Therapeutic Advances in Chronic Disease最新文献

{"title":"Can chronic kidney disease staging early predict outcome of large-artery ischemic stroke with impaired renal function?","authors":"Ie-Bin Lian, Ping-Fang Chiu, Yi-Chen Hsieh, Yang-Hao Ou, Chih-Ming Lin","doi":"10.1177/20406223231153564","DOIUrl":"https://doi.org/10.1177/20406223231153564","url":null,"abstract":"<p><strong>Background: </strong>Ischemic stroke poses a major threat to human beings, and a prompt intravenous thrombolytic management remains the gold standard protocol for stroke sufferers. Although the role of thrombolytic therapy (r-tPA) for ischemic stroke patients and those with underlying impaired renal function has been advocated as effective treating strategy, there is still a lack of investigation as to finding out baseline important variables that are capable of early outcome prediction.</p><p><strong>Objectives: </strong>In this project, we hypothesize that the change of clinical chronic kidney disease (CKD) staging (delta stage = CKD stage after 3-month follow-up - CKD stage at admission) could serve as a crucial predictor of the prognosis of patients.</p><p><strong>Design: </strong>This is a cohort longitudinal retrospective study.</p><p><strong>Sources and methods: </strong>A total of 765 cerebral artery ischemic stroke patients with impaired renal function were recruited and followed up for 1 year. Among them, 116 had received the thrombolytic treatment (r-tPA) after being evaluated at the triage in the emergency department and the rest had not (non-r-tPA). Propensity-matching was applied to compare the mortality between the r-tPA and non-r-tPA groups. Multiple logistic regression (LR) and decision tree (DT) algorithm were used to identify important prediction factors for mortality as well as the improvement in neurological function.</p><p><strong>Results: </strong>The 1-year mortality rates for r-tPA and non-r-tPA groups were 32.8% and 44.4%, respectively. The propensity-matched odds ratio of mortality for the r-tPA group compared with the non-r-tPA group is 0.469, with <i>p</i> = 0.003. Logistic regressions suggest that age, Hct, diabetes mellitus type 2, coronary artery disease, and delta stage are important factors for mortality for the non-r-tPA group, whereas age, diabetes mellitus type 2, chronic heart failure, hospital day, and delta stage are important factors for the r-tPA group. On the usage of antihypertensive drugs, ACEI/ARB was not associated with mortality (<i>p</i> = 0.198), whereas the diuretic was, with odds ratio at 1.619 (<i>p</i> = 0.025), indicating higher mortality after administration. Both LR and DT analyses indicate that delta stage is the most important predictor. For the r-tPA group, patients with delta stage ⩽0 had a 24% mortality, while that for delta stage >0 the mortality is 75%. For non-r-tPA patients, the corresponding mortalities were 30.9 and 66.3, respectively. Delta stage is also useful for predicting patients' improvement of neurological function, assessed by NIHSS, mRS, and Barthel Index. The areas under the curve for the three assessments are 0.83, 0.835, and 0.663, respectively.</p><p><strong>Conclusion: </strong>Large-artery ischemic stroke patients who received thrombolytic treatment had significantly lower mortality, even when presenting underlying impaired renal function. The change of","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231153564"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/98/10.1177_20406223231153564.PMC9940177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10765179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to air pollution and mortality in patients with chronic obstructive pulmonary disease: a cohort study in South Korea.","authors":"","doi":"10.1177/20406223231201066","DOIUrl":"https://doi.org/10.1177/20406223231201066","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/20406223231176175.].</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231201066"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/90/ec/10.1177_20406223231201066.PMC10504827.