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Current guidelines recommend to prolong anticoagulant treatment in patients with cancer with venous thromboembolism (VTE); only few studies evaluated other parameters than cancer itself for selecting patients at higher risk of recurrent VTE. Long-term management of VTE is thus challenged by several controversies mainly for patients compliance. We here report results of a long-term follow-up in patients with deep vein thrombosis under anticoagulant treatment with low-molecular-weight heparin (LMWH) for residual vein thrombosis (RVT) detected at compression ultrasonography (CUS), 6 months after standard anticoagulant treatment. Patients with RVT were deemed at high risk of recurrences and included in the current observational study. They continued LMWH (reduced at 75% standard dose) for further additional 2 years after enrolment or until death. Patients were followed up every 3 months or earlier, if needed. Among ancillary study end points, there was the assessment of patients' quality of life during daily treatment with subcutaneous injections. Quality of life was determined by the EORTC-C30 questionnaire, administered by a skilled psychologist at enrolment and every 6 months follow-up visits. Overall, 128 patients were evaluated during follow-up. Mean global EORTC-C30 score at enrollment and at 6, 12 and 24 months follow-up were 52.1, 51.4, 50.8 and 50.1, respectively. There were no statistically significant differences between scores at enrolment and at the last available follow-up (P =.1). Long-term treatment with LMWH resulted, effective and safe, it was globally well tolerated and exempt of negative impact on quality of life of the enrolled patients. Reported results support long-term anticoagulant treatment with LMWH in cancer patients at risk of recurrent VTE. [ABSTRACT FROM AUTHOR]

Cervical cancer is still a major health problem in India with majority of patients presenting with locally advanced stages. Management of local recurrences of cervical cancer after chemoradiation is a challenging task. Pelvic exenteration is a radical surgery with en bloc resection of pelvic organs is an accepted treatment modality for local recurrence of cervical cancer. In a low-resource country like India where alternate treatment modalities like chemotherapy and targeted therapy are unaffordable to these patients, this radical surgery may be the only treatment modality which gives long-term survival benefit. The aim of the study is to evaluate the morbidity and survival outcome following pelvic exenteration in patients with recurrent cervical cancer in our institution. After obtaining institutional review board approval, a retrospective audit was conducted of all patients who underwent pelvic exenterative surgery for recurrent cervical cancer in our institution from January 2007 to December 2017. The parameters assessed were age of the patient, histologic type and grade, stage of disease, surgical procedures performed, type of reconstruction, intra-operative complications, length of hospital stay, and post-operative morbidity. Patients were followed until March 2017. Survival time was calculated from the date of surgery to the date of last contact or death. Survival estimation was done by Kaplan-Meier method. Between 2007 and 2017, 30 patients underwent the surgery. Mean age of the cohort was 50.9 years (range 33–67 years). Histological type was squamous cell carcinoma in 23 and adenocarcinoma in 7 patients. Twelve patients had anterior exenteration, one had posterior and 17 had total exenteration. The mean operating time was 367.3 min (210–600 min). No post-operative mortality was observed. Post-operative complications were seen in 66.6% of which the most common was of the urinary tract including 4 patients with recurrent urosepsis, one patient with obstructive uropathy and acute renal failure necessitating laparotomy and ureteric reimplantation. Two patients developed fistulae, one urinary and one bowel. Median follow-up time was 27.5 months (1.8–99.1 months). A five-year overall survival for the cohort was 60.5%. It is suggested that pelvic exenteration is an effective technique with reasonable long-term survival benefit and acceptable morbidity in selected patients with cervical cancer recurrence. [ABSTRACT FROM AUTHOR]

In this article, a semiotic approach is proposed to explain how human agents use and give meaning to art in complex contexts. Inspired by the psycho-historical approach on art appreciation, which attempts to embrace psychological and cognitive aspects of art sense-making, as well as the art-historical context dependence of artworks, an extended theory is suggested: an agent's art use and interpretation can be described using three general categories of meaning grounding: phylogenetic recurrence, ontogenetic recurrence and collective recurrence. These categories explain how a certain meaning of a sign is possible and justifiable, supported by human agents' capabilities and purposes. This article also proposes that it is possible to narrate, using such categories of meaning grounding, how different agents enact art, that is, give meaning and act upon art in different circumstances. Finally, I offer some examples about how the model can be used in real art contexts. The objective of this narrative-enactive approach, even though it offers a limited and edited focus, is to offer an orderly and comprehensible method to explain the dynamic nature of art meaning and how biologic, individual and collective grounding and purposes intertwine. [ABSTRACT FROM AUTHOR]

We examine two truncated series derived from a classical theta identity of Gauss. As a consequence, we obtain two infinite families of inequalities for the overpartition function p o ¯ (n) counting the number of overpartitions into odd parts. We provide partition-theoretic interpretations of these results. [ABSTRACT FROM AUTHOR]

Background: Warts are mucocutaneous infections caused by human papillomavirus (HPV). Of the various modalities of treatment currently available, no single modality is uniformly efficacious and recurrences are common. Homologous autoimplantation is a minimally invasive procedure, which treats warts by stimulating a specific immune response against HPV. Aim: The aim of the study was to evaluate the clinical outcomes and recurrences after a single sitting of homologous autoimplantation therapy for multiple nonvenereal warts. Materials and Methods: Single homologous autoimplantation of wart tissue was done in 75 patients of multiple facial, palmoplantar, or common warts, reporting to a tertiary care dermatology center. They were assessed at 3 months for the outcome of the procedure, and those with complete clearance were followed up for 1 year for any recurrences. Results: Complete clearance was observed in 30 (40%) of the cases and 10 (13.3%) cases showed moderate clearance. In 13 (17.3%) cases, there was mild clearance, whereas 22 (29.3%) patients did not show any response to treatment. Patients with facial warts showed good therapeutic response with complete clearance seen in 62.5%, compared to plantar warts, where complete clearance was achieved only in 16%. At the end of the study period, recurrence was seen in only 1 (3.33%) patient in the complete clearance group. Conclusion: Autoimplantation therapy as a one time minimally invasive procedure has moderate efficacy in treating multiple warts with the best outcome being for facial warts. The virus-specific immunity generated in the process reduces the chances of recurrences.

