Although Epirubicin (EPI) is a commonly used anthracycline for the treatment of breast cancer in clinic, the serious side effects limit its long-term administration including myelosuppression and cardiomyopathy. Nanomedicines have been widely utilized as drug delivery vehicles to achieve precise targeting of breast cancer cells. Herein, we prepared a DSPE-PEG nanocarrier conjugated a peptide, which targeted the breast cancer overexpression protein Na+/K+ ATPase α1 (NKA-α1). The nanocarrier encapsulated the EPI and grafted with the NKA-α1 targeting peptide through the click reaction between maleimide and thiol groups. The EPI was slowly released from the nanocarrier after entering the breast cancer cells with the guidance of the targeting NKA-α1 peptide. The precise and controllable delivery and release of the EPI into the breast cancer cells dramatically inhibited the cells proliferation and migration in vitro and suppressed the tumor volume in vivo. These results demonstrate significant prospects for this nanocarrier as a promising platform for numerous chemotherapy drugs.Atrial fibrillation is an increasingly prevalent entity faced by cardiac surgeons. While oral anticoagulation therapy aims to reduce the risk of thromboembolic events patients may desire to discontinue these medications or develop contraindications to their use. Left atrial appendage ligation permits stoppage of oral anticoagulation while also reducing the risk of cerebrovascular events. This manuscript describes the techniques employed in the first reported successful uniportal/single-incision, thoracoscopic epicardial left atrial appendage ligation.
Obesity is a strong and independent factor for the development of atrial fibrillation (AF), and adversely impacts the success of catheter ablation procedures for AF. This study evaluated the impact of body mass index (BMI) on the outcomes following surgical ablation of AF.
Between 2003 and 2019, 236 patients underwent a stand-alone biatrial Cox maze IV procedure (CMP-IV) for refractory AF. Obesity was defined as BMI ≥30 kg/m
. Patients were divided into two groups BMI <30 kg/m
(
= 100) and BMI ≥30 kg/m
(
= 136). Freedom from atrial tachyarrhythmia (ATA) was determined using electrocardiography, Holter, or pacemaker interrogation at 1 year and annually thereafter. Recurrence was defined as any documented ATA lasting ≥30 s. Predictors of recurrence were determined using multivariable logistic regression. Preoperative and procedural outcomes were compared between groups.
Obese patients had a higher rate of diabetes (16% vs 7%,
= 0.044) and larger left atrial diameter (4.9 ± 1.1 cm vs 4.6 ± 1complications in obese patients.
To report the 5-year clinical efficacy of PRP intra articular injections in knee osteoarthritis (OA) and to investigate the risk factors predictive for treatment failure and poor clinical outcome.
We retrospectively evaluated 118 patients treated for low to moderate knee OA demonstrated by X-Ray and magnetic resonance imaging (MRI) with autologous PRP injection from 2014 to 2018 with a mean 51.1 ± 14.8 (range 29 to 89) months follow-up. All the patients were evaluated with Lysholm and WOMAC score. The role of Kellgren Lawrence (KL) grade, patello-femoral (PF) degeneration, age, body mass index (BMI), relevant comorbilities, smoking status, gender, previous surgery or conservative measures were analyzed with univariate and multivariate analysis.
There was a significant improvement of all outcome measures at final follow-up and high satisfaction rate (79.7%). The overall failure rate was of 15.3% after a mean of 57.7 ± 15.1 (range 33 to 85) months. The BMI and the KL grade were identified as significant independent risk factor related to failure of autologous PRP injection. Patients under 60 reported significantly higher Tegner activity scale (
= 0.032) at final follow-up. Patients with KL grade 3 and patients with PF MRI-KL grade 3 had significantly lower Lysholm scores (
= 0.026 and
= 0.042 respectively) at final assessment. Younger patients with lower BMI and lower grade of radiographic OA had significantly longer therapeutic benefit (
< 0.05).
Intra articular PRP injections led to a significant clinical improvement in middle-aged adults with a low to moderate knee OA. BMI and high KL grade have been identified as significant risk factors predictive for failure at mid-term follow-up.
Intra articular PRP injections led to a significant clinical improvement in middle-aged adults with a low to moderate knee OA. BMI and high KL grade have been identified as significant risk factors predictive for failure at mid-term follow-up.Oncology is going through the fastest innovation period in the history of medicine and a growing number of patients improve or experience increased chances of survival. The declining death rate, starting from 1991, resulted in 2.9 million deaths avoided in the United States so far. A growing prevalence of patients is observed in all Western countries. New cancer drug approvals between 2000 and 2016, linked to other diagnostic, surgical, and health care improvements, were significantly associated with death reduction for the most common cancers. Alongside many positive aspects, other effects of innovations in oncology also deserve attention, especially challenges associated with the substantial increase of knowledge volume, the sharp growth of prevalence, and a concomitant or consequent increase in clinical, social, and organizational complexity. We analyse some of the consequences of oncology innovation on healthcare systems and professionals and present some suggestions on how these could be addressed by healthcare systems.This study examines treatment typologies over time and their relationship to reoffending outcomes. Latent transition analysis was conducted with 6,675 men on community supervision in Alberta, Canada using risk and strength factors measured by the Service Planning Instrument (Orbis Partners, 2003). L-α-Phosphatidylcholine in vivo Three timepoints were assessed Time 1 = first assessment within 90 days of start of supervision, Time 2 = 3 to 8 months post initial assessment, and Time 3 = 9 to 14 months post initial assessment. Five profiles consistently emerged Low risk/Low strength profile, Aggressive, complex need/Low strength profile, Moderate risk/Moderate strength profile, Low risk/High strength profile, and Non-aggressive, complex need/Low strength profile. At Time 3, a sixth profile emerged labeled Moderate complex need/Low strength. Profiles characterized as aggressive and those with complex needs had highest rates of reoffending. Results demonstrate the utility of incorporating strengths, mental health needs, and adverse childhood experiences in risk assessment protocols.L-α-Phosphatidylcholine in vivo
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