Purpose: Although controversial, assessment of epidermal growth factor receptor (EGFR) expression is required for the approved indications of Cetuximab in metastatic colorectal cancer (mCRC). With the objective of imp...Purpose: Although controversial, assessment of epidermal growth factor receptor (EGFR) expression is required for the approved indications of Cetuximab in metastatic colorectal cancer (mCRC). With the objective of improving patient selection, “ERBITUX-OUEST” study aimed at analyzing EGFR status in a large cohort of mCRC patients who received cetuximab without preliminary EGFR screening, and assessing the correlation between EGFR status and response to treatment retrospectively. Patients and methods: 332 patients treated with Irinotecan Cetuximab based regimen after progression on irinotecan or oxaliplatin therapy were included. EGFR status was assessed using three available immunohistochemistry (IHC) tests and in situ hybridization in case of negativity. Clinical outcomes of EGFR-positive and EGFR-non-detected (or considered as negative with at least one test) patients were compared. Results: Of the 332 samples centrally screened, 194 were classified as full-positive (i.e., EGFR-positive for all three tests), 86 as full-negative, and 52 as discordant. One third of the 131 negative samples with FDA approved test should be reclassified as positive with at least one of the two others tests. Regarding results from FDA approved test only, neither objective response rate (ORR), progression-free survival (PFS) nor overall survival (OS) differed significantly between EGFR-negative and EGFR-positive patients (P = 0.788, 0.326 and 0.888, respectively). Similarly, comparison of full-negative to other groups did not show any significant difference in terms of ORR (P = 0.507), PFS (P = 0.222) or OS (P = 0.686). Conclusion: These data strongly argue against mCRC patients selection for Cetuximab treatment based on EGFR expression as measured by currently available IHC technics.展开更多
The hepatitis C virus is hitherto a tremendous threat to human beings,but many researchers have analyzed mathematical models for hepatitis C virus transmission dynamics only in the deterministic case.Stochasticity pla...The hepatitis C virus is hitherto a tremendous threat to human beings,but many researchers have analyzed mathematical models for hepatitis C virus transmission dynamics only in the deterministic case.Stochasticity plays an immense role in pathology and epidemiology.Hence,the main theme of this article is to investigate a stochastic epidemic hepatitis C virus model with five states of epidemiological classification:susceptible,acutely infected,chronically infected,recovered or removed and chronically infected,and treated.The stochastic hepatitis C virus model in epidemiology is established based on the environmental influence on individuals,is manifested by stochastic perturbations,and is proportional to each state.We assert that the stochastic HCV model has a unique global positive solution and attains sufficient conditions for the extinction of the hepatotropic RNA virus.Furthermore,by constructing a suitable Lyapunov function,we obtain sufficient conditions for the existence of an ergodic stationary distribution of the solutions to the stochastic HCV model.Moreover,this article confirms that using numerical simulations,the six parameters of the stochastic HCV model can have a high impact over the disease transmission dynamics,specifically the disease transmission rate,the rate of chronically infected population,the rate of progression to chronic infection,the treatment failure rate of chronically infected population,the recovery rate from chronic infection and the treatment rate of the chronically infected population.Eventually,numerical simulations validate the effectiveness of our theoretical conclusions.展开更多
Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as ...Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .展开更多
Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and di...Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and diagnostic aspects of childhood proptosis in Lome (Togo). Methods: Retrospective cross-sectional study conducted from June 2010 to May 2020, which is 10 years, in the ophthalmology department of CHU-campus of Lome. Files of patients between the age of 0 and 15 who presented a proptosis during the study period were taken into account in the study. Patients with a false proptosis or incomplete records during the study period were not taken into account in the study. Results: The study considered 42 children with an age average of 7.63 years ± 4.96 [4 days;15 years] and a sex-ratio of 1.33. The frequency of proptosis was 0.5% with an average progression of 383.7 days before the first consultation. The proptosis was unilateral in 80.95% of cases. The orbito-cerebral CT scan was done in 47.62% of cases. The proptosis in these patients was predominantly of grade 3 in 45% of cases. The tumor pathologies were at the forefront in 35.71%, dominated by retinoblastoma, and followed by infectious and inflammatory diseases in 14.29%. Conclusion: Childhood proptosis is rare and often indicative of infectious and tumor pathologies in our context. Its diagnosis is delayed, which shows the importance of an early and effective diagnosis. .展开更多