Let λ (s) = ∑ n = 0 ∞ 1 (2 n + 1) s , β (s) = ∑ n = 0 ∞ (− 1) n (2 n + 1) s , and η (s) = ∑ n = 1 ∞ (− 1) n − 1 n s be the Dirichlet lambda function, its alternating form, and the Dirichlet eta function, respectively. According to a recent historical book by Varadarajan ([25, p. 70]), these three functions were investigated by Euler under the notations N (s) , L (s) , and M (s) , respectively. In this paper, we shall present some additional properties for them. That is, we obtain a number of infinite families of linear recurrence relations for λ (s) at positive even integer arguments λ (2 m) , convolution identities for special values of λ (s) at even arguments and special values of β (s) at odd arguments, and a power series expansion for the alternating Hurwitz zeta function J (s , a) , which involves a known one for η (s). [ABSTRACT FROM AUTHOR]

Background: Some pathogenetic risk factors (platelet-derived growth factor (PDGF); tumor necrosis factor alpha (TNFα); and Endothelin-1 (ET1)) are involved in the development of diabetic maculopathy (DMP) in type 2 diabetes mellitus. We hypothesized that the same factors are involved in the formation of postsurgical recurrent DMP. Purpose: To investigate new risk factors of postsurgical recurrent DMP in patients with DM2. Materials and Methods: The study included 313 patients with DM2 (313 eyes) and diabetic maculopathy. These included patients with mild nonproliferative diabetic retinopathy (NPDR; Group 1; n=40), moderate or severe NPDR (Group 2; n=92), and proliferative diabetic retinopathy (PDR; Group 3; n=181). Patients received one of the four types of surgical treatment: only three-port closed subtotal vitrectomy (CSTV; n=78); CSTV combined with internal limiting membrane (ILM) peeling (n=85); CSTV combined with ILM peeling and panretinal laser coagulation (PRLC) (n=81); and CSTV combined with ILM peeling, PRLC and cataract phacoemulsification (phaco) (n=69). Enzyme-linked immunosorbent assay was used to determine presurgical levels of DMP risk factors in blood. Statistical analyses were conducted using Statistica 10.0 (StatSoft, Tulsa, OK, USA) software. Results: Presurgical levels of DMP risk factors in blood substantially increased with an increase in severity of diabetic retinopathy (from Group 1 to Group 3), with the maximum values achieved in patients with PDR. For each group, PDGF blood levels in patients with recurrent DMP were 1.3- to 1.4-fold (and statistically significantly, p < 0.001) higher than in those without recurrent DMP. TNFα blood levels in Group 1 and Group 2 patients with recurrent DMP were 1.2- to 1.4-fold (and statistically significantly) higher than in those without recurrent DMP. Only for Group 1, median ET1 blood level in patients with recurrent DMP was significantly (1.4-fold; p < 0.001) higher than in those without recurrent DMP. All patients exhibiting recurrent DMP after any of the used surgical treatment technologies had statistically significantly increased baseline PDGF levels (p < 0.001). The pre-surgery cut-off PDGF blood level for which the development of recurrent DMP becomes probable was > 51.8 ng/mL. Associations of TNFα and ЕT1 blood levels with recurrent DMP were most prominent in NPDR, and depended on recurrence time points: presurgical TNFα blood levels were associated with early recurrent DMP, whereas presurgical ЕT1 blood levels were associated with late recurrent DMP. Conclusion: New risk factors for post-surgical recurrent DMP in DM2 were established. The PDGF blood level was found to influence the development of both early and late recurrent DMP, whereas the TNFα blood level, only early SMP recurrence, and the ET1 blood level, only late recurrent DMP. [ABSTRACT FROM AUTHOR]

Purpose: In primary conjunctival melanoma (CoM), one of the characteristics that is associated with an increased risk of metastases and death is a lack of tumour pigmentation. The aim of this study was to investigate whether the degree of pigmentation of CoM recurrences relates similarly to clinical outcome. Methods: A data set of 177 patients with a CoM recurrence from the Wills Eye Hospital (USA) and the Leiden University Medical Center (The Netherlands) was analysed. The relation between clinical tumour pigmentation of the recurrences, the characteristics of the primary lesions and clinical outcome was investigated. Results: In 117 (66%) of 177 patients with a CoM recurrence, tumour pigmentation was known: 71 patients (61%) had recurrences with low pigmentation. Primary lesions had low pigmentation in 39% of cases, which is significantly different (p = 0.001). However, low tumour pigmentation of recurrences correlated with low tumour pigmentation of the primary lesion (p < 0.001). No association was observed between pigmentation of the recurrences and iris colour (p = 0.66). Low pigmentation of the recurrences was not significantly associated with an increased risk for metastases (HR 1.96, p = 0.12) or death (HR 1.79, p = 0.27), whereas primary tumours with low pigmentation did show a greater risk for metastases (HR 2.82, p = 0.016) and death (HR 2.90, p = 0.037). Conclusions: CoM recurrences are more often lightly pigmented compared to primary lesions. A correlation exists between the degree of pigmentation of primary and recurrent lesions, but recurrences can appear with any degree of pigmentation. Unlike primary CoM, the level of pigmentation of CoM recurrences is not related to metastasis or death. [ABSTRACT FROM AUTHOR]

