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《Cancer cell》2022,40(10):1223-1239.e6
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《International journal of oral and maxillofacial surgery》2022,51(3):332-337
The purpose of this study was to investigate the association between habitual snoring (HS), middle ear disease (MED), and speech problems in children with cleft palate. This cross-sectional study included children aged 2.0–7.9 years with non-syndromic cleft palate anomalies. Parents completed the Pediatric Sleep Questionnaire and a questionnaire about MED. Audiograms and speech assessment were also conducted. Ninety-five children were enrolled; 15.2% of families reported HS, 97.6% MED, and 17.1% speech problems. HS (37.5% vs 10.3%, P = 0.007) and early episodes of MED (92.3% vs 58.2%, P = 0.021) were more likely to be reported for children with isolated cleft palate when compared to those with cleft lip and palate. Children with cleft lip and palate had a higher frequency of MED with effusion compared to those with Robin sequence (86.4% vs 57.1%, P = 0.049). The odds ratio for HS in children with ≥1 episode of MED in the last year was 7.37 (95% confidence interval 1.55–35.15, P = 0.012). There was a trend for children with speech problems reported by parents to have HS (30.8% vs 11.5%, P= 0.076). Anatomical factors play a role in the frequency of upper airway symptoms in children with cleft palate. A recent history of at least one episode of MED was associated with an increased frequency of HS. 相似文献
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《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2019,13(1):408-412
AimsChild growth is one of the important health indicators in pediatric care. Few studies focused on the impact of prenatal exposure to gestational diabetes mellitus (GDM) on growth trajectories particular in early years of childhood. The aim of this study was identifying growth pattern of GDM exposed offspring's, comparison with new WHO child growth standards.Methods and materialsIn a population-based Longitudinal study 438 infants exposed to gestational diabetes in utero, aged 0–24 months, born between 2014 and 2016 with at least 9 visits in first 2 years of life were enrolled. Twenty health centers of Ahvaz city (Capital of Khuzestan province, located in south western of Iran) and two referral centers for neonatal hypothyroidism involved the study.ResultsOf 438 GDM exposed infants, 54.6% were boys. Incidence of low birth weight and macrosomia were 4.6% and 8.7% respectively.Results4.6% had birth weight less than 2500gr and 8.7% was rate of macrosomia. Boys had higher weight and BMI than girls. Peak of BMI was 17.8 (±2.07) at 6 months after Gender was significant factor in predicted of BMI growth trajectories in GDM exposed children (p = 0.001). BMI in GDM exposed infants, in first 2 years of life was higher than WHO growth standards 2006 (P < 0.01).ConclusionMedians of BMI in GDM exposed infants in all measures was higher than WHO reference data 2006 (P < 0.01). Obesity prevention programs must be priority in GDM exposed infants. 相似文献
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Milan Milojevic Patrick W. Serruys Joseph F. Sabik David E. Kandzari Erick Schampaert Ad J. van Boven Ferenc Horkay Imre Ungi Samer Mansour Adrian P. Banning David P. Taggart Manel Sabaté Anthony H. Gershlick Andrzej Bochenek Jose Pomar Nicholas J. Lembo Nicolas Noiseux John D. Puskas Arie Pieter Kappetein 《Journal of the American College of Cardiology》2019,73(13):1616-1628
Background
The randomized EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial reported a similar rate of the 3-year composite primary endpoint of death, myocardial infarction (MI), or stroke in patients with left main coronary artery disease (LMCAD) and site-assessed low or intermediate SYNTAX scores treated with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Whether these results are consistent in high-risk patients with diabetes, who have fared relatively better with CABG in most prior trials, is unknown.Objectives
In this pre-specified subgroup analysis from the EXCEL trial, the authors sought to examine the effect of diabetes in patients with LMCAD treated with PCI versus CABG.Methods
Patients (N = 1,905) with LMCAD and site-assessed low or intermediate CAD complexity (SYNTAX scores ≤32) were randomized 1:1 to PCI with everolimus-eluting stents versus CABG, stratified by the presence of diabetes. The primary endpoint was the rate of a composite of all-cause death, stroke, or MI at 3 years. Outcomes were examined in patients with (n = 554) and without (n = 1,350) diabetes.Results
The 3-year composite primary endpoint was significantly higher in diabetic compared with nondiabetic patients (20.0% vs. 12.9%; p < 0.001). The rate of the 3-year primary endpoint was similar after treatment with PCI and CABG in diabetic patients (20.7% vs. 19.3%, respectively; hazard ratio: 1.03; 95% confidence interval: 0.71 to 1.50; p = 0.87) and nondiabetic patients (12.9% vs. 12.9%, respectively; hazard ratio: 0.98; 95% confidence interval: 0.73 to 1.32; p = 0.89). All-cause death at 3 years occurred in 13.6% of PCI and 9.0% of CABG patients (p = 0.046), although no significant interaction was present between diabetes status and treatment for all-cause death (p = 0.22) or other endpoints, including the 3-year primary endpoint (p = 0.82) or the major secondary endpoints of death, MI, or stroke at 30 days (p = 0.61) or death, MI, stroke, or ischemia-driven revascularization at 3 years (p = 0.65).Conclusions
In the EXCEL trial, the relative 30-day and 3-year outcomes of PCI with everolimus-eluting stents versus CABG were consistent in diabetic and nondiabetic patients with LMCAD and site-assessed low or intermediate SYNTAX scores.(Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776) 相似文献8.
