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Oncology Letters Aug 2024Cutaneous squamous cell carcinoma (cSCC) is the second most common type of skin cancer. Photodynamic therapy (PDT) is a promising therapeutic method for managing cSCC...
Increased CD56 expression after photodynamic therapy indicates an increased natural killer cell count following early photodynamic therapy for cutaneous squamous cell carcinoma.
Cutaneous squamous cell carcinoma (cSCC) is the second most common type of skin cancer. Photodynamic therapy (PDT) is a promising therapeutic method for managing cSCC due to its proven ability to target specific areas over time and its low risk of side effects. PDT may cause tissue damage and vascular shutdown, and may regulate local immunological responses. The present study aimed to investigate and compare the early lymphocyte modifications before and after PDT for SCC. A total of 10 patients with SCC were identified by pathological investigation. Initially, all wounds were treated with 20% aminolevulinic acid (ALA)-PDT as the initial stage in the therapeutic procedure. The wounds were treated by exposing them to red LED light with a wavelength of 635 nm, an energy density of 100 J/cm and an intensity of 80 mW/cm. The tumor tissue was surgically removed 24 h later, and another round of PDT therapy was administered. Immunohistochemistry for CD3 and CD56 was conducted on the wound tissue post-surgery. If the wound showed granulation, necrosis or secretion, debridement was added to the therapy. All patients were monitored for 0.6-1.0 year post-treatment. ALA-PDT combination surgery fully controlled the tumor tissue in all 10 patients. The immunohistochemical analysis of the wound tissues showed that the expression of CD56 increased, while the expression of CD3 was not different after photodynamic therapy. These results also indirectly indicated that the overall count of NK cells in the 10 patients increased, nevertheless, there was no alteration in the T lymphocyte count. In conclusion, the ALA-PDT combination surgical therapy for cSCC demonstrates favorable results. An increase in CD56 expression may be a mechanism for the effective treatment of cSCC with PDT.
PubMed: 38910905
DOI: 10.3892/ol.2024.14505 -
Cureus May 2024Gender-based discrimination, particularly in healthcare, affects women's roles and opportunities, including in surgery where they remain underrepresented in leadership...
INTRODUCTION
Gender-based discrimination, particularly in healthcare, affects women's roles and opportunities, including in surgery where they remain underrepresented in leadership positions. The extent to which such discrimination is prevalent in attending positions is unclear.
METHODS
The publicly available records of 48 universities and university-associated hospitals in Germany were extracted to quantify gender ratios among attending surgeons and head surgeons in the fields of visceral, vascular, cardiac, thoracic, pediatric, orofacial, neuro-, trauma, and plastic surgery. Statistical analysis, including Chi-Square tests and Student's t-test, was used to analyze the data.
RESULTS
Among the 367 department heads, 353 (96.2%) were male and 14 (3.8%) were female. Among the 2,366 attendings, 1,854 (78.4%) were men and 512 (21.6%) were women. These differences were significant (χ²=64.95, p<0.001, odds ratio=0.14, 95% confidence interval=0.08-0.25). Departments being led by a female department head were not more likely to employ female attendings (χ²=0.379, p=0.538, odds ratio=1.17, 95% confidence interval=0.70-1.96).
CONCLUSION
German surgical departments in University Hospitals have significant gender disparities, with women underrepresented at higher levels. This may negatively affect patient outcomes. To tackle the problem, further research is needed to fully understand the issue.
PubMed: 38910788
DOI: 10.7759/cureus.60860 -
Cureus May 2024Although cutaneous melanoma (CM) is one of the most prevalent cancers in adults, it is rarely reported in children. Often, the diagnosis is delayed and difficult to...
