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Exploring the Synergistic Effects of Concurrent Exercise for Managing Type-II Diabetes Mellitus: A Meta-Analysis. 探索同时锻炼对控制 II 型糖尿病的协同作用:元分析。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1355
Uroosa Amin, Qurat-Ul-Ain Adnan, Tauseef Ahmad, Sumaira Imran Farooqui

The effectiveness of concurrent exercise (CE) as an emerging approach for type-II diabetes mellitus (T2DM) patients was evaluated through a comprehensive search on Google Scholar, PubMed, Pedro, CINAHL, and Medline from 2015 to March 2023. Sixteen RCTs were selected which evaluated CE (aerobic + resistance in the same session) effects on a minimum of three days/week among T2DM patients, and the control group received usual care or no exercise. Studies that evaluated at least one glycaemic variable, i.e. HbA1C, fasting blood glucose level (FBGL), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), were eligible. Intervention with a follow-up period of ≥8 weeks, patients of any age and gender, and literature in the English language were included. A rigorous review was performed using the Cochrane Collaboration risk of bias tool (RoB 2) to minimise biases, which include the randomisation process, deviation from intended intervention, missing outcome data, outcome measurement, and selection bias. CE significantly improved HbA1C (95% CI of -0.654 to 0.363, I2 = 84.92% moderate heterogeneity), FBGL (95% CI of -0.239 to 1.145, I2 = 93.74% - high level of heterogeneity), and insulin resistance (HOMA-IR) (95% CI of -0.593 to 0.544, I2 = 92.85% - high level of heterogeneity). Collectively, findings indicate the potential of CE as an intervention to impact glycaemic control in T2DM patients positively. However, the relatively high I² values suggest notable variability among studies, and further research to explore the factors contributing to this heterogeneity, exercise protocol along with progression, and duration of diabetes are needed, which is more challenging to determine a precise dose-response relationship. Therefore, more studies are required to provide thorough insights into these components for T2DM management. Key Words: Glycated haemoglobin, Glycaemic control, Insulin resistance, Physical exercise, Type-II diabetes mellitus.

从 2015 年到 2023 年 3 月,我们在谷歌学术、PubMed、Pedro、CINAHL 和 Medline 上进行了全面搜索,评估了同期运动(CE)作为一种新方法对 II 型糖尿病(T2DM)患者的疗效。研究选取了 16 项 RCT,这些研究对 T2DM 患者每周至少三天的 CE(有氧运动+阻力运动)效果进行了评估,对照组则接受常规护理或不做运动。符合条件的研究至少评估了一个血糖变量,即 HbA1C、空腹血糖水平 (FBGL) 和胰岛素抵抗静态模型评估 (HOMA-IR)。随访时间≥8 周的干预措施、任何年龄和性别的患者以及英文文献均可纳入。采用 Cochrane 协作组织的偏倚风险工具(RoB 2)进行了严格审查,以尽量减少偏倚,其中包括随机化过程、偏离预期干预、结果数据缺失、结果测量和选择偏倚。CE明显改善了HbA1C(95% CI为-0.654至0.363,I2=84.92%,中度异质性)、FBGL(95% CI为-0.239至1.145,I2=93.74%,高度异质性)和胰岛素抵抗(HOMA-IR)(95% CI为-0.593至0.544,I2=92.85%,高度异质性)。总之,研究结果表明,作为一种干预措施,CE 有可能对 T2DM 患者的血糖控制产生积极影响。然而,相对较高的 I² 值表明各研究之间存在显著的差异,需要进一步研究探讨导致这种异质性的因素、运动方案与进展以及糖尿病持续时间,这对确定精确的剂量-反应关系更具挑战性。因此,需要进行更多的研究,以深入了解这些因素对 T2DM 管理的影响。关键字糖化血红蛋白 血糖控制 胰岛素抵抗 体育锻炼 II型糖尿病
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引用次数: 0
Impact of Simultaneous Presence of Multiple PML-RARA Isoforms on Phenotype in Patients with Acute Promyelocytic Leukaemia. 同时存在多种 PML-RARA 异构体对急性早幼粒细胞白血病患者表型的影响
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1294
Emine Goktas, Ayse Gul Zamani, Mahmut Selman Yildirim, Sinan Demircioglu, Atakan Tekinalp, Ozcan Ceneli

Objective: To determine the coexistence of multiple PML-RARA transcripts in adult APL (acute promyelotic leukaemia) patients, and its impact on  the patients' laboratory parameters, treatment responses, and prognoses.

Study design: Cross-sectional study. Place and Duration of the Study: Department of Medical Genetics, Medical Faculty of Necmettin Erbakan University, Konya, Turkiye, from January 2015 to March 2023.

