ABSTRACT

BACKGROUND: Recent studies suggested a relationship between Takotsubo syndrome (TTS) and malignancy. However, clinical outcomes of TTS associated with cancer have not been assessed completely. This study was aimed to investigate the outcomes of patients with TTS and cancer.

METHODS: We performed a systematic review and meta-analysis to evaluate the clinical outcomes of TTS in patients with and without malignancy. We systematically reviewed and analyzed 14 studies (189,210 patients) published in PubMed and Cochrane Library databases until December 2022. The primary outcome was all-cause mortality at the longest follow-up.

RESULTS: The prevalence of current or previous malignancy in patients with TTS was 8.7% (16,461 patients). Patients with TTS and malignancy demonstrated a higher risk of mortality at the longest follow-up than those with TTS alone (odds ratio [OR], 2.41; 95% confidence interval [CI]; 1.95-2.98; P < 0.001). Moreover, cancer was significantly associated with an increased risk of in-hospital or 30-day mortality (OR 2.36; 95% CI, 1.67-3.33; P < 0.001), shock (OR 1.42; 95% CI, 1.30-1.55; P < 0.001), mechanical respiratory support (OR 1.68; 95% CI, 1.59-1.77; P < 0.001), arrhythmia (OR 1.27; 95% CI, 1.21-1.34; P < 0.001), and major adverse cardiac events (OR 1.69; 95% CI, 1.18-2.442; P < 0.001).

CONCLUSIONS: This study revealed significant associations between previous or active cancer and an increased risk of all-cause mortality and in-hospital adverse events in patients with TTS.

PMID:37840966 | PMC:PMC10570743 | DOI:10.3389/fcvm.2023.1244808

07:04

PubMed articles on: Cardio-Oncology

Association of chronic kidney disease with cardiovascular disease in cancer patients: a cross-sectional study

Cardiorenal Med. 2023 Oct 14. doi: 10.1159/000534182. Online ahead of print.

 

ABSTRACT

OBJECTIVE: While most of the evidence in CTO interventions emerge from Western and Japanese studies, few data have been published up today from the Middle East. Objective of this study was to evaluate technical success rates and clinical outcomes of an Iranian population undergoing CTO PCI in a tertiary referral hospital. Moreover, we sought to evaluate the efficacy of our CTO teaching program.

METHODS: This is a retrospective single-center cohort study including 790 patients who underwent CTO PCI performed by operators with different volumes of CTOs PCI performed per year. According to PCI result, all patients have been divided into successful (n = 555, 70.3 %) and unsuccessful (n = 235, 29.7 %) groups. Study endpoints were Major Adverse Cardiovascular Events and Health Status Improvement evaluated using the Seattle Angina Questionnaire at one year.

RESULTS: A global success rate of 70 % for antegrade and 80 % for retrograde approach was shown despite the lack of some CTO-dedicated devices. During the enrollment period, the success rate increased significantly among operators with a lower number of CTO procedures per year. One-year MACE rate was similar in both successful and unsuccessful groups (13.5 % in successful and 10.6 % in unsuccessful group, p = 0.173). One year patients' health status improved significantly only in successful group.

CONCLUSIONS: No significant differences of in-hospital and one-year MACE were found between the successful and unsuccessful groups. Angina symptoms and quality of life significantly improved after successful CTO PCI. The RAIAN registry confirmed the importance of operator expertise for CTO PCI success.

PMID:37866775 | DOI:10.1016/j.ihj.2023.10.002

07:04

PubMed articles on: Cardio-Oncology

Clinical outcomes of takotsubo syndrome in patients with cancer: a systematic review and meta-analysis

Front Cardiovasc Med. 2023 Sep 29;10:1244808. doi: 10.3389/fcvm.2023.1244808. eCollection 2023.

 

ABSTRACT

BACKGROUND: Although VEGFR tyrosine kinase inhibitors (TKIs) are a preferred systemic treatment approach for patients with advanced renal cell carcinoma (RCC) and thyroid carcinoma (TC), treatment-related cardiovascular (CV) toxicity is an important contributor to morbidity. However, the clinical risk assessment and impact of CV toxicities, including early significant hypertension, among real-world advanced cancer populations receiving VEGFR TKI therapies remain understudied.

METHODS: In a multicenter, retrospective cohort study across 3 large and diverse US health systems, we characterized baseline hypertension and CV comorbidity in patients with RCC and those with TC who are newly initiating VEGFR TKI therapy. We also evaluated baseline patient-, treatment-, and disease-related factors associated with the risk for treatment-related early hypertension (within 6 weeks of TKI initiation) and major adverse CV events (MACE), accounting for the competing risk of death in an advanced cancer population, after VEGFR TKI initiation.

RESULTS: Between 2008 and 2020, 987 patients (80.3% with RCC, 19.7% with TC) initiated VEGFR TKI therapy. The baseline prevalence of hypertension was high (61.5% and 53.6% in patients with RCC and TC, respectively). Adverse CV events, including heart failure and cerebrovascular accident, were common (occurring in 14.9% of patients) and frequently occurred early (46.3% occurred within 1 year of VEGFR TKI initiation). Baseline hypertension and Black race were the primary clinical factors associated with increased acute hypertensive risk within 6 weeks of VEGFR TKI initiation. However, early significant "on-treatment" hypertension was not associated with MACE.

CONCLUSIONS: These multicenter, real-world findings indicate that hypertensive and CV morbidities are highly prevalent among patients initiating VEGFR TKI therapies, and baseline hypertension and Black race represent the primary clinical factors associated with VEGFR TKI-related early significant hypertension. However, early on-treatment hypertension was not associated with MACE, and cancer-specific CV risk algorithms may be warranted for patients initiating VEGFR TKIs.

PMID:37856199 | DOI:10.6004/jnccn.2023.7047

07:03

PubMed articles on: Cardio-Oncology

Outcomes of chronic total occlusion percutaneous coronary intervention from the RAIAN (RAjaie - Iran) registry

Indian Heart J. 2023 Oct 20:S0019-4832(23)00166-9. doi: 10.1016/j.ihj.2023.10.002. Online ahead of print.

 

ABSTRACT

Introduction: Exercise interventions for breast cancer survivors have proved their potential to improve clinical, physical, and psychosocial outcomes. However, limited studies have explored exercise effects on autonomic dysfunction and the measurement of exercise tolerance and progression through daily heart rate variability (HRV). Purpose: To analyze the effects of a 16-wk exercise intervention on the autonomic modulation of breast cancer survivors, as well as to examine the evolution of daily measured HRV and its interaction with exercise sessions in this population. Methods: A total of 29 patients who had undergone chemotherapy and radiotherapy were randomly assigned to the exercise group or to the control group. The exercise intervention was delivered remotely through online meetings and consisted of supervised training resistance and cardiovascular exercise 3 times per week. During the intervention all patients measured their HRV daily obtaining the napierian logarithm of the root mean square of successive differences between normal heartbeats (lnrMSSD) and the napierian logarithm of the standard deviation of the interbeat interval of normal sinus beats (lnSDNN) values at four moments: day 0 (the morning of the training sessions), 24, 48, and 72 h after exercise. Results: The results revealed a significant interaction between group and months during the intervention period for lnrMSSD and lnSDNN (p < 0.001). Additionally, there were significant differences in lnSDNN recovery time between months (p < 0.05), while differences in lnrMSSD become apparent only 24 h after exercise (p = 0.019). The control group experienced a significant decrease in both variables monthly (p < 0.05) while exercise group experienced a significant increment (p < 0.05). Conclusion: HRV is daily affected by exercise training sessions in cancer patients. Although results strongly support the role of exercise as a post-chemotherapy and radiotherapy rehabilitation strategy for breast cancer survivors to improve autonomic imbalance, further research is necessary to validate these initial findings.

PMID:37841312 | PMC:PMC10570414 | DOI:10.3389/fphys.2023.1256644

07:03

PubMed articles on: Cardio-Oncology

Early Increases in Blood Pressure and Major Adverse Cardiovascular Events in Patients With Renal Cell Carcinoma and Thyroid Cancer Treated With VEGFR TKIs

J Natl Compr Canc Netw. 2023 Oct;21(10):1039-1049.e10. doi: 10.6004/jnccn.2023.7047.

