Pub Date : 2023-12-29DOI: 10.37349/emed.2023.00196
D. Coradini, Federico Ambrogi
Aim: Cholesterol is an essential component of cell membranes and serves as a precursor for several bioactive molecules, including steroid hormones and isoprenoids. Generally supplied by the bloodstream, the de novo cholesterol biosynthesis is activated in response to an increased cell requirement due to normal tissue remodeling or tumor proliferation. In estrogen receptor (ER)-positive breast cancers, cholesterol biosynthesis may promote and sustain tumor growth and concur with the failure of the treatment with aromatase inhibitors. Methods: In this study, the comparison of gene compared the expression involved in cholesterol biosynthesis was conducted in ER-positive tumors that were responsive and nonresponsive to letrozole; besides, an exploration of their association with genes implicated in estrogen production, the Hippo pathway, and cell cycle control was performed. Results: In responsive tumors, letrozole significantly decreased the expression of five genes [acetyl-coenzyme A (CoA) acetyltransferase 2 (ACAT2), 3-hydroxy-3-methylglutaryl-CoA synthase 1 (HMGCS1), 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), farnesyl diphosphate synthase (FDPS), and squalene epoxidase (SQLE)] crucial for the biosynthetic process. Conversely, in nonresponsive tumors, these genes were unaffected by letrozole but associated with several genes involved in estrogens production [cytochrome P450 family 19 subfamily A member 1 (CYP19A1), hydroxysteroid 17-beta dehydrogenase 2 (HSD17B2), and sulfotransferase family 1A member 1 (SULT1A1)], cell cycle [control cyclin dependent kinase 4 (CDK4) and CDK6], and Hippo pathway [Yes1 associated transcriptional regulator (YAP1) and baculoviral inhibitor of apoptosis (IAP) repeat containing 5 (BIRC5)]. Conclusions: The findings corroborated the notion that the dysregulation of the mevalonate pathway may contribute to the resistance to letrozole and supported the use of statins to contrast this metabolic dysfunction.
{"title":"Cholesterol de novo biosynthesis: a promising target to overcome the resistance to aromatase inhibitors in postmenopausal patients with estrogen receptor-positive breast cancer","authors":"D. Coradini, Federico Ambrogi","doi":"10.37349/emed.2023.00196","DOIUrl":"https://doi.org/10.37349/emed.2023.00196","url":null,"abstract":"Aim: Cholesterol is an essential component of cell membranes and serves as a precursor for several bioactive molecules, including steroid hormones and isoprenoids. Generally supplied by the bloodstream, the de novo cholesterol biosynthesis is activated in response to an increased cell requirement due to normal tissue remodeling or tumor proliferation. In estrogen receptor (ER)-positive breast cancers, cholesterol biosynthesis may promote and sustain tumor growth and concur with the failure of the treatment with aromatase inhibitors. Methods: In this study, the comparison of gene compared the expression involved in cholesterol biosynthesis was conducted in ER-positive tumors that were responsive and nonresponsive to letrozole; besides, an exploration of their association with genes implicated in estrogen production, the Hippo pathway, and cell cycle control was performed. Results: In responsive tumors, letrozole significantly decreased the expression of five genes [acetyl-coenzyme A (CoA) acetyltransferase 2 (ACAT2), 3-hydroxy-3-methylglutaryl-CoA synthase 1 (HMGCS1), 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), farnesyl diphosphate synthase (FDPS), and squalene epoxidase (SQLE)] crucial for the biosynthetic process. Conversely, in nonresponsive tumors, these genes were unaffected by letrozole but associated with several genes involved in estrogens production [cytochrome P450 family 19 subfamily A member 1 (CYP19A1), hydroxysteroid 17-beta dehydrogenase 2 (HSD17B2), and sulfotransferase family 1A member 1 (SULT1A1)], cell cycle [control cyclin dependent kinase 4 (CDK4) and CDK6], and Hippo pathway [Yes1 associated transcriptional regulator (YAP1) and baculoviral inhibitor of apoptosis (IAP) repeat containing 5 (BIRC5)]. Conclusions: The findings corroborated the notion that the dysregulation of the mevalonate pathway may contribute to the resistance to letrozole and supported the use of statins to contrast this metabolic dysfunction.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139143278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-29DOI: 10.37349/emed.2023.00198
Freda N. Gonot-Schoupinsky
Gelotology (the study of laughter) has it seems mainly evaded the attention of longevity scientists, positive biologists, and geroscientists. However, the potential of laughter to result in immediate improved affect, increase overall well-being, reduce cortisol levels, benefit the immune system, and support cardiovascular health, to name only a few of its possible effects, renders it of high interest as an anti-aging strategy. As an intervention, laughter has, at least theoretically, the potential to slow the process of aging, and to ameliorate its lived experience. What makes laughter particularly attractive is that it is accessible to all, is very low risk, and is inherently, for most people, enjoyable. Ten years ago, lifestyle medics first proposed that laughter be prescribed in primary care. They pointed to its efficacy in general patient care, geriatrics, rheumatology, critical care, oncology, rehabilitation, psychiatry, home care, palliative care, terminal care, and hospice care. Nevertheless, laughter prescription has been slow to take off. It is therefore of interest to contemplate why, how, and to what effect, laughter can be harnessed to improve people’s lives. Quality research is recommended to uncover the secrets of laughter, its dynamic effects on the body, if, and how, it may impact longevity, and how it can best be used to promote successful and active aging.