Although cutaneous melanoma (CM) is one of the most prevalent cancers in adults, it is rarely reported in children. Often, the diagnosis is delayed and difficult to make. We presented two novel examples of pediatric CM from the Department of Pediatric Plastic Surgery Unit at Rabat Children's Hospital. The first case included a 14-year-old girl who had a cutaneous nodule on her right leg. She first came with an inguinal enlargement, for which a lymph node biopsy was positive. A further inguinal dissection of 10 lymph nodes revealed four metastatic ones (4N+\10N). She received a wide local excision of the lesion, which revealed nodular melanoma with an 8 mm thickness as determined by Breslow, as well as safe lateral and deep margins. The course was distinguished by the emergence of new metastatic lymph node locations, and the patient died a few weeks later. The second case included a 13-year-old girl who appeared with a cutaneous lesion centered on a scar on her right leg. She also underwent a large local excision, which revealed nodular melanoma with a thickness of 12 mm according to Breslow, as well as complete lateral and deep excisions. Her follow-up revealed favorable results, with no local recurrence or distant metastases. This case series emphasized the difficult management of two separate occurrences of pediatric CM. We also emphasized the importance of early detection of suspicious lesions, regular follow-ups, and raising awareness among high-risk patients.
PubMed: 38910782
DOI: 10.7759/cureus.60999 -
Cureus May 2024Introduction Lung cancer is the leading cause of oncological deaths worldwide. Various combined inflammatory indexes, such as the systemic immune-inflammation index...
Introduction Lung cancer is the leading cause of oncological deaths worldwide. Various combined inflammatory indexes, such as the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) have shown associations with pretreatment survival prognosis in patients suffering of lung cancer with or without brain metastases. This study aimed to compare the average values of NLR, PLR, LMR, and SII in healthy patients, patients with lung cancer without any other metastases, and patients with lung cancer and brain metastases. Materials and methods In this prospective study, we have divided the patients into three groups: Group 1 included patients diagnosed with lung cancer and one or more brain metastases of lung cancer origin, Group 2 included patients diagnosed with lung cancer without known metastases, and Group 3 was the control group which included healthy subjects. Preoperative complete blood counts were extracted for all included patients and we calculated the values of SII, NLR, PLR, and LMR for each individual patient in each group. The next step was to calculate the average values of SII, NLR, PLR, and LMR for each group of patients and to identify the differences between groups. Results A total number of 228 patients were enrolled in the study. Group 1 included 67 patients with average values of SII = 2020.98, NLR = 7.25, PLR = 199.46, and LMR = 2.97. Group 2 included 88 patients with average values of SII = 1638.01, NLR = 4.58, PLR = 188.42, and LMR = 3.43. Group 3 included 73 subjects with the following average values of the inflammatory indexes: SII = 577.41, NLR = 2.34, PLR = 117.84, and LMR = 3.56. Conclusion We observed statistically significant differences in SII, NLR, and PLR among the three groups of patients, suggesting their potential role as prognostic markers. Furthermore, our analysis revealed significant correlations between inflammatory markers within lung cancer patients, highlighting their involvement in tumor microenvironment modulation. Our findings demonstrate an escalation in SII, NLR, and PLR values as the disease progresses. These parameters of inflammation and immune status are readily and cost-effectively, and repeatedly assessable in routine clinical practice.
PubMed: 38910770
DOI: 10.7759/cureus.60921 -
Cureus May 2024Hair-thread tourniquet syndrome (HTTS) is an uncommon but preventable disorder in which a body appendage becomes constricted after becoming firmly wrapped by a hair or... (Review)
Review
Hair-thread tourniquet syndrome (HTTS) is an uncommon but preventable disorder in which a body appendage becomes constricted after becoming firmly wrapped by a hair or substance that resembles hair. The genitalia, fingers, and toes are typically affected. Prompt diagnosis and treatment by complete removal of the constricting agent are crucial for the preservation of the affected appendage. This narrative review article revisits HTTS in the context of the recent literature with the aim of raising healthcare professionals' awareness of this surgical emergency so that the condition can be prevented, correctly diagnosed, and treated early.
PubMed: 38910739
DOI: 10.7759/cureus.60832 -
Cureus May 2024Introduction As of 2008, the United States had 41,000 people living with upper extremity amputation. This number is projected to reach 300,000 by 2050. Human upper...
