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Zeitschriftenartikel zum Thema "914.445 95"
1
Bowe, Benjamin, Yan Xie, Tingting Li, Yan Yan, Hong Xian und Ziyad Al-Aly. „Estimates of the 2016 global burden of kidney disease attributable to ambient fine particulate matter air pollution“. BMJ Open 9, Nr. 5 (Mai 2019): e022450. http://dx.doi.org/10.1136/bmjopen-2018-022450.
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ObjectiveTo quantitate the 2016 global and national burden of chronic kidney disease (CKD) attributable to ambient fine particulate matter air pollution ≤ 2.5 μm in aerodynamic diameter (PM2.5).DesignWe used the Global Burden of Disease (GBD) study data and methodologies to estimate the 2016 burden of CKD attributable to PM2.5in 194 countries and territories. Population-weighted PM2.5levels and incident rates of CKD for each country were curated from the GBD study publicly available data sources.SettingGBD global and national data on PM2.5and CKD.Participants194 countries and territories.Main outcome measuresWe estimated the attributable burden of disease (ABD), years living with disability (YLD), years of life lost (YLL) and disability-adjusted life-years (DALYs).ResultsThe 2016 global burden of incident CKD attributable to PM2.5was 6 950 514 (95% uncertainty interval: 5 061 533–8 914 745). Global YLD, YLL and DALYs of CKD attributable to PM2.5were 2 849 311 (1 875 219–3 983 941), 8 587 735 (6 355 784–10 772 239) and 11 445 397 (8 380 246–14 554 091), respectively. Age-standardised ABD, YLL, YLD and DALY rates varied substantially among geographies. Populations in Mesoamerica, Northern Africa, several countries in the Eastern Mediterranean region, Afghanistan, Pakistan, India and several countries in Southeast Asia were among those with highest age-standardised DALY rates. For example, age-standardised DALYs per 100 000 were 543.35 (391.16–707.96) in El Salvador, 455.29 (332.51–577.97) in Mexico, 408.41 (283.82–551.84) in Guatemala, 238.25 (173.90–303.98) in India and 178.26 (125.31–238.47) in Sri Lanka, compared with 5.52 (0.82–11.48) in Sweden, 6.46 (0.00–14.49) in Australia and 12.13 (4.95–21.82) in Canada. Frontier analyses showed that Mesoamerican countries had significantly higher CKD DALY rates relative to other countries with comparable sociodemographic development.ConclusionsOur results demonstrate that the global toll of CKD attributable to ambient air pollution is significant and identify several endemic geographies where air pollution may be a significant driver of CKD burden. Air pollution may need to be considered in the discussion of the global epidemiology of CKD.
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Kotapati, Sravanthi, Insija Ilyas Selene, Madeeha Shafqat, Syeda Fatima Hassan, Zunairah Shah, Arshia Akbar, Owais ur Rehman et al. „Efficacy and Toxicity of Lenalidomide for Treatment of Chronic Lymphocytic Leukemia: A Systematic Review and Meta-Analysis“. Blood 134, Supplement_1 (13.11.2019): 5488. http://dx.doi.org/10.1182/blood-2019-129733.
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Background: During last decade, several therapeutic options have emerged for newly diagnosed (ND) or relapsed / refractory (RR) patients with chronic lymphocytic leukemia (CLL). Lenalidomide (Lena) has immunomodulatory, anti-angiogenic and antitumor activity. Lena is showing antitumor activity against CLL with durable responses.The main aim of our analysis is to study the published literature on the efficacy and safety of Lena based regimens in patients with ND and RR CLL. Methods: We performed the literature search (10/5/2019) using following databases (PubMed, Embase, Cochrane Library, Web of Science, and Clinical trials.gov) identified a total of 4835 articles. Following PRISMA guidelines, we selected twenty articles (Phase I/II/III) with a total of 1309 patients (pts) in which eleven articles (n= 914) were about ND CLL pts and nine articles (n=396) had pts with RR CLL. CMA software v.3 was used for meta-analysis. Results: Lenalidomide based regimens in previously untreated CLL Based on the pooled analysis,(table 1)(an overall response rate (ORR) of 59.9% (95% CI: 55.4-64.2) with complete response (CR) of 17.6% (95% CI: 8.9-31.8) is observed in previously untreated CLL and ORR of 57.6% (95% CI: 50.4-64.4) with a CR of 12.9% (95% CI: 7.7-20.8) in RR CLL were calculated. Most common grade (G) ≥3 adverse events (AE's) based on regimen were calculated using pooled analysis in CLL pts and results are given intable2. Lena in single drug regimen: Three studies (n=445) evaluated the efficacy of Lena as single agent (5mg-25mg). Subgroup pooled analysis showed an ORR of 56.4% (95% CI: 51.6-61) with CR of 7.3% (95% CI: 4.4-11.3). Pooled analysis for safety profile on most common G ≥3 AE's were neutropenia 72.2% (95% CI: 45.1-89.2), thrombocytopenia (tcp) 29.7% (95% CI: 9.1-64), anemia 0.8% (95% CI: 0.1-11.1), fatigue 3% (95% CI: 1.5-5.8) and infections 5% (95% CI: 1.22-18.7). Lena in two drug regimen: One study (n=69) evaluated the efficacy of Lenaas double regimen with ofatumumab. Sub-group pooled analysis showed an ORR of 88% (95% CI: 78-93.8) with CR of 16% (95% CI: 9.1-26.6). Best response was seen when Lena was used with Ofatumumab, with reported ORR of 71%. Pooled analysis for safety profile on most common G ≥3 AE's were neutropenia 58% (95% CI: 46.1-69), anemia 10% (95% CI: 4.8-19.6), tcp 3% (95% CI: 0.8-11) and fatigue 6% (95% CI: 2.3-14.7). Lena in three drug regimen: For six studies (n=375), a pooled analysis on Lena as three drug regimen calculated an ORR of 59.2% (95% CI: 45.2-86) with CR of 24.1% (95% CI: 18.5-30.7). Pooled analysis for safety profile on most common G ≥3 AE's were neutropenia 55% (95% CI: 28.4-79.1), tcp 17.6% (95% CI: 6.1-41.3), anemia 13.9% (95% CI: 4.2-37.5), fatigue 29.1% (95% CI: 0.8-95.6) and infection 10.4% (95% CI: 5.6-18.5). Lena in four drug combination regimen: One study (n=25) evaluated Lena in quadruple regimen (Lena, rituximab, cyclophosphamide and fludarbine) with ORR of 98.1% (95% CI: 75.6-99.9) with CR 75% (95% CI: 54.8-88.1). Pooled analysis for common AE's were neutropenia of 51.6% (95% CI: 37.7-70), tcp of 1.6% (95% CI: 0.1-27), anemia of 1.6% (95% CI: 0-27) and infections of 3% (95% CI: 0.3-23.5) Lena based regimens in Relapsed or Refractory (RR) CLL Nine studies ( n=396)(table 1) evaluated the efficacy of Lena in RR CLL and have given promising results in these pts. Three studies (n=209) evaluated the efficacy of Lena as single agent, pooled analysis (95% CI) on Lena as mono measured an ORR of 32.7% (95% CI: 15.1-57)(fig. 1) with CR of 8.8% (95% CI: 3.1-22.8). Similarly subgroup pooled analysis for double regimen which includes four studies (n=139) measured ORR of 63.2% (95% CI: 54.4- 71.3) with CR of 14% (95% CI: 5.7-30.4). Two studies (n=56) evaluated Lena as triple regimen, an ORR of 52.5% (95% CI: 39.5-65.2) with CR of 21% (95% CI: 10.4-37.8) was calculated. Pooled analysis (95% CI) common G ≥3 AE's are neutropenia 69.9% (62.8-76.2), tcp 26.5% (18.4-36.5), anemia 9.4% (6.4-13.5), infections 29.4% (10.7-59) and fatigue 14.6% (6.2-30.6)(table 2) Conclusion: Lenalidomide is highly efficacious when used for treatment of previously untreated or RR CLL. Regimen efficacy is greater in untreated CLL compared to RR CLL. Four drug Lena based combination regimen showed the best result with an ORR of 98.1% (95%CI: 75.6-99.9). Large prospective studies are required to evaluate efficacy and safety of Lena in newer combination regimens. Disclosures Anwer: In-Cyte: Speakers Bureau; Seattle Genetics: Membership on an entity's Board of Directors or advisory committees.
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Christensen, S. „Removal of haem from lipids extracted from intact erythrocytes with particular reference to polyphosphoinositides“. Biochemical Journal 233, Nr. 3 (01.02.1986): 921–24. http://dx.doi.org/10.1042/bj2330921.
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With the use of a modified acid version of a current lipid-extraction technique [Bligh & Dyer (1959) Can. J. Biochem. Physiol. 37, 911-917], 92% of phosphatidylinositol 4,5-bisphosphate obtained by means of three sequential extractions from intact human erythrocytes was obtained during the first one. Some 95% of the haem co-extracted with the lipids could then be removed, with a maximal loss of polyphosphoinositides of less than 3%. About 58 nmol of phosphatidylinositol 4,5-bisphosphate was found per ml of erythrocytes.