 

ABSTRACT

Cancer and cardiovascular disorders are known as the two main leading causes of mortality worldwide. Cardiotoxicity is a critical and common adverse effect of cancer-related chemotherapy. Chemotherapy-induced cardiotoxicity has been associated with various cancer treatments, such as anthracyclines, immune checkpoint inhibitors, and kinase inhibitors. Different methods have been reported for the management of chemotherapy-induced cardiotoxicity. In this regard, sodium-glucose cotransporter-2 inhibitors (SGLT2i), a class of antidiabetic agents, have recently been applied to manage heart failure patients. Further, SGLT2i drugs such as EMPA exert protective cardiac and systemic effects. Moreover, it can reduce inflammation through the mediation of major inflammatory components, such as Nucleotide-binding domain-like receptor protein 3 (NLRP3) inflammasomes, Adenosine 5'-monophosphate-activated protein kinase (AMPK), and c-Jun N-terminal kinase (JNK) pathways, Signal transducer and activator of transcription (STAT), and overall decreasing transcription of proinflammatory cytokines. The clinical outcome of EMPA administration is related to improving cardiovascular risk factors, including body weight, lipid profile, blood pressure, and arterial stiffness. Intriguingly, SGLT2 suppressors can regulate microglia-driven hyperinflammation affecting neurological and cardiovascular disorders. In this review, we discuss the protective effects of EMPA in chemotherapy-induced cardiotoxicity from molecular, immunological, and neuroimmunological aspects to preclinical and clinical outcomes.

PMID:37839109 | DOI:10.1016/j.biopha.2023.115686

07:03

PubMed articles on: Cardio-Oncology

An online home-based exercise program improves autonomic dysfunction in breast cancer survivors

Front Physiol. 2023 Sep 29;14:1256644. doi: 10.3389/fphys.2023.1256644. eCollection 2023.

 

ABSTRACT

BACKGROUND: Current treatment of acute leukemia is based on anthracycline chemotherapy. Anthracyclines, despite improving patient survival, have serious cardiotoxicity and therefore cardiac monitoring should be a priority. The purpose of this study is to explore the possible early predictors of anthracycline-induced subclinical cardiotoxicity(AISC)in acute leukemia patients.

METHODS: We conducted a prospective observational study involving 51 patients with acute leukemia treated with anthracycline. Demographic data, clinical variables, echocardiography variables and biochemical variables were collected at baseline and after 3 cycles of chemotherapy. Patients were divided into the AISC and No-AISC groups according to changes of global longitudinal peak systolic strain. Regression models and receiver operating characteristic curve analysis were used to explore the relationship between the variables and AISC.

RESULT: 17 of the patients suffered subclinical cardiotoxicity after 3 cycles of anthracycline treatment. Multiple logistic regression analysis showed a significant association of DBil (OR 0.612, 95% CI 0.409-0.916, p = 0.017), TBil (OR 0.841, 95% CI 0.717-0.986, p = 0.033), PLT (OR 1.012, 95% CI 1.002-1.021, p = 0.016) and Glu (OR 1.873, 95% CI 1.009-3.475, p = 0.047) with the development of AISC. After 3 cycles of chemotherapy, there was a significant difference in PLT between the AISC and NO-AISC groups. Moreover, the dynamic changes in PLT from baseline to after 3 cycles of chemotherapy were each statistically significant in the AISC and NO-AISC groups. The combination of PLT and N-terminal pro-B-type natriuretic peptide (NT-proBNP) had the highest area under curves (AUC) for the diagnosis of AISC than PLT and NT-proBNP alone (AUC = 0.713, 95%CI: 0.56-0.87, P = 0.017).

CONCLUSION: Total bilirubin (TBil), direct bilirubin (DBil), platelets (PLT) and blood glucose (Glu) are independent influencing factors for AISC in acute leukemia patients receiving anthracycline therapy. Bilirubin may be a protective factor and PLT may be a contributing factor for AISC. The combination of baseline PLT and baseline NT-proBNP shows satisfactory predictive ability for AISC in acute leukemia cases treated with 3 cycles of chemotherapy.

PMID:37833648 | PMC:PMC10571315 | DOI:10.1186/s12885-023-11060-5

07:03

PubMed articles on: Cardio-Oncology

Empagliflozin treatment of cardiotoxicity: A comprehensive review of clinical, immunobiological, neuroimmune, and therapeutic implications

Biomed Pharmacother. 2023 Oct 13;168:115686. doi: 10.1016/j.biopha.2023.115686. Online ahead of print.

ABSTRACT

BACKGROUND: This review focuses on multimodality imaging of cardiotoxicity in cancer patients, with the aim of evaluating the effectiveness of different techniques in detecting and monitoring cardiac changes associated with cancer therapy.

METHODS: Eight studies were included in the review, covering various imaging modalities such as cardiac magnetic resonance imaging, echocardiography, and multigated acquisition scanning.

RESULTS: Cardiac magnetic resonance imaging emerged as the most definitive modality, offering real-time detection, comprehensive assessment of cardiac function, the ability to detect early myocardial changes, and superior detection of cardiotoxicity when compared to the other imaging modalities. The studies also emphasize the importance of parameters such as left ventricular ejection fraction and global longitudinal strain in assessing cardiac function and predicting cardiotoxicity.

CONCLUSION: Due to the common use of HER2 agents and anthracyclines within the breast cancer population, the LVEF as a critical prognostic measurement for assessing heart health and estimating the severity of left-sided cardiac malfunction is a commonly used endpoint. CTRCD rates differed between imaging modalities, with cardiac MRI the most sensitive. The use of multimodal cardiac imaging remains a nuanced area, influenced by local availability, the clinical question at hand, body habits, and medical comorbidities. All of the imaging modalities listed have a role to play in current care; however, focus should be given to increasing the provision of cardiac MRI for breast cancer patients in the future to optimize the detection of CTRCD and patient outcomes thereafter.

PMID:37834939 | PMC:PMC10573256 | DOI:10.3390/jcm12196295

07:03

PubMed articles on: Cardio-Oncology

Influencing factors of anthracycline-induced subclinical cardiotoxicity in acute leukemia patients

BMC Cancer. 2023 Oct 13;23(1):976. doi: 10.1186/s12885-023-11060-5.

 

 

ABSTRACT

BACKGROUND: Cardiac lymphoma is a rare disease. Effusive-constrictive pericarditis can be a characteristic of pericardial involvement in patients with this disease. Conversely, a phenotype with electrocardiogram changes similar to those of Brugada syndrome is called Brugada phenocopy, and these changes improve after treatment.

CASE SUMMARY: A 71-year-old man was transported to our hospital with chest pain, hypotension, and ST-segment elevation in V1 and V2 leads during maintenance dialysis for renal failure. After arrival at the hospital, his ST-segment elevation disappeared, and emergency coronary angiography scan revealed no significant coronary artery stenoses or obstructions. His computed tomography and echocardiography scans revealed pericardial effusion and an intrapericardial mass. Further, his blood pressure dropped and ST-segment elevation recurred during dialysis after 7 days. Thus, pericardiocentesis was performed, but haemodynamic improvement was insufficient, and right catheterization findings suggested effusive-constrictive pericarditis. Meanwhile, flow cytometry of the pericardial fluid suggested the diagnosis of B-cell lymphoma; however, radical chemoradiotherapy was impossible because of cardiogenic shock. The patient died on Day 17. Further, autopsy revealed diffuse large B-cell lymphoma with pericardial and myocardial infiltration.

DISCUSSION: Cardiac lymphoma is rare but can be associated with effusive-constrictive pericarditis, which may be difficult to manage even with pericardial drainage. In such cases, radical treatment, including chemotherapy, should be promptly considered, if possible. Our patient presented with Brugada-type electrocardiogram but no syncope or family history, suggesting Brugada phenocopy and not true Brugada syndrome due to cardiac lymphoma. Notably, temporary improvement in ST-segment elevation was observed despite the absence of treatment.

PMID:37854103 | PMC:PMC10580269 | DOI:10.1093/ehjcr/ytad463

07:03

PubMed articles on: Cardio-Oncology

Multimodal Imaging of Cancer Therapy-Related Cardiac Dysfunction in Breast Cancer-A State-of-the-Art Review

J Clin Med. 2023 Sep 29;12(19):6295. doi: 10.3390/jcm12196295.

 

ABSTRACT

BACKGROUND: Doxorubicin (DOX)-induced cardiotoxicity is an important cause of poor prognosis in cancer patients treated with DOX. Angiotensin IV (Ang IV) has multiple protective effects against cardiovascular diseases, including diabetic cardiomyopathy and myocardial infarction, but its role in DOX-induced cardiotoxicity is currently unclear. In this study, we investigated the effects of Ang IV on DOX-induced cardiotoxicity.

METHODS: The viability of primary cardiomyocytes was measured by Cell Counting Kit-8 assays and Hoechst 33342/propidium iodide staining in vitro. ELISAs (serum cTnT and CK-MB) and echocardiography were performed to assess myocardial injury and cardiac function in vivo. Phalloidin staining, haematoxylin and eosin staining and wheat germ agglutinin staining were conducted to detect cardiomyocyte atrophy. We also performed C11 BODIPY staining, measured the levels of Ptgs2 and malondialdehyde and detected the concentrations of ferrous ions, glutathione and oxidized glutathione to indicate ferroptosis.

