Bosnian Journal of Basic Medical Sciences (BJBMS)
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Intravenous immunoglobulin: A potential treatment for the post-acute sequelae of SARS-Cov-2 infection?
Get PDFFollowing the recovery from an initial infection with SARS-CoV-2, a recent meta-analysis of almost 1 million patients worldwide suggested that an estimated 43% of patients had experienced a variety of sequelae [1]. Furthermore, numerous studies indicate that patients can develop somatic, musculoskeletal, neuropsychiatric, cardiovascular, dermatologic, renal, hepatic and gastrointestinal manifestations that are heterogeneous and vary in intensity and duration (for up to 12 months) [2,3]. The CDC has defined this phenomenon as “long-term symptoms that might be experienced weeks to months after primary infection with SARS-CoV-2, the virus that causes COVID-19 [4]” and proposed designations for this syndrome have included long covid, long chronic covid syndrome, chronic covid, post-COVID-19 syndrome, post-acute covid-19 syndrome and long – haulers [5]. On Feb. 23, 2021, Dr. Francis Collins indicated that the persistent symptoms that occur in patients after recovery from the initial infection could be designated, post-acute sequelae of SARS-CoV-2 (PASC), which we will use in this article. Currently, there is no clear or agreed upon definition or diagnostic criteria for PASC. PASC is most likely a post-infectious illness similar to that reported by patients that had long - term sequelae that persisted for up to 14 months after infection with SARS-CoV-1 or the Middle Eastern respiratory SARS virus (MERS) [6].
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The Oncology Association of Bosnia and Herzegovina\u27s recommendations for fertility preservation in oncologic patients
No full textMalignancy is one of the major public health problems in Bosnia and Herzegovina. Along with breakthroughs in specific oncological therapy, improving the quality of life of cancer patients and management of therapy-induced side effects need to be recognized as a priority in the comprehensive cancer patient care. Fertility loss after cancer treatment is a field requiring special attention due to its various consequences on patients themselves. Although oncofertility is well-recognized area of oncology, low- to middle-income countries are facing issues with its implementation in everyday practice. Increased awareness about fertility preservation is of high priority for all specialists who participate in the medical care of cancer patients. The absence of a systemic solution and lack of expertise led to the founding of Fertility Preservation Working Group of the Oncology Association of Bosnia and Herzegovina. We have made recommendationsas an expert consensus with the ultimate goal of making the first step towards enhancement of oncofertility implementation in Bosnia and Herzegovina
Prognostic nomograms for predicting overall survival and cancer-specific survival of patients with very early-onset colorectal cancer: A population‑based analysis
Get PDFIn contrast to the declining incidence in older populations, the incidence of very early onset colorectal cancer (VEO-CRC) patients (aged ≤40 years) has been increasing in different regions of the world. In this study, we aimed to establish nomogram models for the prognostic prediction of patients with VEO-CRC for both overall survival (OS) and cancer-specific survival (CSS). Patients diagnosed with VEO-CRC between 2010 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were collected and randomly assigned to the training cohort and validation cohort at a ratio of 7:3 for model construction and internal validation. Using univariate and multivariate Cox regression analysis to screen important variables, which were then used to construct a nomogram. The nomogram was evaluated using calibration curves and the receiver operating characteristic (ROC) curves. A total of 3061 patients were included and randomly divided into the training cohort (n = 2145) and validation cohort (n = 916). Five independent prognostic factors, including race, grade, tumor size, AJCC stage, and AJCC T stage were all significantly identified in OS multivariate Cox regression analysis. Meanwhile in CSS, multivariate Cox regression analysis demonstrated that race, grade, tumor size, AJCC stage, AJCC T stage, AJCC N stage, and SEER stage were independent prognostic factors. The calibration plots of the established nomograms indicated high correlations between the predicted and observed results. C-index and ROC analysis implied that our nomogram model has a strong predictive ability. Moreover, nomograms also showed higher C-index values compared to tumor-node-metastasis (TNM) and SEER stages. We established and validated a simple-to-use nomogram to evaluate the 1-, 3-, and 5-year OS and CSS prognosis of patients with VEO-CRC. This tool can assist clinicians to optimize individualized treatment plans
An improved joint non-negative matrix factorization for identifying surgical treatment timing of neonatal necrotizing enterocolitis
