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  1. Article ; Online: Stereotactic Radiosurgery vs Conventional Radiotherapy for Spine Metastases.

    Yan, Michael / Moraes, Fabio Ynoe

    JAMA oncology

    2023  Volume 10, Issue 2, Page(s) 258–259

    MeSH term(s) Humans ; Radiosurgery ; Spinal Neoplasms/pathology ; Brain Neoplasms/secondary
    Language English
    Publishing date 2023-12-21
    Publishing country United States
    Document type Journal Article
    ISSN 2374-2445
    ISSN (online) 2374-2445
    DOI 10.1001/jamaoncol.2023.6060
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Post-COVID-19 Syndrome Comprehensive Assessment: From Clinical Diagnosis to Imaging and Biochemical-Guided Diagnosis and Management.

    Yan, Michael Zhipeng / Yang, Ming / Lai, Ching-Lung

    Viruses

    2023  Volume 15, Issue 2

    Abstract: The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. The majority of the COVID-19 patients survived and developed Post-COVID-19 Syndrome (PC19S) of varying severity. Currently, the diagnosis of PC19S is achieved ... ...

    Abstract The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. The majority of the COVID-19 patients survived and developed Post-COVID-19 Syndrome (PC19S) of varying severity. Currently, the diagnosis of PC19S is achieved through history and symptomatology that cannot be explained by an alternative diagnosis. However, the heavy reliance on subjective reporting is prone to reporting errors. Besides, there is no unified diagnostic assessment tool to classify the clinical severity of patients. This leads to significant difficulties when managing patients in terms of public resource utilization, clinical progression monitorization and rehabilitation plan formulation. This narrative review aims to review current evidence of diagnosis based on triple assessment: clinical symptomatology, biochemical analysis and imaging evidence. Further assessment tools can be developed based on triple assessment to monitor patient's clinical progression, prognosis and intervals of monitoring. It also highlights the high-risk features of patients for closer and earlier monitoring. Rehabilitation programs and related clinical trials are evaluated; however, most of them focus on cardiorespiratory fitness and psychiatric presentations such as anxiety and depression. Further research is required to establish an objective and comprehensive assessment tool to facilitate clinical management and rehabilitation plans.
    MeSH term(s) Humans ; Post-Acute COVID-19 Syndrome ; COVID-19/diagnosis ; Disease Outbreaks ; Disease Progression ; COVID-19 Testing
    Language English
    Publishing date 2023-02-14
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2516098-9
    ISSN 1999-4915 ; 1999-4915
    ISSN (online) 1999-4915
    ISSN 1999-4915
    DOI 10.3390/v15020533
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: ChatGPT and medicine: how AI language models are shaping the future and health related careers.

    Yan, Michael / Cerri, Giovanni G / Moraes, Fabio Y

    Nature biotechnology

    2023  Volume 41, Issue 11, Page(s) 1657–1658

    Language English
    Publishing date 2023-10-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1311932-1
    ISSN 1546-1696 ; 1087-0156
    ISSN (online) 1546-1696
    ISSN 1087-0156
    DOI 10.1038/s41587-023-02011-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Sequelae of COVID-19 among previously hospitalized patients up to 1 year after discharge: a systematic review and meta-analysis.

    Yang, Tianqi / Yan, Michael Zhipeng / Li, Xingyi / Lau, Eric H Y

    Infection

    2022  Volume 50, Issue 5, Page(s) 1067–1109

    Abstract: Objective: Although complications and clinical symptoms of COVID-19 have been elucidated, the prevalence of long-term sequelae of COVID-19 is less clear in previously hospitalized COVID-19 patients. This review and meta-analysis present the occurrence ... ...

