Repair of descending thoracic aortic aneurysms with Ankura Thoracic Stent Graft

Objective

The aim of the study was to present the results for patients with atherosclerotic aneurysm of the descending thoracic aorta (DTA) treated with a novel thoracic stent graft.

New evidence supporting lung cancer screening with low dose CT & surgical implications

IntroductionLung cancer is the leading cause of cancer-death worldwide. The U.S. Preventative Services Task Force (USPTSF) approved screening for current or former smokers aged 55–80 based on the results of the National Lung Screening trial (NLST). Following the NLST, new evidence has emerged from clinical trials and updates to previous trials prior to the anticipated update to the USPSTF guideline. We review the new evidence on lung cancer screening with low dose computed tomography (LDCT) and the surgical implications.MethodsA review of new literature was performed pertaining to lung cancer screening since implementation of UPSTF guidelines. Articles for inclusion were identified by both authors’, then search of the Pubmed and Cochrane database was performed from January 1st, 2013 through February 4th, 2020 using the MeSH search terms: “lung cancer”; “screening”; “low dose CT”. The results of these studies are summarized.ResultsWe identified multiple prospective randomized control trials and meta-analysis since the NLST supporting lung cancer-specific mortality with screening. We identified new nodule classification systems and the development of risk-models which may reduce false positive rates and identify high risk patients not currently eligible for screening. Finally, we discussed the surgical implications of screening.ConclusionNew data supports NLST findings and show ongoing benefit to LDCT for lung cancer screening. Standardized LDCT screening classification has been shown to reduce harm and lower false positive rates. Further study is needed regarding use of risk-modeling. Screening will require an increase in the thoracic workforce to accommodate the amount of surgically operable cancers.     

Clinical presentation and prognosis of adenosquamous carcinoma of the pancreas – Matched-pair analysis with pancreatic ductal adenocarcinoma

IntroductionAdenosquamous carcinoma of the pancreas (ASCP) is a rare subtype of pancreatic adenocarcinoma. The aim of this study was to investigate the characteristics and outcomes of ASCP in comparison to pancreatic ductal adenocarcinoma (PDAC).Materials and methodsAll patients with ASCP treated between December 2001 and December 2017 were identified from a prospective database. Clinicopathological and follow-up data were analyzed. A nested case-control-study with matched-pair analysis was performed to compare overall survival of ASCP and PDAC.ResultsOf 4009 patients undergoing surgery for pancreatic adenocarcinoma 91 patients had ASCP. Compared to PDAC ASCP were larger (4.0 vs. 3.2 cm; p < 0.0001), more frequently involved lymph nodes (88% vs. 78%; p = 0.0216), more frequently showed poor differentiation (G3: 79% vs. 36%; p < 0.0001) and more frequently were located in the pancreatic tail (19% vs. 10%; p = 0.0179). Overall median post-resection-survival was shorter in ASCP (10.8 vs. 20.5 months in PDAC; p = 0.0085), but 5-year survival rates were comparable (18.2% vs. 17.5%). After matching for the unevenly distributed prognostic factors survival after resection of ASCP and PDAC was comparable (p = 0.8301). Localization in the head or several parts of the pancreas, high CA 19-9 levels, and M1 disease were independent predictors of survival in patients with ASCP.ConclusionASCP is more aggressive with poorer differentiation and higher rates of lymph node metastases compared to PDAC. In spite of a shorter median survival, 5-year survival rates after surgical resection of about 18% can be expected in ASCP and support resection as part of a multimodal therapy as the treatment of choice in this rare cancer.     

The incidence of oropharyngeal cancer and rate of human papillomavirus vaccination coverage in Florida, 2011 through 2015

ObjectivesThe authors aimed to compare the incidence of oropharyngeal cancer (OPC) from 2011 through 2015 and the rate of human papilloma virus (HPV) vaccination from 2015 through 2017 in the United States overall and in Florida.MethodsUsing SEER*Stat software (Surveillance Research Program, National Cancer Institute), the authors calculated age-specific OPC incidence rates for various age groups and age-adjusted rates by sex and race to analyze Surveillance, Epidemiology, and End Results program and National Program of Cancer Registries data. The authors used Joinpoint software (Surveillance Research Program, National Cancer Institute) to model time trends of OPC incidence. They estimated the rate of HPV vaccination among teenagers in Florida and explored the main reasons parents gave for not getting their children vaccinated by means of analyzing data from the National Immunization Survey-Teen. The authors used the χ² test to determine the association between sociodemographic factors and HPV vaccination and to compare the rate of HPV vaccination in the United States overall with that in Florida.ResultsThe incidence of OPC was higher and the rate of HPV vaccination was lower in Florida than in the United States overall. The OPC incidence rate was highest in those who were aged 50 through 70 years, non-Hispanic white, and male. The rate of being up-to-date on HPV vaccination in Florida was higher among female teenagers than male teenagers but did not differ significantly by other sociodemographic characteristics. The top reason for not getting an HPV vaccination in Florida was that it had not been recommended.ConclusionsThe authors found relatively higher and increasing incidence rate of OPC in Florida and lower rate of HPV vaccination among adolescents in Florida than in the nation overall.Practical ImplicationsThe trends illustrated may stimulate policy changes to increase HPV vaccination for children and enhance the understanding of its benefits.     

纳米骨组织材料用于骨质疏松治疗进展

目的旨在探究通过纳米骨组织材料治疗骨质疏松的进展,以促进其临床应用。方法由第一作者应用计算机检索PubMed、中国期刊全文数据库(CNKI)1997-05～2011-10相关文献。在标题、摘要、关键词中以"nano,osteoporosis,bone marrow mesenchymal stem cells(BMMSCs),treatment"或"纳米,骨质疏松,骨髓间充质干细胞,治疗"为检索词进行检索。选择文章内容与纳米技术治疗骨质疏松有关者,同一领域文献则选择近期发表在权威杂志文章。结果初检得到127篇文献,根据纳入标准选择36篇文献进行综述。结论纳米技术治疗骨质疏松已经成为骨质疏松治疗中的一项新兴技术。目前通过纳米技术治疗骨质疏松主要通过促进药物吸收,维持药物作用时间,增加药物靶向性,促进干细胞分化的机制来进行骨质疏松的治疗。目前常用的技术包括药物纳米化,纳米微载体,材料表面纳米化,纳米材料修饰干细胞等。但目前纳米技术治疗骨质疏松尚未成熟,仍有许多问题有待解决。