RESULTS: Ang IV not only attenuated DOX-induced atrophy and cardiomyocyte injury in vitro but also alleviated myocardial injury and improved cardiac function in DOX-treated mice in vivo. Moreover, Ang IV reversed DOX-induced downregulation of glutathione peroxidase 4 (GPX4) and inhibited ferroptosis both in vitro and in vivo. Knockdown of GPX4 by siRNA abolished the cardioprotective effects of Ang IV. Furthermore, Ang IV increased GPX4 levels and ameliorated ferroptosis in RAS-selective lethal 3-treated primary cardiomyocytes.

CONCLUSIONS: Ang IV ameliorates DOX-induced cardiotoxicity by upregulating GPX4 and inhibiting ferroptosis. Ang IV may be a promising candidate to protect against DOX-induced cardiotoxicity in the future.

PMID:37838222 | DOI:10.1016/j.taap.2023.116713

07:03

PubMed articles on: Cardio-Oncology

Brugada phenocopy with altered ST-segment elevation in pericardial diffuse large B-cell lymphoma and effusive-constrictive pericarditis: a case report

Eur Heart J Case Rep. 2023 Oct 17;7(10):ytad463. doi: 10.1093/ehjcr/ytad463. eCollection 2023 Oct.

 

ABSTRACT

The synergy between radiotherapy and immunotherapy in treating thoracic cancers presents a potent therapeutic advantage, yet it also carries potential risks. The extent and nature of cumulative cardiac toxicity remain uncertain, prompting the need to discern its mechanisms and devise effective mitigation strategies. Radiation alone or in combination with an anti- Programmed cell death protein1 (PD-1) antibody significantly reduced cardiac function in C57BL/6J mice, and this pathologic effect was aggravated by anti-PD-1 (anti-PD-1 + radiation). To examine the cellular mechanism that causes the detrimental effect of anti-PD-1 upon cardiac function after radiation, AC16 human cardiomyocytes were used to study cardiac apoptosis and cardiac autophagy. Radiation-induced cardiomyocyte apoptosis was significantly promoted by anti-PD-1 treatment, while anti-PD-1 combined radiation administration blocked the cardiac autophagic flux. Adenosine 5'-triphosphate (ATP) (a molecule that promotes lysosomal acidification) not only improved autophagic flux in AC16 human cardiomyocytes, but also attenuated apoptosis induced by radiation and anti-PD-1 treatment. Finally, ATP administration in vivo significantly reduced radiation-induced and anti-PD-1-exacerbated cardiac dysfunction. We demonstrated for the first time that anti-PD-1 can aggravate radiation-induced cardiac dysfunction via promoting cardiomyocyte apoptosis without affecting radiation-arrested autophagic flux. ATP enhanced cardiomyocyte autophagic flux and inhibited apoptosis, improving cardiac function in anti-PD-1/radiation combination-treated animals.

PMID:37842574 | PMC:PMC10570000 | DOI:10.1016/j.heliyon.2023.e20660

07:03

PubMed articles on: Cardio-Oncology

Angiotensin IV ameliorates doxorubicin-induced cardiotoxicity by increasing glutathione peroxidase 4 and alleviating ferroptosis

Toxicol Appl Pharmacol. 2023 Oct 12;479:116713. doi: 10.1016/j.taap.2023.116713. Online ahead of print.

 ABSTRACT

BACKGROUND: With population aging, the prevalence of both cancer and atrial fibrillation (AF) have increased. However, there is scarce epidemiological data concerning the comorbid state of cancer and AF in low- and middle-income countries, including China.

OBJECTIVE: We aimed to evaluate the site-, sex-, and age-specific profiles of cancer and AF comorbidities in Chinese populations.

METHODS: Data from the Shanghai Municipal Health Commission database between 2015 and 2020 were screened, covering all medical records of Shanghai residents with medical insurance. Site-specific cancer profiles were evaluated for the population with AF relative to the age- and sex-adjusted population of residents without AF. The sex distribution and peak age of cancer diagnosis were also assessed.

RESULTS: A total of 25,964,447 adult patients were screened. Among them, 22,185 patients presented cancers comorbid with AF (median 77, IQR 67-82 years of age; men: n=13,631, 61.44%), while 839,864 presented cancers without AF (median 67, IQR 57-72 years of age; men: n=419,020, 49.89%), thus yielding a higher cancer prevalence among residents with AF (8.27%) than among those without AF (6.05%; P<.001).

CONCLUSIONS: Patients with AF are associated with increased prevalence, heightened male predominance, and younger peak age of cancer. Further studies are needed to determine whether early screening of specific cancers is cost-effective and beneficial for patients with AF.

PMID:37847541 | DOI:10.2196/40149

07:03

PubMed articles on: Cardio-Oncology

ATP protects anti-PD-1/radiation-induced cardiac dysfunction by inhibiting anti-PD-1 exacerbated cardiomyocyte apoptosis, and improving autophagic flux

Heliyon. 2023 Oct 5;9(10):e20660. doi: 10.1016/j.heliyon.2023.e20660. eCollection 2023 Oct.

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4 April 2022

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13:08

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🔴 انظمة فصائل الدم

1. نظام ABO

كريات الدم الحمراء تحمل تركيبة خاصة من جزيئات البروتينات تدعى مستضدّ أو مولّد الضد (Antigen) وهي عبارة عن مادة تثير استجابة الجهاز المناعي

بالمقابل تحمل البلازما أيضًا مادة أخرى تسمى الأجسام المضادة (Antibodies).

🔷 الفئة الأولى تحوي على مادة A لذا تدعى فصيلة الدم A.

🔷 الفئة الثانية تحوي على مادة B لذا تدعى فصيلة الدم B.

🔷 الفئة الثالثة تحوي على المادتين A و B لذا تدعى فصيلة الدم AB.

🔷 الفئة الرابعة لا تحتوي على أي المواد لذا تدعى فصيلة الدم O.

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🔴 انظمة فصائل الدم

2. نظام RH

بالإضافة إلى المستضدات والأجسام المضادة، هناك مستضدّ آخر يدعى العامل الرايزيسي وهو إمّا أن يكون موجبًا أو سالبًا، لذا عند إضافة هذا العامل إلى نظام (ABO) يتم تحديد فصائل الدم الثمانية.

O+ , AB+ , B+ , A+

O- , AB- , B- , A-

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𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

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13:31

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🔴 المستضدات ( انتيجين ) والاجسام المضادة في فصائل الدم

المجموعة A

🔷 تحتوي على المستضد A

🔷 والجسم المضاد B.

المجموعة B

🔷 تحتوي على مستضد B

🔷والجسم المضاد A.

المجموعة AB

🔷 تحتوي على مستضدات A و B

🔷ولكن لا تحتوي على أجسام مضادة A و B.

المجموعة O

🔷 لا تحتوي على مستضدات A أو B

🔷ولكنها تحتوي على أجسام مضادة A وB.

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🔴 فصائل الدم النادرة

🔷 تعتبر فصائل الدم السالبة هي أكثر فصيلة دم نادرة في العالم، حسب النسب المذكورة في الصورة اعلاه 👆🏻👆🏻👆🏻

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𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

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13:54

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مختبرات طبية Analytics Lab🧪🔬 04.04.2022 13:14:41

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🔴 فصائل الدم والتّبرّع

تؤثّر فصيلة الدم على عملية التبرّع بالدم واختيار المتبرّع، حيث أنّ الجسم يقبل الدم الذي يحتوي على مستضدّات يعرفها مسبقًا، حيث لا يعتبرها دخيلة وبالتالي لا يرفضها الجهاز المناعي، أمّا إذا تلقى دم يحتوي على مستضدّات جديدة عليه عندها سيرفضها ويحدث تكتّل وانكماش في الدم.

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𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

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مختبرات طبية Analytics Lab🧪🔬 04.04.2022 13:15:32

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🔴 على سبيل المثال

في حال كان دمك من نوع B، وقام طبيبك بتزويدك بدم متبرّع من نوع AB سيجد جهازك المناعي أنّ المادّة B الموجودة على خلايا الدم الجديدة هي غريبة عنه فيقوم بتعريفها على أنها فيروسات عليه محاربتها، هذا الأمر قد يؤدّي بخلايا الدم البيضاء إلى محاربة خلايا الدم الحمراء الجديدة.