Purpose: The PINQ-PHONE is a 4-question telephone questionnaire designed and validated as a recurrence detection method after laparo-endoscopic inguinal hernia repair. The study aim was to evaluate the PINQ-PHONE by describing our experience with the questionnaire in a high-volume randomized-controlled trial.Methods: The PINQ-PHONE was performed 5 years postoperatively after endoscopic totally extraperitoneal (TEP) repair. Positive PINQ-PHONE responses were compared with clinical assessments for a recurrence. An "experience with the PINQ-PHONE"-survey was conducted among the executing researchers. Furthermore, positive predictive values (PPV) for the separate questions and overall PINQ-PHONE were determined.Results: Fifty-two of 769 responding patients (6.8%) had positive PINQ-PHONE responses and were invited to visit the outpatient clinic, thus preventing follow-up visits in 93.2% of included patients. Two recurrences were detected (0.3%). The overall PPV of the PINQ-PHONE was low (0.057). The PPV of question 1 (0.040) and 2 (0.100) was lower than that of question 3 (0.222) and 4 (0.286). The PPV of only question 3 and 4 combined was 0.183, and no recurrence would have been missed. The researcher survey unanimously produced that the PINQ-PHONE was user-friendly and executed in < 5 min, and questions 3 and 4 were considered adequate for recurrence detection. The majority found questions 1 and 2 to be inadequate questions.Conclusions: The PINQ-PHONE proved to be a valuable tool in TEP repair follow-up for recurrences. Enhancement of the PINQ-PHONE using only question 3 and 4 is recommended, since more patients refrain from outpatient clinic visits, and nevertheless, recurrences are safely detected. [ABSTRACT FROM AUTHOR]

Key Summary Points: Aim: The study sought to assess the impact of age on recurrent ventricular tachyarrhythmias, appropriate ICD therapies and all-cause mortality at 5 years in consecutive ICD recipients. Findings: Age ≥ 75 years was associated with higher rates of first recurrent ventricular tachyarrhythmias, appropriate ICD therapies and all-cause mortality at 5 years. Message: Elderly ICD recipients aged ≥ 75 years are at increased risk of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and all-cause mortality at 5 years. Background: Data regarding the prognostic impact of age in implantable cardioverter defibrillator (ICD) recipients is limited. Objective: The study sought to assess the impact of age on recurrences of ventricular tachyarrhythmias in ICD recipients. Methods: This "secondary prevention" study is based on a large retrospective registry including consecutive ICD recipients with documented ventricular tachyarrhythmias from 2002 to 2016. Patients < 75 years of age were compared to patients ≥ 75 years. The primary endpoint was first recurrence of ventricular tachyarrhythmias at 5 years. Secondary endpoints were ICD-related therapies, rehospitalization, and all-cause mortality at 5 years. Statistics comprised Kaplan–Meier survival curves, multivariable Cox regression analyses, and propensity-score matching. Results: A total of 592 consecutive ICD recipients with index ventricular tachyarrhythmias was included (< 75 years: 78%; ≥ 75 years 22%). Age ≥ 75 years was associated with the primary endpoint of first recurrence of ventricular tachyarrhythmias (49% vs. 43%, log-rank p = 0.015; HR 1.418; 95% CI 1.070–1.881; p = 0.015), and with the secondary endpoint of first appropriate ICD therapy (78% vs. 22%, log-rank p = 0.011) even within multivariable Cox regression analyses. After propensity-score matching, age ≥ 75 years was still associated with the primary endpoint of first recurrence of ventricular tachyarrhythmias (49% vs. 42%, log-rank p = 0.045; HR 1.482; 95% CI 1.007–2.182; p = 0.046). Conclusion: Elderly ICD recipients aged ≥ 75 years are at increased risk of recurrent ventricular tachyarrhythmias, appropriate ICD therapies, and all-cause mortality at 5 years. [ABSTRACT FROM AUTHOR]

Purpose: The study sought to evaluate the prognostic impact of recurrences of ventricular tachyarrhythmias in consecutive ICD recipients with ventricular tachyarrhythmias on admission. Methods: All consecutive patients surviving at least one episode of ventricular tachyarrhythmias from 2002 to 2016 and discharged with an ICD (pre-existing ICD or ICD implantation at index hospitalization) were included. The primary endpoint was all-cause mortality according to the presence or absence of recurrences of ventricular tachyarrhythmias at 5 years. Secondary endpoints comprised the impact of different types of recurrences, appropriate ICD therapies, as well as predictors of recurrences and appropriate ICD therapies. Kaplan–Meier, multivariable Cox regression and propensity score matching analyses were applied. Results: A total of 592 consecutive ICD recipients was included (44% with recurrences of ventricular tachyarrhythmias and 56% without). Recurrences of ventricular tachyarrhythmias were associated with increased all-cause mortality at 5 years (HR = 1.498; 95% CI = 1.052–2.132; p = 0.025). Worst survival was observed in patients with sustained VT or VF as first recurrences compared to non-sustained VT, as well as in patients with cumulative recurrences of non-sustained or sustained VT plus VF, whereas mortality was not affected by the number of recurrences of ventricular tachyarrhythmias (> 4 vs. ≤ 4). Moreover, appropriate ICD therapies were associated with increased all-cause mortality (HR = 1.874; 95% CI = 1.318–2.666; p = 0.001), mainly attributed to secondary preventive ICDs. Finally, atrial fibrillation, LVEF < 35% and non-ischemic cardiomyopathy were identified as predictors of recurrences of ventricular tachyarrhythmias and appropriate ICD therapies. Conclusions: Recurrences of ventricular tachyarrhythmias and recurrent appropriate ICD therapies are associated with increased long-term all-cause mortality in consecutive ICD recipients. Non-ischemic cardiomyopathy, AF and LVEF < 35% revealed to be significant predictors of both endpoints. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to retrospectively evaluate the recurrence detection rate of Gallium-68-prostate-specific membrane antigen [(68Ga)PSMA] imaging and therapy (I&T) positron emission tomography/computed tomography (PET/CT) at different PSA levels, which enables early detection of patients with radical prostatectomy. We also aimed to compare Gleason scores, used drugs (LHRH analogs and antiandrogens), PSA levels with SUVmax values, and detection rates.Method: This retrospective study included 107 patients who underwent radical prostatectomy and who underwent (68Ga)PSMA I&T PET/CT imaging between January 2015 and December 2018 for the early detection of recurrence. The PSA values, Gleason scores, treatments, lesions detected on (68Ga)PSMA I&T, and SUVmax values were recorded for all patients.Results: Patients with a median PSA level of 1.22 ng/mL were divided into seven groups according to the PSA values. The lowest lesion detection rate was found to be 7/16 patients (43.8%) when the PSA was < 0.2 ng/ml, and the highest lesion detection rate was found to be 33/33 patients (100%) when the PSA was > 3.5 ng/ml. There was a positive correlation between PSA level and ppSUVmax (per patient SUVmax) value of the patients with lesions (p < 0.001 and r = 0.49). As the Gleason score increased, the lesion detection rates also increased and there was a significant correlation between these values (p < 0.001 and r = 0.360). A positive correlation was determined between the Gleason scores and ppSUVmax values in patients with lesions (p = 0.007 and r = 0.302). A statistically significant correlation was found between bicalutamide use and lesion detection on (68Ga)PSMA I&T (p < 0.001). A similar relationship was also determined in patients undergoing maximal androgen blockade (MAB) (p = 0.003). Patients determined with lesions on (68Ga)PSMA I&T and who were administered luteinizing hormone-releasing hormone (LHRH) agonists were found to have statistically significantly higher ppSUVmax values than those who were not administered LHRH agonists (p < 0.001). In binary logistic regression test, when PSA levels and Gleason scores were selected as continuous variables, both PSA levels and Gleason scores were demonstrated as significant covariates (p = 0.006 and p = 0.022) for lesion detection; by contrast, bicalutamide and MAB were not found as significant factors.Conclusion: In the present study, (68Ga)PSMA I&T was found to be quite successful in determining lesions in the biochemical recurrence, which is consistent with the findings of other I&T studies and studies conducted with different PSMA ligands. Thus, it can be considered that the use of (68Ga)PSMA I&T will become increasingly common. [ABSTRACT FROM AUTHOR]