Purpose: Primary malignant musculosqueletal tumors in adult are rare affections group and its treatment is still a real challenge today. The aim of this work was to describe the epidemiologic and treatment aspects of ...Purpose: Primary malignant musculosqueletal tumors in adult are rare affections group and its treatment is still a real challenge today. The aim of this work was to describe the epidemiologic and treatment aspects of these tumors in the national reference center of our country. Materiel and Methods: It was a retrospective review of primary malignant musculosqueletal tumors treated in orthopedics and trauma unit of Sylvanus Olympio teaching hospital of Lomé, Togo from January 2000 to December 2014. Results: During the study period, 28 cases were selected and reviewed. There were 17 men (60.71%) and 11 women (39.29%). The average age was 32.7 years. There were 20 cases (71%) of primary malignant bone tumors (PMBT) and 8 cases (29%) of primary malignant soft tissues tumors (PMSTT). There were 6 (30%) of osteosarcoma. The tumor was located in the bones of the forearm and wrist/hand in 2 (10%) patients for each anatomical site;for the lower limb, around knee in 7 (35%) patients. Eight patients had PMSTT (28, 57%). There were three cases of rhabdomyosarcoma, 2 cases of fibrosarcoma. Tumors were located around knee in 4 cases and around ankle/foot in 3 cases. In the two groups of tumor, tumor resection was performed in 5 patients (17.86%) and limb amputation indicated in 23 patients (82.14%), was performed in 15 (53.57%) and 8 patients (37.78%), rejected it and left hospital against medical advice. Conclusion: Malignant musculoskeletal tumors are relatively rare in Togo. Their treatment is based on radical surgery which is often not supervised by adjuvant therapies. Ignorance, poverty of the population and embryonic state of diagnostic and treatment infrastructures are the obstacles to their care. Education and awareness must be integrated to care and fight against this group of diseases.展开更多
文摘Purpose: Although controversial, assessment of epidermal growth factor receptor (EGFR) expression is required for the approved indications of Cetuximab in metastatic colorectal cancer (mCRC). With the objective of improving patient selection, “ERBITUX-OUEST” study aimed at analyzing EGFR status in a large cohort of mCRC patients who received cetuximab without preliminary EGFR screening, and assessing the correlation between EGFR status and response to treatment retrospectively. Patients and methods: 332 patients treated with Irinotecan Cetuximab based regimen after progression on irinotecan or oxaliplatin therapy were included. EGFR status was assessed using three available immunohistochemistry (IHC) tests and in situ hybridization in case of negativity. Clinical outcomes of EGFR-positive and EGFR-non-detected (or considered as negative with at least one test) patients were compared. Results: Of the 332 samples centrally screened, 194 were classified as full-positive (i.e., EGFR-positive for all three tests), 86 as full-negative, and 52 as discordant. One third of the 131 negative samples with FDA approved test should be reclassified as positive with at least one of the two others tests. Regarding results from FDA approved test only, neither objective response rate (ORR), progression-free survival (PFS) nor overall survival (OS) differed significantly between EGFR-negative and EGFR-positive patients (P = 0.788, 0.326 and 0.888, respectively). Similarly, comparison of full-negative to other groups did not show any significant difference in terms of ORR (P = 0.507), PFS (P = 0.222) or OS (P = 0.686). Conclusion: These data strongly argue against mCRC patients selection for Cetuximab treatment based on EGFR expression as measured by currently available IHC technics.
基金jointly supported by National Natural Science Foundation of China(62173139)the Science and Technology Innovation Program of Hunan Province(2021RC4030)+1 种基金Hunan Provincial Science and Technology Project Foundation(2019RS1033)the Science and Engineering Research Board(SERB)of India(EEQ/2021/001003).