Introduction As of 2008, the United States had 41,000 people living with upper extremity amputation. This number is projected to reach 300,000 by 2050. Human upper extremity transplantation (HUET) may become a more common treatment option with the potential to significantly improve the quality of life for certain amputees. Awareness and opinions regarding HUET among Americans, particularly in Veterans/Service Members (VSM) affiliates, are largely unknown. Materials and methods We administered a survey on Amazon Mechanical Turk (MTurk) workers. Eligible participants were US citizens aged ≥18 years; MTurk worker selection targeted workers who self-reported being a VSM. We used descriptive statistics to summarize study findings and Fisher's exact and Wilcoxon's rank-sum tests for between-group comparisons. Results The survey was completed by 764 individuals, 604 (79.1%) of whom reported being aware of HUET. Among those familiar versus unfamiliar, a significantly higher proportion were aged ≤35 years (n=385, 64.0% vs. n=86, 53.7%; p=0.017), employed (n=523, 86.6% vs. n=114, 71.3%; p<0.001), and aware of their religion's stance on organ/tissue donation (n=341, 54.5% vs. n=62, 38.8%; p<0.001). Amputees and/or respondents related to an amputee were more likely to be aware of HUET than individuals who were amputation naive (n=211, 90.6% vs. n=393, 74.0%, respectively; p<0.001), as were individuals with a personal or familial military affiliation (n=286, 85.4% with vs. n=318, 74.1% with no affiliation; p<0.001). The most reported HUET information sources were digital media (n=157, 31.2%) and internet (n=137, 27.2%). Conclusions Our survey of MTurk workers found greater awareness of HUET among individuals with a VSM or amputee connection. Our additional findings that the internet and academic sources, such as journals or reputable medical publications, were respondents' preferred sources of HUET information emphasize the importance of vascularized composite allotransplantation (VCA) centers' involvement in creating accurate and accessible content to help educate the public about this treatment.
PubMed: 38910738
DOI: 10.7759/cureus.60941 -
Acta Oncologica (Stockholm, Sweden) Jun 2024
Topics: Humans; Neoplasms; Practice Guidelines as Topic; Cancer Survivors
PubMed: 38910334
DOI: 10.2340/1651-226X.2024.40787 -
Journal of Advanced Research Jun 2024Rosacea is an inflammatory skin disorder characterized by the release of inflammatory mediators from keratinocytes, which are thought to play a crucial role in its...
BACKGROUND
Rosacea is an inflammatory skin disorder characterized by the release of inflammatory mediators from keratinocytes, which are thought to play a crucial role in its pathogenesis. Despite an incidence of approximately 5.5%, rosacea is associated with a poor quality of life. However, as the pathogenesis of rosacea remains enigmatic, treatment options are limited.
OBJECTIVES
To investigate the pathogenesis of rosacea and explore new therapeutic strategies.
METHODS
Transcriptome data from rosacea patients combined with immunohistochemical staining were used to investigate the activation of STAT3 in rosacea. The role of STAT3 activation in rosacea was subsequently explored by inhibiting STAT3 activation both in vivo and in vitro. The key molecules downstream of STAT3 activation were identified through data analysis and experiments. Dual-luciferase assay and ChIP-qPCR analysis were used to validate the direct binding of STAT3 to the IL-36G promoter. DARTS, in combination with experimental screening, was employed to identify effective drugs targeting STAT3 for rosacea treatment.
RESULTS
STAT3 signaling was hyperactivated in rosacea and served as a promoter of the keratinocyte-driven inflammatory response. Mechanistically, activated STAT3 directly bind to the IL-36G promoter region to amplify downstream inflammatory signals by promoting IL-36G transcription, and treatment with a neutralizing antibody (α-IL36γ) could mitigate rosacea-like inflammation. Notably, a natural plant extract (pogostone), which can interact with STAT3 directly to inhibit its activation and affect the STAT3/IL36G signaling pathway, was screened as a promising topical medication for rosacea treatment.
CONCLUSIONS
Our study revealed a pivotal role for STAT3/IL36G signaling in the development of rosacea, suggesting that targeting this pathway might be a potential strategy for rosacea treatment.
PubMed: 38909883
DOI: 10.1016/j.jare.2024.06.013 -
Journal of Plastic, Reconstructive &... Jun 2024Protocols surrounding opioid reduction have become commonplace in plastic surgery to improve peri-operative outcomes. Within such protocols, opioid requirement is a... (Review)
Review
INTRODUCTION
Protocols surrounding opioid reduction have become commonplace in plastic surgery to improve peri-operative outcomes. Within such protocols, opioid requirement is a frequently analyzed outcome. Though often examined, there is no literature standard conversion for morphine milligram equivalents (MME) at present, leading to questionable external validity. We hypothesized significant heterogeneity in MME reporting would exist within plastic surgery literature.
