Association of positively selected eIF3a polymorphisms with toxicity of platinum-based chemotherapy in NSCLC patients

Aim:

Eukaryotic translation initiation factor 3 subunit A (eIF3a) plays critical roles in regulating the initiation of protein translation, and eIF3a is highly expressed in lung cancer. In this study, we investigated the association of the positively selected SNPs of eIF3a with the response to and toxicity of platinum-based chemotherapy in Chinese patients with non-small cell lung cancer (NSCLC).

Methods:

SNP data for eIF3a locus were downloaded from HapMap database. For each SNP, haplotype, LD profile and population differentiation were analyzed. The long-range haplotype (LRH) test was employed to identify positively selected SNPs of eIF3a. A total of 325 NSCLC patients were enrolled and genotyped for these SNPs.

Results:

Five positively selected (rs1409314, rs4752219, rs4752220, rs7091672 and rs10510050) and 5 non-positively selected SNPs (rs10886342, rs11198804, rs2275112, rs10787899 and rs4752269) were identified in the LRH test. However, none of them was correlated with the platinum-based chemotherapy response. In contrast, 4 of the positively selected SNPs (rs1409314, rs4752219, rs4752220 and rs7091672) were significantly correlated with the toxicities tested (neutropenia, anemia, thrombocytopenia, emesis and hepatotoxicity). In addition, rs10510050 was significantly correlated with thrombocytopenia, emesis and hepatotoxicity. None of the 5 non-positively selected SNPs was correlated with the 5 toxicities.

Conclusion:

The positively selected SNPs of eIF3a are significantly correlated with platinum-based chemotherapy toxicities in Chinese NSCLC patients.     

Psychological effects of traditional Chinese mind-body exercises for low back pain: A protocol for meta-analysis

Introduction:Several studies reported that traditional Chinese mind-body exercises showed beneficial effects on improving anxiety and depression of patients with low back pain (LBP) in recent years. However, the effects of traditional Chinese mind-body exercises on improving psychological disorders of patients with LBP remain controversial. Most previous reviews only focused on the effects of traditional Chinese mind-body exercises for LBP on pain and dysfunction. Therefore, the present systematic review and meta-analysis will be conducted to evaluate the evidence on psychological effects of traditional Chinese mind-body exercises for LBP.Methods and analysis:The electronic databases (PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, China Knowledge Resource Integrated Database, and Wanfang Data) will be searched. The search will include all documents from their inception to February 2021. The Physiotherapy Evidence Database scale will be used for quality assessment of eligible studies. Risk of bias of eligible studies will also be assessed by Cochrane tool. The meta-analysis will be conducted using the Review Manager Version 5.3 software. The Higgins I² statistic will be performed to examine for heterogeneity. The subgroup analysis will be conducted based on different types of traditional Chinese mind-body exercises, different intervention time, and different outcomes. Quality of evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation.Ethics and dissemination:No ethical statement will be required for the performance of this review and meta-analysis. The results of this review will be published in an international peer-reviewed journal.INPLASY registration number:INPLASY202130075.     

Major determinants of death in patients hospitalized with COVID-19 during the first epidemic wave in Madrid,Spain

Spain is one of the European countries most largely affected by COVID-19, being Madrid the epicenter. A good knowledge of the main features of hospitalized patients during the complete lockdown should improve the management of new COVID-19 surges.All patients hospitalized at one large tertiary hospital in Madrid for suspected COVID-19 pneumonia from March 1 to May 31 were retrospectively identified.A total of 1752 patients were admitted with suspected pneumonia due to SARS-CoV-2 infection during the 3-month study period. The peak of daily admissions (n = 84) was reached on March 24, whereas the maximal cumulative number of hospitalized patients (n = 626) occurred on March 30. Overall, 85.3% had a positive PCR test for SARS-CoV-2 at least once during admission. Their median age was 65 (54–77) and 59.9% were male. The median length of hospitalization was of 7 (4–13) days. Roughly 6.5% were admitted at the intensive care unit.Death occurred in 242 (13.8%). Overall, 75% of deaths occurred in patients older than 75 years-old. It was 38.2% in patients hospitalized older than 80 years-old versus 2.2% in patients younger than 60 years-old (p < 0.001). Up to 94 (38.8%) of deceased patients had been transferred from nursing homes. The median Charlson co-morbidity score was 6 in deceased patients.The in-hospital mortality rate during the first wave of COVID-19 in Madrid was 14%. It was largely driven by older age, the presence of underlying chronic conditions (≥2) and living at nursing homes.     