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Bradbury, Charlotte A., Zoe Craig, Gordon Cook, Charlotte Pawlyn, David A. Cairns, Anna Hockaday, Andrea Paterson et al. „Thrombosis in patients with myeloma treated in the Myeloma IX and Myeloma XI phase 3 randomized controlled trials“. Blood 136, Nr. 9 (27.08.2020): 1091–104. http://dx.doi.org/10.1182/blood.2020005125.
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Abstract Newly diagnosed multiple myeloma (NDMM) patients treated with immunomodulatory drugs are at high risk of venous thromboembolism (VTE), but data are lacking from large prospective cohorts. We present thrombosis outcome data from Myeloma IX (n = 1936) and Myeloma XI (n = 4358) phase 3 randomized controlled trials for NDMM that treated transplant-eligible and transplant-ineligible patients before and after publication of thrombosis prevention guidelines. In Myeloma IX, transplant-eligible patients randomly assigned to cyclophosphamide, vincristine, doxorubicin, and dexamethasone (CVAD) induction had higher risk of VTE compared with patients treated with cyclophosphamide, thalidomide, and dexamethasone (CTD) (22.5% [n = 121 of 538] vs 16.1% [n = 89 of 554]; adjusted hazard ratio [aHR],1.46; 95% confidence interval [95% CI], 1.11-1.93). For transplant-ineligible patients, those randomly assigned to attenuated CTD (CTDa) induction had a higher risk of VTE compared with those treated with melphalan and prednisolone (MP) (16.0% [n = 68 of 425] vs 4.1% [n = 17 of 419]; aHR, 4.25; 95% CI, 2.50-7.20). In Myeloma XI, there was no difference in risk of VTE (12.2% [n = 124 of 1014] vs 13.2% [n = 133 of 1008]; aHR, 0.92; 95% CI, 0.72-1.18) or arterial thrombosis (1.2% [n = 12 of 1014] vs 1.5% [n = 15 of 1008]; aHR, 0.80; 95% CI, 0.37-1.70) between transplant-eligible pathways for patients treated with cyclophosphamide, lenalidomide, and dexamethasone (CRD) or CTD. For transplant-ineligible patients, there was no difference in VTEs between attenuated CRD (CRDa) and CTDa (10.4% [n = 95 of 916] vs 10.7% [n = 97 of 910]; aHR, 0.97; 95% CI, 0.73-1.29). However, arterial risk was higher with CRDa than with CTDa (3.1% [n = 28 of 916] vs 1.6% [n = 15 of 910]; aHR, 1.91; 95% CI, 1.02-3.57). Thrombotic events occurred almost entirely within 6 months of treatment initiation. Thrombosis was not associated with inferior progression-free survival (PFS) or overall survival (OS), apart from inferior OS for patients with arterial events (aHR, 1.53; 95% CI, 1.12-2.08) in Myeloma XI. The Myeloma XI trial protocol incorporated International Myeloma Working Group (IMWG) thrombosis prevention recommendations and compared with Myeloma IX, more patients received thromboprophylaxis (80.5% vs 22.3%) with lower rates of VTE for identical regimens (CTD, 13.2% vs 16.1%; CTDa, 10.7% vs 16.0%). However, thrombosis remained frequent in spite of IMWG-guided thromboprophylaxis, suggesting that new approaches are needed.
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Mellish, Martha, Kasadee Allan und Bronwyn Crane. „Effects of sunlight hours and hormones on double ovulation, and singleton and twin pregnancies in mares“. Clinical Theriogenology 13, Nr. 2 (01.06.2021): 81–84. http://dx.doi.org/10.58292/ct.v13.9356.
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Equine twin pregnancies are almost exclusively dizygotic, without the application of advanced reproductive technologies, requiring 2ovulations in 1 estrous cycle. Breeding records were used to determine the effects of sunlight hours, prostaglandin F2α, human chorionicgonadotropin, deslorelin (a gonadotropin releasing hormone agonist), and progesterone and estradiol on double ovulation rates,and singleton and twin pregnancy rates. Breeding records of mares (n = 267) and their estrous cycles (n = 914) were analysed. Doubleovulations occurred in 10.5% (96/914) of estrous cycles. Twin pregnancies were observed in 42.7% (38/89) of mares that had doubleovulations. Overall, per estrous cycle pregnancy rate was 47.2% (405/858) and twin pregnancies was 4.4% (38/858). Double ovulationshad higher (p < 0.001) per cycle singleton pregnancy rate (69.7%; 62/89) than 1-ovulation cycles (44.6%; 343/769). Deslorelinincreased (p < 0.05; OR =1.24 95% CI) double ovulations and human chorionic gonadotropin tended (p = 0.089; OR =1.68; 95%CI) to increase double ovulations. Deslorelin use resulted in an odds ratio of 2.47 for a positive pregnancy (either singleton or twin)diagnosis compared to cycles without deslorelin use. None of the factors examined had a substantial impact on twin pregnancy rates.
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Tsuchiya, Norihiko, Yoshiaki Yamamoto, Hirotsugu Uemura, Hiro-Omi Kanayama, Masatoshi Eto, Hideaki Miyake, Thomas Powles et al. „Avelumab (Ave) first-line (1L) maintenance plus best supportive care (BSC) versus BSC alone for advanced urothelial carcinoma (UC): JAVELIN Bladder 100 Japanese subgroup analysis.“ Journal of Clinical Oncology 39, Nr. 6_suppl (20.02.2021): 425. http://dx.doi.org/10.1200/jco.2021.39.6_suppl.425.
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425 Background: A randomized phase III trial (JAVELIN Bladder 100; NCT02603432) to investigate avelumab (anti–PD-L1) as 1L maintenance therapy in patients with advanced UC met its primary objective, demonstrating significantly prolonged overall survival (OS) with Ave + BSC vs BSC alone in all randomized patients and in patients with PD-L1+ tumors. We report efficacy and safety in Japanese patients enrolled in this study. Methods: Eligible patients with unresectable locally advanced or metastatic UC that had not progressed with 4-6 cycles of gemcitabine with either cisplatin or carboplatin were randomized 1:1 to receive maintenance Ave (10 mg/kg IV every 2 weeks) + BSC or BSC alone, stratified by best response to 1L chemotherapy (complete/partial response vs stable disease) and by visceral vs nonvisceral disease when initiating 1L chemotherapy. The primary endpoint was OS, assessed from randomization in all randomized patients and in patients with PD-L1+ tumors (Ventana SP263 assay). Secondary endpoints included progression-free survival (PFS) per blinded independent central review and safety. Results: Japanese patients (n=73) were randomized to receive Ave + BSC (n=36) or BSC alone (n=37); 52.8% vs 62.2% had PD-L1+ tumors, respectively. Median OS (95% CI) was 24.7 months (18.2-not estimable [NE]) with Ave + BSC vs 18.7 months (12.8-33.0) with BSC alone (HR, 0.81 [95% CI; 0.409-1.585]) in all randomized patients and 18.6 months (9.4-NE) with Ave + BSC vs 19.4 months (11.7-33.0) with BSC alone (HR, 1.00 [95% CI, 0.413-2.412]) in patients with PD-L1+ tumors. Median PFS (95% CI) was 5.6 months (1.9-9.4) with Ave + BSC vs 1.9 months (1.9-3.8) with BSC alone (HR, 0.63 [95% CI, 0.358-1.113]) in all randomized patients and 5.6 months (1.8-11.2) with Ave + BSC vs 1.9 months (1.9-3.8) with BSC alone (HR, 0.62 [95% CI, 0.298-1.301]) in patients with PD-L1+ tumors. The most common treatment-emergent adverse events (all grade; grade ≥3) in the Ave + BSC arm were pyrexia (10 [27.8%]; 0), nasopharyngitis (7 [19.4%]; 0), and anemia (7 [19.4%]; 4 [11.1%]). Conclusions: Ave 1L maintenance + BSC was efficacious and tolerable in Japanese patients with advanced UC, and results were generally consistent with those in the overall population. Clinical trial information: NCT02603432.
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Schulz, Victor C., Pedro S. C. de Magalhaes, Camila C. Carneiro, Julia I. T. da Silva, Vivian N. Silva, Vanessa V. Guesser, Juliana Safanelli et al. „Improved Outcomes after Reperfusion Therapies for Ischemic Stroke: A “Real-world” Study in a Developing Country“. Current Neurovascular Research 17, Nr. 4 (14.12.2020): 361–75. http://dx.doi.org/10.2174/1567202617666200521083132.
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Background: It is unknown if improvements in ischemic stroke (IS) outcomes reported after cerebral reperfusion therapies (CRT) in developed countries are also applicable to the “real world” scenario of low and middle-income countries. We aimed to measure the long-term outcomes of severe IS treated or not with CRT in Brazil. Methods: Patients from a stroke center of a state-run hospital were included. We compared the survival probability and functional status at 3 and 12 months in patients with severe IS treated or not with CRT. From 2010 to 2011, we performed intravenous reperfusion when patients arrived within 4.5 h time-window (IVT group) and after 2011, mechanical thrombectomy (MT) combined or not with intravenous alteplase (IAT group). Those who arrived >4.5 h in 2010-2011 and >6 h in 2012-2017 did not undergo CRT (NCRT group). Results: From 2010 to 2017, we registered 917 patients: 74% (677/917) in the NCRT group, 19% (178/917) in the IVT group and 7% (62/917) in the IAT group. Compared to the NCRT group, IVT patients had a 28% higher (HR: 0.72; 95% CI 0.53-0.96) 3-month adjusted probability of survival and risk of functional dependence was 19% lower (adjusted RR: 0.81; 95% CI 0.73-0.91). For those who underwent MT, the adjusted probability of survival was 59 % higher (HR: 0.41; 95% CI 0.21-0.77) and the risk of functional dependence was 21% lower (adjusted RR: 0.79; 95% CI 0.66-094). These outcomes remained significantly better throughout the first year. Conclusion: CRT led to better outcomes in patients with severe IS in Brazil.
