Systematic Review and Meta-Analysis Confirms Significant Contribution of Surfactant Protein D in Chronic Obstructive Pulmonary Disease
Conclusion: Serum concentration and alleleic conformation of SFTPD has a significantly high predictive value for COPD and AECOPD. Thus, these can be tested further and could be applied as a predictive or prognostic marker. Introduction Chronic Obstructive Pulmonary Disease (COPD) affects lungs and exhibits irreversible airflow conditions that leads to improper respiratory function (Carolan et al., 2014). COPD is a global disease burden which accounts for ~3 million deaths annually (Zemans et al., 2017) and is responsible for the increase in worldwide mortality and morbidity (Dickens et al., 2011). Chronic Obstructive Pulmonary Disease is projected to be the third leading cause of death by 2020 (Dickens et al., 2011). Chronic Obstructive Pulmonary Disease has multiple sub-phenotypic conditions like emphysema, lean body mass, mucus hypersecretion, and acute exacerbation (Dickens et al., 2011; Shakoori et al., 2012; Carolan et al., 2014). Each sub-phenotype is considered to be the outcome of different immune related pathways which are involved in COPD pathogenesis (Ishii et al., 2012). Surfactant protein D (SF-D or SFTPD) is a highly lung specific glycoprotein secreted by type II alveolar cells and non-ciliated clara cells and functionally involved in maintaining the lung functions (Shakoori et al., 2012; Akiki et al., 2016). This multimeric glycoprotein belongs to lectin super family (Moreno et al., 2014) and takes part in immune regulation and maintenance of lung func...
“The tide of time flow’d back with me,The forward-flowing tide of time;And many a sheeny summer-morn,A down the Tigris I was borne,By Baghdad’s shrines of fretted gold,High-walled gardens green and old;”From “Recollections of the Arabian Nights”Alfred Lord Tennyson
Every few years, a new staging system is published, and we have survived many in the past 30 years. Each succeeding one is more complex and difficult to memorize. At the end of our careers, we have to admit giving up to some extent on learning the nuances of our most recent version. Additionally, we have witnessed our residents wasting countless hours trying to memorize this cobweb of minutia. Would their time not be more productively spent learning about patient care and outcomes?
First, and perhaps most importantly, Dinh et al are to be applauded for presenting their prospective series of men treated with proton therapy at the University of Washington and their carefully reported rectal toxicity outcomes in the context of dose-volume histogram analysis as well as differing rectal immobilization devices.1 These result s provide strong evidence suggesting that without the use of a rectal spacer, there is increased rectal toxicity with proton therapy compared with intensity modulated radiation therapy (IMRT).
Concurrent chemoradiation, the mainstay of treatment in locally advanced head and neck cancer, is a challenging endeavor even for the fittest of individuals. On one hand, it confers superior therapeutic outcomes compared with either chemotherapy or radiation alone; on the other hand, the high-intensity treatment is associated with substantial treatment toxicity that in turn leads to treatment schedule interruption or incompletion, hospitalization, or even death.1-4
The recent meta-analysis of the dose-response rate of prostate cancer biochemical control during hypofractionated radiation therapy by Vogelius and Bentzen1 showed that the standard linear-quadratic model was insufficient to model the observed clinical response. They proposed 2 possible corrections: either (1) the slope of the α/β ratio increases by 0.6 for every Gray of increase in the dose per fraction or (2) there is an arbitrary limit to the dose-response curve at 80 Gy.
We thank Drs. Alfonso and Berk for their interest1 in our meta-analysis of outcome data from randomized controlled trials of hypofractionated radiation therapy for low-risk prostate cancer.2 Specifically, we showed how the recently published study of ultrahypofractionated radiation therapy by Widmark et al3 provides further evidence for a diminishing benefit from radiation therapy intensified by increasing the dose per fraction.2 This is a purely empirical observation and does not rely on any mechanistic assumptions.
We appreciate the authors for their letter1 highlighting the complex issues of predicting survival and treatment toxicity in patients with head and neck cancer (HNC) before definitive chemoradiation therapy.
This study concluded that vulnerability, as measured by comprehensive geriatric assessment (CGA), was independently associated with poorer survival and hig her treatment-related toxicities.1
A 48-year-old male presented with worsening gait instability, blurry vision, headache, and intermittent emesis over a 4-month period. Magnetic resonance imaging of the brain demonstrated a right ventricular mass at the foramen of Monro with associated obstructive hydrocephalus (Fig 1). The lesion was well circumscribed and nonenhancing and measured 1.9 cm × 1.9 cm × 2.1 cm with minimal surrounding edema. A computed tomography scan of the chest/abdomen/pelvis showed no evidence of extracranial disease.
Conditions: Emphysema; COPD; Severe Emphysema Interventions: Device: AeriSeal; Device: Zephyr Valves Sponsor: Pulmonx Corporation Not yet recruiting
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