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A Prospective Study on Local Complications of Primary Total Laryngectomy/Laryngopharyngectomy for Laryngeal and Hypopharyngeal Malignancies
Shashidhar Kallappa,
Navaneetha Kallidil Kallavalappil
Issue:
Volume 6, Issue 2, June 2021
Pages:
49-55
Received:
12 March 2021
Accepted:
27 March 2021
Published:
7 April 2021
Abstract: Background: Carcinoma larynx is one among the most common head and neck malignancy which accounts for 2% of all cancers whereas hypopharyngeal cancer is one of the most aggressive tumor with poorer prognosis. Total laryngectomy/laryngopharyngectomy (TL/TLP) is the treatment of choice for locally advanced laryngeal and hypopharyngeal cancers. Objectives: To study the complications associated with primary TL/TLP along with the sociodemographic profile and clinicopathologic features of laryngeal and hypopharyngeal cancers. We also aimed to assess the risk factors associated with complications. Methods: All stage III or IVA laryngeal and hypopharyngeal malignancy cases as per American Joint Committee on Cancer (AJCC) 8th edition staging, who underwent primary total laryngectomy/total laryngopharyngectomy during the year 2018-2019 in our institute, KIMS Hubli, have been studied. Sociodemographic profile and clinicopathological features were noted. These patients were followed up for 6 months for any local complications. Results: Mean age of the study population was 58 years with male predominance. Primary glottic carcinoma was most common. Most common presenting symptom was change in voice and most common anatomical site involved was true cords. Overall complication rate was 32%. Most common complication encountered was wound infection and pharyngocutaneous fistula (8% each). As complications set in length of hospital stay increases. We found significant association with PCF and length of hospital stay. Conclusion: With proper case selection, and regular wound care, complications can be avoided in case of TL/TLP. Once complications set in, it increases hospital stay and the expenditure, hence is traumatizing to the patient and hence should be avoided.
Abstract: Background: Carcinoma larynx is one among the most common head and neck malignancy which accounts for 2% of all cancers whereas hypopharyngeal cancer is one of the most aggressive tumor with poorer prognosis. Total laryngectomy/laryngopharyngectomy (TL/TLP) is the treatment of choice for locally advanced laryngeal and hypopharyngeal cancers. Object...
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Modelling the Sex – Specific Prevalence of Cancer Types in Mpumalanga and Eastern Cape Provincial Hospitals in South Africa
Wezile Chitha,
John Sungwacha Nasila,
Zukiswa Jafta,
Buyiswa Swartbooi,
Siyabonga Sibulawa,
Onke Mnyaka,
Natasha Williams,
Longo-Mbenza Benjamin
Issue:
Volume 6, Issue 2, June 2021
Pages:
56-68
Received:
24 February 2021
Accepted:
6 April 2021
Published:
26 April 2021
Abstract: Cancer has been identified to be a major community health issue of concern to many societies. This is of particular interest when it comes to the developing South Africa. The epidemiology of cancer cases has been made known, though still under study. This research intended to understand the prevalence of different cancers and suggest preventive measures to reduce the burden of the disease and furthermore, reduce the effect of destruction to those affected in good time. The methods for data collection and overall treatment classified the study to be a cross-sectional study whose data were collected by use of a questionnaire. The questionnaire focused on variables such as counts of breast cancer, cervix cancer counts, oesophageal cancer counts and counts of other types of cancer. The analysis was analysed by use of descriptive and inferential analyses. Outcomes were well tabulated and interpreted. The results were obtained by the application of a number of methods, which were used to perform the analysis for this study. The methods were: descriptive analysis, T-test comparisons and some were complemented by error bar plots and box-plots. The following were some of the observed results for the indicated variables: Breast Cancer: Mean (201.4545), Std Dev (18.62452), 95% Ci (164.21, 238.70); Kaposi Sarcoma: Mean (29.4167), Std Dev (6.76163), 95% Ci (15.89, 42.94); Prostate Cancer: Mean (7.7500), Std Dev (.71217), 95% Ci (-1.67, 17.17); Lung Cancer: Mean (6.9167), Std Dev (.67848), 95% Ci (1.56, 12.27); Choriocarcinoma: Mean (5.3333), Std Dev (2.77434), 95% Ci (-0.22, 0.88). It is quite fitting to understand that this research as a revelation of the establishment of some very important outcomes. Of great significance, was the discovery that breast cancer among women continued to destroy the female gender in the communities where the data were collected. Results further show that cervix cancer is another cancer on the rise with a higher prevalence rate in the stated communities.
Abstract: Cancer has been identified to be a major community health issue of concern to many societies. This is of particular interest when it comes to the developing South Africa. The epidemiology of cancer cases has been made known, though still under study. This research intended to understand the prevalence of different cancers and suggest preventive mea...
