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The result of Unhealthy weight on In-patient Benefits in Reduce Extremity Shock: A Systematic Evaluate and Meta-analysis.
We suggested operative techniques and indications of robotic neck surgery. To determine operative techniques and the indications for robotic neck surgery, we analyzed treatment outcomes of patients who received robotic neck surgery. Between May 2010 and July 2018, a total of 945 patients with various neck diseases visited Severance Hospital and underwent robotic neck surgery. A variety of approaches, including the retroauricular approach (RA), modified facelift approach (MFLA), transaxillary approach (TA), and transaxillary retroauricular approach (TARA), was used to remove various tumors in the neck. A total of 235 patients underwent a robotic neck dissection (elective or therapeutic) in the treatment of head and neck cancer with metastatic cervical lymph nodes. Five hundred-seventeen patients underwent robotic thyroidectomy or parathyroidectomy for thyroid or parathyroid disease, respectively. The remaining 193 patients underwent robotic neck surgery in the treatment of other neck diseases. Various neck lesions were successfully excised using RA or MFLA (including salivary gland tumors, thyroid tumors, vascular tumors, neurogenic tumors, lipomas, lymphangiomas, venous malformations, dermoid cysts, and others). Robotic neck surgery is a feasible and safe technique for the resection of various head and neck tumors. This method could be particularly useful in young patients with thyroid tumors, salivary gland tumors, and vascular tumors, among others, because it does not leave a visible scar on the face or neck. The superior visualization and articulate robotic arm that moves freely at various angles allows surgeons to perform delicate and precise surgeries.BACKGROUND Carbon ion radiotherapy (CIRT) is an emerging radiation therapy to treat skull base chordomas and chondrosarcomas. To date, its use is limited to a few centers around the world, and there has been no attempt to systematically evaluate survival and toxicity outcomes reported in the literature. Correspondingly, the aim of this study was to qualitatively and quantitatively assess these outcomes. METHODS A systematic search of seven electronic databases from inception to November 2019 was conducted following PRISMA guidelines. Articles were screened against pre-specified criteria. Outcomes were then pooled by random-effects meta-analyses of proportions. RESULTS A total of nine studies provided unique metadata for assessment, with six originating from Heidelberg, Germany. The surveyed cohort size was 632 patients, with 389 (62%) chordomas and 243 (38%) chondrosarcomas of the skull base. Across all studies, median cohort age at therapy and female proportion were 46 years and 51% respectively. Estimates of local control incidence at 1-, 5-, and 10-years in chordoma-only studies were 99%, 80%, and 56%, and in chondrosarcoma-only studies were 99%, 89%, and 88%. Estimates of overall survival probability at 1-, 5-, and 10-years in chordoma-only studies were 100%, 94%, and 78%, and in chondrosarcoma-only studies were 99%, 95%, and 79%. The incidence of early and late toxicity (Grade ≥ 3) ranged from 0 to 4% across all study groups. CONCLUSIONS The emerging use of CIRT to treat skull base chordomas and chondrosarcomas appear promising with regard to tumor control, overall survival, and risk profile of early and late toxicity. The current literature suffers from the fact only a few centers in the world currently employ this technology.INTRODUCTION Standard of care for glioblastoma includes concurrent chemoradiation and maintenance temozolomide with tumor treatment fields (TTFields). Preclinical studies suggest TTFields and radiation treatment have synergistic effects. We report our initial experience evaluating toxicity and tolerability of scalp-sparing radiation with concurrent TTFields. METHODS This is a single arm pilot study (clinicaltrials.gov Identifier NCT03477110). Adult patients (age ≥ 18 years) with KPS ≥ 60 with newly diagnosed glioblastoma were eligible. All patients received concurrent scalp-sparing radiation (60 Gy in 30 fractions), standard concurrent temozolomide (75 mg/m2 daily), and TTFields. Maintenance therapy included standard temozolomide and continuation of TTFields. Radiation treatment was delivered through TTFields arrays. The primary endpoint was safety and toxicity for concurrent TTFields with chemoradiation in newly diagnosed glioblastoma. RESULTS We report the first ten patients on the trial. Eight were male, a PFS of 6.9 months (range 2.8 to 9.6 months). CONCLUSIONS Concurrent TTFields with scalp-sparing chemoradiation is a safe and feasible treatment option with limited toxicity. Future randomized prospective trial is warranted to define therapeutic advantages of concurrent TTFields with chemoradiation. TRIAL REGISTRATION Clinicaltrials.gov Identifier NCT03477110.BACKGROUND Tumor necrosis factor-α (TNFα) inhibitors (TNFi) have greatly improved the prognosis of RA and become the first therapeutic option for patients who failed the conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) therapy, but not all these patients respond well to TNFi. So far, there has been no definite biomarker to predict the response to TNFi yet. METHODS Sixty rheumatoid arthritis (RA) patients with disease duration more than 6 months and at least low disease activity defined by DAS28-CRP > 3.2 although after csDMARDs (including MTX and/or leflunomide) treatment for more than 3 months were included. They were further treated with TNFα receptor Fc fusion protein and MTX 10 mg per week for 12 weeks. Soluble ICAM-1 (sICAM-1) and CXCL13 concentrations in sera from 60 RA patients and 20 healthy controls were tested by ELISA right before and at the end of 12 weeks of TNFi therapy. N-Methyl-D-aspartic acid order The correlation between sICAM-1 and CXCL13 with disease activity and their predictive values for TNFi seline sICAM-1 concentration was independently associated with the EULAR response.• The sICAM-1high/CXCL13highpatients had significantly higher response rate than the sICAM-1low/CXCL13lowgroup.OBJECTIVE Takayasu arteritis (TAK) is a large vessel vasculitis affecting young women of childbearing age. The outcome of pregnancies in TAK patients, factors associated with maternal and foetal complications and adverse outcomes were analysed. METHODS All pregnancies in women with a TAK diagnosis were retrospectively included from 20 French hospitals providing care for TAK, until August 2015. RESULTS The study consisted of 43 pregnancies in 33 women, including 29 with a pre-existing TAK diagnosis and 4 diagnosed during pregnancy. Complications were observed in 20 pregnancies (47%), including 35% with arterial hypertension (n = 15), 9% with pre-eclampsia (n = 4), 2% with HELLP syndrome (n = 1) and 14% with intrauterine growth restriction (IUGR, n = 6, leading in one case to a medically indicated termination of pregnancy). There were 42 live births (98%) at a median term of 38 [27-42] weeks gestation including 9 before 37 weeks (21%). The median birth weight was 2940 [610-4310] grams. Five children (12%) required transfer to a neonatal intensive care unit.
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