47 research outputs found

    Chronic Obstructive Pulmonary Disease and Lung Cancer: Underlying Pathophysiology and New Therapeutic Modalities

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    Chronic obstructive pulmonary disease (COPD) and lung cancer are major lung diseases affecting millions worldwide. Both diseases have links to cigarette smoking and exert a considerable societal burden. People suffering from COPD are at higher risk of developing lung cancer than those without, and are more susceptible to poor outcomes after diagnosis and treatment. Lung cancer and COPD are closely associated, possibly sharing common traits such as an underlying genetic predisposition, epithelial and endothelial cell plasticity, dysfunctional inflammatory mechanisms including the deposition of excessive extracellular matrix, angiogenesis, susceptibility to DNA damage and cellular mutagenesis. In fact, COPD could be the driving factor for lung cancer, providing a conducive environment that propagates its evolution. In the early stages of smoking, body defences provide a combative immune/oxidative response and DNA repair mechanisms are likely to subdue these changes to a certain extent; however, in patients with COPD with lung cancer the consequences could be devastating, potentially contributing to slower postoperative recovery after lung resection and increased resistance to radiotherapy and chemotherapy. Vital to the development of new-targeted therapies is an in-depth understanding of various molecular mechanisms that are associated with both pathologies. In this comprehensive review, we provide a detailed overview of possible underlying factors that link COPD and lung cancer, and current therapeutic advances from both human and preclinical animal models that can effectively mitigate this unholy relationship

    Shortening osteotomy for the treatment of spinal neuroarthropathy following spinal cord injury. A case report and literature review

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    The development of Charcot’s arthropathy of the spine secondary to spinal cord injury is rare and reports in the literature concerning it’s surgical management are limited. Arthrodesis is the recommended treatment for painful and unstable neuropathic joints. Traditionally this involves extensive debridement of the affected joint with anterior and posterior instrumented fusion and autograft to bridge the defect. This paper reviews the reported surgical management of post-traumatic spinal neuroarthropathy in the recent literature and presents a case where sound fusion was achieved by a shortening osteotomy and end-to-end apposition of the fresh bleeding bony surfaces of the adjacent vertebral bodies. The patient reported marked improvement of symptoms post-operatively without any complications of surgery. CT scan at 13 months confirmed successful bony union. Clinical follow up was completed to 3 years. This technique eliminated the need for anterior surgery and extensive autograft thus reducing surgical morbidity
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