{"title":"From positive psychology to positive biology: laughter and longevity","authors":"Freda N. Gonot-Schoupinsky","doi":"10.37349/emed.2023.00198","DOIUrl":"https://doi.org/10.37349/emed.2023.00198","url":null,"abstract":"Gelotology (the study of laughter) has it seems mainly evaded the attention of longevity scientists, positive biologists, and geroscientists. However, the potential of laughter to result in immediate improved affect, increase overall well-being, reduce cortisol levels, benefit the immune system, and support cardiovascular health, to name only a few of its possible effects, renders it of high interest as an anti-aging strategy. As an intervention, laughter has, at least theoretically, the potential to slow the process of aging, and to ameliorate its lived experience. What makes laughter particularly attractive is that it is accessible to all, is very low risk, and is inherently, for most people, enjoyable. Ten years ago, lifestyle medics first proposed that laughter be prescribed in primary care. They pointed to its efficacy in general patient care, geriatrics, rheumatology, critical care, oncology, rehabilitation, psychiatry, home care, palliative care, terminal care, and hospice care. Nevertheless, laughter prescription has been slow to take off. It is therefore of interest to contemplate why, how, and to what effect, laughter can be harnessed to improve people’s lives. Quality research is recommended to uncover the secrets of laughter, its dynamic effects on the body, if, and how, it may impact longevity, and how it can best be used to promote successful and active aging.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"113 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139146887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer cure with immunotherapy is an innovative step towards cancer treatment with better survivability, but it is mostly dependent on the response of the patient’s immune system to the immunotherapeutic approach. This descriptive review article emphasizes the conventional and advanced treatment modalities currently available for breast cancer management. This review also highlights the clinical management of breast cancer concerning immune response especially to unravel the prospects for manipulation of immune cells: such as lymphocytes, including T-cells, T-regulatory cells and natural killer cells, and others like macrophages, dendritic cells, and the panel of interleukins or interferons released by them which has made a significant impact on breast cancer research. In addition, an effort was made to emphasize the different clinical trials and their future implication for the reduction of breast cancer cases. Overall, an attempt has been made to shed light on the possibilities of immunotherapeutics in breast cancer care, as well as the role of immune response in the incidence, aggressiveness, and survival of breast cancer.
