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BackgroundInflammatory myofibroblastic tumors (IMTs) are rare intermediate-grade neoplasms that have a high recurrence rate after excision and exhibit low metastatic potential. These tumors contain proliferating neoplastic, fibroblastic and myofibroblastic cells, and are also characterized by chronic inflammatory infiltration by lymphocytes, plasma cells, eosinophils, and histiocytes. They belong to the group of inflammatory spindle cell lesions. Some reactive lesions, such as inflammatory pseudotumors, may appear to be IMTs, which makes their differential diagnosis extremely difficult. The aim of this article is to compile the recent information on IMTs to aid in their diagnosis and treatment.MethodsWe reviewed articles published between 2017 and 2021, which were selected from online medical databases. In addition, some earlier articles and latest scientific monographies were analyzed.ResultsThe terminology used for inflammatory spindle cell lesions seems to be confusing. The terms “inflammatory myofibroblastic tumors” and “inflammatory pseudotumors” are interchangeably used by many scientists. However, a detailed analysis of the development of terminology suggests that the term “inflammatory myofibroblastic tumors” should be used to refer to a neoplastic lesion.ConclusionsIMTs are rare neoplasms, which have not been investigated in detail due to the difficulty in collecting a large number of cases. Thus, our knowledge about this disease remains unsatisfactory. Recently developed techniques such as next-generation sequencing and computer-aided histopathological diagnosis may be useful in understanding the etiopathology of IMTs, which will help in the selection of the most appropriate therapy for patients.  相似文献   

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BackgroundRecent advances in information technology (IT) coupled with the increased ubiquitous nature of information technology (IT) present unique opportunities for improving diabetes self-management. The objective of this paper is to determine, in a systematic review, how IT has been used to improve self-management for adults with Type 1 and Type 2 diabetes.MethodsThe review covers articles extracted from relevant databases using search terms related information technology and diabetes self-management published after 1970 until August 2012. Additional articles were extracted using the citation map in Web of Science. Articles representing original research describing the use of IT as an enabler for self-management tasks performed by the patient are included in the final analysis.ResultsOverall, 74% of studies showed some form of added benefit, 13% articles showed no-significant value provided by IT, and 13% of articles did not clearly define the added benefit due to IT. Information technologies used included the Internet (47%), cellular phones (32%), telemedicine (12%), and decision support techniques (9%). Limitations and research gaps identified include usability, real-time feedback, integration with provider electronic medical record (EMR), as well as analytics and decision support capabilities.ConclusionThere is a distinct need for more comprehensive interventions, in which several technologies are integrated in order to be able to manage chronic conditions such as diabetes. Such IT interventions should be theoretically founded and should rely on principles of user-centered and socio-technical design in its planning, design and implementation. Moreover, the effectiveness of self-management systems should be assessed along multiple dimensions: motivation for self-management, long-term adherence, cost, adoption, satisfaction and outcomes as a final result.  相似文献   

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The inflammasome complex is part of the innate immune system, which serves to protect the host against harm from pathogens and damaged cells. It is a term first proposed by Tschopp's group in 2002, with numerous original research articles and reviews published on the topic since. There have been many types of inflammasome identified, but all result in the common pathway of activation of caspases and interleukin 1β along with possible cell death called pyroptosis. Despite a growing body of research investigating the structure and function of the inflammasome in animal models, there is still limited evidence identifying inflammasome components in human physiology and disease. In this review, we explore the molecular structure and mechanism of activation of the inflammasome with a particular focus on inflammasome complexes expressed in humans. Inflammasome components have been identified in several human peripheral and brain tissues using both in vivo and ex vivo work, and the inflammasome complex has been shown to be associated with several genetic and acquired inflammatory and neoplastic disorders. We discuss the strengths and weaknesses of the information available on the inflammasome with an emphasis on the importance of prioritizing work on human tissue. There is a huge demand for more effective treatments for a number of inflammatory and neurodegenerative diseases. Modulation of the inflammasome has been proposed as a novel treatment for several of these diseases and there are currently clinical trials ongoing to test this theory.  相似文献   

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Since last decade, the debate on the parameter which reflects prostate cancer sensitivity to fractionation in a radiotherapy treatment, the α/β, has become extensive. Unlike most tumors, the low labeling indices (LI) and large potential doubling time that characterize the prostate tumor led some authors to consider that it may behave as a late responding tissue. So far, the existing studies with regard to this subject point to a low value of α/β, around 2.7 Gy, which may be considered as a therapeutic gain in relation to surrounding normal tissues by using fewer and larger fractions. The aim of this paper is to review several estimates that have been made in the last few years regarding the prostate cancer α/β both from clinical and experimental data, as well as the set of factors that have potentially influenced these evaluations.  相似文献   

