Background: Hip joint diseases are common in adult population and their prevalence increases with age. Osteoarthritis, rheumatoid arthritis and femoroacetabular impingement are the most common chronic diseases in the hip joint. Viscosupplementation with exogenous hyaluronic acid (HA) is one of the most widely used conservative treatment aiming to improve synovial fluid properties and to decrease pain. There is no global consensus on the type of HA, method of injection and frequency, or on its efficacy in hip joint. Methods: We selected published data in English in the PubMed and Google Scholar electronic databases up to March 2016 about hyaluronic acid injections in hip disorders. Results: 26 articles were included following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Conclusion:There is a lack of standardization of HA injections for hip conditions. Our results suggest that this is the best conservative therapy before surgery and it can act on pain relief and function however there is no evidence to prove its ability to modify the morphological structure of the pathological hip and the natural history of the disease. There are few data about the use of HA in other hip disorders rather than osteoarthritis. The most relevant evidence seems to show the utility of HA injections in improving synovial inflammation, but only a few studies have been conducted. Level of evidence: I.
Background Blastocystis hominis is a unicellular protozoan parasite with a worldwide distribution. It was hypothesized that the infection with B. hominis plays a role in the pathogenesis of colorectal cancer in humans. Objective We aimed to test this hypothesis in a 1-year study using patients from Saudi Arabia with colorectal cancer. Subjects and Methods Colorectal cancer patients with various stages were enrolled in the study as cases (n = 75) along with a noncolorectal cancer patients as controls (n = 25). All participants in the study were subjected to history taking and investigated for B. hominis infection by microscopy and molecular-based tests applied to their fecal samples. Also, the tumor necrosis factor α in serum collected from both patients and controls was calculated in our study. Results The B. hominis were identified more in cases (20/75; 26.6%) than in controls (2/25; 8%), with significant difference (P < 0.05). Marked inflammatory cells infiltrate and mucin contents were demonstrated more in colorectal cancer patients infected with B. hominis, particularly those with stage 3 and stage 4 cancers. In patients with stage 4 colorectal cancer, there was a significantly higher level of mucin content and serum level of tumor necrosis factor α compared with colorectal cancer patients with less advanced stages (P < 0.05). In colorectal cancer cases, a statistically significant higher serum level of tumor necrosis factor α was observed compared with the controls (P < 0.05). Conclusions The findings of our study support the hypothesis that the infection with B. hominis has a possible role in the pathogenesis of colorectal cancer because it increases inflammatory cells infiltration and proinflammatory cytokines (tumor necrosis factor α) in the study's setting. This possibility demands future cohort prospective studies to prove whether the infection induces the colonic tissue to form a tumor or exacerbates the existing tumor. After this, we suggest that the study's population be screened for B. hominis, especially those suffering from colorectal cancers.
Introduction and objectives PD-L1 and B7-H3 have been found to be overexpressed in urothelial carcinoma (UC) of the urinary bladder. Recent studies have also demonstrated that B7-H3 and PD-L1 can promote resistance to platinum-based drugs but the predictive value of B7-H3 expression in patients treated with platinum-based chemotherapy is unknown. This study aims to investigate the association of PD-L1 and B7-H3 tumor expression with oncological outcomes in patients who underwent radical cystectomy (RC) and received subsequent adjuvant chemotherapy. Materials and methods Immunohistochemistry was performed on paraffin-embedded sections from bladder and lymph node specimens of 81 patients who had RC for bladder cancer. PD-L1 and B7-H3 expression on tumor cells was assessed by immunohistochemistry in both primary tumors and lymph node specimens. Association with clinicopathologic outcomes was determined using Fisher's exact test and postoperative survival using Kaplan–Meier survival curves and Cox regression model. Results B7-H3 expression in cystectomy specimens was more common than PD-L1 expression (72.8% vs. 35.8%). For both markers, no association was found with pathologic tumor stage, lymph node (LN) status, and histological subtype. Similar findings were observed for double-positive tumors (PD-L1+B7-H3+). Concordance between the primary tumor and patient-matched lymph nodes was found in 76.2% and 54.1% of patients for PD-L1 and B7-H3, respectively. PD-L1 tumor expression was not associated with oncologic outcomes. However, B7-H3 expression was associated with recurrence-free survival (HR: 2.38, 95% CI 1.06–5.31, p = 0.035) and cancer-specific survival (HR: 2.67, 95% CI 1.18–6.04, p = 0.019). Conclusions In our single institutional study, B7-H3 is highly expressed in patients with UC treated with adjuvant chemotherapy and it was associated with decreased recurrence-free survival and cancer-specific survival. Pending further validation in larger cohorts, B7-H3 expression may function as a predictor of response to adjuvant chemotherapy and thus be useful in patient and regimen selection.
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