Ritchiegarza1282
osteoarthritis or femoroacetabular impingement morphology should not be made based on the sole presence of ossifications at the acetabular rim.
• Acetabular rim ossifications are extremely common in asymptomatic, non-osteoarthritic adult hips. • Acetabular rim ossifications are present independently from other signs of osteoarthritis in adult hips at all ages and should not be interpreted as a pathological finding. • The diagnosis of osteoarthritis or femoroacetabular impingement morphology should not be made based on the sole presence of ossifications at the acetabular rim.
To compare the efficacy and safety of high dose-intensity combination of methotrexate, vinblastine, adriamycin and cisplatin (HD MVAC) with gemcitabine plus cisplatin (GC) as a neoadjuvant chemotherapy (NAC) in muscle-invasive bladder cancer (MIBC) or locally advanced upper tract urothelial cancer (UTUC).
A retrospective analysis was conducted for patients with UC (cT2-4aN0-1M0) who received NAC from January 2011 and December 2017 at Asan Medical Center. Pathologic complete response (pCR), down-staging (< ypT2 and no N upstaging), disease-free survival (DFS), OS and safety were compared for each regimen.
Out of a total of 277 patients, 176 patients received GC and 41 patients received HD MVAC. With the exception of age (patients receiving HD MVAC were younger; p = 0.002), other baseline characteristics were well balanced between groups. pCR rates were 27.0% for GC and 22.6% for HD MVAC (p = 0.62), and down-staging rate was 50.8% for GC and 58.1% for HD MVAC (p = 0.47). There were no differences in OS (72.1% vs 73.1% for GC vs HD MVAC; p = 0.58) and DFS (54.9% vs 63.3% for GC vs HD MVAC; p = 0.21) at 3years. HD MVAC with prophylactic G-CSF was associated with a higher incidence of febrile neutropenia (p < 0.001) than GC. The NAC regimen was not an independent prognostic factor for OS.
Oncologic outcomes were not significantly different between the GC and HD MVAC when used as NAC in MIBC/UTUC.
Oncologic outcomes were not significantly different between the GC and HD MVAC when used as NAC in MIBC/UTUC.
There are still controversial data regarding the prognostic value of Venous ThromboEmbolism (VTE) in advanced Pancreatic Ductal AdenoCarcinoma (PDAC) and thromboprophylaxis is poorly prescribed despite international recommendations.
Medical charts of patients consecutively treated for advanced PDAC from 2010 to 2019 were retrospectively reviewed. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier method. Prognostic Factors were identified using a multivariate Cox's proportional hazard model. Early VTE was defined as VTE occurring within the three months following the PDAC diagnosis.
A total of 174 patients were included (median age 67years; males 55.2%; performance status (PS) 0-1 88.5%) with metastatic disease in 74.7%. At baseline, Khorana score was high (≥ 3) in the vast majority of cases (93.7%). The cumulative incidences of VTE were 12.4% (95% CI 7.3-17.2) at 3months, 20.4% (95% CI 13.9-26.4) at 6months and 28.1% (95% CI 20.0-35.3) at 12months. Patients who experienced early VTE had shorter PFS (3.8months vs. 7.1months; HR = 2.02; 95% CI 1.21-3.37; p = 0.006) and shorter OS (8.0months vs. 14.1months; HR = 2.42; 95% CI 1.37-4.30; p = 0.002) compared to the others, independently of prognostic factors such as PS, liver metastases, carcinomatosis, and chemotherapy regimen.
early VTE is a strong prognostic factor in advanced PDAC and occurs in about one in 10 patients.
early VTE is a strong prognostic factor in advanced PDAC and occurs in about one in 10 patients.
While SWI/SNF chromatin remodeling complex alterations occur in approximately 20% of cancer, the frequency and potential impact on clinical outcomes in meningiomas remains to be comprehensively elucidated.
A large series of 255 meningiomas from a single institution that was enriched for high grade and recurrent lesions was identified. We performed next-generation targeted sequencing of known meningioma driver genes, including NF2, AKT1, PIK3CA, PIK3R1, and SMO and SWI/SNF chromatin remodeling complex genes, including ARID1A, SMARCA4, and SMARCB1 in all samples. Clinical correlates focused on clinical presentation and patient outcomes are presented.
The series included 63 grade I meningiomas and 192 high-grade meningiomas, including 173 WHO grade II and 19 WHO grade III. Samples from recurrent surgeries comprised 37.3% of the series. A total of 41.6% meningiomas were from the skull base. NF2, AKT1, PIK3CA, PIK3R1, and SMO were mutated in 40.8, 7.1, 3.5, 3.9, and 2.4% of samples, respectively. ARID1A, SMARCA4, and SMARCB1 mutations were observed in 17.3, 3.5, and 5.1% of samples, respectively. A total of 68.2% of ARID1A-mutant meningiomas harbored a p.Gln1327del in-frame deletion. ARID1A mutations were seen in 19.1% of Grade I, 16.8% of Grade II, and 15.8% of Grade III meningiomas (P = 0.9, Fisher's exact). Median overall survival was 16.3years (95% CI 10.9, 16.8). With multivariable analysis, the presence of an ARID1A mutation was significantly associated with a 7.421-fold increased hazard of death (P = 0.04).
ARID1A mutations occur with similar frequency between low and high-grade meningiomas, but ARID1A mutations are independently prognostic of worse prognosis beyond clinical and histopathologic features.
ARID1A mutations occur with similar frequency between low and high-grade meningiomas, but ARID1A mutations are independently prognostic of worse prognosis beyond clinical and histopathologic features.
The dietary approaches to stop hypertension (DASH) diet have several components like high amounts of fruits, vegetables, low-fat dairy products, and vitamin C and low amounts of simple sugars that might improve attention-deficit hyperactivity disorder (ADHD) symptoms. We aimed to investigate the effect of a DASH diet on children (aged 6-12years) with ADHD, for the first time.
Participants were randomized to receive a DASH or a control diet for 12weeks. The severity of ADHD symptoms [determined by abbreviated 10-item Conner's scale (ACS), 18-item Swanson, Nolan and Pelham (SNAP-IV) scale and strengths and difficulties questionnaire (SDQ)] were assessed every four weeks.
Eighty children completed the study. After adjustment for confounders, parent (- 4.71 for the DASH group vs. - 3 for the control group) and teacher-reported (- 5.35 vs. - 1.87) ACS scores, parent-, teacher-, child-reported hyperactivity (- 1.40 vs. selleck compound - 0.66, - 1.95 vs. -0.63, - 1.60 vs. - 0.43, respectively), emotional symptoms (- 1.50 vs. - 0.