利用免疫疗法治愈癌症是提高癌症治疗存活率的创新举措，但这主要取决于患者的免疫系统对免疫疗法的反应。这篇描述性综述文章强调了目前可用于乳腺癌治疗的常规和先进治疗方法。这篇综述还强调了与免疫反应有关的乳腺癌临床治疗，特别是揭示了操纵免疫细胞的前景：如淋巴细胞，包括 T 细胞、T 调节细胞和自然杀伤细胞，以及其他如巨噬细胞、树突状细胞和它们释放的白细胞介素或干扰素，这对乳腺癌研究产生了重大影响。此外，还努力强调不同的临床试验及其对减少乳腺癌病例的未来影响。总之，我们试图揭示免疫疗法在乳腺癌治疗中的可能性，以及免疫反应在乳腺癌发病率、侵袭性和存活率中的作用。
{"title":"The differential effect of the immune system in breast cancer","authors":"Banashree Bondhopadhyay, Showket Hussain, Vishakha Kasherwal","doi":"10.37349/emed.2023.00197","DOIUrl":"https://doi.org/10.37349/emed.2023.00197","url":null,"abstract":"Cancer cure with immunotherapy is an innovative step towards cancer treatment with better survivability, but it is mostly dependent on the response of the patient’s immune system to the immunotherapeutic approach. This descriptive review article emphasizes the conventional and advanced treatment modalities currently available for breast cancer management. This review also highlights the clinical management of breast cancer concerning immune response especially to unravel the prospects for manipulation of immune cells: such as lymphocytes, including T-cells, T-regulatory cells and natural killer cells, and others like macrophages, dendritic cells, and the panel of interleukins or interferons released by them which has made a significant impact on breast cancer research. In addition, an effort was made to emphasize the different clinical trials and their future implication for the reduction of breast cancer cases. Overall, an attempt has been made to shed light on the possibilities of immunotherapeutics in breast cancer care, as well as the role of immune response in the incidence, aggressiveness, and survival of breast cancer.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"19 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139147908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-29DOI: 10.37349/emed.2023.00199
Silvia Siragusa, Giulia Natali, A. Nogara, Marcello Trevisani, C. Lagrasta, Silvia Pontis
Chronic obstructive pulmonary disease (COPD) is an inflammatory lung pathology characterized by persistent airflow limitation and is the third leading cause of death globally. COPD pathophysiology includes both environmental and host risk factors and the presence of comorbidities contributes to its harmful outcome. Cardiovascular disease (CVD) is closely related to COPD and their coexistence is associated with worse outcomes than either condition alone. COPD impairs the cardiovascular system favoring mostly endothelial dysfunction that is a significant COPD prognostic factor at different stages of the disease. The mechanisms promoting endothelial dysfunction in the systemic and/or pulmonary circulation of COPD patients are different and include systemic inflammation, alteration of adhesion and pro-inflammatory molecules, oxidative stress, cellular senescence, and apoptosis. Nevertheless, the role of endothelium in the onset and progression of COPD and CVD is not yet fully understood. Hence, the purpose of this narrative review is to analyze the literature and provide evidence supporting the importance of endothelial dysfunction in COPD.
{"title":"The role of pulmonary vascular endothelium in chronic obstructive pulmonary disease (COPD): Does endothelium play a role in the onset and progression of COPD?","authors":"Silvia Siragusa, Giulia Natali, A. Nogara, Marcello Trevisani, C. Lagrasta, Silvia Pontis","doi":"10.37349/emed.2023.00199","DOIUrl":"https://doi.org/10.37349/emed.2023.00199","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is an inflammatory lung pathology characterized by persistent airflow limitation and is the third leading cause of death globally. COPD pathophysiology includes both environmental and host risk factors and the presence of comorbidities contributes to its harmful outcome. Cardiovascular disease (CVD) is closely related to COPD and their coexistence is associated with worse outcomes than either condition alone. COPD impairs the cardiovascular system favoring mostly endothelial dysfunction that is a significant COPD prognostic factor at different stages of the disease. The mechanisms promoting endothelial dysfunction in the systemic and/or pulmonary circulation of COPD patients are different and include systemic inflammation, alteration of adhesion and pro-inflammatory molecules, oxidative stress, cellular senescence, and apoptosis. Nevertheless, the role of endothelium in the onset and progression of COPD and CVD is not yet fully understood. Hence, the purpose of this narrative review is to analyze the literature and provide evidence supporting the importance of endothelial dysfunction in COPD.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"5 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139147427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The integration of three-dimensional (3D) printing techniques into the domains of biomedical research and personalized medicine highlights the evolving paradigm shifts within contemporary healthcare. This technological advancement signifies potential breakthroughs in patient-specific therapeutic interventions and innovations. This systematic review offers a critical assessment of the existing literature, elucidating the present status, inherent challenges, and prospective avenues of 3D printing in augmenting biomedical applications and formulating tailored medical strategies. Based on an exhaustive literature analysis comprising empirical studies, case studies, and extensive reviews from the past decade, pivotal sectors including tissue engineering, prosthetic development, drug delivery systems, and customized medical apparatuses are delineated. The advent of 3D printing provides precision in the fabrication of patient-centric implants, bio-structures, and devices, thereby mitigating associated risks. Concurrently, it facilitates the ideation of individualized drug delivery paradigms to optimize therapeutic outcomes. Notwithstanding these advancements, issues concerning material biocompatibility, regulatory compliance, and the economic implications of avant-garde printing techniques persist. To fully harness the transformative potential of 3D printing in healthcare, collaborative endeavors amongst academicians, clinicians, industrial entities, and regulatory bodies are paramount. With continued research and innovation, 3D printing is poised to redefine the trajectories of biomedical science and patient-centric care. The paper aims to justify the research objective of whether to what extent the integration of 3D printing technology in biomedicine enhances patient-specific treatment and contributes to improved healthcare outcomes.
