Κυριακή 26 Δεκεμβρίου 2021

Regulation of nuclear medicine services: Perception of the problems and challenges in Colombia for the approach to cancer

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Biomedica. 2021 Dec 15;41(4):692-705. doi: 10.7705/biomedica.6123.

ABSTRACT

Introduction: Colombia has modified the nuclear medicine norms that impact the administration of radioactive iodine therapy in the treatment of thyroid cancer. Objective: To identify the areas of agreement regarding the issue, as well as the current and emergent requirements associated with the normative for the operation of nuclear medicine services that have an impact on the care of patients with thyroid cancer in Colombia. Materials and methods: We conducted a two-round Delphi study for each expert, clinical, and regulatory group. The first round explored views on the implications of the regulations that apply to nuclear medicine. The second round rated the statements from the first round by their relevance. Results: The issues regarding nuclear medicine services were related to the normative clarity and the lack of synergy and coherence among inspection, surveillance, and control bodies. The demands on the waste management system require a high economic investment that can influence the service offer and have an impact on the integral control of thyroid cancer. Unification of the auditors' criteria, delimitation of the acting agent functions, technical assistance to the services to comply with the normative, and the oversight of the inspection, surveillance, and control bodies by the regulatory entities are among the current and future needs. Conclusions: Our findings suggest th at nuclear medicine services are going through a time of multiple institutional, regulatory, and economic challenges that put at risk the development and maintenance of nuclear medicine in cancer care.

PMID:34936254 | DOI:10.7705/biomedica.6123

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Machine learning can identify patients at risk of hyperparathyroidism without known calcium and intact parathyroid hormone

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Abstract

Background

To prove the concept of diagnosing primary hyperparathyroidism (pHPT) without calcium and parathyroid hormone (PTH) values and identifying potential risk factors for pHPT.

Methods

Data were extracted from the clinical data warehouse (CDW) at the University of Arkansas for Medical Sciences (UAMS) Epic EHR (2014–2019).

Results

1737 patients with over 185 000 rows of clinical data were provided in a relational structure and processed/flattened to facilitate modeling. Phenotype elements were identified for pHPT without advance knowledge of calcium and PTH levels. The area under the curve (AUC) for the prediction of pHPT using our model was 0.86 with sensitivity and specificity of 0.8953 and 0.6686, respectively, using a 0.45 probability threshold.

Conclusion

Primary hyperparathyroidism was predicted from a dataset excluding calcium and PTH data with 86% accuracy. This approach needs to be validated/refined on larger samples of data and plans are in place to do this with other regional/national datasets.

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A Systematic Review of Robotic Surgery: From Supervised Paradigms To Fully Autonomous Robotic Approaches

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Abstract

Background

From traditional open surgery to laparoscopic surgery and robot-assisted surgery (RAS), advances in robotics, machine learning, and imaging are pushing the surgical approach to-wards better clinical outcomes. Pre-clinical and clinical evidence suggests that automation may standardise techniques, increase efficiency, and reduce clinical complications.

Methods

A PRISMA-guided search was conducted across PubMed and OVID.

Results

Of the 89 screened articles, 51 met the inclusion criteria, with 10 included in the final review. Automatic data segmentation, trajectory planning, intra-operative registration, trajectory drilling, and soft tissue robotic surgery were discussed.

Conclusion

Although automated surgical systems remain conceptual, several research groups have developed supervised autonomous robotic surgical systems with increasing consideration for ethico-legal issues for automation. Automation paves the way for precision surgery and improved safety and opens new possibilities for deploying more robust artificial intelligence models, better imaging modalities and robotics to improve clinical outcomes.

This article is protected by copyright. All rights reserved.

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The programmed gene expression change in mouse skin after ultraviolet radiation damage

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ABSTRACT

Ultraviolet (UV) radiation is a major cause of skin damage and carcinogenesis. Here we systematically analyze the acute gene expression change in skin in vivo after UV exposure, aiming to establish the common C57BL/6 mouse strain as a convenient model for future pathological research and drug discovery. The back fur of C57BL/6 mice was depilated, and a mixed UV light source was used to irradiate the skin. Full thickness skin samples were collected at 0, 0.5h, 2h, 6h, 12h, and 24h. Total RNAs were extracted and subjected to RNA sequencing analysis. We found that the gene expression change in mouse skin is highly similar to previous reports in human skin. These include down-regulation of differentiation-related genes and extracellular matrix genes, and up-regulation of cytokine/chemokine genes. An early wave of activator protein 1 (AP-1) expression is induced, whereas activation of the p53 pathway is not significant. The impact of the AP-1 transcription factors and the antioxidant t ea polyphenols is discussed. The analysis of acute gene expression change in skin after UV irradiation provides a starting point to investigate how the skin responds to genotoxic stress.

