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DEN Open Apr 2025For early gastrointestinal lesions, size is an important factor in the selection of treatment. Virtual scale endoscope (VSE) is a newly developed endoscope that can...
OBJECTIVES
For early gastrointestinal lesions, size is an important factor in the selection of treatment. Virtual scale endoscope (VSE) is a newly developed endoscope that can measure size more accurately than visual measurement. This study aimed to investigate whether VSE measurement is accurate for early gastrointestinal lesions of various sizes and morphologies.
METHODS
This study prospectively enrolled patients with early gastrointestinal lesions ≤20 mm in size visually. Lesion sizes were measured in the gastrointestinal tract visually, on endoscopic resection specimens with VSE, and finally on endoscopic resection specimens using a ruler. The primary endpoint was the normalized difference (ND) of VSE measurement. The secondary endpoints were the ND of visual measurement and the variation between NDs of VSE and visual measurements. ND was calculated as (100 × [measured size - true size] / true size) (%). True size was defined as size measured using a ruler.
RESULTS
This study included 60 lesions from April 2022 to December 2022, with 20 each in the esophagus, stomach, and colon. The lesion size was 14.0 ± 6.3 mm (mean ± standard deviation). Morphologies were protruded, slightly elevated, and flat or slightly depressed type in 8, 24, and 28 lesions, respectively. The primary endpoint was 0.3 ± 8.8%. In the secondary endpoints, the ND of visual measurement was -1.7 ± 29.3%, and the variability was significantly smaller in the ND of VSE measurement than in that of visual measurement ( < 0.001, F-test).
CONCLUSIONS
VSE measurement is accurate for early gastrointestinal lesions of various sizes and morphologies.
PubMed: 38903962
DOI: 10.1002/deo2.386 -
Nucleic Acid Insights Mar 2024mRNA therapeutics have garnered significant attention in the biomedical realm, showing immense potential across a spectrum of applications from COVID-19 to cancer...
mRNA therapeutics have garnered significant attention in the biomedical realm, showing immense potential across a spectrum of applications from COVID-19 to cancer treatments. Their ability to trigger precise protein expression, particularly in genome editing, is pivotal in minimizing off-target effects. At the core of mRNA therapy lies a dual-component system, comprising the mRNA itself and a delivery vehicle. The breakthrough success of novel COVID-19 vaccines has catapulted lipid nanoparticles to prominence as the preferred delivery vehicle. However, despite their US FDA approval and efficacy, lipid nanoparticles face a significant challenge: poor stability at room temperature, which limits their applications in various geographic regions with disparities in infrastructure and technology. This review aims to dissect the issue of stability inherent in lipid nanoparticles and other mRNA delivery platforms such as polymer-based materials and protein derivative materials. We herein endeavor to unravel the factors contributing to their instability and explore potential strategies to enhance their stability. By doing so, we provide a comprehensive analysis of the current landscape of mRNA delivery systems, highlighting both their successes and limitations, and paving the way for future advancements in this rapidly evolving field.
PubMed: 38903876
DOI: 10.18609/nai.2024.015 -
Frontiers in Medicine 2024Over the last decade there has been a transition from traditional laparoscopy to robotic surgery for the treatment of endometrial cancer. A number of gynecological...
INTRODUCTION
Over the last decade there has been a transition from traditional laparoscopy to robotic surgery for the treatment of endometrial cancer. A number of gynecological oncology surgical fellowship programmes have adopted robot-assisted laparoscopy, but the effect of training on complications and survival has not been evaluated. Our aim was to assess the impact of a proficiency-based progression training curriculum in robot-assisted laparoscopy on peri-operative and survival outcomes for endometrial cancer.
