Pharmacokinetic-Based Prognostic Markers for Advanced Intrahepatic Cholangiocarcinoma Treated with Standardised Extract of Atractylodes lancea (Thunb.) DC | Chapter 5 | An Overview of Disease and Health Research Vol. 4

Background: Intrahepatic cholangiocarcinoma (ICC), a biliary tract cancer, is a major cause of primary liver cancers. It is recognised as a deadly gastrointestinal cancer with a poor disease prognosis due to the lack of effective biomarkers for early diagnosis and effective treatment. Recently, research has indicated that Atractylodes lancea (Thunb.) DC. (AL) may offer greater clinical benefits for patients with advanced-stage ICC when compared with standard supportive care.

 

Aim: This study investigated the relationships between clinical efficacy and pharmacokinetic parameters of serum bioactivity of AL and its active constituent, “atractylodin,” and determined the therapeutic ranges.

 

Methods: A retrospective study was conducted as part of a single-centre, open-label, randomised controlled Phase 2A trial, which took place over four months at Sakhon Nakhon Hospital, Sakhon Nakhon Province, Thailand. Patients with advanced-stage ICC were randomised to three groups. Group 1 received daily doses of 1,000 mg of standardised extract of the capsule formulation of AL (CMC-AL) for 90 days. Group 2 received daily doses of 1,000 mg of CMC-AL for 14 days, followed by 1,500 mg for 14 days and 2,000 mg for 62 days. Group 3 (the control group) received palliative care. The Cox proportional hazard model and the Receiver Operating Characteristic (ROC) curve were applied to determine the cut-off values of AUC0-inf, Cmax, and Cavg associated with therapeutic outcomes. Number-needed-to-be-treated (NNT) and relative risk (RR) were also applied to determine potential predictors. Mann-Whitney U test and Wilcoxon signed-rank test were used for non-normally distributed data. Paired t-tests and unpaired t-tests were applied to analyse normally distributed quantitative variables, while chi-square analysis was used for qualitative variables. A significance level of α = 0.05 was used.

 

Results: The AUC_0-inf of total AL bioactivity of> 96.71 µg*h/ml was identified as a promising predictor of disease prognosis, specifically progression-free survival (PFS) and disease control rate (DCR). Cmax of total AL bioactivity of>21.42 was identified as a predictor of the prognosis of death. The therapeutic range of total AL bioactivity for PFS and DCR is 14.48-65.8 µg/ml, and for overall survival is 10.97-65.8 µg/ml.

 

Conclusions: The predictors of ICC disease prognosis were established based on the pharmacokinetics of total AL bioactivity. The information could be exploited to improve the clinical efficacy of AL in patients with advanced-stage ICC. These predictors will be validated in a phase 2B clinical study. Further study is needed to validate the model externally with a larger sample size to confirm its accuracy and applicability.

 

 

Author(s) Details

Teerachat Sae-heng
Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University (Rangsit Campus), Pathumthani, Thailand.

 

Juntra Karbwang
Drug Discovery and Development Center, Office of Advanced Science and Technology, Thammasat University (Rangsit Campus), Thailand.

 

Anurak Cheomung

Graduate Program in Bio-clinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Pathumthani 12120, Thailand.

 

 

Nisit Tongsirid
Sakon Nakorn Hospital, Sakon Nakorn 47000, Thailand.

 

Tullayakorn Plengsuriyakarnc
Graduate Program in Bio-clinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Pathumthani 12120, Thailand.

 

Kesara Na-Bangchanga
Center of Excellence in Pharmacology and Molecular Biology of Malaria and Cholangiocarcinoma, Chulabhorn International College of Medicine, Thammasat University (Rangsit Campus), Pathumthani, Thailand, Drug Discovery and Development Center, Office of Advanced Science and Technology, Thammasat University (Rangsit Campus), Thailand and Graduate Program in Bio-clinical Sciences, Chulabhorn International College of Medicine, Thammasat University, Pathumthani 12120, Thailand.

 

Please see the book here:- https://doi.org/10.9734/bpi/aodhr/v4/5794

Correlation of Microvessel Density with Tumor Characteristics and Prognostic Factors in Breast Carcinoma | Book Publisher International

 An abnormal tissue that grows by cellular proliferation more rapidly than normal and continues to grow after the stimuli that instigated the growth cease 

Neoplasms show a partial or complete lack of structural organisation & functional coordination with the normal tissue. The term tumor, which literally means swelling, is a synonym of neoplasm. Breast carcinoma arises from the terminal ductal–lobular units of epithelial tissue, which is the mature breast, and represents 10% of the total value.

 

Author (s) Details

V. VIJAYASREE (I)
Kamineni Institute of Medical Sciences, Narketpally, Telangana, India.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mono/978-93-49729-48-3

Predictive Biomarkers and Factors in Oral Squamous Cell Carcinoma: A Comprehensive Overview | Chapter 11 | Medical Research and Its Applications Vol. 2

 

Oral squamous cell carcinoma (OSCC) is a type of cancer that arises from the squamous cells, which are the flat, thin cells that make up the lining of the mouth and throat. This cancer commonly affects areas such as the tongue, the floor of the mouth, and the inner lining of the cheeks, but it can occur anywhere in the oral cavity. It typically presents as a persistent sore or growth in the mouth that does not heal. Risk factors for OSCC include tobacco use, excessive alcohol consumption, human papillomavirus (HPV) infection, and prolonged exposure to sunlight (for lip cancer). Early detection and treatment are crucial for improving outcomes. The incidence rate of oral cancers, including OSCC, is reported to be around 20 per 100,000 people annually, making it a significant public health issue in India.

