European medical Journal. Urology最新文献_第10页

Demystifying the Discussion of Sequencing Panel Size in Oncology Genetic Testing 揭秘肿瘤基因检测中测序小组大小的讨论

European medical Journal. Urology Pub Date : 2022-06-16 DOI: 10.33590/emj/22c9259

Cecília Durães, Carla Pereira Gomes, J. L. Costa, L. Quagliata

{"title":"Demystifying the Discussion of Sequencing Panel Size in Oncology Genetic Testing","authors":"Cecília Durães, Carla Pereira Gomes, J. L. Costa, L. Quagliata","doi":"10.33590/emj/22c9259","DOIUrl":"https://doi.org/10.33590/emj/22c9259","url":null,"abstract":"Clinical laboratories worldwide are implementing next-generation sequencing (NGS) to identify cancer genomic variants and ultimately improve patient outcomes. The ability to massively sequence the entire genome or exome of tumour cells has been critical to elucidating many complex biological questions. However, the depth of information obtained by these methods is strenuous to process in the clinical setting, making them currently unfeasible for broader adoption. Instead, targeted sequencing, usually on a selection of clinically relevant genes, represents the predominant approach that best balances accurate identification of genomic variants with high sensitivity and a good cost-effectiveness ratio. The information obtained from targeted sequencing can support diagnostic classification, guide therapeutic decisions, and provide prognostic insights. The use of targeted gene panels expedites sample processing, including data analysis, results interpretation, and medical reports generation, directly affecting patient management. The key decision factors for selecting sequencing methods and panel size in routine testing should include diagnostic yield and clinical utility, sample availability, and processing turnaround time.\u0000\u0000Profiling by default all patients with late-stage cancer with large panels is not affordable for most healthcare systems and does not provide substantial clinical benefit at present. Balancing between understanding cancer biology, including patients in clinical trials, maximising testing, and ensuring a sustainable financial burden for society requires thorough consideration. This review provides an overview of the advantages and drawbacks of different sizes NGS panels for tumour molecular profiling and their clinical applicability.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81753213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Climate Change Health Emergency: The Role of Healthcare Professionals 气候变化卫生紧急情况:卫生保健专业人员的作用

European medical Journal. Urology Pub Date : 2022-06-16 DOI: 10.33590/emj/22f0616-1

K. Colvin

引用次数: 0

A Self-Resolving Flare of Psoriasis after COVID-19 Vaccination COVID-19疫苗接种后牛皮癣的自解性耀斑

European medical Journal. Urology Pub Date : 2022-06-06 DOI: 10.33590/emjrheumatol/22-00023

I. Kaur, P. Bansal

引用次数: 1

A Retrospective Database Cohort Study Evaluating the Association Between Immune Suppressive Therapy and the Development of Cancer in Patients with Atopic Dermatitis Within UK Primary Care 一项回顾性数据库队列研究评估免疫抑制治疗与英国初级保健中特应性皮炎患者癌症发展之间的关系

European medical Journal. Urology Pub Date : 2022-05-30 DOI: 10.33590/emj/22-00004

S. W. Y. Ming, Yi Zhou, Mike Smith, J. Were

{"title":"A Retrospective Database Cohort Study Evaluating the Association Between Immune Suppressive Therapy and the Development of Cancer in Patients with Atopic Dermatitis Within UK Primary Care","authors":"S. W. Y. Ming, Yi Zhou, Mike Smith, J. Were","doi":"10.33590/emj/22-00004","DOIUrl":"https://doi.org/10.33590/emj/22-00004","url":null,"abstract":"Introduction: First-line regular systemic treatment for atopic dermatitis (AD) in the UK consists of methotrexate, azathioprine, ciclosporin, or mycophenolate (immune-suppressive therapies [IST]). ISTs have been associated with malignancy, hence the need for evaluation for the relationship to the risk of developing cancer.\u0000\u0000Method: This retrospective cohort study utilising the Clinical Practice Research Datalink (CPRD) followed two cohorts with moderate or severe AD: one prescribed ISTs and one without. A total of 222,978 patients were included. The index date was the date of first IST prescription within primary care for the IST cohort, and the date of first potent topical steroid prescription from January 2001 to May 2021. Cohorts were propensity matched 1:1, resulting in 17,556 patients per cohort. Cox proportional hazard models were used to model the hazard of a cancer diagnosis. A secondary analysis was carried out on a restricted population, excluding patients with other comorbidities where ISTs were commonly prescribed. A further analysis explored the relation between the dose and the association with the risk of cancer.\u0000\u0000Results: Both the primary (hazard ratio: 1.01; 95% confidence interval: 0.94–1.08) and secondary (hazard ratio: 1.03; 95% confidence interval: 0.93–1.14) analyses did not show a significant difference in the hazard of a cancer code in the IST and non-IST cohorts. The exploratory dose–response analysis showed a higher risk of cancer associated with more prescriptions of IST per year.\u0000\u0000Conclusion: This study shows that amongst patients with moderate or severe AD, overall IST prescription in primary care is not associated with the onset of a cancer code. However, there is a trend with a higher risk of cancer coding with more prescriptions of IST.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78584635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sodium-Glucose Co-transporter-2 Inhibitors in Heart Failure with Preserved Ejection Fraction: A Breakthrough in Improvement of Clinical Outcomes? 钠-葡萄糖共转运蛋白-2抑制剂治疗保留射血分数的心力衰竭:改善临床结果的突破?

