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《Clinical breast cancer》2022,22(6):507-514
Breast cancer (BC) is a highly metastatic, pathological cancer that significantly affects women worldwide. The mortality rate of BC is related to its heterogeneity, aggressive phenotype, and metastasis. Recent studies have highlighted that the tumor microenvironment (TME) is critical for the interplay between metastasis mediators in BC. BC stem cells, tumor-derived exosomes, circulatory tumor cells (CTCs), and signaling pathways dynamically remodel the TME and promote metastasis. This review examines the cellular and molecular mechanisms governing the epithelial to mesenchymal transition (EMT) that facilitate metastasis. This review also discusses the role of cancer stem cells (CSCs), tumor-derived exosomes, and CTs in promoting BC metastasis. Furthermore, the review emphasizes major signaling pathways that mediate metastasis in BC. Finally, the interplay among CSCs, exosomes, and CTCs in mediating metastasis have been highlighted. Therefore, understanding the molecular cues that mediate the association of CSCs, exosomes, and CTCs in TME helps to optimize systemic therapy to target metastatic BC.  相似文献   
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Familial hypercholesterolemia (FH) is a common autosomal dominant disorder that affects ~1 in 250–500 individuals globally. The only prevalence study in India shows FH in 15% of patients with premature CAD in North Indians. There are only 6 genetic studies in India of the total mutations, 32% are LDLR mutations, 4% are ApoB, 2% are PCSK9 mutations and the mutational spectrum for 37% is unknown. This calls for widespread genetic screening which could help identify definite FH patients.European Atherosclerosis Society-Familial Hypercholesterolemia Studies Collaboration (EAS- FHSC) has taken an initiative to develop a worldwide registry of FH. India is also a part of the collaboration and 3 groups from Mumbai, Delhi and Chennai are actively contributing to this registry. We believe this review might help to understand the Indian scenario of FH and investigators across India can contribute in managing FH in India and further help in the detection, diagnosis and treatment.  相似文献   
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IntroductionAcetabulum fractures, though relatively uncommon, are associated with significant morbidity and mortality. These involve high energy trauma and due to their complex nature, the management requires understanding the relevant surgical anatomy, defining the injury via appropriate radiographic assessment and determining a suitable treatment plan. Literature is scarce for the demographic data, fracture patterns, associated injuries, management and early complications in the Indian scenario. These factors play a pivotal role in the ultimate recovery of the patients. Therefore this study was conceptualised to assess the epidemiology and evaluate the complications of these fractures. Furthermore the effects of various factors determining the quality of reduction in surgically treated patients were also assessed.MethodologyThis was a prospective observational study in which patients presenting to the advance trauma centre of our institute with acetabulum fractures were included. Demographical data of the patients, mechanisms of injuries, fractures morphologies, complications and radiological outcomes were recorded prospectively.Results116 patients with acetabular fractures were included in the study. 81% of these were males, with average age of 39.95 ± 15.87 years; with road traffic accidents being the predominant mode of injuries. Mortality was reported in 5 patients; 4 patients had deep venous thrombosis and sciatic nerve injuries were seen in 12 patients of which 4 were iatrogenic. 8 patients had some form of infection, out of which 4 required multiple debridements. 4 cases developed heterotrophic ossification while 2 cases had loss of reduction. The timing of surgery and other associated fractures had significant effect on the quality of reduction (p < 0.05); while age, gender, mode of injury or individual fracture patterns had no such effect.ConclusionsProper radiological assessment and evaluation of fracture configuration is important for management of acetabulum fractures. When indicated, this should be followed by early open reduction and internal fixation to achieve anatomical reduction, with management of associated injuries for better outcomes.  相似文献   
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BackgroundAllen’s test (AT) and Modified Allen’s Test (MAT) are used as screening methods for assessment of the hand circulation. Few people lack the dual blood supply of hand and are at risk of hand ischemia after any intervention on radial artery. The Purpose of the study was to assess the collateral circulation of hand using MAT in normal Indian subjects and in elderly population to know the prevalence of positivity of Allen’s test.Methods900 participants (1800 hands) were divided in two groups. Group I had participants with age <50 years and group II had participants with age ≥50 years. MAT was performed in all participants and results were compared between the two groups.ResultsIn group I (n = 450, 900 hands), 313 were males and 137 were females, with mean age of 35.04 years. The relative percentages of a normal, equivocal, borderline and abnormal MAT were 77.8%, 16.6%, 3.7% and 1.6%, respectively. In group II (n = 450, 900 hands), 248 were males and 202 were females, with mean age of 60.4 years. The relative percentages of a normal, equivocal, borderline and abnormal MAT were 69.0%, 18.6%, 6.60% and 5.66%, respectively. A positive/abnormal test was significantly more common (5.66% Vs 1.66%, P < 0.00001) in older group.ConclusionMAT is simple, time tested and non invasive test to assess collateral circulation of the hand. A negative MAT safely selects patients for radial artery harvest; however, if the test is positive and in older patients then a second objective test may be needed.  相似文献   
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The current pandemic caused by SARS-CoV-2 virus is going to be a prolonged melee. Identifying crucial areas, proactive planning, coordinated strategies and their timely implication is essential for smooth functioning of any system during a crunch.Addressing the impact of COVID-19 on transfusion services, there are 4 potential challenges viz. blood/ component shortage, donor/ staff safety, consumable supply/ logistics and catering to the convalescent plasma need. In this review article, we will be discussing about these potential challenges in detail along with the necessary mitigative steps to be adopted to tide over the COVID-19 crisis in an Indian set up.  相似文献   
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Aims/Introduction

To develop and evaluate a simple, non-invasive, diabetes risk score for detecting individuals at high risk for type 2 diabetes in rural Bangladesh.

Materials and Methods

Data from 2,293 randomly selected individuals aged ≥20 years from a cross-sectional study in a rural community of Bangladesh (2009 Chandra Rural Study) was used for model development. The validity of the model was assessed in another rural cross-sectional study (2009 Thakurgaon Rural Study). The logistic regression model used included age, sex, body mass index, waist-to-hip ratio and hypertension status to predict individuals who were at high risk for type 2 diabetes.

Results

On applying the developed model to both cohorts, the area under the receiver operating characteristic curve was 0.70 (95% confidence interval 0.68–0.72) for the Chandra cohort and 0.71 (95% confidence interval 0.68–0.74) for the Thakurgaon cohort. The risk score of >9 was shown to have the optimal cut-point to detect diabetes. This score had a sensitivity of 62.4 and 75.7%, and specificity of 67.4 and 61.6% in the two cohorts, respectively. This risk score was shown to have improved sensitivity and specificity to detect type 2 diabetes cases compared with the Thai, Indian, Omani, UK, Dutch, Portuguese and Pakistani diabetes risk scores.

Conclusions

This simple, non-invasive risk score can be used to detect individuals at high risk for type 2 diabetes in rural Bangladesh. Subjects with a score of 9 or above (out of 15) should undergo an oral glucose tolerance test for definitive diagnosis of diabetes.  相似文献   
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