This review consolidates the current understanding of prognostic markers for OSCC, providing insights into their clinical relevance and potential therapeutic implications. A thorough search of PubMed, Scopus, and Web of Science databases identified 30 highly cited articles, forming this review's basis.

Prognostic factors encompass tumor-related features, host factors, and molecular markers, each playing a crucial role in OSCC prognosis. Tumor size, lymph node involvement, histological grade, and depth of invasion are well-established predictors of patient outcomes. Additionally, biomarkers such as p53 mutations, EGFR overexpression, and altered miRNA profiles offer valuable insights into disease progression. Host factors, including age, gender, and lifestyle habits, also impact the prognosis. This review critically evaluates the evidence supporting these factors, highlighting their potential for personalized treatment strategies and improved patient care in OSCC.

 

Author(s)details:-

 

Dave Rushang M.
Department of Pathology, Shantabaa Medical College and General Hospital, India.

 

Goswami Parth R.
Department of Pathology, AIIMS RAJKOT, India.

 

Kateshiya Darshit L.
Department of Pathology, Shantabaa Medical College and General Hospital, India.

 

Belani Vaishali T.
Department of Pathology, Shantabaa Medical College and General Hospital, India.

 

Bhalodiya Nayana H.
Department of Pathology, Shantabaa Medical College and General Hospital, India.

 

Please See the book here :- https://doi.org/10.9734/bpi/mria/v2/351

Perforative Peritonitis: A Clinical Overview | Chapter 10 | Advanced Concepts in Medicine and Medical Research Vol. 5

 This stage was aimed to identify determinants in patients accompanying peritonitis which have a significant concerning morbidity and death.In India, perforative peritonitis is the most frequent surgical emergency needing immediate surgical care. Even with improvements in surgical procedures, antibiotic situations, and critical care assistance, directing peritonitis remains extremely disputing, complex, and demanding. The study was a alone center, prospective observational study administered in Lokmanya Tilak Municipal Hospital, Sion, Mumbai, India. Consecutive patients accompanying perforative peritonitis admitted to the emergency and those the one were fitting into the eligibility tests included in the study. A particularized history and clinical test and blood review performed followed by use of appropriate demonstrative procedures such as X-ray, CT-thumb through with supplementary help of USG and diagnostic paracentesis if required and in accordance with the need of the hour. A total of 50 patients intentional with age range 18-60 age with mean age of presentation 36.80 age and mortality rate was 16%. The result tells that 33.33% of the mortality rate in age group 41-50 age which is highest attended by the grave in age group 51-60 years is 28.6%. There is growing trend in humanness with age except there is slight visit age group 51-60 and 60% of >10 day nursing home stay was found in that group of same status.. We found most of the patients bearing no growth in peritoneal adulteration followed by E. coli (34%) highly alert amikacin. Most common complication was wound contamination. study indicated that most low surgical procedure used is basic closure as most common study of plants was gastroduodenal perforation. Patients' condition deteriorates on account of delayed hospital admittance, which is a big contributing factor to antagonistic outcomes. The characteristics that considerably predict demise are anemia, renal failure, infection of blood, quantity of dirtiness, size, and number of perforations. These risks are all significant at 5%. Therefore, humanness can be decreased if inmates exhibiting the earlier symptoms are identified early and endure the appropriate treatment.

Author(s) Details:

Ranjeet S. Kamble,
Department of Surgery, LTMMC and LTMGH, Sion, Mumbai-400022, India.

Mansha Singh,
Department of Surgery, LTMMC and LTMGH, Sion, Mumbai-400022, India.

Please see the link here: https://stm.bookpi.org/ACMMR-V5/article/view/12562

Assessment of Mortality Predictors in Patients with Severe Community-acquired Pneumonia Requiring ICU Admission | Chapter 15 | New Horizons in Medicine and Medical Research Vol. 3

 Community-acquired pneumonia (CAP) is a prominent cause of death in the United States. It's critical to understand the pathogen patterns that cause severe CAP.

The goal of this prospective study was to determine predictors of mortality and describe patient characteristics, mortality rates, and etiological infections in patients with severe CAP who required ICU hospitalisation.

Patients and Methods: From October 2012 to August 2015, this was a multicenter prospective observational study of 57 consecutive patients admitted to the ICU with a diagnosis of severe CAP.