Methodology: The study group consisted of individuals diagnosed with APL. RNA isolation was performed by taking blood or bone marrow samples and the presence of breakpoints in PML-RARA bcr1, bcr2, and bcr3 was detected using the real-time PCR. However, the quantification of PML-RARA fusion transcripts cannot be provided using the utilised kit.

Results: Twelve women and eight men were examined with a mean age of 38 years (range: 19-80), and 46.5 years (range: 22-60) were examined, respectively. When evaluating patients based on isoforms, it was found that 40% had multiple isoforms. Nineteen (95%) patients achieved haematologic remission after the treatment. Only one patient who had three different isoforms did not achieve remission. The estimated median survival for patients with a single isoform and those with multiple isoforms was 78.1 months (95% CI: 37.8-117.6) and 71.7 months (46.2-97.2), respectively. Two of the patients with multiple isoforms were lost in the early stage, whereas no early-stage mortality was recorded among patients with a single isoform.

Conclusion: Identifying PML-RARA isoform subtypes is important for predicting prognosis and informing clinical follow-up.

Key words: Acute promyelocytic leukaemia, Breakpoint cluster region, Isoform, PML-RARA.

研究目的研究设计:横断面研究:横断面研究。研究地点和时间土耳其科尼亚内克梅廷-埃尔巴坎大学医学院医学遗传学系,2015年1月至2023年3月:研究组由确诊为 APL 的患者组成。通过采集血液或骨髓样本进行 RNA 分离,并使用实时 PCR 检测 PML-RARA bcr1、bcr2 和 bcr3 是否存在断点。然而,使用所使用的试剂盒无法提供 PML-RARA 融合转录本的定量结果:受检者中有 12 名女性和 8 名男性,平均年龄分别为 38 岁(19-80 岁)和 46.5 岁(22-60 岁)。根据同种异构体对患者进行评估时发现,40%的患者具有多种同种异构体。19名患者(95%)在治疗后获得了血液学缓解。只有一名有三种不同同工酶的患者没有得到缓解。单一异构体和多重异构体患者的估计中位生存期分别为 78.1 个月(95% CI:37.8-117.6)和 71.7 个月(46.2-97.2)。多同工酶型患者中有两人在早期死亡,而单一同工酶型患者没有早期死亡记录:结论:识别PML-RARA同工酶亚型对预测预后和临床随访具有重要意义:急性早幼粒细胞白血病 断点簇区 同工型 PML-RARA
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引用次数: 0
Identification and Validation of a Novel PANoptosis-related Gene Signatured for Osteosarcoma as Prognostic Model. 鉴定和验证骨肉瘤的新型 PANoptosis 相关基因签名作为预后模型
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1315
Xianglin Peng, Wanchun Wang

Objective: To construct and validate a prognostic model for osteosarcoma prognostication and therapeutic potential of PANoptosis- related genes.

Study design: Observational study. Place and Duration of the Study: Department of Orthopaedics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China, from August 2021 to January 2024.

Methodology: Transcriptomic data from the GEO and TARGET databases were utilised to construct and validate a prognostic model for osteosarcoma. The analysis involved the use of the LASSO Cox-regression method with the Glmnet R package to identify key PANoptosis-related genes. Differential gene expression analysis was conducted using the Limma R package, and model validation was performed using Kaplan-Meier survival analysis and time-dependent ROC curves.

Results: This model, derived from five key PANoptosis-related genes, demonstrated significant predictive capability for patient survival across training and validation cohorts. Further analysis confirmed the model's effectiveness and identified metastasis stage and risk scores as the robust independent prognostic indicators.

Conclusion: The prognostic model offers a novel tool for osteosarcoma prognostication and underscores the therapeutic potential of targeting PANoptosis-related pathways.

Key words: PANoptosis-related genes, Osteosarcoma, Prognosis, Bioinformatics, Tumour micro-environment.

研究目的构建并验证骨肉瘤预后模型,以及 PANoptosis 相关基因的治疗潜力:观察性研究。研究地点和时间研究地点和时间:中国湖南长沙中南大学湘雅二医院骨科,2021年8月至2024年1月:方法:利用GEO和TARGET数据库中的转录组数据构建并验证骨肉瘤预后模型。分析中使用了LASSO Cox回归法和Glmnet R软件包,以确定关键的PAN凋亡相关基因。使用Limma R软件包进行了差异基因表达分析,并使用Kaplan-Meier生存分析和随时间变化的ROC曲线对模型进行了验证:结果:该模型由五个关键的 PANoptosis 相关基因衍生而来,在训练和验证队列中对患者的生存率具有显著的预测能力。进一步的分析证实了该模型的有效性,并确定转移分期和风险评分是可靠的独立预后指标:结论:该预后模型为骨肉瘤预后提供了一种新工具,并强调了靶向PAN凋亡相关通路的治疗潜力:PAN凋亡相关基因 骨肉瘤 预后 生物信息学 肿瘤微环境
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引用次数: 0
Immunomodulatory Potential of Melatonin in Immunosuppression: An in-vivo Study. 褪黑素在免疫抑制中的免疫调节潜力:体内研究
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1270
Aamina Quddus Qureshi, Saghir Ahmed Jafri, Ambreen Tauseef, Waqar Ahmed Siddiqui, Amna Irum, Ayela Eman Zia

Objective: To assess the immunomodulatory effects of melatonin on the acquired immunity of immunosuppressed male Wistar rats by checking Interleukin 6 (IL-6) levels, total leucocyte counts (TLC), and differential leucocyte counts.