METHODS
Following the PRISMA guidelines, the authors conducted a systematic review of 16 journals. Clinical studies focused on opioid reduction within plastic surgery were identified. Primary outcomes included reporting of morphine equivalents (ME) delivery (IV/oral), operative ME, inpatient ME, outpatient ME, timeline, and method of calculation.
RESULTS
Among the 101 studies analyzed, 73% reported opioid requirements in the form of ME. Among those that used ME, 3% reported IV ME, 41% reported oral, 32% reported both, and 25% gave no indication of either. Operative ME were reported in 19% of studies. Furthermore, 54% of studies reported inpatient ME whereas 32% of studies reported outpatient ME. Only 19% reported the number of days opioids were consumed postoperatively. Moreover, 27% of the studies reported the actual method of ME conversion, with 17 unique methods described. Only 8 studies (8%) reported using the Center for Disease Control and Prevention guidelines for ME conversion.
CONCLUSION
There is significant variability among the reported ME conversion methodology within plastic surgery literature. Highlighting these discrepancies is an essential step in creating and implementing a single, standard method to mitigate opioid morbidity in plastic surgery and to optimize enhanced recovery protocols.
PubMed: 38909598
DOI: 10.1016/j.bjps.2024.06.001 -
Lipids in Health and Disease Jun 2024Observational studies have indicated that the plasma lipid profiles of patients with atopic dermatitis show significant differences compared to healthy individuals....
BACKGROUND
Observational studies have indicated that the plasma lipid profiles of patients with atopic dermatitis show significant differences compared to healthy individuals. However, the causal relationship between these differences remains unclear due to the inherent limitations of observational studies. Our objective was to explore the causal effects between 179 plasma lipid species and atopic dermatitis, and to investigate whether circulating inflammatory proteins serve as mediators in this causal pathway.
METHODS
We utilized public genome-wide association studies data to perform a bidirectional two-sample, two-step mendelian randomization study. The inverse variance-weighted method was adopted as the primary analysis technique. MR-Egger and the weighted median were used as supplementary analysis methods. MR-PRESSO, Cochran's Q test, and MR-Egger intercept test were applied for sensitivity analyses to ensure the robustness of our findings.
RESULTS
The Mendelian randomization analysis revealed that levels of Phosphatidylcholine (PC) (18:1_20:4) (OR: 0.950, 95% CI: 0.929-0.972, p = 6.65 × 10), Phosphatidylethanolamine (O-18:1_20:4) (OR: 0.938, 95% CI: 0.906-0.971, p = 2.79 × 10), Triacylglycerol (TAG) (56:6) (OR: 0.937, 95% CI: 0.906-0.969, p = 1.48 × 10) and TAG (56:8) (OR: 0.918, 95% CI: 0.876-0.961, p = 2.72 × 10) were inversely correlated with the risk of atopic dermatitis. Conversely, PC (18:1_20:2) (OR: 1.053, 95% CI: 1.028-1.079, p = 2.11 × 10) and PC (O-18:1_20:3) (OR: 1.086, 95% CI: 1.039-1.135, p = 2.47 × 10) were positively correlated with the risk of atopic dermatitis. The results of the reverse directional Mendelian randomization analysis indicated that atopic dermatitis exerted no significant causal influence on 179 plasma lipid species. The level of circulating IL-18R1 was identified as a mediator for the increased risk of atopic dermatitis associated with higher levels of PC (18:1_20:2), accounting for a mediation proportion of 9.07%.
CONCLUSION
Our research suggests that plasma lipids can affect circulating inflammatory proteins and may serve as one of the pathogenic factors for atopic dermatitis. Targeting plasma lipid levels as a treatment for atopic dermatitis presents a potentially novel approach.
Topics: Dermatitis, Atopic; Humans; Mendelian Randomization Analysis; Genome-Wide Association Study; Lipids; Triglycerides; Phosphatidylethanolamines; Phosphatidylcholines; Polymorphism, Single Nucleotide
PubMed: 38909247
DOI: 10.1186/s12944-024-02134-9