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Jin, Linda, Bradley Krasnick, Jesse Davidson, Cecilia Grace Ethun, Timothy M. Pawlik, George A. Poultsides, Thuy Tran et al. „The effect of postoperative morbidity on long-term survival after curative resection for extra-hepatic biliary tumors: A multi-institution analysis from the U.S. Extrahepatic Biliary Malignancy Consortium.“ Journal of Clinical Oncology 34, Nr. 4_suppl (01.02.2016): 435. http://dx.doi.org/10.1200/jco.2016.34.4_suppl.435.
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435 Background: Surgical resection is the cornerstone of curative therapy for extrahepatic biliary tumors (EHBTs) Postoperative complications (POCs) can negatively impact survival after oncologic resection. We evaluated the impact of POCs on survival after resection of EHBTs. Methods: We analyzed 914 patients from ten institutions of the U.S. Extrahepatic Biliary Malignancy Consortium who underwent curative resection for gallbladder adenocarcinoma (n=389), hilar (n=295) and distal (n=294) cholangiocarcinoma between 1998 and 2015. POCs were graded using the modified Clavien-Dindo system. Overall survival (OS) probabilities were estimated using the method of Kaplan and Meier and analyzed using multivariate Cox regression. Results: Median follow-up was 20 months. The median age was 66 years, and the overall complication rate was 54%. Complication rates were significantly higher in patients with distal or hilar cholangiocarcinoma (62%) when compared with gallbladder cancer (41%, p<0.001). For all cancer types, patients who experienced POCs had lower 5-year OS when compared with those who did not (18% vs 28%, p<0.001). On multivariate Cox regression, POC remained an independent predictor for decreased OS (HR 1.5, 95% CI 1.3-1.9, p<0.001; Table). Among patients who experienced POCs, survival did not differ by greatest Clavien grade of complication experienced (p=0.89), however patients who had 2 or more POCs did have decreased long term survival when compared with patients with only a single POC (HR 1.5, 95% CI 1.2-1.8, p=0.001). Conclusions: POCs adversely affect long-term outcomes after curative resection for extra-hepatic biliary tumors. While any complication grade did not have a significant impact on long-term survival, increasing number of POCs did significantly worsen the prognosis for OS. [Table: see text]
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Patel, Kiran, Brenda Diergaarde, Adam Brufsky, Rachel Catherine Jankowitz, Barry C. Lembersky, Priya Rastogi und Shannon Leigh Huggins-Puhalla. „Incidence of febrile neutropenia with use of docetaxel plus cyclophosphamide (TC) for breast cancer.“ Journal of Clinical Oncology 35, Nr. 15_suppl (20.05.2017): e12073-e12073. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e12073.
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e12073 Background: Incidence of febrile neutropenia (FN) is reported as 5% in breast cancer patients receiving TC (Jones et al., JCO 2006), which would not justify the usage of prophylactic granulocyte colony stimulating factors (G-CSF). We previously showed that the incidence of FN may be as high as 23% in a small study. (N = 130, Soni et al., ASCO 2011). In the current study, we determined the incidence of FN in a larger cohort (N = 415), and evaluated the usage of G-CSF and its relation to FN, age, stage, and hormonal status. Methods: We retrospectively reviewed the electronic medical records from patients diagnosed with breast cancer who received at least one standard dose cycle of adjuvant TC between 2010-2016 at a university-based breast oncology practice. Chi-square or Fisher’s exact tests were used to assess differences between groups. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using multiple logistic regression models. Results: We identified in total 415 patients who received adjuvant TC. Median age at diagnosis was 58 (range: 25-86), the majority had stage I or II (N = 382; 92.1%) disease, and 315 (75.9%) were ER+, 277 (66.8%) PR+, 42 (10.1%) HER2+, 22 (5.3%) triple-positive, and 81 (19.5%) triple-negative. Prophylactic G-CSF was utilized in 247 patients (59.5%), and unknown for 43 (10.4%). Overall 39 (9.4%) patients experienced febrile neutropenia. Incidence of FN among those receiving G-CSF was 4.5% versus 17.6% among those who did not (p < 0.001). Use of G-CSF significantly lowered risk of FN, OR (95%CI): 0.20 (0.10-0.43) adjusted for age at diagnosis and stage. Use of G-CSF on incidence of FN did not differ significantly by age, stage, or hormonal status. Conclusions: Our data confirms a high rate of FN in patients receiving TC without G-CSF prophylaxis. Our institutional high rate of G-CSF use ( > 50%) reduced the incidence of FN to 4.5% and the observed significant difference in FN incidence between the non G-CSF group and G-CSF group suggests that prophylaxis may be considered when administering TC. Age, stage, and hormonal status do not seem to affect the usage of G-CSF or incidence of FN in our population.
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Bando, H., T. Yoshino, E. Shinozaki, S. Yuki, T. Nishina, S. Kadowaki, K. Yamazaki, K. Tsuchihara, S. Fujii und T. Yamanaka. „Clinical outcome in patients with metastatic colorectal cancer harboring KRAS p.G13D mutation treated with cetuximab.“ Journal of Clinical Oncology 29, Nr. 4_suppl (01.02.2011): 448. http://dx.doi.org/10.1200/jco.2011.29.4_suppl.448.
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448 Background: Metastatic colorectal cancer patients with KRAS codon 12 or 13 mutated tumors are presently excluded from treatment with cetuximab (Cmab). On the other hand, a few patients who have mutated KRAS status occasionally respond to Cmab. The tumors of those patients predominantly had codon 13 mutation, and all codon 13 responder have mutation of p.G13D. We now compared the efficacy of Cmab among patients with p.G13D- mutant, other KRAS mutant and KRAS wild-type colorectal cancer. Methods: The patients from 9 Japanese institutions were retrospectively collected and analyzed. All patients were refractory to fluoropyrimidine, oxaliplatin and irinotecan, and were treated with Cmab and irinotecan combination regimen. Response rate (RR), progression-free survival (PFS) and overall survival (OS) were calculated respectively according to KRAS status. Results: Ninety four patients were treated with combination therapy. Among 94 cases, 7 cases were p.G13D-mutant KRAS, 23 cases were other mutant KRAS and 63 cases were wild-type KRAS. Baseline characteristics by each subset were well-balanced. While one partial response (PR) and 4 stable diseases (SD) cases were found in 7 p.G13D-mutated cases, no PR was found in other KRAS mutated cases. Median PFS of the patients with p.G13D-mutant, other KRAS mutant and KRAS wild-type were 4.5 months (95%CI 1.7-), 2.3 months (95%CI 1.9-4.3), 4.6 months (95%CI 3.5-6.5) respectively. And median OS of the patients with p.G13D- mutant, other KRAS mutant and KRAS wild-type were 9.3months (95%CI 8.5- 11.8), 7.4 months (95%CI 4.5-9.4), 12.2 months (95%CI 8.7-19.8) respectively. Although statistical significance was not found between the two mutated groups, there are trends that the patients with p.G13D-mutant may have received better clinical benefits from Cmab than the patients with other KRAS mutant. Conclusions: Cmab may have therapeutic benefit in the patients with KRAS p.G13D-mutant colorectal cancer although further evaluation is warranted. No significant financial relationships to disclose.
Buchteile zum Thema "914.445 95"
1
Baxter, Roger, Joan Bartlett, Bruce Fireman, Edwin Lewis und Nicola P. Klein. „Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis“. In Immunization Strategies and Practices, 37–44. American Academy of Pediatrics, 2018. http://dx.doi.org/10.1542/9781610022774-effectiveness.
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BACKGROUND Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the first infant dose of diphtheria, tetanus and acellular pertussis (DTaP) vaccine and during the first year of life in infants who have received DTaP. METHODS In a retrospective cohort study of infants born at Kaiser Permanente Northern California from 2010 to 2015, we estimated the effectiveness of maternal pertussis vaccination for protecting newborns against pertussis in the first 2 months of life and in the first year of life accounting for each infant DTaP dose. RESULTS Among 148 981 newborns, the vaccine effectiveness of maternal Tdap was 91.4% (95% confidence interval [CI], 19.5 to 99.1) during the first 2 months of life and 69.0% (95% CI, 43.6 to 82.9) during the entire first year of life. The vaccine effectiveness was 87.9% (95% CI, 41.4 to 97.5) before infants had any DTaP vaccine doses, 81.4% (95% CI, 42.5 to 94.0) between doses 1 and 2, 6.4% (95% CI, −165.1 to 66.9) between doses 2 and 3, and 65.9% (95% CI, 4.5 to 87.8) after infants had 3 DTaP doses. CONCLUSIONS Maternal Tdap vaccination was highly protective against infant pertussis, especially in the first 2 months of life. Even after infant DTaP dosing, there was evidence of additional protection from maternal Tdap vaccination for the first year of life. This study strongly supports the United States’ current recommendation to administer Tdap during each pregnancy.
