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A retrospective observational study was carried out in Baskent University School of Medicine, Ankara, Turkey. Recurrent ovarian cancer patients treated between 2007 and 2017 were divided into two groups according to their bevacizumab status. The primary endpoints were overall survival (OS) and safety. Three hundred and ninety-six patients enrolled in this study, 200 (50.5%) received bevacizumab while 196 (49.5%) patients never received bevacizumab. The median follow-up time was 48.2 and 47.6 months, respectively. The 5-year OS was 61% and 46%, respectively (p=.007). In multivariate analysis, only platinum-sensitivity (HR 3.75, 95% CI 3.0-5.32; p less then .001) was identified as independent prognostic factors. In subgroup analyses according to platinum status, bevacizumab did not affect the 5 year OS in platinum sensitive patients (64% versus 68% p=.28) but increased survival in platinum resistant patients (36% versus 44%, p=.00). The rate of grade III-IV haematologic toxicities was 13.7% in the bevacizumab group and 11% in the other group (p=.6).Impact StatementWhat is already known on this subject? Bevacizumab increases the progression-free survival in platinum-sensitive and resistant recurrent ovarian cancer patients without changing overall survival.What do the results of this study add? Bevacizumab did not affect OS in platinum sensitive recurrent ovarian cancer patients however improved OS in platinum resistant patients with mild toxicity.What are the implications of these findings for clinical practice and/or further research? This study emphasised the crucial role of bevacizumab in the treatment of recurrent ovarian cancer patients.
Patients with irritable bowel syndrome (IBS) may benefit from psychological treatment when diet changes and medications do not sufficiently reduce symptoms. this website Our research team has developed an exposure based cognitive behavioral therapy protocol (ECBT), which has been shown to be effective in several randomized controlled trials.
To investigate the effectiveness of ECBT in clinical routine care at a gastroenterological clinic in Stockholm and to find predictors for treatment outcome.
A ten session ECBT based on our protocol was given face to face by licensed psychologists in groups of 4-6 patients. A total of 129 patients provided information regarding IBS symptoms, quality of life, gastrointestinal symptom-specific anxiety (GSA), and depression pre and post-treatment. We used linear regression analyses to identify patient characteristics that predicted treatment outcome.
The primary outcome was symptom severity measured with The Gastrointestinal Symptom Rating Scale for IBS (GSRS-IBS). Average pre-and post-treatment GSRS-IBS scores were 49.24 (SD = 11.54) and 37.03 (SD = 10.03), corresponding to a 34.0% reduction in symptom severity (
< .001). Reductions were also found in GSA, 43.9% (
< .001) and depression, 38.6% (
< .001). IBS-related quality of life was on average increased by 68.2% (
< .001). The effect sizes were large and varied between (Cohen's d) 0.95 and 1.84. None of the patients' pre-treatment characteristics predicted outcome.
We conclude that ECBT for IBS delivered face-to-face in a group-format is very effective, also in a routine care setting. We did not find any reliable predictors for treatment outcome. The trial was registered at Clinicaltrials.gov with ID NCT04756414.
We conclude that ECBT for IBS delivered face-to-face in a group-format is very effective, also in a routine care setting. We did not find any reliable predictors for treatment outcome. The trial was registered at Clinicaltrials.gov with ID NCT04756414.Due to the emergence of COVID-19 virus worldwide and need to identify ways of transmitting the virus, we conducted a cross-sectional study from July to November 2020 on 80 women with COVID-19 infection was confirmed by nasopharyngeal proper time polymerase chain reaction (RT-PCR). We investigated SARS-CoV-2 in their vaginal and rectal swabs. The results showed that (n = 6, 7.5%) patients had positive rectal PCR and (n = 10, 12.5%) had positive vaginal PCR. There was a statistically significant relationship between positive rectal test and positive vaginal test (p=.001). Positive rectal PCR was significantly higher in women over 60 years old than in other age groups (p=.004).Impact StatementWhat is already known on this subject? In the past studies, the presence of the virus in the vagina and rectum was less or not confirmed.What do the results of this study add? The results of our study showed that the COVID-19 virus can infect the vagina and rectum of women.What are the implications of these findings for clinical practice and/or further research? This finding should be considered in sexual transmission and mother to child transmission and also vaginal colonisation, especially at the time of delivery.Good quality of water determines the healthy life of living beings on this earth. The cleanliness of water was interrupted by the pollutants emerging out of several human activities. Industrialization, urbanization, heavy population, and improper disposal of wastes are found to be the major reasons for the contamination of water. Globally, the inclusion of volatile organic compounds (VOCs) and heavy metals released by manufacturing industries, pharmaceuticals, and petrochemical processes have created environmental issues. The toxic nature of these pollutants has led researchers, scientists, and industries to exhibit concern toward the complete eradication of them. In this scenario, the development of wastewater treatment methodologies at low cost and in an eco-friendly way had gained importance at the international level. Recently, bio-based technologies were considered for environmental remedies. Biofiltration-based works have shown a significant result for the removal of volatile organic compounds and heavy metals in the treatment of wastewater. This was done with several biological sources such as bacteria, fungi, algae, plants, yeasts, etc. The biofiltration technique is cost-effective, simple, biocompatible, sustainable, and eco-friendly compared to conventional techniques. This review article provides deep insight into biofiltration technologies engaged in the removal of volatile organic compounds and heavy metals in the wastewater treatment process.
