Medicina-Lithuania最新文献

{"title":"Efficacy and Clinical Outcomes of Crizotinib in Patients with ROS1-Rearranged NSCLC: A Multicenter Study.","authors":"Alper Topal, Goncagul Akdag, Sedat Yildirim, Oguzcan Kinikoglu, Deniz Isik, Gizem Yildirim, Salih Tunbekici, Fatih Kus, Aydın Acarbay, Murad Guliyev, Nargiz Majidova, Yasin Kutlu, Mustafa Erman, Hatice Odabas, Nedim Turan, Nuri Karadurmus","doi":"10.3390/medicina61030490","DOIUrl":"10.3390/medicina61030490","url":null,"abstract":"<p><p><i>Background and Objectives:</i> ROS1 rearrangement is a rare but targetable alteration in non-small-cell lung cancer (NSCLC), occurring in 1-2% of cases. Crizotinib, a tyrosine kinase inhibitor, has demonstrated efficacy in clinical trials, but real-world data remain limited. This study evaluates the safety and efficacy of crizotinib in ROS1-rearranged NSCLC patients in a real-world setting. <i>Materials and Methods:</i> This multicenter, retrospective research included 43 individuals with advanced/metastatic NSCLC and confirmed ROS1 rearrangements. Patients were treated with crizotinib in first- or second-line settings. Efficacy endpoints included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate (DCR). Safety was assessed using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. <i>Results:</i> The median follow-up was 45.8 months. The ORR for first-line crizotinib was 72.1%, with a DCR of 79%. The median PFS was 20.9 months (95% CI: 6.02-35.69), and the median OS was 52.7 months (95% CI: 13.08-92.31). ECOG performance status was a significant prognostic factor for ORR (<i>p</i> = 0.02). The most common adverse events were fatigue (16.2%), elevated transaminases (13.9%), and vision disorders (11.6%). All reported adverse events were grade 1 or 2, with no grade ≥ 3 events observed. <i>Conclusions:</i>Crizotinib demonstrated significant efficacy and a favorable safety profile in real-world individuals with ROS1-rearranged NSCLC. These findings align with pivotal trials, underscoring crizotinib's role as a standard treatment for this molecular subset. Further prospective studies are warranted to explore intracranial efficacy and long-term outcomes.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wilms' Tumor: A Review of Clinical Characteristics, Treatment Advances, and Research Opportunities.","authors":"Mihai Cristian Neagu, Vlad Laurenţiu David, Emil Radu Iacob, Sorin Dan Chiriac, Florin Lucian Muntean, Eugen Sorin Boia","doi":"10.3390/medicina61030491","DOIUrl":"10.3390/medicina61030491","url":null,"abstract":"<p><p>Nephroblastoma is a complex childhood cancer with a generally favorable prognosis, well-defined incidence, and demographic profile but with significant challenges in terms of recurrence and long-term health outcomes. Although the management of this pathology has evolved, leading to improved survival rates, continued research into the long-term effects of treatment and the genetic factors influencing its development is still required. The survival landscape for Wilms tumor is evolving, with emerging research focusing on therapeutic biomarkers and genetic predispositions that influence treatment efficacy and survival rates. Identifying predictors for treatment response, such as specific genetic markers and histologic features, emerges as a critical area of study that could refine future interventions. The management of Wilms tumor is complex, taking into account the stage of the disease, histological classification, and individual patient factors, including age and the presence of syndromic associations. As treatment paradigms evolve, the integration of precision medicine approaches may enhance the ability of clinicians to personalize treatment to improve long-term survival outcomes for a broader range of patients. Recent advances in technology, including machine-learning approaches, have facilitated the identification of therapeutic biomarkers that correlate with clinical outcomes. This innovative method enhances the ability to integrate clinical and genetic data to predict disease trajectory and therapeutic response.