أما في حال كان نوع دمك هو O عندها سيقوم جهازك المناعي باعتبار كل أنواع الدّم الأخرى كمواد غريبة لأنه لا يحتوي على أي من المواد A و B، ما يفسر إعطائك وجبات دم من نوع O فقط.

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👍 5

13:58

هسه راح نبلش الجزء العملي

شلون نعرف فصيلة الدم !!

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السلام عليكم طلاب الي يسالون شلون تكون الدورة هاي الية الدورة اقروها زين

ملاحضة دورة على التلي كرام و مجاني وكل شخص يكدر يشارك بيها ويستفاد🌿💚

ᗩᗷᗪ ᗩᒪKᕼᗩᒪEᑫ ۦٰ‏┋❥ ͢˓🦁💛ۦ‏

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14:07

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مختبرات طبية Analytics Lab🧪🔬 29.01.2022 08:11:25

https://t.me/ldnod

رابط كروب قناة الخاص بالقناة كروب للنقاش موجود فيه الاساتذة للمساعدة و الرد على اسئلتكم 🌹🌹انضو فيه🌹🌹

https://t.me/ldnod

الي عندة اعلان يريد ينشرة مراسلتي خاص على المعرف 👈 @F_U_7

ᗩᗷᗪ ᗩᒪKᕼᗩᒪEᑫ ۦٰ‏┋❥ ͢˓🦁💛ۦ‏

👍 2

م

14:30

مختبرات طبية Analytics Lab🧪🔬

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🟥 فصائل الدم الجانب العملي

🔷 الادوات والمواد التي نحتاجها للفحص

💠 قطن

💠 كحول

💠 لانسيت

💠 سلايد

💠 اعواد

💠 كت الفحص الخاص بفصائل الدم ( يتكون من ثلاث قطارات Anti A , Anti B , Anti D )

🔷 طريقة العمل

💠 نقوم بوخز الاصبع (بعد تعقيمه) بواسطة اللانسيت

💠 نضع ثلاث قطرات من الدم متجاورة على السلايد ( في الطرفين والمنتصف )

💠 نضع على قطرة الدم الاولى قطرة من Anti A

💠 نضع على قطرة الدم الثانية قطرة من Anti B

💠 نضع على قطرة الدم الثالثة قطرة من Anti D

💠 نمزج كل قطرة دم مع المضاد ونلاحظ حدوث التخثر في اي قطرة من القطرات

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 2

14:30

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🟥 فصائل الدم الجانب العملي

🔷 تحليل النتائج

💠 اذا حصل تخثر في قطره الدم المضاف لها Anti A يعني اني فصيلة الدم هي A.

💠 اذا حصل تخثر في قطره الدم المضاف لها Anti B يعني اني فصيلة الدم هي B.

💠 اذا حصل تخثر في قطرتي الدم المضاف لها Anti A و Anti B يعني اني فصيلة الدم هي AB.

💠 اذا لم يحصل تخثر في قطرتي الدم المضاف لها Anti A و Anti B يعني اني فصيلة الدم هي O.

💠 بالنسبة لقطرة الدم المضاف لها Anti D

اذا حصل فيها تخثر ، يعني ان الفصيلة موجبة + .

واذا لم يحصل تخثر فيعني اني الفصيلة سالبة - .

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 6

14:33

فيديو يوضح طريقة عمل تحليل فصائل الدم

https://youtu.be/b2dZn1HVT-k

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 3

14:36

إنتهى الشرح لمحاضرة اليوم في دورة امي جنتي للتحليلات المرضية

المحاضرة كانت عن فصائل الدم وطريقة عملها

نلتقيكم في الساعة العاشرة مساءا ان شاء الله في بث مباشر لشرح هذه المحاضرة وسماع اسئلتكم

يتبعها اختبار بسيط عن هذه المحاضرة

نتمنى لكم التوفيق

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 4 ❤ 3

14:47

ماوهي نسبة استفادتكم من الشرح في القناة والدورة ؟

Final results

- 100 123 votes

- 90 29 votes

- 75 19 votes

- 50 6 votes

- 25 1 vote

- 0 12 votes

190 votes

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

🔥 9

Voice chat

م

19:58

مختبرات طبية Analytics Lab🧪🔬

https://t.me/an_abd1?livestream=67f842784276a0330a

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

19:59

In reply to this message

صيام مقبول وافطار هني يارب 😍🤗🌿

يلا ياابطالنا حان وقت المحاظرة ارجو من الجميع الحظور 🍃🌿🤍

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

👍 1

م

20:27

مختبرات طبية Analytics Lab🧪🔬

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الادوات المستخدمة في تحليل فصائل الدم 🩸💉

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

👍 7 ❤ 2

20:28

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03:00, 28.9 MB

فيديو توضيحي لكيفية عمل تحليل فصائل الدم ✌🏻🤗🩸💉

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

20:30

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شوفولي هاي العينات والتكتل وين صاير بكل فصيلة 🤗🩸💉

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

20:32

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وهذا بعد يوضحلكم الأنواع ال 8 من فصائل الدم بالحالتين الموجب والسالب ✌🏻🩸💉❤

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

❤ 3

20:35

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مانوع فصيلة الدم؟؟؟

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

20:36

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نوع فصيلة الدم؟؟؟

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

20:37

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نوع فصيلة الدم؟؟؟

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

20:38

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نوع فصيلة الدم؟؟؟

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

20:40

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نوع فصيلة الدم؟؟

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

20:41

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نوع فصيلة الدم؟؟؟

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

Voice chat (3370 seconds)

م

21:21

مختبرات طبية Analytics Lab🧪🔬

نتائج محاضرة 4.pdf

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𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

21:32

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فيديو يوضح جميع انواع فصائل الدم

من الواهب ومن المستلم وكل فصيلة ومع من تتطابق 🤗✌🏻😍🤍

@an_abd1

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

👍 1

21:40

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00:29, 3.4 MB

⛔ ماهي الاخطاء الموجودة في الفيديو ⛔😥💔

@an_abd1

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

❤ 5 👍 2 👎 1

5 April 2022

م

02:34

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تسحرتو وصليتو وقراتو قران نامو ارتاحو خلص البث🥰

امي جنتي

02:47

من رقة جمالها اصبح قلبي ذائبٌ...؟! 💖

ومن حدت عيناها كاد ان ينفطرُ....؟! 💖

حسناء جمالها لا يهـــــزمُ.....؟! 💖

وهذا حال المحب المتيمُ.....؟! 💖

شوية غزل ب #قلمي😁💖

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

ᗩᗷᗪ ᗩᒪKᕼᗩᒪEᑫ ۦٰ‏┋❥ ͢˓🦁💛ۦ‏

❤ 9

02:52

اجاهد كل يوم للتوبة من حبها

ويابى قلبي وان كان عصيانٌ حبها

فاني بحبها قد فتنتُ وسابقى

امدا طول العمر لها بحبها مذنبٌ

#بقلمي😁💖

ادري ابدعتكم كافي نامو😁💖

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

ᗩᗷᗪ ᗩᒪKᕼᗩᒪEᑫ ۦٰ‏┋❥ ͢˓🦁💛ۦ‏

❤ 7

م

08:54

مختبرات طبية Analytics Lab🧪🔬

السلام عليكم

موعدنا اليوم مع المحاضرة الخامسة من محاضرات دورة امي جنتي للتحليلات المرضية

عنوان المحاضرة // تحليل pcv

المحاضرة النظرية في الساعة 12 ظهرا

البث المباشر الساعة 10 مساءا

تمنياتنا لكم بالموفقية

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 7

م

09:19

مختبرات طبية Analytics Lab🧪🔬

In reply to this message

صار تعديل بسيط على نظام محاظرة اليوم

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

م

09:39

مختبرات طبية Analytics Lab🧪🔬

فصومي للرحمان عبادةٌ💖

وصومي عن حبها منكراتٌ💖

#بقلمي💖😁

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

ᗩᗷᗪ ᗩᒪKᕼᗩᒪEᑫ ۦٰ‏┋❥ ͢˓🦁💛ۦ‏

09:50

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🔴 اختبار PCV

أو

🔴 اختبار حجم الخلايا الحمر المكدسة (Packed cell volume- PCV)

أو

🔴 اختبار الهيماتوكريت (Hematocrit)

🔷 هو أحد فحوصات الدم الضرورية التي تساعد في تشخيص العديد من الحالات المرضية المرتبطة بكريات الدم الحمراء

🔷 اختبار حجم الخلايا الحمر المكدسة هو اختبار سهل الإجراء، يتم من خلاله قياس نسبة حجم كريات الدم الحمراء إلى حجم جميع مكونات الدم معًا.

