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Radiotherapy and Oncology : Journal of... Apr 2024Guideline adherence in radiotherapy is crucial for maintaining treatment quality and consistency, particularly in non-trial patient settings where most treatments occur....
BACKGROUND AND PURPOSE
Guideline adherence in radiotherapy is crucial for maintaining treatment quality and consistency, particularly in non-trial patient settings where most treatments occur. The study aimed to assess the impact of guideline changes on treatment planning practices and compare manual registry data accuracy with treatment planning data.
MATERIALS AND METHODS
This study utilised the DBCG RT Nation cohort, a collection of breast cancer radiotherapy data in Denmark, to evaluate adherence to guidelines from 2008 to 2016. The cohort included 7448 high-risk breast cancer patients. National guideline changes included, fractionation, introduction of respiratory gating, irradiation of the internal mammary lymph nodes, use of the simultaneous integrated boost technique and inclusion of the Left Anterior Descending coronary artery in delineation practice. Methods for structure name mapping, laterality detection, detection of temporal changes in population mean lung volume, and dose evaluation were presented and applied. Manually registered treatment characteristic data was obtained from the Danish Breast Cancer Database for comparison.
RESULTS
The study found immediate and consistent adherence to guideline changes across Danish radiotherapy centres. Treatment practices before guideline implementation were documented and showed a variation among centres. Discrepancies between manual registry data and actual treatment planning data were as high as 10% for some measures.
CONCLUSION
National guideline changes could be detected in the routine treatment data, with a high degree of compliance and short implementation time. Data extracted from treatment planning data files provides a more accurate and detailed characterisation of treatments and guideline adherence than medical register data.
PubMed: 38944554
DOI: 10.1016/j.radonc.2024.110289 -
Journal of Ethnopharmacology Jun 2024The genus L. has high medicinal value and has traditional been used to treat a variety of gastrointestinal disorders, as well as diabetes, edema, colds, arthritis,... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
The genus L. has high medicinal value and has traditional been used to treat a variety of gastrointestinal disorders, as well as diabetes, edema, colds, arthritis, asthma, and traumatic injuries.
AIM OF THE REVIEW
This work addresses the missing information by conducting a comprehensive analysis of the traditional uses, chemical components, and pharmacological applications of the more reported species of the genus L.. The origin of the genus, its toxicology, and the use of classical therapies in modern medicine were also discussed. It provides references for historical evidence, resource development, and medical research on the genus.
METHOD
ology: Data about the genus L. were gathered via Web of Science, PubMed, Science Direct, Google Scholar, Connected Papers, China National Knowledge Infrastructure (CNKI), electronic ancient books and local chronicles. The WFO Plant List (wfoplantlist.org) and Flora of China (www.iplant.cn) confirmed L.'s Latin name, and the species information. The program ChemBioDraw Ultra 14.0 was used to create the molecular structures of the compounds that were displayed in the text.
RESULT
Currently, at least 740 constituents have been isolated and identified from L.. These include 9 groups of chemicals, such as flavonoids, alkaloids, and terpenoids. They have been shown to have over 20 biological properties in vivo and in vitro, such as antibacterial, anti-inflammatory, and anti-oxidant effects.
CONCLUSION
Based on pharmacological investigations, chemical components, and traditional folk applications, L. is considered a medicinal plant having a variety of pharmacological actions. However, although the pharmacological activity of the L. genus has been preliminary demonstrated, most have only been assessed using simple in vitro cell lines or animal disease models. In order to fully elucidate the pharmacological activity and mechanisms of L., future studies should be conducted in a more comprehensive clinical manner.
PubMed: 38944358
DOI: 10.1016/j.jep.2024.118494 -
Comparative Biochemistry and... Jun 2024The daily variations of temperature are one of the main synchronizers of the circadian rhythms. In addition, water temperature influences the embryonic and larval...
Ontogeny of daily rhythms in the expression of metabolic factors in Nile tilapia (Oreochromis niloticus) kept at two different temperature regimes: Thermocycle and constant temperature.
