Background Current soil-transmitted helminth(STH)control guidelines endorse the use of albendazole or meben-dazole for school-based targeted preventive chemotherapy(PC),yet their reduced efficacy against Strongyloides...Background Current soil-transmitted helminth(STH)control guidelines endorse the use of albendazole or meben-dazole for school-based targeted preventive chemotherapy(PC),yet their reduced efficacy against Strongyloides sterc-oralis and Trichuris trichiura presents significant limitations.Emerging evidence indicates that community-wide PC[or mass drug administration(MDA)]using ivermectin,commonly used in other neglected tropical disease(NTD)control programs,may play an important role in controlling these parasites.We conducted a systematic review and meta-analysis to evaluate the effectiveness of ivermectin PC in reducing STH prevalence in endemic populations.Methods We searched Pubmed,EMBASE,and Web of Science on February 14,2023,for studies that investigated the effectiveness of ivermectin PC,either alone or in combination with other anthelmintic drugs,on STH infec-tions,and provided a measure of STH prevalence before and after PC.We calculated pooled prevalence reductions for each STH using random-effects meta-analyses.Our protocol is available on PROSPERO(registration number CRD42023401219).Results A total of 21 were eligible for the systematic review,of which 15 were eligible for meta-analysis.All studies delivered ivermectin through MDA.The pooled prevalence reduction of S.stercoralis following MDA with ivermec-tin alone was 84.49%(95%CI:54.96-94.66)across five studies and 81.37%(95% CI:61.62-90.96)across seven studies with or without albendazole.The prevalence reduction of T.trichiura was 49.93%(95%CI:18.23-69.34)across five studies with ivermectin alone,and 89.40%(95%CI:73.66-95.73)across three studies with the addition of albendazole.There was high heterogeneity for all syntheses(I^(2)>65%).Conclusions This study underscores the key role of ivermectin-based MDA in addressing limitations in current global STH guidelines in terms of limited efficacy against S.stercoralis and T.trichiura.Based on these findings,revising inter-national STH guidelines to include ivermectin is a promising option to progress the 展开更多
BACKGROUND Colorectal cancer is the third most prevalent malignancy globally and ranks second in cancer-related mortality,with the liver being the primary organ of metastasis.Preoperative chemotherapy is widely recomm...BACKGROUND Colorectal cancer is the third most prevalent malignancy globally and ranks second in cancer-related mortality,with the liver being the primary organ of metastasis.Preoperative chemotherapy is widely recommended for initially or potentially resectable colorectal liver metastases(CRLMs).Tumour pathological response serves as the most important and intuitive indicator for assessing the efficacy of chemotherapy.However,the postoperative pathological results reveal that a considerable number of patients exhibit a poor response to preoperative chemotherapy.Body mass index(BMI)is one of the factors affecting the tumori-genesis and progression of colorectal cancer as well as prognosis after various antitumour therapies.Several studies have indicated that overweight and obese patients with metastatic colorectal cancer experience worse prognoses than those with normal weight,particularly when receiving first-line chemotherapy regimens in combination with bevacizumab.AIM To explore the predictive value of BMI regarding the pathologic response following preoperative chemotherapy for CRLMs.METHODS A retrospective analysis was performed in 126 consecutive patients with CRLM who underwent hepatectomy following preoperative chemotherapy at four different hospitals from October 2019 to July 2023.Univariate and multivariate logistic regression models were applied to analyse potential predictors of tumour pathological response.The Kaplan-Meier method with log rank test was used to compare progression-free survival(PFS)between patients with high and low BMI.BMI<24.0 kg/m^(2) was defined as low BMI,and tumour regression grade 1-2 was defined as complete tumour response.RESULTS Low BMI was observed in 74(58.7%)patients and complete tumour response was found in 27(21.4%)patients.The rate of complete tumour response was significantly higher in patients with low BMI(29.7%vs 9.6%,P=0.007).Multivariate analysis revealed that low BMI[odds ratio(OR)=4.56,95%confidence interval(CI):1.42-14.63,P=0.011],targeted therapy with bevaciz展开更多
