Clinical and Investigative Medicine最新文献

{"title":"Assessment Of Tumour Infiltrating Lymphocytes And Pd-l1 Expression In Adenoid Cystic Carcinoma Of The Salivary Gland.","authors":"Wenqian Chen,&nbsp;Andrea S Fung,&nbsp;John B McIntyre,&nbsp;Roderick Simpson,&nbsp;Arfan R Afzal,&nbsp;Desiree Hao,&nbsp;Harold Lau","doi":"10.25011/cim.v44i1.35218","DOIUrl":"https://doi.org/10.25011/cim.v44i1.35218","url":null,"abstract":"<p><strong>Purpose: </strong>Early phase clinical studies are ongoing to evaluate the role of immune checkpoint inhibitors in adenoid cystic carcinoma (ACC) despite a paucity of information on the immune microenvironment. This study aims to better characterize the immune microenvironment of ACC tumours and evaluate survival outcomes based on tumour infiltrating lymphocyte (TIL) and programmed death-ligand 1 (PD-L1) expression.</p><p><strong>Methods: </strong>Patient characteristics, treatment and outcome data were collected for 24 ACC patients. The CD8+(cluster of differentiation 8) TIL and PD-L1 expression were quantified by immunohistochemistry. Marker expression and survival outcomes were evaluated by Kaplan-Meier analysis.</p><p><strong>Results: </strong>All cases were negative for PD-L1 expression; four cases had focal high, eight cases had focal moderate and 12 cases had low TIL expression. Based on TIL expression, there was no difference in disease-free or overall survival.</p><p><strong>Conclusion: </strong>Adenoid cystic carcinoma tumours were found to be associated with a poor immunogenic microenvironment, with absent PD-L1 expression and low CD8+ TILs. There was no association between TIL expression and survival. These data suggest that PD-L1 and TIL expression are unlikely to be useful as predictive biomarkers for response to immunotherapy.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25497952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy Of Pegylated Liposomal Doxorubicin-based Neoadjuvant Chemotherapy In Breast Cancer: A Single Center Experience.","authors":"I-Chen Tsai,&nbsp;Chih-Chiang Hung","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant chemotherapy using a doxorubicin-based regimen has recently become a common therapeutic option for operable breast cancer. This study aimed to investigate the efficacy of polyethylene glycol-coated liposomal doxorubicin (PLD)-based chemotherapy for breast cancer in neoadjuvant settings.</p><p><strong>Methods: </strong>A total of 227 female operable breast cancer patients who were diagnosed between January 2009 and December 2017 and completed neoadjuvant PLD-based chemotherapy were retrospectively included. The logistic regression analysis was used to determine the associations between pathologic complete response (pCR) and preoperative clinicopathological characteristics. The breast cancer recurrence rate was estimated using the survival analysis.</p><p><strong>Results: </strong>A higher pCR rate was found in the patients with clinically negative lymph nodes and HER2-enriched patients. Moreover, the patients who achieved pCR also had a better prognosis outcome. A recurrence rate of 11.5% (n=26) was observed during a median follow-up of 11.63 months, and the recurrence rate of the pCR group (2.04%; 95% CI = 0.29-13.62) was lower than the non-pCR group (14.62%; 95% CI = 10.12-20.87). Higher histological grade was also associated high pCR rate (52.0% vs 40.0%).</p><p><strong>Conclusion: </strong>The use of PLD-containing chemotherapeutics in neoadjuvant settings might have benefits for non-metastatic operable breast cancer in Taiwanese females.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25498304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Composite Biomarker Panel For Detection Of Early Stage Non-small Cell Lung Cancer.","authors":"Eric L R Bedard,&nbsp;Aswin G Abraham,&nbsp;Anil A Joy,&nbsp;Sunita Ghosh,&nbsp;Xiaoyu Wang,&nbsp;Andrew Lim,&nbsp;Dongyu Shao,&nbsp;Raimar Loebenberg,&nbsp;Wilson H Roa","doi":"10.25011/cim.v44i1.36016","DOIUrl":"https://doi.org/10.25011/cim.v44i1.36016","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate a novel composite methodology of using targeted serum microRNAs (micro ribonucleic acid; miRNA) and urine metabolites for the accurate detection of early stage non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>Consecutively consenting NSCLC