    Abstract Objective: Although complications and clinical symptoms of COVID-19 have been elucidated, the prevalence of long-term sequelae of COVID-19 is less clear in previously hospitalized COVID-19 patients. This review and meta-analysis present the occurrence of different symptoms up to 1 year of follow-up for previously hospitalized patients.
    Methods: We performed a systematic review from PubMed and Web of Science using keywords such as "COVID-19", "SARS-CoV-2", "sequelae", "long-term effect" and included studies with at least 3-month of follow-up. Meta-analyses using random-effects models were performed to estimate the pooled prevalence for different sequelae. Subgroup analyses were conducted by different follow-up time, regions, age and ICU admission.
    Results: 72 articles were included in the meta-analyses after screening 11,620 articles, identifying a total of 167 sequelae related to COVID-19 from 88,769 patients. Commonly reported sequelae included fatigue (27.5%, 95% CI 22.4-33.3%, range 1.5-84.9%), somnipathy (20.1%, 95% CI 14.7-26.9%, range 1.2-64.8%), anxiety (18.0%, 95% CI 13.8-23.1%, range 0.6-47.8%), dyspnea (15.5%, 95% CI 11.3-20.9%, range 0.8-58.4%), PTSD (14.6%, 95% CI 11.3-18.7%, range 1.2-32.0%), hypomnesia (13.4%, 95% CI 8.4-20.7%, range 0.6-53.8%), arthralgia (12.9%, 95% CI 8.4-19.2%, range 0.0-47.8%), depression (12.7%, 95% CI 9.3-17.2%, range 0.6-37.5%), alopecia (11.2%, 95% CI 6.9-17.6%, range 0.0-47.0%) over 3-13.2 months of follow-up. The prevalence of most symptoms reduced after > 9 months of follow-up, but fatigue and somnipathy persisted in 26.2% and 15.1%, respectively, of the patients over a year. COVID-19 patients from Asia reported a lower prevalence than those from other regions.
    Conclusions: This review identified a wide spectrum of COVID-19 sequelae in previously hospitalized COVID-19 patients, with some symptoms persisting up to 1 year. Management and rehabilitation strategies targeting these symptoms may improve quality of life of recovered patients.
    MeSH term(s) COVID-19/epidemiology ; Fatigue/epidemiology ; Humans ; Patient Discharge ; Quality of Life ; SARS-CoV-2
    Language English
    Publishing date 2022-06-24
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 185104-4
    ISSN 1439-0973 ; 0300-8126 ; 0173-2129
    ISSN (online) 1439-0973
    ISSN 0300-8126 ; 0173-2129
    DOI 10.1007/s15010-022-01862-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Meta-Analysis of STereotactic body radiothERapy in non-spine BONE metastaseS (MASTER-BONES).

    Moraes, Fabio Ynoe / Gouveia, Andre Guimaraes / Marta, Gustavo Nader / da Silva, Mauricio Fraga / Hamamura, Ana Carolina / Tsakiridis, Theodoros / Yan, Michael / Viani, Gustavo Arruda

    International journal of radiation oncology, biology, physics

    2024  

    Abstract: Purpose: The efficacy and safety of stereotactic body radiation (SBRT) for patients with non-spine bone metastases (NSBM) remains in question. A systematic review and meta-analysis was performed to evaluate SBRT treatment outcomes in NSBM.: Methods ... ...

    Abstract Purpose: The efficacy and safety of stereotactic body radiation (SBRT) for patients with non-spine bone metastases (NSBM) remains in question. A systematic review and meta-analysis was performed to evaluate SBRT treatment outcomes in NSBM.
    Methods and materials: Eligible studies were retrieved from Medline, Embase, Scielo, the Cochrane Library, and annual meeting proceedings until July 6, 2023. We adhered to the PRISMA and MOOSE guideline recommendations. Quantitative synthesis was performed using a random effects model.
    Results: Seven retrospective studies, with a total of 807 patients (1048 lesions) treated with stereotactic body radiation were included, with median follow-up ranging from 7.6-26.5 months. The most common stereotactic body radiation sites were pelvis (39.2%), ribs (25.8%), femur (16.7%), and humerus/shoulder region (8.7%). At 1-year, the LF and FR were 7% (95%CI 5.5-8.5%; I2=0, n= 75/1048), and 5.3% (95%CI 3-7.5%;I2=0, n= 65/1010). The 2-year cumulative LF incidence was 12.1% (95% CI: 10-15.5%). The OS and PFS at 1-year were 82% (95%CI 75-88%;I2=82%, n= 746/867), and 33.5%(95%CI 26-41%;I2=0%, n= 51/152), with a median of 20.2 months (95%CI: 10.9-49.1 months) and 8.3 months (95% CI: 6.3-10.3%) for OS and PFS, respectively. Meta-regression analysis revealed a significant relationship between planning target volume and fracture rate (p<0.05). Ribs 2.5% followed by the femur 1.9% (95%CI:0-6.1%) were the most common fracture sites. The occurrence of pain flare, fatigue and dermatitis were 7 %, 5.4 %, and 0.65 %, respectively.
    Conclusions: Stereotactic body radiation proves both safety and efficacy for non-spine bone metastases and serious complications (grade 3) are infrequent. Careful consideration of target volume is crucial due to its link with a higher fracture risk.
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2023.12.045
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: COVID-19’s impact on interest in gastrointestinal topics

    Yan, Michael B. / Pakhchanian, Haig / Raiker, Rahul / Boustany, Osama / Khan, Ahmad / Singh, Shailendra

    Environ Sci Pollut Res. 2022 Nov., v. 29, no. 52 p.79041-79052

    2022  

    Abstract: There has been a disparity in familiarity regarding the public interest in gastroenterology terminologies during the COVID-19 pandemic. This study aimed to understand the outcomes of the public’s view on gastrointestinal topics and their potential social ...

