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Understand the chronic pain! 了解慢性疼痛!
Pub Date : 2024-05-08 DOI: 10.17352/2581-5407.000052
Abdelrazek Essam
Chronic pain has been always difficult to manage for different reasons including a very complex and multi-factorial pathophysiology, which is still poorly understood, very limited treatment options, and not very sufficient conclusive research in the field of chronic pain. Because of the complex relationship between the central and the peripheral nervous system as well as the body’s hormones, chronic pain requires a multidisciplinary treatment approach. Chronic pain is different from the acute one, which is much easier to deal with because it has a well-known definite cause, however, chronic pain is usually very special and there isn’t a clear cause for it and no single treatment will cure it. Unfortunately, not every chronic pain patient understands the dilemma of his/her pain condition, therefore when they get referred to the pain clinic they go with very high and unrealistic expectations. In this short article, we will try to shed light on this very important problem helping chronic pain patients to understand the nature of their pain and advising them how to deal with it.
慢性疼痛一直以来都很难控制,原因有很多,包括病理生理学非常复杂且具有多种因素,但人们对其仍然知之甚少,治疗方法非常有限,以及在慢性疼痛领域的研究还不够充分。由于中枢神经系统和外周神经系统以及体内激素之间的复杂关系,慢性疼痛需要多学科的治疗方法。慢性疼痛与急性疼痛不同,急性疼痛因为有众所周知的明确病因而更容易处理,但慢性疼痛通常非常特殊,没有明确的病因,也没有单一的治疗方法可以治愈。不幸的是,并不是每个慢性疼痛患者都了解自己疼痛状况的困境,因此,当他们被转介到疼痛诊所时,他们会抱着非常高的、不切实际的期望。在这篇短文中,我们将试图揭示这个非常重要的问题,帮助慢性疼痛患者了解疼痛的本质,并指导他们如何应对疼痛。
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引用次数: 0
Melanoma and basal cell carcinoma: Mimickers of each other 黑色素瘤和基底细胞癌:相互模仿
Pub Date : 2023-09-23 DOI: 10.17352/2581-5407.000051
Menezes Carvalho Gustavo de Sá, Dana Isabella N, Tavoloni Braga Juliana Casagrande, Marghoob Ashfaq A
Basal cell carcinoma and malignant melanoma display unique dermoscopic features, at times they can mimic each other. A few clinical and dermoscopic algorithms, including the ABCD rule and the seven-point checklist, have been developed to simplify the diagnostic process. However, these tumors may present ambiguous dermoscopic patterns, lacking typical dermoscopic criteria. We present four cases where dermoscopic structures act as a confounding factor for the incorrect diagnosis of basal cell carcinoma and malignant melanoma. This work aims to improve the differentiation between melanoma and basal cell carcinoma. These tumors can sometimes be clinically similar and this can interfere with treatment if the correct diagnosis is not made.
基底细胞癌和恶性黑色素瘤表现出独特的皮肤镜特征,有时它们可以相互模仿。一些临床和皮肤镜算法,包括ABCD规则和七点检查表,已经开发出来简化诊断过程。然而,这些肿瘤可能表现出模糊的皮肤镜模式,缺乏典型的皮肤镜标准。我们提出了四个病例,其中皮肤镜结构作为一个混淆因素对基底细胞癌和恶性黑色素瘤的错误诊断。本研究旨在提高黑色素瘤与基底细胞癌的鉴别水平。这些肿瘤有时在临床上是相似的,如果没有做出正确的诊断,这可能会干扰治疗。
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引用次数: 0
Advances in cancer therapy: A comprehensive review 癌症治疗的进展:综述
Pub Date : 2023-06-23 DOI: 10.17352/2581-5407.000050
Gpt Chat, A. Torgeir
Cancer remains one of the most challenging health issues worldwide, causing significant morbidity and mortality. Over the years, tremendous progress has been made in cancer therapy, leading to improved survival rates and enhanced quality of life for patients. This article aims to provide a comprehensive review of recent advances in cancer therapy, focusing on various treatment modalities, including surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy, antibody-drug conjugates, and emerging approaches. The article explores the latest developments, clinical trials, and promising strategies that have shown potential in the field of cancer therapy. Additionally, it discusses challenges, future directions, and the importance of personalized medicine in optimizing cancer treatment outcomes.