Study design: Experimental study. Place and Duration of the Study: Animal laboratory, CMH Lahore Medical College, from June to October 2023.

Methodology: Fifty male Wistar rats, weighing 180g to 200g, were included in this study with 10 rats in each of the five groups namely cyclophosphamide (CP), CP + melatonin, CP + immunomodulator, melatonin-only, and control. A calculated dose of CP was administered intraperitoneally for 30 days (from 13/06/23 to 13/07/23) to each group except the control groups. After this, the experimental group was given melatonin CP + Melatonin for 7 days (from 14/07/23 to 20/07/23). CP + Immunomodulatory group was kept for comparison of immunomodulatory effects. Blood samples were drawn from all 5 groups. IL-6 was estimated through ELISA. Other parameters assessed were TLC and absolute differential leucocyte counts.

Results: Melatonin increased IL-6 levels significantly (p = 0.042) as well as the TLC levels (p <0.001) compared to the immuno-suppressed CP group. Melatonin was seen to have an upregulation of IL-6 levels in immunosuppression compared to the administration of immunomodulator preparation (p = 0.506) which was not as effective. Administration of melatonin significantly increased the TLC, neutrophil, lymphocyte, monocyte, and eosinophil count compared to known immunomodulators.

Conclusion: Melatonin as a supplement may have some role in activating multiple immune response processes in immune-depressed states. It was also established that it allows quick recovery of cell components from immunosuppressed states.

Key words: Melatonin, Immunomodulation, Rats, Interleukin-6, Acquired immunity, Cyclophosphamide.

目的通过检测白细胞介素6(IL-6)水平、白细胞总数(TLC)和差异白细胞计数,评估褪黑素对免疫抑制雄性Wistar大鼠获得性免疫的免疫调节作用:实验研究。研究地点和时间:2023 年 6 月至 10 月,拉合尔医学院动物实验室:研究对象:50 只雄性 Wistar 大鼠,体重 180 克至 200 克,分为环磷酰胺 (CP)、CP + 褪黑激素、CP + 免疫调节剂、纯褪黑激素和对照组五组,每组 10 只。除对照组外,每组均腹腔注射计算剂量的 CP 30 天(13/06/23 至 13/07/23)。之后,实验组给予褪黑素 CP + 褪黑素 7 天(从 14/07/23 到 20/07/23)。保留 CP + 免疫调节组,以比较免疫调节效果。从所有 5 组中抽取血液样本。通过 ELISA 测定 IL-6。其他评估参数包括TLC和绝对差异白细胞计数:结果:褪黑素能显著提高 IL-6 水平(p = 0.042)和 TLC 水平(p 结论:褪黑素作为一种补充剂,可能对人体有一定的调节作用:褪黑素作为一种补充剂,可能在激活免疫抑制状态下的多种免疫反应过程中发挥一定作用。此外,褪黑素还能使免疫抑制状态下的细胞成分快速恢复:褪黑素 免疫调节 大鼠 白细胞介素-6 后天免疫 环磷酰胺
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引用次数: 0
Preoperative Ultrasound-Guided Marking, Mammogram, and Peroperative Use of Image Intensifier: A Cost-Effective Technique in Clipped Non-Palpable Breast Cancer Lesions to Achieve Adequate Surgical Margins. 术前超声引导标记、乳腺造影和围手术期使用图像增强器:一种经济有效的技术,用于切除无法触及的乳腺癌病灶,以获得足够的手术边缘。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1364
Amna Masud, Huma Majeed Khan, Eisha Tahir, Anam Waseem, Hafsa Ahmed, Rabia Ikram

Objective: To measure the effectiveness of localisation and removal of impalpable target lesions without compromising patient safety in a resource-limited setup using preoperative ultrasound and mammography with peroperative use of C-arm image intensifier.

Study design: Descriptive study. Place and Duration of the Study: Department of Breast Surgery, Ittefaq Hospital (Trust), Lahore, Pakistan, from 25th October 2011 to 17th February 2023.