将三维（3D）打印技术融入生物医学研究和个性化医疗领域，凸显了当代医疗保健领域不断发展的范式转变。这一技术进步标志着在针对患者的治疗干预和创新方面可能取得突破。这篇系统性综述对现有文献进行了批判性评估，阐明了 3D 打印在增强生物医学应用和制定定制医疗策略方面的现状、固有挑战和前景。基于详尽的文献分析，包括过去十年的实证研究、案例研究和大量综述，对组织工程、假肢开发、给药系统和定制医疗器械等关键领域进行了划分。三维打印技术的出现为制造以患者为中心的植入物、生物结构和设备提供了精确度，从而降低了相关风险。同时，3D 打印技术还促进了个性化给药模式的构思，以优化治疗效果。尽管取得了这些进步，但有关材料生物兼容性、监管合规性以及前卫打印技术的经济影响等问题依然存在。要充分利用 3D 打印技术在医疗保健领域的变革潜力，学术界、临床医生、工业实体和监管机构之间的合作至关重要。随着研究和创新的不断深入，3D 打印技术有望重新定义生物医学科学和以患者为中心的医疗服务的发展轨迹。本文旨在论证以下研究目标：3D 打印技术与生物医学的结合是否能在多大程度上增强针对患者的治疗，并有助于改善医疗效果。
{"title":"3D printing in biomedicine: advancing personalized care through additive manufacturing","authors":"K. Pathak, Riya Saikia, Aparoop Das, Dibyajyoti Das, Md Ariful Islam, Pallab Pramanik, Abhishek Parasar, PARTHA PROTIM BORTHAKUR, Pranjal Sarmah, Madhurjya Saikia, Barbie Borthakur","doi":"10.37349/emed.2023.00200","DOIUrl":"https://doi.org/10.37349/emed.2023.00200","url":null,"abstract":"The integration of three-dimensional (3D) printing techniques into the domains of biomedical research and personalized medicine highlights the evolving paradigm shifts within contemporary healthcare. This technological advancement signifies potential breakthroughs in patient-specific therapeutic interventions and innovations. This systematic review offers a critical assessment of the existing literature, elucidating the present status, inherent challenges, and prospective avenues of 3D printing in augmenting biomedical applications and formulating tailored medical strategies. Based on an exhaustive literature analysis comprising empirical studies, case studies, and extensive reviews from the past decade, pivotal sectors including tissue engineering, prosthetic development, drug delivery systems, and customized medical apparatuses are delineated. The advent of 3D printing provides precision in the fabrication of patient-centric implants, bio-structures, and devices, thereby mitigating associated risks. Concurrently, it facilitates the ideation of individualized drug delivery paradigms to optimize therapeutic outcomes. Notwithstanding these advancements, issues concerning material biocompatibility, regulatory compliance, and the economic implications of avant-garde printing techniques persist. To fully harness the transformative potential of 3D printing in healthcare, collaborative endeavors amongst academicians, clinicians, industrial entities, and regulatory bodies are paramount. With continued research and innovation, 3D printing is poised to redefine the trajectories of biomedical science and patient-centric care. The paper aims to justify the research objective of whether to what extent the integration of 3D printing technology in biomedicine enhances patient-specific treatment and contributes to improved healthcare outcomes.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139142204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-29DOI: 10.37349/emed.2023.00195
Zhanglan Fang, Hao Yang, Yi Long, Dongyun Xu, Benyu Su, Chao Xu, Huguang Yang, Feng Xu, Ling Luo
Aim: Respiratory failure is common after esophagectomy for esophageal cancer (EC). This study aimed to identify the risk factors associated with postoperative respiratory failure following esophagectomy for EC. Methods: A single-center observational study from China was conducted on 262 patients with EC who underwent thoracoscopic esophagectomy between April 2014 and June 2016. The patients were divided into two groups: group I (respiratory failure) and group II (without respiratory failure). Demographic and perioperative variables, tumor-related factors, surgical factors, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and clinical course were compared between the groups. Univariable and multivariable logistic regression analyses were performed to assess the risk factors of postoperative respiratory failure after esophagectomy. Results: Among the 262 patients, 24 (9.2%) developed respiratory failure. Univariable analysis revealed several risk factors, including age, smoking, comorbidities, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), forced vital capacity (FVC), FVC percentage (FVC%), urine volume during surgery, and APACHE II score. Multivariable analysis showed that age, comorbidities of diabetes mellitus (DM), FVC%, urine volume during surgery, and APACHE II score were independent predictors of respiratory failure. Specifically, elderly patients (> 65 years) with comorbidities of DM, lower FVC%, higher urine volume during surgery, and elevated APACHE II score were found to be more susceptible to respiratory failure, resulting in prolonged hospitalization and increased healthcare burden. These findings emphasize the importance of considering these factors in the management and care of patients at risk of respiratory failure. Conclusions: As a common complication following esophagectomy for EC. Respiratory failure is significantly associated with age, comorbidities of DM, FVC%, urine volume during surgery, and APACHE II score in the dataset. The findings will contribute to the evaluation of the risk of respiratory failure and guide early intervention strategies in clinical decision-making.
目的：食管癌（EC）食管切除术后呼吸衰竭很常见。本研究旨在确定食管癌食管切除术后呼吸衰竭的相关风险因素。方法：一项来自中国的单中心观察性研究对2014年4月至2016年6月期间接受胸腔镜食管切除术的262例食管癌患者进行了研究。患者分为两组：I组（呼吸衰竭）和II组（无呼吸衰竭）。比较了两组患者的人口统计学和围手术期变量、肿瘤相关因素、手术因素、急性生理学和慢性健康评估 II（APACHE II）评分以及临床病程。进行单变量和多变量逻辑回归分析，以评估食管切除术后呼吸衰竭的风险因素。结果262 名患者中有 24 人（9.2%）出现呼吸衰竭。单变量分析显示了几个风险因素，包括年龄、吸烟、合并症、氧分压（PO2）、二氧化碳分压（PCO2）、强迫生命容量（FVC）、FVC 百分比（FVC%）、术中尿量和 APACHE II 评分。多变量分析显示，年龄、糖尿病（DM）合并症、FVC%、术中尿量和 APACHE II 评分是呼吸衰竭的独立预测因素。具体来说，合并有 DM、FVC% 较低、术中尿量较多、APACHE II 评分较高的老年患者（65 岁以上）更容易出现呼吸衰竭，导致住院时间延长和医疗负担加重。这些发现强调了在管理和护理有呼吸衰竭风险的患者时考虑这些因素的重要性。结论：呼吸衰竭是食管切除术后常见的并发症。在数据集中，呼吸衰竭与年龄、DM合并症、FVC%、术中尿量和APACHE II评分明显相关。研究结果将有助于评估呼吸衰竭的风险，并指导临床决策中的早期干预策略。
{"title":"Risk factors associated with postoperative respiratory failure after esophagectomy for esophageal cancer","authors":"Zhanglan Fang, Hao Yang, Yi Long, Dongyun Xu, Benyu Su, Chao Xu, Huguang Yang, Feng Xu, Ling Luo","doi":"10.37349/emed.2023.00195","DOIUrl":"https://doi.org/10.37349/emed.2023.00195","url":null,"abstract":"Aim: Respiratory failure is common after esophagectomy for esophageal cancer (EC). This study aimed to identify the risk factors associated with postoperative respiratory failure following esophagectomy for EC. Methods: A single-center observational study from China was conducted on 262 patients with EC who underwent thoracoscopic esophagectomy between April 2014 and June 2016. The patients were divided into two groups: group I (respiratory failure) and group II (without respiratory failure). Demographic and perioperative variables, tumor-related factors, surgical factors, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and clinical course were compared between the groups. Univariable and multivariable logistic regression analyses were performed to assess the risk factors of postoperative respiratory failure after esophagectomy. Results: Among the 262 patients, 24 (9.2%) developed respiratory failure. Univariable analysis revealed several risk factors, including age, smoking, comorbidities, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), forced vital capacity (FVC), FVC percentage (FVC%), urine volume during surgery, and APACHE II score. Multivariable analysis showed that age, comorbidities of diabetes mellitus (DM), FVC%, urine volume during surgery, and APACHE II score were independent predictors of respiratory failure. Specifically, elderly patients (> 65 years) with comorbidities of DM, lower FVC%, higher urine volume during surgery, and elevated APACHE II score were found to be more susceptible to respiratory failure, resulting in prolonged hospitalization and increased healthcare burden. These findings emphasize the importance of considering these factors in the management and care of patients at risk of respiratory failure. Conclusions: As a common complication following esophagectomy for EC. Respiratory failure is significantly associated with age, comorbidities of DM, FVC%, urine volume during surgery, and APACHE II score in the dataset. The findings will contribute to the evaluation of the risk of respiratory failure and guide early intervention strategies in clinical decision-making.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":" 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139143045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-29DOI: 10.37349/emed.2023.00201