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Evaluation by Point of Care Ultrasound in Patients with Sepsis
Zheng Xin,
Xiong Ying,
Wang Ni,
Su Yang,
Zhang Yanjun
Issue:
Volume 6, Issue 2, June 2021
Pages:
69-73
Received:
22 March 2021
Accepted:
23 April 2021
Published:
30 April 2021
Abstract: At present, point of care ultrasound (POCUs) is widely used in emergency and critical care disciplines, to realize the rapid diagnosis and evaluation of critical diseases such as dyspnea and shock. The rapid diagnosis and evaluation of critical diseases such as dyspnea and shock can provide a good reference for the development of anesthesiology and a rapid diagnostic tool for the perioperative critical diseases of respiratory or circulation disorders. Point of care ultrasound has the characteristics of real-time, dynamic, non-radiation and repeatability, so it has a good advantage in perioperative application. provide visual evidence for treatment, and promote perioperative treatment closer to the direction of evidence-based medicine. Point of care ultrasound has many simple and effective protocols for the diagnosis of critical diseases. The corresponding procedures can be selected according to different symptoms, and different procedures can also be combined to achieve the comprehensiveness and accuracy of the assessment, avoid missing important information, especially for emergency patients. Perioperative pulmonary edema leads to hypoxemia, etiology can be quickly identified and dynamically evaluated by point of care ultrasound, B-lines detected by lung sonography are signs of pulmonary interstitial syndrome. Point of care gastric ultrasound can effectively and reliably evaluate the nature and volume of gastric contents, and its clinical application can be extended to the evaluation of gastric contents in patients with delayed gastric emptied emergency, thus reducing the risk of perioperative reflux aspiration, point of care ultrasound provides visual evidence for perioperative decision making, ensure patient safety and improve outcomes.
Abstract: At present, point of care ultrasound (POCUs) is widely used in emergency and critical care disciplines, to realize the rapid diagnosis and evaluation of critical diseases such as dyspnea and shock. The rapid diagnosis and evaluation of critical diseases such as dyspnea and shock can provide a good reference for the development of anesthesiology and...
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Positive Mutation of EGFR Inhibitor Undergo Erlotinib, Gefitinib, Icotinib or Osimertinib Plus Chinese Medicine Versus EGFRTKIs Alone In Patients With NSCLC, A Regional Study East China
Kayembe Mwimbi David,
Gaochenxi Zhang,
Zaiwei Huang,
Ying Wang,
Wenpei Zhu,
Dan Wang,
Mwema Ngoy Gracia,
Wang Hong,
Liang Yi,
Shuyi Chen,
Chen Huihui,
Qijin Shu
Issue:
Volume 6, Issue 2, June 2021
Pages:
74-89
Received:
19 March 2021
Accepted:
30 March 2021
Published:
15 May 2021
Abstract: Management of non-small cell lung cancer has been changed dramatically since detection of EGFR mutation. The rate of EGFR mutation in East China is unknown. In China, lung cancer is the most frequently diagnosed cancer and the leading cause of cancer-related mortality. The five-year survival rate in patients with lung cancer varies from 3.7–32.9%, depending on stage and regional differences. The majority of the tumors were Stage IIIB or IV Advanced Lung Adenocarcinoma. The two year survival rate of the patients was 70.6%, the overall survival was 58.8%. Methods: We electronically searched CNKI, Pub Med, Cochrane from database inception and manually searched Chinese-language oncology journals to identify A Positive Mutation of EGFR Inhibitor Undergo Erlotinib, Gefitinib, Icotinib Or Osimertinib Plus Chinese Medicine Versus Erlotinib, Gefitinib, Icotinib Or Osimertinib Alone In Patients With NSCLC, A Regional Study East China. The quality of the included trials was assessed using the method of Cochrane. If heterogeneity existed among subgroups, then overall results (OS) were calculated based on a random-effects model; otherwise, a fixed effects model used. Results: Electronic database searches yielded 1450 citations with NSCLC. We identified full text articles retrieved for detailled evaluation 70. Sample size of each trial had calculated by Rev Man 5.3.
Abstract: Management of non-small cell lung cancer has been changed dramatically since detection of EGFR mutation. The rate of EGFR mutation in East China is unknown. In China, lung cancer is the most frequently diagnosed cancer and the leading cause of cancer-related mortality. The five-year survival rate in patients with lung cancer varies from 3.7–32.9%, d...