Methodology: All the breast cancer patients who achieved complete clinical response after neoadjuvant systemic treatment and underwent breast conservation surgery during the study period were included. Tumour / clip localisation was done using preoperative ultrasound or image-guided marking, a 2-view mammogram in all cases and the use of an image intensifier to confirm the presence of clips in the excised specimen. The primary outcome was the accurate localisation and removal of the index lesion, while the secondary outcome included the reoperation rate for positive margins and early local recurrence.

Results: Data from 144 patients were reviewed. Successful localisation was done in all the patients; only one patient had a positive margin for ductal carcinoma-in situ (DCIS), achieving a 99.3% clear margin rate. Local recurrence within two years after primary operation was seen in one patient only.  Conclusion: By a combined approach of preoperative ultrasound-guided marking, a 2-view mammogram, and the use of image intensifier, successful localisation of an impalpable breast lesion is possible without compromising oncological and aesthetic principles.

Key words: Breast conservation surgery, Localisation, Non-palpable, Margins, Image intensifier.

目的在资源有限的情况下,利用术前超声波和乳腺造影术,并在围手术期使用 C 型臂图像增强器,在不影响患者安全的前提下,测量定位和切除不可触及的靶病灶的有效性:描述性研究。研究地点和时间:研究地点和时间:巴基斯坦拉合尔伊特法克医院(信托)乳腺外科,2011 年 10 月 25 日至 2023 年 2 月 17 日:纳入所有在新辅助系统治疗后获得完全临床反应并在研究期间接受保乳手术的乳腺癌患者。肿瘤/夹子定位采用术前超声或图像引导标记,所有病例均采用双视角乳腺造影,并使用图像增强仪确认切除标本中是否存在夹子。主要结果是准确定位和切除指标病灶,次要结果包括边缘阳性和早期局部复发的再手术率:结果:共审查了 144 名患者的数据。所有患者均成功定位;只有一名患者的导管原位癌(DCIS)边缘阳性,边缘清晰率达到99.3%。只有一名患者在初次手术后两年内局部复发。 结论通过术前超声引导标记、双视角乳腺造影和使用图像增强器等综合方法,可以在不影响肿瘤学和美学原则的前提下成功定位无法发现的乳腺病灶:关键词: 保乳手术 定位 不可触及 边缘 图像增强器
{"title":"Preoperative Ultrasound-Guided Marking, Mammogram, and Peroperative Use of Image Intensifier: A Cost-Effective Technique in Clipped Non-Palpable Breast Cancer Lesions to Achieve Adequate Surgical Margins.","authors":"Amna Masud, Huma Majeed Khan, Eisha Tahir, Anam Waseem, Hafsa Ahmed, Rabia Ikram","doi":"10.29271/jcpsp.2024.11.1364","DOIUrl":"10.29271/jcpsp.2024.11.1364","url":null,"abstract":"<p><strong>Objective: </strong>To measure the effectiveness of localisation and removal of impalpable target lesions without compromising patient safety in a resource-limited setup using preoperative ultrasound and mammography with peroperative use of C-arm image intensifier.</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Department of Breast Surgery, Ittefaq Hospital (Trust), Lahore, Pakistan, from 25th October 2011 to 17th February 2023.</p><p><strong>Methodology: </strong>All the breast cancer patients who achieved complete clinical response after neoadjuvant systemic treatment and underwent breast conservation surgery during the study period were included. Tumour / clip localisation was done using preoperative ultrasound or image-guided marking, a 2-view mammogram in all cases and the use of an image intensifier to confirm the presence of clips in the excised specimen. The primary outcome was the accurate localisation and removal of the index lesion, while the secondary outcome included the reoperation rate for positive margins and early local recurrence.</p><p><strong>Results: </strong>Data from 144 patients were reviewed. Successful localisation was done in all the patients; only one patient had a positive margin for ductal carcinoma-in situ (DCIS), achieving a 99.3% clear margin rate. Local recurrence within two years after primary operation was seen in one patient only.  Conclusion: By a combined approach of preoperative ultrasound-guided marking, a 2-view mammogram, and the use of image intensifier, successful localisation of an impalpable breast lesion is possible without compromising oncological and aesthetic principles.</p><p><strong>Key words: </strong>Breast conservation surgery, Localisation, Non-palpable, Margins, Image intensifier.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 11","pages":"1364-1368"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570781","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}
引用次数: 0
Prognostic Factors Affecting Day+100 Survival in Patients Undergoing Allogeneic Haematopoietic Stem Cell Transplantation for Acute Leukaemia - A Single Centre Experience. 影响急性白血病异基因造血干细胞移植患者第 100 天存活率的预后因素--单中心经验。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1287
Awais Siddiq, Mehreen Ali Khan, Jehanzeb Ur Rehman, Yasir Abbas, Hashim Khan, Uzma Rahim

Objective: To determine the factors affecting the first 100 days of survival in acute leukaemia patients undergoing allogeneic haematopoietic stem cell transplantation (Allo-HSCT).

