Physikalische Medizin Rehabilitationsmedizin Kurortmedizin最新文献

{"title":"The Effect of Dry Needling on Suprapatellar Tendonitis: A Case Report","authors":"M. Shahbazi","doi":"10.1055/a-2065-3790","DOIUrl":"https://doi.org/10.1055/a-2065-3790","url":null,"abstract":"Abstract Background Patellar tendinitis is common in jumping sports. Pain from patellar tendinopathy is challenging to manage. Dry needling as a stand-alone treatment for tendinopathy is supported. To our knowledge, dry needling has never been used alone. This case report depicts dry needling on the proximal patellar pole. Case description A 43-year-old male presented with left suprapatellar tendinitis. He was injured four months before beginning dry needling while playing futsal without warming up. The superior pole of the patellar was tender to palpation and caused moderate pain. At 20 degrees of knee flexion, discomfort began during double leg squats. The Clarke’s Sign, Eccentric Step, and Step Up tests showed positive results. The patient received five sessions of DN at the proximal pole of the patella twice weekly. This study’s primary outcomes were the numeric pain rating scale (NPRS), the Kujala Anterior Knee Pain Scale (AKPS), the global rating of change scale (GRC), and the angle of knee flexion during the squat. The researcher collected data at the five stages. Outcomes The patient’s primary outcome measures improved after three weeks of DN and three months of follow-up. The NPRS showed a reduction in pain, while the AKPS demonstrated a decrease in disability. Conclusion The successful treatment of a patient with suprapatellar tendinopathy utilizing DN is possibly described for the first time in this case report. This study demonstrated the efficacy of dry needling as a first-line treatment for managing chronic tendinopathy with a history of trauma.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48005995","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":"Plädoyer für die Freiheit der\u0000 Wissenschaft","authors":"N. Best","doi":"10.1055/a-1920-5507","DOIUrl":"https://doi.org/10.1055/a-1920-5507","url":null,"abstract":"Nicht erst seit der Coronapandemie werden häufiger Rufe nach Erhalt der\u0000 Wissenschaftsfreiheit laut. Ich bin ein großer Befürworter dieses\u0000 Grundgedankens. Aus meiner Sicht sind wesentliche Punkte unter diesem\u0000 Freiheitsbegriff zu subsumieren:","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48337902","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":"Study On The Pathogenesis Of Post-Stroke Shoulder Pain Based On The Characteristics Of Magnetic Resonance Imaging-A Retrospective Study","authors":"Wenjuan Yu, Luoluo Wang, Yige Li, Shuwei Tao, Qingrui Li, Mingyue Zhu","doi":"10.1055/a-2147-0259","DOIUrl":"https://doi.org/10.1055/a-2147-0259","url":null,"abstract":"Abstract Background High morbidity has been proved frequently happened in post-stroke shoulder pain (PSSP), but the specific pathogenesis of PSSP still remains unclear. Therefore, further research needs to be done to investigate this field. Objective The aim of this study which reviewed the features of magnetic resonance imaging (MRI) on shoulder joint of patients with PSSP, is to find the consequence of pathogenesis. Methods This study starts from June 2017 to August 2021, 74 PSSP patients who accepted MRI examination were selected in the Department of rehabilitation medicine of the Second Affiliated Hospital of Nanjing Medical University (inpatient and outpatient). This study sorted out and summarized patients’ MRI characteristics, analyzing differences of MRI appearance according to age, gender, hemiplegic side, stroke type and onset time. Results After examining all PSSP patients’ MRI characteristics, this study found 56 (75.67%) had supraspinatus tendon injury, 11 (14.86%) infraspinatus tendon injury, 24 (32.43%) subscapular tendon injury, 2 (2.7%) teres minor tendon injury, 60 (81.08%) tendon sheath effusion (inflammation) of long head of biceps brachii, 23 (31.08%) humeral head bone marrow edema and 64 (86.49%) shoulder joint capsule effusion. Moreover, there were 6 cases of acromial descending sac effusion (8.11%), 11 