《Clinical genitourinary cancer》2020,18(2):e103-e111
IntroductionWe aimed to evaluate the treatment sequence for patients with metastatic castration-resistant prostate cancer (mCRPC) in real-world practice and compare overall survival in each sequential therapy.Patients and MethodsWe retrospectively evaluated 146 patients with mCRPC who were initially treated with androgen deprivation therapy as metastatic hormone-naive prostate cancer in 14 hospitals between January 2010 and March 2019. The agents for the sequential therapy included new androgen receptor-targeted agents (ART: abiraterone acetate or enzalutamide), docetaxel, and/or cabazitaxel. We evaluated the treatment sequence for mCRPC and the effect of sequence patterns on overall survival.ResultsThe median age was 71 years. A total of 35 patients received ART-ART, 33 received ART-docetaxel, 68 received docetaxel-ART, and 10 received docetaxel-cabazitaxel sequences. The most prescribed treatment sequence was docetaxel-ART (47%), followed by ART-ART (24%). Overall survival calculated from the initial diagnosis reached 83, 57, 79, and 37 months in the ART-ART, ART-docetaxel, docetaxel-ART, and docetaxel-cabazitaxel, respectively. Multivariate Cox regression analyses showed no significant difference in overall survival between the first-line ART (n = 68) and first-line docetaxel (n = 78) therapies (hazard ratio [HR], 0.84; P = .530), between the ART-ART (n = 35) and docetaxel-mixed (n = 111) sequences (HR, 0.82; P = .650), and between the first-line abiraterone (n = 32) and first-line enzalutamide (n = 36) sequences (HR, 1.58; P = .384).ConclusionThe most prescribed treatment sequence was docetaxel followed by ART. No significant difference was observed in overall survival among the treatment sequences in real-world practice. 相似文献
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Shogo Yamamoto Yutaka Midorikawa Genta Nagae Kenji Tatsuno Hiroki Ueda Mitsuhiko Moriyama Tadatoshi Takayama Hiroyuki Aburatani 《Cancer science》2020,111(2):601-609
Multiple hepatocellular carcinoma (HCC) is divided into two categories: intrahepatic metastasis (IM), which is a true relapse of HCC, and multicentric origin (MO), which is a second primary tumor. Clinical diagnosis of multiple HCC is usually made based on tumor location and/or time to recurrence; however, it is often difficult to distinguish the two types of multiple HCC. Using 41 matched pairs of multiple HCC specimens, we confirmed the accuracy of clinical diagnoses using exome sequence data and investigated the importance of discriminating the type of multiple HCC. Genomic analysis revealed that 18 (43.9%) patients diagnosed as having genomic IM had common mutations in a pair of HCC tumors with the main tumor of these patients being more progressive compared to those with genomic MO. The accuracy of clinical diagnosis based on lobe (Definition 1) and segment (Definition 2) were 68.3% and 78.0%, respectively. Intriguingly, recurrence ≥2 years after initial surgery for 3 patients was IM. The survival of patients with clinical IM was significantly shorter than for those with clinical MO based on both Definition 1 (P = 0.045) and Definition 2 (P = 0.043). However, mean survival was not different between the patients with genomic IM and those with MO (P = 0.364). Taken together, genomic analysis elucidated that liver cancer may spread more extensively and more slowly than previously thought. In addition, distinguishing multiple HCC as IM or MC may have provided biological information but was not of clinical importance with respect to patient prognosis. 相似文献
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目的:采用简单重复序列(SSR)分子标记技术对广西苦玄参主产区69份苦玄参种质样本进行遗传多样性及亲缘关系分析,并筛选与苦玄参苷含量相关联的优良种质基因。为苦玄参种质资源评价、遗传进化分析及分子标记辅助育种等提供依据。方法:基于转录组测序技术,开发20对引物进行批量扩增。利用各标记位点的遗传多态信息,分析69份苦玄参种质的遗传多样性及亲缘关系,并通过一元线性和多元逐步回归分析,筛选与苦玄参苷含量相关联的分子标记。结果:20对SSR引物共扩增出76个等位基因,平均每个位点观测等位基因3.8个,高于有效等位基因数(1.9692个),稀有等位基因率为38.2%,等位基因分布不均匀。等位基因多态率范围为0~59%,平均38.24%,各位点多态率差异较大。各位点多态信息含量(PIC)变化范围为0~0.6211,平均0.3780;Shannon多态性信息指数变化范围为0~1.2401,平均0.7590;Nei’s基因多样性指数(Nei)变化范围为0~0.6823,平均0.4409;以上3个指标最高的为P21,最低为P7,各位点遗传多样性存在较大差异。各位点平均观测杂合度为0.3824,低于平均期望杂合度(0.4425),表现为杂合子缺失;平均遗传分化系数Fst为0.3659;基因流Nm平均值为0.4332,种质遗传分化较大,基因流较小。一元线性回归分析和多元逐步回归分析结果表明,与苦玄参苷IA和IB相关的位点各有5个,其中仅有1个位点与2个成分的含量均相关。结论:20个SSR标记位点遗传多样性存在较大的差异,供试69份种质遗传分化大,基因流较小;从供试20个SSR标记中筛选出9个与苦玄参苷含量相关联的标记位点,试验结果可为苦玄参遗传进化分析及良种选育和繁育等提供依据。 相似文献