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Z. Ibaid, Zahra. „Bio-char as an adsorbent for wastewater purification“. In Sustainable Use of Biochar [Working Title]. IntechOpen, 2024. http://dx.doi.org/10.5772/intechopen.1002450.
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This study was conducted to investigate the feasibility of use of olivepomace residues and citrus tree wood residues after burning at 550°(olivepomace charcoal and citrus charcoal) as alternative non-traditional substrates in vertical flow wetland systems (VFCWs) for removing inorganic pollutants and organic pathogens from municipal wastewater through secondary treatment for carbon emission reduction to combat climate change. The effectiveness of this treatment was examined by two pilot scale vertical flow constructed wetlands (VFCWs) systems with alternative substrates. Each system was designed from two operated units in series (two stages of treatment), each unit was manufactured with the same design and size. The difference between each system was the substrates used for treatment. The first system included olivepomace charcoal, while the second system included olivepomace charcoal with citrus charcoal. Both models were operated at the same time and under the same conditions. Both systems were tested with seven different hydraulic retention time (HRT) (12-24-36-48-96-144-192 hours). After conducting laboratory tests on wastewater samples after treatment for several biological, physical, and chemical tests, the results indicated that citrus charcoal and olive charcoal are effective alternative substrates in constructed wetland systems. The systemic way test results showed the lowest removal efficiency for TSS, BOD, COD, TP, TKN, and Fecal Coliform (95, 53, 44, 52, 40, and 66% at 12 hr), while the highest removal rates (97, 94, 94, 80, 69, and 98% at 12 hr), respectively in Model 1. And minimum removal rates for TSS, BOD, COD, TP, TKN and Fecal Coliform (95, 34, 22, 42, 48, and 50% at 12 hr), respectively, while the optimal removal (97, 98, 98, 71, 71, and 99% at 12 hr), respectively, in Model 2. This study proved that olive solid waste and tree wood residues are effective alternative substrates in removing pollutants from wastewater, which are inexpensive and environmentally friendly.
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Santos, Luanna Alves dos, Carlos Alberto Andrade Serra dos Santos, Jairo Rodrigues Santana Nascimento, Geovana Andressa Mendes de Sousa, Italo Hugo Almeida Antero, Marcus Vinícius Pereira de Sousa, Eveline Pinheiro Beserra, Roberta de Araújo e. Silva, Leonardo Hunaldo dos Santos und Maria Aparecida Alves de Oliveira Serra. „PREVALÊNCIA DE OBESIDADE EM PACIENTES DISPÉPTICOS ATENDIDOS EM UM SERVIÇO PÚBLICO DE ENDOSCOPIA EM IMPERATRIZ-MA“. In O cuidado em saúde baseado em evidências, 217–27. Editora Científica Digital, 2023. http://dx.doi.org/10.37885/230412652.
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Objetivo: Identificar a prevalência de obesidade em pacientes com sintomas dispépticos atendidos em um serviço público de endoscopia. Métodos: Estudo transversal realizado com 77 pacientes atendidos em um serviço público de endoscopia em Imperatriz, Maranhão, no período de maio a julho de 2019. Foram incluídos pacientes de ambos os sexos, com idade entre 18 e 91 anos. Foram realizadas entrevistas para coleta dos dados e avaliação antropométrica antes da realização do exame de endoscopia digestiva alta. A obesidade foi definida de acordo com os critérios do índice de massa corporal (IMC). Resultados: Dos 77 pacientes analisados, houve o predominante do sexo feminino (71,4%) com idade variando de 18 a 87 anos (média da idade 40,6 anos ± 18,4). A média do IMC entre os participantes foi de 26,3 kg/m². Observaram-se menores médias de circunferência de pescoço (p≤0,0001) e circunferência abdominal (p=0,04) para o sexo feminino e maior média de circunferência abdominal na faixa de 60 a <64 anos (p=0,018). Pacientes dispépticos com idade menor ou igual a 45 anos apresentaram menores chances de ter obesidade (p=0,05, RC= 0,43, 95%IC=0,16-1,12). Conclusão: O estudo evidenciou que a obesidade estava presente em mais da metade dos pacientes dispépticos analisados, com maior frequência na faixa etária acima de 60 anos. Portanto, faz-se necessário a elaboração de ações em saúde voltadas para orientação, tratamento e acompanhamento da obesidade, principalmente para pacientes acima de 45 anos e idosos.
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Pickover, Clifford A. „Saippuakauppias“. In Wonders of Numbers, 140–41. Oxford University PressNew York, NY, 2001. http://dx.doi.org/10.1093/oso/9780195133424.003.0057.
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Abstract In this chapter Dr. Googol is more interested in palindromic numbers than palindromic words or sentences. Palindromic numbers are positive integers that “read” the same backward or forward. For example, 12,321, 11, 261162, and 454 are all palindromic numbers. Figure 57.1 is an interesting plot showing the distribution of the first 200 palindromes when multiplied by a constant. To create the plot, start with an integer x between 1 and 200, multiply it by a constant a, and determine if the result is a palindrome. The “multiplier” a on the y axis of the plot goes from 1 to 200. A dot on the graph indicates a palindromic number. The various patterns produced are quite interesting, and Dr. Googol is fond of making a few casual observations. Note that there is clearly a dense structure below some “hyperbolic” boundary. There is a conspicuous vertical line of closely spaced dots at x = 55 corresponding to 10 consecutive odd a values that produce palindromes. The products are 55 x 91, 55 × 93, 55 × 95, 55 × 97, 55 × 99, 55 × 101, 55 × 103, 55 × 105, 55 × 107, and 55 × 109. Also, when the x-axis value is an even multiple of 5, there are no y data. When the x-axis value is a nonpalindromic odd multiple of 5, they data are scarce. When x is palindromic, there are many y-data points. Notice the plot has symmetry: if x × y is palindromic, y × x is also palindromic.
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Knutsen, Ingrid Ruud, Unni Johnsrud, Stine Jessli Slorafoss, Antonie Grasmo Haugen und Pål Joranger. „We Are No Better Than the Weakest Link: Nurses’ Experiences With Medication Management in Primary Healthcare“. In Medication Safety in Municipal Health and Care Services, 367–90. Cappelen Damm Akademisk/NOASP, 2022. http://dx.doi.org/10.23865/noasp.172.ch17.
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Today patients are discharged earlier from hospital, and consequently, an increasing number of seriously ill patients are being followed up by the primary healthcare services, and use various medications. Errors in pharmaceutical treatment, which cause deaths and adverse events, are among the errors most frequently reported. In this study, we explored experience, competence and competence needs related to medication management among nurses in primary healthcare. One hundred and ten nurses working in four municipalities in southeastern Norway were invited to fill in a paper-based questionnaire, and 87 responded (79%). Bivariate and cross-table analyses were performed. Of these, 84% considered their medication management competence to be good or very good, but 70% of the nurses did not feel confident about drug interaction, and 45% were not confident about the effects and side effects of medication. Further, 55% had administered medication incorrectly or to the wrong patient (35%). The most common adverse event was to administer medication at the wrong time. The most common way to update one’s knowledge was by reading the Norwegian Pharmaceutical Product Compendium (95%), and through dialogue with colleagues and doctors (94%). Most of the nurses (75%–85%) expressed a need for more knowledge. There was little difference between nurses working in home nursing care and in nursing homes. Despite reporting a low incidence of errors, few nurses have taken part in formal training after qualifying. Our findings indicate a special need for structural measures to increase nurses’ competence related to medication and medication management in primary healthcare.
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„Royal Women of Judea“. In Women’s Religions in the Greco-Roman World, herausgegeben von Ross Shepard Kraemer, 133–37. Oxford University PressNew York, NY, 2004. http://dx.doi.org/10.1093/oso/9780195170658.003.0061.
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Abstract note: This entry, together with the following entry, is neither by, from, or to women, but because it is about actual historical women, whose identities are attested in numerous sources, including inscriptions, it seemed most appropriate here. For other information, see entry 15. bibliography: Tal Ilan, Jewish Women in Greco-Roman Palestine: An Inquiry into Image and Status, Texte und Studien zum Antiken Judentum 44 (Tübingen: J. C. B. Mohr [Siebeck], 1995); Tal Ilan, “Josephus and Nicolaus on Women,” in Peter Schäfer, ed., Geschichte—Tradition—Reflexion: Festschrift für Martin Hengel zum Geburtstag, vol. 1, Judentum (Tübingen: J. C. B. Mohr [Siebeck], 1996), 221–62; Tal Ilan, Integrating Women into Second Temple History, Texte und Studien zum Antiken Judentum 76 (Tübingen: J. C. B. Mohr [Siebeck], 1999); Nikos Kokkinos, The Herodian Dynasty: Origins, Role in Society and Eclipse, JSOPseud Suppl. 30 (Sheffield, U.K.: Sheffield Academic Press, 1998); Ross S. Kraemer, “Jewish Women and Women’s Judaism(s) at the Beginning of Christianity,” in Women and Christian Origins, 50–79; Ross S. Kraemer, “Herodias 1,” “Herodias 2,” “Salome 2,” in WIS, 92– 95, 148–49; Grace H. Macurdy, “Royal Women in Judaea,” in Vassal Queens and Some Contemporary Women in the Roman Empire, Johns Hopkins University Studies in Archaeology 22 (Baltimore: Johns Hopkins University Press; London: Humphrey Milford, Oxford University Press, 1937; repr., in Two Studies on Women in Antiquity, Chicago: Ares Press, 1993), 63–91; Peter Richardson, Herod: King of the Jews and Friend of the Romans (Columbia: University of South Carolina Press, 1996).
