J Formos Med Assoc
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The prognosis of triple-negative breast cancer (TNBC) is worse and a major proportion of TNBC expresses epidermal growth factor receptor (EGFR). Afatinib can inhibit EGFR signal pathway; however, its treatment effect for TNBC is unknown. Thus, we aimed to assess the efficacy and biomarkers of afatinib in combination with paclitaxel in a neoadjuvant setting. ⋯ Adding afatinib to neoadjuvant paclitaxel generated a modest effect in TNBC. Exploratory molecular analysis suggested that activated PI3K, JAK2 pathways and mutation of HR genes were associated with therapeutic non-responsiveness, and amplification of DAXX genes was associated with responsiveness to afatinib in combination with paclitaxel.
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The combination of bevacizumab and atezolizumab has been established as a standard first-line systemic treatment for unresectable hepatocellular carcinoma (HCC). We examined the treatment outcomes of patients in Taiwan who received the combination in 2 pivotal clinical trials. ⋯ In Taiwanese patients with advanced HCC, the efficacy and safety outcomes of bevacizumab and atezolizumab treatment were generally consistent with the global intent-to-treat populations.
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Alanine aminotransferase (ALT) is a cost-effective screening test for asymptomatic liver diseases. The aims of this study are to redefine the ULNs of ALT using the 2010-2012 Nutrition and Health Survey in Taiwan (NAHSIT) database and to determine whether the updated ULNs can better screen for metabolic dysfunction-associated fatty liver disease (MAFLD) in obese children. ⋯ After taking into account MAFLD-related metabolic risk factors, the ULNs of ALT are 23 IU/L for boys and 18 IU/L for girls in Taiwan. The updated ULNs may be better cutoffs for screening MAFLD in obese children.
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Review Meta Analysis
Complete intraureteral stent placement reduces stent-related symptoms: Systemic review and meta-analysis.
The distal coil of a double-J ureteral stent is considered the major cause of stent-related symptoms. We noticed that some recent studies investigated whether complete intraureteral stent placement (CIU-SP) reduced these symptoms. The current systemic review and meta-analysis aimed to evaluate the safety and the effectiveness of CIU-SP, as compared to conventional stent placement (C-SP). ⋯ This meta-analysis reveals that CIU-SP significantly decreases stent-related urinary symptoms and pain. Based on the current evidence, CIU-SP is ready to be applied in clinical practice, at least in those requiring short-term stent placement following uncomplicated ureteroscopic lithotripsy.
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Fatty liver disease and chronic hepatitis B (CHB) are the major causes for chronic liver diseases and the associated adverse outcomes. Concurrent hepatic steatosis has been found to inversely correlate with hepatitis B virus (HBV) activity both in vivo and in vitro; however, the subsequent effects on the prognosis, including advanced fibrosis and hepatocellular carcinoma (HCC) development, remain diverse and inconclusive. Although the newly-proposed criteria of metabolic dysfunction-associated fatty liver disease (MAFLD) help raise disease awareness and facilitate timely diagnosis and management, its clinical impact on patients with CHB, especially after taking the metabolic dysfunction into consideration, is largely unknown and warrants comprehensive investigations to improve the management of CHB population. In this review, these relevant issues are summarized and discussed.