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Τετάρτη 22 Δεκεμβρίου 2021

Case Reports in Otolaryngology


Arteriovenous Malformation in the Auricle in a 59-Year-Old Woman
, Junhui Jeong
Volume 2021 (2021), Article ID 7438571, 3 pages
A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base, Kohei Matsuo, Satoshi Tanaka, Masayuki Sakata, Hiroki Takeda, Akihiro Nagata, Masashi Mori, Rie Ito, Yoshifumi Yamamoto, Kiyonobu Ueno, and Atsuhiko Uno
Volume 2021 (2021), Article ID 7500273, 4 pages
Deep Neck Infection: Atypical Presentation of Papillary Thyroid Cancer, Apichana Mahattanapreut, Rangsima Aroonroch, Chalermchai Chintrakarn, and Chutintorn Sriphrapradang
Volume 2021 (2021), Article ID 1479201, 4 pages
Alobar Holoprosencephaly with Cebocephaly in a Neonate Born to an HIV-Positive Mother in Eastern Uganda, Franck Katembo Sikakulya, Sonye Magugu Kiyaka, Robert Masereka, and Robinson Ssebuufu
Volume 2021 (2021), Article ID 7282283, 4 pages
ALK-Positive Anaplastic Large Cell Lymphoma: A Diagnostic Dilemma for the Otolaryngologist in a Resource Poor Setting, Nicholas Figaro, Rickhi Ramoutar, Rodolfo Arozarena, Dawn Meyers, and Solaiman Juman
Volume 2021 (2021), Article ID 3756742, 6 pages
INI1-Intact Sinonasal Carcinoma with Rhabdoid Features, Erin Mulry, Danielle M. Blake, Poornima Hegde, and Todd E. Falcone
Volume 2021 (2021), Article ID 6075130, 3 pages
Bilateral Recurrent Laryngeal Nerve Palsy following Total Thyroidectomy in Triple A Syndrome, an Unexpected but Critical Complication, Mathieu Chamberland, Marc-Antoine Poulin, and Danielle Beaudoin
Volume 2021 (2021), Article ID 1315117, 3 pages
Importance of Imaging in Congenital Unilateral Vocal Fold Paralysis: A Case of Neck Neuroblastoma Presenting with Unilateral Vocal Fold Paralysis, W. X. Yeo, C. Y. Chan, and K. K. H. Tan
Volume 2021 (2021), Article ID 7368567, 4 pages
A Rare Complication of Fine-Needle Aspiration of Neck Structures, Yazeed M. Qadadha, Nainika Nanda, Chad Ennis, and Timothy McCulloch
Volume 2021 (2021), Article ID 8944119, 5 pages
Delayed-Onset Neuropathic Pain after Septoplasty, Foteini-Stefania Koumpa, Mark Ferguson, and Hesham Saleh
Volume 2021 (2021), Article ID 9966318, 4 pages

In vitro and in vivo effects of AVA4746, a novel competitive antagonist of the ligand binding of VLA-4, in B-cell acute lymphoblastic leukemia

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Exp Ther Med. 2022 Jan;23(1):47. doi: 10.3892/etm.2021.10969. Epub 2021 Nov 15.

ABSTRACT

Treatment of resistant or recurrent acute lymphoblastic leukemia (ALL) remains a challenge. It was previously demonstrated that the adhesion molecule integrin α4, referred to hereafter as α4, mediates the cell adhesion-mediated drug resistance (CAM-DR) of B-cell ALL by binding to vascular cell adhesion molecule-1 (VCAM-1) on bone marrow stroma. In addition, it was previously observed that the blockade of α4 with natalizumab or inhibition using the small molecule antagonist TBC3486 sensitized relapsed ALL cells to chemotherapy. However, α4-targeted therapy is not clinically available for the treatment of leukemia to date. In the present study, the use of a novel non-peptidic small molecule integrin α4 antagonist, AVA4746, as a potential new approach to combat drug-resistant B-ALL was explored. An in vitro co-culture = model of primary B- ALL cells and an in vivo xenograft model of patient-derived B-ALL cells were utilized for evaluation of AVA4746. VLA-4 conformation activation, cell adhesion/de-adhesion, endothelial tube formation, in vivo leukemia cell mobilization and survival assays were performed. AVA4746 exhibited high affinity for binding to B-ALL cells, where it also efficiently blocked ligand-binding to VCAM-1. In addition, AVA4746 caused the functional de-adhesion of primary B-ALL cells from VCAM-1. Inhibition of α4 using AVA4746 also prevented angiogenesis in vitro and when applied in combination with chemotherapy consisting of Vincristine, Dexamethasone and L-asparaginase, it prolonged the survival of ~33% of the mice in an in vivo xenograft model of B-ALL. These data implicate the potential of targeting the α4-VCAM-1 interaction using AVA4746 for the treatment of drug-resistant B-lineage ALL.

PMID:34934426 | PMC:PMC8652384 | DOI:10.3892/etm.2021.10969

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The Nonrecurrent Laryngeal Nerve Without Abnormal Subclavian Artery: Report of Two Cases and Review of the Literature

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Ear Nose Throat J. 2021 Dec 22:1455613211056547. doi: 10.1177/01455613211056547. Online ahead of print.

ABSTRACT

As a variant of recurrent inferior laryngeal nerve (RILN), the nonrecurrent inferior laryngeal nerve (NRILN) is closely related to the occurrence of abnormal subclavian artery (ASA). The nonrecurrent inferior laryngeal nerve has been found in patients without arterial abnormalities, which is seen in the coexistence of NRILN and RILN, but it is easily confused with sympathetic-inferior laryngeal anastomosis branch (SILAB). We encountered 2 right NRILN patients without ASA during thyroid surgery. This article summarizes the characteristics of these cases and proposes methods to distinguish the coexistence of NRILN and RILN from SILAB. So far, 11 articles have reported 16 cases of NRILN without arterial abnormalities. In patients without artery abnormality, the vagus nerve could send out a descending branch NRILN at the bifurcation of the carotid artery and enter the larynx after anastomosis with RILN. Adequate dissection of the carotid sheath may avoid confusion with SILAB, and neural monitoring is also expected to provide a reference for the identification.

PMID:34935547 | DOI:10.1177/01455613211056547

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