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„TABLE 9 Mineral Composition of Rye, Wheat, Barley, Corn, Oats, and Rice (mg/100 g, dry wt.) Barley Oats Rice Whole Kernel Whole Kernel Whole Kernel Rye Wheat grain only Corn grain only grain only Phosphorus 380 410 470 400 310 340 400 285 290 Potassium 520 580 630 600 330 460 380 340 120 Calcium 70 60 90 80 30 95 66 68 67 Magnesium 130 180 140 130 140 140 120 90 47 Iron 966 - 274 - 6 Copper 0.90.80.90.2450.30.4 Mangenese 7.55.51.80.65462 Zinc 3.44.44.0 - 3.91.5-2.21.2-2.1 Sodium 3.14.6 11.8 8.63.1-6.92.2-5.1 TABLE 10 Mineral Composition of Sorghum, Triticale, barley contains the highest average levels of phosphorus and Wild Ricea and whole grain rice the lowest (285 mg/100 g). From a di-Sorghum Triticale Wild rice etary standpoint, barley, corn, and rice are considered moderate sources of phosphorus (100-200 mg/100 g); Phosphorus 405 0.19% 0.4-0.5% buckwheat, millet, oats, brown rice, rice bran, rye, wheat, Potassium 400 1.21% 0.4-0.6% wheat germ, wheat bran and wild rice are classified as high Calcium 20 0.21% 0.01-0.03% sources (200-1200 mg/100 g) (Tables 13-16). Magnesium 150 0.16% 0.1-0.2% The data in Tables 13-16 indicate that quantities of Iron 6 12-51 ppm Copper 0.53.9 ppm 1.8-14.5 ppm phosphorus vary significantly from one wheat variety to Manganese 1.5 37 ppm another. This variation can also be seen in barley. In con-Zinc 0.0008% 36 ppm 40-121 ppm trast, phosphorus content from one variety of rye or oats to Sodium 0.00008% another does not vary significantly. In the Syvalahti and Korkman [42] study, phosphorus content of the grain was 'mg/100 g (dry wt.) unless otherwise noted. not affected by the fertilizer treatments of spring wheat, Refs. 15, 17, 35, 36. barley, and rye. Significant differences in phosphorus con-tent were seen in winter wheat and oats when different fer-[40], calcium levels in various rye and oat varieties tend to tilizer treatments were used (Tables 17-21). be reasonably consistent (Tables 13-16). The effects of various fertilizer treatments on mineral C. Magnesium content of spring and winter wheat, barley, oats and rye Eighty-seven percent of the magnesium in cereal grains is grown in 10 localities in Finland are shown in Tables located in the aleurone layer [34]. Because magnesium 17-21. These data [42] show that fertilizer treatment did binds with phytic acid, much of the magnesium is probably not result in a variation in calcium content in the grains present as Ca5 Mg phytate or as potassium-magnesium studied (Tables 17-21). phytate [34]. The remainder is likely to be present in phos-B. Phosphorus phates and sulfates [34]. From a dietary standpoint, brown rice is considered to Compared to other minerals, phosphorus is found in large be a poor source of magnesium (50-100 mg/100 g). Mod-quantities in cereal grains. It is mostly associated with erately good sources (100-200 mg/100 g) include barley, phytic acid (myoinositol hexaphosphoric acid) and its millet, oats, rye, wheat, and wild rice. Buckwheat, wheat salts. In wheat, rice, and maize, 80% or more of the total bran, and wheat germ are considered to be high sources of phosphorus is accounted for by the phytate [34]. Over 80% this mineral (200-400 mg/100 g) [1-3,6,8,37,43] (Tables of the phytate is located in the aleurone portion of wheat 13-16). In the mid-1970s the Food and Nutrition Board and the pericarp of rice; in corn, over 80% is found in the proposed that wheat flour be enriched with magnesium at germ [34]. In wheat, phosphorus becomes incorporated the rate of 200 mg/lb flour [9,14]. However, this proposal into phytic acid during maturation [34]. As seen in Table 9, was never implemented.“ In Handbook of Cereal Science and Technology, Revised and Expanded, 501–9. CRC Press, 2000. http://dx.doi.org/10.1201/9781420027228-49.
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Nakka, Thejeswar, Prasanth Ganesan, Luxitaa Goenka, Biswajit Dubashi, Smita Kayal, Latha Chaturvedula, Dasari Papa, Prasanth Penumadu, Narendran Krishnamoorthy und Divya B. Thumaty. „Epithelial Ovarian Cancer: Real-World Outcomes“. In Annual Conference of Indian Society of Medical and Paediatric Oncology (ISMPO). Thieme Medical and Scientific Publishers Pvt. Ltd., 2021. http://dx.doi.org/10.1055/s-0041-1735369.
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Abstract Introduction Ovarian cancer is the third most common cancer and the second most common cause of death among gynecological cancers in Indian women. Ovarian cancer is heterogeneous, among them, epithelial ovarian cancer (EOC) is the most common. Primary cytoreductive surgery along with six to eight cycles of a combination of platinum and taxanes chemotherapy is the cornerstone of first-line treatment in EOC. This study was done to find clinicopathological factors affecting survival outcomes with first-line therapy in EOC in a real-world setting. Objectives This study was aimed to find factors affecting progression-free survival (PFS) and overall survival (OS) with first-line treatment in EOC. Materials and Methods We conducted a single-center retrospective study. We screened all the patients diagnosed with ovarian cancer from January 2015 till December 2019. We locked data in August 2019. Eligible patients were histologically confirmed EOC who underwent primary cytoreduction or received more than or equal to two cycles of chemotherapy or both. Patients who had received first-line treatment at another hospital were excluded. Results Patients demographics and clinical characteristics: between January 5, 2015 to August 31, 2019, 435 patients with a diagnosis of ovarian malignancy were registered at our center. Among them, 406 (82%) had EOC, 290 (64%) newly diagnosed, and fulfilling eligibility criteria were included in the final analysis. The median age of the cohort was 53 years (range: 21–89 years) and 157 patients (54%) were >50 years of age (the Eastern Oncology Cooperative Group Performance status was ≥ 2 in 124 patients [43%]; median duration of symptoms was 3 months; and stage III/IV: 240 [83%]). Grading of the tumor was available in 240 patients of which 219 (91%) were of high grade. Subtyping was available in 272 patients (94%) of which the serous subtype was the most common constituting 228 patients (79%).Treatment Most patients received chemotherapy (n = 283 [98%]) as the first modality of treatment (neoadjuvant/adjuvant and palliative). As neoadjuvant (NACT) in 130 patients (45%) and as adjuvant following surgery in 81 patients (29%). The most common chemotherapy regimen was a combination of carboplatin and paclitaxel in 256 patients (88%). Among 290 patients 218 (75%) underwent cytoreductive surgery. Among them, optimal cytoreduction was achieved in 108 patients (52%). Optimal cytoreduction rate (OCR) with upfront surgery and after NACT was 44 and 53%, respectively (Chi-square test: 0.86; p = 0.35).Survival The median follow-up of the study was 17 months (range: 10–28 months) and it was 20 months (range: 12–35 months) for patients who were alive. At last, follow-up, 149 patients (51%) had progressed and 109 (38%) died. The estimated median PFS and OS were 19 months (95% CI: 16.1–21.0) and 39 months (95% CI: 29.0–48.8), respectively. On multivariate analysis, primary surgery (HR: 0.1, 95% CI: 0.06–0.21; p-value: <0.001) and early-stage disease (HR: 0.2, 95% CI: 0.1–0.6; p-value 0.04) were associated with superior PFS and primary surgery (HR: 0.1, 95% CI: 0.09–0.2; p-value: <0.001) was associated with superior OS. Conclusion Primary surgery (upfront or interval) was associated with improved survival. Newer agents like bevacizumab, poly-ADP (adenosine diphosphate)-ribose polymerase inhibitors and HIPEC should be incorporated precisely into first line of therapy to improve outcomes.
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Арутюнова, М. С., М. И. Евлоева, А. С. Северина, С. А. Мартынов, И. И. Клефортова, М. Ш. Шамхалова und М. В. Шестакова. „РАСПРОСТРАНЕННОСТЬ И ПРЕДИКТОРЫ РАЗВИТИЯ СЕРДЕЧНО-СОСУДИСТОЙ И ПОЧЕЧНОЙ ПАТОЛОГИИ У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 1 ТИПА ДЛИТЕЛЬНОГО ТЕЧЕНИЯ (БОЛЕЕ 20 ЛЕТ)“. In X (XXIX) НАЦИОНАЛЬНЫЙ КОНГРЕСС ЭНДОКРИНОЛОГОВ с международным участием «Персонализированная медицина и практическое здравоохранение». ФГБУ «НМИЦ эндокринологии» Минздрава России, 2023. http://dx.doi.org/10.14341/cong23-26.05.23-58.