Hervé Agonsanou, Ricardo Figueiredo, Maurice Bergeron
According to recent data reported, it is noted that lung cancer is the leading cause of cancer death internationally followed by cardiovascular diseases and diabetes. This disease is observed in both women and men and is related to lifestyle habits. Several causes are reported to be at the origin of lung cancer, especially smoking. It is important to note that the majority of lung cancers develop in the bronchi, that is to say at the level of the upper airways which lead to the lungs, which does not however make it possible to rule out the risk factors that come under environmental pollution since man breathes the air quality of the environment every day for his breathing. This review of the literature has made it possible to draw up a state of knowledge in order to understand the risk factors that increase lung cancer. More specifically, this work will make it possible to raise awareness in the field of the fight against cancer, in particular lung cancer.
{"title":"Risk factors for the development of lung cancer around the world: a review","authors":"Hervé Agonsanou, Ricardo Figueiredo, Maurice Bergeron","doi":"10.37349/emed.2023.00201","DOIUrl":"https://doi.org/10.37349/emed.2023.00201","url":null,"abstract":"According to recent data reported, it is noted that lung cancer is the leading cause of cancer death internationally followed by cardiovascular diseases and diabetes. This disease is observed in both women and men and is related to lifestyle habits. Several causes are reported to be at the origin of lung cancer, especially smoking. It is important to note that the majority of lung cancers develop in the bronchi, that is to say at the level of the upper airways which lead to the lungs, which does not however make it possible to rule out the risk factors that come under environmental pollution since man breathes the air quality of the environment every day for his breathing. This review of the literature has made it possible to draw up a state of knowledge in order to understand the risk factors that increase lung cancer. More specifically, this work will make it possible to raise awareness in the field of the fight against cancer, in particular lung cancer.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"104 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139145631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-28DOI: 10.37349/emed.2023.00194
K. Keskinbora
Artificial intelligence (AI) studies are increasingly reporting successful results in the diagnosis and prognosis prediction of ophthalmological diseases as well as systemic disorders. The goal of this review is to detail how AI can be utilized in making diagnostic predictions to enhance the clinical setting. It is crucial to keep improving methods that emphasize clarity in AI models. This makes it possible to evaluate the information obtained from ocular imaging and easily incorporate it into therapeutic decision-making procedures. This will contribute to the wider acceptance and adoption of AI-based ocular imaging in healthcare settings combining advanced machine learning and deep learning techniques with new developments. Multiple studies were reviewed and evaluated, including AI-based algorithms, retinal images, fundus and optic nerve head (ONH) photographs, and extensive expert reviews. In these studies, carried out in various countries and laboratories of the world, it is seen those complex diagnoses, which can be detected systemic diseases from ophthalmological images, can be made much faster and with higher predictability, accuracy, sensitivity, and specificity, in addition to ophthalmological diseases, by comparing large numbers of images and teaching them to the computer. It is now clear that it can be taken advantage of AI to achieve diagnostic certainty. Collaboration between the fields of medicine and engineering foresees promising advances in improving the predictive accuracy and precision of future medical diagnoses achieved by training machines with this information. However, it is important to keep in mind that each new development requires new additions or updates to various social, psychological, ethical, and legal regulations.