🔷 يعكس هذا الاختبار مدى عدد وحجم كريات الدم الحمراء، فكلما زاد عدد أو حجم كريات الدم الحمراء ارتفعت نسبة PCV والعكس صحيح.

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 2

09:50

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🔴 دواعي إجراء اختبار PCV

🔷 تقييم حدة فقر الدم (Anemia) وتحديد أنواعه.

🔷 تقييم حدة كثرة الكريات الحمراء (Polycythemia).

🔷 تقييم شدة الجفاف.

🔷 تقييم مستوى بعض أنواع الفيتامينات والمعادن، مثل: الحديد، وفيتامين ب12، وحمض الفوليك.

🔷 تحديد إذا كان المريض بحاجة إلى عملية نقل الدم.

🔷 تقييم استجابة العلاجات.

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

09:51

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🔴 عوامل تؤثر على قيم PCV

🔷العمر.

🔷الجنس.

🔷العِرق.

🔷المختبرات الطبية وأجهزتها.

🔷فترة الحمل.

🔷سكان المناطق المرتفعة.

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 2

09:51

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النسب الطبيعية لتحليل PCV

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 4

09:52

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🔴 انخفاض وارتفاع PCV وعلى ماذا يدل

1. انخفاض نسبة PCV

تشير النسب المنخفضة إلى ما يأتي:

🔷فقر الدم بأنواعه.

🔷نقص بعض الفيتامينات والمعادن.

🔷سوء التغذية.

🔷فقدان الدم الناجم عن النزيف.

🔷أمراض الكلى.

🔷تراكم سوائل في الجسم.

🔷قلة إنتاج كريات الدم الحمراء نتيجة بعض المشكلات الصحية، مثل: تثبيط نخاع العظم أو سرطان الدم أو استعمال بعض أنواع الأدوية، مثل العلاج الكيميائي.

🔷مشكلات في الغدة الدرقية.

🔷الأمراض المناعية التي تسبب تكسر كريات الدم الحمراء.

2. ارتفاع نسبة PCV

تشير النسب المرتفعة إلى ما يأتي:

🔷كثرة كريات الدم الحمراء.

🔷الجفاف.

🔷قلة توفر الأكسجين كما في حالة التليف الرئوي أو السكن في المناطق المرتفعة أو التدخين.

🔷بعض أمراض الجهاز التنفسي المزمنة، مثل: انقطاع التنفس الانسدادي أثناء النوم، والانسداد الرئوي المزمن، والانصمام الرئوي.

🔷أمراض القلب الخلقية.

🔷استخدام دواء التستوستيرون (Testosterone).

🔷التسمم بأحادي أكسيد الكربون.

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 2 ❤ 1

09:52

الجزء العملي من تحليل PCV 👇🏻👇🏻👇🏻👇🏻

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

👍 2

09:54

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🔴المواد المطلوبة 🦋🌼⬇️

🎀 • الأنابيب الشعرية (الطرف الأحمر)

🎀 • لانسيت.

🎀• قطن.

🎀 • طين مانع التسرب.

🎀 • أجهزة الطرد المركزي الدقيقة (Microcentifuge).

🎀 • قارئ (Microhematocrit).

📌طريقه العمل 🔬⬇️:

🌟-نقوم بسحب عينه الدم بواسطه الانبوبه الشعريه

🌟-نغلق احد طرفي الانبوب بالطين الصناعي

🌟-نضع الانبوبه الشعريه في جهاز (MICROCENTRIFUGE) لفصلها ونتركها لمده ٥ دقايق نخرج الانبوبه من الجهاز ونلاحظ ان الدم مفصول

🌟-بعدين نضع الانبوبه الشعريه على مسطره الخاصه لحساب النسبه بحيث يكون طرف الانبوب التي بها الجزء الشفاف العالي والجزء الاخر للاسفل ونحسب بالمسطره الجزء الفاصل بين السيرم والبلازما ونشوف قيمته على تدريج المسطره.🌟🦋

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

❤ 2 👍 1

09:55

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🔴 طريقة حساب قيمة PCV على المسطرة الخاصة به

🔷 يوضع الطرف الاسفل للأنبوبة الشعرية عند خط الصفر على المسطرة من جهة اليسار ثم تحرك باتجاه اليمين حتى يتقاطع الخط العلوي للدم والفاصل بين الدم والبلازما مع أي خط على المسطرة ثم تقرأ القيمة على امتداد الخط الفاصل بين اللون الأحمر والشفاف في الأنبوب فتكون هذه القراءة هي قيمة PCV.

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

❤ 4 👍 1

10:06

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02:39, 9.9 MB

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

❤ 10 👍 1

م

15:59

مختبرات طبية Analytics Lab🧪🔬

السلام عليكم برنامج يفيدكم للترجمة يترجم ملفات كاملة وpdf

https://www.onlinedoctranslator.com/ar/

امي جنتي

❤ 3

م

17:24

مختبرات طبية Analytics Lab🧪🔬

جميعنا سنحصل على مانريد بإذن الله ..أحلامنا تنتظر القليل من الجهد لتتحقق 😌💜

#مختبرات طبية Analytics Lab🧪🔬

@an_abd1

ᗩᗷᗪ ᗩᒪKᕼᗩᒪEᑫ ۦٰ‏┋❥ ͢˓🦁💛ۦ‏

❤ 11 👍 2 🔥 2

م

17:41

مختبرات طبية Analytics Lab🧪🔬

https://www.onlinedoctranslator.com/ar/?ez_vid=203d4caa831615f105a85d3e420c48a4b8d83ef8#ezoic-pub-video-placeholder-11

كيف يمكنني استخدام مترجم المستندات؟

𝑀.𝐿.𝑆. 𝑌𝑂𝑈𝑁𝐼𝑆

م

19:21

مختبرات طبية Analytics Lab🧪🔬

🤍🌿مساكم الله بالخير والبركه والعافية 🌿🤍

صيام مقبول وتقبل الله الطاعات 🤗🍃❤

المحاظرة ساعة 10 اتمنى من الجميع يكون حاظر 🌿🤗🍃🤍🌿

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

👍 7

Voice chat

م

20:01

مختبرات طبية Analytics Lab🧪🔬

اصعدو

𝟏𝟎:𝟎𝟏 |

20:06

نتضرنا 5دقايق يلة نبدي 🤝😊

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20:07

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طريقة توضيحية للجانب العملي لتحليل ال pcv 🍃🤍🌿💉🩸

وٌتٌيَنِ ♥ 🍒🦋ŴÃŤẸŇ

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20:26

مختبرات طبية Analytics Lab🧪🔬 – pcvتحليل

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21:11

مختبرات طبية Analytics Lab🧪🔬

11:11 أللهم تلك الأمنيات 🌿🤍🍃🙏🏻

 

ABSTRACT

Up to 15-20% of cancer patients experience one or more episodes of venous thromboembolism during cancer disease. Approximately 80% of all cancer-associated venous thromboembolic events occur in non-hospitalized patients. Routine thromboprophylaxis for outpatients with cancer who start new anticancer treatment is currently not recommended by the international guidelines due to the high heterogeneity of these patients in terms of VTE or bleeding risks, the difficulties in selecting patients at high risk, and the uncertainty of duration of prophylaxis. Although the international guidelines endorsed the Khorana score for estimating the thrombotic risk in ambulatory cancer patients, the discriminatory performance of this score is not completely convincing and varies according to the cancer type. Consequently, a minority of ambulatory patients with cancer receive an accurate screening for primary prophylaxis of VTE. The aim of this review is to provide support to physicians in identifying those ambulatory patients with cancer for whom thromboprophylaxis should be prescribed and those that should not be candidate to thromboprophylaxis. In absence of high bleeding risk, primary thromboprophylaxis should be recommended in patients with pancreatic cancer and, probably, in patients with lung cancer harboring ALK/ROS1 translocations. Patients with upper gastrointestinal cancers are at high risk of VTE, but a careful assessment of bleeding risk should be made before deciding on antithrombotic prophylaxis. Primary prevention of VTE is not recommended in cancer patients at increased risk of bleeding as patients with brain cancer, with moderate-to-severe thrombocytopenia or severe renal impairment.

PMID:37227679 | DOI:10.1007/s11739-023-03306-8

13:16

PubMed articles on: Cancer & VTE/PE

A new anticoagulant strategy: the factor XI inhibitors

G Ital Cardiol (Rome). 2023 Jun;24(6):0-454. doi: 10.1714/4041.40204.

 

ABSTRACT

PURPOSE: This study aims to construct a machine learning model that can recognize preoperative, intraoperative, and postoperative high-risk indicators and predict the onset of venous thromboembolism (VTE) in patients.