The daily variations of temperature are one of the main synchronizers of the circadian rhythms. In addition, water temperature influences the embryonic and larval development of fish and directly affects their metabolic processes. The application of thermocycles to fish larvae has been reported to improve growth and the maturation of the digestive system, but their effects on metabolism are poorly understood. The aim of the present study was to evaluate the effect of two different temperature regimes, cycling versus constant, on the daily rhythms of metabolic factors of Nile tilapia (Oreochromis niloticus) larvae. For this purpose, fertilized eggs were divided into two groups: one reared in a 31 °C:25 °C day:night thermocycle (TCY) and another group maintained in a constant 28 °C temperature (CTE). The photoperiod was set to a 12:12 h light/dark cycle. Samples were collected every 4 h during a 24-h cycle on days 4, 8 and 13 post fertilization (dpf). The expression levels of alanine aminotransferase (alt), aspartate aminotransferase (ast), malic enzyme, glucose-6-phosphate dehydrogenase (g6pd), phosphofructokinase (pfk) and pyruvate kinase (pk) were analyzed by qPCR. Results showed that, in 13 dpf animals, most of the genes analyzed (alt, ast, malic, g6pd and pfk) showed daily rhythms in TCY, but not in the group kept at constant temperature, with most acrophases detected during the feeding period. An increase in nutrient metabolism around feeding time can improve food utilization and thus increase larval performance. Therefore, the use of thermocycles is recommended for tilapia larviculture.
PubMed: 38944269
DOI: 10.1016/j.cbpa.2024.111687 -
Environmental Pollution (Barking, Essex... Jun 2024Increased systemic oxidative stress, implicated in adverse pregnancy outcomes for both mothers and fetuses, has been associated with gestational exposure to air...
Increased systemic oxidative stress, implicated in adverse pregnancy outcomes for both mothers and fetuses, has been associated with gestational exposure to air pollutants such as polycyclic aromatic hydrocarbons (PAHs), fine particulate matter (PM), and nitrogen dioxide (NO). However, it is unclear whether exposure to pollutants at levels below the current air quality standards can increase oxidative stress in pregnant women. In a cohort of 305 pregnant persons residing in western New York, we examined the association between exposure to PM, NO, and PAHs (measured as urinary 1-hydroxypyrene) and urinary biomarkers of oxidative stress (malondialdehyde [MDA] and 8-hydroxy-2'-deoxyguanosine [8-OHdG]) measured in each trimester. After controlling for gestational stage, maternal age, lifestyles, and socioeconomic factors, each interquartile range (IQR) increase in 1-hydroxypyrene concentration (65.8 pg/ml) was associated with a 7.73% (95%CI: 3.18%,12.3%) higher in MDA levels throughout the pregnancy and in the first and second trimester. An IQR increase in PM concentration (3.20 μg/m) was associated with increased MDA levels in the first trimester (8.19%, 95%CI: 0.28%,16.1%), but not the 2 (-7.99%, 95% CI: -13.8%, -2.23%) or 3 trimester (-2.81%, 95% CI: -10.0%, 4.38%). The average cumulative PM exposures in the 3-7 days before urine collection were associated with increased 8-OHdG levels during the second trimester, with the largest difference (22.6%; 95% CI: 3.46%, 41.7%) observed in relation to a one IQR increase in PM concentration in the previous 7 days. In contrast, neither oxidative stress biomarker was associated with NO exposure. Observed in pregnant women exposed to low-level air pollution, these findings expanded previously reported associations between systemic oxidative stress and high-level PM and PAH concentrations. Further, the first and second trimesters may be a susceptible window during pregnancy for oxidative stress responses to air pollution exposure.
PubMed: 38942277
DOI: 10.1016/j.envpol.2024.124463 -
The American Journal of the Medical... Jun 2024Idiopathic edema (IE) is a disease that occurs predominantly in women. It is characterized by increasing weight gain of > 1.4 kg from morning to night, increasing edema,... (Review)
Review
Idiopathic edema (IE) is a disease that occurs predominantly in women. It is characterized by increasing weight gain of > 1.4 kg from morning to night, increasing edema, increasing truncal and abdominal girth with bloating when assuming an upright position and nocturia that is unrelated to menses. There is an increase in morbidity but not mortality. Increased capillary membrane leakage appears to be the underlying pathophysiologic abnormality that explains the myriad of clinical presentations. We present 2 cases of life-threatening complications of IE that resulted in seizures related to acute hyponatremia in one and extreme postural dizziness and fainting induced by postural hypotension in the other. The first patient was successfully treated with salt restriction, timely use of furosemide and limitation of water intake; the other was successfully treated by use of support hose. Treatment of these patients required a fundamental understanding of the intricate pathophysiological consequences of a leaky capillary membrane, an understanding of Starling forces and detailing the effectiveness of a low salt diet, use of diuretics and limited water intake in one and why support hose would be beneficial in the other patient. Both patients experienced significant physical and emotional benefits that substantially improved quality of life.