Study design: Descriptive study. Place and Duration of the Study: Bone Marrow Transplant Centre, Rawalpindi, Pakistan, from March 2016 to February 2022.

Methodology: Patients with acute myeloid leukaemia (AML) or acute lymphoblastic leukaemia (ALL) in complete remission (CR) undergoing Allo-HSCT were included. Data were collected on patient demographics, diagnosis, remission status, pre-transplant analysis, donor compatibility, conditioning regimen, GVHD prophylaxis, engraftment times, post-transplant complications, mortality causes, and overall survival (OS) at 100 days.

Results: Among 101 transplant recipients (mean age of 24 ± 11.05 years; n = 76 males, n = 25 females), 41 had AML and 60 had ALL. Ninety patients underwent matched sibling donor (MSD)-HSCT, while 11 had haplo-identical sibling-HSCT. Patients ≤13 years had higher survival rates than older patients (94.4% vs. 67.5%, p = 0.03). High pre-transplant serum ferritin levels (>2500 mg/dl) predicted lower OS (48.9% vs. 100% in ferritin <1000 mg/dl, p <0.01). AML patients had a survival advantage over ALL patients (82.9% vs. 65%, p = 0.05). Early neutrophil engraftment within 14 days correlated with better survival (96.4% vs. 54.3%, p <0.01). Lastly, severe mucositis also adversely affected survival (60% in Grade III vs. 9.5% in Grade IV, p <0.01).

Conclusion: Identifying modifiable factors can improve long-term support and follow-up, enhancing the patient outcomes in underdeveloped nations.

Key words: Haematopoietic stem cell transplant, Day + 100 survival, Acute leukaemia, Pakistan.

研究目的确定影响接受异基因造血干细胞移植(Allo-HSCT)的急性白血病患者头100天存活率的因素:描述性研究。研究地点和时间:巴基斯坦拉瓦尔品第骨髓移植中心,2016年3月至2022年2月:纳入接受异体骨髓移植(Allo-HSCT)的完全缓解(CR)的急性髓性白血病(AML)或急性淋巴细胞白血病(ALL)患者。收集的数据包括患者人口统计学、诊断、缓解状态、移植前分析、供体相容性、调理方案、GVHD预防、移植时间、移植后并发症、死亡原因和100天的总生存率(OS):在101名移植受者(平均年龄为24±11.05岁;男性76人,女性25人)中,41人患有急性髓细胞白血病,60人患有急性淋巴细胞白血病。90名患者接受了匹配的同胞供体(MSD)-HSCT,11名患者接受了单倍体同胞供体-HSCT。13岁以下患者的存活率高于年龄较大的患者(94.4% vs. 67.5%,P = 0.03)。移植前血清铁蛋白水平过高(>2500 mg/dl)预示着较低的OS(48.9%对100%):确定可改变的因素可改善长期支持和随访,提高欠发达国家患者的治疗效果:造血干细胞移植 第100天存活率 急性白血病 巴基斯坦
{"title":"Prognostic Factors Affecting Day+100 Survival in Patients Undergoing Allogeneic Haematopoietic Stem Cell Transplantation for Acute Leukaemia - A Single Centre Experience.","authors":"Awais Siddiq, Mehreen Ali Khan, Jehanzeb Ur Rehman, Yasir Abbas, Hashim Khan, Uzma Rahim","doi":"10.29271/jcpsp.2024.11.1287","DOIUrl":"10.29271/jcpsp.2024.11.1287","url":null,"abstract":"<p><strong>Objective: </strong>To determine the factors affecting the first 100 days of survival in acute leukaemia patients undergoing allogeneic haematopoietic stem cell transplantation (Allo-HSCT).</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Bone Marrow Transplant Centre, Rawalpindi, Pakistan, from March 2016 to February 2022.</p><p><strong>Methodology: </strong>Patients with acute myeloid leukaemia (AML) or acute lymphoblastic leukaemia (ALL) in complete remission (CR) undergoing Allo-HSCT were included. Data were collected on patient demographics, diagnosis, remission status, pre-transplant analysis, donor compatibility, conditioning regimen, GVHD prophylaxis, engraftment times, post-transplant complications, mortality causes, and overall survival (OS) at 100 days.</p><p><strong>Results: </strong>Among 101 transplant recipients (mean age of 24 ± 11.05 years; n = 76 males, n = 25 females), 41 had AML and 60 had ALL. Ninety patients underwent matched sibling donor (MSD)-HSCT, while 11 had haplo-identical sibling-HSCT. Patients ≤13 years had higher survival rates than older patients (94.4% vs. 67.5%, p = 0.03). High pre-transplant serum ferritin levels (>2500 mg/dl) predicted lower OS (48.9% vs. 100% in ferritin <1000 mg/dl, p <0.01). AML patients had a survival advantage over ALL patients (82.9% vs. 65%, p = 0.05). Early neutrophil engraftment within 14 days correlated with better survival (96.4% vs. 54.3%, p <0.01). Lastly, severe mucositis also adversely affected survival (60% in Grade III vs. 9.5% in Grade IV, p <0.01).</p><p><strong>Conclusion: </strong>Identifying modifiable factors can improve long-term support and follow-up, enhancing the patient outcomes in underdeveloped nations.</p><p><strong>Key words: </strong>Haematopoietic stem cell transplant, Day + 100 survival, Acute leukaemia, Pakistan.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 11","pages":"1287-1293"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570782","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}
引用次数: 0
Nodular Melanoma Presenting with Cutaneous Horn and Displaying Rhabdoid Features: An Unusual Presentation. 结节型黑色素瘤伴有皮肤角并显示横纹肌样特征:不寻常的表现
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1396
Asuman Kilitci