European medical Journal. Urology Pub Date : 2022-05-23 DOI: 10.33590/emj/22-00026

A. Berezin, A. Berezin

{"title":"Sodium-Glucose Co-transporter-2 Inhibitors in Heart Failure with Preserved Ejection Fraction: A Breakthrough in Improvement of Clinical Outcomes?","authors":"A. Berezin, A. Berezin","doi":"10.33590/emj/22-00026","DOIUrl":"https://doi.org/10.33590/emj/22-00026","url":null,"abstract":"The conventional conception of the therapy of heart failure (HF) with reduced ejection fraction has been recently modified by adding sodium-glucose co-transporter-2 (SGLT2) inhibitors to the combination consisting of beta blockers, mineralocorticoid receptor antagonists, and angiotensin receptor-neprilysin inhibitors, with the aim of improving clinical outcomes. It remains unclear whether other sub-populations of patients with HF, having either HF with preserved ejection fraction (HFpEF) or HF with mildly reduced ejection fraction, are relevant candidates for the effective therapeutic intervention that includes SGLT2 inhibitors.\u0000\u0000The purpose of the narrative review is to elucidate plausible perspectives for the clinical implementation of SGLT2 inhibitors into optimal medical therapy in patients with HFpEF. The authors searched the bibliographic databases (Embase, Medline, and the Web of Science) and the Cochrane Central to find English-written publications satisfying the purpose of this study. The authors included eight studies and two meta-analyses that have been reported as completed and found that there were high heterogeneous data regarding the fact that SGLT2 inhibitors had strict resemblance in their efficacy among patients with HFpEF with and without Type 2 diabetes. Due to the use of unpublished data and findings from the trials ended early, there is a lack of upper left ventricular ejection fraction threshold levels to identify inclusion criteria and no agreement in heart failure with reduced ejection fraction determination. However, the results of the meta-analysis, especially come from subgroups’ analysis, appeared to be relevantly optimistic for use of SGLT2 inhibitors in HFpEF therapy.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89680587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perspectives on Treatment of Inflammatory Bowel Disease in Older Patients: Applying Gut-Feeling in an Evidence-Based Era? 老年炎症性肠病的治疗展望:在循证时代应用直觉疗法?

European medical Journal. Urology Pub Date : 2022-05-20 DOI: 10.33590/emj/21-00262

V. Asscher, Cynthia M. Verbiest, S. Waars, S. Mooijaart, A. E. van der Meulen-de Jong, A. Pieterse, P. J. Maljaars

{"title":"Perspectives on Treatment of Inflammatory Bowel Disease in Older Patients: Applying Gut-Feeling in an Evidence-Based Era?","authors":"V. Asscher, Cynthia M. Verbiest, S. Waars, S. Mooijaart, A. E. van der Meulen-de Jong, A. Pieterse, P. J. Maljaars","doi":"10.33590/emj/21-00262","DOIUrl":"https://doi.org/10.33590/emj/21-00262","url":null,"abstract":"Background: The older inflammatory bowel disease (IBD) population is challenging to treat because of heterogeneity in characteristics related to frailty. The authors aimed to study factors contributing to the difference in treatment between older and younger patients with IBD and the relation between frailty and therapy goals, from the perspectives of both professionals and patients with IBD.\u0000\u0000Methods: Semi-structured interviews in 15 IBD professionals and 15 IBD patients aged ≥65 years.\u0000\u0000Results: Professionals had 1–20 years of experience, and three practiced in an academic hospital. Patients were aged 67–94 years and had a disease duration between 2 years and 62 years. The authors found that professionals aimed more often for clinical remission and less often for endoscopic remission in older compared with younger patients. Older patients also aimed for clinical remission, but valued objective confirmation of remission as a reassurance. Professionals sometimes opted for surgery earlier in the treatment course, while older patients aimed to prevent surgery. Professionals’ opinion on corticosteroids in older patients differed, while patients preferred to avoid corticosteroids. In professionals and patients, there was a shift towards goals related to frailty in patients with frailty. However, professionals did not assess frailty systematically, but judged frailty status by applying a clinical view.\u0000\u0000Conclusions: Many therapy goals differed between older and younger patients, in both professionals and patients. Professionals did not assess frailty systematically, yet aspects of frailty influenced therapy goals. This underlines the need for clinically applicable evidence on frailty in IBD, which could aid tailored treatment.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83341490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thromboembolic Storm in the Recovering Stage of COVID-19: A Case Report COVID-19恢复期血栓栓塞风暴1例

European medical Journal. Urology Pub Date : 2022-03-22 DOI: 10.33590/emj/21-00210

Matthew O Jervis, Katie Purohit, V. Greener, Rakshit Kumar

引用次数: 0

ST Elevation Myocardial Infarction in Patients with COVID-19: Case Series COVID-19患者ST段抬高型心肌梗死:病例系列

