Floresmckay4199
The PRECISE recommendations for magnetic resonance imaging (MRI) in patients on active surveillance (AS) for prostate cancer (PCa) include repeated measurement of each lesion, and attribution of a PRECISE radiological progression score for the likelihood of clinically significant change over time. We aimed to compare the PRECISE score with clinical progression in patients who are managed using an MRI-led AS protocol.
A total of 553 patients on AS for low- and intermediate-risk PCa (up to Gleason score 3 + 4) who had two or more MRI scans performed between December 2005 and January 2020 were included. Overall, 2161 scans were retrospectively re-reported by a dedicated radiologist to give a PI-RADS v2 score for each scan and assess the PRECISE score for each follow-up scan. selleck inhibitor Clinical progression was defined by histological progression to ≥ Gleason score 4 + 3 (Gleason Grade Group 3) and/or initiation of active treatment. Progression-free survival was assessed using Kaplan-Meier curves and log-rank test was un MRI (PRECISE 4-5)during AS. • Patients with radiological progressionon MRI (PRECISE 4-5)during AS showed a trend to an increase in PSA density.
• Patients without radiological progression on MRI (PRECISE 1-3) during AS had a very low likelihood of clinical progression and many could avoid routine re-biopsy. • Clinical progression was almost always detectable in patients with radiological progression on MRI (PRECISE 4-5) during AS. • Patients with radiological progression on MRI (PRECISE 4-5) during AS showed a trend to an increase in PSA density.
To assess arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) in the differentiation of metastatic from reactive lymph nodes (LNs) in head and neck squamous cell carcinoma (HNSCC).
Retrospective analysis of 113 LNs in 43 patients with HNSCC underwent ASL and DWI of the neck. The tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the cervical LNs were calculated. The final diagnosis of metastatic (n = 82) and reactive (n = 31) was proved with the pathological examination.
The TBF of metastatic LNs (58.8 ± 10.2, 58.6 ± 8.5mL/100g/min) was significantly higher (p = 0.001) than the reactive LNs (23.2 ± 10.3, 28.2 ± 16.7mL/100g/min) for both observers, respectively. The ADC of metastatic LN (1.12 ± 0.07, 1.21 ± 0.07 × 10
mm
/s) was significantly lower (p = 0.001) than reactive LN (1.41 ± 0.09, 1.44 ± 0.14 × 10
mm
/s) for both observers, respectively. The threshold of TBF (> 39.5, 40.5mL/100g/min), ADC (≥ 1.31, 1.30 X10
mm
/s) and combined parameters for both observers, respectively, used for differentiating metastatic from reactive LNs revealed an area under the curve of (0.94, 0.945), (0.90, 0.931), and (0.98, 0.989), an accuracy of (88.6%, 80.5%), (80.0%, 88.5%), and (94.3%, 98.2), respectively.
Combined TBF and ADC are non-invasive imaging parameters that can play a role in differentiation metastatic from reactive LNs in patients with HNSCC.
Combined TBF and ADC are non-invasive imaging parameters that can play a role in differentiation metastatic from reactive LNs in patients with HNSCC.
This study analyzed survival and toxicity after (chemo)radiotherapy for primary salivary gland cancer patients aged ≥ 65years and compared these results with younger patients using a matched-pair analysis.
Twenty-nine elderly patients with primary salivary gland carcinomas treated with (chemo)radiotherapy from 2008 to 2020 at University of Freiburg Medical Center were analyzed for oncological outcomes and therapy-associated toxicities. Local/locoregional control (LRC), progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method, and the influence of clinical parameters on patient outcomes was assessed. A matched-pair analysis was performed after matching with patients < 65years.
Nine patients (31.0%) received definitive (chemo)radiotherapy, and 20 patients (69.0%) were treated in the adjuvant setting. 2-year LRC, PFS and OS ranged at 82.4%, 53.7% and 71.8%, respectively. Smoking (HR 3.980, p = 0.020), reduced performance status (HR 3.735, p = 0.016) and higde treatment decisions in affected elderly patients.
Although idiopathic fecal incontinence (FI) patients have some psychological characteristics, the personality of FI patients was not described. The present study aims to describe the clinical and personality characteristics of FI patients.
This retrospective observational study included 996 outpatients, 72 with fecal incontinence. They filled out the Rome III diagnostic questionnaire, the personality inventory MMPI-2, the questionnaires for urological and sexual disorders, and Likert scales for bowel disorders perceived symptom severity. The main outcome measures were the presence in FI patients of functional gastrointestinal disorders, the self-reported symptom severity, and the personality profile.
Patients were mainly females (72%). FI patients were characterized by higher age (P = 0.015), and by a higher prevalence of functional diarrhea (P = 0.001), urological (P = 0.001), and sexual disorders (P = 0.005). These patients also report higher diarrhea severity (P < 0.001) and lower abdominal pain severity (P = 0.009). The personality of FI patients is distinguished by a higher score for psychopathic deviate (P = 0.006), social responsibility (P = 0.003), Mac Andrew revised scale (P = 0.005), and antisocial practice (P = 0.007), and a lower score for type A behavior (P = 0.005).
FI patients are characterized not only by older age, and a high prevalence of diarrhea but also by a specific personality profile characterized by an unfavorable comparison with others.
FI patients are characterized not only by older age, and a high prevalence of diarrhea but also by a specific personality profile characterized by an unfavorable comparison with others.Extending licensed drug use to the pediatric population has become an essential part of the drug development process. Nonetheless, ethical concerns limit clinical testing in pediatric populations and data collected from oral bioavailability and food effect studies in adults are often extrapolated to the target pediatric (sub)populations. However, based on published information, food effects on drug absorption in infants may not be adequately evaluated by data collected in adults. In the present study, a physiologically based pharmacokinetic (PBPK) approach for modeling paracetamol suspension data collected in adults was proposed with the ultimate aim to investigate whether extrapolation to infants is substantially affected by the dosing conditions applied to adults. The development of the PBPK model for adults was performed using GastroPlus™ V9.7, and after scaling to infants considering physiological, anatomical, and drug clearance changes, extrapolation of the different dosing conditions was performed by applying dosing conditions dependent on changes on the paracetamol gastric emptying process.