Null.

无效。
{"title":"Nodular Melanoma Presenting with Cutaneous Horn and Displaying Rhabdoid Features: An Unusual Presentation.","authors":"Asuman Kilitci","doi":"10.29271/jcpsp.2024.11.1396","DOIUrl":"10.29271/jcpsp.2024.11.1396","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 11","pages":"1396-1397"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570740","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}
引用次数: 0
Prognostic Value of Preoperative Systemic Immune-Inflammation Index in Non-Metastatic Paediatric Wilms' Tumour Patients Undergoing Upfront Radical Nephrectomy. 接受前期根治性肾切除术的非转移性儿科 Wilms' 肿瘤患者术前全身免疫炎症指数的预后价值
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1327
Kai Sai, Yi-Bo Ding, Qun Gao

Objective: To analyse the relationship between the preoperative systemic immune-inflammation index (SII) and the relapse-free survival (RFS) of paediatric patients with Wilms' tumour (WT) after radical surgery, and to establish and validate a prognostic survival model.

Study design: Observational study. Place and Duration of the Study: Department of Oncologic Surgery, Anhui Children's Hospital of Fudan University, Hefei, China, from January 2013 to August 2023.

Methodology: A retrospective analysis was conducted on 79 WT patients treated with radical resection, with their preoperative SII values computed. The best cut-off for SII was determined through the ROC curve, categorising patients into high and low SII groups. The Kaplan-Meier method and Cox-regression were used for survival analysis. A survival prognostic model was constructed and its predictive capability gauged (AUC of the ROC).

Results: The study included 79 WT patients with a median RFS of 65 months and an average of 75.5 ± 3.4 months. The optimal cut-off value for SII was 534.95. The low SII group had a higher RFS (Log-rank: χ2 = 9.380, p = 0.002). Preoperative SII (HR = 3.277, 95% CI: 1.167 - 9.200, p = 0.024), clinical staging (HR = 8.408, 95% CI: 2.604 - 27.147, p <0.001), and tissue differentiation (HR = 2.237, 95% CI: 1.043 - 5.828, p = 0.039) were independent risk factors for RFS. The model's diagnostic performance was 0.749 (95% CI: 0.636 - 0.861). Internal validation showed an AUC of 0.723 (95% CI: 0.608 - 0.838).

Conclusion: Lower preoperative SII suggests a more favourable prognosis. The SII-based nomogram efficiently forecasts post-radical surgery prognosis for WT.

Key words: Wilms' Tumour, Systemic immune-inflammation index, Relapse-free survival, Nomogram.