PATIENTS AND METHODS: A total of 1239 patients diagnosed with gastric cancer were enrolled in this retrospective study, among whom 107 patients developed VTE after surgery. We collected 42 characteristic variables of gastric cancer patients from the database of Wuxi People's Hospital and Wuxi Second People's Hospital between 2010 and 2020, including patients' demographic characteristics, chronic medical history, laboratory test characteristics, surgical information, and patients' postoperative conditions. Four machine learning algorithms, namely, extreme gradient boosting (XGBoost), random forest (RF), support vector machine (SVM), and k-nearest neighbor (KNN), were employed to develop predictive models. We also utilized Shapley additive explanation (SHAP) for model interpretation and evaluated the models using k-fold cross-validation, receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA), and external validation metrics.

RESULTS: The XGBoost algorithm demonstrated superior performance compared to the other three prediction models. The area under the curve (AUC) value for XGBoost was 0.989 in the training set and 0.912 in the validation set, indicating high prediction accuracy. Furthermore, the AUC value of the external validation set was 0.85, signifying good extrapolation of the XGBoost prediction model. The results of SHAP analysis revealed that several factors, including higher body mass index (BMI), history of adjuvant radiotherapy and chemotherapy, T-stage of the tumor, lymph node metastasis, central venous catheter use, high intraoperative bleeding, and long operative time, were significantly associated with postoperative VTE.

CONCLUSION: The machine learning algorithm XGBoost derived from this study enables the development of a predictive model for postoperative VTE in patients after radical gastrectomy, thereby assisting clinicians in making informed clinical decisions.

PMID:37228741 | PMC:PMC10202705 | DOI:10.2147/IJGM.S408770

13:16

PubMed articles on: Cancer & VTE/PE

Ambulatory cancer patients: who should definitely receive antithrombotic prophylaxis and who should never receive

Intern Emerg Med. 2023 May 25. doi: 10.1007/s11739-023-03306-8. Online ahead of print.

 

ABSTRACT

Lung cancer can be revealed by thromboembolic complications. Its association with pregnancy is becoming more frequent due to the increasing number of smoking women. The care of a pregnant woman with cancer is quite delicate because it requires finding a balance between the treatment of the mother and the potential foetal risk.

CASE PRESENTATION: The authors report the case of a 38-year-old patient, with a twin pregnancy of 16 weeks, complicated by proximal and distal peripheral venous thrombosis of the left lower limb under low molecular weight heparin therapy at a curative dose. A week later, the patient presented to the emergency room with respiratory distress associated with chest pain and low-abundance metrorrhagia. The obstetrical ultrasound performed confirmed the vitality of only one of the two foetuses. The transthoracic ultrasound objectified a very abundant pericardial effusion producing a tamponade, which was drained percutaneously and whose cytological study revealed a liquid rich in tumour cells. After the unfortunate death of the second twin and an endouterine evacuation, a chest computed tomography angiogram demonstrated a bilateral proximal pulmonary embolism associated with bilateral moderate pulmonary effusion as well as multiple thrombosis and secondary aspect liver lesions with a suspicious parenchymal lymph node of the upper lung lobe. A liver biopsy concluded to a secondary hepatic localization of a moderately differentiated adenocarcinoma whose immunohistochemical complement revealed a pulmonary origin. A multidisciplinary consultation meeting leaned towards treatment with neoadjuvant chemotherapy. The patient died 7 months later.

DISCUSSION: Venous thromboembolic disease is more common in pregnant women. Delayed diagnosis is common in these cases, resulting in a high rate of locally advanced or metastatic disease. Since the treatment of pregnancy-associated cancer does not rely on a standardized approach, the decision on how to proceed must be made by a multidisciplinary team.

CONCLUSION: The cornerstone of management remains to find the balance between treating the mother as well as possible while preventing the foetus from the possible harm of cytotoxic drugs frequently used to treat lung cancer. Because of the delayed diagnosis, the maternal prognosis often remains poor.

PMID:37228933 | PMC:PMC10205297 | DOI:10.1097/MS9.0000000000000516

13:16

PubMed articles on: Cancer & VTE/PE

Ten-Year Multicenter Retrospective Study Utilizing Machine Learning Algorithms to Identify Patients at High Risk of Venous Thromboembolism After Radical Gastrectomy

Int J Gen Med. 2023 May 18;16:1909-1925. doi: 10.2147/IJGM.S408770. eCollection 2023.

 

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) is a complication of COVID-19 in hospitalized patients. Little information is available on long-term outcomes of VTE in this population.

OBJECTIVES: We aimed to compare the characteristics, management strategies, and long-term clinical outcomes between patients with COVID-19-associated VTE and patients with VTE provoked by hospitalization for other acute medical illnesses.

METHODS: This is an observational cohort study, with a prospective cohort of 278 patients with COVID-19-associated VTE enrolled between 2020 and 2021 and a comparison cohort of 300 patients without COVID-19 enrolled in the ongoing START2-Register between 2018 and 2020. Exclusion criteria included age <18<3

RESULTS: Patients with VTE secondary to COVID-19 had more frequent pulmonary embolism without deep vein thrombosis than controls (83.1% vs 46.2%, P<.001),P<.001),P<.001).P= 0.9) and the proportion of patients who discontinued anticoagulation (78.0% and 75.0%, P= 0.4) were similar between the 2 groups. Thrombotic event rates after discontinuation were 1.5 and 2.6 per 100 patient-years, respectively (P = 0.4).

CONCLUSION: The risk of recurrent thrombotic events in patients with COVID-19-associated VTE is low and similar to the risk observed in patients with VTE secondary to hospitalization for other medical diseases.

PMID:37229314 | PMC:PMC10131739 | DOI:10.1016/j.rpth.2023.100167

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PubMed articles on: Cancer & VTE/PE

Pulmonary embolism complicated by tamponade revealing metastatic lung cancer in a woman pregnant with twin: about a case report

Ann Med Surg (Lond). 2023 Apr 7;85(5):1966-1970. doi: 10.1097/MS9.0000000000000516. eCollection 2023 May.

 

ABSTRACT

Cardiac tumors are a heterogeneous group of pathologic masses of the heart that contain primary tumors-benign or malignant, and secondary tumors. Metastases are significantly more frequent, mostly originating from lung, breast, gastrointestinal tract, or ovary carcinomas. Secondary cardiac tumors may be asymptomatic or may cause cardiovascular, systemic, or embolic symptoms. The study is a summary of the available knowledge on cancerous metastatic lesions of the heart. Pleural mesothelioma (48.4%), adenocarcinoma (19.5%), or squamous cell carcinoma (18.2%) of lung, breast carcinoma (15.5%), ovarian carcinoma (10.3%), and bronchoalveolar carcinomas (9.8%) are cited as the most common origin of secondary heart tumors. Masses can spread by direct tumor invasion, by lymphatic vessels, veins, or arteries. Patients with cancer and nonspecific cardiovascular symptoms should be particularly vigilant, and the possibility of metastasis in an unusual location such as the myocardium should be considered in the diagnosis. Diagnostic methods include echocardiography, cardiac magnetic resonance, computed tomography, positron emission tomography, and histologic evaluation. Treatment of choice is managing primary carcinoma, due to the poor outcomes of surgical methods.

PMID:37231541 | DOI:10.1097/COC.0000000000001013

13:16

PubMed articles on: Cancer & VTE/PE

Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes

Res Pract Thromb Haemost. 2023 May;7(4):100167. doi: 10.1016/j.rpth.2023.100167. Epub 2023 Apr 26.

 

ABSTRACT

The aim of this study was to determine which type of prophylaxis was effective for postoperative symptomatic venous thromboembolism (VTE) in patients with gynecological malignancies. A total of 1756 consecutive patients undergoing laparotomy as first-line treatment were included. In Period 1 (2004-2009), low-molecular weight heparin (LMWH) was not available for postoperative VTE prophylaxis, but available in after Period 2 (2009-2013). In Period 3 (2013-2020), patients with pretreatment VTE could switch from LMWH to direct oral anticoagulant (DOAC) as of 2015. Preoperative VTE was screened by measuring D-dimer, followed by venous ultrasound imaging, and computed tomography and/or perfusion lung scintigraphy. Postoperative symptomatic VTE occurred with an incidence of 2.8% by the measures without prophylactic LMWH administration in Period 1. The incidence of postoperative symptomatic VTE was 0.6% in Period 2 and 0.3% in Period 3, being significantly reduced compared with Period 1 (P < .01 and < .0001). The incidences were not significantly different between Periods 2 and 3, but no patient switching to DOAC in Period 3 (n = 79) developed symptomatic VTE. Our preoperative VTE screening and postoperative selective LMWH administration were significantly preventive against postoperative symptomatic VTE.