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intravitreal Dexamethasone Implant (Ozurdex^®) in Naïve and Refractory Patients with Different Morphological Subtypes of Diabetic Macular Edema.","authors":"Panagiotis Stavrakas, Evita Evangelia Christou, Vasileios Nasikas, Chrysoula Koutsiouki, Athanasios Vakalis, Solon Asteriadis, Georgios D Panos, Paris Tranos","doi":"10.3390/medicina61030488","DOIUrl":"10.3390/medicina61030488","url":null,"abstract":"<p><p><i>Background and Objectives</i>: To investigate anatomical and functional outcomes in different morphological subtypes of diabetic macular edema (DME) treated with an intravitreal dexamethasone implant (Ozurdex) over 6 months follow-up. <i>Materials and Methods</i>: A retrospective, comparative study on patients with DME who received an intravitreal dexamethasone implant. Best-corrected visual acuity (BCVA), central subfoveal thickness (CST) and maximum CST on optical coherence tomography (OCT) were measured. The recruits were divided into three groups based on the morphological patterns of DME: serous retinal detachment (SRD), cystic macular edema (CME) and diffuse retinal thickening (DRT). The presence or absence of previous treatment were considered as being previously treated with anti-VEGF (PT) vs. naïve eyes (TN). All subjects received a single injection of the dexamethasone implant. The primary outcomes included changes in BCVA, CST and CSTMax at 2-, 4- and 6-months of follow-up. <i>Results</i>: CST was significantly reduced following one dexamethasone injection in the whole cohort from a total mean value of 513.3 μm to 368.2 μm at 2 months, 447.2 μm at 4 months and 471.5 μm at 6 months. The change in CST was significantly greater in SRD as opposed to the DRT and CME group at all time points. Overall, BCVA improved from 0.82 at baseline to 0.75 and 0.76 LogMAR at 2 and 4 months, respectively, whilst showing an overall deterioration to 0.84 at 6 months. The CME group showed the best BCVA at 6 months. Concerning treatment status (TN vs. PT), there was no significant difference in CST at 2 and 4 months, while CST was reduced at 6 months for the PT group (<i>p</i> = 0.023). Similarly, BCVA was significantly better in the PT group at 6 months (<i>p</i> = 0.017). <i>Conclusions</i>: The dexamethasone implant was effective in reducing DME and providing short-term BCVA improvement. The presence of SRD was associated with more favorable anatomical results, while CME was associated with better visual acuity. Dexamethasone provided superior results in previously treated patients.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Skeletal, Dental, and Soft Tissue Changes Before and After Orthodontic Treatment in Patients with Congenitally Missing Bilateral Maxillary Lateral Incisors.","authors":"Tuğba Şenel, Orhan Cicek","doi":"10.3390/medicina61030485","DOIUrl":"10.3390/medicina61030485","url":null,"abstract":"<p><p>(1) <i>Background and Objectives</i>: Congenitally missing bilateral maxillary lateral incisors (CMBMLIs) present significant aesthetic, functional, and psychosocial challenges that require an orthodontic approach based on multidisciplinary consensus. The aim of this study was to evaluate the skeletal, dental, and soft tissue changes in patients with CMBMLIs treated with space opening and closure methods and to compare these changes with those in untreated individuals. (2) <i>Materials and Methods</i>: A total of 53 patients (mean age 16 ± 3.5 years) were included, and three groups were formed: the study groups, consisting of the space opening group (<i>n</i> = 18) and the space closure group (<i>n</i> = 17), and the control group (<i>n</i> = 18), which had ideal occlusion. A total of 14 angular and 13 linear measurements were performed on lateral cephalograms before (T0) and after (T1) treatment. Statistical significance was set at <i>p</i> < 0.05. (3) <i>Results</i>: Compared to the control group, significant post-treatment changes were more evident in dental measurements and less evident in skeletal and soft tissue measurements. A statistically significant increase in the U1/SN angle was observed in the space opening group compared to the space closure group. The U1/NA angle increased significantly in both study groups, with a greater increase in the space opening group. However, although the change in U1/NA angle was not significantly different between groups, the increase was greater in the space opening group. No significant differences were found between the control and study groups in the nasolabial angle, upper lip length and thickness, and the distance from the upper and lower lips to the E-line. (4) <i>Conclusions</i>: While space opening and closure methods had minimal effects on most skeletal and soft tissue parameters, the space opening method significantly altered the maxillary incisor position. Considering the waiting period for prosthetic restoration after space opening and potential alveolar bone limitations, space closure is recommended for CMBMLIs when feasible because it ensures a more predictable planned maxillary incisor position.