    Abstract There has been a disparity in familiarity regarding the public interest in gastroenterology terminologies during the COVID-19 pandemic. This study aimed to understand the outcomes of the public’s view on gastrointestinal topics and their potential social effects. This study is a comparative analysis of American Google Trends gastrointestinal terminology during the COVID-19 pandemic compared to a similar time frame (March 2018-February 2020) to determine how trends in the patient-seeking behavior of gastrointestinal terminology changed throughout the pandemic. The analysis discovered a substantial decrease in search volumes of gastrointestinal topics, more significantly in the first pandemic months. Later in the pandemic, search volumes trended toward pre-pandemic years in terms of public interest. In the case of gastrointestinal procedures, endoscopy and colonoscopies, they surpassed pre-pandemic interest levels statistically (p-values of 0.01 and 0.002). The public’s decreased interest in gastrointestinal topics at the beginning of the COVID-19 pandemic may have adverse effects on the healthcare maintenance of patients who could have had a positive outcome in their gastrointestinal health with proper monitoring. Although gastrointestinal internet searches increased toward pre-pandemic levels as the seasons progressed, further research is needed to determine the social impact of decreased public interest.
    Keywords COVID-19 infection ; Internet ; endoscopy ; gastrointestinal system ; health services ; pandemic ; social impact ; terminology
    Language English
    Dates of publication 2022-11
    Size p. 79041-79052.
    Publishing place Springer Berlin Heidelberg
    Document type Article ; Online
    ZDB-ID 1178791-0
    ISSN 1614-7499 ; 0944-1344
    ISSN (online) 1614-7499
    ISSN 0944-1344
    DOI 10.1007/s11356-022-21173-2
    Database NAL-Catalogue (AGRICOLA)

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  7. Article ; Online: Systematic Review of Modern Case Series of Squamous Cell Cancer Arising in a Chronic Ulcer (Marjolin's Ulcer) of the Skin.

    Abdi, Mohamed A / Yan, Michael / Hanna, Timothy P

    JCO global oncology

    2020  Volume 6, Page(s) 809–818

    Abstract: Purpose: Marjolin's ulcer is an aggressive cutaneous malignancy that arises in chronic nonhealing wounds. A review of modern series describing Marjolin's ulcer would be helpful in defining optimal management strategies and expected outcomes.: Methods!# ...

    Abstract Purpose: Marjolin's ulcer is an aggressive cutaneous malignancy that arises in chronic nonhealing wounds. A review of modern series describing Marjolin's ulcer would be helpful in defining optimal management strategies and expected outcomes.
    Methods: A systematic review was performed on October 18, 2018, by querying Medline and EMBASE. Key inclusion criteria were as follows: human studies, English language, published in 2000 or later, > 10 patients, and at least 80% of the patients having squamous cell carcinoma (SCC) histology.
    Results: There were 599 patients in 14 case series from 10 countries; 82% of patients were from low-income and middle-income countries, and 48% were women. Overall, 65% of the ulcers were preceded by burns. Mean latency ranged from 11 years to 41 years (median, 28 years). Lower extremities were the most common site (62%). Differentiation was reported as well differentiated (64%), moderately differentiated (27%), or poorly differentiated (9%). Almost one third of cases were clinically node positive, though only 7% of all cases (24 of 334) were confirmed to be pathologically involved. Distant metastasis rates were reported in only 7 series, with median rate of 5% (range, 0%-27%). The main treatment modality was surgical excision (71%), followed by amputation (24%), primary radiotherapy (2%), and chemotherapy (< 1%). Outcomes data varied in content and quality. Mortality rates were 12%, 24%, and 37% in the three series reporting between 2 and 3 years of follow-up.
    Conclusion: Marjolin's ulcer with SCC histology is an aggressive cancer with a notable potential for lymph node metastasis and distant metastasis. Comprehensive staging is recommended, with management optimally having a multidisciplinary context. Low- and middle-income countries are overrepresented in reports of Marjolin's ulcer, and there may be opportunities for prevention and early detection.
    MeSH term(s) Burns ; Carcinoma, Squamous Cell/therapy ; Female ; Humans ; Skin Neoplasms ; Skin Ulcer/etiology ; Ulcer
    Language English
    Publishing date 2020-06-12
    Publishing country United States
    Document type Journal Article ; Systematic Review
    ISSN 2687-8941
    ISSN (online) 2687-8941
    DOI 10.1200/GO.20.00094
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: COVID-19's impact on interest in gastrointestinal topics.