文摘The hepatitis C virus is hitherto a tremendous threat to human beings,but many researchers have analyzed mathematical models for hepatitis C virus transmission dynamics only in the deterministic case.Stochasticity plays an immense role in pathology and epidemiology.Hence,the main theme of this article is to investigate a stochastic epidemic hepatitis C virus model with five states of epidemiological classification:susceptible,acutely infected,chronically infected,recovered or removed and chronically infected,and treated.The stochastic hepatitis C virus model in epidemiology is established based on the environmental influence on individuals,is manifested by stochastic perturbations,and is proportional to each state.We assert that the stochastic HCV model has a unique global positive solution and attains sufficient conditions for the extinction of the hepatotropic RNA virus.Furthermore,by constructing a suitable Lyapunov function,we obtain sufficient conditions for the existence of an ergodic stationary distribution of the solutions to the stochastic HCV model.Moreover,this article confirms that using numerical simulations,the six parameters of the stochastic HCV model can have a high impact over the disease transmission dynamics,specifically the disease transmission rate,the rate of chronically infected population,the rate of progression to chronic infection,the treatment failure rate of chronically infected population,the recovery rate from chronic infection and the treatment rate of the chronically infected population.Eventually,numerical simulations validate the effectiveness of our theoretical conclusions.
文摘Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .
文摘Background: Although proptosis is rare, it is nevertheless the main sign of orbital disease. Its discovery usually indicates a serious eye disease especially in children. Objective: To determine epidemiological and diagnostic aspects of childhood proptosis in Lome (Togo). Methods: Retrospective cross-sectional study conducted from June 2010 to May 2020, which is 10 years, in the ophthalmology department of CHU-campus of Lome. Files of patients between the age of 0 and 15 who presented a proptosis during the study period were taken into account in the study. Patients with a false proptosis or incomplete records during the study period were not taken into account in the study. Results: The study considered 42 children with an age average of 7.63 years ± 4.96 [4 days;15 years] and a sex-ratio of 1.33. The frequency of proptosis was 0.5% with an average progression of 383.7 days before the first consultation. The proptosis was unilateral in 80.95% of cases. The orbito-cerebral CT scan was done in 47.62% of cases. The proptosis in these patients was predominantly of grade 3 in 45% of cases. The tumor pathologies were at the forefront in 35.71%, dominated by retinoblastoma, and followed by infectious and inflammatory diseases in 14.29%. Conclusion: Childhood proptosis is rare and often indicative of infectious and tumor pathologies in our context. Its diagnosis is delayed, which shows the importance of an early and effective diagnosis. .
文摘Purpose: Primary malignant musculosqueletal tumors in adult are rare affections group and its treatment is still a real challenge today. The aim of this work was to describe the epidemiologic and treatment aspects of these tumors in the national reference center of our country. Materiel and Methods: It was a retrospective review of primary malignant musculosqueletal tumors treated in orthopedics and trauma unit of Sylvanus Olympio teaching hospital of Lomé, Togo from January 2000 to December 2014. Results: During the study period, 28 cases were selected and reviewed. There were 17 men (60.71%) and 11 women (39.29%). The average age was 32.7 years. There were 20 cases (71%) of primary malignant bone tumors (PMBT) and 8 cases (29%) of primary malignant soft tissues tumors (PMSTT). There were 6 (30%) of osteosarcoma. The tumor was located in the bones of the forearm and wrist/hand in 2 (10%) patients for each anatomical site;for the lower limb, around knee in 7 (35%) patients. Eight patients had PMSTT (28, 57%). There were three cases of rhabdomyosarcoma, 2 cases of fibrosarcoma. Tumors were located around knee in 4 cases and around ankle/foot in 3 cases. In the two groups of tumor, tumor resection was performed in 5 patients (17.86%) and limb amputation indicated in 23 patients (82.14%), was performed in 15 (53.57%) and 8 patients (37.78%), rejected it and left hospital against medical advice. Conclusion: Malignant musculoskeletal tumors are relatively rare in Togo. Their treatment is based on radical surgery which is often not supervised by adjuvant therapies. Ignorance, poverty of the population and embryonic state of diagnostic and treatment infrastructures are the obstacles to their care. Education and awareness must be integrated to care and fight against this group of diseases.