Mild to moderate COVID-19 illness in adult outpatients: Characteristics,symptoms, and outcomes in the first 4 weeks of illness

Most patients with coronavirus disease 2019 (COVID-19) have mild to moderate illness not requiring hospitalization. However, no study has detailed the evolution of symptoms in the first month of illness.At our institution, we conducted remote (telephone and video) visits for all adult outpatients diagnosed with COVID-19 within 24 h of a positive nasopharyngeal polymerase chain test for SARS-CoV-2. We repeated regular video visits at 7, 14, and 28 days after the positive test, retrospectively reviewed the prospective data collected in the remote visits, and constructed a week by week profile of clinical illness, through week 4 of illness.We reviewed the courses of 458 symptomatic patients diagnosed between March 12, 2020, and June 22, 2020, and characterized their weekly courses. Common initial symptoms included fever, headache, cough, and chest pain, which frequently persisted through week 3 or longer. Upper respiratory or gastrointestinal symptoms were much shorter lived, present primarily in week 1. Anosmia/ageusia peaked in weeks 2 to 3. Emergency department visits were frequent, with 128 visits in the 423 patients who were not hospitalized and 48 visits among the 35 outpatients (7.6%) who were eventually hospitalized (2 subsequently died). By the fourth week, 28.9% said their illness had completely resolved. After the 4-week follow up, 20 (4.7%) of the 423 nonhospitalized patients had further medical evaluation and management for subacute or chronic COVID-19 symptoms.Mild to moderate outpatient COVID-19 is a prolonged illness, with evolving symptoms commonly lasting into the fourth week of illness.     

Image-based diagnosis of residual or recurrent nasopharyngeal carcinoma may be a phantom tumor phenomenon

Some nasopharyngeal carcinoma (NPC) patients may present convincing radiological evidence mimicking residual or recurrent tumor after radiotherapy. However, by means of biopsies and long term follow-up, the radiologically diagnosed residuals/recurrences are not always what they appear to be. We report our experience on this “phantom tumor” phenomenon. This may help to avoid the unnecessary and devastating re-irradiation subsequent to the incorrect diagnosis.In this longitudinal cohort study, we collected 19 patients of image-based diagnosis of residual/recurrent NPC during the period from Feb, 2010 to Nov. 2016, and then observed them until June, 2019. They were subsequently confirmed to have no residual/recurrent lesions by histological or clinical measures. Image findings and pathological features were analyzed.Six patients showed residual tumors after completion of radiotherapy and 13 were radiologically diagnosed to have recurrences based on magnetic resonance imaging (MRI) criteria 6 to 206 months after radiotherapy. There were 3 types of image patterns: extensive recurrent skull base lesions (10/19); a persistent or residual primary lesion (3/19); lesions both in the nasopharynx and skull base (6/19). Fourteen patients had biopsy of the lesions. The histological diagnoses included necrosis/ inflammation in 10 (52.7%), granulation tissue with inflammation in 2, and reactive epithelial cell in 1. Five patients had no pathological proof and were judged to have no real recurrence/residual tumor based on the absence of detectable plasma EB virus DNA and subjective judgment. These 5 patients have remained well after an interval of 38–121 months without anti-cancer treatments.Image-based diagnosis of residual or recurrent nasopharyngeal carcinoma may be unreliable. False positivity, the “phantom tumor phenomenon”, is not uncommon in post-radiotherapy MRI. This is particularly true if the images show extensive skull base involvement at 5 years or more after completion of radiotherapy. MRI findings compatible with NPC features must be treated as a real threat until proved otherwise. However, the balance between under- and over-diagnosis must be carefully sought. Without a pathological confirmation, the diagnosis of residual or recurrent NPC must be made taking into account physical examination results, endoscopic findings and Epstein-Barr virus viral load. A subjective medical judgment is needed based on clinical and laboratory data and the unique anatomic complexities of the nasopharynx.     

Farmacología y seguridad de tofacitinib en colitis ulcerosa

The use of Janus kinase (JAK) inhibitors is a new approach in the therapy of inflammatory diseases with immune base. Tofacitinib is one of these inhibitors targeting JAK1 and JAK3, and its efficacy has been demonstrated in the treatment of moderate to severe ulcerative colitis (UC). It is a small synthetic molecule administered orally, with a fast bioavailability and elimination rate, predictable pharmacokinetics and lack of immunogenicity, which are convenient characteristics for both efficacy and safety. This article reviews the pharmacological characteristics of tofacitinib and its safety profile.     

Clinical features and risk factors of intracranial artery disease in patients with Takayasu arteritis

Clinical Rheumatology - It has been known that aorta, subclavian, and extracranial arteries are commonly involved in Takayasu arteritis (TA). However, the involvement of intracranial artery in TA...     

Life among Chinese fibromyalgia patients: a cross-sectional study

Clinical Rheumatology - This study is to examine the impact of age on the clinical characteristics, fibromyalgia-related symptom severity and quality of life (QOL) among Chinese fibromyalgia...