研究目的分析Wilms'肿瘤(WT)儿科患者术前全身免疫炎症指数(SII)与根治术后无复发生存率(RFS)之间的关系,并建立和验证预后生存模型:观察性研究。研究地点和时间研究地点和时间:中国合肥复旦大学附属安徽儿童医院肿瘤外科,2013年1月至2023年8月:对79例接受根治性切除术的WT患者进行回顾性分析,计算其术前SII值。通过ROC曲线确定SII的最佳临界值,将患者分为高SII组和低SII组。采用 Kaplan-Meier 法和 Cox 回归法进行生存分析。构建了生存预后模型,并对其预测能力(ROC 的 AUC)进行了评估:研究共纳入 79 例 WT 患者,中位 RFS 为 65 个月,平均为(75.5 ± 3.4)个月。SII 的最佳临界值为 534.95。低 SII 组的 RFS 较高(Log-rank:χ2 = 9.380,P = 0.002)。术前 SII(HR = 3.277,95% CI:1.167 - 9.200,P = 0.024)、临床分期(HR = 8.408,95% CI:2.604 - 27.147,P 结论:术前 SII 值越低,预后越好。基于SII的提名图能有效预测WT根治术后的预后:Wilms' Tumour 全身免疫炎症指数 无复发生存期 直方图
{"title":"Prognostic Value of Preoperative Systemic Immune-Inflammation Index in Non-Metastatic Paediatric Wilms' Tumour Patients Undergoing Upfront Radical Nephrectomy.","authors":"Kai Sai, Yi-Bo Ding, Qun Gao","doi":"10.29271/jcpsp.2024.11.1327","DOIUrl":"10.29271/jcpsp.2024.11.1327","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the relationship between the preoperative systemic immune-inflammation index (SII) and the relapse-free survival (RFS) of paediatric patients with Wilms' tumour (WT) after radical surgery, and to establish and validate a prognostic survival model.</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Oncologic Surgery, Anhui Children's Hospital of Fudan University, Hefei, China, from January 2013 to August 2023.</p><p><strong>Methodology: </strong>A retrospective analysis was conducted on 79 WT patients treated with radical resection, with their preoperative SII values computed. The best cut-off for SII was determined through the ROC curve, categorising patients into high and low SII groups. The Kaplan-Meier method and Cox-regression were used for survival analysis. A survival prognostic model was constructed and its predictive capability gauged (AUC of the ROC).</p><p><strong>Results: </strong>The study included 79 WT patients with a median RFS of 65 months and an average of 75.5 ± 3.4 months. The optimal cut-off value for SII was 534.95. The low SII group had a higher RFS (Log-rank: χ2 = 9.380, p = 0.002). Preoperative SII (HR = 3.277, 95% CI: 1.167 - 9.200, p = 0.024), clinical staging (HR = 8.408, 95% CI: 2.604 - 27.147, p <0.001), and tissue differentiation (HR = 2.237, 95% CI: 1.043 - 5.828, p = 0.039) were independent risk factors for RFS. The model's diagnostic performance was 0.749 (95% CI: 0.636 - 0.861). Internal validation showed an AUC of 0.723 (95% CI: 0.608 - 0.838).</p><p><strong>Conclusion: </strong>Lower preoperative SII suggests a more favourable prognosis. The SII-based nomogram efficiently forecasts post-radical surgery prognosis for WT.</p><p><strong>Key words: </strong>Wilms' Tumour, Systemic immune-inflammation index, Relapse-free survival, Nomogram.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 11","pages":"1327-1333"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570783","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}
引用次数: 0
Diagnostic Accuracy of Combined Measurement of Serum Homocysteine, C-Reactive Protein, and Serum Ferritin in Mild Cognitive Impairments and Alzheimer's Disease. 联合测量血清同型半胱氨酸、C-反应蛋白和血清铁蛋白对轻度认知障碍和阿尔茨海默病的诊断准确性。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1303
Yiyang Li, Lin Duan, Yankui Shi, Ji Qi, Tongtong Li

Objective: Evaluation of the diagnostic accuracy of combined detection of serum homocysteine (Hcy), C-reactive protein (CRP), and serum ferritin (SF) levels in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI).

Study design: Descriptive study. Place and Duration of the Study: Clinical Laboratory Section, Affiliated Hospital of Hebei University, Baoding, Heibei, China, from May 2022 to June 2023.

Methodology: Data of 120 patients with memory decline were retrospectively collected. They were divided into an MCI group and an AD group. A further 50 healthy participants were used as a normal control (NC) group. Differences in the Hcy, CRP, and SF levels between the three groups were evaluated. The specificity, accuracy, and sensitivity of these three indices in the combined or single diagnosis of AD and MCI were compared. Their associations with the severity of AD and MCI were also compared.

Results: The AD group had the highest levels of Hcy, CRP, and SF (18.79 ± 4.50, 6.35 ± 2.04, and 355.69 ± 120.36), followed by MCI (16.75 ± 3.06, 4.58 ± 2.31, and 203.48 ± 12.76), and NC group (14.32 ± 2.06, 2.06 ± 0.76, and 98.46 ± 5.06), with statistically significant differences (all p <0.001). The diagnostic efficacy of AD for CRP was 98.50%, sensitivity was 96.00%, and specificity was 94.00%, which was higher than Hcy and SF. Tested together, the area under the ROC curve was 99.90%, specificity was 98.00%, and sensitivity was 98.00%. The diagnostic efficacy of SF for MCI had sensitivity of 100.00%, and specificity of 100.00%, which was higher than that of Hcy and CRP. When the three were combined for detection, the area under the curve of SF was 100.00%, sensitivity of 100.00%, and specificity of 100.00%. The levels of Hcy, CRP, and SF were positively correlated with the severity of AD (p <0.01), while negatively correlated with the mini-mental state examination (MMSE) score (p <0.01).

Conclusion: The combined detection of Hcy, CRP, and SF improved the diagnostic accuracy of comorbid AD and MCI.

Key words: Homocysteine, C-reactive protein, Cognitive impairment, Serum ferritin, Alzheimer's disease.

