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Mshingo, David M., Mikidadi I. Muhanga, Raymond J. Salanga y Edwin E. Ngowi. "Determinants of Primary School Teachers’ Health Literacy in Morogoro Municipality, Tanzania: A Reflection on Access to Health Information". Advances in Public Health 2023 (12 de septiembre de 2023): 1–10. http://dx.doi.org/10.1155/2023/1799988.
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Background. Teachers have the potential of promoting health knowledge and consequently health-literacy (HL) enhancement. Cognizant of this, interventions geared toward influencing and strengthening school teachers’ HL have remained important. However, for such interventions to be effective, understanding what determines teachers’ HL is inevitable. Purpose. This article analyses the determinants of primary school teachers’ HL by analyzing what prompts their health information-seeking patterns. Methods. A cross-sectional research involving 189 randomly sampled primary school teachers was conducted in 2021 in Morogoro Municipality whereby data were collected through a structured questionnaire survey and analyzed using IBM-SPSS. A score index gauged HL while frequencies and percentages measured other variables. Results. All teachers had high HL with a mean HL (standard deviation) of 8.10062. Only 43.4% searched for HI, 20.1% of those who searched for HI were influenced by health-related problems encountered, 12.2% searched for HI to broaden their knowledge on health-related issues, and 7.4% were prompted by health risks around. Also, 3.7% of the teachers acceded that health-seeking information is influenced by an interest in searching HI for self-health management. About 36.0%, 32.3%, and 31.7% of the teachers agree that the provision of health education, interest to read issues related to HL, and addressing issues related to HL influence teachers’ HL. Conclusion. Teachers have been searching for HI due to different concerns, though there is a need to further enhance such efforts. Recommendation. The government, communities, and development partners should enhance HI seeking to promote teachers’ HL for a healthier society.
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Veshovda, Solveig, Hedda Eik, Marit Helen Andersen, Henriette Jahre y Kirsti Riiser. "Health literacy and musculoskeletal disorders in adolescents: a scoping review". BMJ Open 13, n.º 6 (junio de 2023): e072753. http://dx.doi.org/10.1136/bmjopen-2023-072753.
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ObjectivesHealth literacy (HL) related to musculoskeletal disorders (MSDs) in adolescents is a field with limited previous evidence. This study aimed to review and synthesise studies on MSDs and HL as well as various dimensions of HL in adolescents.DesignScoping review in accordance with Arksey and O’Malleys framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.Search strategyThe search strategy was performed in the following databases in November 2021 (initial search) and December 2022 (updated search); Medline, EMBASE, PsychINFO, Cochrane, CINAHL, ERIC, Web of Science and Google Scholar. Eligible studies involving MSDs and HL or either of the HL dimensions related to finding, understanding, appraising or applying health information in adolescents were considered. Any dimension of HL studied, the outcome measure(s) used to assess HL and the type of MSD examined were charted, reviewed and synthesised. A directed content analysis was used for the subjective interpretation of text data.ResultsA total of 16 841 studies were identified and 33 were eligible for inclusion. Ten articles presented HL with a definition or description in the theoretical background. The remaining 23 studies involved finding, understanding, appraising or applying health information, without using the term ‘health literacy’. Most of the studies addressed how adolescentsunderstand(n=32), andapply(n=23) health information, while few studies focused on how theyfind(n=11) andappraise(n=7) musculoskeletal health information.ConclusionFew studies have addressed HL and MSDs in adolescents explicitly, while most studies have considered dimensions of HL. Our findings suggest that there is important work to be done to align conceptual understandings with the measurement of HL in adolescents and that further research should be carried out to explore how HL is distributed among adolescents with MSDs and how adolescents living with MSDs report their HL.
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Schwendemann, Hanna Elisabeth y Holm Thieme. "Health literacy and the role of therapeutic professionals: A scoping review / Gesundheitskompetenz und die Rolle der Therapieberufe: Ein scoping Review". International Journal of Health Professions 10, n.º 1 (1 de enero de 2023): 161–72. http://dx.doi.org/10.2478/ijhp-2023-0012.
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Abstract Background and aim Health literacy (HL) describes people’s knowledge, motivation, and competences to access, understand, appraise, and apply health information. Limited health literacy can clearly negatively impact health outcomes and therapeutic professionals are potentially important contact persons for patients and their relatives to address health literacy. The aim of this scoping review is to summarize the current literature regarding HL in the selected therapeutic professions (occupational therapy, physical therapy, and speech and language therapy). Methods (incl. inclusion criteria) We conducted an electronic database search in PubMed and CINAHL (EBSCO) up to September 2022. Two authors independently selected studies using the following inclusion criteria: (1) addressing the topic HL and (2) explicitly integrating therapeutic professionals. After extracting relevant information, the included articles were qualitatively analyzed using a narrative synthesis. Results We identified 39 research and non-research articles. The content analysis revealed the following 5 themes: (1) HL–related knowledge and skills, (2) Education and training regarding HL, (3) assessment of HL of their clients, (4) Preparation and communication of health-related information, and (5) HL in organizations. Discussion Most therapeutic professionals were familiar with the term HL, but a lack of deep understanding is described. However, therapeutic professionals are aware of the importance of addressing the needs of clients with low HL. An integration of HL-related issues in professional training and further research regarding concepts to screen and address HL in therapeutic practice are needed.
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Swiggers, Pierre. "Linguistic Bibliography for the Years 2012, 2013, 2014 and Supplements for Previous Years". Historiographia Linguistica 43, n.º 3 (16 de diciembre de 2016): 412–21. http://dx.doi.org/10.1075/hl.43.3.08swi.
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Sun, Yan, Hui-Juan Xu, Yan-Xia Zhao, Ling-Zhen Wang, Li-Rong Sun, Zhi Wang y Xiu-Fang Sun. "Crocin Exhibits Antitumor Effects on Human Leukemia HL-60 Cells In Vitro and In Vivo". Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/690164.
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Crocin is a carotenoid of the saffron extract that exhibits antitumor activity against many human tumors. However, the effects of crocin on HL-60 cells in vivo have not been evaluated. This study aimed to examine the effects of crocin on HL-60 cells in vitro and in vivo and investigate the underlying mechanisms. HL-60 cells were treated by crocin, and cell proliferation, apoptosis, and cell cycle profiles were examined by MTT assay, AO/EB staining, and flow cytometry, respectively. Furthermore, HL-60 cells were xenografted into nude mice and treated by crocin, the tumor weight and size were calculated, and the expression of Bcl-2 and Bax in xenografts was detected by immunohistochemical staining. The results showed that crocin (0.625–5 mg/mL) inhibited HL-60 cell proliferation and induced apoptosis and cell cycle arrest at G0/G1 phase, in a concentration and time-dependent manner. In addition, crocin (6.25, 25 mg/kg) inhibited the tumor weight and size of HL-60 xenografts in nude mice, inhibited Bcl-2 expression, and increased Bax expression in xenografts. In summary, crocin inhibits the proliferation and tumorigenicity of HL-60 cells, which may be mediated by the induction of apoptosis and cell cycle arrest and the regulation of Bcl-2 and Bax expression.
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Seifert, Nicole, Sarah Reinke, Johanna Grund, Berit Müller-Meinhard, Andreas Engert, Peter Borchmann, Paul J. Bröckelmann, Michael Altenbuchinger y Wolfram Klapper. "Contrasting Features of T-Cell Expansion in Classical Hodgkin Lymphoma: Tumor Microenvironment Vs. Peripheral Blood and before Vs. during Anti-PD1 Treatment". Blood 142, Supplement 1 (28 de noviembre de 2023): 3018. http://dx.doi.org/10.1182/blood-2023-186527.
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Introduction The Tumor Microenvironment (TME) in classical Hodgkin Lymphoma (HL) contains abundant CD4+ and CD8+ T-cells and only few Hodgkin-Reed-Sternberg cells (HRSC). Despite their low abundance, HRSC comprise the neoplastic cell population that intensively interacts with cells of the TME. Understanding these interactions is crucial to the further development of immune checkpoint blockade (ICB) based treatment options. Clinical trials have shown high efficacy of ICB with anti-PD1 antibodies in relapsed HL and more recently promising results of anti-PD1 antibodies in combination with conventional chemotherapy were reported in the first-line setting. (NIVAHL trial, NCT03004833) In solid cancers, anti-PD1 ICB was shown to revert tumor-induced exhaustion of CD4+ and CD8+ T-cells, thereby enabling T-cell activation and a tumor-directed immune response. Since HL differs in many aspects from non-lymphoid tumors due to e.g. loss of HLA-expression, the exact mechanisms of action of ICB in HL is not fully understood and T-cell expansion after anti-PD1 first-line treatment not yet studied. Methods To characterize T-cell activation at different timepoints and to investigate a possible T-cell mediated immune response in HL, we analyzed T-cell Receptor (TCR) repertoires of the NIVAHL study cohort before (tissue: n=90; blood: n=9) and during anti-PD1 treatment (tissue: n=4; blood: n=9). The final cohort comprised additional TCR repertoires of in-house tissue biopsies of treatment-naïve HL (n=18), relapsed HL after chemotherapy (HL-R; n=18)) and publicly available TCR repertoires of the blood of treatment-naïve HL (n=11), HL-R (n=20) and HL-R patients during anti-PD1 treatment (n=20). (Cader et al. Nat Med. 2020 Sep;26(9):1468-1479) TCR repertoires of in-house reactive lymph nodes (n=8, healthy control) and breast cancer (BC; n=6, positive control) patients served as controls for T-cell activation in the tissue, publicly available TCR repertoires of CMV- (n=22, healthy control) and CMV+ otherwise healthy (n=9, positive control) people as controls in the blood. (De Neuter et al. Genes Immun. 2019 Mar;20(3):255-260) TCR repertoires were sequenced by Adaptive Biotechnologies. For each sample, TCR sequences with the same amino acid sequence were aggregated by the sum of their counts. We computed three measures to describe T-cell expansion: debiased Simpson's Clonality (dSC), Percentage of Singletons (PoS), and clonal expansion. Singletons have recently been defined as TCR sequences detected only once in a given sample. Clonal expansion is computed as the percentage of TCR sequences that increase their frequency in a patient from one timepoint to a following by ≥ 2. Results In tissue biopsies, treatment-naïve HL showed a significantly lower dSC compared to treatment-naïve BC and significantly higher dSC compared to RLN from healthy controls. No significant differences could be observed comparing HL with different treatments (during anti-PD1 vs. after chemotherapy) and treatment-naïve HL vs. HL during anti-PD1 treatment. HL and HL-R biopsies showed a significantly lower clonal expansion of Non-Singletons than BC tumors. In peripheral blood, healthy controls, treatment-naïve HL and HL patients during anti-PD1 treatment showed significantly lower dSC in their CD4+ T-cells compared to CMV+ controls and also compared to HL-R patients. We identified significantly higher dSC in CD8+ T-cells compared to CD4+ T-cells in the blood of HL patients before and during any treatment and in relapsed HL. During anti-PD1 treatment, CD8+ T-cells showed a significantly higher clonal expansion of Non-Singletons than CD4+ T-cells in HL-R and a similar but not significant trend in HL. All observed differences in dSC were significant for the PoS too, but as expected by their respective definitions with an opposing pattern (i.e. dSC high = PoS low). Discussion We did not observe features of intratumoral T-cell expansion in primary HL samples, early during anti-PD1 treatment or at relapse after chemotherapy, suggesting that within the HL tissue, T-cell expansion is hampered. However, patterns of T-cell expansion differed between TME and the peripheral blood, where we observed features of CD8+ T-cell clonal expansion, already prior to any treatment. In summary, our findings suggest a possible anti-tumor immune response of CD8+ T-cells in the peripheral blood of HL patients, that is not found in the TME.
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Park, Mi Yung. "Identity and Voluntary Language Maintenance Efforts: A Case of Bilingual Korean-American University Students in Hawai‘i". Sustainable Multilingualism 22, n.º 1 (1 de junio de 2023): 1–26. http://dx.doi.org/10.2478/sm-2023-0001.
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Summary Reporting on the experiences of four bilingual Korean-American university students enrolled in Korean language classes in Hawai‘i, this case study focuses on their identity development and voluntary efforts to achieve heritage language (HL) competence. According to the participants’ narratives, they all experienced regression in their HL abilities and language shift from Korean to English after entering school. However, they began to regain HL skills as adolescents, which was possible due both to their voluntary engagement with HL literacy and speaking practices and to the abundance of opportunities to learn and speak the HL in the home and community. Transnational connections with their heritage nation, including Korean media and visits to Korea, were key in motivating and facilitating their voluntary HL learning. Their narratives further show that the HL played an important role in the participants’ ability to construct a strong sense of ethnic identity, and that they tended to view themselves as part of two distinct cultures. They were connected to the norms and values of both the receiving country’s culture and the culture of their heritage nation. As second-generation immigrant children, they learned to utilize their bilingual and bicultural knowledge to navigate between the two cultures in a flexible manner, to construct situated identities, and to avoid conflicts and achieve collective identity, solidarity, and group membership. The study’s insights into the role of voluntary effort in HL learning and identity development have implications for HL education.
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Song, Hyekyung. "Heritage Language Learning Trajectories and Multiple Influencing Factors: A Multiple-Case Study of University-Aged Korean Canadians". Language and Literacy 24, n.º 3 (2 de diciembre de 2022): 45–67. http://dx.doi.org/10.20360/langandlit29564.
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This study explores six university-aged 1.5 and second generation Korean Canadians’ varied heritage language (HL) learning experiences and the factors that encourage and discourage HL learning in Canada. Drawing on sociocultural perspectives (Duff, 2007, 2019; Norton, 2013), this multiple-case study reveals the core HL learning domains of home, friends at school and ethnic communities, Korean media, and university classes and various familial, sociocultural, and transnational factors. The participants’ HL learning trajectories fluctuated depending on life environments, accessibility to HL learning, and their identities and different responses to social factors. This study also underscores the importance of educational inclusivity of HLs.