cases of coracoid descending sac effusion (14.86%), 8 cases of synovial thickening (10.81%), and 1 case of ossifying myositis (1.35%). Conclusion No significant differences were found in MRI features according to gender and hemiplegic side .The results showed the injury of supraspinatus tendon significantly increased in the older group compared to the younger group (P=0.039).The patients with supraspinatus tendon injury and tendon sheath effusion (inflammation) of long head of biceps brachii have higher cerebral infarction than patients with cerebral hemorrhage (P=0.002, P=0.028). Based on the time of onset, the participants were divided into three groups: within 1 month, 1–3 months and more than 3 months. The results suggested significant differences in humeral head bone marrow edema and shoulder joint capsule effusion numbers among the three groups (P=0.049, P=0.002). The results of this research could help to improve the accuracy of clinical diagnosis and treatment of PSSP, putting forward a more reasonable treatment scheme.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45239880","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":"Ökonomische und ökologische Effekte von Bandagehilfen in der KPE Phase I des Lymphödems – eine explorative Analyse des Materialverbrauchs in einer Sekundäranalyse einer Studie zu Schaumstoffbandagehilfen","authors":"Simone Kornappel, A. Reißhauer, A. Stroux, M. Liebl","doi":"10.1055/a-2037-5955","DOIUrl":"https://doi.org/10.1055/a-2037-5955","url":null,"abstract":"Zusammenfassung Hintergrund Bezogen auf klinische Wirksamkeit und Therapieeffekte von Schaumstoff-Bandagehilfen in der KPE Phase I des Armlymphödems führten die Autoren eine RCT durch, die die Nichtunterlegenheit der Bandagehilfen im Vergleich zu Standarduntermaterial zeigte. Die parallele Erfassung des Polstermaterialverbrauchs und der Applikationsdauer hat die Frage nach ökonomischen und ökologischen Effekten anschließen lassen. Methoden Explorative Analyse des Materialverbrauches und der Applikationszeit von Bandagehilfen im Vergleich mit Standardunterpolsterung in der KPE Phase I bei Patient*innen mit sekundärem Armlymphödem Stadium II bis III. Ergebnisse: 1. Materialverbrauch: Insgesamt wurden im Beobachtungszeitraum in der Kontrollgruppe 50,7 m Schlauchverband und 207 m Polsterwatte bei n=15 Probanden verbraucht. Demgegenüber standen insgesamt 92 m wiederverwendbare Schaumstoffbandagen bei n=15 Proband*innen in der Interventionsgruppe. 2. Applikationszeit: In der Kontrollgruppe belief sich die Applikationszeit im Mittel auf 13,4±3,4 min., in der Inventionsgruppe auf 10,3±2,2 min. Die Analyse zeigt einen signifikanten Gruppenunterschied (p=0.007). Diskussion In der KPE Phase I zeigen sich bei Patient*innen mit Armlymphödem Einsparungen in puncto Materialverbrauch und Applikationsdauer unter Verwendung von Schaumstoffbandagen. Beide Parameter sind für Physiotherapeut*innen und Einrichtungen auch von ökonomischer Relevanz. Die Schaumstoffbandagen haben durch Waschbarkeit und damit Wiederverwendbarkeit überdies ökologische Effekte. Bislang übliche Polstermaterialien werden überwiegend nach der Anwendung verworfen.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43921566","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 Addition of Exercise to High-Intensity Laser Therapy Improves Treatment Effectiveness on Pain and Muscle Strength in Patients with Subacromial Pain Syndrome: A Randomized Trial","authors":"S. Yeşilyaprak, Seda Paskal, C. Koşay, O. Hapa","doi":"10.1055/a-2108-4574","DOIUrl":"https://doi.org/10.1055/a-2108-4574","url":null,"abstract":"Abstract Objective To assess the efficacy of adding exercise to high-intensity laser therapy (HILT) in improving treatment effectiveness for clinical outcomes in patients with subacromial pain syndrome. Methods Thirty patients with subacromial pain syndrome were randomly assigned to the HILT-only group (n=15) or HILT&Exercise group (n=15). The primary outcome was shoulder function and disability. Secondary outcomes were pain, range of motion, proprioception (joint position sense), and muscle strength. Results Shoulder function and disability, pain, range