{"title":"Current roles of artificial intelligence in ophthalmology","authors":"K. Keskinbora","doi":"10.37349/emed.2023.00194","DOIUrl":"https://doi.org/10.37349/emed.2023.00194","url":null,"abstract":"Artificial intelligence (AI) studies are increasingly reporting successful results in the diagnosis and prognosis prediction of ophthalmological diseases as well as systemic disorders. The goal of this review is to detail how AI can be utilized in making diagnostic predictions to enhance the clinical setting. It is crucial to keep improving methods that emphasize clarity in AI models. This makes it possible to evaluate the information obtained from ocular imaging and easily incorporate it into therapeutic decision-making procedures. This will contribute to the wider acceptance and adoption of AI-based ocular imaging in healthcare settings combining advanced machine learning and deep learning techniques with new developments. Multiple studies were reviewed and evaluated, including AI-based algorithms, retinal images, fundus and optic nerve head (ONH) photographs, and extensive expert reviews. In these studies, carried out in various countries and laboratories of the world, it is seen those complex diagnoses, which can be detected systemic diseases from ophthalmological images, can be made much faster and with higher predictability, accuracy, sensitivity, and specificity, in addition to ophthalmological diseases, by comparing large numbers of images and teaching them to the computer. It is now clear that it can be taken advantage of AI to achieve diagnostic certainty. Collaboration between the fields of medicine and engineering foresees promising advances in improving the predictive accuracy and precision of future medical diagnoses achieved by training machines with this information. However, it is important to keep in mind that each new development requires new additions or updates to various social, psychological, ethical, and legal regulations.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"137 9‐12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139149389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-28DOI: 10.37349/emed.2023.00192
K. Zaman, Abdelmonem Siddiq, A. Mohanty, Darwin A. León-Figueroa, J. J. Barboza, T. AL-Ahdal, Ranjit Sah
Within group A Streptococcus (GAS), only Streptococcus pyogenes exhibits clinical significance. GAS is typed serologically based on unique surface proteins and critical virulence factors, such as a hyaluronic acid capsule that shields GAS from phagocytosis. The burden of GAS was estimated in the last five years as 14,000 to 25,000 cases of the invasive group A streptococcal disease in the USA with an estimated death from 1,500 to 2,300 cases per year. Early in the summer of 2022 in England, there was more scarlet fever than was anticipated. Early in the current season, the number of notifications rose to unusual heights. The analysis of invasive GAS (iGAS) isolate typing data shows that this season has seen a wide variety of encoding mature M protein (emm) gene sequence types found. Therefore, public health authorities should think about initiatives to increase clinicians’ and the general public’s awareness of GAS infections and to promote their quick diagnosis, molecular testing and antibiotic susceptibility testing, and standard treatment.
在 A 组链球菌（GAS）中，只有化脓性链球菌具有临床意义。根据独特的表面蛋白和关键的毒力因子（如透明质酸囊，它能保护 A 组链球菌免受吞噬作用），可对 A 组链球菌进行血清学分型。据估计，在过去五年中，GAS 在美国造成的负担为 1.4 万至 2.5 万例侵袭性 A 组链球菌疾病，估计每年死亡病例为 1500 至 2300 例。2022 年初夏，英国的猩红热发病率高于预期。在当前季节的早期，通报数量上升到不寻常的高度。对侵袭性猩红热（iGAS）分离株分型数据的分析表明，本季发现的编码成熟 M 蛋白（emm）基因序列类型多种多样。因此，公共卫生部门应考虑采取措施，提高临床医生和公众对革兰阳性菌感染的认识，促进其快速诊断、分子检测和抗生素敏感性检测以及规范治疗。
{"title":"Group A streptococcal infection in the United Kingdom: an emerging threat","authors":"K. Zaman, Abdelmonem Siddiq, A. Mohanty, Darwin A. León-Figueroa, J. J. Barboza, T. AL-Ahdal, Ranjit Sah","doi":"10.37349/emed.2023.00192","DOIUrl":"https://doi.org/10.37349/emed.2023.00192","url":null,"abstract":"Within group A Streptococcus (GAS), only Streptococcus pyogenes exhibits clinical significance. GAS is typed serologically based on unique surface proteins and critical virulence factors, such as a hyaluronic acid capsule that shields GAS from phagocytosis. The burden of GAS was estimated in the last five years as 14,000 to 25,000 cases of the invasive group A streptococcal disease in the USA with an estimated death from 1,500 to 2,300 cases per year. Early in the summer of 2022 in England, there was more scarlet fever than was anticipated. Early in the current season, the number of notifications rose to unusual heights. The analysis of invasive GAS (iGAS) isolate typing data shows that this season has seen a wide variety of encoding mature M protein (emm) gene sequence types found. Therefore, public health authorities should think about initiatives to increase clinicians’ and the general public’s awareness of GAS infections and to promote their quick diagnosis, molecular testing and antibiotic susceptibility testing, and standard treatment.