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Koerner, E. F. K. "Bibliographie Linguistique de l’année 2003 et compléments des années précédentes / Linguistic Bibliography for the Year 2003 and supplements for previous years. Compiled by Sijmen Tol & Hella Olbertz (with the assistance of Dirk Glandorf and Theo Horstman)". Historiographia Linguistica 36, n.º 1 (6 de abril de 2009): 178–80. http://dx.doi.org/10.1075/hl.36.1.18koe.
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Rossetti, Sara, Sidsel Jacobsen Juul, Frank Eriksson, Peder Emil Warming, Charlotte Glinge, Tarec Christoffer Christoffer El-Galaly, Jacob Haaber Christensen et al. "Long-Term Cause-Specific Mortality in Hodgkin Lymphoma Patients - a Nationwide Danish Cohort Study". Blood 142, Supplement 1 (28 de noviembre de 2023): 4450. http://dx.doi.org/10.1182/blood-2023-172989.
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Introduction: The documented treatment-induced excess mortality in Hodgkin lymphoma (HL) has led to significant changes in treatment regimens aimed at maintaining efficacy while reducing toxicity. These modifications include the replacement of alkylator-based regimens with anthracycline-based combinations and the adoption of highly conformal radiotherapy. Danish and Nordic radiation oncologists were pioneers in implementing these changes nationwide 10-15 years earlier than most other nations. These early adaptations make Danish HL data uniquely valuable for assessing long-term mortality in a cohort where modern treatment regimens have been implemented nationwide throughout the entire study period. The impact of these treatment modifications on mortality risk in HL survivors remains unclear, therefore, this study aims to assess cause-specific mortality among HL patients treated with contemporary strategies. Methods: This nationwide, unselected study included all HL patients in Denmark aged 15-40 years at diagnosis and treated between 1995 and 2015. Patients were followed from diagnosis until emigration, death, or the study end. HL cases were identified through meticulous individual record reviews of medical records, national registries, and pathology data. Disease-specific death due to HL was the primary outcome, with other cause-specific mortality as a competing risk. Cox proportional hazard models assessed factors influencing overall survival and cause-specific survival. A landmark analysis was conducted to compare the risk of death between the study population and the national background population. Results: Among 1,348 included HL patients, 66.5% had Ann Arbor stage I-II at the time of diagnosis. During 18,731 person-years of follow-up, 139 deaths occurred, resulting in a 5-year overall survival rate of 94.6% (95% CI 93.4-95.8). Factors associated with higher overall mortality risk included older age, advanced disease stage at diagnosis, earlier treatment periods, and exposure to intensive treatment regimens. Causes of death included: HL (71 cases), cardiovascular disease (9 cases), second malignancies (19 cases including 3 hematologic malignancies), bone-marrow transplant-related complications (9 cases), acute treatment-related toxicity (<5 cases), pulmonary diseases (<5 cases), other diseases not related to HL (11 cases), and deaths related to accidents, poisoning or suicide (7 cases). The cumulative risk of mortality due to HL steeply increased over the first 10 years, reaching a plateau at 5.3% at the 10-year mark. Cumulative risk of death due to cardiovascular or pulmonary disease and second cancers had a gradual increase around 10 years after HL diagnosis, but only reached 1.2% and 2.0%, respectively, at the 20-year mark. The cumulative risk of death due to other causes had a slower rise, reaching 2.5% 15 years after diagnosis. Stratifying the cumulative cause-specific risk of death into HL and other causes, we found an initial sharp increase in cumulative risk of death due to HL in the first year after diagnosis, which was surpassed by the risk of death from other causes by 17.8 years of follow-up, with a cumulative risk of death of 5.72%. HL cases had a 7.5-fold higher hazard of mortality compared to the background population. Conclusion: Despite the implementation of contemporary treatment regimes, HL patients still face higher mortality compared to the general population. In the initial years after diagnosis, most deaths are disease-specific, while the risk of mortality due to possible treatment-related late effects gradually increases after 10 years. However, our findings demonstrate a markedly lower overall risk of mortality and cause-specific mortality among HL patients exposed to contemporary treatment, compared to the risk reported in earlier studies among patients from earlier treatment eras (Aleman, B. et al. Long-term cause-specific mortality of patients treated for Hodgkin's disease. J Clin Oncol21 2003, 3431-3439). Furthermore, we observe a remarkably low overall and cause-specific risk of death due to possible treatment-related late effects. The treatment of HL remains a balance between efficacy and toxicity in the individual patient, but our results suggest that recent changes in treatment strategies have led to a distinct reduction in the risk of fatal long-term toxicity and have improved HL-specific survival.
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Rivarola, Sofía Gabriela, German R. Stemmelin, Jule F. Vasquez, Maria Elvira Enciso Arrua, Seisha Von Glasenapp, Carolina Oliver, Fernando Warley et al. "Clinical Features, Treatment Patterns and Outcomes of 864 Newly Diagnosed Hodgkin Lymphoma Patients in Latin America and the Impact of PET Scan Availability on Survival: A Study from the Grupo De Estudio Latinoamericano De Linfoproliferativos (GELL)". Blood 142, Supplement 1 (28 de noviembre de 2023): 4441. http://dx.doi.org/10.1182/blood-2023-185131.
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Background: Hodgkin lymphoma (HL) is a lymphoid neoplasm with high cure rates. Around 90% of patients (pts) will achieve response to first-line treatment. Real-world studies in Latin America (LATAM) are lacking. Moreover, inequity in the access to imaging technology and drugs represent a real challenge for Latin American countries with palpable influences in patient outcomes. Herein, we describe the clinical features, treatment patterns, and outcomes of HL pts managed in LATAM. Method: We conducted a retrospective cohort study of adults aged ≥17 years with newly diagnosed HL across academic centers in 7 LATAM countries from 2003 to 2022, with follow-up through July 2023. Medical records were manually reviewed, and data were abstracted in a standardized form. Cancer staging was performed by Ann Arbor and German HL Study Group criteria. Survival probabilities were estimated with the Kaplan-Meier method and compared with the Log-rank test. Multivariable Cox regression models were fitted by cancer stage stratification. A landmark analysis was performed to assess the lack of PET scan availability at the end of treatment (EOT) in LATAM. Results: Of 965 pts identified, 864 had sufficient data for analysis. Pts were young (56% <40 years; median 36 [17-88]) with slight male predominance (53%). 9 (3%) pts were HIV positive. Nodular sclerosing (62%) and mixed cellularity (22%) were the most common HL subtypes (p<0.01). Clinically, most pts had good performance status (ECOG≤1, 96%), no B symptoms (62%) and normal serum LDH (60%). Mediastinal presentation was seen in 14%, bulky mass (>10 cm) 23%, nodal involvement >3 sites 34% and extranodal involvement 25%. Advanced stage was common (57%); 22% and 21% had favorable and unfavorable limited stage HL, respectively. ABVD was the most common first-line regimen (96%); 8 pts received BEACOPP, and 1 BV-AVD. Radiation was utilized in 40% of limited and 21% of advanced stage HL. Only 63% and 48% had interim (iPET) and EOT PET scan, respectively. Most pts were managed at private than public institutions (59%, p<0.01). With a median follow up of 65 [59-71] months the 5-yr overall survival (OS) and progression-free survival (PFS) rates in all HL pts were 85% (82-88, 95% CI not reached, NR) and 64% (60-69, 95% CI NR), respectively. Better OS and PFS were seen in pts younger than 60 (p<0.01), ECOG≤1 (p<0.01) and limited stage HL (p<0.01). Overall response rate at the EOT assessed by either PET or CT scan was 89% (76% complete and 13% partial). In those assessed by iPET, results yielded 86% keeping same plan, 7% de-escalation and 3% escalation. In our cohort, 11% had refractory HL and 18% relapsed after achieving response. Given the inferior PFS to first-line seen in our LATAM HL pts compared to historical cohorts, we looked at possible factors associated to early relapse. Those assessed by PET at the EOT had significantly superior 5-yr PFS than those assessed by CT scan (PET vs CT: favorable HL 91 vs 71%; unfavorable 83 vs 35%; advanced 79 vs 51%) ( Figure). OS was inferior only in pts with unfavorable HL not assessed by PET (94 vs 76%, p=0.03). In the multivariable analysis, the lack of PET assessment at the EOT was associated with short PFS in unfavorable (aHR 7.81 [1.46-41.88], p=0.02) and advanced (aHR 17.35 [4.66-64.61], p<0.01), and a non-statistically significant worse PFSvin favorable HL (aHR 5.05 [0.56-45.72], p=0.15). Other factors associated to short PFS were extranodal disease (aHR 35.29 [5.62-209.07], p<0.01) in unfavorable, and high serum LDH (aHR 2.31 [1.2-4.46], p=0.01) in advanced HL. Interestingly, pts with advanced HL managed in public institution had less risk for relapse than those in private institutions (aHR 0.13 [0.03-0.51], p<0.01). Conclusion: To our knowledge, this is the largest cohort of newly diagnosed HL pts in LATAM in the real-world setting. We observed similar clinical features in LATAM HL pts than those previously reported. ABVD was widely utilized in LATAM, and the 5-yr OS of 85% in all pts aligns with international estimates. However, our findings underscore the impact of limited access to PET scan at the EOT in LATAM, leading to lower PFS outcomes compared to those reported in developed countries. Despite this challenge, salvage therapy seems to rescue our LATAM HL pts, thus, OS remains optimal. To improve outcomes and minimize late effects following treatment completion, increasing the use of PET-adapted therapy for managing adult pts with HL in LATAM should be prioritized.
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NG, HEOK HEE, WAN-SHENG JIANG y XIAO-YONG CHEN. "Glyptothorax lanceatus, a new species of sisorid catfish (Teleostei: Siluriformes) from southwestern China". Zootaxa 3250, n.º 1 (29 de marzo de 2012): 54. http://dx.doi.org/10.11646/zootaxa.3250.1.4.
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Glyptothorax lanceatus, a new species of sisorid catfish from the upper Salween River drainage in southwestern China,is described. It can be distinguished from congeners in having the following combination of characters: length of nasalbarbel 18.1–21.5% HL; length of maxillary barbel 86.2–91.1% HL; length of inner mandibular barbel 23.8–28.2% HL;length of outer mandibular barbel 42.8–49.1% HL; eye diameter 6.8–8.3% HL; interorbital distance 20.2–22.1% HL;elongate, ovoid tubercles on dorsal surface of head; head length 23.0–25.1% SL; head width 16.3–18.8% SL; width ofadhesive apparatus 1.60–1.74 times in its length; depressed area in thoracic adhesive apparatus not wholly enclosed byridges; ridges of thoracic adhesive apparatus not extending onto gular region;10–13 serrations on posterior edge of pecto-ral spine; pectoral-fin length 21.1–24.5% SL; length of adipose-fin base 12.2–13.2% SL; dorsal-to-adipose distance 23.0–24.8% SL; distally expanded neural spines in vertebrae between dorsal and adipose fins; body depth at anus 12.4–14.8%SL; post-adipose distance 18.7–20.3% SL; caudal-peduncle length 20.3–21.8% SL; caudal-peduncle depth 6.7–7.4%SL;40–41 vertebrae; reaching to at least ca. 170 mm TL in size; and uniformly dark-colored body generally devoid of pale or dark markings.
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Konrad, Jörg y Martha Holst. "HL Display übernimmt Wettbewerber". Lebensmittel Zeitung 75, n.º 14 (2023): 39. http://dx.doi.org/10.51202/0947-7527-2023-14-039-1.
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Liu, Qian, Hairong Chen, Anand Thirupathi, Meimei Yang, Julien S. Baker y Yaodong Gu. "A Pilot Study of Plantar Mechanics Distributions and Fatigue Profiles after Running on a Treadmill: Using a Support Vector Machine Algorithm". Journal of Healthcare Engineering 2023 (21 de febrero de 2023): 1–10. http://dx.doi.org/10.1155/2023/7461729.
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The treadmill is widely used in running fatigue experiments, and the variation of plantar mechanical parameters caused by fatigue and gender, as well as the prediction of fatigue curves by a machine learning algorithm, play an important role in providing different training programs. This experiment aimed to compare changes in peak pressure (PP), peak force (PF), plantar impulse (PI), and gender differences of novice runners after they were fatigued by running. A support vector machine (SVM) was used to predict the fatigue curve according to the changes in PP, PF, and PI before and after fatigue. 15 healthy males and 15 healthy females completed two runs at a speed of 3.3 m/s ± 5% on a footscan pressure plate before and after fatigue. After fatigue, PP, PF, and PI decreased at hallux (T1) and second-fifth toes (T2–5), while heel medial (HM) and heel lateral (HL) increased. In addition, PP and PI also increased at the first metatarsal (M1). PP, PF, and PI at T1 and T2–5 were significantly higher in females than in males, and metatarsal 3–5 (M3–5) were significantly lower in females than in males. The SVM classification algorithm results showed the accuracy was above average level using the T1 PP/HL PF (train accuracy: 65%; test accuracy: 75%), T1 PF/HL PF (train accuracy: 67.5%; test accuracy: 65%), and HL PF/T1 PI (train accuracy: 67.5%; test accuracy: 70%). These values could provide information about running and gender-related injuries, such as metatarsal stress fractures and hallux valgus. Application of the SVM to the identification of plantar mechanical features before and after fatigue. The features of the plantar zones after fatigue can be identified and the learned algorithm of plantar zone combinations with above-average accuracy (T1 PP/HL PF, T1 PF/HL PF, and HL PF/T1 PI) can be used to predict running fatigue and supervise training. It provided an important idea for the detection of fatigue after running.