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Development and Validation of a Health Needs Assessment Scale for Primary Liver Cancer Patients Receiving Surgical Management
Quan Jiang,
Yu Wang,
Rui Xi,
Xiaolan Wang
Issue:
Volume 6, Issue 2, June 2021
Pages:
90-97
Received:
22 May 2021
Accepted:
3 June 2021
Published:
16 June 2021
Abstract: Cancer survivors usually have varying degrees of physical and psychosocial issues and poor quality of life. Understanding the health needs from a patient's view is necessary for developing targeted supportive services. There is neither research on the postoperative health needs of primary liver cancer (PLC) patients, nor the assessment tools specifically designed for PLC patients. The purpose of this study was to develop a postoperative health needs assessment scale for PLC patients receiving surgical management. This was a methodological instrument validation study conducted in the first affiliated of Jinan University between August 2018 and December 2019. PLC patients receiving surgical management were selected by convenient sampling methods. Ten patients were selected for semi-structured in-depth interviews to generate a 50-item initial scale. After two rounds of expert consultation, a 44-item initial scale was used for a 20-respondent small sample pre-test. The pre-survey scale was distributed to 250 patients. Structural validity was examined with factor analysis, and reliability was evaluated with the Cronbach alpha and split-half reliability. Among the 250 respondents of the pre-survey scale, 232 cases completed the questionnaire. After item analysis and factor analysis, 38 items were kept in the final scale. The content validity index for the whole scale (S-CVI) and each item (I-CVI) was 0.90 and 0.80-0.90, respectively. The total Cronbach alpha value was 0.935, and the split-half reliability was 0.931. The healthy needs assessment scale for PLC patients receiving surgical management has good reliability and validity.
Abstract: Cancer survivors usually have varying degrees of physical and psychosocial issues and poor quality of life. Understanding the health needs from a patient's view is necessary for developing targeted supportive services. There is neither research on the postoperative health needs of primary liver cancer (PLC) patients, nor the assessment tools specif...
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Prognostic and Predictive Role of Neutrophil to lymphocyte Ratio in Second Line Immunotherapy of Non-small Cell Lung Cancer
Chiara Bennati,
Manolo D’Arcangelo,
Alessio Gili,
Federica Gazzaneo,
Sara Pini,
Antonello Menghi,
Marco Montanari,
Giorgio Papiani,
Valentina Mazza,
Simona Scodes,
Michela Spreafico,
Giulio Rossi,
Dora Caruso,
Guido Bellezza,
Martina Mandarano,
Stefano Tamberi
Issue:
Volume 6, Issue 2, June 2021
Pages:
98-108
Received:
11 May 2021
Accepted:
27 May 2021
Published:
28 June 2021
Abstract: Background: Programmed death-ligand 1 (PD-L1) expression at immunohistochemistry is the only approved, but still unsatisfactory, biomarker for immunotherapy in Non-Small Cell Lung Cancer (NSCLC). Neutrophil to Lymphocyte ratio (NLR) is a surrogate of systemic inflammation and could correlate with outcome to immunotherapy. This retrospective study (NCT03816657) explored the role of NLR in predicting benefit to nivolumab and susceptibility to hyperprogression (HPD). Methods: PD-L1, baseline and on-therapy NLR values were available in 173NSCLC patients receiving nivolumab. PD-L1 positivity was defined as expression on ≥1% of tumor cells; NLR was dichotomized in high (≥5) or low (<5). Patients were divided in 4 cohorts: 1 (PD-L1+/low NLR), 2 (PD-L1-/high NLR), 3 (PD-L1+/high NLR), 4 (PD-L1-/low NLR). A landmark analysis explored the impact of cohorts and NLR change on objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and its influence on HPD. Results: PD-L1 was positive in 48% and negative in 52% of cases. Pre-treatment NLR was ≥5in 42% and <5 in 58%of patients; on-treatment NLR was ≥5in approximately 50% of patients. PD-L1 positivity was not associated with outcome. Both high pre- and on-therapy NLR was a negative predictor of ORR (p=0.004), PFS (p<0.0001) and OS (p<0.0001). High NLR cohorts (2 and 4) showed poorer outcome than low NLR cohorts. Relative NLR excursion ≥25% at 4 weeks from nivolumab start was associated with reduced PFS and OS, while its decrease or stability was associated with improved outcomes. Although NLR value and its dynamic did not influence HPD occurrence (p=0.062), 53% of hyperprogressors belonged to high NLR cohorts. Conclusion: The current retrospective analysis supports the role of high NLR as a independent negative predictive factor. Its increment during immunotherapy may identify patients with low likelihood of response to immunotherapy.
Abstract: Background: Programmed death-ligand 1 (PD-L1) expression at immunohistochemistry is the only approved, but still unsatisfactory, biomarker for immunotherapy in Non-Small Cell Lung Cancer (NSCLC). Neutrophil to Lymphocyte ratio (NLR) is a surrogate of systemic inflammation and could correlate with outcome to immunotherapy. This retrospective study (...
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