PubMed: 38942171
DOI: 10.1016/j.amjms.2024.06.024 -
F1000Research 2024Irritable bowel syndrome (IBS) is common with a global prevalence of 4%. Dietary regimes with a low content of fermentable oligo-, di-, and monosaccharides and polyol... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Irritable bowel syndrome (IBS) is common with a global prevalence of 4%. Dietary regimes with a low content of fermentable oligo-, di-, and monosaccharides and polyol (FODMAP) or a starch- and sucrose-reduced diet (SSRD) have proven to be efficient. The aim of the present study was to describe the recruitment process for a randomized dietary trial with low FODMAP or SSRD for 4 weeks with a follow-up period of 5 months. The results of the dietary trial itself are not included in this paper but will be presented in another publication.
METHODS
The County of Skåne, with 1,41 million inhabitants, was used as a base to perform a dietary trial in which IBS patients, age 18-70 years, were randomized to either low FODMAP or SSRD for 4 weeks. The estimated number of IBS patients in the actual age span was approximately 32,000. The trial was announced through lectures, letters to all primary healthcare centers (n=203), social media (two campaigns), and invitations to IBS patients identified in medical records (n=744).
RESULTS
Three referrals arrived from the healthcare system, 17 patients contacted the investigators in person after receiving information from their healthcare center, and four patients contacted the investigators after recommendations from friends. Of these, 14 were enrolled in the study. From social media, 218 names were delivered, of which 93 fulfilled the study criteria and were willing to participate when contacted by the investigators (42.7%). Of the 3587 identified IBS patients in medical records in close proximity to the hospital, 744 were randomly contacted. Forty-eight patients (6.5 %) were willing to be included in the study. Thus, 155 patients with IBS were included in this study.
CONCLUSIONS
The inclusion rate for dietary intervention was very low considering the large population informed about the study. Announcements on social media seem to be the best way to recruit patients for intervention.
TRIAL REGISTRATION
NCT05192603, 29/11/2021, ClinicalTrials.gov. The PRS URL is https://register.clinicaltrials.gov.
Topics: Humans; Irritable Bowel Syndrome; Adult; Middle Aged; Male; Female; Adolescent; Aged; Patient Selection; Young Adult
PubMed: 38939366
DOI: 10.12688/f1000research.147710.2 -
BMC Musculoskeletal Disorders Jun 2024Jaffe-Campanacci syndrome is a rare syndrome, characterized by multiple non-ossifying fibromas (NOF) and cafe-au-lait patches. The name was coined in 1982 by Mirra after... (Review)
Review
BACKGROUND
Jaffe-Campanacci syndrome is a rare syndrome, characterized by multiple non-ossifying fibromas (NOF) and cafe-au-lait patches. The name was coined in 1982 by Mirra after Jaffe who first described the case in 1958. Although it's suggested there is a relation with Neurofibromatosis type 1, there is still no consensus on whether Jaffe-Campanacci syndrome is a subtype or variant of neurofibromatosis-1(NF-1).
CASE PRESENTATION
In this article, we present a case series of 2 patients. The first case is a 13-year-old male with Jaffe-Campanacci syndrome who presented with a distal femur fracture. His father had positive features of both Jaffe-Campanacci syndrome and NF-1, while his sister only had features of NF-1, so we presented both.
CONCLUSION
Jaffe-Campanacci has a clear relationship with type 1 neurofibromatosis, which still has to be genetically established. Due to the presence of several large non-ossifying fibromas of the long bones, it is linked to a significant risk of pathological fractures. We concur with previous authors, that an osseous screening program should be performed for all patients with newly diagnosed type 1 neurofibromatosis, to identify non-ossifying fibromas and assess the potential for pathological fracture. Moreover, siblings of patients with NF-1 should be screened for multiple NOFs that may carry a high risk of pathological fractures.
Topics: Humans; Male; Adolescent; Neurofibromatosis 1; Cafe-au-Lait Spots; Female; Fibroma; Femoral Fractures
PubMed: 38937801
DOI: 10.1186/s12891-024-07581-0 -
Der Nervenarzt Jun 2024Which theoretical and practical competences do the neurological and psychiatric case histories of the Hippocratic Corpus convey? (Review)
Review
OBJECTIVE
Which theoretical and practical competences do the neurological and psychiatric case histories of the Hippocratic Corpus convey?