PMID:37231620 | DOI:10.1177/10760296231178300

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PubMed articles on: Cancer & VTE/PE

Cardiac Metastatic Tumors: Current Knowledge

Am J Clin Oncol. 2023 May 26. doi: 10.1097/COC.0000000000001013. Online ahead of print.

 

ABSTRACT

Cancer alters the function of multiple organs beyond those targeted by metastasis1,2. Here we show that inflammation, fatty liver and dysregulated metabolism are hallmarks of systemically affected livers in mouse models and in patients with extrahepatic metastasis. We identified tumour-derived extracellular vesicles and particles (EVPs) as crucial mediators of cancer-induced hepatic reprogramming, which could be reversed by reducing tumour EVP secretion via depletion of Rab27a. All EVP subpopulations, exosomes and principally exomeres, could dysregulate hepatic function. The fatty acid cargo of tumour EVPs-particularly palmitic acid-induced secretion of tumour necrosis factor (TNF) by Kupffer cells, generating a pro-inflammatory microenvironment, suppressing fatty acid metabolism and oxidative phosphorylation, and promoting fatty liver formation. Notably, Kupffer cell ablation or TNF blockade markedly decreased tumour-induced fatty liver generation. Tumour implantation or pre-treatment with tumour EVPs diminished cytochrome P450 gene expression and attenuated drug metabolism in a TNF-dependent manner. We also observed fatty liver and decreased cytochrome P450 expression at diagnosis in tumour-free livers of patients with pancreatic cancer who later developed extrahepatic metastasis, highlighting the clinical relevance of our findings. Notably, tumour EVP education enhanced side effects of chemotherapy, including bone marrow suppression and cardiotoxicity, suggesting that metabolic reprogramming of the liver by tumour-derived EVPs may limit chemotherapy tolerance in patients with cancer. Our results reveal how tumour-derived EVPs dysregulate hepatic function and their targetable potential, alongside TNF inhibition, for preventing fatty liver formation and enhancing the efficacy of chemotherapy.

PMID:37225988 | DOI:10.1038/s41586-023-06114-4

13:16

Cardiotoxicity News

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PubMed articles on: Cancer & VTE/PE

Preoperative Venous Thromboembolism Screening and Postoperative Selective Anticoagulant Therapy Effectively Prevents Postoperative Symptomatic Venous Thromboembolism in Gynecological Malignancies: A 15-Year, Single-Center Study

Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231178300. doi: 10.1177/10760296231178300.

 

ABSTRACT

PURPOSE: This systematic review aims to compare the efficacy and safety of multilevel and single level surgery, including barbed pharyngoplasties, in the treatment of obstructive sleep apnea (OSA).

METHODS: The study followed PRISMA guidelines and searched PubMed/MEDLINE, Google Scholar, and Ovid databases for studies evaluating the effect of barbed pharyngoplasties on adults with OSA. Prospective and retrospective cohort studies were included with pre- and post-treatment comparisons of sleep tests and self-reported clinical outcomes. Exclusion criteria were non-English studies, case reports, reviews, conference abstracts, letters, and pediatric studies. Successful surgery was classified using Sher's criteria.

RESULTS: The study selected a total of 1014 patients from 26 studies, 24 of which were longitudinal studies with 10 retrospective trials and 14 prospective studies. The average age of the patients was 46.9 years, with an average Body Mass Index (BMI) of 25.6 kg/m2. Most of the patients were male (84.6%). The study included only palatal surgical techniques with barbed sutures, and patients who underwent cardio-respiratory monitoring and Drug Induced Sleep Endoscopy (DISE) before surgery. Mean Apnea Hypopnea Index (AHI) preoperative was 32.9/h, AHI postoperative was 11.9/h, and mean reduction of AHI was 62.3%. The most commonly adopted palatoplasty was Barbed Repositioning Pharyngoplasty (BRP) in 16 out of 26 studies, followed by its subsequent modifications in 3 studies.

CONCLUSIONS: Barbed pharyngoplasties appear to be effective both on objective measurement and subjective scores. DISE represents a fundamental tool to assess uni-level or multilevel obstruction. When retro-palatal collapse is present, barbed pharyngoplasty appears to be effective. Barbed pharyngoplasties maintain their good results both in single level or multilevel surgery. Randomized clinical controlled trials with multi-center cooperation and long-term study are necessary.

PMID:37227471 | DOI:10.1007/s00405-023-08018-5

11:33

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PubMed articles on: Cardio-Oncology

Tumour extracellular vesicles and particles induce liver metabolic dysfunction

Nature. 2023 May 24. doi: 10.1038/s41586-023-06114-4. Online ahead of print.

 

ABSTRACT

Immune checkpoint inhibitors (ICI) have changed the prognosis of many tumors. However, concerning associated cardiotoxicity has been reported. Little is known about the real-life incidence-specific surveillance protocols or the translational correlation between the underlying mechanisms and the clinical presentation of ICI-induced cardiotoxicity. The lack of data from prospective studies led us to review the current knowledge and to present the creation of the Spanish Immunotherapy Registry of Cardiovascular Toxicity (SIR-CVT), a prospective registry of patients receiving ICI that aims to examine the role of hsa-miR-Chr8:96, (a specific serum biomarker of myocarditis) in the early diagnosis of ICI-induced myocarditis. An exhaustive prospective cardiac imaging study will be performed before and during the first 12 months of treatment. The correlation between clinical, imaging, and immunologic parameters may improve our understanding of ICI-induced cardiotoxicity and enable simpler surveillance protocols. We assess ICI-induced cardiovascular toxicity and describe the rationale of the SIR-CVT.

PMID:37227656 | DOI:10.1007/s12094-023-03217-2

11:33

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PubMed articles on: Cardio-Oncology

Barbed palatal surgery: single stage or multilevel setting-a systematic review by the Young Otolaryngologists of the Italian Society of Otolaryngology

Eur Arch Otorhinolaryngol. 2023 May 25. doi: 10.1007/s00405-023-08018-5. Online ahead of print.

 

ABSTRACT

INTRODUCTION: Breast cancer treated with adjuvant hypofractionation radiotherapy with two different techniques, i.e., volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) and their effects in terms of loco-regional control and adverse effects in terms of cutaneous, pulmonary, and cardiac outcomes are compared.

MATERIALS AND METHODS: This is a prospective non-randomized observational study. VMAT and IMRT plan for 30 breast cancer patients who were supposed to receive adjuvant radiotherapy were prepared using a hypofractionation schedule. The plans were dosimetrically evaluated.

OBJECTIVE: Dosimetric comparative analysis of IMRT and VMAT in hypofractionated radiotherapy in breast cancer is done and tested whether VMAT has a dosimetric advantage over IMRT. These patients were recruited for a clinical assessment of toxicities. They were followed up for at least three months.

RESULT: On dosimetric analysis, planning target volume (PTV) coverage (PTV_ V95) of both VMAT (96.41 ± 1.31) and IMRT (96.63 ± 1.56) were similar with significantly lower monitor units required with VMAT plans (1,084.36 ± 270.82 vs 1,181.55 ± 244.50, p = 0.043). Clinically, all patients tolerated hypofractionation through VMAT (n = 8) and IMRT (n = 8) satisfactorily in the short term. No cardiotoxicity or appreciable falls in pulmonary function test parameters were observed. Acute radiation dermatitis poses challenges similar to standard fractionation or any other delivery technique.

CONCLUSION: PVT dose, homogeneity, and conformity indices were similar in both VMAT and IMRT groups. In VMAT, there was high-dose sparing of some critical organs like the heart and lungs at the cost of the low-dose baths to these organs. Increased risk of secondary cancer will require a decade-long follow-up study to indict the VMAT technique. As we move toward precision in oncology, "one-size-fits-all" can never be an acceptable dictum. Each patient is unique and therefore we must offer, and the patient must "choose wisely."

PMID:37228558 | PMC:PMC10206676 | DOI:10.7759/cureus.38045

11:33

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PubMed articles on: Cardio-Oncology

Cardiovascular toxicity of checkpoint inhibitors: review of associated toxicity and design of the Spanish Immunotherapy Registry of Cardiovascular Toxicity

Clin Transl Oncol. 2023 May 25. doi: 10.1007/s12094-023-03217-2. Online ahead of print.

 

ABSTRACT

BACKGROUND: In addition to cardiotoxicity, ocular toxicity induced by chemotherapeutic agents is not uncommon.

OBJECTIVE: This study aimed to explore the association between ocular adverse events and major adverse cardiovascular events (composite endpoint) caused by chemotherapy, and whether specific ocular events could be potential predictors of some specific components of the composite endpoint.

