Long-term results of suppressing thyroid-stimulating hormone during radiotherapy to prevent primary hypothyroidism in medulloblastoma/PNET and Hodgkin lymphoma: a prospective cohort study
AbstractPrimary hypothyroidism commonly occurs after radiotherapy (RT), and coincides with increased circulating thyroid-stimulating hormone (TSH) levels.We tested therefore the protective effect of suppressing TSH with L-thyroxine during RT for medulloblastoma/PNET and Hodgkin lymphoma (HL) in a prospective cohort study. From1998 to 2001, a total of 37 euthyroid children with medulloblastoma/PNET plus 14 with HL, scheduled for craniospinal irradiation and mediastinum/neck radiotherapy, respectively, underwent thyroid ultrasound and free triiodothyronine (FT3), free thyroxine (FT4), and TSH evaluation at the beginning and ...
Source: Frontiers of Medicine - August 12, 2020 Category: General Medicine Source Type: research
Different sites of extranodal involvement may affect the survival of patients with relapsed or refractory non-Hodgkin lymphoma after chimeric antigen receptor T cell therapy
In this study, we found that the different sites of extranodal involvement may affect response, overall survival (OS), and progression-free survival (PFS) in patients with r/r NHL treated with anti-CD19 CAR-T cells. In a cohort of 32 treated patients, 12 (37.5%) and 8 (25%) patients exhibited soft tissue lymphoma and bone marrow (BM) infiltrations, respectively, and 13 (41%) patients exhibited infiltration at other sites. The factors that may affect prognosis were identified through multivariable analysis. As an independent risk factor, soft tissue infiltration was the only factor significantly correlated with adverse prog...
Source: Frontiers of Medicine - August 12, 2020 Category: General Medicine Source Type: research
Progress in systemic therapy for triple-negative breast cancer
AbstractTriple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer with a heterogeneous genetic profile. Chemotherapy exhibits substantial activity in a small subset of these patients. Drug resistance is inevitable. Major progress has been made in the genetic analysis of TNBC to identify novel targets and increase the precision of therapeutic intervention. Such progress has translated into major advances in treatment strategies, including modified chemotherapy approaches, immune checkpoint inhibitors, and targeted therapeutic drugs. All of these strategies have been evaluated in clinical trials. N...
Source: Frontiers of Medicine - August 12, 2020 Category: General Medicine Source Type: research
Advances on immune-related adverse events associated with immune checkpoint inhibitors
AbstractImmunotherapy has recently led to a paradigm shift in cancer therapy, in which immune checkpoint inhibitors (ICIs) are the most successful agents approved for multiple advanced malignancies. However, given the nature of the non-specific activation of effector T cells, ICIs are remarkably associated with a substantial risk of immune-related adverse events (irAEs) in almost all organs or systems. Up to 90% of patients who received ICIs combination therapy experienced irAEs, of which majority were low-grade toxicity. Cytotoxic lymphocyte antigen-4 and programmed cell death protein-1/programmed cell death ligand 1 inhi...
Source: Frontiers of Medicine - August 9, 2020 Category: General Medicine Source Type: research
Successful management of seven cases of critical COVID-19 with early noninvasive-invasive sequential ventilation algorithm and bundle pharmacotherapy
We report the clinical and laboratory findings and successful management of seven patients with critical coronavirus disease 2019 (COVID-19) requiring mechanical ventilation (MV). The patients were diagnosed based on epidemiological history, clinical manifestations, and nucleic acid testing. Upon diagnosis with COVID-19 of critical severity, the patients were admitted to the intensive care unit, where they received early noninvasive –invasive sequential ventilation, early prone positioning, and bundle pharmacotherapy regimen, which consists of antiviral, anti-inflammation, immune-enhancing, and complication-prophylaxis m...
Source: Frontiers of Medicine - August 5, 2020 Category: General Medicine Source Type: research
Clinical study using mesenchymal stem cells for the treatment of patients with severe COVID-19
AbstractThe Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was identified in December 2019. The symptoms include fever, cough, dyspnea, early symptom of sputum, and acute respiratory distress syndrome (ARDS). Mesenchymal stem cell (MSC) therapy is the immediate treatment used for patients with severe cases of COVID-19. Herein, we describe two confirmed cases of COVID-19 in Wuhan to explore the role of MSC in the treatment of COVID-19. MSC transplantation increases the immune indicators (including CD4 and lymphocytes) and decreases the inflammation indicators (interleukin-6 and C-reactive protein). High-flow nasal...