Get PDFNeonatal necrotizing enterocolitis is a severe neonatal intestinal disease. Timely identification of surgical indications is essential for newborns in order to seek the best time for treatment and improve prognosis. This paper attempts to establish an algorithm model based on multimodal clinical data to determine the features of surgical indications and construct an auxiliary diagnosis model. The proposed algorithm adds hypergraph constraints on the two modal data based on Joint Nonnegative Matrix Factorization (JNMF), aiming to mine the higher-order correlations of the two data features. In addition, the adjacency matrix of the two kinds of data is used as a network regularization constraint to prevent overfitting. Orthogonal and L1-norm regulations were introduced to avoid feature redundancy and perform feature selection, respectively, and confirmed 14 clinical features. Finally, we used three classifiers, random forest, support vector machine, and logistic regression, to perform binary classification of patients requiring surgery. The results show that when the features selected by the proposed algorithm model are classified by random forest, the area under the ROC curve is 0.8, which has high prediction accuracy
Associations of non-HDL-C and triglyceride/HDL-C ratio with coronary plaque burden and plaque characteristics in young adults
Get PDFCoronary artery disease (CAD) is uncommon in young adult patients. However, these patients have different risk factor profiles and high-risk coronary plaques are more common. The aim of this study was to examine the relations between the coronary plaque burden, plaque composition, serum non-high-density lipoprotein cholesterol (non–HDL-C) levels, and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio in young adults. We analyzed a total of 551 patients under age 45 who had undergone coronary computed tomography angiography (CCTA). Coronary plaque characteristics were analyzed using CCTA. Multivariate linear regression analysis was used to assess the predictors of non-calcified plaque (NCB) and calcified plaque (CB) burdens. Serum non–HDL-C levels and TG/HDL-C ratio were higher in the coronary atherosclerosis patient group. Serum non–HDL-C levels and the TG/HDL-C ratio were higher in the obstructive CAD patient group. The plaque burden was positively correlated with non-HDL-C (r = 0.30; p < 0.001), and TG/HDL-C ratio (r = 0.18; p < 0.001). NCB was positively correlated with age, gender, smoking status, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, serum triglycerides, hbA1c, non–HDL-C, and TG/HDL-C ratio. Non–HDL-C (β coefficient = 0.13; p = 0.023) and TG/HDL-C ratio (β = 0.10; p = 0.042) were independent predictors of NCB. Serum non–HDL-C levels and TG/HDL-C were significantly associated with the presence and burden of coronary plaques. Serum non–HDL-C and TG/HDL-C ratios were independently associated with NCB, suggesting their use as easy-to-compute markers for identifying high-risk groups in young adults
An insight into lung cancer: a comprehensive review exploring ALK TKI and mechanisms of resistance
No full textImplementation of precision medicine in lung cancer has benefited from intense research in the past years, developing subsequently an improved quality of life and increased overall survival of the patients. Targeted therapy has become one of the most important therapeutic innovations for the non-small cell lung cancer (NSCLC) category with anaplastic lymphoma kinase (ALK) gene rearrangement. The aim of this review is to provide a through overview of the main molecules of ALK tyrosine kinase inhibitors (TKI) with their general and particular mechanisms of resistance, the main methods of ALK gene detection, each with advantages and limits and the future perspectives currently under research which try to overcome the mechanisms of resistance. We have used two of the most reliable medical databases EMBASE and PubMed to properly select the latest and the most relevant articles for this topic. Encouraged by the promising results, the clinical practice was enriched by the approval of tyrosine kinase inhibitor molecules, three generations being developed, each one with more powerful agents than the previous ones. Unfortunately, the resistance to TKI eventually occurs and it may be induced by several mechanisms, either known or unknown. Crizotinib was the most intensely studied TKI , becoming the first molecule approved into clinical practice and although four other drugs have been broadly used (alectinib, ceritinib, brigatinib and lorlatinib) it seems that even the most recently developed one remains imperfect due to the resistance mutations that developed. There are two types of resistance generally described for the entire class and for the particular drugs, but half of them remain unknown
 
Sustained seroprevalence of SARS-CoV-2 antibodies one year after infection: one of the first COVID-19 cluster cases in Bosnia and Herzegovina