patients and matched control subjects were recruited to provide samples of serum for miRNA and/or urine for metabolite analyses. Serum miRNA levels were measured using quantitative real-time reverse-transcription with exogenous control, and the comparative delta cycle threshold (CT) method was used to calculate relative miRNA expression of two targeted miRNAs (miR-21 and miR-223). The concentrations of six targeted urinary metabolites in patients and healthy controls were measured using proton nuclear magnetic resonance (1H NMR) spectroscopy. A composite methodology of using the 35 accruals with both serum and urine biomarkers was then established with binary logistic regression, receiver operating characteristic (ROC) models with or without artificial intelligence (AI).</p><p><strong>Results: </strong>The ROC analysis of miRNA expression yielded a sensitivity of 96.4% and a specificity of 88.2% for the detection of early stage NSCLC, with area under the curve (AUC) = 0.91 (CI 95%: 0.80-1.0). Relative urinary concentrations of 4-methoxyphenylacetic acid (4MPLA) were significantly different between NSCLC and healthy control (p=0.008). The ROC analysis of 4MPLA yielded a sensitivity of 82.1% and a specificity of 88.2%, with AUC = 0.85. The composite process combining miRNA and metabolite expression demonstrated a sensitivity and specificity of nearly 100% and AUC=1.</p><p><strong>Conclusions: </strong>A highly specific, sensitive and non-invasive detection method for NSCLC was developed. Pending validation, this can potentially improve the early detection and, hence, the treatment and survival outcomes of patients.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25497950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spring 2021: Clinician Investigator Trainee Association Of Canada (CITAC).","authors":"Melissa S Phuong Phuong,&nbsp;Valera Castanov,&nbsp;Sophie Hu MSc Hu,&nbsp;Danny Jomaa,&nbsp;Wenxuan Wang,&nbsp;Heather Whittaker,&nbsp;Adam Pietrobon","doi":"10.25011/cim.v44i1.36102","DOIUrl":"https://doi.org/10.25011/cim.v44i1.36102","url":null,"abstract":"<p><p>The Clinician Investigator Trainee Association of Canada (CI) trainees across the country around the common goal of improving training conditions for those pursuing a career at the junction of research and medicine. Since then, the CI training landscape has shifted dramatically. The number of Canadian CI trainees enrolled totaling 289 MD-PhD trainees and 389 Clinical Investigator Program (CIP) trainees as of 2019 [1]. Alumni outcome data have presented conclusive evidence that MD-PhD training programs are effective in producing CI careers [2-4].</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25498302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment Of Ratio Of Peak Expiratory Flow Rate To Vital Capacity For Identifying Pulmonary Fibrosis.","authors":"Stacey D Lok,&nbsp;Donald W Cockcroft,&nbsp;Alexander Simidchiev","doi":"10.25011/cim.v44i1.35976","DOIUrl":"https://doi.org/10.25011/cim.v44i1.35976","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary fibrosis (PF) is associated with reduction in vital capacity (VC) and increase in expiratory flow rates, including peak expiratory flow (PEF). Full pulmonary function testing and computed tomography chest scans are limited resources in some geographic areas and a simple and sensitive screening test would be of value. We hypothesized that increase in the ratio of % predicted PEF over % predicted VC (%PEF/%VC), from spirometry alone might be sensitive to screen for pulmonary fibrosis.</p><p><strong>Methods: </strong>The %PEF/%VC from 1,000 consecutive spirometric flow volume curves was nearly normally distributed: 7.5% (approximately 1.5 standard deviations) had a ratio ≥ 1.4. We evaluated the sensitivity and specificity of this cut point for a diagnosis of PF in a retrospective chart review of 391 patients with good quality spirometry and respirologists' confirmed diagnoses.</p><p><strong>Results: </strong>Of the 391 patients analyzed, 98 had PF, 79 were normal, 70 had a combined obstructive and restrictive processes, 57 had obstructive lung disease, 61 had extra-parenchymal restriction and 26 had non-fibrotic interstitial lung disease. A %PEF/%VC ≥ 1.4 was only 54.1% sensitive in predicting PF, however it had a specificity of 94.9%. There was a 95.1% specificity for ruling in intra-parenchymal opposed to extra-parenchymal restriction.