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10300438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic patient-reported outcomes in clinical kidney practice (ePRO Kidney): a process evaluation of educational support for clinicians.","authors":"Kara Schick-Makaroff,&nbsp;Scott Klarenbach,&nbsp;Jae-Yung Kwon,&nbsp;S Robin Cohen,&nbsp;Joanna Czupryn,&nbsp;Loretta Lee,&nbsp;Robert Pauly,&nbsp;Jennifer M MacRae,&nbsp;Bruce Forde,&nbsp;Richard Sawatzky","doi":"10.1177/20406223231173624","DOIUrl":"https://doi.org/10.1177/20406223231173624","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcomes (PROs) are increasingly mandated in kidney care to incorporate patients' perspectives.</p><p><strong>Objectives: </strong>We assessed whether educational support for clinicians using electronic (e)PROs could enhance person-centered care.</p><p><strong>Design: </strong>A process evaluation, using a mixed methods longitudinal comparative concurrent design was undertaken of educational support to clinicians on routine use of ePROs. In two urban home dialysis clinics in Alberta, Canada, patients completed ePROs. At the implementation site, clinicians were provided with ePROs and clinician-oriented education via voluntary workshops. At the non-implementation site, neither were provided. Person-centered care was measured using the Patient Assessment of Chronic Illness Care-20 (PACIC-20).</p><p><strong>Methods: </strong>Longitudinal structural equation models (SEMs) compared change in overall PACIC scores. The interpretive description approach, using thematic analysis of qualitative data, further evaluated processes of implementation.</p><p><strong>Results: </strong>Data were collected from questionnaires completed by 543 patients, 4 workshops, 15 focus groups, and 37 interviews. There was no overall difference in person-centered care throughout the study, including after delivery of workshops. The longitudinal SEMs revealed substantial individual-level variability in overall PACIC trajectories. However, there was no improvement at the implementation site and no difference between the sites during both the pre- and post-workshop periods. Similar results were obtained for each PACIC domain. Qualitative analysis provided insights into why there was no substantial difference between sites: (1) clinicians wanted to see kidney symptoms, not quality of life, (2) workshops were tailored to clinicians' educational needs, not patients' needs, and (3) variable use of ePRO data by clinicians.</p><p><strong>Conclusion: </strong>Training clinicians on use of ePROs is complex and likely only part of what is required to enhance person-centered care.</p><p><strong>Registration: </strong>NCT03149328. https://clinicaltrials.gov/ct2/show/NCT03149328.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231173624"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10272664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10301169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bimekizumab for the treatment of moderate-to-severe plaque psoriasis: a meta-analysis of randomized clinical trials.","authors":"Yuqian Wang,&nbsp;Sheng Li,&nbsp;Juan Bai,&nbsp;Xiaoxuan Cai,&nbsp;Shunli Tang,&nbsp;Peiyi Lin,&nbsp;Qingmiao Sun,&nbsp;Jianjun Qiao,&nbsp;Hong Fang","doi":"10.1177/20406223231163110","DOIUrl":"https://doi.org/10.1177/20406223231163110","url":null,"abstract":"<p><strong>Background: </strong>Bimekizumab is a monoclonal IgG1 antibody that selectively inhibits both interleukin (IL)-17A and IL-17F, and is a promising drug for patients with moderate-to-severe plaque psoriasis.</p><p><strong>Objectives: </strong>This study aimed to assess the efficacy and safety of bimekizumab in treating patients with psoriasis and to determine the optimal maintenance dosing schedules of bimekizumab.</p><p><strong>Methods and design: </strong>Eligible trials were identified from PubMed, Cochrane Controlled Register of Trials, Embase, ClinicalTrials.gov, and Chinese medical databases. Only double-blind, randomized, active comparator, or placebo-controlled trials of bimekizumab treatment on patients with psoriasis were included in this study.