We introduce an infinite family of lacunary recurrences for the Fibonacci numbers and give a combinatorial proof. The first entry in the family was proved by Lucas in 1876. [ABSTRACT FROM AUTHOR]

Abstract In this paper, we introduce a new class of bargraphs – circular bargraphs , which are self-avoiding walks in a cylindrical lattice, and study the enumerations of them with respect to perimeter statistic. More precisely, we study the perimeter of a circular bargraph , a statistic defined naturally as the number of edges in the boundary of the bargraph. We also find an explicit formula for the total length of the perimeter over all bargraphs with n -cells. [ABSTRACT FROM AUTHOR]

Sinonasal papilloma is a benign tumor, derived from Schneiderian sinonasal epithelium. There have been described three histological subtypes: inverted, oncocytic and exophytic. The case presented here is A 66-yearold male patient, which was hospitalized in our Otolaryngology Department for a giant tumor, that was exteriorized from the left nostril, repeated epistaxis, nasal obstruction and anosmia. The computed tomography scan revealed an iodophilic and non-homogeneous tumor, with areas of necrosis, which included the entire left nasal cavity, with extension to the rhinopharynx and the left maxillary sinus. We completely removed the tumor by an endoscopic medial maxillectomy, with the subsequent histopathological examination revealing an inverted papilloma, with areas of low grade dysplasia and also areas with oncocytic Schneiderian papilloma. At the six-months postoperative control, there was no tumor recurrence. Major issues of this type of tumor is fast invasion capacity and numerous local recurrence. More recent studies have shown that these relapses are often overdue tumors. [ABSTRACT FROM AUTHOR]

Abstract In the last decade, there has been a growing body of literature addressing the utilization of complex network methods for the characterization of dynamical systems based on time series. While both nonlinear time series analysis and complex network theory are widely considered to be established fields of complex systems sciences with strong links to nonlinear dynamics and statistical physics, the thorough combination of both approaches has become an active field of nonlinear time series analysis, which has allowed addressing fundamental questions regarding the structural organization of nonlinear dynamics as well as the successful treatment of a variety of applications from a broad range of disciplines. In this report, we provide an in-depth review of existing approaches of time series networks, covering their methodological foundations, interpretation and practical considerations with an emphasis on recent developments. After a brief outline of the state-of-the-art of nonlinear time series analysis and the theory of complex networks, we focus on three main network approaches, namely, phase space based recurrence networks, visibility graphs and Markov chain based transition networks, all of which have made their way from abstract concepts to widely used methodologies. These three concepts, as well as several variants thereof will be discussed in great detail regarding their specific properties, potentials and limitations. More importantly, we emphasize which fundamental new insights complex network approaches bring into the field of nonlinear time series analysis. In addition, we summarize examples from the wide range of recent applications of these methods, covering rather diverse fields like climatology, fluid dynamics, neurophysiology, engineering and economics, and demonstrating the great potentials of time series networks for tackling real-world contemporary scientific problems. The overall aim of this report is to provide the readers with the knowledge how the complex network approaches can be applied to their own field of real-world time series analysis. [ABSTRACT FROM AUTHOR]