癌症仍然是世界范围内最具挑战性的健康问题之一,导致严重的发病率和死亡率。多年来,癌症治疗取得了巨大进展,提高了患者的生存率和生活质量。本文旨在全面回顾癌症治疗的最新进展,重点介绍各种治疗方式,包括手术、化疗、放射治疗、免疫疗法、靶向治疗、抗体偶联物和新兴方法。本文探讨了癌症治疗领域的最新进展、临床试验和有前景的策略。此外,它还讨论了挑战、未来方向以及个性化医疗在优化癌症治疗结果方面的重要性。
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引用次数: 0
New modalities of surgery for renal tumors in children: A Mini-Review 儿童肾肿瘤手术的新模式:综述
Pub Date : 2022-11-29 DOI: 10.17352/2581-5407.000049
Godzinski Jan
Nephroblastoma is one of the most frequent solid tumors in childhood. It is also a classical example of success in oncology achieved by consequent and randomized studies run since mid-XX until now. As systemic treatment is constantly very effective and has not changed markedly since the last 30 years, the development of precise imaging and surgical technique allowed for the introduction of several new operative methods offering intriguing advantages. This paper is based on the literature review limited to the state-of-the-art or corner-stone positions and over 30 years of personal experience of the author. It does not pretend to be a form of a systematic meta-analysis.
肾母细胞瘤是儿童最常见的实体肿瘤之一。它也是自xx年中期至今的后续随机研究在肿瘤学领域取得成功的经典案例。由于全身治疗一直非常有效,并且自过去30年以来没有明显改变,精确成像和手术技术的发展允许引入几种具有有趣优势的新手术方法。本文是基于文献综述,限于国家的最先进或基石的立场和作者超过30年的个人经验。它并不假装是一种系统的元分析。
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引用次数: 0
Investigation of the effectiveness of ECOLAB ’Drape ArmourTM’ Radiation Protection in limiting eye-lens doses of healthcare personnel exposed to ionizing radiation during gastroenterology - interventional radiology procedures ECOLAB“Drape ArmourTM”辐射防护在限制医疗人员在胃肠病学-介入放射治疗过程中暴露于电离辐射的眼透镜剂量的有效性调查
Pub Date : 2022-10-20 DOI: 10.17352/2581-5407.000048
Fucilli Fulvio IM, Giovanni Giuseppe Di, Mastrorocco Alessandro, Ninni Matteo, Loprete Piero, Crudis Isa De, Marano Massimiliano, Santomauro Antonio, Fucilli Fabio
Objectives: To investigate the efficiency of the ECOLAB “Drape ArmourTM” device in limiting the eye-lens doses absorbed by healthcare personnel exposed to ionizing radiation, in a four-month trial during gastroenterology interventional radiology procedures. Methods: Eyelens doses measured with eye-lens dosimeters calibrated in terms of equivalent dose at 3 mm depth ( Hp(3) ) were collected and analyzed since 2016 along with the irradiation parameters (Dose Area Product - DAP). The eye-lens doses received during the four-month trial, have been compared with doses normally received, in the same conditions of irradiation, in the absence of the protection drape. Results: During the period of use of Drape ArmourTM, the average dose to the eye lens was estimated to be 0.73 mSv (St.dev = 0.40 mSv). The average dose to the eye lens, measured in the same four-month period, across different years from 2017 to 2021, was equal to 1.30 mSv (st. dev = 0.35 mSv). Conclusions: Results suggest the effectiveness of Drape ArmourTM in containing the doses to the eye lens. Keypoint: Limiting eye-lens doses to a maximum value of 20 mSv/year is a real challenge, especially in interventional radiologic facilities. The use of suitable radio-opaque drapes may help healthcare workers involved in such facilities. The aim of the work is to evaluate the efficiency of the ECOLAB “Drape ArmourTM” sterile mono-use drape.
