Gotowa bibliografia na temat „Ciivil rights”

Background. Spiral computed tomography makes it possible to visualize in detail the anatomical structures of the spinal column and thereby makes it possible to create a regulatory framework for the subsequent assessment of the results of this research method. Aim. To determine the anatomical parameters for assessing the cervical spine in normal conditions and with Kimmerle’s anomaly according to spiral computed tomography. Material and methods. Spiral computed tomograms (in DICOM format) of the cervical spine of people aged 21 to 70 years of both sexes who do not have pathology of the cervical spine (n=54), as well as with Kimmerle anomaly (n=36), were studied. The width, height and length of the cervical vertebral bodies were analyzed, the longitudinal and transverse diameters of the atlas, the thickness of the anterior arch of the atlas were measured, the transverse-longitudinal index of the atlas, and the ratio of the width of the arch to the transverse diameter of the atlas were calculated. The parameters of the vaulted foramen were measured: the vertical and anteroposterior dimensions of the vaulted foramen and the thickness of the bone bridge. Processing of statistical material was carried out using the application package Excel and Statistica 10.0. To assess the normality of data distribution, the Kolmogorov–Smirnov test was used. The reliability of differences in the average values of independent samples was assessed using the nonparametric Mann–Whitney test in case of non-normal distribution of the initial data. Changes were considered significant at p 0.05. Results. In those examined without pathology of the cervical spine and with Kimmerle's anomaly, the vertebral body height indicators were characterized by a decrease from CII to CIII, with a subsequent increase from CIII to CVII; the vertebral body width and length indicators increased from CII to CVII. According to spiral computed tomography data, in examined patients with Kimmerle anomaly, the average values [M (SD)] of the width of the posterior arch of the atlas on the right [8.8 (2.0) mm] and on the left [9.1 (1.7) mm], the ratio of the posterior arch to the transverse diameter of the atlas on the right [11.2 (2.6)%] and on the left [11.8 (2.2)%] was significantly (p 0.05) higher than similar sizes [7.5 (1.5) mm; 7.5 (1.1) mm; 9.6 (1.8)%; 9.6 (1.4)%, respectively] in people who did not have pathology of the cervical spine. Conclusion. In patients with Kimmerle's anomaly, compared with the norm, there are differences in the width of the arch of the atlas, the ratio of the posterior arch to the transverse diameter of the atlas on the right and left.

Introduction. Myogenic torticollis is the most common injury in children′s musculoskeletal system. Atlantoaxial rotatory subluxation is one of the main reasons for this pathology. In the newborn even a minor injury during pathological delivery can cause this. The ultrasound method allows you to conduct a real time examination and provide the physician by complete information about the state of pulpal nucleus, fi brous ring, and relative position of cervical vertebrae bodies, spinal canal and radicular canals. Also it allows you to estimate neck muscles thickness and area, which is an informative complementary method of osteopathic diagnosis.Goal of research — clarifi cation of the criteria for biomechanical component of local and regional level somatic dysfunction by ultrasound examination of the cervical spine Materials and methods. The paper presents the data of cervical spine ultrasound examination for 57 nursing infants, infants and preschoolers with myogenic torticollis due to birth injury (ICD code X: P 15.8).Results. An ultrasound examination of the cervical spine determined the quantitative parameters of the atlantoaxial joint and the spinal canal, which was 17,57±0,44 mm. By posterior approach, the asymmetric position of the C II odontoid bone with respect to lateral masses of the atlas was determined; a statistically signifi cant width difference in atlantoaxial joint space was revealed (p<0,001). By muscles ultrasound examination, signifi cant thickness differences between left and right larger posterior straight muscles of the head (p<0,05) were found. Signs of instability at the CII–CIII level were detected in all patients, with no instability signs at other levels.Conclusion. The established criteria for ultrasound examination are atlantoaxial joint state, hypermobility of spinal motor segments, as well as muscles thickness and area in region under study. This allows us to verify instrumentally biomechanical SD of both local and regional levels, thus dynamic control over osteopathic treatment effectiveness is possible.

ObjectiveBlood-based biomarkers for the early diagnosis of Alzheimer’s disease (AD) are a ‘Holy Grail’ of AD research. Growing evidence shows that levels of apolipoproteins and various inflammation-related factors are altered in the peripheral blood of patients with AD. The purpose of this study was to clear and definite whether these biomarkers are differentially expressed at the early stages of AD, and could be a biomarker as an early diagnosis of the disease.DesignObservation study.SettingThis study was a part of the Sino Longitudinal Study on Cognitive Decline, an ongoing prospective cohort study (ClinicalTrials.gov identifier: NCT03370744) that centres on Xuanwu Hospital (Beijing, China) in cooperation with an alliance of 94 hospitals from 50 cities across China.ParticipantsIn the present study, 416 right-handed Chinese Han subjects were recruited through standardised public advertisements from 2014 to 2019.Outcome measuresConcentrations of plasma apolipoprotein A1, apolipoprotein CIII (ApoCIII), apolipoprotein E (ApoE), A-2-macroglobulin (A2M), complement C3 (C3) and complement factor H (FH) were determined using a commercial multiplex Luminex-based panel in normal controls (NC), subjective cognitive decline (SCD), mild cognitive impairment and AD groups.ResultsFor individual analysis, pairwise comparisons showed that: (1) For SCD versus NC, no biomarker showed significant difference; (2) For amnestic mild cognitive impairment (aMCI) versus NC, levels of ApoCIII, ApoE, A2M, C3 and FH increased significantly; and (3) For AD versus NC, amounts of C3 increased. For models differentiating clinical groups, discriminant analysis was performed by including all protein markers, age, sex, genotype and education level in the model. This approach could distinguish between patients with aMCI (area under the curve (AUC): 0.743) and AD (AUC: 0.837) from NC.ConclusionOur results suggest that concentrations of certain apolipoproteins and inflammation-related factors are altered at the early stage of AD, and could be useful biomarkers for early diagnosis.Trial registration numberNCT03370744.

