排序方式: 共有96条查询结果,搜索用时 31 毫秒
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Bimal Bhindi Girish S. Kulkarni Antonio Finelli Shabbir M.H. Alibhai Robert J. Hamilton Ants Toi Theodorus H. van der Kwast Andrew Evans Karen Hersey Michael A.S. Jewett Alexandre R. Zlotta John Trachtenberg Neil E. Fleshner 《European urology》2014
Background
Active surveillance (AS) is an expectant management strategy for prostate cancer (PCa). The impact of obesity on progression is not well characterized in this population.Objective
To determine if obesity is associated with progression in men on AS for low-risk PCa.Design, setting, and participants
Men undergoing AS for low-risk PCa (no Gleason pattern ≥4, three or fewer cores involved or one-third or less of the total number of cores involved, and no core with >50% cancer involvement) were identified at our institution.Outcome measurements and statistical analysis
The outcomes were pathologic progression (defined as no longer meeting low-risk criteria on follow-up biopsy) and therapeutic progression (defined as intent to initiate active treatment). Kaplan-Meier curves and multivariable logistic regression and Cox proportional hazards models were used, with separate models for reclassification at confirmatory biopsy (first biopsy after diagnostic biopsy) and progression beyond confirmatory biopsy.Results and limitations
In this cohort of 565 men (median follow-up: 48 mo), 124 (22%) were obese (body mass index [BMI] ≥30 kg/m2). Pathologic and therapeutic progression occurred in 168 men (30%) and 172 men (30%), respectively. No association was noted between obesity and risk of progression at the confirmatory biopsy. However, beyond confirmatory biopsy, obesity was associated with a greater probability of pathologic progression (p = 0.007) and therapeutic progression (p = 0.007) in Kaplan-Meier analyses. In adjusted Cox models, each 5-unit increase in BMI was associated with an increased risk of pathologic progression (hazard ratio [HR]: 1.5; 95% confidence interval [CI], 1.1–2.1; p = 0.02) and therapeutic progression (HR: 1.4; 95% CI, 1.0–1.9; p = 0.05). The main limitation is the retrospective design, limiting the ability to assess BMI changes over time.Conclusions
Obesity was associated with a significantly increased risk of progression beyond the confirmatory biopsy. This suggests an increased risk of long-term biologic progression rather than solely misclassification.Patient summary
As opposed to immediate active treatment (surgery or radiation), active surveillance (AS) involves closely monitoring low-risk prostate cancers and only using active treatment if there are signs of progression. Our study is the first to suggest that obesity is associated with a higher risk of cancer progression while on AS. Further research is needed to determine if diet and exercise can decrease the risk of cancer progression while on AS. 相似文献34.
Adrian Attinger‐Toller Rahul Bhindi Gidon Y. Perlman Dale Murdoch Jonathan Weir‐McCall Philipp Blanke Marco Barbanti Janarthanan Sathananthan Philipp Ruile Caterina Gandolfo Francesco Saia Fabian Nietlispach David Wood Jonathon Leipsic John G. Webb 《Catheterization and cardiovascular interventions》2020,95(6):1186-1192
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Hall Mary E. Bhindi Bimal Luckenbaugh Amy N. Laviana Aaron A. Moses Kelvin A. Satkunasivam Raj Rini Brian Klaassen Zachary Wallis Christopher J. D. 《Cancer causes & control : CCC》2021,32(7):675-680
Cancer Causes & Control - Cytoreductive nephrectomy (CN) has played a role in treatment of metastatic renal cell carcinoma (mRCC) since trials demonstrated a survival benefit in patients... 相似文献
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Despite improvements in treatment, myocardial infarction (MI) remains an important cause of morbidity and mortality. Inflammation arising from ischaemic and reperfusion injury is a key mechanism which underpins myocardial damage and impairment of cardiac function. Early growth response-1 (Egr-1) is an early immediate gene and a master regulator that has been implicated in the pathogenesis of ischaemia-reperfusion (IR) injury. This study sought to examine the effect of selective inhibition of Egr-1 using catalytic deoxyribonucleic acid molecules (DNAzymes, DZs) delivered via the clinically relevant coronary route in a large animal model of myocardial IR. It was hypothesized that Egr-1 inhibition with intracoronary DZ would reduce infarction size by modulating its downstream effector molecules. Egr-1 DZs inhibited the adherence of THP-1 monocytes to IL-1β-activated endothelial cells in vitro and retained its catalytic activity up to 225 min after in vivo administration. In a porcine model of myocardial IR (45 min ischaemia/3 h reperfusion), DZ was taken up in the cytoplasm and nuclei of cardiomyocytes and endothelial cells in the myocardium after intracoronary delivery. Egr-1 DZs reduced infarct size and improved cardiac functional recovery following intracoronary delivery at the initiation of IR in this large animal model of MI. This was associated with inhibition of pro-inflammatory Egr-1 and ICAM-1 expression, and the reduced expression of TNF-α, PAI-1, TF, and myocardial MPO activity in tissue derived from the border zone of the infarct. Taken together, these data suggest that strategies targeting Egr-1 via the intracoronary route after IR injury in pigs have potential therapeutic implications in human MI. 相似文献
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Ali OA Bhindi R McMahon AC Brieger D Kritharides L Lowe HC 《American heart journal》2006,152(2):207-216
Iatrogenic and spontaneous downstream microembolization of atheromatous material is increasingly recognized as a source of cardiovascular morbidity and mortality. Devising ways of reducing this distal embolization using a variety of mechanical means--distal protection--is currently under intense and diverse investigation. This review therefore summarizes the present status of distal protection. It examines the problem of distal embolization, describes the available distal protection devices, reviews those areas of cardiovascular medicine where distal protection devices are being investigated, and discusses potential future developments. 相似文献
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Bimal Bhindi Ronald Kool Girish S. Kulkarni D. Robert Siemens Armen G. Aprikian Rodney H. Breau Fadi Brimo Adrian Fairey Christopher French Nawar Hanna Jonathan I. Izawa Louis Lacombe Victor McPherson Ricardo A. Rendon Bobby Shayegan Alan I. So Alexandre R. Zlotta Peter C. Black Wassim Kassouf 《Canadian Urological Association journal》2021,15(8):230