目的:在一项为期4个月的试验中,研究ECOLAB“Drape ArmourTM”装置在限制暴露于电离辐射的医护人员的眼晶体剂量方面的效率。方法:收集2016年以来以3mm深度等效剂量计(Hp(3))标定的眼镜片剂量计测量的眼镜片剂量,并对辐照参数(剂量面积积- DAP)进行分析。在为期4个月的试验中接受的眼球透镜剂量已与在没有保护膜的相同照射条件下正常接受的剂量进行了比较。结果:在使用期间,对眼晶状体的平均剂量估计为0.73 mSv (St.dev = 0.40 mSv)。在2017年至2021年不同年份的相同四个月期间测量的眼晶状体平均剂量等于1.30毫西弗(st. dev = 0.35毫西弗)。结论:结果表明,垂甲tm对晶状体有一定的抑制作用。重点:将眼透镜剂量限制在20msv /年的最大值是一个真正的挑战,特别是在介入放射设施中。使用合适的不透光窗帘可能有助于在此类设施工作的卫生保健工作者。这项工作的目的是评估ECOLAB“披挂ArmourTM”无菌单用途披挂的效率。
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引用次数: 0
The effects of thymoquinone and cytozine arabinoside on apoptosis and cell proliferation in acute myeloide leukemia 胸腺醌和阿糖胞苷对急性粒细胞白血病细胞凋亡和增殖的影响
Pub Date : 2022-10-11 DOI: 10.17352/2581-5407.000047
Altun Aslı, Kara Nurten, Tural Şengül, Yıldıran Alişan, Tomak Leman
Purpose: The aim of this study was to investigate the effects of a chemotherapeutic agent Cytosine Arabinoside (Ara-C) and a natural anticancer agent of Thymoquinone (TQ) on apoptosis and cell proliferation of AML cell lines (Kasumi-6) both alone and in combined form. Material and method: Kasumi-6 AML cells were treated with three different doses of Ara-C (0.1, 0.5 and 1 µmol) and TQ (25, 50 and 100 µM) for 48 and 72 hours incubations. After Annexin V and Propidium Iodide (PI) staining, apoptosis, viability, and cell proliferation were evaluated for each group in flow cytometry. Results: As a result, AML cell lines showed a statistically significant difference in a single treatment of the active substances. Their combined treatment showed an increase in apoptosis and a decrease in viability in both groups at 48 and 72 hours incubation times (p < 0.001). In each group, it was observed that apoptosis was increased and viability was decreased and consequently cell proliferation was suppressed. Conclusion: Ara-C was used for the first time in this study with TQ in AML. It was determined that the combined use of TQ and Ara-C did not have a synergistic effect on apoptosis.
目的:本研究的目的是研究化疗剂阿糖胞苷(Ara-C)和天然抗癌剂胸腺醌(TQ)对AML细胞系(Kasumi-6)凋亡和细胞增殖的影响,无论是单独还是联合使用。材料和方法:用三种不同剂量的Ara-C(0.1、0.5和1µmol)和TQ(25、50和100µM)处理Kasumi-6 AML细胞48和72小时孵育。在膜联蛋白V和碘化丙啶(PI)染色后,在流式细胞术中评估各组的细胞凋亡、活力和细胞增殖。结果:因此,AML细胞系在单一活性物质处理中显示出统计学上的显著差异。它们的联合治疗显示,在培养48小时和72小时时,两组的细胞凋亡增加,生存能力下降(p<0.001)。在每组中,观察到细胞凋亡增加、生存能力下降,因此细胞增殖受到抑制。结论:本研究首次将Ara-C与TQ联合应用于AML。已确定TQ和Ara-C的联合使用对细胞凋亡没有协同作用。
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引用次数: 0
A first comprehensive look at the order-disorder nature of RTK KIT native and carcinogenic targets 首先全面了解RTK KIT原生和致癌靶标的有序-无序性质
Pub Date : 2022-10-07 DOI: 10.17352/2581-5407.000046
Tchertanov Luba, Ledoux Julie
Receptors Tyrosine Kinases (RTKs) act as sensors for extracellular ligands, the binding of which triggers dimerization, activation, and autophosphorylation of specific tyrosine (Y) residues in the Cytoplasmic Domain (CD). This leads to the recruitment and activation of multiple downstream signaling proteins, which regulate various aspects of cellular physiology.