    Yan, Michael B / Pakhchanian, Haig / Raiker, Rahul / Boustany, Osama / Khan, Ahmad / Singh, Shailendra

    Environmental science and pollution research international

    2022  Volume 29, Issue 52, Page(s) 79041–79052

    Abstract: There has been a disparity in familiarity regarding the public interest in gastroenterology terminologies during the COVID-19 pandemic. This study aimed to understand the outcomes of the public's view on gastrointestinal topics and their potential social ...

    Abstract There has been a disparity in familiarity regarding the public interest in gastroenterology terminologies during the COVID-19 pandemic. This study aimed to understand the outcomes of the public's view on gastrointestinal topics and their potential social effects. This study is a comparative analysis of American Google Trends gastrointestinal terminology during the COVID-19 pandemic compared to a similar time frame (March 2018-February 2020) to determine how trends in the patient-seeking behavior of gastrointestinal terminology changed throughout the pandemic. The analysis discovered a substantial decrease in search volumes of gastrointestinal topics, more significantly in the first pandemic months. Later in the pandemic, search volumes trended toward pre-pandemic years in terms of public interest. In the case of gastrointestinal procedures, endoscopy and colonoscopies, they surpassed pre-pandemic interest levels statistically (p-values of 0.01 and 0.002). The public's decreased interest in gastrointestinal topics at the beginning of the COVID-19 pandemic may have adverse effects on the healthcare maintenance of patients who could have had a positive outcome in their gastrointestinal health with proper monitoring. Although gastrointestinal internet searches increased toward pre-pandemic levels as the seasons progressed, further research is needed to determine the social impact of decreased public interest.
    MeSH term(s) Humans ; United States ; Pandemics ; COVID-19
    Language English
    Publishing date 2022-06-15
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1178791-0
    ISSN 1614-7499 ; 0944-1344
    ISSN (online) 1614-7499
    ISSN 0944-1344
    DOI 10.1007/s11356-022-21173-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Stereotactic body radiotherapy versus surgery for early-stage non-small cell lung cancer: an updated meta-analysis involving 29,511 patients included in comparative studies.

    Viani, Gustavo Arruda / Gouveia, André Guimarães / Yan, Michael / Matsuura, Fernando Konjo / Moraes, Fabio Ynoe

    Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia

    2022  Volume 48, Issue 3, Page(s) e20210390

    Abstract: Objective: To evaluate the efficacy of stereotactic body radiotherapy (SBRT) versus surgery for early-stage non-small cell lung cancer (NSCLC) by means of a meta-analysis of comparative studies.: Methods: Following the Preferred Reporting Items for ... ...