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ЦЕЛЬ: оценить распространенность и предикторы развития хронической болезни почек (ХБП) и сер-
дечно-сосудистой (СС) патологии у пациентов с длительным течением сахарного диабета 1 типа (СД1).
МАТЕРИАЛЫ И МЕТОДЫ: в исследование включено 500 пациентов с длительностью СД1≥20 лет.
Проведены клинико-лабораторные, антропометрические методы обследования, оценка распространен-
ности ХБП и СС патологии.
РЕЗУЛЬТАТЫ: средний возраст пациентов на момент включения в исследование составил 42 года
(35;53; 22-83); средний возраст дебюта СД1=13 лет (8;20;1-50); средняя длительность СД1=28 лет
(23;34; 21-57). У 63,2% пациентов имелась ХБП различных стадий: С1А2 - 14 (2,9%), С1А3 – 4 (0,9%), С2А2 –
23 (4,6%), С2А3 - 7 (1,4%), С3а – 47 (9,4%), С3б – 26 (5,2%), С4 – 58 (11,6%), С5 – 77 (15,4%), где 70 пациентов
(14%) находились на заместительной почечной терапии гемодиализом; после трансплантации - 60 (12%).
Из 500 пациентов у 87 (17,4%) пациентов - ишемическая болезнь сердца, 83 (16,6%) -хроническая сер-
дечная недостаточность, 15 (3%) - аритмия, 298 (59,6%) - атеросклероз артерий нижних конечностей,
173 (34,6%) брахиоцефальных артерий, 11 (2,2%) почечных артерий, 34 (6,8%) перенесли инфаркт миокарда,
21 (4,2%) - острые нарушения мозгового кровообращения.
Факторы, влиявшие на развитие ХБП: возраст пациента ≤ 25 лет: ОШ=7,53 (95%ДИ 2,18;26,0; p=0,001),
26–45 лет: ОШ=3,92 (95%ДИ 1,83;8,38; p<0,001) vs возраст пациента≥46 лет; длительность СД1=20 лет
vs 21-30 лет ОШ=22,22 (95%ДИ 8,70;58,82; p<0,001) и vs >30 лет ОШ=45,46 (95%ДИ 7,52;71,43; p<0,001).
Манифестация СД1 в 1996-2002 гг. снижала риск развития ХБП в 10,75 раз (95% ДИ 4,37; 27,03) vs мани-
фестация СД ранее. Возраст дебюта СД1 6-17 лет повышал риск достижения терминальной ХБП (тХБП)
и трансплантации vs возраст дебюта >18 лет: ОШ=2,4 (95% ДИ 1,22; 5,022; р=0,012). Наличие выраженной
артериальной гипертензии (АГ) повышало риск прогрессирования до тХБП и трансплантации почки:
ОШ=15,3 (95%ДИ 2,1;112,3; р=0,007). Факторы повышения риска развития СС патологии: систолическое
артериальное давление>140 мм рт.ст. ОШ=3,5 (95%ДИ 2,2-5,6; p<0,001), гипертрофия левого желудочка
ОШ 5,4 (95%ДИ 3,6-8,2; p<0,001), АГ ОШ=8,8 (95%ДИ 4,9-15,7; p<0,001), курение ОШ=2,1 (95%ДИ 1,3-3,1;
p<0,001); рСКФ<60 мл/мин/1,73 м2 ОШ=7,1 (95%ДИ 3,6-8,4; p<0,001), рСКФ <30 мл/мин/1,73 м2 ОШ=8,7
(95%ДИ 2,8-8,4; p<0,001), рСКФ <15 мл/мин/1,73 м2 ОШ=14 (95%ДИ 6,3-31,3; p<0,001); альбуминурия разовой
мочи более 20 мг/л ОШ=2,4 (95%ДИ 1,6-3,6; p<0,001), диализ ОШ=14,1 (95%ДИ 6,2-32,1; p<0,001), трансплан-
тация почки ОШ=11,7 (95%ДИ 5,4-24,9; p<0,001). Мужской пол и ожирение не оказали значимого влияния
на развитие СС патологии.
ВЫВОДЫ: результаты исследования определили прогностические факторы развития и прогрессиро-
вания почечной патологии у пациентов с длительным течением СД1 (более молодой возраст, длитель-
ность заболевания не более 20 лет, возраст дебюта от 6 до 17 лет) с меньшим шансом ее развития у лиц
с манифестацией СД1 после 1996-2002 гг. Снижение почечной функции, особенно развитие терминаль-
ных стадий ХБП, существенно увеличивает риск СС патологии, превышая по значимости традиционные
факторы риска
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Балашова, А. В., Л. В. Мачехина, Е. Н. Дудинская, И. Н. Стражеско und О. Н. Ткачева. „СОСТОЯНИЕ УГЛЕВОДНОГО ОБМЕНА У ДОЛГОЖИТЕЛЕЙ“. In Сборник тезисов III Конференции по лечению и диагностике сахарного диабета «Фундаментальная и клиническая диабетология в 21 веке: от теории к практике». ФГБУ «НМИЦ эндокринологии» Минздрава России, 2023. http://dx.doi.org/10.14341/diaconfiii25-26.05.23-10.
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ЦЕЛЬ: оценить состояние углеводного обмена у долгожителей Москвы и близлежащих регионов.
МАТЕРИАЛЫ И МЕТОДЫ: в это когортное исследование включались лица в возрасте 90 лет и старше, давшие письменное согласие на участие. В домашних условиях проводилась комплексная гериатрическая оценка, включавшая сбор анамнеза, применение стандартных гериатрических шкал и опросников, выполнение антропометрических измерений. Всем участникам оценивались следующие лабораторные показатели: глюкоза, инсулин, индекс инсулинорезистентности HOMA-IR, гликированный гемоглобин (HbA1c). Интерпретация состояния углеводного обмена проводилась согласно актуальным на 2022 г. клиническим рекомендациям. Статистический анализ данных проводился с помощью языка программирования R версии 4.1.3. Количественные переменные представлены в виде Me (Q1-Q3). Для сравнения непараметрических значений применялся критерий Краскела-Уоллиса, номинальных переменных – χ2 Пирсона или точный критерий Фишера. Исследование было одобрено локальным этическим комитетом.
РЕЗУЛЬТАТЫ: за период с 2019 по 2022 г. в исследование было включено 3 811 человек (75,4% женщины) в возрасте 92 (91–94) года. Средний индекс массы тела составил 25,4 (23-28,2) кг/м2, доля участников с ожирением составила 15,2%, при этом у 72,9% пациентов были значения окружности талии соответствовали абдоминальному ожирению. Средние значения глюкозы составили 5 (4,5 – 5,7) ммоль/л, HbA1c 5,6 (5,4 – 5,9)%, HOMA-IR – 1,5 (0,9 – 2,6).
В группу СД были отнесены 20,5% (780); предиабета – 16,1% (613). Все случаи СД были интерпретированы как 2 тип. В группе с СД большая часть пациентов 71,7% имела диагноз на основании данных анамнеза; у 28,3% пациентов были впервые выявлены значения параметров углеводного обмена в диабетическом диапазоне. С клинической точки зрения, значения показателей углеводного обмена в группе пациентов с СД были близки к значениям в группе предиабета: глюкоза - 6,3 (5,1 - 7,9) и 5,9 (5 - 6,4) ммоль/л, HbA1c 6,2 (5,6 - 7) и 6,1 (6 - 6,2)%, HOMA-IR 2,3 (1,3 - 6,1) и 2,2 (1,4 - 4,5), соответственно. При этом лишь 4,8% (38) участников с СД получали сахароснижающую терапию (ССТ): 3,8% (30) монтерапию инсулином, 0,6% (5) – терапию пероральными сахароснижающими препаратами, 0,4% (3) – комбинированную терапию. Несмотря на то, что в группе с впервые выявленным СД значения показателей углеводного обмена были статистически значимо выше, чем в группе с ранее выявленным СД (глюкоза 7,4 и 5,9 ммоль/л; HbA1c 6,8 и 6,1%, соответственно), они всё равно были ниже предполагаемых целевых значений для этой возрастной категории. Дополнительно пациенты были разделены на возрастные подгруппы: 90-94 лет (3091), 95-99 лет (674), >100 лет (46); достоверных различий в значениях показателей глюкозы и HbA1c, частоте СД и предиабета между группами получено не было.
ВЫВОДЫ: доля пациентов с СД в исследованной когорте долгожителей была практически сопоставима с данными о распространённости СД в группе пожилых людей, при этом показатели углеводного обмена указывали на компенсацию углеводного обмена даже при низкой доле пациентов, получающих ССТ.
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Oliveira, Tereza Cristina Ferreira de, Henrique Lima Couto, Nayara Carvalho de Sá, Roberta Nogueira Furtado Ferreira und Larissa Barbosa Oliveira. „IMPACT OF A SHORT TRAINING PROGRAM IN MAMMOGRAPHIC POSITIONING IN THE CLINICAL QUALITY OF THE EXAMINATION“. In XXIV Congresso Brasileiro de Mastologia. Mastology, 2022. http://dx.doi.org/10.29289/259453942022v32s1043.