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What do we really know about mindfulness-based stress reduction?   总被引:17,自引:0,他引:17  
OBJECTIVE: Mindfulness-Based Stress Reduction (MBSR) is a clinical program, developed to facilitate adaptation to medical illness, which provides systematic training in mindfulness meditation as a self-regulatory approach to stress reduction and emotion management. There has been widespread and growing use of this approach within medical settings in the last 20 years, and many claims have been made regarding its efficacy. This article will provide a critical evaluation of the available state of knowledge regarding MBSR and suggestions for future research. METHODS: A review of the current literature available within the medical and social sciences was undertaken to provide an evaluation regarding what we know about the construct of mindfulness, the effectiveness of MBSR, and mechanisms of action. RESULTS: There has been a paucity of research and what has been published has been rife with methodological problems. At present, we know very little about the effectiveness of this approach. However, there is some evidence that suggests that it may hold some promise. CONCLUSIONS: The available evidence does not support a strong endorsement of this approach at present. However, serious investigation is warranted and strongly recommended.  相似文献   

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The study of pathological gambling and its treatment is in a nascent stage. To date, no consistent definition of relapse to gambling exists, and only a few empirical studies have evaluated the phenomenon of relapse directly in this patient population. Perspectives on relapse to drug and alcohol use appear relevant to the study of pathological gambling, and relapse to gambling is reviewed within the larger context of addictive disorders. The application of psychological, biological, environmental, and treatment factors are described as they may relate to relapse among pathological gamblers.  相似文献   

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide causing a pandemic with millions of infected people and deaths. Currently, the scientific community is working hard to develop a specific vaccine or treatment. However, since antibody production is an important part of the adaptive immune response, to develop vaccines and therapies, we must understand the antibody response to SARS-CoV-2 infection. In this work, we summarize the most important findings of antibody-mediated immunity against SARS-CoV-2 and highlight its role in the efficient use of plasma from convalescent patients and the direct application of antibodies as treatment.  相似文献   

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<正>Over the past 3 years, the COVID-19 pandemic has posed a significant global challenge to the public health system. However, other diseases, such as hepatitis of unknown origin in children and monkeypox,havebeenrecentlyreportedinEuropean,African,and American countries. These data showed that monkeypox and other emerging or re-emerging viruses are novel global threats.Monkeypoxiscausedbyinfectionwiththemonkeypoxvirus(MPXV),alinear,enveloped,double-strandedDNA(dsDNA)virusbelongingtotheOrth...  相似文献   

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Mast cells (MCs) are derived from committed precursors that leave the hematopoietic tissue, migrate in the blood, and colonize peripheral tissues where they terminally differentiate under microenvironment stimuli. They are distributed in almost all vascularized tissues where they act both as immune effectors and housekeeping cells, contributing to tissue homeostasis. Historically, MCs were classified into 2 subtypes, according to tryptic enzymes expression. However, MCs display a striking heterogeneity that reflects a complex interplay between different microenvironmental signals delivered by various tissues, and a differentiation program that decides their identity. Moreover, tissue-specific MCs show a trained memory, which contributes to shape their function in a specific microenvironment. In this review, we summarize the current state of our understanding of MC heterogeneity that reflects their different tissue experiences. We describe the discovery of unique cell molecules that can be used to distinguish specific MC subsets in vivo, and discuss how the improved ability to recognize these subsets provided new insights into the biology of MCs. These recent advances will be helpful for the understanding of the specific role of individual MC subsets in the control of tissue homeostasis, and in the regulation of pathological conditions such as infection, autoimmunity, and cancer.  相似文献   

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In order to cope with normal cognitive aging we must understand the patterns and neurofunctional underpinnings of cognitive and behavioral changes throughout adulthood. In this review, we summarize recent advances in our understanding of age-related behavioral differences and changes in brain structure throughout the spatial domain. Although spatial cognition is critically important to everyday life, few studies have examined the relationship between this cognitive function and neural changes in the aged brain. Thus, spatial cognition is considered a key area in which the cognitive neuroscience of aging may expand in the near future. The first section of this review examines the methodologies and studies used to assess differences in spatial cognition during normal cognitive aging in animals and humans. We then relate how each domain of spatial cognition (e.g., visuospatial perception, mental imagery, memory and navigation) is affected by the aging process, and discuss possible links with changes in neural mechanisms. Lastly, we address putative links among the age-related deterioration patterns of the various spatial domains and make suggestions for future research.  相似文献   

