Prone Positioning in Patients With COVID-19: Analysis of Multicenter Registry Data and Meta-analysis of Aggregate Data

xlomafota13 shared this article with you from Inoreader Prone Positioning in Patients With COVID-19: Analysis of Multicenter Registry Data and Meta-analysis of Aggregate Data Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):361-370. doi: 10.21873/invivo.12711. ABSTRACT BACKGROUND/AIM: Evidence suggests a beneficial effect of prone positioning (PP) in COVID-19. MATERIALS AND METHODS: Meta-analysis of individual (7 investigators' groups) and aggregate data (PubMed/EMBASE) regarding the impact of PP on the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PO2/FiO2) in patients with COVID-19. RESULTS: Among 121 patients (mean age±SD 59.1±10.7 years, 55% males, 57% intubated) the mean post-versus pre- PP PO2/FiO2 difference was: (i) 50.4±64.3 mmHg, p<0.01, (ii) similar in awake (58.7±72.1 mmHg) versus intubated patients (44.1±57.5 mmHg, p=NS), (iii) inversely correlated with body mass index (r=-0.43, p<0.01). Meta-analysis of 23 studies (n=547, weighted age 58.3±4.1, 73% males, 59% intubated) showed a pooled PO2/FiO2 difference of 61.8 [95% confidence intervals=49.9-73.6] mmHg. Meta-regression analysis revealed no associations with baseline demographics, the time in PP before assessment, and the risk of bias of the studies. CONCLUSION: PP seems to improve oxygenation of patients with COVID-19. PMID:34972735 | DOI:10.21873/invivo.12711 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epipharyngeal Abrasive Therapy Down-regulates the Expression of SARS-CoV-2 Entry Factors ACE2 and TMPRSS2

xlomafota13 shared this article with you from Inoreader Epipharyngeal Abrasive Therapy Down-regulates the Expression of SARS-CoV-2 Entry Factors ACE2 and TMPRSS2 Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):371-374. doi: 10.21873/invivo.12712. ABSTRACT BACKGROUND: The epipharynx, with its high expression of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry factors angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2), is a primary target for SARS-CoV-2 replication in the early stage of Coronavirus Disease 19 (COVID-19). Epipharyngeal abrasive therapy (EAT) is a treatment for epipharyngitis in Japan which involves applying zinc chloride to the epipharyngeal mucosa. In this study, we evaluated the expression patterns of ACE2 and TMPRSS2 in tissue samples from patients before and after EAT. PATIENTS AND METHODS: The study subjects were seven patients that had not been treated with EAT and 11 patients that had. For immunohistochemical assessment of the epipharyngeal mucosa, the staining intensity of ACE2 and TMPRSS2 was described as an immunohistochemical score (IHC score). RESULTS: The IHC scores for ACE2 and TEMPRSS2 in the EAT-treated group were 3.40-fold and 1.81-fold lower, respectively, than those in the non-treated group (p=0.0208 and p=0.0244, respectively). CONCLUSION: EAT down-regulates the expression of SARS-CoV-2 entry factors ACE2 and TMPRSS2. Thus, EAT has potential as a novel COVID-19 preventative method. PMID:34972736 | DOI:10.21873/invivo.12712 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Pectoral Muscle Values on Clinical Outcomes in Patients With Severe Covid-19 Disease

xlomafota13 shared this article with you from Inoreader Impact of Pectoral Muscle Values on Clinical Outcomes in Patients With Severe Covid-19 Disease Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):375-380. doi: 10.21873/invivo.12713. ABSTRACT BACKGROUND/AIM: The effect of sarcopenia on patients with severe Covid-19 disease is unknown. We aimed to assess the influence of baseline computed tomography (CT)-based body composition parameters (pectoralis muscle area, pectoralis muscle index, skeletal muscle gauge) on clinical variables in patients with severe Covid-19 disease. PATIENTS AND METHODS: Chest CT scans of adult patients with confirmed Covid-19 who were hospitalized from March 2020 to May 2021 at a level-one medical center in Germany were retrospectively analyzed. Pectoralis muscle area, pectoralis muscle index and skeletal muscle gauge were measured on the first CT scan after admission. Body composition parameters were assessed for association with clinical variables and 30-day mortality. RESULTS: A total of 46 patients were included. None of the body composition parameters was a pred ictor for 30-day mortality, duration of hospital stay, duration of intensive care unit treatment, or duration of invasive mechanical ventilation. CONCLUSION: Pectoralis muscle composition parameters in CT chest scans did not predict outcomes in adult patients with severe Covid-19 infection. PMID:34972737 | DOI:10.21873/invivo.12713 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Optimal Type and Management of Biliary Drainage in Patients With Obstructive Jaundice Who Undergo Pancreaticoduodenectomy

xlomafota13 shared this article with you from Inoreader The Optimal Type and Management of Biliary Drainage in Patients With Obstructive Jaundice Who Undergo Pancreaticoduodenectomy Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):391-397. doi: 10.21873/invivo.12716. ABSTRACT BACKGROUND/AIM: The aims of this study were to clarify optimal type and management of preoperative biliary drainage (PBD) in patients with obstructive jaundice who underwent pancreatoduodenectomy (PD). PATIENTS AND METHODS: A total of 156 patients with obstructive jaundice who underwent PD were enrolled. We compared clinical variables and postoperative complications between patients who underwent endoscopic retrograde biliary drainage (ERBD) and those who underwent endoscopic nasobiliary drainage (ENBD). RESULTS: All patients underwent PBD, with ERBD in 117 and ENBD in 39. The incidence of infectious complications and clinically relevant pancreatic fistula (CR-PF) were significantly higher in the ERBD group (39% vs. 13%, p=0.012 and 39% vs. 10%, p<0.00001, respectively). However, there was no significant difference in the postoperative complication s between two groups when the duration of drainage exceeded 30 days. CONCLUSION: ERBD should not be performed in patients with obstructive jaundice prior to PD because of the increased rates of infectious complications and CR-PF following PD, and ENBD should be chosen instead. Furthermore, PD should be performed within 30 days of drainage period in patients with ENBD. PMID:34972740 | DOI:10.21873/invivo.12716 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Changes in Chemotherapeutic Strategies and Their Prognostic Impact in Patients With Advanced Gastric Cancer

