Search

The article discusses a study which advocates the use of proton magnetic resonance spectroscopic imaging (MRSI) to diagnose prostate cancer. However, the lack of robust quantification methods yielding reproducible results blocks the widespread use of this technique. It aims to develop a standardized and fully automated approach for quantitative prostate MRSI. It looks at the metabolic variables as potential biomarkers for prostate cancer diagnosis by correlation MRSI results.

Objectives: Induction of moderate hypothermia in patients with median cerebral artery (MCA) infarction may produce metabolic and nutritional impairments. Currently, we do not know which is the best method to carry out nutritional assessment in this population group. The aim of the present study was to assess the usefulness of nitrogen balance in the follow-up of patients with MCA submitted to moderate hypothermia (32-33 degrees C) by means of intravascular cooling at the Neurocritical Patients Unit at a tertiary hospital. Material and methods: We designed a retrospective study including patients with MCA infarction of whom we gathered bio-demographical, clinical, hypothermia, and nutritional variables. Similarly, we carried out a prospective follow-up of a patient with MCA infarction and induced hypothermia, gathering the same variables at different time points of his clinical course. Results: Six patients with MCA infarction submitted to moderate hypothermia for a mean duration of 12 days (interval 9-15) were included in the retrospective series. We observed that nitrogen losses (mean 9.9 g) were lower than those previously thought for critical patients during the acute phase. During the prospective follow-up of the patient with malignant infarction of the MCA from day 1 to day 22 after the application of hypothermia, low levels of nitrogen losses were similarly observed during the phase of induced hypothermia, which increased later on when the patient recovered normothermia. The mean nitrogen expenditure during the period of hypothermia was 10.7 g and increased up to 27.3 g during the normothermia period (day 17). Conclusions: These results suggest that moderate hypothermia-induced metabolic suppression is clinically relevant and thus the determination of nitrogen balance does not seem to be a useful tool in the nutritional followup of this type of patients. [ABSTRACT FROM AUTHOR]

Objectives: Induction of moderate hypothermia in patients with median cerebral artery (MCA) infarction may produce metabolic and nutritional impairments. Currently, we do not know which is the best method to carry out nutritional assessment in this population group. The aim of the present study was to assess the usefulness of nitrogen balance in the follow-up of patients with MCA submitted to moderate hypothermia (32-33 °C) by means of intravascular cooling at the Neurocritical Patients Unit at a tertiary hospital. Material and methods: We designed a retrospective study including patients with MCA infarction of whom we gathered bio-demographical, clinical, hypothermia, and nutritional variables. Similarly, we carried out a prospective follow-up of a patient with MCA infarction and induced hypothermia, gathering the same variables at different time points of his clinical course. Results: Six patients with MCA infarction submitted to moderate hypothermia for a mean duration of 12 days (interval 9-15) were included in the retrospective series. We observed that nitrogen losses (mean 9.9 g) were lower than those previously thought for critical patients during the acute phase. During the prospective follow-up of the patient with malignant infarction of the MCA from day 1 to day 22 after the application of hypothermia, low levels of nitrogen losses were similarly observed during the phase of induced hypothermia, which increased later on when the patient recovered normothermia. The mean nitrogen expenditure during the period of hypothermia was 10.7 g and increased up to 27.3 g during the normothermia period (day 17). Conclusions: These results suggest that moderate hypothermia-induced metabolic suppression is clinically relevant and thus the determination of nitrogen balance does not seem to be a useful tool in the nutritional followup of this type of patients. [ABSTRACT FROM AUTHOR]

The incidence of p53 gene abnormalities in human hepatocellular carcinoma (HCC) varies in different geographical areas, being higher in regions where hepatitis virus infection and dietary exposure to aflatoxin B1 are the most common aetiological agents. These mutations are less frequently encountered in Europe, although some studies have reported p53 protein overexpression in up to 45% of cases analysed. We have analysed 129 tumour samples of primary malignant hepatic neoplasms recovered from paraffin blocks processed in two pathology laboratories in a Mediterranean area of Spain (Valencia and Gerona). Among 14 cases in which p53 immunohistochemistry expression proved positive, 5 stained in more than 50% of the cell nuclei. By PCR-SSCP analysis we could detect the complete sequence from exon 5 through 8 in 70 cases and part of this region in the remaining cases, but no mutations were found. We found no relationship with the clinical stage, tumour stage or clinical outcome. We conclude that p53 gene alterations are not a major event in the malignant transformation of hepatic cells in this region of the Mediterranean. The variable incidence of p53 gene alterations in other geographical areas may reflect a different genetic background for the aetiology of HCC. [ABSTRACT FROM AUTHOR]