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Naik, Ganesh N., Raghavendra P. Bakale, Aishakhanam H. Pathan, Shashikala G. Ligade, Shreenivas A. Desai y Kalagouda B. Gudasi. "2,4-Dichlorophenoxyacetic Acid Derived Schiff Base and Its Lanthanide(III) Complexes: Synthesis, Characterization, Spectroscopic Studies, and Plant Growth Activity". Journal of Chemistry 2013 (2013): 1–13. http://dx.doi.org/10.1155/2013/810892.
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2,4-Dichlorophenoxyacetic acid derived Schiff base (HL) and its lanthanide [La(III), Pr(III), Nd(III), Sm(III), Eu(III), Gd(III), Dy(III), Y(III)] complexes were synthesized and characterized by various spectroscopic (1H,13C, DEPT and 2D HMQC NMR, FT-IR, UV-Vis, and mass) techniques and other analytical methods. HL exhibits “E” and “Z” isomerism and was confirmed by variable temperature1H NMR studies. The spectral and analytical data reveals the bidentate coordination of HL to lanthanide(III) ion, through carboxylic acid group via deprotonation. Fluorescence spectrum of europium complex shows bands at 578, 592, and 612 nm assignable toD05→F07,D05→F17, andD05→F27, respectively. Auxin activity of HL and lanthanum(III) complex on wheat seeds (Triticum durum) was measured at different concentrations. The percentage germination, root length, and shoot length were recorded. An enhancement in the plant growth activity of the ligand was observed on complexation and the best activity was observed at 10−6 M concentration.
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Sørensen, Maria Leonora Birk, Lotte Linnemann Rønfeldt y Birgitte Nørgaard. "Cancer Patients’ Experience of a Patient-Safe Pathway Is Associated with Health Literacy and Support from Relatives: A Cross-Sectional Survey". European Journal of Cancer Care 2023 (3 de agosto de 2023): 1–8. http://dx.doi.org/10.1155/2023/3838925.
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Introduction. The aim was to assess the impact of cancer patients’ health literacy (HL) on their experience of patient safety. Furthermore, we investigated whether support from relatives affected cancer patients’ experiences of patient safety. Methods. A cross-sectional study was conducted using questionnaire data from the Danish National Cancer Patient Survey 2017 among Danish cancer patients (n = 5,389) and sociodemographic characteristic data from national registries. Results. A low level of HL is associated with increased patient safety errors among cancer patients regarding patient-reported adverse events and an experience of inadequate information. Results also showed increased odds of patient safety risks among patients with no support from relatives. Conclusion. Having a low level of HL or no support from relatives has a negative impact on patient safety. Focusing on improvements related to cancer patients’ HL and supportive network may increase patients experiencing a high quality and safe health care system and reduce inequalities and inequity in the cancer pathway.
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Liévin, Raphaël, Nicolas Duployez, Loïc Vasseur, Juliette Lambert, Mael Heiblig, Mathilde Hunault, Claude Gardin et al. "Hyperleukocytosis Increases the Risk of Early Relapses Independently of Genetics in AML". Blood 142, Supplement 1 (28 de noviembre de 2023): 4322. http://dx.doi.org/10.1182/blood-2023-173614.
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Background. Higher white blood cell (WBC) count at diagnosis is associated with specific gene lesions and higher early death rates in AML patients (pts) treated intensively. Whether higher WBC count at diagnosis affects outcome beyond remission independently of genetics is unknown. Methods. 1,371 AML pts treated intensively in 3 ALFA trials (0702 18-60y, 0701 50-70y, 1200 60y+) with centralized genetics were studied. Genetic alterations found in >5% of pts (n=22) were analyzed. Hyperleukocytosis (HL) was defined as WBC > 50 x10 9/L. NPM1 MRD was stratified as published (Balsat, J Clin Oncol 2017). All prognostic analyses were stratified on trial. Time-dependent effects were introduced in multivariable Cox models when the proportional hazard (PH) assumption was violated. Results. The median WBC count at diagnosis was 7.1 x10 9/L (range 0.3-546.6), and 235 pts (17.1%) had HL. HL pts had poorer performance status (p<0.001), lower platelet counts (p=0.003), higher frequency of de novo AML (p=0.006) and more favorable genetic risk (ELN 2022 criteria, p<0.001). In a multivariable model, HL was independently associated with more frequent NPM1, FLT3-ITD and -TKD mutations, and less frequent STAG2 and -17/17p- alterations (all p<0.05, Figure 1A). Complete remission (CR [including CR with incomplete platelet recovery, CRp]) and early death (ED) rates were 77.4 vs 80.0% (p=0.38) and 8.9 vs 5.0% (p=0.03) in pts with and without HL, respectively (resp). In a multivariable model accounting for ELN22 risk and age, HL was independently associated with more frequent ED (OR =2.20, 95%CI 1.26-3.75, p=0.004), and a trend to more frequent primary induction failure (OR=1.40, 95%CI 0.95-2.05, p=0.08). In the 1,091 pts achieving CR/CRp (182 and 909 with and without HL resp), 1-y and 2-y cumulative incidence of relapse were 39.0% vs 26.1% and 44.0% vs 40.2% resp, suggestive of a time-dependent effect of HL on post-remission outcome ( Figure 1B). Considering relapse and death as competing events, a multivariable model revealed a significant impact of HL on relapse (subdistribution hazard ratio, sHR=1.59, p=0.0003), independent of ELN22 risk and age, but not on non-relapse mortality (sHR=0.69, p=0.23). HL violated the PH assumption in a univariable Cox model for DFS (p=0.0003). We thus performed multivariable Cox models for DFS separating early (< 1 year from CR) and late (≥1 year) effects for HL. In a multivariable time-dependent model, HL significantly impaired early (HR=1.89, p<10 -4), but not late (HR=0.79, p=0.29) DFS, independently of ELN risk and age. These results were confirmed considering WBC count as a (log-transformed) continuous variable, accounting for all differentially represented genetic lesions instead of ELN22 risk or censoring at allogeneic HCT. In a validation cohort of 1,089 pts <60y reaching CR after intensive chemotherapy in the BIG-1 trial (NCT02416388) where median WBC was 7.7 x10 9/L and 16.1% of pts were HL, the adverse risk of HL on CIR (sHR=1.39, p=0.007) but not NRM (sHR=1.02, p=0.95) and on early (HR=1.42, p=0.01), but not late (HR=1.24, p=0.23) DFS independent of ELN22 risk and age was validated. Finally, to explore the mechanism underlying the higher early relapse rate of HL pts, we analyzed NPM1 MRD (n=152) and LSC17 (n=504) data from the 0702 trial. A higher WBC count was predictive of suboptimal MRD (OR=1.97, p=0.05) independently of FLT3-ITD status. A higher WBC count was significantly correlated to lower LSC17 score (Spearman rho=0.23, p<10-5). Conclusion. A high WBC count at diagnosis predicts higher rates of early, but not late relapse, independent of genetic risk. Our results strengthen the hypothesis that distinct biological mechanisms underpin early vs late chemoresistance in AML.
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Ng’ondya, Odino Brighton, Raphael Zozimus Sangeda y Kennedy Daniel Mwambete. "Prevalence and Management of Helminthiasis and Virological Outcomes among HIV Co-infected Under-fives: A Case Study of Mwananyamala Hospital, Tanzania". Asian Journal of Medicine and Health 21, n.º 7 (21 de abril de 2023): 56–64. http://dx.doi.org/10.9734/ajmah/2023/v21i7831.
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Background: Helminthiasis (HL) is a parasitic infection caused by worms that infect human body. The disease affects different regions of the world, but it is more prevalent in sub-Saharan African countries. A strong association between immunological status and helminthiasis among under-fives living with HIV infection (ULHI) has been reported.
Aim: The study aimed to assess the prevalence and management of helminthiasis and virological outcomes among ULHI receiving health care at the Care and Treatment Centre (CTC) located at Mwananyamala Regional Referral Hospital (MRRH) in Dar es Salaam, Tanzania.
Methodology: This was a retrospective and descriptive cross-sectional study involving scrutiny of the clinical records of ULHI, who sought medical attention at MRRH. The clinical records were randomly selected and examined, focusing on the prevalence rate of HL, the co-management of HIV and HL infections, the virological outcome based on the HIV viral load, and other relevant data.
Results: A total of 499 ULHI were involved; of those, 254 (50.9%) were females and 245 (49.5%) were males. About 49% of the ULHI had HL. The prevalence of HL and the age of ULHI were both associated with the virological outcome (HVL). ULHI with lower HVL had a relatively greater HL prevalence. The most widely utilized antihelmintics were ABZ, MBZ and IVE, in that order. The most frequently prescribed drugs for co-infections were ABZ-ALL and MBZ-TLD combinations, which exhibited lower HVL.
Conclusion: Helminthiasis is still prevalent among ULHI, and use of prophylactic antihelminthics was associated with virological success (lower HVL). The prevalence of HL was relatively higher among ULHI with lower HVL.
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Valiev, T. T. y E. S. Belyaeva. "Results of longstanding, single-center trial for pediatric Hodgkin lymphoma treatment". Oncohematology 16, n.º 3 (10 de septiembre de 2021): 95–104. http://dx.doi.org/10.17650/1818-8346-2021-16-3-95-104.
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Background. Actually, treatment results of Hodgkin lymphoma (HL) are the most dramatic oncohematology achievements, therefore modern treatment protocols designed to toxicity reduction with the same high level of patients’ survival. Time of complete response occupies a central position in the prognostic factors for HL and helps to find a group of patients whose treatment could be de-escalated.Objective: to evaluate the efficacy of original domestic risk-adopted protocol RDC POG-HL 2003 with treatment de-escalation and refused radiation therapy (RT) for early-responded patients.Materials and methods. 192 patients were enrolled in prospective RDC POG-HL 2003 protocol from February 2003 to November 2020. Median age was 12.8 years (from 3 to 17). Local stages (IA–IIA) were diagnosed in 48 (25 %) patients, disseminated (IIB–IVB) – in 144 (75 %) cases. For local (IA–IIA) stages by RCD POG-HL 2003 treatment included DBVE + RT, for disseminated (IIB–IVB) – BEACOPP escalated (esc.) + RT. In case of 70 % and more tumor reduction after 4 induction courses of BEACOPP-esc., the following treatment included less intensive schemes (ABVD, COPP/ABV). Because of high risk of breast cancer in girls after mediastinal RT, it was possible to omit a RT in case of early response.Results. All patients with local stages are alive by the time of study end. Event- and relapse-free survivals in this group were 97.8 ± 2.5 % (median follow up 181.9 ± 4.8 months). Event-free survival for disseminated stages patients was 90.3 ± 3.3 % (median follow up 179.1 ± 4.2 months), relapse-free survival – 93.5 ± 2.1 % (median follow up 191.7 ± 2.3 months) and overall survival – 97.9 ± 1.2 % (median follow up 196.3 ± 2.6 months). In 48 (25 %) patients it was possible to omit RT without reducing survival rates.Conclusion. Differentiated HL treatment with respect to disease stage and time of complete response is a key to success of treatment. Such approach permits us to reduce cumulative therapy toxicity by its de-escalation and, in some cases, to omit RT.
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Оганесянц, Л. А. y А. Л. Панасюк. "Trends in Production and Consumption of Wine in the World in 2023". Beer and beverages, n.º 2 (22 de junio de 2023): 4–8. http://dx.doi.org/10.52653/pin.2023.02.02.006.
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Представлен анализ данных по производству винограда и вина в 2022 г. Общая площадь виноградников в мире составляет 7,3 млн га. Наибольшие площади виноградников расположены в Испании (955 тыс. га), Франции (812), Китае (785), Италии (718), Турции (410) и США (390 тыс. га). В России площадь виноградников составляет 99 тыс. га. Мировое производство вина составило 258 млн гкл, то есть на 1% ниже в сравнении с 2021 г. На Италию, Францию и Испанию приходится более половины мирового производства вина, соответственно 49,8; 45,6 и 35,7 млн гкл. Несмотря на засуху и жару весной и летом в Европе, потери урожая оказались незначительными. Мировое потребление вина снизилось до 232 млн гкл, что связано со значительным ростом цен, вызванным энергетическим кризисом и сбоями в глобальной цепочке поставок. В 2022 г. мировой экспорт вина составит 107 млн гкл, что на 5% меньше по сравнению с исторически высоким показателем 2021 г. Италия экспортировала в 2022 г. 21,9 млн гкл вина, что составляет 20% мирового экспорта. Наибольшее снижение экспорта зафиксировали Испания (–2,4 млн гкл), Аргентина (–0,7), Франция (–0,7), США (–0,5) и ЮАР (–0,4 млн гкл). На экспорт вина отрицательно повлияло снижение активности морских перевозок, связанной с высокой инфляцией. Предварительные данные по производству вина в Южном полушарии в 2023 г. показывают его заметное снижение во всех странах, кроме Чили. The analysis of data on the production of grapes and wine in 2022 is presented. The total area of vineyards in the world is 7.3 million hectares. The largest areas of vineyards are located in Spain 955 thousand hectares, France 812 thousand hectares, China 785 thousand hectares, Italy 718 thousand hectares, Turkey 410 thousand hectares and the USA 390 thousand hectares. In Russia the area of vineyards is 99 thousand hectares. World wine production amounted to 258 million hl, that is 1% lower compared to 2021 Italy, France and Spain account for more than half of the world’s wine production, respectively 49.8, 45.6 and 35.7 million hl. Despite the drought and heat in spring and summer in Europe, crop losses were insignificant. Global wine consumption decreased to 232 million hl, which is due to a significant price increase caused by the energy crisis and disruptions in the global supply chain. In 2022, world wine exports will amount to 107 million hectoliters, which is 5% less than the historically high figure of 2021. Italy exported 21.9 million hectoliters in 2022, which is 20% of world exports. The largest decrease in exports was recorded by Spain (–2.4 million hl), Argentina (–0.7), France (–0.7), the USA (–0.5) and South Africa (–0.4 million hl). Wine exports were negatively affected by a decrease in the activity of sea transportation associated with high inflation. Preliminary data on wine production in the Southern Hemisphere in 2023 show a marked decline in all countries except Chile.