METHODS
This is an observational cohort study performed in a tertiary referral and subspecialty training center. Women with primary endometrial cancer treated with robot-assisted laparoscopic surgery between 2015 and 2022 were included. Surgery would normally include a hysterectomy and salpingo-oophorectomy with some form of pelvic lymph node dissection (sentinel lymph nodes or lymphadenectomy). Training was provided according to a training curriculum which involves step-wise progression of the trainee based on proficiency to perform a certain surgical technique. Training cases were identified pre-operatively by consultant surgeons based on clinical factors. Case complexity matched the experience of the trainee. Main outcome measures were intra- and post-operative complications, blood transfusions, readmissions < 30 days, return to theater rates and 5-year disease-free and disease-specific survival for training versus non-training cases. Mann-Witney U, Pearson's chi-squared, multivariable regression, Kaplan-Meier and Cox proportional hazard analyses were performed to assess the effect of proficiency-based progression training on peri-operative and survival outcomes.
RESULTS
Training cases had a lower BMI than non-training cases (30 versus 32 kg/m, = 0.013), but were comparable in age, performance status and comorbidities. Training had no influence on intra- and post-operative complications, blood transfusions, readmissions < 30 days, return to theater rates and median 5-year disease-free and disease-specific survival. Operating time was longer in training cases (161 versus 137 min, = < 0.001). The range of estimated blood loss was smaller in training cases. Conversion rates, critical care unit-admissions and lymphoedema rates were comparable.
DISCUSSION
Proficiency-based progression training can be used safely to teach robot-assisted laparoscopic surgery for women with endometrial cancer. Prospective trails are needed to further investigate the influence of distinct parts of robot-assisted laparoscopic surgery performed by a trainee on endometrial cancer outcomes.
PubMed: 38903811
DOI: 10.3389/fmed.2024.1370836 -
Frontiers in Microbiology 2024has been used extensively for dissecting the genetic and functional bases of host innate antiviral immunity and virus-induced pathology. Previous studies have shown...
has been used extensively for dissecting the genetic and functional bases of host innate antiviral immunity and virus-induced pathology. Previous studies have shown that the presence of endosymbionts in confers resistance to infection by certain viral pathogens. Zika virus is an important vector-borne pathogen that has recently expanded its range due to the wide geographical distribution of the mosquito vector. Here, we describe the effect of on the immune response of adult flies following Zika virus infection. First, we show that the presence of endosymbionts promotes the longevity of uninfected wild type adults and increases the survival response of flies following Zika virus injection. We find that the latter effect is more pronounced in females rather than in males. Then, we show that the presence of regulates Zika virus replication during Zika virus infection of female flies. In addition, we demonstrate that the antimicrobial peptide-encoding gene and the sole Jun N-terminal kinase-specific MAPK phosphatase are upregulated in female adult flies, whereas the immune and stress response gene is upregulated in male individuals. Finally, we find that the activity of RNA interference and Toll signaling remain unaffected in Zika virus-infected female and male adults containing compared to flies lacking the endosymbionts. Our results reveal that endosymbionts in affect innate immune signaling activity in a sex-specific manner, which in turn influences host resistance to Zika virus infection. This information contributes to a better understanding of the complex interrelationship between insects, their endosymbiotic bacteria, and viral infection. Interpreting these processes will help us design more effective approaches for controlling insect vectors of infectious disease.
PubMed: 38903791
DOI: 10.3389/fmicb.2024.1380647 -
Frontiers in Plant Science 2024Viral diseases have become a vital factor limiting the development of the alfalfa () industry. Six viruses infecting alfalfa with a high incidence rate are Alfalfa...
INTRODUCTION
Viral diseases have become a vital factor limiting the development of the alfalfa () industry. Six viruses infecting alfalfa with a high incidence rate are Alfalfa mosaic virus (AMV), Medicago sativa alphapartitivirus 1 (MsAPV1), Medicago sativa alphapartitivirus 2 (MsAPV2), Medicago sativa deltapartitivirus 1 (MsDPV1), Medicago sativa amalgavirus 1 (MsAV1), and Cnidium vein yellowing virus 1 (CnVYV1). The purpose of this study was to develop preventive measures against these viruses by investigating their transmission through alfalfa seeds.
METHODS
In this study, we investigated the transmission rate of alfalfa viruses from seed to seedling by PCR, determined the location of viruses in seed by dissecting seed embryos and seed coat, tracked the changes of viruses in seedlings, and finally discover effective elimination measures for alfalfa viruses from 16 measures.