xlomafota13 shared this article with you from Inoreader Changes in Chemotherapeutic Strategies and Their Prognostic Impact in Patients With Advanced Gastric Cancer Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):409-415. doi: 10.21873/invivo.12718. ABSTRACT BACKGROUND/AIM: To investigate changes in post-progression chemotherapy (PPC) before and after nivolumab approval and determine their prognostic impact. PATIENTS AND METHODS: A total of 146 patients with unresectable gastric cancer who had at least progressive disease after first- and/or second-line chemotherapy were retrospectively enrolled. RESULTS: Among the 146 patients, 46 and 23 received ramucirumab and nivolumab, respectively. Moreover, 95 and 62 patients received PPC after first- and second-line chemotherapy, respectively. Group B (i.e., at least chemotherapy after nivolumab approval) had significantly higher proportions of patients receiving ramucirumab therapy, nivolumab therapy, and PPC after first- or second-line chemotherapy compared to group A (i.e., termination of chemotherapy before nivolumab approval). Group A had significantly poorer prognosis than group B. Multivariate analysis showed that age, number of distant metastatic sites, and ramucirumab therapy were independent prognostic factors. CONCLUSION: Changes in chemotherapeutic strategies, including PPC, might contribute to improved prognosis in patients with advanced gastric cancer. PMID:34972742 | DOI:10.21873/invivo.12718 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stereotactic Radiotherapy and Androgen Deprivation Therapy for Localized Prostate Cancer: A Retrospective Mono-institutional Experience

xlomafota13 shared this article with you from Inoreader Stereotactic Radiotherapy and Androgen Deprivation Therapy for Localized Prostate Cancer: A Retrospective Mono-institutional Experience Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):306-313. doi: 10.21873/invivo.12703. ABSTRACT BACKGROUND/AIM: Stereotactic radiotherapy (SRT) is an effective treatment for localized prostate cancer. However, is it not clear whether the addition of androgen deprivation therapy (ADT) to SRT is beneficial. The aim of this study was to analyze the outcomes of a series of patients treated with SRT plus ADT for localized prostate cancer. PATIENTS AND METHODS: Patients were treated with SRT with 42 Gy in 7 fractions with volumetric-modulated arc therapy plus Image Guided Radiotherapy (V-MAT IGRT) technique. ADT was administered to patients with intermediate unfavorable- and high-risk disease. Study endpoints were biochemical disease-free survival (bDFS), overall survival (OS), acute and late toxicity and patient-reported outcomes (PROs) using international prostate cancer symptoms scale (IPSS) and international index of erectile function (IIEF). RESU LTS: A total of 170 consecutive patients were identified, of which 49 (28.8%) with low-risk, 15 (8.8%) with favorable intermediate-risk 76 (44.7%) with unfavorable intermediate-risk and 30 (17.6%) with high-risk class. All patients of unfavorable intermediate- and high-risk groups were administered LHRH analogue concurrently to SRT and for at least 6 months. Patients with unfavorable intermediate- and high-risk presented a 5-year bDFS of 81.7% and 76.9%, respectively. CONCLUSION: SRT consisting of 42 Gy in seven fractions with short-term ADT represents a safe and effective treatment for unfavorable intermediate and high risk prostate cancer. Our results support the need of high quality studies to test the efficacy of ADT combined with SRT for unfavorable intermediate- and high-risk localized prostate cancer. PMID:34972727 | DOI:10.21873/invivo.12703 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Techniques of Y-Sleeve Lobectomy in Patients With Primary Lung Cancer

xlomafota13 shared this article with you from Inoreader Surgical Techniques of Y-Sleeve Lobectomy in Patients With Primary Lung Cancer Via In vivo (Athens, Greece) In Vivo. 2022 Jan-Feb;36(1):350-354. doi: 10.21873/invivo.12709. ABSTRACT BACKGROUND/AIM: The directions of distal and proximal airway stumps were different in Y-sleeve lobectomy. This difference might make Y-sleeve lobectomy a difficult procedure. In this article, we present our surgical techniques and analyse short-term outcomes of Y-sleeve lobectomy. PATIENTS AND METHODS: Right middle and lower, left lower, and left lower and lingular segment sleeve lobectomies are categorized in Y-sleeve lobectomy. We retrospectively investigated the clinical courses of 17 patients who underwent Y-sleeve lobectomy from January 2017 to December 2020. RESULTS: No treatment-related deaths occurred. One patient developed a bronchopleural fistula. Four patients developed pneumonia and were cured by repeated bronchoscopies and antibiotic therapy. Three patients had retention of pleural effusion, and two had prolonged air leakage. One patient had empyema after prolonged air leakage and was cured by thoracic drainage and antibiotic therapy. CONCLUSION: A major complication was observed only in one patient. Y-sleeve lobectomy is a reliable surgical method to avoid pneumonectomy. PMID:34972733 | DOI:10.21873/invivo.12709 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.