of motion, joint position sense, and some muscle strength improved in both groups (p<0.05). There was no significant time-group interaction for the Constant-Murley Score, Shoulder Pain and Disability Index, rest pain, range of motion, and joint position sense (p>0.05). Time-group showed significant effects for activity pain and strength in favor of the HILT&Exercise group. Middle trapezius, lower trapezius, and supraspinatus strength increased after HILT plus exercise (p<0.05), activity pain, upper trapezius, serratus anterior, and subscapularis strength improved more compared to HILT (p<0.05). Conclusions We found no clinically important differences between HILT and HILT-plus exercise in shoulder function and disability, rest pain, mobility, and proprioception, in patients with subacromial pain syndrome. The addition of exercise to HILT was superior to HILT for improving activity pain and muscle strength.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46085973","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":"Effect of different Intensity Electrotherapy on Functional Recovery in Patients with Knee Osteoarthritis","authors":"Zhijiao Fan, Weiguang Gao, Ma Yubao, Qie Shuyan","doi":"10.1055/a-2047-4009","DOIUrl":"https://doi.org/10.1055/a-2047-4009","url":null,"abstract":"Abstract Objective To explore the effects of different-intensity intermediate frequency therapy on functional recovery of patients with knee osteoarthritis. Methods Three-band electromagnetic waves of constant amplitude intermediate frequency electrotherapy group (Group A), interference electrotherapy group (Group B) and modulated intermediate frequency electrotherapy group (Group C) were used to treat knee osteoarthritis (KOA) patients, 20 min/time, 1 time/day and 5 days/week for four weeks. Other rehabilitation items were performed the same way. The rehabilitation therapy were evaluated by VAS score, Timed Up and Go test and balance ability. Results After 4 weeks of treatment, the treatment effects of the three groups were all significant compared with the pre-treatment. Among the three groups, the treatment effect of Group B was better than that of the other two groups, and there was no significant difference in the treatment effect between Group A and Group C. Conclusion According to thee. g.results, it is possible that the interference current is of a great action depth, and the \"endogenous\" low-frequency modulated intermediate frequency current possesses the advantages of both low and intermediate frequency, so with the intermediate frequency current getting through the high resistance of skin, the current effect of the low and intermediate frequency in the deep part of the human body can be achieved.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":"353 1","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41257204","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":"Standing Flexion Test: A Manual Diagnostic Test as First Indication\u0000 of Sacroiliac Dysfunction – Study from Practice","authors":"D. Loudovici-Krug, C. Lemhöfer, N. Best","doi":"10.1055/a-1967-2509","DOIUrl":"https://doi.org/10.1055/a-1967-2509","url":null,"abstract":"\u0000 Background The standing flexion test (SFT) is an orienting test,\u0000 supporting to diagnose a sacroiliac joint dysfunction (SIJ-D) in manual\u0000 medicine. However, the literature research for this term shows the paucity of\u0000 according investigations. The aim is to investigate the importance of the SFT\u0000 with regard to possible functional disorder of the SIJ.\u0000 Method Teachers of the Medical Association for Manual Medicine\u0000 (physiotherapists and physicians) were asked to fill in a documentation sheet\u0000 considering different exsmination procedures belonging to routine manual\u0000 medicine anamnestic findings. The only inclusion criterion was the positive SFT.\u0000 The results are presented descriptive with according percentages.