    Abstract Objective: To evaluate the efficacy of stereotactic body radiotherapy (SBRT) versus surgery for early-stage non-small cell lung cancer (NSCLC) by means of a meta-analysis of comparative studies.
    Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines, searches were performed on PubMed, MEDLINE, Embase, and Cochrane Library for eligible studies. The meta-analysis compared the hazard ratios (HR) for overall survival (OS), cancer-specific survival (CSS), and local control (LC). Subgroup and meta-regression analyses evaluated the association of extent of surgical resection, study publication year, tumor staging, propensity score matching, proportion of chemotherapy use, and proportion of pathological lymph node involvement with CSS and OS.
    Results: Thirty studies involving 29,511 patients were included (surgery group: 17,146 patients and SBRT group: 12,365 patients). There was a significant difference in favor of surgery vs. SBRT in the 3-year OS (HR = 1.35; 95% CI: 1.22-1.44; I2 = 66%) and 3-year CSS (HR = 1.23; 95% CI: 1.09-1.37; I2 = 17%), but not in the 3-year LC (HR = 0.97; 95% CI: 0.93-1.08; I2 = 19%). In the subgroup analysis for OS, no significant difference between surgery and SBRT groups was observed in the T1N0M0 subgroup (HR = 1.26; 95% CI: 0.95-1.68; I2 = 0%). In subgroup analysis for CSS, no significant difference was detected between the sublobar resection subgroup and the SBRT group (HR = 1.21; 95% CI: 0.96-1.53; I2 = 16%).
    Conclusions: Surgery generally resulted in better 3-year OS and CSS than did SBRT; however, publication bias and heterogeneity may have influenced these findings. In contrast, SBRT produced LC results similar to those of surgery regardless of the extent of surgical resection. These findings may have important clinical implications for patients with comorbidities, advanced age, poor pulmonary reserve, and other factors that may contraindicate surgery.
    MeSH term(s) Carcinoma, Non-Small-Cell Lung/radiotherapy ; Carcinoma, Non-Small-Cell Lung/surgery ; Humans ; Lung Neoplasms/radiotherapy ; Lung Neoplasms/surgery ; Neoplasm Staging ; Propensity Score ; Radiosurgery/methods
    Language Portuguese
    Publishing date 2022-04-29
    Publishing country Brazil
    Document type Journal Article ; Meta-Analysis
    ZDB-ID 2223157-2
    ISSN 1806-3756 ; 1806-3713
    ISSN (online) 1806-3756
    ISSN 1806-3713
    DOI 10.36416/1806-3756/e20210390
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Adjuvant Radiotherapy for Upper Tract Urothelial Carcinoma: Systematic Review and Meta-Analysis.

    Zalay, Osbert / Yan, Michael / Sigurdson, Samantha / Malone, Shawn / Vera-Badillo, Francisco Emilio / Mahmud, Aamer

    Current oncology (Toronto, Ont.)

    2022  Volume 30, Issue 1, Page(s) 19–36

    Abstract: Purpose: Upper tract urothelial carcinoma (UTUC) is a rare form of malignancy comprising only 5% of urothelial cancers. The mainstay of treatment is radical nephroureterectomy (RNU) with bladder cuff excision. Neoadjuvant or adjuvant chemotherapy is ... ...

    Abstract Purpose: Upper tract urothelial carcinoma (UTUC) is a rare form of malignancy comprising only 5% of urothelial cancers. The mainstay of treatment is radical nephroureterectomy (RNU) with bladder cuff excision. Neoadjuvant or adjuvant chemotherapy is often used in locally advanced disease. The role of adjuvant radiotherapy (RT), however, remains controversial. To further explore the potential role of adjuvant RT, we performed a systematic review and meta-analysis of the literature from 1990 to present.
    Methods and materials: We identified 810 candidate articles from database searches, of which 67 studies underwent full-text review, with final inclusion of 20 eligible studies. Among the included studies, there were no randomized controlled trials and a single prospective trial, with the remainder being retrospective series. We performed quantitative synthesis of the results by calculating the pooled odds ratios (OR) for the primary outcome of locoregional recurrence (LRR) and secondary outcomes of overall survival (OS), cancer-specific survival (CSS) and distant recurrence (DR).
    Results: Adjuvant RT, which was mostly prescribed for locally advanced or margin-positive disease following RNU, significantly reduced locoregional recurrence risk OR 0.43 (95% CI: 0.23-0.70), and the effect remained significant even following subgroup analysis to account for adjuvant systemic therapy. The effect of adjuvant RT on 3-year OS, 5-year CSS and DR was non-significant. However, 5-year OS was unfavourable in the adjuvant RT arm, but study heterogeneity was high, and analysis of small-study effects and subgroups suggested bias in reporting of outcomes.
    Conclusions: Adjuvant RT in the setting of locally advanced UTUC improves locoregional control following definitive surgery, but does not appear to improve OS. Higher-quality studies, ideally randomized controlled trials, are needed to further quantify its benefit in this setting, and to explore multi-modal treatments that include systemic agents given concomitantly or sequentially with RT, which may offer an OS benefit in addition to the locoregional control benefit of RT.
    MeSH term(s) Humans ; Carcinoma, Transitional Cell/radiotherapy ; Carcinoma, Transitional Cell/surgery ; Carcinoma, Transitional Cell/drug therapy ; Urinary Bladder Neoplasms ; Radiotherapy, Adjuvant ; Retrospective Studies ; Prospective Studies ; Neoplasm Recurrence, Local
    Language English
    Publishing date 2022-12-20
    Publishing country Switzerland
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Review
    ZDB-ID 1236972-x
    ISSN 1718-7729 ; 1198-0052
    ISSN (online) 1718-7729
    ISSN 1198-0052
    DOI 10.3390/curroncol30010002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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