</p><p><strong>Results: </strong>Five studies were identified, which included 2473 patients with moderate-to-severe plaque psoriasis. The results indicated that bimekizumab had better efficacy than placebo or active comparator for Psoriasis Area and Severity Index (PASI) 90 [risk ratio (RR) = 29.29, 1.52; 95% confidence interval (CI) = 10.30-83.30, 1.06-2.19], PASI 100 (RR = 59.87, 2.06; 95% CI = 15.06-237.99, 1.12-3.79), and Investigator's Global Assessment scores of 0 or 1 (IGA 0/1) (RR = 21.55, 1.36; 95% CI = 9.25-50.19, 1.02-1.81). Faster onset of clinically meaningful responses was observed with bimekizumab compared with both active comparators (RR = 2.59; 95% CI = 1.32-5.10) and placebo (RR = 40.46; 95% CI = 13.19-124.13), with PASI 75 response observed at week 4 after one dose. Subgroup analysis showed no significant difference in the reduction of PASI scores between 320 mg q4w dosage and q8w dosage (RR = 1.00; 95% CI = 0.96-1.03). Rates of patients with adverse events (AEs) were comparable in the bimekizumab and active comparator groups (RR = 1.13; 95% CI = 1.01-1.26), and oral candidiasis was one of the most common treatment-emergent AEs.</p><p><strong>Conclusion: </strong>The results of this meta-analysis suggest that bimekizumab is more efficacious and has a rapid onset of action than active comparators and placebo in the treatment of moderate-to-severe plaque psoriasis. After 16 weeks of initial maintenance treatment, both bimekizumab maintenance dosing schedules (320 mg every 4 and 8 weeks) had similar efficacy.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231163110"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/1d/10.1177_20406223231163110.PMC10084576.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the efficacy and safety of leflunomide versus placebo combined with basic prednisone therapy in patients with active disease phase of Takayasu arteritis: study protocol for a randomized, double-blinded controlled trial (Takayasu arteritis clinical trial in China: TACTIC).","authors":"Ying Sun,&nbsp;Bingjie Wu,&nbsp;Wei Zhang,&nbsp;Lili Ma,&nbsp;Xiufang Kong,&nbsp;Huiyong Chen,&nbsp;Lindi Jiang","doi":"10.1177/20406223231158567","DOIUrl":"https://doi.org/10.1177/20406223231158567","url":null,"abstract":"<p><strong>Background: </strong>Takayasu arteritis (TAK) is an immune-induced granulomatous vasculitis that occurs primarily in young Asian women. Our previous cohort studies have indicated that leflunomide (LEF), which can lead to rapid induction and might be a promising alternative treatment for TAK.</p><p><strong>Objectives: </strong>To compare the efficacy and safety of LEF <i>versus</i> placebo combined with prednisone for active TAK in a Chinese population.</p><p><strong>Design: </strong>This will be a multicenter, randomized, double-blinded controlled trial aiming to recruit 116 TAK patients with active disease. This study will last 52 weeks.</p><p><strong>Methods and analysis: </strong>Participants will be assigned randomly to the LEF intervention arm or placebo control arm at a 1:1 ratio. Initially, LEF combined with prednisone will be given to the intervention arm and a placebo tablet combined with prednisone will be given to the placebo arm. At the end of week 24, subjects who achieved clinical remission or partial clinical remission will proceed to maintenance therapy with LEF to the end of week 52; those who did not achieve clinical remission or partial clinical remission in the LEF intervention arm will drop out from the study, and those in the placebo control arm will switch to LEF treatment to week 52. The primary endpoint will be the clinical remission rate of LEF <i>versus</i> placebo at the end of week 24. The secondary endpoints will be the time to clinical remission, mean dose of prednisone, disease recurrence, time to recurrence, adverse events, as well as clinical remission in subjects who switched from the placebo control arm to LEF therapy after week 24. Intention to treat will be the primary analysis.</p><p><strong>Discussion: </strong>This is the first randomized double-blinded placebo-controlled trial to clarify the efficacy and safety of LEF in treating active TAK. The results will provide more evidence for TAK management.</p><p><strong>Registration: </strong>ClinicalTrials.gov identifier: NCT02981979.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231158567"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/69/10.1177_20406223231158567.PMC9989417.