受体酪氨酸激酶(RTKs)作为细胞外配体的传感器,其结合触发细胞质结构域(CD)中特定酪氨酸(Y)残基的二聚化、活化和自磷酸化。这导致多种下游信号蛋白的募集和激活,这些蛋白调节细胞生理学的各个方面。
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引用次数: 0
Clinical trials cannot provide sufficient accuracy for studying weak factors necessary for curing chronic diseases 临床试验不能为研究慢性疾病治疗所需的弱因子提供足够的准确性
Pub Date : 2022-03-23 DOI: 10.17352/2581-5407.000044
Wu Jianqing, Zhao Ping
Chronic diseases are still known as incurable diseases, and we suspect that the medical research model is unfit for characterizing chronic diseases. In this study, we examined accuracy and reliability required for characterizing chronic diseases, reviewed implied presumptions in clinical trials and assumptions used in statistical analysis, examined sources of variances normally encountered in clinical trials, and conducted numeric simulations by using hypothetical data for several theoretical and hypothetical models. We found that the sources of variances attributable to personal differences in clinical trials can distort hypothesis test outcomes, that clinical trials introduce too many errors and too many inaccuracies that tend to hide weak and slow-delivering effects of treatments, and that the means of treatments used in statistical analysis have little or no relevance to specific patients. We further found that a large number of uncontrolled co-causal or interfering factors normally seen in human beings can greatly enlarge the means and the variances or experimental errors, and the use of high rejection criteria (e.g., small p values) further raises the chances of failing to find treatment effects. As a whole, we concluded that the research model using clinical trials is wrong on multiple grounds under any of our realistic theoretical and hypothetical models, and that misuse of statistical analysis is most probably responsible for failure to identify treatment effects for chronic diseases and failure to detect harmful effects of toxic substances in the environment. We proposed alternative experimental models involving the use of single-person or mini optimization trials for studying low-risk weak treatments.
慢性病仍然被认为是不治之症,我们怀疑医学研究模式不适合表征慢性病。在本研究中,我们检查了表征慢性疾病所需的准确性和可靠性,回顾了临床试验中的隐含假设和统计分析中使用的假设,检查了临床试验中通常遇到的方差来源,并通过使用几种理论和假设模型的假设数据进行了数值模拟。我们发现,临床试验中可归因于个人差异的差异来源可能会扭曲假设检验结果,临床试验引入了太多的错误和不准确,这些错误和不准确往往会掩盖治疗的微弱和缓慢递送效果,并且统计分析中使用的治疗手段与特定患者的相关性很小或没有相关性。我们进一步发现,通常在人类中看到的大量不受控制的共同因果或干扰因素可以极大地扩大平均值和方差或实验误差,并且使用高排斥标准(例如,小p值)进一步增加了未能发现治疗效果的机会。总的来说,我们得出的结论是,使用临床试验的研究模型在我们任何现实的理论和假设模型下都是错误的,而且统计分析的滥用很可能是未能确定慢性病的治疗效果和未能检测到环境中有毒物质的有害影响的原因。我们提出了其他实验模型,包括使用单人试验或小型优化试验来研究低风险弱治疗。
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引用次数: 0
Surgery, Chemotherapy and Radiotherapy May Promote Cancer Growth Speeds and Shorten Patient Lives 手术、化疗和放疗可能会加快癌症的生长速度,缩短患者的生命
Pub Date : 2022-03-19 DOI: 10.17352/2581-5407.000043
Wu Jianqing, Z. Ping