Introduction: Triple-negative breast cancer (TNBC) is a subtype of breast cancer which is defined as the absence of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 overexpression by immunohistochemistry. As the survival data on TNBC in the Indian population are scant, this study was done to analyze the clinicopathological features and clinical outcomes of TNBC patients. Materials and Methods: Data from medical records of patients with breast cancer between 2009 and 2014 were retrieved, and patients with TNBC were identified and analyzed for demographic and clinicopathological features. Survival analyses were performed using the Kaplan-Meier method for disease-free survival (DFS) and overall survival (OS). Results: A total of 1024 breast cancer patients were registered at our institute during the study period, of which 198 were TNBCs accounting for 19.3% of all breast cancers. Median age at the diagnosis was 50 years (range, 22-78 years). Lymph nodal positivity in TNBC was associated with larger tumor size (P = 0.003) and higher tumor grade (P = 0.01). At a median follow-up of 48 months (range, 12-88), 36 (19.1%) patients had recurrence of the disease, whereas 28 (14%) patients were lost to follow-up. Lung (52.7%) was the most common site of recurrence followed by bone (25%) and brain (11.1%). Three-year DFS and OS were 63.2% and 65.6%, respectively. On univariate analysis, nodal status, size of tumor, and lymphovascular invasion were found to have a significant impact on OS and DFS. On multivariate analysis, only nodal status was significant for DFS and OS (P < 0.001 and P = 0.001, respectively). Conclusions: TNBCs have a rapid clinical course, and early recurrences are common inspite of timely medical intervention which reflects the aggressive tumor biology. This warrants further studies on intensification of chemotherapy and identification and development of targeted therapy aimed at decreasing recurrences and improving survival in this patient population. [ABSTRACT FROM AUTHOR]

Aims: To report on the long-term impact of tumor and non-tumor related parameters on local recurrence, distant recurrence and survival in patients with naïve or recurrent type hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA). Methods: We performed 240 RFA sessions on 133 patients with 156 HCC nodules developed on a background of liver cirrhosis and analyzed the outcomes. Results: Contrast-enhanced ultrasound performed one month after RFA showed complete ablation in 119 out of 133 (89.65%) patients. With a median follow-up of 46 months, 3-, 5- and 7-year survival rates were 61.7%, 35.7%, and 22.6%, respectively. Previous ethanol injection and histological grade were significantly related to local tumor progression. Child-Pugh class, incomplete ablation, histological grade, previous ethanol injection, alpha-fetoprotein level before the treatment, and local recurrence were all significantly related to distant recurrence. Multivariate analysis demonstrated that age, Child-Pugh class, distant recurrence and multiple incomplete ablations were significantly related to survival. Conclusion: Radiofrequency ablation could be locally curative for HCC, resulting in a survival longer than 7 years. Previous ethanol injection and incomplete ablations were strongly associated with poor outcomes. [ABSTRACT FROM AUTHOR]

The paper highlights main areas in the development of European oncology care to patients with malignant ovarian neoplasms. It discusses the major issues considered at the 5th Annual Meeting of Oncologists on Arrangement of Anticancer Therapy into the Era of Personalized Therapy hosted by the MD Anderson Cancer Center.

Background and Objectives: Psoriasis is a chronic, papulosquamous disorder of the skin with variable morphology, characterized by periods of remission and reactivity. Psoriasis is less common in the tropics and in dark-skinned persons. Prevalence in West Africans has been noted to be similar to that of the African-Americans suggesting a similarity in genetic ancestry. This study aimed to describe the clinical characteristics of psoriasis and precipitating factors in Nigerian patients. Materials and Methods: This is a retrospective study of all dermatology patients with features of psoriasis who attended the dermatology outpatient clinic of the hospital between January 2007 and May 2012. Data were obtained from the patients′ clinic notes and protocol for psoriasis, which documented patients′ demographic data, clinical presentations, and precipitating factors. Results: Psoriasis was found in 1.13% (124/11,015) of the study population. There was a male preponderance with a male to female ratio of 1.34:1. The majority of patients seen were in the fourth decade of life. Stress, alcohol, and drugs were the most reported predisposing factors to psoriasis. All types of psoriasis were found, and plaque psoriasis was the most common. Conclusion: This study confirms the increasing frequency of psoriasis among dermatology patients in Nigeria, which may either be due to an increased proficiency in diagnosing the condition by physicians or increase prevalence of environmental factors. The current trend in the management of psoriasis is focused on treating the inflammatory process as well as managing the modifiable environmental triggers.

Gingival growths are one of the frequently encountered types of lesion in the oral cavity. It is the common site for neoplastic and nonneoplastic lesions. Peripheral ossifying fibroma (POF) is one of the inflammatory reactive hyperplasias of the gingiva. It represents a separate clinical entity with diverse histopathological features. Even after adequate surgical excision of the lesion, repeated recurrence is not uncommon. Studies show a recurrence rate of 16-20% in these lesions. The suggested etiology for POF is low-grade irritation due to plaque and calculus. Proper excision of such overgrowths and appropriate oral hygiene instructions will ensure that the lesion does not recur. This case report is of a large, solitary gingival swelling in the maxilla of a 36-year-old male patient that had recurred for the third time after the surgical excision.

Abstract Background The natural history of patients with lung cancer and venous thromboembolism (VTE) has not been consistently evaluated. Methods We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to assess the clinical characteristics, time course, and outcomes during anticoagulation of lung cancer patients with acute, symptomatic VTE. Results As of May 2017, a total of 1,725 patients were recruited: 1,208 (70%) presented with pulmonary embolism (PE) and 517 with deep vein thrombosis (DVT). Overall, 865 patients (50%) were diagnosed with cancer

In a rooted tree, protected nodes are neither leaves nor parents of any leaves. They have some practical motivations, e.g., in organizational schemes, security models and social-network models. Protected node profile measures the number of protected nodes with the same distance from the root in rooted trees. For no rooted tree, protected node profile has been investigated so far. Here, we present the asymptotic expectations, variances, covariance and limiting bivariate distribution of protected node profile and non-protected internal node profile in random tries, an important data structure on words in computer science. Also we investigate the fraction of these expectations asymptotically. These results are derived by the methods of analytic combinatorics such as generating functions, Mellin transform, Poissonization and depoissonization, saddle point method and singularity analysis.

