Padillakeith0304

We performed an updated meta-analysis to clarify the relationship between glutathione S-transferase Mu and theta (GSTM1 and GSTT1, respectively) null/positive genotypes and asthma.

We performed a literature search using PubMed and Web of Science databases in August 2019. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the role of GSTM1 and GSTT1 genotypes in the risk of asthma.

Overall, we found a significant association with asthma risk in the general population for both the GSTM1 genotype (OR = 1.21; 95% CI 1.07-1.35; P < .001; I = 69.5%) and the GSTT1 genotype (OR = 1.61; 95% CI 1.30-2.00; P < .001; I = 83.6%). Moreover, significant associations between both genotypes and asthma risk were also found by age stratification. Furthermore, for GSTM1 we found significant associations in populations living in Asia, Europe, and Russia, but not in Africa. Conversely, for GSTT1, we found a significantly increased risk in populations living in Asia, Europe, Africa, and Russia. In addition, a significant association was found for both genotypes with a sample size <500, but not a sample size >2000.

Our meta-analysis provides evidence that GSTM1 and GSTT1 genotypes could be used as asthma-associated biomarkers.

Our meta-analysis provides evidence that GSTM1 and GSTT1 genotypes could be used as asthma-associated biomarkers.

The most common critical incidents in pediatric anesthesia are perioperative respiratory adverse events (PRAE), which occur more often in neonates and account for one-third of anaesthesia-related cardiac arrests. It is crucial to maintain an open stable airway during anesthesia in neonates, as this population has a low oxygen reserve, small airways, and the loss of protective airway reflexes under general anesthesia.

A 6-day-old premature newborn underwent minimally invasive sclerotherapy under general anesthesia. For high-risk premature neonates, the selections of the anesthesia and airway device are extremely important, as those factors directly affect the prognosis.

B ultrasound and computed tomography (CT) revealed a large mass from the left chest wall to axilla, which was suspected to be a lymphocele.

Minimally invasive sclerotherapy was performed under inhalation anesthesia. After the initiation of anesthesia, a laryngeal mask was placed to control airway. Anesthesia was maintained intraoperativsevoflurane inhalation general anesthesia and laryngeal mask airway control with spontaneous breathing may be an ideal option to reduce PRAE during very short surgery in a premature neonate.Reports on lymphatic intervention for chylothorax complicating thoracic aortic surgery are limited. We aimed to evaluate technical and clinical outcomes of lymphangiography and thoracic duct embolization (TDE) for chylothorax complicating thoracic aortic surgery.Nine patients (mean age, 38.9 years) who underwent chylothorax interventions after thoracic aortic surgery (aorta replacement [n = 7] with [n = 2] or without [n = 5] lung resection, and vascular ring repair [n = 2]) were reviewed retrospectively. Magnetic resonance (MR) lymphangiograms were obtained in 5 patients. The median interval between surgery and conventional lymphangiography was 9 days (range, 4-28 days). TDE clinical success was defined as lymphatic leakage resolution with chest tube removal within 2 weeks.MR lymphangiograms revealed contrast leakage from the thoracic duct (n = 4) or no definite leakage (n = 1), which correlated well with conventional lymphangiogram findings. The technical success rate of conventional lymphangiography was 88.9% (8/9); 8 patients showed contrast leakage, while the patient without definite leakage on MR lymphangiography had small inguinal lymph nodes, and thoracic duct visualization by conventional lymphangiography failed. The technical success rates of antegrade and retrograde TDE via pleural access were 75% (6/8) and 100% (3/3), respectively. find more Clinical outcomes after embolization, as judged by the tube-removal day, were similar between low- ( less then 500 mL/day) and high-output (≥500 mL/day) chylothorax patients. The drainage amount decreased significantly after lymphangiography/TDE, from 710.0 mL/day to 109.7 mL/day (p  less then  .05). The clinical success rate of TDE was 87.8% (7/8).Conventional lymphangiography and TDE yielded high technical success rates and demonstrated encouraging clinical outcomes for chylothorax complicating thoracic aortic surgery.

Programmed death receptor-1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors have been demonstrated to improve the prognosis of patients with advanced non-small cell lung cancer (NSCLC) compared with chemotherapy. However, there were still some non-responders. Thus, how to effectively screen the responder may be an important issue. Recent studies revealed the immune-related indicator, neutrophil-lymphocyte ratio (NLR), may predict the therapeutic effects of anti-PD1/PD-L1 antibodies; however, the results were controversial. This study was to re-evaluate the prognostic potential of NLR for NSCLC patients receiving PD1/PD-L1 inhibitors by performing a meta-analysis.

Eligible studies were identified by searching online databases of PubMed, EMBASE and Cochrane Library. The predictive values of NLR for overall survival, (OS), progression free survival (PFS) and overall response rate (ORR) were estimated by hazard ratio (HR) with 95% confidence interval (CI).

Twenty-four studies involving 2196 patients were included. The pooled analysis demonstrated that elevated NLR before PD-1/PD-L1 inhibitor treatment was a predictor of poor OS (HR = 2.17; 95% CI 1.64 - 2.87, P < .001), PFS (HR = 1.54; 95% CI 1.34 - 1.78, P < .001) and low ORR (HR = 0.64; 95% CI 0.44 - 0.95, P = .027) in NSCLC patients. Subgroup analysis revealed the predictive ability of NLR for OS and PFS was not changed by ethnicity, sample size, cut-off, HR source, study design or inhibitor type (except the combined anti-PD-L1 group); while its association with ORR was only significant when the cut-off value was less than 5 and the studies were prospectively designed.