MATERIAL AND METHODS
The 431 Hippocratic case histories have been studied for reports and communication on the diagnostics, treatment and prognosis of single persons and groups of patients suffering from neurological and psychiatric diseases.
RESULTS
In the 7 books of the Hippocratic Epidemics, a total of 128 patients with neurological and psychiatric symptoms are described. Epidemic fever and its variants were the leading predisposing conditions and the main symptoms were delirium, coma, insomnia, headache, speech disorders and convulsions. A number of patients with phrenitis and opisthotonos are also reported. The majority of the sick persons were male, were teenagers or adults and 47 of them are mentioned by name. The patient's information about the course is often just as informative as the doctor's observations. Treatment was limited to physical and dietary measures.
DISCUSSION
The Hippocratic physician diagnosed and attempted to treat a large number of neurological and psychiatric diseases. The often almost continuous observations of the patients led to astonishingly precise predictions of the course and the prospects of recovery. Numerous symptoms described in the case studies, including carphologia and opisthotonus, have entered the neurological vocabulary. The retrospective etiological analysis of the reports leads to the almost explicit identification of neurosyphilis and encephalitis lethargica. The therapeutic measures described by the author were, as the changeable course of the diseases shows, only of limited effectiveness despite a very differentiated application over time, both against the underlying diseases and the neurological and psychiatric complications.
PubMed: 38937324
DOI: 10.1007/s00115-024-01698-2 -
Fitoterapia Jun 2024Buxus plants have been used in traditional medicine for a very long time. The Buxus genus has been used to cure a variety of illnesses. (Review)
Review
BACKGROUND
Buxus plants have been used in traditional medicine for a very long time. The Buxus genus has been used to cure a variety of illnesses.
OBJECTIVE
This review aimed to provide a literature review on the genus Buxus including its biological and phytochemical properties.
MATERIALS AND METHODS
The current study was conducted using several scientific databases. Correct plant names were verified from plantlist.org. The results of this search were interpreted, analyzed, and documented based on the obtained bibliographic information.
RESULTS
Within all the species of the family Buxaceae, 5 species of the genus Buxus are reported to be antibacterial, 3 species have been found to be antioxidant, 5 species are cytotoxic, 1 species is anti-inflammatory, 1 species is antidiabetic, and 4 species are antifungal. Alkaloids, terpenoids, tannins, flavonoids, peptides, and phenolic compounds are the main chemical components of this genus. The study of >11 Buxuss pecies has identified >201 compounds. Pharmacological research has demonstrated that crude extracts and some pure compounds obtained from Buxus have several pharmacological activities such as antibacterial, antioxidant, cytotoxic, anti-inflammatory, antidiabetic, and antifungal. Based on the study of the phytochemistry of Buxus species, it was concluded that all the studied plants have active compounds, among which 55 molecules showed interesting activities.
CONCLUSIONS
The numerous traditional uses of Buxus species have been supported by several studies. Before Buxus plants can be fully employed clinically, further research is necessary.
PubMed: 38936673
DOI: 10.1016/j.fitote.2024.106081 -
American Journal of Pharmaceutical... Jun 2024Prefixes and suffixes in pharmacy might suggest a drug class, generation, or mechanism of action. As pharmacy educators we also use an alphabet soup of acronyms and...
Prefixes and suffixes in pharmacy might suggest a drug class, generation, or mechanism of action. As pharmacy educators we also use an alphabet soup of acronyms and abbreviations to describe board certifications or professional organizations and our affiliation to them. While we may be experts in nomenclature and abbreviations related to health professions education, sometimes we also have to remind ourselves to be humble and embrace a learning mindset relative to the abbreviations and naming conventions used more broadly in higher education and in other fields. This article discusses the use of abbreviations in minority serving institutions as well as the financial, historical, and political implications surrounding their names and definitions. The need to appreciate institutional designations and what they represent is not unique to minority-serving institutions or solely the responsibility of personnel who lead diversity, equity, inclusion, and accessibility (DEIA) efforts. Appreciating what institution designations mean is a logical first step towards discovering and acting upon the possibilities to facilitate and support the success of all learners recruited into the pharmacy profession.
PubMed: 38936480
DOI: 10.1016/j.ajpe.2024.100744