目的评估联合检测阿尔茨海默病(AD)和轻度认知障碍(MCI)患者血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)和血清铁蛋白(SF)水平的诊断准确性:描述性研究。研究地点和时间:研究地点和时间:河北省保定市河北大学附属医院临床检验科,2022年5月至2023年6月:回顾性收集 120 例记忆力衰退患者的数据。方法:回顾性收集 120 名记忆力衰退患者的数据,将其分为 MCI 组和 AD 组。另有50名健康参与者作为正常对照组(NC)。评估了三组之间 Hcy、CRP 和 SF 水平的差异。比较了这三项指标在合并或单独诊断 AD 和 MCI 时的特异性、准确性和敏感性。同时还比较了它们与 AD 和 MCI 严重程度的关系:结果:AD组的Hcy、CRP和SF水平最高(18.79±4.50、6.35±2.04和355.69±120.36),其次是MCI组(16.75±3.06、4.58±2.31和203.48±12.76)和NC组(14.32±2.06、2.06±0.76和98.46±5.06),差异有统计学意义(均为P 结论:Hcy、CRP和SF在AD组和MCI组中的联合检测结果均高于MCI组:Hcy、CRP和SF的联合检测提高了合并AD和MCI的诊断准确性:同型半胱氨酸 C反应蛋白 认知障碍 血清铁蛋白 阿尔茨海默病
{"title":"Diagnostic Accuracy of Combined Measurement of Serum Homocysteine, C-Reactive Protein, and Serum Ferritin in Mild Cognitive Impairments and Alzheimer's Disease.","authors":"Yiyang Li, Lin Duan, Yankui Shi, Ji Qi, Tongtong Li","doi":"10.29271/jcpsp.2024.11.1303","DOIUrl":"10.29271/jcpsp.2024.11.1303","url":null,"abstract":"<p><strong>Objective: </strong>Evaluation of the diagnostic accuracy of combined detection of serum homocysteine (Hcy), C-reactive protein (CRP), and serum ferritin (SF) levels in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI).</p><p><strong>Study design: </strong>Descriptive study. Place and Duration of the Study: Clinical Laboratory Section, Affiliated Hospital of Hebei University, Baoding, Heibei, China, from May 2022 to June 2023.</p><p><strong>Methodology: </strong>Data of 120 patients with memory decline were retrospectively collected. They were divided into an MCI group and an AD group. A further 50 healthy participants were used as a normal control (NC) group. Differences in the Hcy, CRP, and SF levels between the three groups were evaluated. The specificity, accuracy, and sensitivity of these three indices in the combined or single diagnosis of AD and MCI were compared. Their associations with the severity of AD and MCI were also compared.</p><p><strong>Results: </strong>The AD group had the highest levels of Hcy, CRP, and SF (18.79 ± 4.50, 6.35 ± 2.04, and 355.69 ± 120.36), followed by MCI (16.75 ± 3.06, 4.58 ± 2.31, and 203.48 ± 12.76), and NC group (14.32 ± 2.06, 2.06 ± 0.76, and 98.46 ± 5.06), with statistically significant differences (all p <0.001). The diagnostic efficacy of AD for CRP was 98.50%, sensitivity was 96.00%, and specificity was 94.00%, which was higher than Hcy and SF. Tested together, the area under the ROC curve was 99.90%, specificity was 98.00%, and sensitivity was 98.00%. The diagnostic efficacy of SF for MCI had sensitivity of 100.00%, and specificity of 100.00%, which was higher than that of Hcy and CRP. When the three were combined for detection, the area under the curve of SF was 100.00%, sensitivity of 100.00%, and specificity of 100.00%. The levels of Hcy, CRP, and SF were positively correlated with the severity of AD (p <0.01), while negatively correlated with the mini-mental state examination (MMSE) score (p <0.01).</p><p><strong>Conclusion: </strong>The combined detection of Hcy, CRP, and SF improved the diagnostic accuracy of comorbid AD and MCI.</p><p><strong>Key words: </strong>Homocysteine, C-reactive protein, Cognitive impairment, Serum ferritin, Alzheimer's disease.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 11","pages":"1303-1308"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570437","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}
引用次数: 0
Prostate Cancer Treatment cannot be Enhanced without including Comprehensive Cancer Rehabilitation. 如果不包括癌症综合康复,就无法加强前列腺癌治疗。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1400
Farooq Azam Rathore

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无效。
{"title":"Prostate Cancer Treatment cannot be Enhanced without including Comprehensive Cancer Rehabilitation.","authors":"Farooq Azam Rathore","doi":"10.29271/jcpsp.2024.11.1400","DOIUrl":"10.29271/jcpsp.2024.11.1400","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 11","pages":"1400-1402"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570784","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}
引用次数: 0
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Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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