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Adel, Ahmed A., Aimilia Exarchakou, Anas Hamad, Ruba Yasin, Hafedh Ghazouani y Mohamed A. Yassin. "Epidemiologic and Clinical Patterns of Lymphoma in Qatar 2013-2017: A Population-Based Cohort Study". Blood 138, Supplement 1 (5 de noviembre de 2021): 4584. http://dx.doi.org/10.1182/blood-2021-144637.
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Abstract Background: Lymphoma: either most common non-Hodgkin (NHL) or less common Hodgkin (HL), are well-known hematological malignancies. With advancement in treatment modalities, the survival in both lymphomas especially the "poor prognosis" non-Hodgkin lymphoma has evolved in the last decades. Hence, patient's outcome may be diverse and quite complicated; with some need extended time for observation, and others having multiple chemotherapy treatments. In this review, we will focus on the clinic-epidemiological patterns of various malignant lymphoma subtypes in Qatar in recent years (2013-2017) Objective: The primary aim is to investigate and compare the overall survival (OS) for both types of lymphoma; HL and NHL at 1, 3 and 5-years of follow up in adult lymphoma patients in Qatar between January 2013 - December 2017. Other objectives include comparing between the most frequent histological varieties, clinical and epidemiological characteristics of HL and NHL lymphoma in Qatar. The secondary objectives included clinical characteristics, treatments used, treatment response, disease-free survival and overall survival. Methods: A retrospective, descriptive study of consecutive cases was carried out at NCCCR, Qatar between 2013-2017. Inclusion criteria included: ≥ 18 years of age, male or female, any clinical stage at diagnosis, who had received any chemotherapy regimen, with a known outcome. Descriptive statistics was performed for all variables, and survival was assessed using Kaplan-Meier curves. Data was abstracted by Qatar National Cancer Registry and the 2008 World Health Organization (WHO) classification of hematopoietic and lymphoid tumors is used as reference for disease staging and pathological classification. We used STATA version 13.0 (StataCorp., College Station, TX) for exploratory data analysis and descriptive statistics. Results: During the period 2013-2017, 414 men and women were diagnosed with lymphoma in the state of Qatar. The median age at diagnosis being 49 years (interquartile range IQR 36-95 years; p<0.001)) for all lymphoma patients combined. Males were more likely to develop both lymphoma types; HL and NHL than females; accounting for 2/3 of cases in each, yet statistically insignificant (74% and 70%, p=0.45). Based on subtypes, mature B-cell neoplasms (61 cases, 60%) were the most common among 13 identifiable NHL-B subtypes. Majority of HL cases belonged to Lymphocyte rich subtype (54 cases, 49%). With a median follow up of 17.3 months, the 1-year, 3-year and 5-year OS for the entire population of lymphoma patients were 99%, 82% and 64% (Figure 12). When stratified by major subtypes; HL and NHL, some trends became evident at 3-years follow-up (94% versus 82%). The 5-year OS were 67% and 60%, respectively. Throughout the study period, the OS in HL group were higher than NHL (p<0.001), yet median OS was not reached. Conclusions: Diffuse large B-cell lymphoma constitutes the most frequent subtype for all lymphomas in Qatar. Overall, the survival was generally better for HL than NHL 67% and 60% respectively. Survival can be slightly deflated than other countries or regions especially HL, this is in part due to higher immigration rate in the country, so changes in survival over time (especially for longer periods) need to be examined alongside trends in incidence rates to interpret improvement in cancer control policies implemented. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.
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Gotti, Manuel, Valeria Fiaccadori, Elisa Bono, Benedetta Landini, Marzia Varettoni, Luca Arcaini y Maurizio Bonfichi. "Therapy-Related Late Adverse Events in Hodgkin’s Lymphoma". Lymphoma 2013 (11 de abril de 2013): 1–7. http://dx.doi.org/10.1155/2013/952698.
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Hodgkin's lymphoma (HL) is one of the most curable hematologic diseases with an overall response rate over 80%. However, despite this therapeutic efficacy, HL survivors show a higher morbidity and mortality than other people of the same age because of long-term therapy-related events. In the last decades, many efforts have been made to reduce these effects through the reduction of chemotherapy dose, the use of less toxic chemotherapeutic agents, and the introduction of new radiation techniques. In this paper, we will describe the main long-term effects related to chemotherapy and radiotherapy for HL, the efforts to reduce toxicity made in the last years, and the clinical aspects which have to be taken into consideration in the followup of these patients.
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Paucar-Caceres, Alberto, Carlos Vílchez-Román y Silvia Quispe-Prieto. "Health Literacy Concepts, Themes, and Research Trends Globally and in Latin America and the Caribbean: A Bibliometric Review". International Journal of Environmental Research and Public Health 20, n.º 22 (20 de noviembre de 2023): 7084. http://dx.doi.org/10.3390/ijerph20227084.
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(1) Background: Health literacy (HL) debates have increased significantly in the last two decades. HL concepts/themes and models have achieved substantial development in the US and Europe. Although there have been some efforts to develop HL in Latin America and the Caribbean (LAC), these seem to be few and scattered. This paper reviews and discusses developments of HL concepts and themes globally and in LAC over the last two decades. (2) Purpose: This study aimed to identify the prevalent health literacy concepts/themes deployed globally and in LAC as reported in academic journals from 2005 to 2022. We looked into which fields of knowledge have been informing HL research over the last decades. (3) Methods: We conducted a structured search on the Web of Science (WoS), Scopus, PubMed, and SciELO databases to extract the textual data for bibliometric analysis. We analyzed the textual data with VOSviewer and Biblioshiny to better understand health literacy themes and strands currently being researched in the LAC region. We conducted the searches in two periods: the first in May 2023 and the second in October 2023. (4) Results: The bibliometric study highlighted five WoS categories informing most HL global studies: (i) public environmental occupational health; (ii) environmental sciences; (iii) health policy services; (iv) health care science services; and (v) communication. The two predominant categories in LAC are public environmental occupation health and health policy services. Journals hosting HL publications come from these WoS categories. Themes in HL publications can be organized into four thematic clusters: (i) analytical (research designs, analytic techniques, and criteria for examining HL data); (ii) psychometric (measurement properties of data collection tools); (iii) pragmatic (practical issues related to implementing HL programs); and (iv) well-being (effectiveness of HL programs on mental health and illness treatment). (5) Conclusions: There is expanding interest in health literacy among scholars. The number of publications has increased substantially, particularly over the last five years. These are dominated by the Global North. The metrics show that LAC and Africa are trailing in publications. There is an emerging focus on adult literacy, functional/low health literacy, and their effect on improving capabilities, comprehension, and communication regarding health-related topics.
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Zeller, Bernward, Nira Arad-Cohen, Daniel Cheuk, Barbara De Moerloose, Jose Maria Fernandez Navarro, Henrik Hasle, Jahnukainen Kirsi et al. "Management of Hyperleukocytosis in Pediatric Acute Myeloid Leukemia Using Immediate Chemotherapy without Leukapheresis, in Protocol NOPHO-DBH AML-2012". Blood 142, Supplement 1 (28 de noviembre de 2023): 2852. http://dx.doi.org/10.1182/blood-2023-184921.
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Introduction: Hyperleukocytosis (HL) in pediatric acute myeloid leukemia (AML) is associated with severe complications and inferior outcome. Initial management is subject to debate, and the role of invasive methods such as leukapheresis (LA) and exchange transfusion (ET) has been questioned. We report the results on HL patients included in the NOPHO-DBH AML 2012 study. Patients and methods: All patients were treated on the NOPHO-DBH AML 2012 protocol. Between January 1 st, 2013 and September 30 th, 2021, 714 patients were diagnosed, of whom 122 (17.1%) had HL, defined as white blood cell count (WBC) ≥100x10 9/L. Sixty-nine patients (9.7%) had WBC ≥200 x10 9/L. Protocol guidelines recommended immediate start of the first chemotherapy course (starting with etoposide [ETO] monotherapy for 5 days at 150 mg/m 2 once daily) followed randomized by either cytarabine/mitoxantrone (MEC) or cytarabine/daunoxome or daunorubicin (D[x]EC). The use of LA, ET, or prephase chemotherapy (PCT) was discouraged. In addition to registered data, we sent out questionnaires asking for additional detailed information on HL patients. Results: HL patients had a median WBC of 211x10 9/L (range 101-880). They did not differ from Non-HL patients in terms of age, sex or CNS involvement, but had a higher proportion of extramedullary tumors (18% vs 11%). They had a significantly lower frequency of RUNX1::RUNX1T1 fusions (1.7% vs. 15.4%), and a higher proportion of KMT2A rearrangements (except KMT2A:: MLLT3) (23.1% vs. 12.2%), and FLT3-ITD without NPM1 mutation (20.7% vs. 8.1%). Of the 122 HL patients, 111 (90.2%) were treated according to the guidelines with ETO upfront. LA was used in six patients (4.9%), in one case combined with ET. One of the LAs was performed in a patient unresponsive to ETO (increasing WBC after 2 days of ETO treatment). Eight patients received prephase chemo (various regimes) before start of the first course. In the 111 patients treated with ETO upfront, the first dose ETO was applied the same day as the AML diagnosis or the day after in 94.4%, and the drug was administered via peripheral veins in 37.8% of patients without major complications. After initiation of ETO, the remaining WBC on days 2-5 was 69.0%, 35.6%, 17.2% and 8.4% respectively, of the value before chemotherapy (Figure 1). On day 3, 80.9% had a WBC<100 x10 9/L. Compared to the non-HL group, HL patients had a trend to higher early death rate within the first 6 weeks (5/122, 4.1% vs. 13/592, 2.2%, P=0.062), and a higher rate of resistant disease defined as > 5% blasts after 2 induction courses (14/122, 11.5% vs. 23/592, 3.9%, P=0.002). Five-year event-free survival (EFS) for all HL patients was 51.9±4.8 compared to 64.7±2.1 in the non-HL group. Overall survival (OS) was 73.5±4.2 and 78.7±1.8, respectively (log rank 0.089). Three children with HL died within 2 weeks from diagnosis (2.5%). Early death within 6 weeks occurred in 3/111 (2.7%) in the ETO-upfront group and 2/11 (18.2%) in the LA/ET/PCT group, P=0.064). Of 69 patients with WBC >200 x 10 9/L, 14 patients died, but only three during the first 6 weeks. Conclusions: The NOPHO-DBH AML 2012 protocol is very effective in pediatric AML. The first chemotherapy course starts with five consecutive days of ETO monotherapy. We made use of this “ETO-window” in the management of HL patients, omitting invasive methods to reduce high WBCs. We conclude that in HL patients immediate ETO-therapy without LA/ET is feasible, easy to administer, safe and effective. Treatment results were excellent in terms of early death and OS. The significantly lower EFS for HL patients is explained mainly by a higher frequency of resistant disease, probably due to the higher proportion of high-risk AMLs (low rate of RUNX1:: RUNX1T1, high frequency of rearranged KMT2A and FLT3-ITD/NPM1wt). However, OS was not significantly lower for the HL group, which may be explained by successful salvage of patients with resistant disease or relapse using stem cell transplantation. WBC reduction during the first days of ETO therapy is comparable to reported results of LA, and outcome seems at least equivalent to studies using LA as part of their recommended therapy. Since the ETO-window allows avoiding invasive, costly and time-consuming procedures, the consortium now called NOPHO-DB-SHIP decided to stick to the same policy in the new protocol, CHIP-AML22.
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Bhethanabhotla, Sainath, Sreenivas Vishnubhatla y Sameer Bakhshi. "Predictors of Poor Response to Salvage Chemotherapy in Relapsed/ Refractory Pediatric Hodgkin Lymphoma- A Retrospective Analysis from Tertiary Cancer Centre in India". Annals of the National Academy of Medical Sciences (India) 54, n.º 03 (julio de 2018): 160–70. http://dx.doi.org/10.1055/s-0040-1712842.
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ABSTRACT Background: Previous studies identified prognostic factors for survival in relapsed pediatric Hodgkin lymphoma (HL) who received salvage chemotherapy followed by autologous stem cell transplant (ASCT). However, data regarding predictors of poor response to salvage chemotherapy is limited. Methods: We conducted retrospective study in all relapsed HL treated from January 2003 to December 2013. Logistic regression analysis was done to identify predictors of response to salvage chemotherapy. Cox regression analysis was done to identify prognostic factors for Freedom from treatment failure (FFTF) and overall survival (OS). Results: Forty six patients had relapsed HL. Among 45 patients who received salvage chemotherapy only 34 (73.4%) underwent ASCT. Stage 4 disease (p=0.02) and bulky disease at relapse (p=0.03) were predictors of poor response to salvage chemotherapy. FFTF and OS at 5 yr for entire cohort were 50.1% and 63.3%, respectively, while the same for patients who underwent ASCT were 66.3% and 80.7%, respectively. Among ASCT patients, those who had primary refractory /early relapse [HR-4.7, (95% CI-1, 22); p=0.05] had significant impact on 5 yr FFTF whereas disease status at transplant (CR vs. No CR) had significant impact on 5 yr OS [HR-4.6, (95% CI-1.03, 20.5); p=0.04]. Conclusions: Identification of predictors of poor response to salvage chemotherapy is an unmet need in the management of pediatric HL since complete response (CR) before transplant is independent predictor of survival. Stage 4 and bulky disease at relapse are high risk factors to predict incomplete response. Future trials should explore newer agents for effective salvage for these patients to attain complete response before ASCT.