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Global Function Index: A Potential Predictor of Mortality and Major Adverse Cardiovascular Events in NSTEMI Patients.","authors":"Mesut Karatas, Cengiz Sabanoglu, Kader Eliz Sahin, Ibrahim Halil Inanc","doi":"10.3390/medicina61030487","DOIUrl":"10.3390/medicina61030487","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The prognostic value of Left Ventricular Global Function Index (LVGFI) in chronic cardiovascular diseases is well-documented; however, limited evidence exists for its utility in non-ST elevation myocardial infarction (NSTEMI). This study aims to evaluate LVGFI as a predictor of three-year mortality and major adverse cardiovascular events (MACE) in NSTEMI patients. <i>Materials and Methods</i>: This retrospective cohort study included 432 NSTEMI patients divided into tertiles based on LVGFI values: T1 (low), T2 (intermediate), and T3 (high). LVGFI values were derived from echocardiographic imaging. Kaplan-Meier survival analysis was used to assess outcomes, and the Cox proportional hazards models, adjusted for demographics and clinical covariates, determined the association between LVGFI tertiles and three-year outcomes. <i>Results</i>: The average age and sex distribution were similar across tertiles with no significant differences in cardiovascular risk factors or most laboratory parameters. However, significant differences were noted in body surface area (higher in T3), platelet counts (higher in T1), and triglyceride levels (lower in T3). The ROC analysis identified an optimal LVGFI cut-off of 23.22 for predicting three-year mortality, with a sensitivity of 72% and specificity of 75% (AUC: 0.81; 95% CI: 0.74-0.87, <i>p</i> < 0.001). Patients in the T1 exhibited a three-year mortality rate of 25%, compared to 2.1% in the T3. After adjustment, the hazard ratio (HR) for mortality was significantly higher in T1 (HR 11.86; 95% CI: 3.60-39.10) compared to T3. Similarly, MACE rates were highest in T1 (27.1%) and lowest in T3 (7.6%). <i>Conclusions</i>: LVGFI is a significant independent predictor of three-year mortality and MACE in NSTEMI patients.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose Escalation in Neoadjuvant Chemoradiotherapy for Rectal Cancer: Short-Term Efficacy and Toxicity of VMAT-SIB vs. 3D-CRT.","authors":"Suzana Stojanovic-Rundic, Mladen Marinkovic, Aleksandra Stanojevic, Dusica Gavrilovic, Radmila Jankovic, Natasa Maksimovic, Aleksandar Tomasevic, Predrag Petrasinovic, Sandra Radenkovic, Milena Cavic","doi":"10.3390/medicina61030483","DOIUrl":"10.3390/medicina61030483","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The standard treatment for locally advanced rectal cancer (LARC) includes neoadjuvant chemoradiotherapy (nCRT), followed by surgery with or without adjuvant chemotherapy (CT). This study evaluated the efficacy and safety of dose-escalated radiotherapy (RT) using the volumetric modulated arc therapy-simultaneous integrated boost (VMAT-SIB) technique in patients with LARC compared to 3D conformal radiotherapy (3D-CRT). <i>Materials and Methods</i>: This study prospectively enrolled 75 patients with LARC. All patients received nCRT using VMAT-SIB, delivering a tumor dose (TD) of 54 Gy in 25 fractions, with concomitant CT following the 5-fluorouracil and leucovorin (5-FU-LV) protocol. To compare the treatment outcomes and toxicity associated with the increased RT dose, a retrospective cohort of 62 patients treated with the 3D-CRT technique was analyzed. The 3D-CRT group received a TD of 50.4 Gy in 28 fractions with the same CT. Outcomes, including pathological complete response (pCR), tumor regression grade (TRG), and sphincter preservation rates, were compared. <i>Results</i>: Among operated patients, the group treated with VMAT-SIB demonstrated improved rates of pCR (20.6% vs. 8.9%), with a statistically significant trend (<i>p</i> = 0.06). Sphincter-preserving surgeries were performed in 49 out of 63 operated patients (77.8%) in the VMAT-SIB group, compared to 35 out of 56 (62.5%) in the 3D-CRT group. Analysis of the definitive postoperative stage revealed a significantly higher prevalence of lower T categories (T0-2) (<i>p</i> < 0.01), negative N status (<i>p</i> < 0.05), and lower stages (I + II) (<i>p</i> < 0.05) in patients treated with the intensified RT approach. However, no significant differences in acute toxicity were observed. <i>Conclusions</i>: The implementation of intensified treatment with a higher dose using the VMAT-SIB technique demonstrated significant benefits in downsizing and downstaging compared to the standard treatment approach. These findings support its integration into clinical practice. However, further prospective, multi-center studies are needed to validate these results and assess long-term outcomes.