The experiment had 57 people in total, with a 49.1% overall ICU death rate. Heart disease and chronic obstructive pulmonary disease were the most common comorbidities linked with severe CAP. Mortality was associated with old age (P=0.01), low diastolic blood pressure (P=0.04), low PaO2/FiO2 (P=0.04), high acute physiology and chronic health evaluation II (APACHE II) score (P=0.001), (CURB-65) score (P=0.005), low haemoglobin (P=0.008), and high urea (P=0.04) when survivors and non-survivors were compared. The following factors were found to be predictors of mortality in the univariate analysis: age greater than 65 years (P=0.03); APACHE II score greater than 20 (P=0.007); CURB-65 of 3 or greater (0.03); total leukocyte count less than 4 or greater than 11109/(P=0.04); PaO2/FiO2 less than 250 (P=0.03); serum urea greater than 30 mg/dl (P=0.04); presence of The use of multiple regression analysis was discovered. Septic shock and a high APACHE II score (>20) as major independent predictors of mortality in severe CAP. Microbiological identification was obtained in 52.6 percent of patients, with positive blood cultures in 17.5 percent. The pathogens most frequently isolated were Streptococcus pneumoniae (S. pneumoniae) (19.3%) and Staphylococcus aureus (S. aureus) (15.8 percent).

Conclusion: As documented by the majority of prior research, the mortality rate in patients with severe CAP was high. Death was predicted by both septic shock and a high APACHE II score. Cardiovascular illness and chronic obstructive pulmonary disease were the most common comorbidities. In 52.6 percent of cases, microbiological identification was obtained, with S. pneumoniae and S. aureus being the most frequently isolated pathogens.

Author(S) Details

Ali O. Abdel Aziz
Department of Chest Diseases, Faculty of Medicine, Minia University, Minya, Egypt

Mohammad T. Abdel Fattah
Department of Chest Diseases, Faculty of Medicine, Minia University, Minya, Egypt.

Ahmed H. Mohamed
Department of Anesthesia, Faculty of Medicine, Minia University, Minya, Egypt.

Mohammad O. Abdel Aziz
Department of Internal Medicine, Faculty of Medicine, Minia University, Minya, Egypt.

Mohammed S. Mohammed
Department of Microbiology, Faculty of Medicine, Minia University, Minya, Egypt.





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A Review on Brain Metastases Prognostic Scoring Systems | Chapter 9 | New Frontiers in Medicine and Medical Research Vol. 1

 The most prevalent intracranial tumours are brain metastases (BMs), and about 25% of all cancer patients are identified with this poor prognostic illness condition at some point throughout their therapy. The primary prevailing treatment options normally include palliative radiotherapy, chemotherapy, targeted medicines, immunotherapy, optimum supportive care, and surgery in select patients, depending on the possible patient's general well-being status. Previous research has shown that prognostic scoring methods can be used to group BM patients into specific prognostic groups based on realistic combinations of several patient- and tumor-related characteristics. Such frameworks could be effective in accurately predicting survival outcomes and selecting the best-fit treatment option. The goal of this study was to look at the benefits and drawbacks of the widely used on-the-spot prognostic grading systems for BMs, as well as their clinical use.

Author (s) Details

Erkan Topkan
Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey.

Ahmet Kucuk
Mersin City Education and Research Hospital, Radiation Oncology Clinics, Mersin, Turkey.

Duygu Sezen
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.

Sukran Senyurek
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.

Eyub Yasar Aydemir
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.

Nulifer Kilic Durankus
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.

Yasemin Bolukbasi
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.

Berrin Pehlivan
Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey.

Ugur Selek
Department of Radiation Oncology, Koc University, School of Medicine, Istanbul, Turkey.

View Book :- https://stm.bookpi.org/NFMMR-V1/article/view/2788

A Brief Overview of History, Pathogenesis and Treatment of Perforated Peptic Ulcer Disease with Evaluation of Prognostic Scoring in Adults | Chapter 12 | Highlights on Medicine and Medical Research Vol. 9

 Peptic ulcer disease, which encompasses both stomach and duodenal ulcers, accounts for a large percentage of people who seek surgical help around the world. After decades of preference for surgical therapies such as stomach resections, vagotomy, and other operations, the discovery of H2-receptor antagonists revolutionized the thought of acid in peptic ulcer disease, contributing to the theory of acid suppression therapy for duodenal ulcer. After the Helicobacter pylori bug was identified as the causal cause, a triple medication treatment regimen for peptic illness was described, which was later adjusted to concurrent therapy to prevent antibiotic resistance. As a result of this recognition, the chapter on peptic ulcers has not yet come to an end. The surgical management of ulcer disease and its consequences is still a problem. All of the materials for this review were found using various search engines on the internet. By omitting cross references, duplicated citations, pediatric studies, case reports, iatrogenic and malignant perforations, and incorporating microbiological, immunohistochemistry, and studies with more than a ten-person sample size, the number of references was reduced to 34. Cohort studies, case-control studies In that order, prospective/retrospective, metaanalytical investigations were preferred. This article aims to provide a comprehensive review of all elements of peptic ulcer treatment. Endoscopy-proven cases of gastroduodenal ulcers necessitate the use of triple medication therapy to eradicate H. pylori.

Author (s) Details

Dr. V. Prabhu
Department of Surgery, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India.

A. Shivani
Department of Surgery, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India.

View Book :- https://stm.bookpi.org/HMMR-V9/article/view/1032