\u0000 Results From January to August 2019, a total of 366 SIJ data sheets with\u0000 positive SFTs were completed by 20 ÄMM-teachers, involving six\u0000 imcomplete ones. 263 of the 360 patients enrolled actually had a SIJ-D\u0000 (73.06%).Further relevant results refer to pain oft he SIJ region (205 of 360; 173 with\u0000 SIJ-D), the Patrick-Kubis-Test (246 of 360; 201 with SIJ-D), the pelvic tilt\u0000 (134 of 360; 134 with SIJ-D), the pelvic torsion (209 of 360; 164 with SIJ-D)\u0000 and the increased iliac muscle tone (282 of 360; 216 with SIJ-D).\u0000 Discussion After a positive SFT, the Patrick-Kubis-test, the tonus check\u0000 of the iliac muscle and the indication of pain in the SIJ-region can be used for\u0000 the diagnosis of a SIJ-D. If at least two of the three aspects are conspicuous,\u0000 SIJ-D is very likely to be present.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45746597","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":"Effekte einer ambulanten Kneippkur als multimodale\u0000 Lebensstilintervention für die primäre Insomnie: eine\u0000 randomisierte kontrollierte Studie","authors":"G. Immich, D. Frisch, C. Oberhauser, A. Schuh, M. Stier-Jarmer","doi":"10.1055/a-1954-5007","DOIUrl":"https://doi.org/10.1055/a-1954-5007","url":null,"abstract":"Zusammenfassung Einleitung In Deutschland leiden 6–10% der Menschen an klinisch relevanten Schlafstörungen, insbesondere unter der arbeitenden Bevölkerung. Werden diese chronisch, können sie zu schwerwiegenden Erkrankungen führen und einen beträchtlichen Teil der Abwesenheit vom Arbeitsplatz ausmachen. Deshalb wurde ein Kneippkurprogramm für nicht-organische Schlafstörungen als ein nicht-medikamentöses Behandlungskonzept im Kurort Füssen entwickelt und überprüft. Methodik Randomisierte monozentrische klinische Studie mit 5 Erhebungszeitpunkten (prä-/post-Intervention, 1, 3 und 6 Monate nach Intervention). Intervention: 19-tägiges multimodales Kneippprogramm (Ordnungstherapie, Hydro- und Thermotherapie, Bewegungstherapie). Primäre Zielgröße: Subjektive Schlafqualität (PSQI-Gesamtscore von 0–21 Punkte:≤5 Punkte=gesunder Schlaf, PSQI-Wert 5–10 Punkte=schlechte Schlafqualität, PSQI-Gesamtscore>10 Punkte=chronische Schlafstörung). Sekundäre Zielgrößen: Allgemeines Wohlbefinden (WHO-5-Wellbeing-Index), chronische Stressbelastung (TICS), dysfunktionale Überzeugungen zum Schlaf (DAB-16), Teilnehmerzufriedenheit. Ergebnisse 96 Erwachsene mit Schlafstörungen (mittleres Alter 56 Jahre, 83% weiblich) wurden in eine Interventionsgruppe IG (N=47) und Wartekontrollgruppe WG (N=49) randomisiert. Zu Studienbeginn gab es keine relevanten Gruppenunterschiede (PSQI-Gesamtwerte: IG 11,7±3,1, WG: 10,6±3,0). Nach 1, 3 und 6 Monaten erhöhte sich der Anteil guter Schläfer deutlich stärker in IG versus WG: 34 vs. 10% nach 1 Monat, 40 vs. 12% nach 3 Monaten sowie 28 vs. 14% nach 6 Monaten. Nach 1, 3 und 6 Monaten reduzierte sich der mittlere PSQI-Gesamtscore deutlich stärker in IG als in der WG: − 4,44 Pkt. vs. − 1,14 Pkt. nach 1 Monat (p=0,001), − 4,19 Pkt. vs. − 1,14 Pkt. nach 3 Monaten (p=0,014]) und − 3,53 Pkt. vs. − 1,28 Pkt. nach sechs Monaten (p=0,111). Dabei erzielte die IG eine klinisch relevante Reduktion des PSQI-Scores von minus 3 Punkten zu allen Messzeitpunkten im Follow-up. Vergleichbare positive Effekte zeigten sich bei der IG bzgl. des allgemeinen Wohlbefindens, der chronischen Stressbelastung und den dysfunktionalen Gedanken zum Schlaf. Schlussfolgerung Die ambulante multimodale Kneippkur erzielte signifikante Verbesserungen bei Schlafqualität und Wohlbefinden sowie eine Reduktion der chronischen Stressbelastung bei Erwachsenen mit nicht-organischen Schlafstörungen. Die Nachhaltigkeit der Effekte über 6 Monate hinaus müssten in weiteren Studien untersucht werden.