Our findings suggest patients with lower NLR may benefit from the use of PD-1/PD-L1 inhibitors to prolong their survival period.

Our findings suggest patients with lower NLR may benefit from the use of PD-1/PD-L1 inhibitors to prolong their survival period.

Stereotactic body radiotherapy (SBRT) superseded conventional radiotherapy (CRT) for the treatment of patients with inoperable early stage non-small cell lung cancer (NSCLC) over a decade ago. However, the direct comparisons of the outcomes of SBRT and CRT remain controversial. This meta-analysis was performed to compare the survival and safety of SBRT and CRT in patients with inoperable stage I NSCLC.

We systematically searched the Cochrane Library, Embase, PubMed, Web of Science, Ovid MEDLINE, ScienceDirect, Scopus and Google Scholar for relevant articles. Overall survival (OS), progression-free survival (PFS), lung cancer-specific survival (LCSS), local control rate (LCR) and adverse effects (AEs) were the primary outcomes.

We identified 11,110 articles, 17 of which were eventually included in this study; these 17 articles had 17,973 patients (SBRT 7395; CRT 10,578). Compared to CRT for the treatment of inoperable stage I NSCLC, SBRT had superior survival in terms of OS (hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.62-0.70, P < .00001), LCSS (HR 0.42 [0.35-0.50], P < .00001), and PFS (HR 0.34 [0.25-0.48], P < .00001). The 4-year OS rate (OSR); 4-year LCSS rate (LCSSR); 3-year local control rate (LCR); 5-year PFS rate (PFSR) with SBRT were all higher than those with CRT. With regard to all-grade AEs, the SBRT group had a significantly lower rate of dyspnea, esophagitis and radiation pneumonitis; no significant difference was found in grade 3-5 AEs (risk ratio [RR] 0.68 [0.30-1.53], P = .35).

With better survival and a lower rate of dyspnea, esophagitis and radiation pneumonitis than CRT, SBRT appears to be more suitable for patients with inoperable stage I NSCLC.

With better survival and a lower rate of dyspnea, esophagitis and radiation pneumonitis than CRT, SBRT appears to be more suitable for patients with inoperable stage I NSCLC.Obturator hernia is a relatively rare type of abdominal hernia, in which abdominal contents protrude through the obturator canal, a condition that can lead to small bowel obstruction. Its rarity and nonspecific signs and symptoms make a preoperative diagnosis difficult. The present study analyzed the clinical manifestations, diagnostic methods and operative treatment outcomes in patients with obturator hernia.Between January 2012 and October 2019, 1028 adults underwent surgical repair of abdominal wall hernia at the Department of Surgery, Kyungpook National University Hospital. The medical records of eleven patients who were treated for small bowel obstruction due to obturator hernia were retrospectively evaluated. Patient characteristics, clinical presentation, preoperative radiological diagnosis, operative findings, treatment, complications, and outcomes were recorded.All 11 patients were elderly women, with a mean age of 80.2 years (range, 71-87 years). Their mean body mass index was 17.9 kg/m (range, 11.9e to avoid postoperative morbidity and mortality associated with intestinal strangulation due to obturator hernia. Obturator hernia can be sufficiently repaired with simple suture closure without mesh.Biliary dyspepsia presents as biliary colic in the absence of explanatory structural abnormalities. Causes include gallbladder dyskinesia, sphincter of Oddi dysfunction, biliary tract sensitivity, microscopic sludges, and duodenal hypersensitivity. However, no consensus treatment guideline exists for biliary dyspepsia. We investigated the effects of medical treatments on biliary dyspepsia.We retrospectively reviewed the electronic medical records of 414 patients who had biliary pain and underwent cholescintigraphy from 2008 to 2018. We enrolled patients who received litholytic agents and underwent follow-up scans after medical treatment. We divided the patients into the GD group (biliary dyspepsia with reduced gallbladder ejection fraction [GBEF]) and the NGD group (biliary dyspepsia with normal GBEF). We compared pre- and post-treatment GBEF and symptoms.Among 57 patients enrolled, 40 (70.2%) patients had significant GBEF improvement post-treatment, ranging from 34.4 ± 22.6% to 53.8 ± 26.8% (P  less then  .001). In GD group (n = 35), 28 patients had GBEF improvement after medical treatment, and value of GBEF significantly improved from 19.5 ± 11.0 to 47.9 ± 27.3% (P  less then  .001). In NGD group (n = 22), 12 patients had GBEF improvement after medical treatment, but value of GBEF did not have significant change. Most patients (97.1% in GD group and 81.8% in NGD group) had improved symptoms after medical treatment. No severe complication was reported during treatment period.Litholytic agents improved biliary colic in patients with biliary dyspepsia. Therefore, these agents present an alternative treatment modality for biliary dyspepsia with or without gallbladder dyskinesia. Notably, biliary colic in patients with gallbladder dyskinesia resolved after normalization of the GBEF. Further prospective and large-scale mechanistic studies are warranted.