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Many women develop postpartum mental health symptoms, ranging from the maternity blues to clinically diagnosed postpartum depression (PPD). Substantial literature supports an association between depression and type 2 diabetes, but there is limited literature regarding to what extent this relationship pertains to gestational diabetes (GDM) and postpartum depression. Review of the literature regarding GDM and PPD with a particular focus on describing the prevalence of PPD among women who may be at increased risk for GDM, including low-income and ethnic minority groups, was performed. Literature searches were conducted across four databases for studies reporting postpartum mental health outcomes (including postpartum depression, behavioral symptoms, mental disorders, mood, anxiety, quality of life) following a diagnosis of GDM. Studies including subgroups of women with GDM were included if postpartum mental health outcomes were reported. Of the 245 abstracts identified, ten studies were included in the final review. Findings suggest that PPD was high among low-income, ethnic minority women. Additional research is required to understand the complex relationship between GDM and PPD among low-income women, with the ultimate goal of implementing tailored interventions to address their medical and psychiatric needs.  相似文献   

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In anticipation of the launch of the national cervical screening programme, a questionnaire was distributed amongst 200 women on the maternity wards of the Coombe Women's Hospital. The questionnaires revealed that 24% of the women surveyed never had a smear test and 50% of these did not know how the test was performed. The majority of all women did not know what a smear test showed and 26% did not know the meaning of an abnormal smear. Irish women's knowledge of cervical screening is limited, and the success of the proposed programme will depend on an improvement in public information and education.  相似文献   

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Much has been written about the effects of aging on reproductive function, especially female fertility. Much less is known about how aging may affect the contractility of the smooth muscle within the uterus, the myometrium. The myometrium is active through a woman's entire life, not just during pregnancy. Here we will discuss briefly the contractile functions of the uterus and the changes it undergoes throughout the stages of a woman's life from menstruation and the menopause, before evaluating the evidence for any changes in myometrial contractility and responses as women age, with a particular focus on women of advanced maternal age. We present original contractility analysis for the widest data set for human myometrium so far examined, and determine inherent spontaneous activity as well as responses to depolarisation and stimulation with oxytocin. Our data show that in the non-pregnant state there is a significant decrease in contractility for both spontaneous and depolarised-induced contractions, with age. We suggest that muscle atrophy and down regulation of Ca channels may account for this. Interestingly in pregnant myometrium we found a wide range of contractile ability between women and little evidence for decreased spontaneous activity between the ages of 25-40. Oxytocin responses appear to be more affected by aging, a finding that is consistent with previously reported clinical findings, and may partly be the result of membrane lipids such as cholesterol, increasing as women age. The marked differences between the age-related decline of force beyond age 30 in non-pregnant uterus, and the lack of difference in the pregnant state over this period, shows that the uterus retains its ability to respond to gestational hormones. The growth of the pregnant uterus and increase in content of myofibrillar proteins, may abolish any previous age-related force deficit. This finding is consistent with what is apparent for postmenopausal women in their 50s and 60s; that with the appropriate hormonal stimulation the uterus can allow an embryo to implant, and then without further intervention, carry the foetus to term. It is tempting therefore to speculate that unlike other well documented declines in female reproductive functions with age, the myometrium remains able to function into a woman's 7th decade.  相似文献   

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IntroductionKRAS mutations are negative predictors of the response to anti-EGFR therapy in colorectal carcinomas (CRCs). Point mutations in codons 12, 13, and 61 are the most common KRAS mutations in CRC. There are few reports on insertions in KRAS, and little is known about its ability to activate the RAS pathway. The scarcity of data regarding insertion frequencies and nucleotide additions in KRAS impedes the management of patients with such mutations. We present data on KRAS insertions in CRC and discuss a case.Materials and methodsPyrosequencing and Sanger sequencing were performed to identify KRAS and BRAF mutations in paraffin-embedded samples of CRC. Expression of mismatch repair proteins was examined by immunohistochemistry.ResultsWe detected a GGT insertion between codons 12 and 13 (c.36_37insGGT;p.G12_G13insG) in a CRC patient. We found that insertions in KRAS is very rare in CRC and that the most frequent type of insertion is c.36_37insGGT.ConclusionsKRAS gene insertions represent a diagnostic and clinical challenge due to the difficult and unusual pyrosequencing findings and the lack of information regarding its clinical impact.  相似文献   

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