Though primarily used to improve neurodevelopmental outcomes, suppressive oral acyclovir therapy following neonatal herpes simplex virus disease also decreases cutaneous recurrences. Skin recurrences can still occur, however, and understanding their frequency is helpful in managing patients with this rare disease. [ABSTRACT FROM AUTHOR]

Surgery for metastatic testicular disease has been an essential factor in the long-term cure rates for men with testicular germ cell tumors. Robotic approaches to retroperitoneal lymph node dissection (R-RPLND) have been proposed as an alternative to open surgery with few if any adverse events reported. We report the clinical course for five recent patients referred to our center for recurrences after R-RPLND, focusing on recurrence patterns, treatment burden, and treatment-related morbidity and mortality. The median time to recurrence after R-RPLND was 259 d. The recurrence patterns after R-RPLND were aberrant from our past experience in managing recurrences after open RPLND. One man experienced an in-field recurrence located in close proximitry to an undivided lumbar vessel. Four patients had out-of-field recurrence in abnormal locations: pericolic space invading the sigmoid colon, peritoneal carcinomatosis with a perinephric mass, large-volume liver lesions with suprahilar disease extending into the retrocrural space, and lymph nodes in the celiac axis. The treatment burden was high: the five men were subjected to 12 different chemotherapy regimens and three underwent additional surgeries. Three patients developed significant cisplatin-induced toxicity. One patient died due to progression of testicular cancer after failing all chemotherapy and surgical options. We report our initial experience in managing patients with testicular cancer referred to our institution after robotic retroperitoneal lymph node dissection (RPLND). We found that the recurrences were highly variable and in unusual locations and were associated with a high treatment burden. We conclude that further investigation into the safety and long-term oncologic efficacy of robotic RPLND is necessary before widespread implementation. The clinical scenarios we report should serve as a word of caution with regard to the widespread implementation of robotic operative approaches for men with germ cell tumors. It is not clear why these unusual recurrence patterns occurred, but further scrutiny going forward would be prudent. [ABSTRACT FROM AUTHOR]

The risk of recurrence in takotsubo syndrome (TTS) appears to be low, although previous studies have shown conflicting results and factors associated with recurrences are unclear. The aim of this study is to evaluate the incidence and predictors of TTS recurrences. Adult patients included in the Spanish Multicenter REgistry of TAKOtsubo syndrome (RETAKO) between January 2003 and September 2019 were identified. Patients were categorized based on recurrences during follow-up and a multivariate logistic regression model was used to identify factors associated with recurrences. A total of 1097 patients (mean age 71.0±11.9 years, 87% females) were included, repeated TTS events were documented in 44 patients (4.0%), including 13 patients with prior TTS and 31 patients with recurrent TTS during a median follow-up of 279 days. Two patients (0.02%) had two episodes of recurrence. Compared to patients who had no recurrence of TTS, those with recurrent TTS more frequently had no identifiable stressful trigger in the index admission (20 [64.5%] vs 352 [33.0%], p <0.001). Primary TTS, defined as TTS without physical trigger, was also more common in the recurrence group (93.5% vs 68.3%, p <0.001). The only factor independently associated with recurrences was the absence of an identifiable trigger (odds ratio 3.7 [95% confidence interval 1.8-7.8], p=0.001). In conclusion, our data indicate that for patients presenting with TTS, the rate of early recurrent TTS is approximately 4% per year. Among TTS patients, those who have no identifiable trigger events appear to have a higher rate of recurrence., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Aim: This study aimed to evaluate the capacity of a genetic risk score (GRS) for coronary artery disease (CAD) independent of classical cardiovascular risk factors to assess the risk of recurrence in patients with first myocardial infarction. The secondary aim was to determine the predictive value of this GRS., Methods: We performed a meta-analysis of individual data from three studies, namely, a prospective study including 75 patients aged <55 years, a prospective study including 184 patients with a mean age of 60.5 years, and a case-control study (77 cases and 160 controls) nested in a cohort of patients with first myocardial infarction. A GRS including 12 CAD genetic variants independent of classical cardiovascular risk factors was developed. The outcome was a composite of cardiovascular mortality and recurrent acute coronary syndrome., Results: The GRS was associated with a higher risk of recurrence [hazard ratio = 1.24; 95% confidence interval (CI): 1.04-1.47]. The inclusion of the GRS in the clinical model did not increase the model's discriminative capacity (change in C-statistic/area under the curve: 0.009; 95% CI: -0.007 to 0.025) but improved its reclassification (continuous net reclassification index: 0.29; 95% CI: 0.08-0.51)., Conclusion: The GRS for CAD, independent of classical cardiovascular risk factors, was associated with a higher risk of recurrence in patients with first myocardial infarction. The predictive capacity of this GRS identified a subgroup of high-risk patients who could benefit from intensive preventive strategies., Competing Interests: The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. RE and JM are members of the scientific advisory board of GENinCode and inventors listed in a patent application by GENinCode based on the GRS evaluated in this manuscript., (© 2023 Rincón, Subirana, Pérez del Villar, Sánchez, Zamorano, Marrugat and Elosua.)

Purpose: Dupilumab represents an innovative and effective therapy for refractory/recurrent severe chronic rhinosinusitis with nasal polyps (CRSwNP). Intranasal corticosteroids should be used during treatment with biological agents. However, adherence to nasal therapy may not be complete. The aim of this study was to evaluate the role of intranasal corticosteroids in patients with CRSwNP who underwent treatment with dupilumab., Materials and Methods: Fifty-two patients treated with dupilumab for CRSwNP were enrolled. Clinical parameters (age, sex, comorbidities, blood eosinophils, Nasal Polyp Score - NPS, Visual Analogue Scale - VAS - for smell loss, Asthma Control Test - ACT), quality of life (Sino Nasal Outcome Test 22 - SNOT-22 questionnaire), nasal cytology, and adherence to regular administration of intranasal corticosteroids were recorded before treatment (T0), and after 3 (T1), 6 (T2), and 12 months (T3)., Results: NPS, VAS for smell, ACT and SNOT-22 total score and subscores improved during treatment (p < 0.05). Blood eosinophils reached a peak at T1-T2 and then decreased toward baseline at T3. Adherence to regular treatment with intranasal steroids was 61.5 %. No statistically significant differences in all the clinical outcomes were observed between patients who regularly used intranasal steroids and other subjects (p > 0.05). Nasal cytology showed a decrease of eosinophils and an increase of neutrophils during treatment., Conclusions: Dupilumab is still effective in patients who are using topical nasal steroids with variable adherence (real world settings)., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