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9140300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colon capsule retention in a patient with large bowel stenosis due to diverticulosis - a case report.","authors":"Benedicte Schelde-Olesen,&nbsp;Benjamin Schnack Brandt Rasmussen,&nbsp;Thomas Bjørsum-Meyer","doi":"10.1177/20406223231159613","DOIUrl":"https://doi.org/10.1177/20406223231159613","url":null,"abstract":"<p><p>Capsule retention is a rare complication to capsule endoscopy. It is often asymptomatic and resolves itself spontaneously. In some cases, endoscopy or surgery is necessary to remove the capsule. Cases of capsule retention in the colon are not reported very often and precautions in subsequent investigations must be considered. We present a case of a 74-year-old woman who underwent colon capsule endoscopy (CCE) due to a positive fecal immunochemical test. The CCE was incomplete, and the patient was referred to conventional colonoscopy, which was complicated by perforation of the large bowel during the procedure. This lead to a CT scan showing the capsule proximal to a stenotic colon segment which was subsequently surgically removed. In patients who report lack of capsule excretion and stenosis is not verified, colonoscopy can be carried out, but with caution.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231159613"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/2a/10.1177_20406223231159613.PMC10028650.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9224524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontal inflammation is associated with increased circulating levels of endothelial progenitor cells: a retrospective cohort study in a high vascular risk population.","authors":"María Vázquez-Reza,&nbsp;Antía Custodia,&nbsp;Iria López-Dequidt,&nbsp;Marta Aramburu-Núñez,&nbsp;Daniel Romaus-Sanjurjo,&nbsp;Alberto Ouro,&nbsp;João Botelho,&nbsp;Vanessa Machado,&nbsp;Ramón Iglesias-Rey,&nbsp;Juan Manuel Pías-Peleteiro,&nbsp;Rogelio Leira,&nbsp;Juan Blanco,&nbsp;José Castillo,&nbsp;Tomás Sobrino,&nbsp;Yago Leira","doi":"10.1177/20406223231178276","DOIUrl":"https://doi.org/10.1177/20406223231178276","url":null,"abstract":"<p><strong>Background: </strong>One of the main biological mechanisms behind the link between periodontitis and atherosclerotic vascular diseases is vascular endothelial dysfunction. Particularly, circulating endothelial progenitor cells (EPCs) have been considered a biomarker of altered vascular endothelial function.</p><p><strong>Objectives: </strong>The aim of this study was to investigate relationship between periodontal inflammation and increased number of circulating EPCs.</p><p><strong>Design: </strong>This is retrospective cohort study.</p><p><strong>Methods: </strong>In this study, 85 elderly patients with a previous history of hypertension were followed up to 12 months. A baseline full-mouth periodontal assessment was carried out, and the amount of periodontal tissue inflamed per subject was calculated as a proxy of periodontal inflammation [periodontal inflamed surface area (PISA)]. The number of circulating EPCs (CD34⁺/CD133⁺/KDR⁺) was determined by flow cytometry from peripheral blood samples collected at baseline and 12 months.</p><p><strong>Results: </strong>Mean concentrations of CD34⁺/CD133⁺/KDR⁺ progenitor cells were higher in periodontitis patients than in those without periodontitis at baseline [55.4, 95% confidence interval (CI) = 20.8 to 90.0 <i>versus</i> 27.2, 95% CI = 13.6 to 40.8, <i>p</i> = 0.008] and 12 months (114.6, 95% CI = 53.5 to 175.7 <i>versus</i> 19.1, 95% CI = 10.8 to 27.4, <i>p</i> = 0.003). A significant increase over the follow-up was noticed in the group of subjects with periodontitis (<i>p</i> = 0.049) but not in the nonperiodontitis group (<i>p</i> = 0.819). PISA was independently associated with CD34⁺/CD133⁺/KDR⁺ EPCs at baseline (<i>B</i> coefficient = 0.031, 95% CI = 0.005 to 0.058; <i>p</i> = 0.021). The relationship between PISA and CD34⁺/CD133⁺/KDR⁺ EPCs at 12 months was confounded by increased baseline body mass index (<i>B</i> coefficient = 0.064, 95% CI = -0.005 to 0.132; <i>p</i> = 0.066).