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Introduction: Breast cancer is the most common malignancy in women worldwide, with the exception of nonmelanoma skin tumors. The initial stage of breast cancer is one of the main predictors of survival. Mammographic screening is the most effective method for an early detection of breast cancer and premalignant lesions, with an impact on reducing mortality, considering that correct positioning during the examination is a critical factor for its quality. Methods: A casecontrol study of a mammography positioning training program (MMG) in a private center specialized in breast diagnosis. In total, 200 incidences were evaluated in 50 examinations performed by two experienced techniques, 25 examinations each. Performance criteria were evaluated in the mediolateral oblique (MLO) and craniocaudal (CC) views. In the CC, well-demonstrated lateral quadrants (QLAT), visualization of the pectoral muscle (MP), centralized nipples (MC), welldemonstrated medial quadrants (QMED), absence of pleats or folds, centralized nipples, and symmetrical breasts were considered as adequate positioning. Buck’s low positioning was considered an error criterion. In the MLO assessment, the criteria for adequate positioning were the inframammary angles (AI) visualized, nipples profiled and at the height of the MP, symmetrical breasts, absence of pleats and folds, and symmetrical MP. Pending breasts and pectoralis minor (PP) visualization were considered positioning failures. An 11-h theoretical-practical training was applied: 7 h of practice and 4 h of theory; new tests were performed and the quality criteria were reassessed. Results: Positioning errors were significantly decreased after the training. Errors in the CC incidence decreased from 39% to 11% and in the MLO from 36% to 13%. After the training, the following improved criteria were evaluated in CC: QLAT well shown rose from 50% to 94%, MP visualization rose from 21% to 62%, MC rose from 49% to 79%, QMED well shown rose from 45% to 100%, absence of pleats or folds rose from 74% to 88%, profiled nipples rose from 91% to 95%, and symmetrical breasts rose from 86% to 98%. Buck’s low positioning dropped from 19% to 0%. In the MLO incidence, the criteria that improved were: AI visualization rose from 45% to 82%, profiled nipples rose from 93% to 95%, nipples at MP height rose from 24% to 84%, absence of pleats or folds rose from 39% to 70%, symmetrical breasts rose from 90% to 100%, symmetrical MP rose from 56% to 82%, symmetrical nipples rose from 72% to 86%, and PP visualization dropped from 13% to 7%. Conclusion: The MMG positioning training program improved examination quality. It acts on a vulnerable part, which is human error. The result indicates that a simple, low-cost intervention with low technological complexity can significantly impact the quality of MMG and screening programs in our country.
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Batista, Bernardo Pinheiro de Senna Nogueira, Suzana Sales de Aguiar, Ana Carolina Padula Ribeiro Pereira, Rosalina Jorge Koifman und Anke Bergmann. „IMPACT OF BREAST RECONSTRUCTION ON MORTALITY AFTER BREAST CANCER: SURVIVAL ANALYSIS IN A COHORT OF 620 CONSECUTIVE PATIENTS“. In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2094.
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Background: Access to breast reconstruction is a complex and poorly understood aspect of survival. In the United States, although the rate of immediate reconstruction has tripled in the past 20 years, less than 40% of women undergoing a mastectomy will do so as part of the same procedure. Although there is common understanding that breast reconstruction is oncologically safe, published data on its impact on survival show conflicting and unjustified observations. Methods: We performed a secondary survival analysis in a fixed cohort of 620 consecutive patients who underwent mastectomy between August 2001 and November 2002 in a publicly financed tertiary cancer center. Results: Median followup was 118.4 months (6–172). Of the 620 patients, 253 (40.8%) died during follow-up. And 94 (15.2%) patients underwent breast reconstruction. An unadjusted Cox regression model with breast reconstruction as a time-dependent covariate showed a 60% reduction in the risk of death for patients who underwent reconstruction (crude HR=0.4; 95%CI 0.25–0.65; p <0.001). When adjusted for potential confounders registered in the primary study, the risk reduction was 44% (adjusted HR=0.56; 95%CI 0.34–0.92; p=0.02). Conclusion: Access to breast reconstruction is associated with better survival after mastectomy. Although encouraging, these observations lack biological plausibility and inferences, suggesting that any causal effect is probably driven by confounding and/or interaction with unmeasured variables. The magnitude of the observed association, however, might suggest that, in settings where access to breast reconstruction is severely limited, patient selection for breast reconstruction could be an important drive of the observed association.
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Queiroz, Andrei Alves de, Gustavo Machado Badan, Marilucia Batina Fernandes Moreira und Amanda Neves Machado. „IMPACT OF COVID-19 ON BREAST CANCER TUMOR SIZE AT DIAGNOSIS“. In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1006.
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Introduction: In 2020, COVID-19 affected the whole world, determining a pandemic situation, with recommendations for social isolation and lockdown. In the state of São Paulo, the shutdown of non-essential services was determined on March 22, 2020. Medical appointments and routine imaging exams were postponedand little is known about the impact on screening delay and the diagnosis of neoplasms. Considering that survival and cure of breast cancer are directly related to an early diagnosis, the size of these malignant tumors can be used in researching the delay in breast cancer diagnoses. Objectives: To evaluate the impact of the pandemic on the size of breast cancer in histological diagnosis, as well as on the number of diagnostic procedures performed at our hospital. Methods: Through a retrospective, analytical and crosssectional study, we analyzed data regarding tumors with histological results of malignancy of core needle breast biopsies guided by ultrasound performed at a private hospital in São Paulo between January 1, 2019 and December 31, 2020. The mean tumor sizes were compared to identify differences between prepandemic and pandemic periods. The prepandemic period (PRE) was established between January 1, 2019 and March 31, 2020, and the pandemic period (PAN) was considered from April 1 to December 31, 2020. Based on the sample size, this study has the power of 80% to detect a variation of 1 cm in the mean tumor size. Results: A total of 493 core needle biopsies were identified in 443 patients. A total of 103 (20.1%) biopsies in 94 patients were malignant. In the PAN group, 36 cases of cancer were diagnosed (4 cases/month), while the PRE group diagnosed 67 cases (4.5 cases/month). The mean size of PRE tumors was 1.66 cm, while in PAN tumors it was 2.21, showing a difference of 0.55 cm without statistical significance (95%CI 0.12–1.21; p=0.12). When considering staging (TNM – Tumor, Node, Metastases), the stages T1, T2 and T3 had no significant difference among the groups (p=0.12). The age at diagnosis of malignant lesions ranged from 30 to 82 years in the PRE period, and from 34 to 85 years in the PAN period. The mean age of patients with malignant lesions diagnosed in PAN was higher than PRE, without statistical significance (59.2 vs 56.0; p=0.30). Despite the fewer biopsies performed in both periods, (p <0.001), there was no statistical difference in the number of biopsies with malignant results (p=0.18), since there were proportionally more diagnoses of malignancy in the PAN period (28.6% vs. 18.3%; RR 1.14; 95%CI 1.01–1.29; p=0.02). Conclusions: Although the pandemic affected breast cancer screening, no statistically significant increase in the mean size of tumors has been diagnosed in this service so far.
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Singh, S., V. Goel, V. Talwar, S. Raina, S. Mitra, U. Saxena, R. Shekhon und S. Rawal. „Neo-adjuvant chemotherapy followed by surgery versus definitive chemo radiation as treatment for localized carcinoma cervix“. In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685273.
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Background: Cervical cancer is ranked as the most common cancer in Indian women, second most common cancer worldwide and the leading cause of death in the developing countries. In the developing countries majority of the patients are diagnosed at locally advanced stages. The standard treatment of locally advanced cervical cancer is concomitant chemoradiation (CTRT) using platinum based chemotherapy. However, some randomized studies have shown improved results for patients receiving neoadjuvant chemotherapy (NACT) followed by surgical resection in comparison to patient receiving radiation alone. The present study was designed to compare response to the treatment and survival of and NACT followed by radical surgery (RS) with CTRT in the patients of uterine cervix of a tertiary cancer care centre. Patients and Methods: Retrospective study was performed in locally advanced/advance stage patients of cervix UTERI registered in the institute between years 2009 to 2013. Patients were included in the two groups, group A consists of 89 patients who have received NACT + RS and 67 patients in group B who have received CTRT. Clinical records were reviewed with particular reference to presenting complaint, clinical stage, response to the therapy, disease free survival and overall survival. Statistical analysis was done using SPSS version 22. Results: In the neoadjuvant group (group A) (n=89) the median age of patients was 53 years (range 31-80 years), most of the patients (70%) were presented with complaint of postmenopausal bleeding. Of the total patients, 69 (77.5%) underwent to radical surgery and 5 (8.5%) received radiotherapy after NACT. From 69 patients, who had undergone to surgery, 54 (78.3%) had also received radiation. The overall response to induction chemotherapy was 84%. In the chemo radiation group (group B) (n=65) median age was 56 years (33-75 years). Vaginal bleeding (34%) followed by postmenopausal bleeding (32%) was major presenting complaint in this group. Overall response to the complete treatment was 91%. The median follow up time was 14.3 months in group A and 12.2 months in group B. The disease free survival for NACT group was 32 months (95% CI 26.8-36.5) whereas for CTRT group it was 28 months (95% CI 23.5-33) with 12 and 13 recurrences per group (p = .226). In NACT group overall survival was 46.2 months (95% CI 44-48.3) and for CTRT group it was 38.3 months (95%CI 36.6-40) with 3 and 2 deaths per group (p=.883). Conclusion: Present study shows comparable results, with no difference in survival between both the groups. However, NACT + RS group had showed better disease free and overall survival than another group. Further studies should be performed with larger number of patients and longer duration of follow up.