We show with some examples how to prove some Ramanujan-type series for in an elementary way by using terminating identities. [ABSTRACT FROM AUTHOR]

Introduction. The aim of the study was to analyse the survival and progression rates in patients with recurrent salivary gland cancer after surgery and adjuvant radio- or chemoradiotherapy. Material and methods. The study included 43 patients treated in 2006-2016 and evaluated in terms of PFS and OS. Results. The 6-, 12- and 24-month OS rates were: 51%, 41%, and 14%, respectively, while the 6-, 12- and 24-month PFS rates were: 44%, 27%, and 14%, respectively. Any treatment improves OS and PFS, with surgery having the greatest effect on improving PFS, followed by chemotherapy and radiotherapy. A multivariate analysis has shown that predictors of PFS are: irradiated volume and radiation technique, while irradiated volume is the predictor of OS. Conclusions. Prognosis in patients with recurrent gland cancer is poor and does not depend on the type of relapse, but rather on further management. [ABSTRACT FROM AUTHOR]

Supplemental digital content is available in the text. Objective: Endometrial cancer (EC) recurrences are relatively common with no standardized way of describing them. We propose a new classification for them called locoregional, nodal, metastasis, carcinomatosis recurrences (rLMNC). Patients and Methods: The data of 1230 women with EC who were initially treated by primary surgery were included in this French multicenter retrospective study. Recurrences were classified based on dissemination pathways: (1) locoregional recurrence (rL); (2) nodal recurrence (rN) for lymphatic pathway; (3) distant organ recurrence (rM) for hematogenous pathway; and (4) carcinomatosis recurrence (rC) for peritoneal pathway. These pathways were further divided into subgroups. We compared recurrence free survival and overall survival (OS) between the 4 groups (rL/rN/rM/rC). Results: The median follow-up was 35.6 months (range, 1.70–167.60). One hundred ninety-eight women (18.2%) experienced a recurrence: 150 (75.8%) experienced a single-pathway recurrence and 48 (24.2%) a multiple-pathway recurrence. The 5-year OS was 34.1% (95% confidence interval [CI], 27.02%–43.1%), and the median time to first recurrence was 18.9 months (range, 0–152 months). The median survival after recurrence was 14.8 months (95% CI, 11.7–18.8). Among women with single pathway of recurrence, a difference in 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) was found between the 4 rLNMC groups. The carcinomatosis group had the worst prognosis compared with other single recurrence pathways. Women with multiple recurrences had poorer 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) than those with single metastasis recurrence, other than women with peritoneal carcinomatosis. Conclusions: This easy-to-use and intuitive classification may be helpful to define EC recurrence risk groups and develop guidelines for the management of recurrence. Its prognosis value could also be a tool to select homogenous populations for further trials. [ABSTRACT FROM AUTHOR]

In this article, we present a beautiful connection between Hadamard matrices and exponential sums of quadratic symmetric polynomials over Galois fields. This connection appears when the recursive nature of these sequences is analyzed. We calculate the spectrum for the Hadamard matrices that dominate these recurrences. The eigenvalues depend on the Legendre symbol and the quadratic Gauss sum over finite field extensions. In particular, these formulas allow us to calculate closed formulas for the exponential sums over Galois field of quadratic symmetric polynomials. Finally, in the particular case of finite extensions of the binary field, we show that the corresponding Hadamard matrix is a permutation away from a classical construction of these matrices. [ABSTRACT FROM AUTHOR]

One of the major concerns in oncology lies in the ability to detect recurrences at their earliest stage to increase the likelihood of cure following second line, or salvage, therapy. Although human papillomavirus (HPV)-driven oropharyngeal cancers have a good prognosis, 20-25% of patients will recur within 5 years of treatment and a significant portion will die from their disease. In recent years, great effort has been put toward evaluating the potential clinical utility of HPV-related biomarkers for early diagnosis of recurrent disease. Indeed, following completion of treatment, detection of HPV-DNA in oral rinses or blood and serologic assays against HPV oncoproteins could be helpful to track residual disease or recurrence. Several recent studies have reported promising findings, thus potentially paving the way for the use of biomarkers in the management of HPV-OPC. In this review, we evaluate and discuss the current knowledge on this topic and provide some directions for future research. [ABSTRACT FROM AUTHOR]

Rotation symmetric Boolean functions are invariant under circular translation of indices. These functions have very rich cryptographic properties and have been used in different cryptosystems. Recently, Thomas Cusick proved that exponential sums of rotation symmetric Boolean functions satisfy homogeneous linear recurrences with integer coefficients. In this work, a generalization of this result is proved over any Galois field. That is, exponential sums over Galois fields of some rotation symmetric polynomials satisfy linear recurrences with integer coefficients. In the particular case of F 2 , an elementary method is used to obtain explicit recurrences for exponential sums of some of these functions. The concept of trapezoid Boolean function is also introduced and it is showed that the linear recurrences that exponential sums of trapezoid Boolean functions satisfy are the same as the ones satisfied by exponential sums of the corresponding rotations symmetric Boolean functions. Finally, it is proved that exponential sums of trapezoid and symmetric polynomials also satisfy linear recurrences with integer coefficients over any Galois field F q . Moreover, the Discrete Fourier Transform matrix and some Complex Hadamard matrices appear as examples in some of our explicit formulas of these recurrences. [ABSTRACT FROM AUTHOR]

In this paper, we present a Hyers–Ulam stability result for the approximately linear recurrence in Banach spaces. An example is given to show the results in more tangible form. [ABSTRACT FROM AUTHOR]