Background: There is substantial evidence that smokers present a less favorable response following regenerative periodontal surgery. However, there are no reports to date on the response to regenerative procedures in chronic cannabis smokers. In the present case study, we discuss the periodontal outcomes of reparative and regenerative surgical treatment in a cannabis consumer patient with generalized stage III grade C periodontitis., Methods and Results: We report the case of a young adult cannabis consumer patient diagnosed with generalized stage III grade C periodontitis who had a probing depth (PD) of ≥ 4 at 18% of sites and of ≥ 7 mm at 12% of sites and radiographically confirmed generalized interproximal bone loss with horizontal and angular defects that reached the middle and apical third of the roots. An appropriate sequence of therapy based on the recommendations in the Clinical Practice Guideline (CPG) involving reparative and regenerative surgical procedures (steps 1-3) was followed. Clinical outcomes at 6 months included a decrease in PD of up to 7 mm and radiographic evidence of newly formed bone in the bony defects., Conclusion: The present case study demonstrates the use of regenerative periodontal procedures as part of a stepwise treatment approach, with different interventions at each step, to successfully manage intrabony periodontal defects in a healthy young adult male cannabis consumer., Key Points: Smoking is a well-documented dose-dependent risk factor for periodontal disease, with a demonstrated negative effect on periodontal therapy outcomes. However, the usefulness of regenerative periodontal therapy in cannabis smokers has not been established to date. This case presents new information in that it is the first report to show that appropriate periodontal treatment can stabilize the periodontal disease and that regenerative therapies were successful in healing intrabony periodontal defects in a healthy young adult cannabis user. The keys to successful management of this case are: -Attention to detail in all aspects of therapy. -Patient compliance as a co-therapist by maintaining effective plaque control. -Patient acceptance of supportive care recommendations. The primary limitations of this case study are: -The main limitation of this study is that a single clinical case study is too small to draw conclusions about regenerative treatment in patients who use cannabis. -The follow-up assessment times were not sufficient to determine the long-term success of regenerative surgery. -Patient compliance with oral hygiene recommendations and supportive care are key to achieving long-term success in regenerative therapy., Plain Language Summary: Background: Smokers have a worse response to regenerative periodontal surgery. There are no reports on how cannabis smokers respond to regenerative procedures. This case study discusses how periodontal surgery worked in a young adult patient with severe periodontitis who was a frequent cannabis user. After 6 months of an appropriate sequence of therapy including strict regenerative surgical procedures, there was new bone filling in the bony defects., Conclusions: This case shows that regenerative periodontal procedures can successfully treat intraosseous periodontal defects in a healthy young adult male cannabis user., (© 2025 American Academy of Periodontology.)