BACKGROUND Previous reports have focused on muscle mass as a prognostic factor in esophageal cancer.AIM To investigate how preoperative body type influences the prognosis of patients with esophageal squamous cell carc...BACKGROUND Previous reports have focused on muscle mass as a prognostic factor in esophageal cancer.AIM To investigate how preoperative body type influences the prognosis of patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemotherapy(NAC)and surgery.METHODS The subjects were 131 patients with clinical stage Ⅱ/Ⅲ esophageal squamous cell carcinoma who underwent subtotal esophagectomy after NAC.Skeletal muscle mass and quality were calculated based on computed tomography images prior to NAC,and their statistical association with long-term outcomes was examined retrospectively in this case-control study.RESULTS The disease-free survival rates in the low psoas muscle mass index(PMI)group vs the high PMI group were 41.3%vs 58.8%(P=0.036),respectively.In the high intramuscular adipose tissue content(IMAC)group vs the low IMAC group,the disease-free survival rates were 28.5%vs 57.6%(P=0.021),respectively.The overall survival(OS)rates for the low PMI group vs the high PMI group were 41.3%vs 64.5%(P=0.008),respectively,and for the high IMAC group vs the low IMAC group,they were 29.9%vs 61.9%(P=0.024),respectively.Analysis of the OS rate revealed significant differences in patients aged 60 years or older(P=0.018),those with pT3 or above disease(P=0.021),or those with lymph node metastasis(P=0.006),aside from PMI and IMAC.Multivariate analysis demonstrated that pT3 or above hazard ratio(HR):1.966,95%confidence interval(CI):1.089-3.550,(P=0.025),lymph node metastasis(HR:2.154,95%CI:1.118-4.148,P=0.022),low PMI(HR:2.266,95%CI:1.282-4.006,P=0.005),and high IMAC(HR:2.089,95%CI:1.036-4.214,P=0.022)were significant prognostic factors for esophageal squamous cell carcinoma.CONCLUSIONSkeletal muscle mass and quality before NAC in patients with esophageal squamous cellcarcinoma are significant prognostic factors for postoperative OS.展开更多
文摘Background Current soil-transmitted helminth(STH)control guidelines endorse the use of albendazole or meben-dazole for school-based targeted preventive chemotherapy(PC),yet their reduced efficacy against Strongyloides sterc-oralis and Trichuris trichiura presents significant limitations.Emerging evidence indicates that community-wide PC[or mass drug administration(MDA)]using ivermectin,commonly used in other neglected tropical disease(NTD)control programs,may play an important role in controlling these parasites.We conducted a systematic review and meta-analysis to evaluate the effectiveness of ivermectin PC in reducing STH prevalence in endemic populations.Methods We searched Pubmed,EMBASE,and Web of Science on February 14,2023,for studies that investigated the effectiveness of ivermectin PC,either alone or in combination with other anthelmintic drugs,on STH infec-tions,and provided a measure of STH prevalence before and after PC.We calculated pooled prevalence reductions for each STH using random-effects meta-analyses.Our protocol is available on PROSPERO(registration number CRD42023401219).Results A total of 21 were eligible for the systematic review,of which 15 were eligible for meta-analysis.All studies delivered ivermectin through MDA.The pooled prevalence reduction of S.stercoralis following MDA with ivermec-tin alone was 84.49%(95%CI:54.96-94.66)across five studies and 81.37%(95% CI:61.62-90.96)across seven studies with or without albendazole.The prevalence reduction of T.trichiura was 49.93%(95%CI:18.23-69.34)across five studies with ivermectin alone,and 89.40%(95%CI:73.66-95.73)across three studies with the addition of albendazole.There was high heterogeneity for all syntheses(I^(2)>65%).Conclusions This study underscores the key role of ivermectin-based MDA in addressing limitations in current global STH guidelines in terms of limited efficacy against S.stercoralis and T.trichiura.Based on these findings,revising inter-national STH guidelines to include ivermectin is a promising option to progress the
基金National Natural Science Foundation of China,No.82170618.
