Clinical and surgical-pathological staging in early non-small cell lung cancer

Staging is of the utmost importance in the evaluation of a patient with non-small cell lung cancer (NSCLC) because it defines the actual extent of the disease. Accurate staging allows multidisciplinary oncology teams to plan the best surgical or medical treatment and to predict patient prognosis. Based on the recommendation of the International Association for the Study of Lung Cancer (IASLC), a tumor, node, and metastases (TNM) staging system is currently used for NSCLC. Clinical staging (c-TNM) is achieved via non-invasive modalities such as examination of case history, clinical assessment and radiological tests. Pathological staging (p-TNM) is based on histological examination of tissue specimens obtained with the aid of invasive techniques, either non-surgical or during the intervention. This review is a critical evaluation of the roles of current pre-operative staging modalities, both invasive and non-invasive. In particular, it focuses on new techniques and their role in providing accurate confirmation of patient TNM status. It also evaluates the surgical-pathological staging modalities used to obtain the true-pathological staging for NSCLC

Internet of Things (IoT)-Enabled Elderly Fall Verification, Exploiting Temporal Inference Models in Smart Homes

Everyday life of the elderly and impaired population living in smart homes is challenging because of possible accidents that may occur due to daily activities. In such activities, persons often lean over (to reach something) and, if they not cautious, are prone to falling. To identify fall incidents, which could stochastically cause serious injuries or even death, we propose specific temporal inference models; namely, CM-I and CM-II. These models can infer a fall incident based on classification methods by exploiting wearable Internet of Things (IoT) altimeter sensors adopted by seniors. We analyzed real and synthetic data of fall and lean over incidents to test the proposed models. The results are promising for incorporating such inference models to assist healthcare for fall verification of seniors in smart homes. Specifically, the CM-II model achieved a prediction accuracy of 0.98, which is the highest accuracy when compared to other models in the literature under the McNemar’s test criterion. These models could be incorporated in wearable IoT devices to provide early warning and prediction of fall incidents to clinical doctors

Soluble ICAM-1 levels in small-cell lung cancer: prognostic value for survival and predictive significance for response during chemotherapy

Intercellular adhesion molecule-1 (ICAM-1) is an adhesion molecule, member of the immunoglobulin gene superfamily that seems to participate in the evolution of the metastatic process. We investigated the significance of baseline soluble ICAM-1 levels on the outcome of patients with small-cell lung cancer and whether soluble ICAM-1 is a predictive marker for objective response during and after chemotherapy in patients with small-cell lung cancer. Fifty patients with recently diagnosed small-cell lung cancer, as well as 27 healthy smokers, were enrolled. Blood samples were collected at the time of diagnosis, during and at the end of chemotherapy. Data were correlated with the characteristics of the patients and survival as well as with ICAM-1 predictive role for objective response. Statistical significant values of baseline soluble ICAM between patients and controls (p < 0.001) were observed. Multivariate analysis revealed an elevated risk of death of 9 % in the first year after diagnosis for every 10 units of increased soluble ICAM-1 at the baseline (p = 0.046). Performance status and disease stage were also independent prognostic factors. Patients with extensive disease who achieved an objective response during chemotherapy showed a significant decrease (25.8 %) in their soluble ICAM-1 levels compared with baseline levels (p = 0.001). Alongside performance status and disease stage, baseline soluble ICAM-1 could be evaluated as an additional prognostic factor in patients with small-cell lung cancer. Also, a possible role for soluble ICAM-1 may exist as a predictive marker for objective response during chemotherapy for patients with extensive disease (p = 0.001)

The health related quality of life of Greek patients with chronic obstructive pulmonary disease

SUMMARY.Background: Chronic Obstructive Pulmonary Disease (COPD) is an advancing disease, characterized by progressive deterioration of lung function. The impact of the disease on human health is massive and it affects the health related quality of life (HRQoL) of patients in every aspect. This study assessed HRQoL of Greek patients with COPD and its association with demographic and clinical factors, and compared the findings with with those of COPD studies in other countries. In addition, the cost of pharmaceutical treatment of these patients was assessed. Material and methods: The study group consisted of 136 Greek patients with COPD (103 men, mean age 64.7±9.2 years, mean FEV1 59±25.6% predicted).I Information was recorded about their demographic and clinical parameters. Their HRQoL was assessed using the Greek versions of the Medical Outcomes Study Short Form 12 (SF-12) and St George’s Respiratory Questionnaire (SGRQ). Results: The HRQoL of Greek patients with COPD was found to be significantly lower than both that in the general population and that of patients COPD reported in other countries. Almost all the HRQoL scores were shown to be associated with gender, educational and financial status, duration of symptoms, age at onset of symptoms, pack-years of cigarettes smoked, disease stage, degree of dyspnoea, pO2 and pCO2 levels, numbers of medical visits and hospital admissions, participation in rehabilitation programmes, and co-morbidities, such as cardiovascular disease and diabetes mellitus (DM). The average cost of pharmaceutical treatment was assessed at 110 ± 63 € / month and was associated with the stage of the disease, the smoking habit, the degree of dyspnoea, annual numbers of medical visits and admissions and nebulizer usage. Conclusions: The HRQoL of Greek patients with COPD is influenced by multiple parameters, which should all be taken into consideration when their treatment is being planned. Cost-effective studies should be made on populations of Greek patients with COPD and more emphasis should be placed on rehabilitation programmes in Greece. Pneumon 2013, 26(2):139-151

The -938C>A Polymorphism in MYD88 Is Associated with Susceptibility to Tuberculosis: A Pilot Study

Introduction. Tuberculosis (TB) is a major disease worldwide, caused by Mycobacterium tuberculosis (MTB) infection. The Toll-Like Receptor (TLR) pathway plays a crucial role in the recognition of MTB. Aim. The present study aimed to investigate the involvement of myeloid differentiation primary response protein 88 (MYD88) gene polymorphisms in TB. Materials and Methods. A total of 103 TB cases and 92 control subjects were genotyped for the MYD88 -938C>A (rs4988453) and 1944C>G (rs4988457) polymorphisms. Results. The MYD88 -938CA and -938AA genotypes were associated with an increased risk for tuberculosis with odds ratio (OR) of 5.71 (95% confidence intervals [CIs] 2.89–11.28, p=0.01). Conclusions. The MYD88 -938C>A genetic polymorphism is associated with increased susceptibility to TB and may serve as a marker to screen individuals who are at risk