</p><p><strong>Conclusion: </strong>A %PEF/%VC ≥ 1.4 was not sensitive enough to screen for PF but did demonstrate high specificity and thus may be helpful in identifying intraparenchymal restriction.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25497949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings From The 11th Annual University Of Calgary Leaders In Medicine Research Symposium.","authors":"Courtney L Schubert,&nbsp;Jessica Tjong,&nbsp;Benjamin W Ewanchuk,&nbsp;Robert T Moore,&nbsp;Morley D Hollenberg,&nbsp;Doreen M Rabi","doi":"10.25011/cim.v44i1.35079","DOIUrl":"https://doi.org/10.25011/cim.v44i1.35079","url":null,"abstract":"<p><p>On November 8th, 2019, the Cumming School of Medicine at the University of Calgary hosted the 11th annual Leaders in Medicine (LIM) Research Symposium. Dr. Donald A. Redelmeier, Professor at the University of Toronto and Canada Research Chair in Medical Decision Sciences, served as the keynote speaker with a talk entitled \"Pitfalls of Reasoning and Clinical Medicine\". In addition, there were five oral and 64 poster presentations. These presentations covered topics ranging from health promotion to neuroimaging. The event celebrated the continuing success and diversity of the LIM program and the training of clinician-scientists at the University of Calgary.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25497953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy Of Pegylated Liposomal Doxorubicin-based Neoadjuvant Chemotherapy In Breast Cancer: A Single Center Experience.","authors":"I. Tsai, Chih-Chiang Hung","doi":"10.25011/CIM.V44I1.35196","DOIUrl":"https://doi.org/10.25011/CIM.V44I1.35196","url":null,"abstract":"PURPOSE\u0000Neoadjuvant chemotherapy using a doxorubicin-based regimen has recently become a common therapeutic option for operable breast cancer. This study aimed to investigate the efficacy of polyethylene glycol-coated liposomal doxorubicin (PLD)-based chemotherapy for breast cancer in neoadjuvant settings.\u0000\u0000\u0000METHODS\u0000A total of 227 female operable breast cancer patients who were diagnosed between January 2009 and December 2017 and completed neoadjuvant PLD-based chemotherapy were retrospectively included. The logistic regression analysis was used to determine the associations between pathologic complete response (pCR) and preoperative clinicopathological characteristics. The breast cancer recurrence rate was estimated using the survival analysis.\u0000\u0000\u0000RESULTS\u0000A higher pCR rate was found in the patients with clinically negative lymph nodes and HER2-enriched patients. Moreover, the patients who achieved pCR also had a better prognosis outcome. A recurrence rate of 11.5% (n=26) was observed during a median follow-up of 11.63 months, and the recurrence rate of the pCR group (2.04%; 95% CI = 0.29-13.62) was lower than the non-pCR group (14.62%; 95% CI = 10.12-20.87). Higher histological grade was also associated high pCR rate (52.0% vs 40.0%).\u0000\u0000\u0000CONCLUSION\u0000The use of PLD-containing chemotherapeutics in neoadjuvant settings might have benefits for non-metastatic operable breast cancer in Taiwanese females.","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74935606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Sirolimus-eluting Biodegradable Magnesium-based Alloy Scaffold: Six-month Results In Porcine Peripheral Arteries.","authors":"Xin-Nong Liu,&nbsp;Cheng-Jia Qu,&nbsp;Yong-Bao Zhang,&nbsp;Jie Fang,&nbsp;Le-Qun Teng,&nbsp;Xiang-Yu Zhang,&nbsp;Chen-Yang Shen","doi":"10.25011/cim.v44i1.35292","DOIUrl":"https://doi.org/10.25011/cim.v44i1.35292","url":null,"abstract":"<p><strong>Purpose: </strong>Magnesium-based alloy scaffold is a promising biodegradable stent due to its intrinsic mechanical performance and biocompatibility. Based on our preliminary experiments, we designed a novel sirolimus-eluting magnesium-based alloy scaffold. This work aimed to assess its safety and degradation performance in vivo.