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Background Transnasal endoscopic sphenopalatine artery ligation (TESPAL) and selective embolization both provide excellent treatment success rate in the management of intractable epistaxis. Few long-term studies comparing these approaches have been previously published. Recommendations often present these techniques as alternatives, but there is no clear consensus. Objective The purpose of this study was to evaluate and compare the clinical efficacy of sphenopalatine artery ligation versus embolization to control intractable epistaxis. Methods We performed a retrospective study including all patients referred to our tertiary medical center for severe epistaxis and treated by surgical ligation and/or embolization. The patients were classified into 2 groups: those who underwent TESPAL only and those who underwent endovascular embolization only. We evaluate and compare long-term clinical outcomes after surgical ligation or embolization for the control of intractable epistaxis in terms of effectiveness (recurrence rate) and safety (complication rate). Results Forty-one procedures of supraselective embolization and 39 procedures of surgical ligation for intractable epistaxis are reported and analyzed. No significant difference was observed between the groups in terms of demographic factors, comorbidities, or average length of hospital stay. The 1-year success rate was similar (75%) in both groups. Complications (minor and/or major) occurred in 34% cases in the embolization group and in 18% in the surgical group (P = .09, ns). Bilateral embolization including facial artery was the only treatment method associated with a significant risk of complications (P = .015). Conclusion TESPAL seems to provide a similar control rate with a decrease in the number of complications compared to selective embolization in the context of intractable epistaxis. Further studies are required. [ABSTRACT FROM AUTHOR]

Background: The treatment of intramucosal early gastric cancer with undifferentiated-type histologies (UD-EGCs) using endoscopic submucosal dissection (ESD) is controversial. This study aimed to compare the clinical and oncologic long-term outcomes of ESD and surgery for UD-EGCs.Methods: A prospectively collected database of patients who underwent ESD or surgery between January 2006 and December 2012 was established. Patients who diagnosed with UD-EGC and satisfied the expanded indications of ESD were included. Clinical data from 111 patients treated with ESD and 382 patients underwent surgery were analyzed, and 1-1 propensity score-matched 81 pairs of patients were also compared.Results: In both groups, two-thirds of the UD-EGCs had signet ring cell (SRC)-type histology and about 90% of UD-EGCs were flat or depressed types. The mean size of tumors was smaller in ESD group (9.7 vs. 13.2 mm; P < 0.001). After propensity score-matched, case-matching covariates were not significantly different between the groups. Disease-free survival (DFS) was significantly shorter in the ESD group, but overall survival (OS) was not different between the two groups both in overall comparison (DFS; P < 0.001 and OS; P = 0.078) and propensity score-matched analysis (DFS; P < 0.001 and OS; P = 0.850). According to histologic type, OS of SRC histology was not different between the group, both in overall comparison and propensity score-matched analysis (P = 0.286 and P = 0.210). On the other hands, OS of poorly differentiated adenocarcinoma was significantly shorter in ESD group in overall comparison (P = 0.007), but was not as so in propensity score-matched analysis (P = 0.088).Conclusions: ESD might be a complementary option for the treatment of UD-EGCs, especially in those with SRC-type histology based on strict expanded indications. Nonetheless, close endoscopic surveillance is required because of a high incidence of intragastric recurrence. [ABSTRACT FROM AUTHOR]

Introduction Current guidelines recommend the use of anticoagulant therapy in patients with symptomatic splanchnic vein thrombosis (SVT) and suggest no routine anticoagulation in those with incidental SVT. Methods We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry to assess the rate and severity of symptomatic venous thromboembolism (VTE) recurrences and major bleeding events appearing during the course of anticoagulation in patients with symptomatic or incidental SVT. Results In March 2017, 521 patients with SVT were recruited. Of them, 212 (41%) presented with symptomatic SVT and 309 had incidental SVT. Most (93%) patients received anticoagulant therapy (median, 147 days). During the course of anticoagulation, 20 patients developed symptomatic VTE recurrences (none died) and 26 had major bleeding (fatal bleeding, 5). On multivariable analysis, patients with incidental SVT had a non-significantly higher risk for symptomatic VTE recurrences (adjusted hazard ratio [HR]: 2.04; 95%CI: 0.71–5.88) and a similar risk for major bleeding (HR: 1.12; 95%CI: 0.47–2.63) than those with symptomatic SVT. Active cancer was associated with at increased risk for VTE recurrences (HR: 3.06; 95%CI: 1.14–8.17) and anaemia (HR: 4.11; 95%CI: 1.45–11.6) or abnormal prothrombin time (HR: 4.10; 95%CI: 1.68–10.1) were associated with at increased risk for major bleeding. Conclusions The rates of recurrent SVT and major bleeding were similar between patients with incidental or symptomatic SVT. Because the severity of bleeding complications during anticoagulation may outweigh the severity of VTE recurrences in both groups, further studies should identify those SVT patients who benefit from anticoagulant therapy. [ABSTRACT FROM AUTHOR]

Verrucous carcinoma is a well differentiated type of squamous cells carcinoma, which may interest both the skin and mucous membranes. It is characterized by local invasion with minimal dysplasia and has a reduced metastatic potential. Clinical case. We present the case of an 80-year-old rural patient with verrucous carcinoma, with the objective to highlight the clinical-evolutionary, histopathological and therapeutic aspects of this disorder. The treatment was hemivermillonectomy, and the post-surgical development was favorable. Discussions. Ackerman's verrucous carcinoma is also known as oral florid papillomatosis, a term created by Rock and Fisher in 1960. Wechsler and Fisher have highlighted the aggressive but clinically benign local nature of the disease by using the term "oral florid papillomatosis". Oral verrucous carcinoma may extend to underlying tissue and regional lymph nodes. Therapy for oral verrucous carcinoma is a challenge, because recurrences and anaplastic transformation are frequent after radiotherapy. Surgical treatment is superior, but radiotherapy is generally considered to be a last resort. Conclusion. Patients with verrucous carcinoma should be closely monitored, as they may develop second cancer, an aggressive epidermoid carcinoma, or anaplastic transformation of a pre-existing verrucous carcinoma. [ABSTRACT FROM AUTHOR]