Medicine fails to find predictable cures for cancer in more than a century, and we explored the feasibility of controlling cancer growth speed by using lifestyle factors. After conducting an extensive literature review, we conducted simulations for cancer growth courses to see the feasibility of controlling cancer growth speeds. We found that (1) medical treatments are often accompanied by three to four lethal factors: treatment side-effects, emotional distress, and chronic stress, reduced exercises and physical inactivity, and excessive nutrition in some cases; (2) clinical trial exaggerates treatments short-term benefits and underestimates the slow-delivering adverse side effects as a result of statistical averaging, interfering effects of personal lifestyle factors and insufficient follow-up times; (3) the benefits of medical treatments are limited by chain comparisons, where surgery may work as a negative standard relative to the best alternatives for resolving cancer; (4) the strategy of destroying the tumor or killing all cancer cells is unworkable; (5) medical treatments can turn natural cancer growth curve into approximately doubly exponential curve; (6) multiple-factor non-medical measures are potentially much more powerful than medical treatments in controlling cancer growth and metastasis speeds; and (7) cancer early diagnosis and over treatments are unwise strategies in light of discoveries. Based on huge increases in cancer growth rate constants, substantial loss of vital organ functional capacity, and severe systemic aging-like cellular damages, we concluded that medical treatments may promote cancer growth and metastasis speeds and shorten patient lives in most situations, and the claimed benefits are caused by triple biases of clinical trials. By using the same method to explore how several lifestyle factors affect cancer growth rates, we concluded that the better strategy for ending the global cancer epidemic in the future is changing caner treatment strategy from killing cancer cells to slowing down cancer growth rates by using various lifestyle factors in combination. This study in part explains why cancer can self-resolve.
一个多世纪以来,医学未能找到可预测的癌症治疗方法,我们探索了利用生活方式因素控制癌症生长速度的可行性。在进行了广泛的文献综述后,我们对癌症生长过程进行了模拟,以了解控制癌症生长速度的可行性。我们发现:(1)药物治疗往往伴随着三到四个致命因素:治疗副作用、情绪困扰和慢性压力、运动减少和身体不活动,以及在某些情况下营养过剩;(2) 由于统计平均值、个人生活方式因素的干扰作用和随访时间不足,临床试验夸大了治疗的短期益处,低估了缓慢产生的不良副作用;(3) 医学治疗的益处受到连锁比较的限制,在连锁比较中,相对于解决癌症的最佳替代方案,手术可能是一个负面标准;(4) 摧毁肿瘤或杀死所有癌症细胞的策略是不可行的;(5) 药物治疗可以将癌症的自然增长曲线转变为近似双指数曲线;(6) 在控制癌症生长和转移速度方面,多因子非医学措施可能比医学治疗更有效;(7)癌症的早期诊断和过度治疗是不明智的策略。基于癌症生长速率常数的大幅增加、重要器官功能能力的大幅丧失和严重的系统性类似想象的细胞损伤,我们得出结论,在大多数情况下,药物治疗可能会促进癌症的生长和转移速度,缩短患者的生命,而声称的益处是由临床试验的三重偏见造成的。通过使用相同的方法来探索几种生活方式因素如何影响癌症生长率,我们得出结论,未来结束全球癌症流行的更好策略是通过结合使用各种生活方式因素,将癌症治疗策略从杀死癌症细胞改变为减缓癌症生长率。这项研究部分解释了为什么癌症可以自我解决。
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引用次数: 1
Photodynamic therapy in a pleural cavity using monte carlo simulations with 2D/3D Graphical Visualization. 利用蒙特卡罗模拟和2D/3D图形可视化技术进行胸膜腔光动力治疗。
Pub Date : 2022-01-01 DOI: 10.17352/2581-5407.000045
K Beeson, E Parilov, Mary Potasek, T Zhu, H Sun, D Sourvanos
Cancer therapy using Photodynamic Therapy (PDT) has been investigated for some time [1,2] and now it is a growing area of interest in clinical trials [3]. Monte Carlo (MC) simulations were used for early laboratory studies [4,5] for analysis in PDT. Various improvements in the MC method have advanced the field in recent years.
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引用次数: 2
期刊
Global journal of cancer therapy
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