RESULTS AND DISCUSSION
Our results demonstrated that all these six viruses could be transmitted from alfalfa seeds to seedlings with the transmission rate ranging from 44.44% to 88.89%. For AMV, MsAPV2, and MsAV1, the viral load was significantly higher in the seed coats than in the seed embryos; however, it did not show significant differences between these two parts of the seeds for MsAPV1, MsDPV1, and CnVYV1. Dynamic accumulation analysis of AMV and MsAPV2 indicated that the viral load in plants increased continuously in the early growth stage, making it important to inactivate these viruses prior to their seed-to-seedling transmission. Sixteen treatments including physical, chemical, and combinations of physical and chemical measures were compared in terms of their elimination efficiency on AMV and MsAPV2 and impacts on seed germination. The results showed that soaking alfalfa seeds in sterile distilled water for 2h + 2% NaClO for 1h or 2% NaClO for 1h were more promisingly applicable because it could significantly reduce AMV and MsAPV2 particles in both seeds and seedlings. Our data revealed a route of virus transmission in alfalfa and shed light on the discovery of a highly efficient method for the management of alfalfa viral diseases.
PubMed: 38903432
DOI: 10.3389/fpls.2024.1330219 -
Cureus May 2024Middle cerebral artery dissection (MCAD) is a rare condition with no consensus on its treatment strategy and prognosis. This report describes a case of MCAD with...
Middle cerebral artery dissection (MCAD) is a rare condition with no consensus on its treatment strategy and prognosis. This report describes a case of MCAD with perforating artery infarction in which radiographic findings progressed despite a lack of symptoms following maintenance infusion without antithrombotic therapy. A five-year-old boy presented to our hospital with right hemiplegia. Magnetic resonance imaging revealed diffusion restriction in the left basal ganglia. Additionally, magnetic resonance angiography (MRA) revealed irregular walls in the horizontal portion of the left middle cerebral artery. MRA performed three months after admission revealed progressive stenosis but no new ischemic lesions. MCAD can be associated with long-term morphological changes in the vessel walls. Intracranial artery dissection (IAD) in pediatric patients often presents without headache or neck pain, and serial imaging helps monitor disease progression. In conclusion, the morphology of the vessels can change over several months. Especially in pediatric patients, IAD often presents without headache or neck pain, and serial imaging evaluations help monitor disease progression.
PubMed: 38903379
DOI: 10.7759/cureus.60625 -
Cureus May 2024Cardiac catheterization is an invasive procedure done for diagnostic and therapeutic purposes to assess coronary artery disease (CAD) and valvular diseases. Although...
Cardiac catheterization is an invasive procedure done for diagnostic and therapeutic purposes to assess coronary artery disease (CAD) and valvular diseases. Although complications rarely occur, they are possible. Of those complications, iatrogenic coronary artery dissection during a coronary catheterization is infrequent and can be severe. This case report discusses a 59-year-old female presenting to the emergency department for sudden onset chest pain, found to have a non-ST-elevation myocardial infarction (NSTEMI), and underwent a left heart catheterization (LHC). During the LHC, she sustained a coronary artery dissection.
PubMed: 38903339
DOI: 10.7759/cureus.60768 -
Cureus May 2024The present study is set in the broad field of assisted reproductive technologies (ARTs) and examines various procedures under assisted hatching (AH). It also reviews... (Review)
Review
The present study is set in the broad field of assisted reproductive technologies (ARTs) and examines various procedures under assisted hatching (AH). It also reviews their effects on implantation success rates. The primary emphasis is on explaining who has benefited and how many have benefited from these interventions. The most important factor determining the success rate of ART is implantation. To increase these rates, we use AH in our clinics to enhance each embryo's chances at life and substantially improve overall results. This comprehensive review includes various approaches, such as chemical-based measures (such as applying Tyrode's solution) and mechanical techniques (such as zona drilling and partial zona dissection). The individual techniques are carefully scrutinized, considering their mechanical detailing, methods of applying therapeutic effects, and the appropriateness of matching present social circumstances. The review begins by analyzing the basic nature of AH as a medium for embryo implantation and then focuses on how this detailed view reveals the advantages and drawbacks of various methods. Moreover, the articles discuss improvements in AH technology and many of the most modern technological developments that can help fine-tune ART issues. A major problem with these methodologies is that they involve serious risks and legal complications. However, a broad assessment of these topics allows us to understand their impact on fertility treatments. This review is written as a guidebook for physicians and researchers working in reproductive medicine. It compiles all current knowledge, providing literature to build on successes that will make breakthroughs possible in ART. Indeed, this is a valuable reference for guiding us in navigating complex AH procedures. It advances ARTs step by step toward perfection.