Source: Frontiers of Medicine - August 5, 2020 Category: General Medicine Source Type: research
Taizhou ’s COVID-19 prevention and control experience with telemedicine features
AbstractThe outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly around the world. As of May 30, 2020, a total of 84 568 confirmed COVID-19 cases have been recorded in China, with a mortality rate of approximately 5.5%. Taizhou is a prefecture-level city in Zhejiang Province. A total of 146 cases were diagnosed in this epidemic, with a fatality rate of 0%. This condition is due to the establishment of an “Internet +” diagnosis and treatment model based on online medical application (APP), telemedicine, WeChat service, and consultation hotline in Taizhou. Taizhou led in opening the “COVID-19 Prevention a...
Source: Frontiers of Medicine - July 31, 2020 Category: General Medicine Source Type: research
Review of surgical robotic systems for keyhole and endoscopic procedures: state of the art and perspectives
AbstractMinimally invasive surgery, including laparoscopic and thoracoscopic procedures, benefits patients in terms of improved postoperative outcomes and short recovery time. The challenges in hand-eye coordination and manipulation dexterity during the aforementioned procedures have inspired an enormous wave of developments on surgical robotic systems to assist keyhole and endoscopic procedures in the past decades. This paper presents a systematic review of the state-of-the-art systems, picturing a detailed landscape of the system configurations, actuation schemes, and control approaches of the existing surgical robotic s...
Source: Frontiers of Medicine - July 28, 2020 Category: General Medicine Source Type: research
Deep learning in digital pathology image analysis: a survey
AbstractDeep learning (DL) has achieved state-of-the-art performance in many digital pathology analysis tasks. Traditional methods usually require hand-crafted domain-specific features, and DL methods can learn representations without manually designed features. In terms of feature extraction, DL approaches are less labor intensive compared with conventional machine learning methods. In this paper, we comprehensively summarize recent DL-based image analysis studies in histopathology, including different tasks (e.g., classification, semantic segmentation, detection, and instance segmentation) and various applications (e.g.,...
Source: Frontiers of Medicine - July 28, 2020 Category: General Medicine Source Type: research
Artificial intelligence in radiotherapy: a technological review
AbstractRadiation therapy (RT) is widely used to treat cancer. Technological advances in RT have occurred in the past 30 years. These advances, such as three-dimensional image guidance, intensity modulation, and robotics, created challenges and opportunities for the next breakthrough, in which artificial intelligence (AI) will possibly play important roles. AI will replace certain repetitive and labor-intensive tasks and improve the accuracy and consistency of others, particularly those with increased complexity because of technological advances. The improvement in efficiency and consistency is important to manage the incr...
Source: Frontiers of Medicine - July 28, 2020 Category: General Medicine Source Type: research
Application of artificial intelligence in surgery
AbstractArtificial intelligence (AI) is gradually changing the practice of surgery with technological advancements in imaging, navigation, and robotic intervention. In this article, we review the recent successful and influential applications of AI in surgery from preoperative planning and intraoperative guidance to its integration into surgical robots. We conclude this review by summarizing the current state, emerging trends, and major challenges in the future development of AI in surgery. (Source: Frontiers of Medicine)
Source: Frontiers of Medicine - July 22, 2020 Category: General Medicine Source Type: research
Traditional Chinese medicine for combating COVID-19
(Source: Frontiers of Medicine)
Source: Frontiers of Medicine - July 22, 2020 Category: General Medicine Source Type: research
Guidelines for navigation-assisted spine surgery
AbstractSpinal surgery is a technically demanding and challenging procedure because of the complicated anatomical structures of the spine and its proximity to several important tissues. Surgical landmarks and fluoroscopy have been used for pedicle screw insertion but are found to produce inaccuracies in placement. Improving the safety and accuracy of spinal surgery has increasingly become a clinical concern. Computerassisted navigation is an extension and application of precision medicine in orthopaedic surgery and has significantly improved the accuracy of spinal surgery. However, no clinical guidelines have been publishe...
Source: Frontiers of Medicine - July 16, 2020 Category: General Medicine Source Type: research
Efficacy of intelligent diagnosis with a dynamic uncertain causality graph model for rare disorders of sex development
In conclusion, the DUCG model has broad application prospects as a computer-aided diagnostic tool for DSD-relate d diseases. (Source: Frontiers of Medicine)
Source: Frontiers of Medicine - July 16, 2020 Category: General Medicine Source Type: research
Development of an artificial intelligence diagnostic model based on dynamic uncertain causality graph for the differential diagnosis of dyspnea
In conclusion, the diagnostic accuracy of the AI model is promising and may compensate for the limitation of medical experience. (Source: Frontiers of Medicine)
Source: Frontiers of Medicine - July 15, 2020 Category: General Medicine Source Type: research
