RESUMEN
Immunotherapies have demonstrated limited efficacy in pancreatic ductal adenocarcinoma (PDAC) patients despite their success in treating other tumor types. This limitation is largely due to the relatively immunosuppressive environment surrounding the tumor. A focal ablative technique called irreversible electroporation (IRE) has been shown to modulate this environment, enhancing the efficacy of immunotherapy. One enhancing factor related to improved prognosis is a decrease in regulatory T cells (Treg). This decrease has been previously unpredictable for clinicians using IRE, who currently have limited real-time metrics for determining the activation of the patient's immune response. Here, we report that larger overall changes in output current are correlated with larger decreases in T cell populations 24 hours post-treatment. This result suggests that clinicians can make real-time decisions regarding optimal follow-up therapy based on the range of output current delivered during treatment. This capability could maximize the immunomodulating effect of IRE in synergy with follow-up immunotherapy. Additionally, these results suggest that feedback from a preliminary IRE treatment of the local tumor may help inform clinicians regarding the timing and choice of subsequent therapies, such as resection, immunotherapy, chemotherapy, or follow-up thermal or non-thermal ablation.
Asunto(s)
Carcinoma Ductal Pancreático/terapia , Electroporación/métodos , Inmunoterapia/métodos , Neoplasias Pancreáticas/terapia , Linfocitos T/inmunología , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/inmunología , Humanos , Inmunomodulación , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/inmunología , Pronóstico , Linfocitos T Reguladores/inmunología , Resultado del TratamientoAsunto(s)
Servicios de Salud Comunitaria/organización & administración , Relaciones Comunidad-Institución , Atención a la Salud/organización & administración , Escuelas para Profesionales de Salud , Servicios de Salud Comunitaria/tendencias , Fundaciones , Personal de Salud/educación , Humanos , Atención Primaria de Salud , Sudáfrica , UniversidadesRESUMEN
This is a retrospective review of 108 patients who underwent decompressive anterior acromioplasty for chronic impingement in the absence of a full thickness rotator cuff tear. Before operation, all the patients had had shoulder pain for at least one year despite conservative treatment. At operation, the rotator cuff tendons were explored and were intact. Anterior acromioplasty, followed by rehabilitation was successful in 87% of patients. The operation was less successful in women, in those who had diminished movement before operation, who were involved in worker's compensation claims, and whose pain followed direct trauma. Appropriate selection of patients is considered the key to success.
Asunto(s)
Acromion/cirugía , Osteotomía/métodos , Escápula/cirugía , Articulación del Hombro , Tendones/fisiopatología , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Artropatías/fisiopatología , Artropatías/cirugía , Masculino , Persona de Mediana Edad , Movimiento , Estudios RetrospectivosRESUMEN
In brief: A questionnaire was used to examine the number, nature, and etiology of injuries to Canadian nationally ranked figure skaters over a one-year period and to measure the consequent loss of training time. Of the 60 respondents, 28 (46.6%) reported having had a significant injury during the year. Fifty percent of the injuries were acute and 43% were overuse injuries. The respondents spent an average of 27.2 hours a week on the ice, but only 11.9 minutes (0.2 hour) per week in stretching and warm-up exercises. Skaters with overuse injuries were kept off the ice an average of 17.9 days; those with acute injuries lost an average of 12.2 days.