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Delon, R., B. Cailleteau, JL Verrier, MN Tanne y M. Sylvestre. "Evaluation of the Efficacy of CGA 245704 Combined or Not with CGA 329 351 (Mefenoxam) for the Control of Tobacco Blue Mold (Peronospora Tabacina): Results of Four Years of Experiments". Beiträge zur Tabakforschung International/Contributions to Tobacco Research 18, n.º 2 (1 de agosto de 1998): 55–62. http://dx.doi.org/10.2478/cttr-2013-0670.
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AbstractA compound for activating systemic resistance (CGA 245 704), in the chemical class of benzothiadiazoles, was studied since 1993 for the control of tobacco blue mold (Peronosporatabacina A.) in seedbeds and in the field. One foliar application of CGA 245 704 at 1.6 g active ingredient/hl every 14 days protected tobacco plants against blue mold but protection was not total. Mixed with mefenoxam (CGA 329 351) at 16 g active ingredient/hl the protection is equivalent to standard Acylon¯ TC (25 % metalaxyl, 50 % maneb) applied as foliar spray at 0.160 kg/hl (40 g active ingredient metalaxyl per hl). This allows a reduction in the quantity of fungicides dispersed in the environment and the pesticide residues on the tobacco leaves. At the rate applied, no phytotoxic effects were observed in seedbeds or in the field.
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Sylwander, C., A. Klopstad Wahl, M. Andersson, E. Haglund y I. Larsson. "POS0597-HPR HEALTH LITERACY IN INDIVIDUALS WITH KNEE PAIN - A MIXED METHOD STUDY". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de mayo de 2023): 569.2–570. http://dx.doi.org/10.1136/annrheumdis-2023-eular.1359.
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BackgroundHealth literacy (HL) is the ability to access, understand, appraise, and apply health information [1]. A low level of HL is associated with worse pain problems, poorer self-care, and an obstacle for health-promoting interventions among individuals with chronic pain and radiographic knee osteoarthritis (rKOA).ObjectivesTo examine 1) the level of HL and associations with chronic pain, rKOA, lifestyle habits and health status, and 2) to explore the individuals’ experiences of HL.MethodsThe study has a convergent parallel mixed-method design, including 221 individuals with knee pain (148 women, mean age 56±8 years). A purposeful sample of 19 individuals (11 women, 8 men) was selected for interviews.Quantitative data were general HL (GHL) assessed by HLS-EU-Q16, electronic HL (eHL) by eHEALS, pain distribution by a pain figure, rKOA by x-rays, lifestyle habits, and health status via SF-36. GHL and eHL were merged into one variable, “HL”, where sufficient HL was defined as having a sufficient level of GHL or eHL. Statistical analyses were Chi2test, Mann-Whitney U-test, univariate and multivariate logistic regressions.Qualitative data consisted of individual semi-structured interviews that were analysed using manifest qualitative content analysis with an abductive approach based on the HLS-EU health literacy matrix [2].ResultsOf the 221 participants, 29% reported limited HL. Those with limited HL reported lower education, less usability and importance of the internet for accessing health information and making informed health-related decisions, and lower general health (GH) compared to the group with sufficient HL (data not shown). Higher education, CRP, a healthier diet, and minor alcohol consumption were associated with sufficient HL (Table 1). Only higher education and GH remained associated when adding GH to the multivariate analysis.Individuals’ experiences of HL were described as 1) Searching for information influences the decision-making process by being an active searcher or passive receiver; 2) Processing of information influences the decision-making process by having light, moderate or high processing of the information; and 3) Taking a stand on the information influences the decision-making process based on trust and/or motivation (Figure 1).ConclusionLimited HL was found in one-third of the individuals with knee pain. CRP and healthy lifestyle habits were associated with sufficient HL, but higher education and health status had the strongest association. The search, level of process and standpoint on the health information influenced the decision on action. More research on HL is needed to gain knowledge of how to develop health promotion to prevent worsening pain problems in individuals with knee pain.References[1]Sørensen et al.,Health literacy and public health: A systematic review and integration of definitions and models.BMC Public Health 2012, 12(1):80.[2]Sørensen et al.,Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q).BMC public health 2013, 13(1):948.Table 1.Two models with multivariate logistic regression analysis of associations with sufficient HL.Sufficient health literacyModel 1Model 2nOR (95% CI)p-valueOR (95% CI)p-valueAge2210.99 (0.95-1.04)0.7780.99 (0.95-1.04)0.749EducationCompulsory schoolSecondaryUniversity22114.39 (1.75–10.99)4.65 (1.83–11.84)0.0020.00114.85 (1.90-12.40)5.41 (2.06-14.22)<0.001<0.001Pain distributionCWPCRPNCP22012.81 (1.16–6.80)1.81 (0.63–5.15)0.0220.26911.85 (0.70–4.87)0.91 (0.27–3.02)0.2130.875rKOAYesNo21611.37 (0.69–2.74)0.37111.35 (0.66–2.76)0.417DietLess healthy dietHealthy diet22112.53 (1.07–5.98)0.03512.14 (0.89–5.15)0.091Alcohol intake≥5 units/week1-4 units/week<1 unit/week21911.94 (0.82–4.59)2.51 (1.00–6.29)0.1310.04911.66 (0.68–4.05)2.48 (0.97–6.34)0.2630.058General health(scoring 0–100, worst-best)2161.02 (1.00–1.04)0.019Figure 1.Overview of the results exploring the experiences of HL in individuals with knee pain.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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Mahmoudi, Elham, Philip Zazove, Terrence Pleasant, Lisa Meeks y Michael M. McKee. "Hearing Loss and Healthcare Access among Adults". Seminars in Hearing 42, n.º 01 (febrero de 2021): 047–58. http://dx.doi.org/10.1055/s-0041-1726000.
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AbstractHearing loss (HL) is common among individuals aged 50 and older and is associated with increased healthcare costs. Whether HL is associated with less access to healthcare is unclear. In this study, we examined the association between HL and access to medical care and prescription drugs among individuals 50+ with and without HL. We used nationally representative 2013–2014 Medical Expenditure Panel Survey data, consisting of 1,977 adults with HL and 17,399 without. We applied an inverse propensity score weighting and regression modeling to adjust for any potential differences in health and socioeconomic conditions between the two groups. Adults with HL were more likely to be white, less educated, poorer, and with public insurance (p < 0.001). They were also likely to have hypertension, heart disease, stroke, emphysema, high cholesterol, diabetes, joint pain, and arthritis (p < 0.001). The odds of reporting unmet medical needs (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.29–2.66), delay in getting medical needs met (OR = 1.37; 95% CI = 1.00–1.87), and having unfilled prescriptions (OR = 1.81; 95% CI = 1.27–2.59) were higher among individuals with HL compared with their counterparts without HL. Individuals with HL have less access to care and prescription drugs. To ensure equitability in access, public health policies should address specific needs of people with HL.
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Iontseva, M. V., S. A. Grishaeva y M. A. Ayvazyan. "Educational needs and opportunities for adaptation of students with disabilities and persons with health limitations in the tertiary education system". Vestnik Universiteta, n.º 5 (23 de junio de 2023): 196–203. http://dx.doi.org/10.26425/1816-4277-2023-5-196-203.
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The article is devoted to the definition consideration of the educational needs of persons with health limitations (hereinafter – HL) and disabled persons in the tertiary education system; the aspects in which these needs are expressed. The article highlights the adaptation possibilities of disabled people in the tertiary education system, as well as the specifics of the organization and goals of an educational institution for teaching people with HL. The authors identify the barriers of social relations faced by students with HL, disabled students and their teachers at universities; analyze the degree of involvement of a student with HL in the educational process. The paper pays attention to the main approaches to the organization of educational activities of persons with HL and disabled people, namely: competence-based, project-based and activity-based approaches. The main types of inclusion, identified on the basis of medical indicators, as conditions for organizing the training of students with HL and disabled students are considered. It is determined that the education organization at the university of students with HL allows to adapt educational programs to the special needs of students, depending on the state of health of students with HL and of disabled students.
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Re, Alessandro, Chiara Cattaneo, Salvatore Casari, Samantha Ferrari, Elisa Cerqui, Graziella Cristini, Giampiero Carosi y Giuseppe Rossi. "Treating Hodgkin Lymphoma in HIV Positive Patients: a Comparative Analysis with the HIV Negative Population." Blood 114, n.º 22 (20 de noviembre de 2009): 3711. http://dx.doi.org/10.1182/blood.v114.22.3711.3711.
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Abstract Abstract 3711 Poster Board III-647 Background HIV-associated Hodgkin Lymphoma (HIV-HL) has peculiar clinicopathologic features and less favourable outcome compared to HL of the HIV negative (neg) population. After the advent of HAART, HIV positive (pos) people seem to be at increased risk of HL than in first years of the epidemic; however, HIV-HL prognosis is expected to improve due to immunepreservation with HAART. Aim of the study To evaluate the chance of cure of HIV pos patients (pts) with HL, in comparison with the HIV neg population. Materials and methods We evaluated the proportion of pts who received treatment with curative intent and analysed the outcome in an intention to treat basis, in our series of consecutive HIV pos and neg pts with HL. Pts were excluded from curative treatment because of poor Performance Status (PS), major infections or severe comorbidities. Since 1997 all HIV pos pts received HAART during chemotherapy and thereafter. Results Since 1985 to Dec 1996 (pre-HAART period) we diagnosed 11 HIV-HL and from 1997 to Dec 2008 (HAART period) 29 HIV-HL. Median age was 39.5 ys (23-63). In the pre-HAART period we could treat with curative intent 7/11 pts (64%) with a complete remission (CR) rate of 43% and a median overall survival (OS) and progression free survival (PFS) of treated pts respectively 14 and 9 ms and 5y-OS and 5y-PFS both 28.5%. During the HAART period the proportion of treated pts was similar with 21/29 pts (72%) treated, the CR rate increased to 62% (versus 43% pre-HAART, P=NS) and the median OS and PFS of treated pts to 31 ms both (vs 14 and 9 ms pre-HAART, P=NS), with 5y-OS 35.4% and 5y-PFS 36%. According to the intention to treat, the OS of all pts was 6 ms pre-HAART (5y-OS 18.1%), and 16 ms in the HAART period (5y-OS 25.6%), with a follow-up of 37.5 ms (7-119). Median CD4 count at diagnosis was higher in the HAART period (213/cmm, range 15-648, vs 119/cmm, range 38-245, P=0.05), while no other significant differencies were seen in pts'characteristics between the two periods. During the HAART period 65% of pts were on HAART at lymphoma diagnosis; this proportion increased throughout the HAART era, from 57% between 1997-2002 to 73% between 2003-2008. The clinical features of HIV-HL showed a trend towards less aggressive disease from 1997-2002 to 2003-2008 (extranodal disease 64% and B symptoms 85% between 1997-2002 vs 42% and 53% between 2003-2008) and less drug abusers (71% vs 33%) and pts with previous AIDS-defining conditions (38% vs 22%). However, the proportion of pts we could treat remained low, 79% (1997-2002) and 67% (2003-2008). Between 1997-2002 most pts received Stanford V, while between 2003-2008 all pts received VEBEP. No pts died because of treatment toxicity. CR rate increased from 55% (1997-2002) to 70% (2003-2008) (P=NS) and the 3y-OS and 3y-PFS of treated pts from respectively 36.3% (median 20 ms) and 18.1% (median 7 ms) between 1997-2002 to 63.4% (P=NS) and 68.5% (P=0.05) between 2003-2008. The overall probability for survival, according to the intention to treat, did not significantly increased with 3y-OS 28.5% (median 9 ms) between 1997-2002 versus 42.3% (median 18 ms) between 2003-2008. The HIV-HL outcome, even in the recent years (2003-2008), remains unsatisfactory compared with a concomitant series of HIV neg pts. From Jan 2003 to Dec 2008 we diagnosed 144 HL in HIV neg subjects with less than 66 ys. All pts (100%) received therapy with curative intent, mostly ABVD, compared with 67% of HIV pos pts during the same period of time (P< 0.001). The CR rate was 90%, higher than in the concomitant series of HIV pos pts (70%) (P=0.05), as well as the probability of OS and PFS for pts receiving treatment (3y-OS 96.1% in HIV neg vs 63.5% in HIV pos pts, P<0.001, and 3y-PFS 79.7% in HIV neg vs 68.5% in HIV pos, P=NS). Relapse rate was 12% (15/126 pts) in the HIV neg pts, compared to 23% (3/13 pts) in the HIV pos group (P=NS). According to the intention to treat, the OS for all pts was strongly higher in the HIV neg group, with 3y-OS 96.1% compared to 42.3% in HIV pos pts (P<0.001). Conclusions Though the outcome of HIV-HL has improved throughout the HAART era, in our single-Institution experience it remains significantly worse compared to the HIV neg population (lower CR and survival rates). Still a high proportion of pts cannot receive adequate treatment due to poor PS or comorbidities. Better control of HIV infection is advisable and specific treatment programs derived from the experience in the HIV negative setting seem warranted. Disclosures: No relevant conflicts of interest to declare.
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Kendir, Candan y Eric Breton. "Health Literacy: From a Property of Individuals to One of Communities". International Journal of Environmental Research and Public Health 17, n.º 5 (2 de marzo de 2020): 1601. http://dx.doi.org/10.3390/ijerph17051601.