</p><p><strong>Conclusion: </strong>Periodontal inflammation is associated with high number of CD34⁺/CD133⁺/KDR⁺ EPCs, thus supporting a potential link between periodontitis and endothelial dysfunction.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231178276"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/49/10.1177_20406223231178276.PMC10285583.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fractional nitric oxide measurement in exhaled air (FeNO): perspectives in the management of respiratory diseases.","authors":"Beatrice Ragnoli,&nbsp;Alessandro Radaeli,&nbsp;Patrizia Pochetti,&nbsp;Stefano Kette,&nbsp;Jaymin Morjaria,&nbsp;Mario Malerba","doi":"10.1177/20406223231190480","DOIUrl":"https://doi.org/10.1177/20406223231190480","url":null,"abstract":"<p><p>Exhaled nitric oxide (NO) production, upregulated by inflammatory cytokines and mediators in central and peripheral airways, can be easily and non-invasively detected in exhaled air in asthma and other respiratory conditions as a promising tool for disease monitoring. The American Thoracic Society and European Respiratory Society released recommendations that standardize the measurement of the fractional exhaled NO (FeNO). In asthma, increased FeNO reflects eosinophilic-mediated inflammatory pathways and, as a biomarker of T2 inflammation can be used to identify asthma T2 phenotype. In this setting its measurement has shown to be an important tool especially in the diagnostic process, in the assessment and evaluation of poor adherence or predicting positive response to inhaled corticosteroids treatment, in phenotyping severe asthma patients and as a biomarker to predict the response to biologic treatments. The discovery of the role of NO in the pathogenesis of different diseases affecting the airways and the possibility to estimate the predominant site of increased NO production has provided new insight on its regulatory role in the airways, making it suitable for a potential extended use in clinical practice for different pulmonary diseases, even though its role remains less clear than in asthma. Monitoring FeNO in pulmonary obstructive lung diseases including chronic bronchitis and emphysema, interstitial lung diseases, obstructive sleep apnea and other pulmonary diseases is still under debate but has opened up a window to the role NO may play in the management of these diseases. The use of FeNO is reliable, cost effective and recommendable in both adults and children, and should be implemented in the management of patients with asthma and other respiratory conditions.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231190480"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/31/10.1177_20406223231190480.PMC10395178.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Third-line treatment patterns and clinical outcomes for metastatic colorectal cancer: a retrospective real-world study.","authors":"Ting Deng,&nbsp;Jingjing Duan,&nbsp;Ming Bai,&nbsp;Le Zhang,&nbsp;Hongli Li,&nbsp;Rui Liu,&nbsp;Tao Ning,&nbsp;Shaohua Ge,&nbsp;Xia Wang,&nbsp;Yuchong Yang,&nbsp;Zhi Ji,&nbsp;Feixue Wang,&nbsp;Yi Ba","doi":"10.1177/20406223231197311","DOIUrl":"https://doi.org/10.1177/20406223231197311","url":null,"abstract":"<p><strong>Background: </strong>There are multiple recommendations on the third-line therapy of metastatic colorectal cancer (mCRC); however, no consensus has been reached.</p><p><strong>Objectives: </strong>This study aimed to explore the patient demographics and the real-world third-line treatment landscape of mCRC.</p><p><strong>Design: </strong>A retrospective real-world cohort study.</p><p><strong>Methods: </strong>Electronic medical records of mCRC patients from Tianjin Medical University Cancer Institute and Hospital between 2013 and 2020 were collected. Upon descriptive, comparative, and survival analyses, a retrospective study was conducted to describe demographics and clinical outcomes of mCRC patients receiving third-line treatment.