PubMed: 38903279
DOI: 10.7759/cureus.60736 -
Cureus May 2024Objective This study investigates the overall survival (OS) of elderly patients who underwent total laryngectomy for laryngeal cancer (LC) and examines the impact of...
Objective This study investigates the overall survival (OS) of elderly patients who underwent total laryngectomy for laryngeal cancer (LC) and examines the impact of tumor-node-metastasis (TNM) staging on survival rates. Methods A retrospective cohort study utilized data from the Otorhinolaryngology Clinic at the University Hospital of Patras, including 75 elderly patients (>65 years) who underwent total laryngectomy for LC between 2000 and 2015. Survival analysis was performed using the Kaplan-Meier estimator, with comparisons made using the Log-rank test. Statistical significance was defined as the p-value being less than or equal to 0.05. Results Over the 16-year period, new LC cases were predominantly male (97.3%) with a mean age of 73.88 years (range: 65-89 years). Most patients were smokers (96%) and alcohol users (54.7%). Histologically, 18.7% of tumors were classified as poorly differentiated, 65.3% as moderately differentiated and 16% as well differentiated. Post-surgical TNM staging indicated 10.7% stage II, 37.3% stage III and 52% stage IV, primarily located in the glottis (62.7%) and followed by supraglottis (34.7%). All patients underwent total laryngectomy, with 69.3% and 37.3% receiving neck dissection and adjuvant therapy (chemotherapy or radiotherapy), respectively. During follow-up, 39 patients died, with 74.3% due to disease-related causes. Five-year OS rates were 44.6%, with variations by stage (stage II: 62.5%, stage III: 55.8%, stage IV: 32.4%; p=0.039) and age (65-75 years: 51.7%, >75 years: 34.7%; p=0.039). Conclusions TNM staging of the laryngeal cancer significantly influences the overall survival of elderly patients undergoing total laryngectomy for LC. Early diagnosis of the disease is crucial for patient survival.
PubMed: 38903270
DOI: 10.7759/cureus.60792 -
Cardiovascular Endocrinology &... Sep 2024The correlation between diabetes and aortic dissection is not fully understood yet, although in literature many studies have suggested that there may be an association...
BACKGROUND
The correlation between diabetes and aortic dissection is not fully understood yet, although in literature many studies have suggested that there may be an association between the two conditions. The purpose of this study is to evaluate whether diabetes represents a short- and long-term risk factor for mortality from type A acute aortic dissection.
MATERIALS AND METHODS
A total of 340 patients with the diagnosis of type A acute aortic dissection underwent aortic surgery between January 2002 and March 2023. The sample was divided into 2 cohorts according to the presence of diabetes ( = 34) or not ( = 306).
RESULTS
The mean age was 66 (±12.4) years and 60.9% were male. The primary endpoint was 30-day mortality. Hospital mortality was 12 (35.3%) for the diabetes group and 70 (22.9%) for nondiabetes group ( = 0.098). Overall survival at 10 years was 48.3% [95% confidence interval (CI): 41.6-54.7%], while the 10-year survival for people with diabetes was 29.5% (95% CI: 13.2-47.9%) and for nondiabetes group 50.6% (95% CI: 43.4-57.3%) (Log-rank, = 0.024).
CONCLUSION
Diabetes was not found to be a risk factor associated with 30-day mortality in patients undergoing surgery for type A acute aortic dissection. It was a risk factor for long-term survival, but this may be related to diabetes complications.
PubMed: 38903248
DOI: 10.1097/XCE.0000000000000306