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"48 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139151196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Arthritis is a degenerative condition characterized by the progressive deterioration of the knee joint, leading to aches, rigidity, and decreased mobility. Total knee arthroplasty (TKA) surgery is performed to alleviate pain for restoring activity in these patients. TKA is carried out due to natural wear of the cartilage and meniscus or by sudden impact at the knee joint area. The surgical procedure involves careful planning, precise bone cuts, and insertion of artificial components made of metal alloys and high-density polyethylene. However, conventional manufacturing of customized knee implants involves time and cost. This work aims to present the application of three-dimensional (3D) printing for developing individualized knee implants for TKA and the challenges faced during it. Methods: Morphometry of the knee joint varies among different populations, including Indian and Western, which pose challenges during the surgery as accurate alignment and implant sizing are crucial for optimal outcomes. A female patient’s pre-surgery computed tomography (CT) scan is considered to identify the disease and to find region of interest (ROI) such as knee joint. Process involves converting scanned data to a file format for 3D printing via computer-aided design (CAD). Results: The patient’s CT scan data is processed to obtain the CAD models of knee joint and standard triangulation language (STL) file. Additional geometries and noise present near the region are removed to get ROI. Open loops and overlapping triangles are rectified in the STL file. Based on the morphometry of the bone, resection is done to obtain the CAD models of knee implants. 3D printing of the knee joint and implant prototypes is then obtained using fused deposition modelling (FDM). Line layers on the printed implant prototype are seen. Conclusions: Patient-specific 3D printed knee joint implant prototypes are successfully obtained using FDM. Challenges faced during the work are successfully worked out.
{"title":"Development of patient-specific 3D printed implants for total knee arthroplasty","authors":"Dasharath Ramavath, S. Yeole, Jaya Prakash Kode, Narendra Pothula, Sudheer Reddy Devana","doi":"10.37349/emed.2023.00193","DOIUrl":"https://doi.org/10.37349/emed.2023.00193","url":null,"abstract":"Aim: Arthritis is a degenerative condition characterized by the progressive deterioration of the knee joint, leading to aches, rigidity, and decreased mobility. Total knee arthroplasty (TKA) surgery is performed to alleviate pain for restoring activity in these patients. TKA is carried out due to natural wear of the cartilage and meniscus or by sudden impact at the knee joint area. The surgical procedure involves careful planning, precise bone cuts, and insertion of artificial components made of metal alloys and high-density polyethylene. However, conventional manufacturing of customized knee implants involves time and cost. This work aims to present the application of three-dimensional (3D) printing for developing individualized knee implants for TKA and the challenges faced during it. Methods: Morphometry of the knee joint varies among different populations, including Indian and Western, which pose challenges during the surgery as accurate alignment and implant sizing are crucial for optimal outcomes. A female patient’s pre-surgery computed tomography (CT) scan is considered to identify the disease and to find region of interest (ROI) such as knee joint. Process involves converting scanned data to a file format for 3D printing via computer-aided design (CAD). Results: The patient’s CT scan data is processed to obtain the CAD models of knee joint and standard triangulation language (STL) file. Additional geometries and noise present near the region are removed to get ROI. Open loops and overlapping triangles are rectified in the STL file. Based on the morphometry of the bone, resection is done to obtain the CAD models of knee implants. 3D printing of the knee joint and implant prototypes is then obtained using fused deposition modelling (FDM). Line layers on the printed implant prototype are seen. Conclusions: Patient-specific 3D printed knee joint implant prototypes are successfully obtained using FDM. Challenges faced during the work are successfully worked out.","PeriodicalId":72999,"journal":{"name":"Exploration of medicine","volume":"271 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139152763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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