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel ABCD1 and MTHFSD Variants in Taiwanese Bipolar Disorder: A Genetic Association Study.","authors":"Yi-Guang Wang, Chih-Chung Huang, Ta-Chuan Yeh, Wan-Ting Chen, Wei-Chou Chang, Ajeet B Singh, Chin-Bin Yeh, Yi-Jen Hung, Kuo-Sheng Hung, Hsin-An Chang","doi":"10.3390/medicina61030486","DOIUrl":"10.3390/medicina61030486","url":null,"abstract":"<p><p><i>Background and Objectives:</i> In recent years, bipolar disorder (BD), a multifaceted mood disorder marked by severe episodic mood fluctuations, has been shown to have an impact on disability-adjusted life years (DALYs). The increasing prevalence of BD highlights the need for better diagnostic tools, particularly those involving genetic insights. Genetic association studies can play a crucial role in identifying variations linked to BD, shedding light on its genetic underpinnings and potential therapeutic targets. This study aimed to identify novel genetic variants associated with BD in the Taiwanese Han population and to elucidate their potential roles in disease pathogenesis. <i>Materials and Methods:</i> Genotyping was conducted using the Taiwan Precision Medicine Array (TPM Array) on 128 BD patients and 26,122 control subjects. Following quality control, 280,177 single nucleotide polymorphisms (SNPs) were analyzed via chi-square tests, and linkage disequilibrium (LD) analyses were employed to examine the associations among key SNPs. <i>Results:</i> Eleven SNPs reached significance (<i>p</i> < 10^-5), with the variant rs11156606 in the ABCD1 gene-implicated in fatty acid metabolism-emerging as a prominent finding. LD analysis revealed that rs11156606 is strongly linked with rs73640819, located in the 3' untranslated region, suggesting a regulatory role in gene expression. Additionally, rs3829533 in the MTHFSD gene was found to be in strong LD with the missense variants rs3751800 and rs3751801, indicating potential alterations in protein function. <i>Conclusion:</i> These findings enhance the genetic understanding of BD within a Taiwanese cohort by identifying novel risk-associated variants and support the potential for using these markers in early diagnosis and targeted therapeutic strategies.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Ultrasound Evaluation of Hemiplegic Shoulder Pain in Stroke Patients: A Longitudinal Observational Study Starting in the First Hours After Stroke.","authors":"Filippo Cotellessa, William Campanella, Luca Puce, Maria Cesarina May, Marta Ponzano, Riccardo Picasso, Matteo Mordeglia, Davide Subbrero, Ester Cecchella, Laura Mori, Davide Sassos, Massimo Del Sette, Matteo Formica, Carlo Trompetto","doi":"10.3390/medicina61030484","DOIUrl":"10.3390/medicina61030484","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Hemiplegic shoulder pain (HSP) is a common and disabling complication in stroke patients, yet its pathogenesis remains unclear. This longitudinal study aimed to investigate the clinical and ultrasound characteristics of HSP emerging within the first 72 h (T0) post-stroke, with follow-ups at one month (T1) and three months (T2). <i>Materials and Methods</i>: A total of 28 stroke patients with hemiparesis were assessed for HSP. Evaluations included pain severity during passive shoulder mobilization, passive and active range of motion, muscle strength, spasticity, and functional disability. Ultrasound examinations were conducted to assess tendon disorders, bursitis, effusion, glenohumeral subluxation, and adhesive capsulitis. <i>Results</i>: HSP prevalence increased over time, affecting 11% of patients at T0, 32% at T1, and 57% at T2. Higher baseline scores on the National Institutes of Health Stroke Scale (NIHSS), an established marker of stroke severity, were significantly associated with HSP (<i>p</i> < 0.05). At T2, patients with HSP exhibited greater impairment, including restricted passive and active range of movement, pronounced muscle weakness, and increased spasticity (<i>p</i> < 0.05). Ultrasound findings at T2 revealed that adhesive capsulitis and glenohumeral subluxation were significantly more frequent in HSP patients (<i>p</i> < 0.05). Adhesive capsulitis showed a significant increase from 0% at T0 to 21% at T2 (<i>p</i> = 0.031), while glenohumeral subluxation exhibited a non-significant rise from 4% to 21% (<i>p</i> = 0.063). Patients with these conditions experienced significantly greater pain progression (<i>p</i> < 0.001). <i>Conclusions</i>: These findings suggest that capsular pathology plays a key role in the development of HSP within the first three months after stroke. The results highlight the need for targeted interventions addressing glenohumeral subluxation and adhesive capsulitis to alleviate pain and improve rehabilitation outcomes.