AbstractThis case series aimed to analyze the outcomes of patients referred for salvage pulmonary resections after treatment with chemotherapy and immunotherapy for previously metastatic or unresectable tumors.From October 2016, after multidisciplinary board discussion, eight patients (median: 67 years, range: 52–78 years) underwent medical treatment due to advanced-stage diseases (stage cIIIA–cIVa). Four patients underwent cisplatin-based chemotherapy and, due to progression, were moved to an immunotherapy second line (nivolumab: two patients and pembrolizumab: two patients). Instead, four patients underwent combined cisplatin-based chemotherapy and immune checkpoint inhibitors (atezolizumab: two patients and pembrolizumab: two patients). After a multidisciplinary evaluation for salvage surgery, six patients underwent lobectomies, one patient underwent left pneumonectomy, and one patient underwent upper right lobectomy enlarged to the posterior arches of four ribs. The median duration of surgery was 179 minutes (range: 122–246 minutes). At the final pathological stage, three patients showed a complete major response (ypT0 ypN0), one patient was ypT1a ypN0, one ypT3 ypN0, 2 ypT3 ypN1, and one ypT4 ypN0. The hospital length of stay was 6 days (range: 3–23 days). Two patients had a postoperative complication. At the time of follow-up (median: 15.3 months [range: 1–32 months]), six patients were alive without evidence of the recurrence. Two patients died due to recurrence progression (N3 lymph nodes involvement) of the disease after 6 and 32 months.In stage IIIB–IVA nonsmall cell lung cancer, salvage lung surgeries after chemotherapy and immunotherapy are feasible, with high rates of R0 resection. Surgery can be technically tricky without significant morbidity and encouraging outcomes (even with a short-interval follow-up).

Abstract 56-year-old male with metastatic papillary thyroid cancer who underwent total thyroidectomy in 8/2014, and I-131 ablation in 9/2014, with post-operative pathology revealing multifocal, bilateral papillary thyroid cancer with extrathyroidal extension with surgical resection margins uninvolved. There were positive lymphovascular spread and multiple central compartments and bilateral neck nodes metastases with extranodal extension. Subsequent thyrogen stimulated whole-body scan in 2/2016 showed no areas of uptake.However, in 12/2016 he was found to have right supraclavicular lymph nodes positive for recurrence which was resected and given another 168 mCi I-131 and 33 treatments of XRT to R shoulder.A repeat PET in 7/2019 showed persistent hyper metabolic lesion in C7, multiple hyper metabolic nodules throughout the R lung, and a new 1.1 cm left Hilar lymph node suggesting disease progression. Biopsy of the C7 lesion confirmed dedifferentiated papillary thyroid cancer and demonstrated the presence of an NTRK mutation.This time he was given lenvatinib 24 mg daily for 4 weeks, followed by 200 mCi I-131. Post-treatment whole body scan showed good uptake in all lesions, except the C7 lesion which was treated with external radiation. DiscussionWhile cure is achieved in most cases of differentiated thyroid cancer, a minority of cases demonstrate disease progression. Loss of response to I-131, very low serum thyroglobulin levels despite known disease, and high PET avidity provide clinical evidence of dedifferentiation, confirmed with tissue sampling.If feasible targeted systemic therapy remains the best tolerated treatment option.While several studies demonstrate an increase in iodine avidity in approximately 50-60% of patients with dedifferentiated thyroid cancer that were treated with tyrosine kinase inhibitors (TKI), (cite alan Ho’s 2013 NEJM article, and the 2015 debrafenib study Rothenberg SM et al, clin cancer res 2015), selumetanib remains unavailable for clinical use and dabrafenib may only be beneficial in cases with known BRAF V600E mutations. Moreover, it is unknown whether a planned short course of TKI therapy would potentially induce resistance to future TKI therapy.Therefore, lenvatinib, which inhibits activity of at least 6[VM1] different tyrosine kinase enzymes important in thyroid cancer was chosen rather than entrectanib, which was reserved for use if the need arises. This patient demonstrated excellent response to I-131 therapy with lenvatinib pretreatment.A number of formal studies of various TKIs for thyroid cancer re-differentiation are currently underway. (cite Brown SR, Hall A, et al BMC cancer 2019; and also cite the CIII trial with cabozatanib)Conclusion This case represents the emerging paradigm for the ability of TKI therapy to redifferentiate advanced thyroid cancer and allow for re-treatment with I-131 targeted therapy.