METHODS: A total of 5378 newly diagnosed patients (age > 18 y/o) with any malignancy or metastatic solid tumors who received chemotherapy from January 1997 to December 2010 were enrolled from the Taiwan National Health Insurance Research Database. Patients who developed new incident ocular diseases were classified as the study group, and those who did not develop incident ocular diseases as the control group.

RESULTS: After propensity score matching, there was a significant increase in the incidence of stroke in the ocular diseases group compared to the no ocular diseases group (13.4% vs. 4.5%, p < 0.0001). Tear film insufficiency, keratopathy, glaucoma, and lens disorders were associated with a significantly higher risk of stroke. A longer duration of methotrexate and a longer duration with higher total amount of tamoxifen were associated with both incident ocular diseases and incident stroke. Cox proportional hazards regression showed that the only independent risk factor for stroke was incident ocular diseases [Adjusted relative risk (95% confidence interval): 2.96 (1.66-5.26), p = 0.0002]. In addition, incident ocular disease was the most significant risk factor compared with other traditional cardiovascular risk factors.

CONCLUSIONS: Incident ocular diseases related to chemotherapy were associated with a significantly higher risk of stroke.

PMID:37229341 | PMC:PMC10203719 | DOI:10.6515/ACS.202305_39(3).20221005A

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PubMed articles on: Cardio-Oncology

Editorial: Cardio-oncology and reverse cardio-oncology: the manifold interconnections between heart failure and cancer

Front Physiol. 2023 May 9;14:1205810. doi: 10.3389/fphys.2023.1205810. eCollection 2023.

NO ABSTRACT

PMID:37228811 | PMC:PMC10203590 | DOI:10.3389/fphys.2023.1205810

11:33

PubMed articles on: Cardio-Oncology

Dosimetric Comparison of Hypofractionated Regimen in Breast Cancer Using Two Different Techniques: Intensity-Modulated Radiation Therapy (IMRT) and Volumetric-Modulated Arc Therapy (VMAT)

Cureus. 2023 Apr 24;15(4):e38045. doi: 10.7759/cureus.38045. eCollection 2023 Apr.

 

ABSTRACT

The overall survival of advanced melanoma has improved dramatically. Immunotherapies, specifically checkpoint inhibitors, have played a large role in this improvement. These agents have also shown benefit in the adjuvant setting, are approved for treatment of resected stage II, III, and IV melanoma, and play an evolving role in the neoadjuvant setting. Although generally well tolerated, immune-related adverse events occur and can be severe. Here we focus on some severe and potentially long term toxicities, including cardiovascular and neurologic toxicities. Our understanding of the acute and long-term toxicities of immune checkpoint inhibitors continues to evolve. Oncologists must continue to balance cancer risk and treatment-related toxicities.

PMID:37229626 | DOI:10.1200/EDBK_390594

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PubMed articles on: Cardio-Oncology

The Incident Ocular Diseases Related to Chemotherapy in Cancer Patients are Associated with Increasing Risk of Incident Stroke

Acta Cardiol Sin. 2023 May;39(3):435-448. doi: 10.6515/ACS.202305_39(3).20221005A.

 

ABSTRACT

BACKGROUND: Postoperative mortality and morbidity rates are high in patients with obstructing colon cancer (OCC). Different treatment options have been evaluated over the years, mainly for left sided OCC. Optimising the preoperative health condition in elective colorectal cancer (CRC) treatment shows promising results. The aim of this study is to determine whether preoptimisation is feasible in patients with OCC, with a special interest/focus on right-sided OCC, and if, ultimately, optimisation reduces mortality and morbidity (stoma rates, major and minor complications) rates in OCC.

METHODS: This is a prospective registration study including all patients presenting with OCC in our hospital. Patients with OCC, treated with curative intent, will be screened for eligibility to receive preoptimisation before surgery. The preoptimisation protocol includes; decompression of the small bowel with a NG-tube for right sided obstruction and SEMS or decompressing ileostomy or colostomy, proximal to the site of obstruction, for left sided colonic obstructions. For the additional work-up, additional nutrition by means of parenteral feeding (for patients who are dependent on a NG tube) or oral/enteral nutrition (in case the obstruction is relieved) is provided. Physiotherapy with attention to both cardio and muscle training prior surgical resection is provided. The primary endpoint is complication-free survival (CFS) at the 90 day period after hospitalisation. Secondary outcomes include pre- and postoperative complications, patient- and tumour characteristics, surgical procedures, total in hospital stay, creation of decompressing and/or permanent ileo- or colostomy and long-term (oncological) outcomes.

DISCUSSION: Preoptimisation is expected to improve the preoperative health condition of patients and thereby reduce postoperative complications.

TRIAL REGISTRATION: Trial Registry: NL8266 date of registration: 06-jan-2020.

STUDY STATUS: Open for inclusion.

PMID:37231376 | DOI:10.1186/s12876-023-02799-z

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PubMed articles on: Cardio-Oncology

A Brain, A Heart, and the Courage: Balancing Benefit and Toxicity of Immunotherapy in Melanoma

Am Soc Clin Oncol Educ Book. 2023 May;43:EDBK39059. doi: 10.1200/EDBK_390594.

 

ABSTRACT

Cardiotoxicity represents an important acute or chronic adverse event of treatment modalities for childhood cancer. In the last two decades the emergence of novel cancer therapies has aimed to increase unaided or mostly in combination with conventional chemotherapy for the survival rates of pediatric cancer especially for those patients with relapsed and/or refractory disease. The use of emerging targeted therapies in combination with conventional chemotherapy is related to cardiovascular adverse events mostly reported in adults. The aim of our short review was to investigate the cardiotoxic side effects of targeted chemotherapeutic agents as monoclonal antibodies and small molecules in pediatric cancer patients.

PMID:37231721 | DOI:10.2174/1871520623666230525162147

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PubMed articles on: Cardio-Oncology

Preoptimisation in patients with acute obstructive colon cancer (PREOCC) - a prospective registration study protocol

BMC Gastroenterol. 2023 May 25;23(1):186. doi: 10.1186/s12876-023-02799-z.

 

ABSTRACT

BACKGROUND: Cyclic nucleotides play critical roles in cardiovascular biology and disease. PDE10A (phosphodiesterase 10A) is able to hydrolyze both cAMP and cGMP. PDE10A expression is induced in various human tumor cell lines, and PDE10A inhibition suppresses tumor cell growth. Chemotherapy drug such as doxorubicin (DOX) is widely used in chemotherapy. However, cardiotoxicity of DOX remains to be a serious clinical complication. In the current study, we aim to determine the role of PDE10A and the effect of PDE10A inhibition on cancer growth and cardiotoxicity induced by DOX.

METHODS: We used global PDE10A KO (knockout) mice and PDE10A inhibitor TP-10 to block PDE10A function. DOX-induced cardiotoxicity was evaluated in C57Bl/6J mice and nude mice with implanted ovarian cancer xenografts. Isolated adult mouse cardiomyocytes and a human ovarian cancer cell line were used for in vitro functional and mechanistic studies.

RESULTS: We found that PDE10A deficiency or inhibition alleviated DOX-induced myocardial atrophy, apoptosis, and dysfunction in C57Bl/6J mice. RNA sequencing study revealed a number of PDE10A-regulated signaling pathways involved in DOX-induced cardiotoxicity. PDE10A inhibition increased the death, decreased the proliferation, and potentiated the effect of DOX on various human cancer cells. Importantly, in nude mice with implanted ovarian cancer xenografts, PDE10A inhibition attenuated tumor growth while protecting DOX-induced cardiotoxicity. In isolated cardiomyocytes, PDE10A contributed to DOX-induced cardiomyocyte death via increasing Top2β (topoisomerase 2β) expression, mitochondrial dysfunction, and DNA damage by antagonizing cGMP/PKG (protein kinase G) signaling. PDE10A contributed to cardiomyocyte atrophy via potentiating FoxO3 (forkhead box O3) signaling via both cAMP/PKA- (protein kinase A) and cGMP/PKG-dependent signaling.

CONCLUSIONS: Taken together, our study elucidates a novel role for PDE10A in cardiotoxicity induced by DOX and cancer growth. Given that PDE10A has been already proven to be a safe drug target, PDE10A inhibition may represent a novel therapeutic strategy in cancer therapy, with effects preventing DOX-induced cardiotoxicity and simultaneously antagonizing cancer growth.

PMID:37232184 | DOI:10.1161/CIRCRESAHA.122.322264

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PubMed articles on: Cardio-Oncology

Cardiotoxicity of targeted therapies in children with haematological malignancies and solid tumors

Anticancer Agents Med Chem. 2023 May 25. doi: 10.2174/1871520623666230525162147. Online ahead of print.