公众接受COVID-19疫苗。
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引用次数: 2
The effectiveness of an educational session about folic acid on pregnant women's knowledge in Yanbu City, Kingdom of Saudi Arabia 沙特阿拉伯王国延布市孕妇叶酸知识教育课程的效果
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022019
Ahlam Al-Zahrani, Shorooq Al-Marwani
Background Folic Acid (FA) is an important nutritional element during pregnancy. It is B vitamin which is found in the natural and complementary source. Deficiency of FA during pregnancy leads to many maternal and fetal complications such as neural tube defect (NTD), birth defect, spontaneous abortion, and megaloblastic anemia. This study aims to assess the effectiveness of an educational session about FA on pregnant women's knowledge in the Kingdom of Saudi Arabia (KSA). Methods A quasi-experimental design was conducted on sixty-five pregnant women from the outpatient clinic in Yanbu General Hospital (YGH) using pre-test and post-test questionnaire to assess their FA knowledge. A purposeful sampling method was used to involve the study participants. All the findings were analyzed through SPSS. Descriptive statistic was used to first generate information about the study participants, after which a t-test was conducted. Results The participants had poor knowledge about FA before the session but the level was increased after the session with mean difference 5.49. Majority of the study participants 81.5% had knowledge that FA protects against NTD. While, 70% understood that FA is an important vitamin during pregnancy. There is a significant association between the age, income, working status, age of marriage, and knowledge of participants. Conclusions An educational session had good effect on pregnant women's knowledge. Health care providers and social media should play more active role to increase the knowledge of FA to pregnant women.
叶酸(FA)是怀孕期间重要的营养元素。它是B族维生素,在天然和补充来源中发现。妊娠期间缺乏FA会导致许多母婴并发症,如神经管缺陷(NTD)、出生缺陷、自然流产和巨幼细胞性贫血。本研究旨在评估沙特阿拉伯王国(KSA)孕妇关于FA知识的教育会议的有效性。方法采用准实验设计,采用前测问卷和后测问卷对65例延布综合医院门诊孕妇的FA知识进行评估。采用有目的的抽样方法使研究参与者参与进来。所有调查结果均通过SPSS进行分析。描述性统计首先用于生成研究参与者的信息,然后进行t检验。结果参试者在会前对FA的了解程度较低,会后对FA的了解程度有所提高,平均差值为5.49。大多数研究参与者(81.5%)知道FA可以预防NTD。然而,70%的人知道FA是怀孕期间重要的维生素。参与者的年龄、收入、工作状态、结婚年龄和知识之间存在显著的相关性。结论一次教育对提高孕妇的知识水平有较好的效果。医疗服务提供者和社交媒体应发挥更积极的作用,提高孕妇对FA的认识。
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引用次数: 3
Prothrombotic role of antiphospholipid antibodies in a patient with sickle cell disease 抗磷脂抗体在镰状细胞病患者血栓形成的作用
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022017
A. Petrungaro, E. Quartarone, L. Rigoli, P. Sciarrone
Sickle cell disease (SCD) is a common inherited condition in African, Caribbean, and Mediterranean countries. SCD is a hematologic disorder caused by a well-characterized point mutation in the β-globin gene, which produces an abnormal hemoglobin S that results in the sickling of red blood cells in deoxygenated conditions. Patients with SCD display a “hypercoagulation state” leading to an increased risk of severe venous and arterial thrombotic vascular events. Herein we report a case of severe thrombotic complications in a patient with SCD who showed high antiphospholipid antibodies (APA) levels during vascular occlusions.
镰状细胞病(SCD)是非洲、加勒比和地中海国家常见的遗传性疾病。SCD是一种血液学疾病,由β-珠蛋白基因的一个明显的点突变引起,该突变产生异常的血红蛋白S,导致缺氧条件下红细胞镰状坏死。SCD患者表现出“高凝状态”,导致严重静脉和动脉血栓性血管事件的风险增加。在此,我们报告一例严重的血栓并发症的SCD患者谁显示高抗磷脂抗体(APA)水平在血管闭塞。
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引用次数: 0
Abdominal pregnancy—a diagnosis never to miss 腹式妊娠——一个绝对不能错过的诊断
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022015
V. Dinwoke, Michael Amara, Linda Uzo Amara
Background

Abdominal pregnancy is very rare, with only a few gynecologists being fortunate to encounter it all through their professional careers. It makes up only 1% of all ectopic pregnancies but has very high perinatal and maternal mortality of 95% and 18% respectively. Hemorrhagic and infectious complications account for these. Removal of the placenta at laparotomy is a big dilemma as torrential bleeding may ensue.

Case

We report the case of an undergraduate teenager who was referred with features of septicemia and anemia following unsafe vaginal instrumentation by a patent medicine dealer (a person without formal training in pharmacy but sells orthodox medications on retail basis) in a bid to terminate an extrauterine pregnancy. Ultrasonography confirmed a nonviable abdominal pregnancy of 20 weeks.