</p><p><strong>Methods: </strong>The scaffolds were implanted in the lower limb arteries of Bama mini-pigs. Safety was defined as no immediate thrombosis or >30% residual stenosis, which was assessed with optical coherence tomography and digital subtraction angiography. Blood biochemical analyses were performed to evaluate hepatorenal toxicity. The degradation process of the scaffolds, the endothelialization, and lumen loss of the stented-vessels were detected with scanning electron microscopy, immunohistochemical, hematoxylin-eosin staining and optical coherence tomography.</p><p><strong>Results: </strong>Twenty-four scaffolds were successfully implanted in six pigs with no signs of immediate thrombosis or >30% residual stenosis. The scaffolds were covered by endothelium at one month and absolutely resorbed at six months post implantation. Blood analysis showed that the hepatorenal function except for alanine aminotransferase and γ-glutamyl transpeptidase was normal. Obvious intimal hyperplasia and lumen loss were found in the stented vessels at three months, while the diameters and inner lumen areas of stented segments had increased significantly at six months (p.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25497951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Covid-19 Pandemic Has Exposed Opportunities To Strengthen Our Health Research Systems.","authors":"Bev J Holmes,&nbsp;Alex MacKenzie,&nbsp;Bruce McManus,&nbsp;Aubie Angel Angel","doi":"10.25011/cim.v44i1.36029","DOIUrl":"https://doi.org/10.25011/cim.v44i1.36029","url":null,"abstract":"<p><p>Professor Sir Mark Walport, FRS, FMed Sci, FRCP, physicianscientist, academic leader and visionary health research planner, was the recipient of the 2020 Henry G. Friesen International Prize in Health Research. He is a former Chief Executive, UK Research and Innovation (UKRI) and UK government's Chief Scientific Advisor. He continues to be a champion of fundamental science in health research, engineering, technology and innovation, and is a major spokesperson on COVID-19 pandemic trends at the global level.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25498303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International training considerations of Canadian Clinician-Scientist Trainees - A national survey.","authors":"Adam Pietrobon,&nbsp;Elina K Cook,&nbsp;Charles Yin,&nbsp;Derek C H Chan,&nbsp;Tina B Marvasti","doi":"10.25011/cim.v43i4.35003","DOIUrl":"https://doi.org/10.25011/cim.v43i4.35003","url":null,"abstract":"<p><strong>Purpose: </strong>Canadian clinician-scientist trainees enrolled in dual degree programs often pursue an extended training route following completion of MD and MSc or PhD degrees. However, the proportion, plans and reasoning of trainees who intend to pursue training internationally following dual degree completion has not been investigated. In this study, we assessed the international training considerations of current clinician-scientist trainees.</p><p><strong>Methods: </strong>We designed an 11-question survey, which was sent out by program directors to all current MDPhD program and Clinician Investigator Program (CIP) trainees. Responses were collected from July 8, 2019 to August 8, 2019.</p><p><strong>Results: </strong>We received a total of 191 responses, with representation from every Canadian medical school and both MD-PhD program and CIP trainees. The majority of trainees are considering completing additional training outside Canada, most commonly post-doctoral and/or clinical fellowships. The most common reasons for considering international training include those related to quality and prestige of training programs. In contrast, the most common reasons for considering staying in Canada for additional training are related to personal and ethical reasons. Irrespective of intentions to pursue international training, the majority of trainees ultimately intend to establish a career in Canada.</p><p><strong>Conclusion: </strong>While most trainees are considering additional training outside of Canada due to prestige and quality of training, the majority of trainees intend to pursue a career as a clinician-scientist back in Canada. Trainees would likely benefit from improved guidance and mentorship on the value of international training, as well as enhanced support in facilitating cross-border mobility.</p>","PeriodicalId":50683,"journal":{"name":"Clinical and Investigative Medicine","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2020-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39105625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}