Background: Preoperative malnutrition is a known risk factor for postoperative complications following total joint arthroplasty (TJA); however, there is scant literature comparing which nutritional index is best at predicting these outcomes. The purpose of this study was to investigate the utility of the Maastricht index, Onodera's Prognostic Nutritional Index, the Geriatric Nutritional Risk index, and a novel, modified Geriatric Nutritional Risk Index (mGNRI) in predicting periprosthetic joint infection (PJI), wound complications (WCs), readmission, and reoperation rates after TJA., Methods: A single-center, retrospective cohort study was performed of patients who underwent primary TJA from January 2016 to December 2021. The 90-day preoperative albumin, prealbumin, and total lymphocyte count were collected. Outcome measures were PJI, WC, readmission, and return to the operating room. Youden's index (YI) and Receiver operator characteristic curves were used to determine optimal cutoff points. Multivariable logistic regression was used to adjust for potential confounders, including body mass index, age, and the Charlson comorbidity index., Results: There were 1,575 patients included in the study. The mGNRI had the greatest accuracy (area under the curve = 0.633; optimal cutoff point = 92.8) in predicting postoperative adverse outcomes. Complication rates were significantly higher in the low mGNRI group (≤ 92.8). When controlled for body mass index, Charlson comorbidity index, and age, the odds of PJI, WC, readmission, and reoperation in patients who had low mGNRI were 6.61 (P = 0.005), 3.04 (P = 0.021), 2.25 (P = 0.020), and 2.75 (P = 0.024), respectively., Conclusions: The mGNRI is an easy-to-calculate nutritional index and an excellent predictor of postoperative complications following TJA. The mGNRI outperformed Geriatric Nutritional Risk index, Maastricht index, and Onodera's Prognostic Nutritional Index in predicting postoperative complications. Our results suggest that patients who fall below the mGNRI threshold of 92.8 should be carefully considered for nutritional optimization prior to TJA., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Introduction: Peripheral blood mononuclear cells (PBMCs) trafficking is regulated by chemokines, which modulate leukocyte migration toward tumors and may collaborate in the efficacy of immunotherapy. In our study, we investigated whether the CXCL12/CXCR4 axis plays a role in the efficacy of immunotherapy in non-small cell lung cancer (NSCLC) by analyzing CXCR4 expression for CXCR4 in peripheral blood (PB), and the expression of its ligand CXCL12 in tumor., Methods: We identified PBMCs expressing CXCR4 using flow cytometry in a prospective cohort of NSCLC patients before starting anti-PD-1 immunotherapy. As a control, we studied patients with advanced cancer before starting any non-immunotherapy treatment. The relative frequency of PBMCs was correlated with treatment outcomes. Uni- and multivariate survival analyses were performed. The expression of CXCL12 in tumor tissue was studied and correlated with the expression of its receptor (CXCR4) in PBMCs., Results: The experimental group included 39 patients and the control group included 40. Low expression of CXCR4-expressing CD8 + T lymphocytes was correlated with a greater benefit from immunotherapy: median OS NR vs. 22.0 months, HR 0.6, p < 0.01; and median PFS 14.2 vs. 5.0 months, HR 0.38, p = 0.05. These differences were not observed in controls. Low expression in PB of these lymphocytes was correlated with a higher expression of CXCL12 in tumor (trend toward significance: p = 0.14)., Conclusion: Patients diagnosed with advanced NSCLC with low percentage of cytotoxic T lymphocytes expressing CXCR4 in PB, show greater benefit from immunotherapy, probably due to increased tumor infiltration by lymphocytes in response to CXCL12 produced by the tumor., Competing Interests: Declarations. Conflict of interest: Jacobo Rogado reports personal fees from Roche, AstraZeneca, Merck, Ferrer, Persan Farma, Fresenius Kabi, Sanofi, MSD, Abott; travel expenses from MSD, BMS, Roche, and AstraZeneca; and advisory consultancies from Fresenius Kabi, Abott, AstraZeneca, Sanofi, MSD, MAIA Biotech. Nuria Romero reports advisory consultancies from Ipsen, Janssen, Clovis, and Astra Zeneca and research funding from Janssen, MSD, and Pfizer. Ramon Colomer reports research funding from Roche, Janssen, BMS, and MSD. All of the declared conflicts of interest are outside of the submitted work. All other authors have no conflict to declare. Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of the Hospital Universitario La Princesa on 22 December 2016 under the code 2918. Informed consent statement: Informed consent was obtained from all patients involved in the study., (© 2024. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)

Background: Although the direct anterior (DA) approach has increased in popularity for primary total hip arthroplasty (THA), there is limited evidence regarding its use for revision THA. It is unknown whether the dislocation benefit seen in the primary setting translates to revision cases., Methods: This retrospective review compared the dislocation rates of revision THA performed through DA versus postero-lateral (PL) approaches at a single institution (2011 to 2021). Exclusion criteria included revision for instability, ≥ 2 prior revisions, approaches other than DA or PL, and placement of dual-mobility or constrained liners. There were 182 hips in 173 patients that met the inclusion criteria. The average follow-up was 6.5 years (range, 2 to 8 years)., Results: There was a trend toward more both-component revisions being performed through the PL approach. There were no differences in dislocation rates between the DA revision and PL revision cohorts, which were 8.1% (5 of 72) and 7.5% (9 of 120), respectively (P = .999). Dislocation trended lower when the revision approach was discordant from the primary approach compared to cases where primary and revision had a concordant approach (4.9 versus 8.5%), but this was not statistically significant (P = .740). No significant differences were found in return to operating room, 90-day emergency department visits, or 90-day readmissions. However, the length of stay was significantly shorter in patients who had DA revisions after a primary PL procedure (P = .021)., Conclusions: Dislocation rates following revision THA did not differ between the DA and PL approaches irrespective of the primary approach. Surgeons should choose their revision approach based on their experience and the specific needs of the patient., (Copyright © 2024 Elsevier Inc. All rights reserved.)