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Health literacy (HL) is increasingly hailed as a strategy to improve the control individuals have over their health. A central critic of HL intervention is its overemphasis on individual level factors, something recognised in the 2008 report of the Commission of Social Determinants of Health (SDoH) that recommended expanding the scope of HL to cover the SDoH. The objective of our study was to assess the extent to which recent progress on HL captures the need for collective action on the SDoH. We conducted a scoping review on PubMed looking for review papers published between 2013–2018 in English and French. Definitions of HL were analysed against two main dimensions (i.e., locus of change of HL strategies and foreseen outcome of HL improvements). Despite a number of authors calling for more research on HL interventions at the community level and an expansion of the definition to cover the SDoH, we found that the recommendation of the Commission has yet to be implemented. Even when the definitions include the capacities of individuals on distal determinants, both the locus of change and outcomes of HL improvement do not go beyond intra individual factors (knowledge, skills, etc.). It is noteworthy that communities were either framed as a setting outside of health care services or as an aggregate of individuals. We found no instance of HL intervention regarding communities as complex systems of actors sharing a common space and dynamic. We conclude by suggesting a new definition of HL and by drawing attention to the research gap in addressing the upstream SDoH through HL actions.
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Muenboonme, Weerayut, Pachanat Nunthaitaweekul y Bhichit Rattakul. "Health Literacy of the Elderly During the COVID-19 Pandemic: A Cross-Sectional Study". Journal of Disaster Research 18, n.º 8 (1 de diciembre de 2023): 924–31. http://dx.doi.org/10.20965/jdr.2023.p0924.
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This study assessed health literacy (HL) and its associated factors among the elderly during the COVID-19 pandemic, in which HL affected disaster risk management. This cross-sectional study included elderly individuals from Dusit District, Bangkok, Thailand. A total sample of 500 was obtained through simple random sampling conducted between March and October 2022. Spearman’s rank correlation and the eta coefficient were used to analyze the relationships. As for the results, the total HL of the elderly was fair (x̄ = 54.01, S.D. = 14.05). Considering each aspect, it was found that 1) access to information and health services was poor (x̄ = 11.91, S.D. = 2.97), 2) comprehension of health information was fair (x̄ = 14.01, S.D. = 3.65), 3) assessment of health information and services was fair (x̄ = 13.60, S.D. = 3.83), and 4) application of information and health services was fair (x̄ = 14.49, S.D. = 3.60). Age, education, and comorbidity were factors related to the HL of the elderly during the COVID-19 pandemic in Dusit District (p < 0.001). The results elucidate the HL of the population of this community during the COVID-19 pandemic, providing an indicator of the community’s potential for disaster risk management, including the preparedness, mitigation, response, and recovery phases.
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Reed, Nicholas S., Matthew G. Huddle, Joshua Betz, Melinda C. Power, James S. Pankow, Rebecca Gottesman, A. Richey Sharrett, Thomas H. Mosley, Frank R. Lin y Jennifer A. Deal. "Association of Midlife Hypertension with Late-Life Hearing Loss". Otolaryngology–Head and Neck Surgery 161, n.º 6 (6 de agosto de 2019): 996–1003. http://dx.doi.org/10.1177/0194599819868145.
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Objective To investigate the association of midlife hypertension with late-life hearing impairment. Study Design Data from the Atherosclerosis Risk in Communities study, an ongoing prospective longitudinal population-based study (baseline, 1987-1989). Setting Washington County, Maryland, research field site. Subjects and Methods Subjects included 248 community-dwelling men and women aged 67 to 89 years in 2013. Systolic blood pressure (SBP) and diastolic blood pressure were measured at each of 5 study visits from 1987-1989 to 2013. Hypertension was defined by elevated systolic or diastolic blood pressure or antihypertensive medication use. A 4-frequency (0.5-4 kHz) better-hearing ear pure tone average in decibels hearing loss (dB HL) was calculated from pure tone audiometry measured in 2013. A cutoff of 40 dB HL was used to indicate clinically significant moderate to severe hearing impairment. Hearing thresholds at 5 frequencies (0.5-8 kHz) were also considered separately. Results Forty-seven participants (19%) had hypertension at baseline (1987-1989), as opposed to 183 (74%) in 2013. The SBP association with late-life pure tone average differed by the time of measurement, with SBP measured at earlier visits associated with poorer hearing; the difference in pure tone average per 10–mm Hg SBP measured was 1.43 dB HL (95% CI, 0.32-2.53) at baseline versus −0.43 dB HL (95% CI, −1.41 to 0.55) in 2013. Baseline hypertension was associated with higher thresholds (poorer hearing) at 4 frequencies (1, 2, 4, 8 kHz). Conclusion Midlife SBP was associated with poorer hearing measured 25 years later. Further analysis into the longitudinal relationship between hypertension and hearing impairment is warranted.
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Bunta, Ferenc y Michael Douglas. "The Effects of Dual-Language Support on the Language Skills of Bilingual Children With Hearing Loss Who Use Listening Devices Relative to Their Monolingual Peers". Language, Speech, and Hearing Services in Schools 44, n.º 3 (julio de 2013): 281–90. http://dx.doi.org/10.1044/0161-1461(2013/12-0073).
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PurposeThe present study investigated the effects of supporting both English and Spanish on language outcomes in bilingual children with hearing loss (HL) who used listening devices (cochlear implants and hearing aids). The English language skills of bilingual children with HL were compared to those of their monolingual English-speaking peers' with HL. The Spanish and English language skills of the bilingual participants were also compared.MethodThe language skills of 40 children with HL (20 bilingual Spanish–English-speaking and 20 monolingual English-speaking) were examined using the Auditory Comprehension, Expressive Communication, and total language scores from the Preschool Language Scale, Fourth Edition (Zimmerman, Steiner, & Pond, 2002a, 2002b).ResultsThe English language skills of the bilingual participants were commensurate with those of their monolingual English-speaking peers on all 3 measures. The Spanish and English total language scores of the bilingual group were also comparable and highly correlated.ConclusionBoth languages of bilingual children with HL can be supported without having adverse effects on the children's language development. Moreover, supporting both languages in bilingual children with HL may have multifarious positive ramifications.
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Xavier, Ana y Luciano J. Costa. "Changes In The Use Of Radiation Therapy Among Adolescents and Young Adults With Early Stage Classical Hodgkin Lymphoma: Implications For Survival and Risk Of Secondary Malignancies". Blood 122, n.º 21 (15 de noviembre de 2013): 722. http://dx.doi.org/10.1182/blood.v122.21.722.722.
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Abstract Background Early stage classical Hodgkin lymphoma (HL) is a highly curable disease with the combined use of chemotherapy and radiation therapy (RT). There has been a recent trend to abandon RT, driven mostly by concerns of development of secondary malignancies (SMN). However, it is unknown whether the omission of RT in adolescents and young adults (AYA) with early stage HL affects survival and the risk of developing SMN. Methods We used data from the National Cancer Institute's Surveillance Epidemiology and End Results program (SEER-13) to determine the overall survival (OS) and the risk of SMN among AYA with early stage HL treated or not with radiation therapy. Inclusion criterion was the diagnosis of stage I or II HL in the period of 1995-2010 as first malignant neoplasm among patients age 13 to 40 years. Patients with less than 6 months of follow up and patients with unknown use of RT were excluded. Follow up was updated to the end of 2012 (November 2012 submission). Cases were divided in two “eras”, 1995-2002 and 2003-2010, with the latter being expected to reflect changes in the use of RT. The impact of the era, RT, age, race, gender, and stage on survival were accessed utilizing multivariate analysis. Cumulative incidence of SMN among early stage HL survivors was calculated using a competing risk model, treating death from any cause in absence of SMN as the competing risk. Results A total of 5,336 early stage HL cases were included in the analysis with median follow up of 89 months (range 7-191). Median age of patients was 27 years, 2,459 (46%) were male, 1,327 (24.8%) had stage I, 512 (9.7%) had classical HL non otherwise specified, 4,231 (79.2%) had nodular sclerosing HL, 442 (8.3%), had mixed-cellularity HL, 130 (2.4%) had lymphocyte-rich HL, and 21 (0.4%) had lymphocyte depleted HL. Most patients were white (4,438; 83.2%), 513 (9.6%) black, 337 (6.4%) other ethnicity, and 44 (0.8%) unknown. There where 2,793 patients in the 1995-2002 era and 2,542 patients in the 2003-2010 era. Radiation was included in the initial treatment of 1,659 (59.4%) patients in the former and 1,351 (53%) patients in the latter era (P<0.001). Factors associated with use of RT were earlier era, white race and stage II HL. Within the 1995-2002 era, there was a trend towards better survival among patients treated with RT (5-year survival 95.0% vs. 93.6%, P=0.058). In the 2003-2010 cohort survival was superior among patients treated with RT (5-year survival 97.3% vs. 95.9%, P=0.008). In multivariate analysis, diagnosis of HL in the 1995-2002 era (HR=1.73, 95% C.I. 1.31-2.28, P < 0.001), black race (HR= 2.18, 95% C.I. 1.63-2.91, P <0.001), male sex (HR=1.55, 97% C.I. 1.24-1.93, P < 0.001), and omission of RT (HR=1.31, 95% C.I. 1.05-1.64, P=0.017) were associated with higher mortality. The cumulative incidence of SMN was not significantly different between patients treated or not with radiation, while the risk of death was higher among patients not treated with RT (Figure). Conclusion There has been a reduction in utilization of RT among AYA with early stage HL in the US. Omission of RT was associated with increased overall mortality but no reduction in incidence of SMN and should not be adopted outside clinical trials. Disclosures: No relevant conflicts of interest to declare.
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Enomoto, Ayaka, Aki Saito, Osamu Takahashi, Takeshi Kimura, Ryoko Tajima, Mahbubur Rahman y Kaoruko Iida. "Associations Between Health Literacy and Underweight and Overweight Among Japanese Adults Aged 20 to 39 Years: A Cross-Sectional Study". Health Education & Behavior 47, n.º 4 (25 de mayo de 2020): 631–39. http://dx.doi.org/10.1177/1090198120919675.
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Background. Both underweight and overweight are public health concerns in Japan. Several studies examined the association between health literacy (HL) and obesity status in the general population; however, there is limited information on young adults. In addition, the association between HL and underweight status has not been extensively investigated. Aim. To examine the association between HL and underweight/overweight status among young Japanese adults aged 20 to 39 years. Method. This study was based on a cross-sectional survey of population-representative adults. HL was assessed using a questionnaire validated in Japanese adults. Body mass index (BMI) was calculated using self-reported weight and height. Participants were divided into two groups by HL score using the median score (lower vs. higher HL). The association between HL and underweight (BMI <18.5) or overweight (BMI ≥25.0) was examined using multinomial logistic regression analyses after adjusting for potential confounders. Results. In total, 476 women and 454 men were included in the analyses. Prevalence of underweight and overweight was 20.8% and 10.3% in women and 8.8% and 20.3% in men, respectively. In women, 45.1% of normal weight, 47.5% of underweight, and 30.6% of overweight had higher HL. Among men, 50.3% of normal weight, 35.0% of underweight, and 44.6% of overweight had higher HL. Bivariate analyses showed no statistically significant association between HL level and underweight/overweight status. Even after adjusting for potential confounders, these associations did not change. Discussion and Conclusion. This study suggests that HL scores may not be associated with underweight or overweight status in Japanese adults.
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Von Glasenapp, Seisha Alana, Maria Elvira Enciso Arrua, Alfredo Quiroz, Aline Nicole Paats, Laura Morel, Leticia Rocio Jiménez, Lidiane Andino, Victor Ladislao Salinas, Bryan Valcarcel y Luis Enrique Malpica Castillo. "Outcomes of Newly Diagnosed Hodgkin Lymphoma Patients in 4 Academic Centers in Paraguay. the Impact to Access to PET-CT Scanning in Survival". Blood 142, Supplement 1 (28 de noviembre de 2023): 6217. http://dx.doi.org/10.1182/blood-2023-186387.
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Background: Hodgkin's lymphoma (HL) is a highly curable lymphoproliferative neoplasm. Assessment of HL at baseline (pre-therapy), intermediate (iPET) and end-of-therapy (EOT) by positron emission tomography/computed tomography (PET/CT) is considered a “gold standard” procedure and has become the main tool for clinical decision making in the management of HL. However, inequity in access to diagnostic medical technology in Paraguay has not allowed clinicians to manage these patients as recommended by international guidelines. We describe here the clinical characteristics, access to PET/CT study and outcomes of patients with HL treated in Paraguay. Methods: We conducted a retrospective cohort study of patients aged ≥17 years with newly diagnosed HL in 4 academic centers in Paraguay between 2015 and 2022, with follow-up until July 2023. Medical records were manually reviewed and data were abstracted in a standardized form. A historical analysis was performed to evaluate the utilization of PET/CT in all stages of HL treatment (baseline, intermediate and EOT). Survival probabilities were estimated using the Kaplan-Meier method. Results: A total of 145 patients were identified; 101 had sufficient data for analysis (Table 1). Patients were young, with a median age of 29 years (16-79) and a slight male vs. female predominance (56.4% vs. 43.6%). Nodular sclerosis (76.6%) and mixed cellularity (20.2%) were the most frequent HL subtypes. More than half of the patients (58%) had ECOG 0, 50% advanced stage and 55.9% B symptoms. The majority of patients (97%) received an ABVD regimen as induction therapy. Sixty-nine percent of patients did not undergo PET/CT at baseline, most of them (97%) due to lack of insurance coverage, 16.5% underwent iPET and 58.4% underwent PET/CT at EOT. With a median follow-up of 44 months, overall survival (OS) at 4 years was 77% and progression-free survival (PFS) was 46%. In a subgroup analysis to investigate the short 4-year PFS observed in our cohort, the PFS of patients who underwent PET/CT at EOT versus those who did not was 84 versus 36, respectively (Figure 1). Conclusions: To our knowledge, this is the first study to characterize the clinical characteristics and outcomes of patients with HL in Paraguay. It is striking to see that lack of access to PET/CT had a significant impact on PFS in our patient population. HL is a highly curable disease affecting young people, therefore, minimizing late side effects in this patient population (e.g., secondary comorbidities and malignancies) remains a high priority. The authors' conclusion is to raise awareness of the importance of improving access to diagnostic tools such as PET/CT to provide optimal care for our patients, especially those who do not have access to PET/CT.