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Balloon Dilation for Primary Obstructive Megaureter in Children: Early Outcomes and Complications-A Case Series.","authors":"George Vlad Isac, Nicolae Sebastian Ionescu","doi":"10.3390/medicina61030479","DOIUrl":"10.3390/medicina61030479","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Congenital urological malformations are among the most frequent causes of pediatric chronic kidney disease. Endoscopic balloon dilation and ureteral stenting can be considered less invasive options compared to conventional surgery for primary obstructive megaureter (POM). Nevertheless, the long-term results and side effects of these methods have not yet been well documented. The purpose of this study is to analyze the effectiveness and safety of the endoscopic treatment of POM in children, with the aim of assisting clinical decision making and improving treatment plans. <i>Materials and Methods</i>: A retrospective longitudinal study was performed at the Pediatric Surgery Department of the \"M.S. Curie\" Emergency Clinical Hospital for Children in Bucharest between October 2020 and September 2024. Eleven endoscopic interventions were performed in five pediatric patients (four boys and one girl) who had six affected ureters, with a median age of 22 months. The inclusion criteria were retrovesical ureter dilation > 7 mm and no prior surgeries of the ureterovesical junction. Cases with secondary megaureters were excluded from the study. The procedures comprised HPEBD and temporary double-J (DJ) stent placement, with systematic postoperative monitoring. Success was defined as improvements in symptoms, a decrease in hydronephrosis, and the preservation of renal function. <i>Results</i>: A final success rate of 83.3% was achieved with endoscopic treatment. Complications were noted in 73% of cases: Clavien-Dindo Grade I (30%); Clavien-Dindo Grade II (20%); Clavien-Dindo Grade IIIb (50%). The documented complications consisted of balloon rupture, stent migration, restenosis, and febrile urinary tract infections (UTIs). Nonetheless, no major complications were observed. The postoperative monitoring showed that renal function was stable and that hydronephrosis had improved gradually. <i>Conclusions</i>: Endoscopic procedures offer a promising, minimally invasive treatment for POM in children with a good success rate. However, the high complication risk necessitates careful patient selection, post-surgery monitoring, and clear guidelines.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibition of Retinoblastoma Cell Growth by Boswellic Acid Through Activation of the Suppressing Nuclear Factor-κB Activation.","authors":"Semih Doğan, Mehmet Cudi Tuncer, İlhan Özdemir","doi":"10.3390/medicina61030480","DOIUrl":"10.3390/medicina61030480","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Despite the development of treatment methods and the emergence of alternative new approaches in recent years, the visual prognosis of retinoblastoma contains deficiencies and this situation increases the need for the development of new treatment approaches. The cytotoxic and apoptosis-inducing effects of the combination of boswellic acid (BA), which has been determined to have significant potential in preclinical and clinical studies of various diseases, and Cisplatin (Cis), a potent chemotherapy agent, were investigated on the human retinoblastoma cell line (Y79). <i>Materials and Methods:</i> The cytotoxic effect of BA and Cis on Y79 cells was determined by the water soluble tetrazolium-1 (WST-1) test, the apoptotic rate of the cells was determined by annexin V staining, and the gene expressions of <i>Protein53 (p53)</i>, <i>Caspase-3</i> and <i>Nuclear factor kappa B (NF-κB)</i>, which play an important role in apoptosis, were determined by RT-qPCR analysis. Interleukin 1-beta (IL1-β), tumor necrosis factor-α (TNF-α) and interferon γ (IFN-γ) levels were analyzed in cell lysates obtained from the experimental groups. <i>Results:</i> The combination of BA and Cis selectively inhibited the growth of Y79 cells and modulated <i>NF-κB</i> signaling, potentially through post-translational regulatory mechanisms. Moreover, it induced apoptosis by increasing <i>p53</i> and <i>Caspase-3</i> expressions, confirming its pro-apoptotic effects. Additionally, the combination treatment was associated with a reduction in inflammatory cytokine levels (TNF-α, IL1-β), suggesting a potential regulatory effect on inflammation-related pathways rather than direct inhibition of <i>NF-κB</i> activation. <i>Conclusions:</i> These findings suggest that BA combined with Cis inhibits Y79 retinoblastoma cell growth by inducing apoptosis and modulating <i>NF-κB</i> signaling. While <i>NF-κB</i> mRNA levels increased, reduced inflammatory cytokines and enhanced apoptosis suggest potential post-translational regulation. Further studies are needed to confirm <i>NF-κB</i> protein-level effects and in vivo efficacy.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}