European medical Journal. Urology Pub Date : 2022-03-22 DOI: 10.33590/emj/21-00264

S. Lakhdar, Chandan Buttar, L. Perez, N. Nso, Mahmoud Nassar, Giovina Collura

{"title":"ST Elevation Myocardial Infarction in Patients with COVID-19: Case Series","authors":"S. Lakhdar, Chandan Buttar, L. Perez, N. Nso, Mahmoud Nassar, Giovina Collura","doi":"10.33590/emj/21-00264","DOIUrl":"https://doi.org/10.33590/emj/21-00264","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2, or COVID-19, has triggered an unprecedented pandemic situation across the globe. Patients with COVID-19 frequently experience a range of clinical complications driven by their health status, comorbidities, and disease responsiveness. Patients with COVID-19 also encounter cardiovascular conditions that potentially increase their risk for mortality. Few clinical studies reveal the development of ST segment elevation myocardial infarction (STEMI) in patients with COVID-19.\u0000\u0000New York City, USA, continues to witness and report a high incidence and prevalence of COVID-19 infections. New York City’s healthcare centres and hospitals have treated more than 6,000 cases of COVID-19 pneumonia in their inpatient and intensive care units.\u0000\u0000The authors conducted a retrospective study of patients admitted to NYC Health + Hospitals, Queens, New York City, USA, with confirmed COVID-19 reverse transcriptase-PCR test findings between 29th March 2020 and 1st May 2020. The authors used a retrospective case series design to evaluate the association between laboratory-confirmed COVID-19 infection and hospitalisation for acute myocardial infarction. They utilised a series of ECGs to record and analyse STEMI patterns across patients with COVID-19. This study aimed to determine the risk/incidence of STEMI in patients with COVID-19, and its impact on their clinical presentation, angiographic findings, and clinical outcomes. The authors hypothesised STEMI as a significant COVID-19 complication, with the potential to impact the long-term prognostic outcomes of patients with COVID-19.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88593629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Epidermodysplasia Verruciformis in a Patient with a Renal Transplant: A Rare Case Report 肾移植患者的疣状表皮发育不良:罕见病例报告

European medical Journal. Urology Pub Date : 2022-03-22 DOI: 10.33590/10.33590/emj/21-00255

M. Mathur, G. Das, Swati D. Shah, Sunil Jaiswal, Srijana Maharjan, A. Shrestha

引用次数: 0

The Impact of Intermediate Antidrug Antibodies to Infliximab and Adalimumab on Clinical Outcomes in Patients with Crohn’s Disease or Ulcerative Colitis 英夫利昔单抗和阿达木单抗中间抗抗体对克罗恩病或溃疡性结肠炎患者临床结局的影响

European medical Journal. Urology Pub Date : 2022-03-22 DOI: 10.33590/emj/21-00149

Chaoyang Wang, M. Tolaymat, R. Cross

{"title":"The Impact of Intermediate Antidrug Antibodies to Infliximab and Adalimumab on Clinical Outcomes in Patients with Crohn’s Disease or Ulcerative Colitis","authors":"Chaoyang Wang, M. Tolaymat, R. Cross","doi":"10.33590/emj/21-00149","DOIUrl":"https://doi.org/10.33590/emj/21-00149","url":null,"abstract":"Background: The anti-TNF drugs adalimumab (ADA) and infliximab (IFX) are effective treatments for inflammatory bowel disease (IBD). However, 40% of patients lose response, often due to the development of antibodies-to-ADA (ATA) and antibodies-to-IFX (ATI). While low ATA/ATI titres (<200 ng/mL) are associated with better outcomes and high ATA/ATI titres (>1,000 ng/mL) are associated with poorer outcomes, the significance of intermediate ATA/ATI titres (200–999 ng/mL) is not well understood. This study aims to investigate the impact of intermediate ATA/ATI titres on outcomes in patients with IBD.\u0000\u0000Methods: A retrospective chart review of 376 patients with IBD was conducted. The primary clinical outcome was persistence on anti-TNF therapy for 1 year after the measurement of ATA/ATI titres. The participants consisted of patients with IBD treated with IFX or ADA at the University of Maryland Medical Center’s Inflammatory Bowel Disease Program between October 2016 and October 2019.\u0000\u0000Results: Out of 322 patients with low titres, 271 persisted on their original anti-TNF, compared with nine out the 15 patients with intermediate titres (p=0.026) and one out the 10 patients with high titres (p<0.0001). The odds ratio of persistence when comparing intermediate titres to low titres was 0.26 (0.09–0.80), and when comparing high titres to low titres was 0.02 (0.00–0.14).\u0000\u0000Conclusion: Patients with intermediate titres were more likely to lose response to anti-TNF drugs and require a change in anti-TNF therapy than patients with low titres. Although the sample size of patients with intermediate titres was small, providers should consider dose optimisation of anti-TNF drugs, with or without the addition of an immunosuppressant, when intermediate titres are present.","PeriodicalId":90162,"journal":{"name":"European medical Journal. Urology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82369861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0