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Yuan, Junyun, Ya Zhang, Xinting Hu, Hua Wang, Zheng Tian, Liyan Lu y Xin Wang. "Causal Relationships between Immune-Mediated Inflammatory Diseases and Hodgkin's Lymphoma: A Mendelian Randomization Study". Blood 142, Supplement 1 (28 de noviembre de 2023): 3065. http://dx.doi.org/10.1182/blood-2023-184534.
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Introduction: Immune-mediated inflammatory diseases (IMIDs) constitute a clinically heterogeneous group with a disruption of the immune system that provokes inflammation of any organ system on a chronic basis. Previous observational investigations have demonstrated an association between a person's or their family's medical background of IMIDs and a higher likelihood of developing Hodgkin's lymphoma (HL). Nevertheless, the exact causal connection between specific IMIDs and HL remains ambiguous. Therefore, the investigation aims to explore the causal effects between IMIDs and HL. Methods: A two-sample Mendelian randomization (TSMR) approach was employed in this study, using publicly available genome-wide association study summary statistics. The inverse variance weighted (IVW) method was the primary approach used for the Mendelian randomization (MR) analysis. Furthermore, supplementary statistical approaches such as MR-Egger, simple mode, weighted median, and MR-PRESSO were employed. In order to identify potential heterogeneity and pleiotropy, several tests were conducted, including Cochran's Q test, the MR-Egger regression test, and the MR-PRESSO test. Moreover, the leave-one-out method was implemented to examine the reliability of the MR results. Results: Based on the IVW analysis the findings revealed a positive causal link at risk for multiple sclerosis (MS) and HL [odds ratio (OR) = 1.281; 95% CI = 1.087-1.510, p = 0. 003] and a negative causal link at risk for type 1 diabetes (T1D) and HL (OR = 0.853; 95% CI = 0.776-0.937, p = 0.001). However, no significant causal relationship was found between the risk of HL and the other eight IMIDs, including inflammatory bowel diseases (OR = 1.034; 95%CI = 0.910-1.176, p = 0.606), systemic lupus erythematosus (OR = 1.041; 95%CI = 0.944-1.149, p = 0.422), Crohn's disease (OR = 0.952; 95%CI = 1.840-1.078, p = 0.436), ulcerative colitis (OR = 1.042; 95%CI = 0.874-1.242, p = 0.644), primary sclerosing cholangitis (OR = 1.061; 95%CI = 0.937-1.202, p = 0.349), primary biliary cirrhosis (OR = 1.046; 95%CI = 0.918-1.192, p = 0.495), psoriasis (OR = 0.989; 95%CI = 0.954-1.026, p = 0.565), celiac disease (OR = 1.198; 95%CI = 0.911-1.574, p = 0.195). Figure 1 displayed a detailed visual representation of the findings obtained in the study. No indication was made of any potential heterogeneity or horizontal pleiotropy. Besides, no outliers were discovered in the MR using MR-PRESSO. In addition, the leave-one-out analysis indicates that the MR estimates are not driven by any single SNP, suggesting that the observed associations are robust and reliable. Conclusions: The present investigation emphasizes an increased susceptibility of MS to the risk of HL and a potential protective effect of T1D against the risk of HL. In light of these findings, patients with MS receiving immunosuppressive therapy are highly suggested to undergo periodic physical evaluations and lymphoma surveillance. Further investigations are warranted to explore the potential mechanisms of MS and T1D on the development of HL.
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Naumova, A. S., O. A. Tiganova, L. I. Ilyenko, D. B. Lavrukhin, K. L. Kondratchik, O. I. Baybak, G. O. Bronin et al. "Results of GPOH-HD-2003 study in treatment of Hodgkin’s lymphoma in children and adolescents in the Morozovskaya Children’s Clinical Hospital". Russian Journal of Pediatric Hematology and Oncology 7, n.º 1 (2 de marzo de 2020): 31–40. http://dx.doi.org/10.21682/2311-1267-2020-7-31-40.
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Relevance. Hodgkin’s lymphoma (HL) is a rare clonal neoplasm of lymphatic tissue. In the structure of malignant neoplasms in children HL accounts for 4–6 % and for 16 % in adolescents. Now children and adolescents with confirmed histology of HL in the Department of Oncology and Hematology, Morozovskaya Children’s Clinical Hospital, treated with the GPOH-HD-2003 protocol. The authors of the article presented the experience of treatment children and adolescents with HL according to recommendations of GPOH-HD-2003 in the Department of Oncology and Hematology, Morozovskaya Children’s Clinical Hospital.Patients and methods. From January 1, 2003 until December 31, 2018, 62 patients (35 boys, 27 girls) received therapy according to recommendations of GPOH-HD-2003 study. Age of patients ranges from 4.7 to 17.6 years, mean age was 13.3 years. All patients are allocated to three treatment groups (TGs) based on staging, in TG-1 were 2 patients, in TG-2 – 30 patients, in TG-3 – 30 patients. TG-1 patients received two courses of for induction: OEPA for boys and OPPA for girls. TG-2 and TG-3 patients received further two or four cycles COPP (girls) or COPDAC (boys), respectively. After chemotherapy all patients received initially involved-field irradiation with 19.8 Gy.Results. CTCEA grade 1 or 2 hematotoxicity was the most common recorded adverse reaction in the OEPA regimen for boys, grade 3 or 4 hematotoxicity – in the OPPA regimen for girls. Also hematotoxicity was more pronounced with COPP than COPDAC. Overall (OS), event-free (EFS) and relapse-free (RFS) survival rates at 5 years were 100 % for the period of the observation time (the median observation time was 48.12 months). No treatment-related deaths, relapses or second malignancies were recorded during this period.Conclusion. OS, EFS and DFS rates indicates high efficiency and low toxicity of GPOH-HD-2003 study regardless of the initial stage.
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Ujjani, Chaitra S. y Philip Cohen. "An Association Between Hodgkin’s Lymphoma and Crohn’s Disease: A Case Series". Blood 124, n.º 21 (6 de diciembre de 2014): 1611. http://dx.doi.org/10.1182/blood.v124.21.1611.1611.
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Abstract Background: Although rare, there is an association between non-Hodgkin’s lymphomas (NHL) and Crohn’s disease (CD). The etiology of NHL in CD has been traditionally been attributed to the use of immunosuppressive agents: TNF blockers and thiopurines. An association between CD and Hodgkin’s lymphoma (HL), however, is less well established. We present a case series of 4 patients (pts), the largest reported thus far. Case 1: An 18 YO M with CD presented in 12/2003 with pruritis, fevers, myalgias, fatigue, and cervical and axillary adenopathy. Diagnosed with CD as a child, he had received multiple prior therapies: corticosteroids, 6-MP, asacol, as well as infliximab for 3 months prior to presentation. Cervical node biopsy indicated classical HL, nodular sclerosis. Infliximab was discontinued, and he received 5 cycles of bleomycin, doxorubicin, vincristine, etoposide, cytoxan, prednisone followed by involved field XRT to the mediastinum. He completed therapy in 5/2004, achieving a complete remission (CR). In regards to his CD, he underwent cecal and ileal resections in 2007 and 2009. He has been managed successfully with adalimumab since 2010 and has not experienced a recurrence of HL. Case 2: A 32 YO F with CD presented in 9/2012 with fatigue, night sweats, weight loss, and fevers. She was diagnosed with CD at age 11, initially receiving balsalazide and sulfasalazine. She received infliximab from Feb-June 2014, but switched to certolizumab and 6- MP in 8/2012 due to infusion-related reactions. Her symptoms were initially attributed to CD; however, CT scans showed a peri-colonic mass and retroperitoneal lymphadenopathy. Biopsy of the mass revealed classical HL, EBV-associated, nodular sclerosis. PET/CT indicated involvement of thoracic and abdominal nodes, liver, spleen, and marrow as well. She discontinued therapy for CD and received 6 cycles of adriamycin, vinblastine, and dacarbazine (AVD). Bleomycin was omitted as PFTs indicated a mild defect. She achieved a CR which she has maintained for a year and a half. She did not resume treatment for CD as she remains asymptomatic. Case 3: A 33 YO F with CD presented in 6/2014 with pruritis and weight loss. CT imaging revealed a mediastinal mass and diffuse lymphadenopathy, biopsy-proven to be classical HL. She was diagnosed with CD in 4/2013, for which she had been receiving adalimumab since 9/2013. It was discontinued subsequently. She had Stage IV disease by PET/CT and is receiving ABVD. Case 4: A 49 YO M presented with a persistent rash for several months, followed by an episode of fever, nausea, vomiting, diarrhea, and abdominal pain in 1/2009. CT imaging indicated an 8 cm cecal mass with mesenteric and para-aortic lymphadenopathy. Biopsy of the mass revealed EBV- associated classical HL. PET/CT imaging indicated involvement of the cecal mass and abdominal nodes as well as bone marrow. He received 6 cycles of AVD. Bleomycin was held early on due to pneumonitis. Post-treatment scans indicated a residual FDG-avid cecal mass; however, biopsies were negative for HL. Laparoscopic resection of the mass in 12/2009 revealed CD, but no HL. As he had no CD-related symptoms, he was not placed on immunosuppression. Restaging scans in 12/2010 indicated an ongoing CR. Conclusion: While HL has been reported with various immunodeficiencies, this is the largest case series in CD disease. The presence of EBV in 2 pts suggests that immune dysregulation may have contributed to its pathogenesis. However, whether the etiology is the immunosuppressive therapy and/or the autoimmune disease remains unclear. Post-marketing surveillance has found a few cases of HL in pts with autoimmune diseases receiving TNF blockers, often with concomitant immunosuppressants. Furthermore, the withdrawal of immunosuppression resulting in a spontaneous regression of HL has also been reported. One of our pts, however, did not receive immunosuppression prior to HL, implying that CD and associated immune dysregulation may be the precipitating factor. This is conceivable given the location of HL in this patient (colon). It is also possible that the occurrence of HL and CD may have been mutually exclusive in pts 1 and 3, who were of the typical age for HL and had the characteristic mediastinal mass. Limited data are available regarding these pts; it appears that cytotoxic chemotherapy and withdrawal of the immunosuppression are appropriate management. Once identified, pts should be followed in a prospective fashion. Disclosures No relevant conflicts of interest to declare.
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Mariano, John, Conrad Gleber y Carla Casulo. "Hypertension and Related-Disorders in Hodgkin Lymphoma Patients Identified from Epic Cosmos System". Blood 142, Supplement 1 (28 de noviembre de 2023): 7259. http://dx.doi.org/10.1182/blood-2023-190936.
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Recent advancements in Hodgkin lymphoma (HL) treatment have significantly improved disease-free survival rates. However, survivors face a higher burden of long-term comorbidities and non-oncologic mortality compared to their peers. Studying survivorship has been challenging due to the time required for comorbidities to develop, patient loss to follow-up, variable disease-specific treatments, and variations across age groups of survivors. In this context, the Cosmos system offers a validated population-based informatics approach to establishing observational relationships between therapy and longitudinal non-oncologic outcomes, with the potential to enhance clinical care. Cosmos, a data science tool based on the Epic Electronic Medical Record (EMR) system, utilizes a HIPAA-defined limited centralized data set from various US health care systems. At the time of this submission, the data set encompasses 152,450,619 patients. A query population of 89,963 HL patients with more than one face-to-face encounter within any two-year period during the query interval was established. Validated associated ICD-10 diagnoses were assessed within the Cosmos system. The query revealed that HL patients had a median age of 56, with a male predominance (51.8%), and 35% were diagnosed between the ages of 15 and 39. Staging information was available for only 10% of patients. The most common comorbid diagnoses defined by ICD-10 were essential hypertension (45.4%), hyperlipidemia (36.1%), anemia (32.1%), GERD (32.1%), shortness of breath (31.4%), fatigue (30.1%), non-HL (30%), cough (26.3%), and anxiety (25.6%). Further assessment of hypertension and associated disorders was conducted by querying Epic grouper terms in comparison to the general Cosmos population. The HL population had a higher prevalence of hypertension (46.1% vs. 24.5%), chronic kidney disease (14.9% vs. 5%), hypertensive renal disease (10.1% vs. 3.1%), hyperlipidemia (44% vs. 21.1%), coronary artery disease (20.7% vs. 6.2%), ischemic or unspecified stroke (4.4% vs. 1.6%), and myocardial infarction (9.6% vs. 2.8%). Notably, death dates were documented for 12.5% of the HL population (compared to 3% in the general Cosmos population), but cause of death information was limited (0.028%). EMR informatics presents a powerful tool for rapidly generating real-time observational data, which can inform focused studies and interventions. Such data is crucial for understanding trends in treatment-related morbidity and mortality in diseases like HL, which can impact future health in survivorship. This study suggests that hypertension and related disorders may be more prevalent in the HL population compared to the general Cosmos population, warranting further directed study and validation in the future.
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Miyatake, Risa, Tatsuya Fujii, Keiichi Kumasawa, Mari Ichinose, Masatake Toshimitsu, Seisuke Sayama, Takahiro Seyama, Takayuki Iriyama, Takeshi Nagamatsu y Yutaka Osuga. "The sFlt-1/PlGF Ratio Trend Is Useful in Predicting Preeclampsia Severity in Hyperreactio Luteinalis Complicated with Preeclampsia". Case Reports in Obstetrics and Gynecology 2023 (19 de septiembre de 2023): 1–5. http://dx.doi.org/10.1155/2023/7352947.