</p><p><strong>Results: </strong>Among 218 mCRC patients receiving third-line therapy, 65.5% received chemotherapy combined with or without targeted drugs, followed by anti-angiogenic monotherapy (18.4%), anti-epidermal growth factor receptor drugs (6.9%) and immunotherapy (6.4%). The overall response rate and disease control rate reached 10.2% and 59.2%, respectively; and median progression-free survival (PFS) and overall survival were 4.0 m and 10.7 m, respectively. After Cox multivariate analysis, we found that therapeutic regime was an independent prognostic factor. Compared to patients receiving anti-angiogenic monotherapy, those receiving chemotherapy combined with or without targeted drugs exhibited better prognosis. For patients whose PFS were longer in the front-line treatment, the PFS of third-line therapy was also relatively longer (<i>p</i> = 0.023). Multiple types of therapies (>3, <i>p</i> = 0.002) or multiple drugs (>5, <i>p</i> = 0.024) in the whole-course management of mCRC are indicators of longer survival.</p><p><strong>Conclusion: </strong>Chemotherapy combined with or without targeted therapy remained dominated third-line choice and showed favorable efficacy compared with anti-angiogenic monotherapy. With the application of more types and quantities of effective drugs, patients would achieve better survival.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231197311"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d7/c1/10.1177_20406223231197311.PMC10501067.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10300442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between age, sex and cervical and upper cervical rotation tests. Descriptive and correlational study in healthy volunteers.","authors":"Carlos Zárate-Tejero,&nbsp;César Hidalgo-García,&nbsp;Orosia Lucha-López,&nbsp;Mar Hernández-Secorún,&nbsp;John Krauss,&nbsp;Pere Rodríguez-Rubio","doi":"10.1177/20406223231170158","DOIUrl":"https://doi.org/10.1177/20406223231170158","url":null,"abstract":"<p><strong>Background: </strong>Active cervical spine rotation (ACROM Rot) shows cervical rotation and flexion rotation test (FRT); side-bending rotation test (SBRT) and upper cervical axial rotation test (C0-C2ART) are described to measure upper cervical rotation. The objectives of this study are (1) to describe the normal range of motion (ROM) of ACROM Rot, and the ROM in FRT, SBRT and C0-C2ART tests; (2) to explore the correlation among the four tests and (3) to investigate the influence of age and sex in their ROM.</p><p><strong>Methods: </strong>A cross-sectional study was carried out with healthy volunteers from 18 to 75 years of age. Tests were measured using a CROM device and a bubble inclinometer. Descriptive analysis was performed to establish normative data for the ROM tests. Correlation analysis was conducted to understand the relation between upper and global cervical rotation ROM and among the three upper cervical rotation tests. Linear regression models were developed to understand the influence of age and sex in the ROM of all tests.</p><p><strong>Results: </strong>Normative values were obtained from 122 healthy volunteers (50% male), by sex and age strata. The degree of correlation ranged between 0.582 (<i>p</i> < 0.01) for FRT and ACROM Rot left and 0.217 (<i>p</i> < 0.05) for SBRT and C0-C2ART left. Linear regression models showed the influence of sex for ACROM Rot right (men -4.64° less than women), SBRT (men -4.1° less than women) left and C0-C2ART right and left (men -2.24° and -1.78° less than women). The age influenced rotation ROM with a decrease for every 10 years of -2.11° and -1.96° for ACROM Rot right and left, of -1.72° and -1.26° for FRT right and left and -0.58° and -0.41° for C0-C2ART right and left in the linear regression models. No association was found between age and SBRT (<i>p</i> = 0.63 for right SBRT and <i>p</i> = 0.49 for left SBRT).</p><p><strong>Conclusion: </strong>Weak-to-moderate correlation was found between the upper cervical spine rotation tests and with the ACROM. Women had a larger ROM in ACROM Rot right, SBRT left and C0-C2ART. Decreases in ROM related with age were observed for ACROM Rot, FRT and C0-C2ART but not for SBRT.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231170158"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c5/3f/10.1177_20406223231170158.PMC10155033.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9783532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}