文摘BACKGROUND Colorectal cancer is the third most prevalent malignancy globally and ranks second in cancer-related mortality,with the liver being the primary organ of metastasis.Preoperative chemotherapy is widely recommended for initially or potentially resectable colorectal liver metastases(CRLMs).Tumour pathological response serves as the most important and intuitive indicator for assessing the efficacy of chemotherapy.However,the postoperative pathological results reveal that a considerable number of patients exhibit a poor response to preoperative chemotherapy.Body mass index(BMI)is one of the factors affecting the tumori-genesis and progression of colorectal cancer as well as prognosis after various antitumour therapies.Several studies have indicated that overweight and obese patients with metastatic colorectal cancer experience worse prognoses than those with normal weight,particularly when receiving first-line chemotherapy regimens in combination with bevacizumab.AIM To explore the predictive value of BMI regarding the pathologic response following preoperative chemotherapy for CRLMs.METHODS A retrospective analysis was performed in 126 consecutive patients with CRLM who underwent hepatectomy following preoperative chemotherapy at four different hospitals from October 2019 to July 2023.Univariate and multivariate logistic regression models were applied to analyse potential predictors of tumour pathological response.The Kaplan-Meier method with log rank test was used to compare progression-free survival(PFS)between patients with high and low BMI.BMI<24.0 kg/m^(2) was defined as low BMI,and tumour regression grade 1-2 was defined as complete tumour response.RESULTS Low BMI was observed in 74(58.7%)patients and complete tumour response was found in 27(21.4%)patients.The rate of complete tumour response was significantly higher in patients with low BMI(29.7%vs 9.6%,P=0.007).Multivariate analysis revealed that low BMI[odds ratio(OR)=4.56,95%confidence interval(CI):1.42-14.63,P=0.011],targeted therapy with bevaciz
文摘BACKGROUND Previous reports have focused on muscle mass as a prognostic factor in esophageal cancer.AIM To investigate how preoperative body type influences the prognosis of patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemotherapy(NAC)and surgery.METHODS The subjects were 131 patients with clinical stage Ⅱ/Ⅲ esophageal squamous cell carcinoma who underwent subtotal esophagectomy after NAC.Skeletal muscle mass and quality were calculated based on computed tomography images prior to NAC,and their statistical association with long-term outcomes was examined retrospectively in this case-control study.RESULTS The disease-free survival rates in the low psoas muscle mass index(PMI)group vs the high PMI group were 41.3%vs 58.8%(P=0.036),respectively.In the high intramuscular adipose tissue content(IMAC)group vs the low IMAC group,the disease-free survival rates were 28.5%vs 57.6%(P=0.021),respectively.The overall survival(OS)rates for the low PMI group vs the high PMI group were 41.3%vs 64.5%(P=0.008),respectively,and for the high IMAC group vs the low IMAC group,they were 29.9%vs 61.9%(P=0.024),respectively.Analysis of the OS rate revealed significant differences in patients aged 60 years or older(P=0.018),those with pT3 or above disease(P=0.021),or those with lymph node metastasis(P=0.006),aside from PMI and IMAC.Multivariate analysis demonstrated that pT3 or above hazard ratio(HR):1.966,95%confidence interval(CI):1.089-3.550,(P=0.025),lymph node metastasis(HR:2.154,95%CI:1.118-4.148,P=0.022),low PMI(HR:2.266,95%CI:1.282-4.006,P=0.005),and high IMAC(HR:2.089,95%CI:1.036-4.214,P=0.022)were significant prognostic factors for esophageal squamous cell carcinoma.CONCLUSIONSkeletal muscle mass and quality before NAC in patients with esophageal squamous cellcarcinoma are significant prognostic factors for postoperative OS.