Result

She had exploratory laparotomy with the evacuation of the dead fetus and successful complete removal of the placenta. Her postoperative recovery was uneventful.

Conclusion

In view of the grave complications like a pelvic abscess, disseminated intravascular coagulation and bowel obstruction that may accompany retention of the placenta in advanced abdominal pregnancy, optimal placental removal at surgery is recommended whenever feasible.

腹部怀孕是非常罕见的,只有少数妇科医生在他们的职业生涯中有幸遇到过这种情况。它仅占所有异位妊娠的1%,但围产期和产妇死亡率分别高达95%和18%。出血性和感染性并发症是主要原因。剖腹手术切除胎盘是一个很大的难题,因为可能会出现大出血。我们报告了一例本科青少年,在不安全的阴道器械后,被一名专利药物经销商(未经正规药学培训但在零售基础上销售正统药物的人)以败血症和贫血的特征转介,以终止宫外妊娠。超声检查证实有20周腹内妊娠。结果经剖腹探查取出死胎,胎盘完全取出。术后恢复顺利。结论考虑到腹式妊娠晚期胎盘潴留可能伴随盆腔脓肿、弥散性血管内凝血和肠梗阻等严重并发症,建议在可行的情况下手术切除胎盘。
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引用次数: 1
Recurrence after treatment of arteriovenous malformations of the head and neck 头颈部动静脉畸形治疗后复发
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022003
Do Thi Ngoc Linh, Lâm Khánh, L. Dung, Nguyen Hong Ha, Tran Cao Son, N. M. Duc
Objective Arteriovenous malformations (AVMs) are aggressive diseases with a high tendency to recur. AVM treatment is complex, especially in the anatomically difficult head and neck region. This study analyzed correlations between extracranial head and neck AVM presentations and the frequency of recurrence. Methods We retrospectively assessed AVM recurrence among 55 patients with head and neck AVMs treated with embolization and resection between January 2008 and December 2015. Recurrence was defined as any evidence of AVM expansion following embolization and resection. Patient variables, including sex, age, AVM size, AVM location, stage, and treatment modalities, were examined for correlations with the recurrence of head and neck AVMs. Statistical analysis was performed using SPSS 20.0. Results A total of 55 patients with at least 6 months of follow-up following AVM treatment with embolization and surgical resection were enrolled in this study. During follow-up, 14 of 55 patients experienced recurrence (the long-term recurrence rate was 25.5%). Sex, stage, AVM size, and treatment modality were identified as independent predictors of recurrence. Recurrence was less likely following the treatment of lower-stage or smaller lesions and did not correlate with age or location. Conclusions AVMs of the head and neck are among the most challenging conditions to manage due to a high risk of recurrence. Early and total AVM resection is the best method for preventing recurrence.
目的动静脉畸形(AVMs)是一种易复发的侵袭性疾病。AVM的治疗是复杂的,特别是在解剖学上困难的头颈部区域。本研究分析颅外头颈部AVM表现与复发率的相关性。方法回顾性分析2008年1月至2015年12月55例经栓塞切除的头颈部AVM患者的AVM复发情况。复发被定义为栓塞和切除后AVM扩张的任何证据。检查患者变量,包括性别、年龄、AVM大小、AVM位置、分期和治疗方式,以确定与头颈部AVM复发的相关性。采用SPSS 20.0进行统计学分析。结果本研究共纳入55例AVM栓塞手术切除后随访至少6个月的患者。随访期间,55例患者中有14例复发,长期复发率为25.5%。性别、分期、AVM大小和治疗方式被确定为复发的独立预测因素。低期或较小病灶治疗后复发的可能性较低,且与年龄或部位无关。结论头颈部savms因其复发风险高,是最具挑战性的疾病之一。早期全切除是预防复发的最佳方法。
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引用次数: 0
Clinical pharmacology to support monoclonal antibody drug development 临床药理学支持单克隆抗体药物开发
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2022-01-01 DOI: 10.3934/medsci.2022014
Sharon Lu
Clinical pharmacology is a multidisciplinary function playing a critical role in the monoclonal antibody development. Besides the requirements of understanding pharmacology, pharmacokinetics, model simulation, biostatistics and immunogenicity, wisely implementation of tactics and strategies to fulfill the agencies' requirements per guidance documents are critical. In this review, clinical pharmacology studies categorized as required, target dependent, development strategy dependent, and not usually needed are discussed. The review ends with the outlook of recent initiations in the clinical pharmacology such as the application of QSP with the integration of AI and machine learning technologies.
临床药理学是一门多学科交叉的学科,在单克隆抗体的发展中起着至关重要的作用。除了了解药理学、药代动力学、模型模拟、生物统计学和免疫原性的要求外,明智地实施策略和策略以满足各机构根据指导文件的要求也是至关重要的。本文综述了临床药理学研究的必要性、目标依赖性、发展策略依赖性和非通常需要性。回顾了最近在临床药理学方面的进展,如QSP的应用与人工智能和机器学习技术的整合。
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引用次数: 0
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AIMS Medical Science
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