Lenvatinib is an oral multitargeted tyrosine kinase inhibitor that has shown efficacy and manageable safety across multiple cancer types. The recommended starting doses for lenvatinib differ across cancer types and indications based on whether it is used as monotherapy or as combination therapy.
This review covers clinical trials that established the dosing paradigm and efficacy of lenvatinib and defined its adverse-event profile as a monotherapy; or in combination with the mTOR inhibitor, everolimus; or the anti-PD-1 antibody, pembrolizumab; and/or chemotherapy.
Lenvatinib has been established as standard-of-care either as a monotherapy or in combination with other anticancer agents for the treatment of radioiodine-refractory differentiated thyroid carcinoma, hepatocellular carcinoma, renal cell carcinoma, and endometrial carcinoma, and is being investigated further across several other tumor types. The dosing and adverse-event management strategies for lenvatinib have been developed through extensive ecessary to achieve required dose intensity for maximized patient benefit. The adverse-event profile of lenvatinib is consistent with that of other tyrosine kinase inhibitors, and clinicians are encouraged to review and adopt relevant symptom-management strategies.
As induction of labor (IOL) becomes more common, hospitals must adjust to accommodate longer length of stays on labor and delivery. An alternative to reduce the length of time spent on labor and delivery during an IOL is to perform cervical ripening on an antepartum unit. However, this may affect patient satisfaction and knowledge about the birthing process. This study aimed to evaluate whether cervical ripening conducted in an antepartum unit, rather than on a labor and delivery unit, was associated with changes in patient satisfaction with birth experience and baseline knowledge about IOL. Additionally, the study aimed to understand how patients would prefer to receive education on the IOL process.
This prospective observational study recruited English and Spanish-speaking patients at or after 39 weeks and 0 days gestation who were admitted for IOL. Consenting patients completed a preliminary survey containing sociodemographic and obstetric information as well as a previously validated survey on IOL kno knowledge of IOL. This suggests that IOL may be initiated in less acute units than labor and delivery without altering birth experience and may potentially allow for increased patient knowledge. Additionally, IOL checklists or technology-based education may help to further increase patient knowledge about IOL.
Unit of admission for IOL is not associated with satisfaction with birth experience but is associated with patient knowledge of IOL. This suggests that IOL may be initiated in less acute units than labor and delivery without altering birth experience and may potentially allow for increased patient knowledge. Additionally, IOL checklists or technology-based education may help to further increase patient knowledge about IOL.The aim of this study was to identify the effect of hyperglycaemia on placentas of gestational diabetes mellitus (GDM) women with macrosomia and normal pre-pregnancy body mass index (BMI), and uncover the molecular mechanism of hyperglycaemia on trophoblast cells in vitro. GDM women with normal pre-pregnancy BMI were divided into GM group (macrosomia, n = 30) and GN group (normal birth weight, n = 35). The study showed GM group had more adverse pregnancy outcomes and higher levels of gestational weight gain, blood glucose and triglyceride. After adjustment for confounding factors, just the fasting plasma glucose level and HbA1c percentage were related to the incidence of GDM-induced macrosomia with normal pre-pregnancy BMI. Meanwhile, the fasting blood glucose was closely related to the placental weight and placental PCNA expression. Furthermore, the in vitro model for placenta showed that hyperglycaemia significantly promoted trophoblast cell proliferation and activated ERK1/2 phosphorylation. ERK1/2 inhibit for the following studies of relationship between placenta and childhood complications.
Parkinson's disease is a common chronic neurodegenerative disease characterized by massive loss of dopaminergic neurons in the substantia nigra. Neuroinflammation has been shown to play an important role in the pathogenesis of neurodegenerative diseases such as Parkinson's disease. The role of immune tolerance in neuroinflammation and neurodegenerative diseases induced by peripheral factors is unclear.
This study established a model of endotoxin tolerance to explore the protective effect of endotoxin tolerance on Parkinson-like changes induced by repeated peripheral injections of high-dose LPS, and to explore its inflammatory mechanism.
In this study, mice were injected intraperitoneally with low dose (0.5 mg/kg) LPS for 4 days to induce endotoxin tolerance (ET). Then, high-dose (1 mg/kg) LPS was injected continuously intraperitoneally for 4 days to induce Parkinson-like changes. Cytokines were detected by enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qRT-PCR).