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Magalhães, Larissa Silva, Gabriel Francisco da Silva Filho, Kamila Cardoso dos Santos, Brunna Rodrigues de Oliveira, Paulie Marcelly dos Santos Carvalho, Bruno Vinicius Diniz e. Silva, Grazielle Rosa da Costa e. Silva, Winny Éveny Alves Moura, Karlla Antonieta Amorim Caetano und Sheila Araújo Teles. „Avaliação do conhecimento de vírus da imunodeficiência humana/aids em mulheres transexuais e travestis do Centro-Oeste goiano: resultados preliminares“. In XIII Congresso da Sociedade Brasileira de DST - IX Congresso Brasileiro de AIDS - IV Congresso Latino Americano de IST/HIV/AIDS. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/dst-2177-8264-202133p121.
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Introdução: Globalmente, o vírus da imunodeficiência humana já infectou mais de 76,1 milhões de pessoas, sendo as mulheres transexuais desproporcionalmente afetadas por essa infecção sexualmente transmissível. Estudos mostram que o conhecimento sobre o vírus da imunodeficiência humana reduz o risco de exposição viral e promove comportamentos protetivos. Objetivo: Avaliar o conhecimento do vírus da imunodeficiência humana/aids em mulheres transexuais e travestis em Goiânia, Goiás. Métodos: Trata-se de um estudo transversal conduzido em mulheres transexuais e travestis que residiam ou estavam em trânsito na região metropolitana de Goiânia, Centro-Oeste do Brasil. Para coleta de dados, foi utilizado o método de amostragem Respondent-Driven Sampling e, para avaliar o conhecimento, o instrumento HIV-KQ. Considerou-se conhecimento satisfatório 8.805,70% de respostas corretas (22 acertos). Foram calculadas frequências, média, mediana e desvio padrão. O teste de qui-quadrado foi utilizado para avaliar diferenças entre proporções e o teste de t de Student para avaliar diferenças entre médias. Valores de p<0,05 foram considerados estatisticamente significantes. Resultados: Participaram deste estudo 180 mulheres transexuais. Verificou-se que 94 (52,2%, intervalo de confiança 95% 45–59), obtiveram acertos 8.805,70%, indicando conhecimento suficiente sobre vírus da imunodeficiência humana/aids. A média de idade das mulheres que possuíam conhecimento suficiente satisfatório sobre vírus da imunodeficiência humana/aids foi maior comparada à das que não tinham (28,16 versus 24,28 anos, p<0,01). Verificou-se também que a média de anos de estudo foi maior em mulheres que possuíam conhecimento satisfatório (11,02 versus 9,86 anos de estudo) (p=0,001) Por outro lado, uma proporção maior de mulheres transexuais que não usavam aplicativos para encontros sexuais possuía conhecimento suficiente sobre vírus da imunodeficiência humana/aids quando comparadas às que usavam (60,5% versus 39,5%, p=0,04) Conclusão: Os achados do presente estudo ratificam a escolaridade como promotor de conhecimento sobre vírus da imunodeficiência humana. Já em relação ao uso de aplicativos e à sua relação com conhecimento sobre a infecção pelo vírus da imunodeficiência humana, mais estudos são necessários para entender o real papel dessa tecnologia.
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Davidson, Barry, Dan Whitney, Niels Laursen, Art Cohn und George A. Hay. „Collaborative Advanced Gas Turbine (CAGT) Program Status: An International Initiative to Catalyze an Intercooled Aeroderivative (ICAD) Gas Turbine Launch Order“. In ASME 1996 International Gas Turbine and Aeroengine Congress and Exhibition. American Society of Mechanical Engineers, 1996. http://dx.doi.org/10.1115/96-gt-292.
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This paper describes the status of the Collaborative Advanced Gas Turbine (CAGT) Program’s initiative to commercialize interCooled AeroDerivative gas turbine (ICAD) technology. CAGT is a consortium of domestic and international electric companies, gas companies and research organizations. ICAD gas turbine technology was selected by CAGT member companies and potential suppliers in a competitive $5 million screening study of various advanced gas turbine options in the 1992–94 time frame. Efforts to commercialize ICAD began in 1994–95. The most attractive ICAD gas turbine options were based on high thrust engines produced by General Electric. Pratt & Whitney and Rolls Royce aircraft divisions. Simple cycle ICAD represents a new intermediate load gas turbine product class with costs and performance unlike any other product available today. Simple cycle efficiencies will approach Chose of many operating combined cycles, but with the low capital costs and rapid start times of a peaking gas turbine. ICAD simple cycle units would be in the 100–130 MW size range with efficiencies in the range of 45–48% + LHV and combined cycle efficiencies potentially as high as 60% + LHV. All efficiencies are presented in the paper in lower heating value (LHV). ICAD gas turbines will eddress a wide range of simple cycle, cogeneration. innovative repowering, combined cycle, distributed generation and renewable energy applications. CAGT members have several projects underway with the goal of the first ICAD unit to begin operation before the year 2000. Industry restructuring has reduced near-term demand for new generation in the United States with a corresponding drop in gas turbine prices. Given the large development cost for any new gas turbine product, potential ICAD suppliers have indicated the need for a launch order to proceed with development. CAGT is pursuing a number of project development and strategic alliance strategies globally to organize a launch order in the range of 10–15 projects. Efforts are also underway to examine options for demonstrating ICAD on a smaller scale (Small ICAD or SICAD) which would address the emerging market for distributed generation. CAGT members feel the low costs and flexibility offered by ICAD could be a significant source of competitive advantage in restructuring electric markets. CAGT members invite others to join the program.
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Gera, Gabriely Karyse Bonfim, Maria Samara da Silva Fernandes, Tais Pace da Silva und Sheila Carminati de Lima Soares. „PERFIL EPIDEMIOLÓGICO DE SÍFILIS GESTACIONAL NO MUNICÍPIO DE CACOAL ENTRE 2016 E 2020“. In I Congresso Brasileiro de Saúde Pública On-line: Uma abordagem Multiprofissional. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/2762.
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Introdução: A sífilis é uma Infecção Sexualmente Transmissível causada pela bactéria Treponema pallidum, com várias formas de apresentações clínicas e com diferentes estágios. Quando não diagnosticada e tratada precocemente, pode acarretar agravos para a gestante e o feto. Objetivo: O presente estudo teve como objetivo identificar as características do perfil epidemiológico das gestantes acometidas por sífilis no município de Cacoal entre 2016 e 2020. Material e Métodos: Pesquisa documental descritiva, retrospectiva e quantitativa, onde a amostra inicial constitui-se de 95 gestantes que foram registradas no banco de dados do SINAN com diagnóstico de Sífilis Gestacional. Os dados coletados foram distribuídos e apresentados por meio de estatística através de tabelas e/ou gráficos elaborados após a análise. O estudo está de acordo com a Resolução do CONEP nº 466/2012 e foi desenvolvida a partir da aprovação junto ao CEP sob o parecer 5.060.962. Resultados: Como resultado da pesquisa identificou-se que o ano com maior índice de notificação foi em 2020 totalizando 26% dos casos, a predominância do diagnóstico se deteve no primeiro trimestre gestacional com 53%, em relação a idade houve uma variação entre 14 e 41 anos de idade, com idade média de 23 anos e maior acometimento na população jovem, de 21 a 30 anos de idade compreendendo 45% da amostra, 33% possuem ensino médio completo e apenas 2% possuem ensino superior completo. Em relação a classificação clínica, 76% dos casos foram diagnosticados como sífilis terciária, o teste rápido foi realizado em 84% das gestantes e o VDRL em 94%, em ambos com taxa de resultado reagente predominante, sem ocorrência de não realização concomitante dos testes, observou-se que a titulação 8 de VDRL/RPR foi preponderante totalizando 18% dos casos pesquisados. Conclusão: Conclui-se que o aumento do número de casos, a predominância na população jovem com ensino médio completo, o diagnóstico de 47% dos casos no segundo e terceiro trimestre, a prevalência de diagnósticos na fase terciária e o teste rápido não ter sido realizado em todas as gestantes, embora preconize o Ministério da Saúde, evidenciam a necessidade de melhorias na efetividade do pré-natal e traçar estratégias para a prevenção, promoção e conscientização em saúde.
Berichte der Organisationen zum Thema "914.445 95"
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Sasaki, L. M. 45-Day safety screen results and final report for Tank 241-SX-113, Auger samples 94-AUG-028 and 95-AUG-029. Office of Scientific and Technical Information (OSTI), Juni 1995. http://dx.doi.org/10.2172/96816.
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