Get PDFSARS-CoV-2 (severe acute respiratory syndrome coronavirus type 2) is a novel virus that has been identified as a causal agent of COVID-19, an emergent infectious disease which brought about a new pandemic in the twenty-first century. The immune responses and clinical features of individuals infected with SARS-CoV-2 have not yet been fully described. Thus, in this study, we compare the seroprevalence and define the correlation between symptoms and serological results in the first COVID-19 cluster in the city of Konjic, Bosnia and Herzegovina. Of the total number, 93% of RT-PCR positive participants had positive IgG serology and 75% of them developed symptoms of COVID-19. We found that there was no significant alteration in specific IgG (p = 0.504) antibody levels during the 1-year period after COVID-19. Our results indicate that symptomatic COVID-19 patients have a higher rate of seroconversion (p < 0.01). The IgG seroconversion was correlated with high fever (p = 0.002) and headache (p = 0.007), suggesting that these symptoms could be considered as indicators of a better immune response. This study has demonstrated persistence of sustained levels of specific SARS-CoV-2 antibodies after recovering from COVID-19 infection. However, in order to gain a better insight into the immune response to SARS-CoV-2, further systematic studies should be focused on quality and longevity analyses
Development and validation of a novel pre-operative comprehensive prognostic score in esophageal squamous cell carcinoma
Get PDFWe herein propose a novel integrative score based on inflammatory and nutritional score, coagulation indicator and tumor marker, named comprehensive prognostic score (CPS), to predict postoperative survival in resectable esophageal squamous cell carcinoma (ESCC). We also aimed to establish and validate a nomogram based on CPS and other clinical features for individual survival prediction. A total of 490 resectable ESCC patients were randomly divided into either a training or validation cohort at a ratio of 7:3 for retrospective analysis. The CPS, based on squamous cell carcinoma antigen (SCCA), C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and fibrinogen (FIB), was divided into two models to verify its prognostic value. The predictive model of CPS-based nomogram was established and validated in two cohorts. Patients with CPS low group in model 1 had better 5-year cancer-specific survival (CSS) than those in CPS high group (50.7% vs. 17.8%, P<0.001). For model 2, the 5-year CSS for CPS 0, 1 and 2 were 75.0%, 38.9% and 13.3%, respectively (P<0.001). CPS was confirmed as an independent prognostic score in both models. The CPS-based nomogram can accurately and effectively predict survival in resected ESCC. The CPS is a novel, simple, and effective predictor in resectable ESCC. Moreover, CPS has a potential independent prognostic value in predicting postoperative survival, which can accurately and effectively predict individual survival in resectable ESCC
Selection of optimal therapeutic modality for early-stage extranodal natural killer/T-cell lymphoma patients under the guidance of single-nucleotide polymorphism signature
Get PDFThe therapeutic modalities of early-stage and advanced extranodal natural killer/T-cell lymphoma (NKTCL) patients are completely different. The former is mainly radiotherapy with or without chemotherapy, while the latter relies on chemotherapy-based systemic treatment. According to Ann Arbor staging system, approximately 70% of the NKTCL patients are classified as early-stage cases who are promising to be cured.Considering NKTCL is sensitive to radiation but may be resistant to chemotherapy, the radiotherapy is considered to be the most important treatment for some early-stage patients with a satisfactory local control rate and could be used alone. However, systemic recurrence after radiotherapy in a portion of NKTCL patients seriously affects their long-term survival, and the first-line treatment combined with radiotherapy and chemotherapy is considered necessary. Therefore, the use of radiotherapy alone in early-stage NKTCL is still a controversial issue.
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Application of microfluidic chips in anticancer drug screening
Get PDFWith the continuous development of drug screening technology, new screening methodologies and technologies are constantly emerging, driving drug screening into rapid, efficient and high-throughput development. Microfluidics is a rising star in the development of innovative approaches in drug discovery. In this article, we summarize the recent years\u27 progress of microfluidic chip technology in drug screening, including the developmental history, structural design, and applications in different aspects of microfluidic chips on drug screening. Herein, the existing microfluidic chip screening platforms are summarized from four aspects: chip structure design, sample injection and drive system, cell culture technology on a chip, and efficient remote detection technology. Furthermore, this review discusses the application and developmental prospects of using microfluidic chips in drug screening, particularly in screening natural product anticancer drugs based on chemical properties, pharmacological effects, and drug cytotoxicity