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48836342","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":"Proprioceptive Exercises in Hemiplegia Improve Balance and Spatiotemporal Parameters","authors":"Gulnihal Deniz, Furkan Bilek","doi":"10.1055/a-2078-4554","DOIUrl":"https://doi.org/10.1055/a-2078-4554","url":null,"abstract":"Abstract Objective It was planned to investigate the effects of proprioceptive exercises applied to patients with hemiplegia on muscle tone, balance, perception, posture, mobility, and spatiotemporal parameters. Materials and Methods 70 participants with hemiplegia were randomized to an experimental group (conventional stroke rehabilitation program+proprioceptive exercise, 30 sessions) and a control group (conventional stroke rehabilitation program, 30 sessions). Timed Up and Go (TUG) Test, Modified Ashworth Scale (MAS), Posture Assessment Scale for Stroke Patients (PASS), Mini-Mental State Examination (MMSE), Rivermead Mobility Index (RMI), Spatiotemporal parameters (cadence, maximum plantar pressure, total weight transfer, step cycle duration, swing phase, step length and foot angle), and Berg Balance Scale (BERG) were applied on all participants before and after treatment. Results When the intra-group values were compared before and after the treatment, TUG, PASS, MMSE, RMI and BERG values increased significantly. MAS upper extremity and MAS lower extremity values decreased significantly. (p<0.01). In the comparison between the groups, one of the spatiotemporal parameters, cadence, total weight transfer, and maximum plantar pressure values, increased significantly after the treatment. Step cycle duration, swing phase, step length and foot angle values decreased significantly after the treatment. (p<0.01) Conclusion Unlike the literature, proprioceptive exercises that we add to the conventional rehabilitation program can be used to improve muscle tone, balance, perception, postural control, mobility, and spatiotemporal parameters.","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47377600","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":"Gene expression profile of high PD-L1 non-small cell lung cancers refractory to pembrolizumab.","authors":"Jamila Talb, Paul Takam Kamga, Marie Mayenga, Adrien Costantini, Catherine Julié, Coraline Dumenil, Jennifer Dumoulin, Julia Ouaknine, Violaine Giraud, Cécile Dujon, Reza Azarian, Claire Glaser, Jean-François Emile, Etienne Giroux Leprieur","doi":"10.1007/s00262-022-03206-4","DOIUrl":"10.1007/s00262-022-03206-4","url":null,"abstract":"<p><strong>Background: </strong>Despite high expression of PD-L1, around half of advanced non-small cell lung cancer (NSCLC) will not experience tumor response with pembrolizumab. There is an need for a better understanding of the resistance mechanisms in this setting.</p><p><strong>Methods: </strong>This bi-centric retrospective study included all consecutive patients with PDL1 ≥ 50% advanced NSCLC treated with pembrolizumab in first-line treatment between 2016 and 2020. We compared the clinical characteristics of patients with early progression (refractory) vs others. We performed a comprehensive gene expression profile screening by RNAseq capture on tumor samples.</p><p><strong>Results: </strong>We included 46 patients. Twenty-two patients were refractory to pembrolizumab, mainly women, with poor performance status and lower albumin concentration. RNAseq analysis was performed on 19 samples. Hierarchical clustering allowed the identification of 3 clusters with various proportion of refractory tumors: intermediate (C1: 57%), high (C2: 71%) and low proportion (C3: 40%). Comparative analysis between C2 and C3 allowed the identification of overexpressed (n = 137) and underexpressed (n = 40) genes. Among the genes of interest, C2 exhibits higher activation of pathways associated with stemness phenotype (Hedgehog, Notch and Hippo pathways) and pathways associated with loss of PTEN and JAK2. In C2, genes associated with PD-1, toll-like receptor-9 (TLR-9), major histocompatibility complex (MHC) and interferon-γ pathways were underexpressed.</p><p><strong>Conclusion: </strong>This study gives an overview of activated and downregulated pathways in high PD-L1 NSCLC refractory to pembrolizumab. These tumors showed activation of pathways associated with cancer stem cells, loss of PTEN and JAK2, and inhibition of both priming and effector phases of the immune response.</p>","PeriodicalId":54611,"journal":{"name":"Physikalische Medizin Rehabilitationsmedizin Kurortmedizin","volume":"26 1","pages":"2791-2799"},"PeriodicalIF":5.8,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10992407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80152689","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}