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Hyperreactio luteinalis (HL) is a rare condition that presents as bilateral ovarian enlargement during pregnancy. Typically, it is thought to be caused by increased production of human chorionic gonadotropin (hCG) associated with gestational trophoblastic diseases or multiple pregnancies. The prognosis is relatively good, with many cases resulting in term birth. However, some obstetric complications, such as preeclampsia (PE) and preterm births, have been reported. We present a serious case of HL with subsequent PE that resulted in preterm delivery at 31 weeks of gestation. The soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) ratio was very high at the onset of PE at 24 weeks of gestation, followed by a modest decline, which then increased in proportion to the exacerbation of symptoms. Since HL cases have also been reported to be associated with PE, repeated measurement of the sFlt-1/PlGF ratio proved useful for better pregnancy management.
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Monnereau, Alain, Sally L. Glaser, Clayton W. Schupp, Karin Ekström Smedby, Silvia de Sanjosé, Eleanor Kane, Mads Melbye et al. "Exposure to UV radiation and risk of Hodgkin lymphoma: a pooled analysis". Blood 122, n.º 20 (14 de noviembre de 2013): 3492–99. http://dx.doi.org/10.1182/blood-2013-04-497586.
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Key Points Our pooled analysis found an inverse association between several measures of UVR exposure and Hodgkin lymphoma. Significant UVR-related inverse associations of EBV-positive HL with a dose-response relationship support etiologic heterogeneity in HL.
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Esparza Torres, Miguel Ángel. "Missionary Linguistics / Lingüística misionera: Selected papers from the First International Conference on Missionary Linguistics, Oslo, 13–16 March 2003. Ed. por Otto Zwartjes & Even Hovdhaugen". Historiographia Linguistica 32, n.º 3 (16 de diciembre de 2005): 401–12. http://dx.doi.org/10.1075/hl.32.3.16esp.
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Wang, Amy Yuan, Annalynn M. Williams, Yan Chen, Yutaka Yasui, Wendy Stock, Wendy Leisenring, Gregory Armstrong et al. "Improved Neurocognitive Outcomes with Contemporary Treatments in Survivors of Early Adolescent and Young Adult Hematologic Malignancies from the Childhood Cancer Survivor Study". Blood 142, Supplement 1 (28 de noviembre de 2023): 3776. http://dx.doi.org/10.1182/blood-2023-182329.
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Background: Neurocognitive impairments in survivors of hematologic malignancies diagnosed specifically during adolescence and early young adulthood (eAYA survivors) are not well described, despite use of intensive neurotoxic therapies. We evaluated how recent shifts in therapeutic approaches have impacted neurocognitive outcomes in survivors diagnosed during eAYA compared to younger survivors and sibling controls. Methods: We identified 1213 eAYA (diagnosed at 15-21 years) and 4538 pediatric (diagnosed at <15 years) survivors of acute lymphoblastic lymphoma (ALL; n= 301 v. 3274), acute myeloid leukemia (AML; n= 77 v. 424), and Hodgkin lymphoma (HL; n= 835 v. 840) as well as 1014 siblings from the Childhood Cancer Survivor Study (>5 year survivors diagnosed 1970-1999) who completed the Neurocognitive Questionnaire ( Table 1). Impairment was defined as a score in worst 10% of the sibling cohort in task efficiency (TE), organization (Org), memory (Mem), and emotional regulation (ER) domains. Survivors were stratified into groups reflective of diagnosis, treatment era, and intensity: HL-chest RT ≥35Gy = HL with chest radiation ≥35Gy (High-risk disease, older regimens); HL-chest RT <35Gy = HL with chest radiation <35Gy (Intermediate risk disease, contemporary regimens); HL-salvage = HL with salvage therapy (High-risk disease, higher intensity regimens), ALL-CRT = ALL with use of cranial radiation (CRT) (Older regimens), ALL-no CRT = ALL without use of CRT (Contemporary regimens), ALL-salvage = ALL with salvage therapy (High-risk disease, higher intensity regimens), AML-chemo = AML with chemotherapy only (Lower risk disease), AML-SCT = AML with history of stem cell transplant (Higher risk disease). The prevalence of neurocognitive impairment compared to siblings was estimated using generalized-estimating-equation logistic regression accounting for potential within-family correlation. Health status and health behaviors were examined as risk factors for neurocognitive impairment. Adjusted odds ratios (OR) and corresponding 95% confidence intervals (CI) are reported. Results: Prevalence of any neurocognitive impairment in the eAYA, pediatric, and sibling groups was 30.8%, 37.7%, and 25.4%, respectively. Prevalence was similar for eAYAs and pediatric survivors of HL (31.0% v. 29.6%, p=0.54) and AML (36.4% v. 40.6%, p=0.49), while lower in eAYA ALL survivors (28.2% v. 38.7%, p<0.01). Compared to siblings, eAYA HL survivors who received salvage therapy were more likely to have impaired Org (OR 2.5, 95% CI 1.2-5.1) and Mem (OR 2.7, 95% CI 1.3-5.8), while those who received high-dose chest RT experienced more Mem impairment (OR 2.0, 95% CI 1.2-3.4) ( Table 2). Compared to siblings, Mem was the most commonly affected domain in eAYA ALL survivors who received CRT (OR 4.0, 95% CI 2.0-7.9); this was not observed in the non-CRT or salvage groups. In a separate analysis of treatment exposures, anthracycline ≥120mg/m 2 uniquely increased prevalence of ER in eAYA ALL survivors (OR 4.7, 95% CI 1.7-12.9). Compared to siblings, survivors of eAYA AML who underwent SCT had higher odds of Mem impairment (OR 5.3, 95% CI 1.9-14.7). In a direct comparison with pediatric AML survivors, eAYA AML survivors were also more likely to have impaired Mem (OR 2.6, 95% CI 1.1-6.2) (data not shown). Being physically active (OR range 0.3-0.7), a never-smoker (OR range 0.5-0.6), and insured (OR range 0.4-0.5) were protective across all domains in eAYA-cancer survivors. Conclusions: Survivors of hematologic cancers diagnosed during eAYA are susceptible to neurocognitive impairment at rates similar to those diagnosed at younger ages for HL and AML but at reduced rates for survivors of ALL. Memory was the most affected domain in eAYA survivors. Contemporary regimens utilizing intermediate-dose (<35Gy) chest RT for HL or omission of cranial RT for ALL attenuated the extent of risk. Future studies should focus on characterizing outcomes across the entire AYA age spectrum.
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Walker, Elizabeth A., Lenore Holte, Meredith Spratford, Jacob Oleson, Anne Welhaven y Melody Harrison. "Timeliness of Service Delivery for Children With Later-Identified Mild-to-Severe Hearing Loss". American Journal of Audiology 23, n.º 1 (marzo de 2014): 116–28. http://dx.doi.org/10.1044/1059-0889(2013/13-0031).
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Purpose In this study, the authors examined diagnostic and intervention services for children identified with hearing loss (HL) after the newborn period. Method The authors compared ages at service delivery and length of delays between service delivery steps for 57 later-identified children with HL and 193 children who referred for assessment from the newborn hearing screen (NHS). For only later-identified children, regression models were used to investigate relationships among predictor variables and dependent variables related to service delivery. Results Children who referred from the NHS received follow-up services at younger ages than later-identified children. Later-identified children had significantly longer delays from HL confirmation to entry into early intervention, compared to children who referred from the NHS. For later-identified children, degree of HL predicted ages at follow-up clinical services. Children with more severe HL received services at younger ages compared to children with milder HL. Gender predicted the length of the delay from confirmation to entry into early intervention, with girls demonstrating shorter delays. Conclusions The current results lend support to the need for ongoing hearing monitoring programs after the neonatal period, particularly when children enter early intervention programs because of language/developmental delays.
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Liu, Dishiwen, Huiyu Chen, Yuntao Fu, Yajun Yao, Shanqing He, Youcheng Wang, Zhen Cao, Xuewen Wang, Mei Yang y Qingyan Zhao. "KCa3.1 Promotes Proinflammatory Exosome Secretion by Activating AKT/Rab27a in Atrial Myocytes during Rapid Pacing". Cardiovascular Therapeutics 2023 (30 de marzo de 2023): 1–22. http://dx.doi.org/10.1155/2023/3939360.
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Purpose. The aim of this study was to investigate the role of the medium-conductance calcium-activated potassium channel (KCNN4, KCa3.1) in the secretion of proinflammatory exosomes by atrial myocytes. Methods. Eighteen beagles were randomly divided into the sham group ( n = 6 ), pacing group ( n = 6 ), and pacing+TRAM-34 group ( n = 6 ). Electrophysiological data, such as the effective refractory period, atrial fibrillation (AF) induction, and AF duration, were collected by programmed stimulation. Atrial tissues were subjected to hematoxylin and eosin, Masson’s trichrome, and immunofluorescence staining. The expression of KCa3.1 and Rab27a was assessed by immunohistochemistry and western blotting. The downstream signaling pathways involved in KCa3.1 were examined by rapid pacing or overexpressing KCNN4 in HL-1 cells. Results. Atrial rapid pacing significantly induced electrical remodeling, inflammation, fibrosis, and exosome secretion in the canine atrium, while TRAM-34 (KCa3.1 blocker) inhibited these changes. Compared with those in control HL-1 cells, the levels of exosome markers and inflammatory factors were increased in pacing HL-1 cells. Furthermore, the levels of CD68 and iNOS in macrophages incubated with exosomes derived from HL-1 cells were higher in the pacing-exo group than in the control group. More importantly, KCa3.1 regulated exosome secretion through the AKT/Rab27a signaling pathway. Similarly, inhibiting the downstream signaling pathway of KCa3.1 significantly inhibited exosome secretion. Conclusions. KCa3.1 promotes proinflammatory exosome secretion through the AKT/Rab27a signaling pathway. Inhibiting the KCa3.1/AKT/Rab27a signaling pathway reduces myocardial tissue structural remodeling in AF.
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Keegan, Theresa, Dolly Penn, Qian Li, Brad Pollock, Marcio H. Malogolowkin, Theodore Wun y Helen M. Parsons. "Changes in clinical trial participation among adolescent and young adult (AYA) cancer patients from 2006 to 2013 in the United States." Journal of Clinical Oncology 35, n.º 15_suppl (20 de mayo de 2017): e18037-e18037. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18037.
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e18037 Background: Stagnant outcomes for AYAs (15 to 39 years) with cancer are partly attributed to poor enrollment onto clinical trials. Initiatives have focused on increasing accrual, but changes at the population-level are unknown. We examined patterns of clinical trial participation over time in AYA cancer patients. Methods: We utilized medical record data from AYAs in two National Cancer Institute Patterns of Care Studies identified through the Surveillance, Epidemiology and End Results (SEER) Program. Among 1,358 AYAs diagnosed with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), acute lymphoblastic leukemia (ALL), germ cell cancer, and sarcoma in 2006 and 3,560 AYAs diagnosed with NHL, HL, ALL, sarcoma, and breast cancer in 2012/2013, we used unconditional logistic regression to evaluate patient and provider characteristics associated with enrollment by year of diagnosis. Analyses were weighted to reflect the SEER populations and associations are summarized as adjusted odds ratios (OR) with 95% confidence intervals (CI). Results: From 2006 to 2012/2013, clinical trial participation increased from 14.8% to 17.9% among AYAs diagnosed with NHL, HL, ALL and sarcoma (p < 0.0001), primarily due to increased participation among ALL patients (2006: 37.4%; 2012/2013: 42.3%). In 2012/2013, participation varied by type of cancer, with the highest among those with ALL and sarcoma (31.2%), followed by HL (9.4%), NHL (6.9%) and breast cancer (4.3%). In both study years, multivariate analyses demonstrated that younger patients and those treated by pediatric oncologists (OR = 3.5; CI: 2.6-4.7) were more likely to enroll onto clinical trials. Uninsured AYAs were less likely to enroll in 2006 but no association was observed in 2012/2013. Hispanic (OR = 0.5; CI: 0.4-0.6), Black (OR = 0.6; CI: 0.5-0.9) and Asian (OR = 0.4; CI: 0.3-0.6) AYAs were less likely to enroll in 2012/2013 but not 2006. Conclusions: Our study identified increasing overall clinical trial participation over time. Disparities in likelihood of participating for racial/ethnic minority groups increased suggesting the need to improve access to clinical trials for all racial/ethnic groups to improve care and outcomes.
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Eviana Norahmawati, Ailen Oktaviana Hambalie, Diah Prabawati Retnani, Agustina Tri Endharti y Nayla Rahmadiani. "Clinicopathological profile of Non-Hodgkin and Hodgkin Lymphoma at the Anatomical Pathology Laboratory of Saiful Anwar General Hospital Malang from January 2018 until May 2023". GSC Biological and Pharmaceutical Sciences 25, n.º 1 (30 de octubre de 2023): 078–85. http://dx.doi.org/10.30574/gscbps.2023.25.1.0405.
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Lymphomas are a lymphocyte-driven malignancy that comprise up to 10% of cancers diagnosed in individuals < 20 years of age globally. Malignant lymphomas are divided into Hodgkin Lymphoma (HL) and Non Hodgkin Lymphoma (NHL). In 2019 at United States, more than 82.000 new patients diagnosed with lymphoma. Since the epidemiology of Lymphoma is different across regions and may have change over time, its global distribution pattern, risk factors, and temporal trends need to be assessed for developing preventive measures. The purpose of this study was to determine the frequency of NHL and HL based on histopathological type, age, and gender. This research is a descriptive analytic study. Data were obtained from patients who underwent histopathological and immunohistochemistry examinations at the Anatomical Pathology laboratory of Saiful Anwar General Hospital Malang from January 2018 until May 2023. There are 408 cases of Lymphoma consisting of 56 HL and 352 NHL. In HL, the percentage higher in men, and occurred mostly during 21 – 30 years old age group. The most common histopathological type of HL is Classical Hodgkin Lymphoma, with mostly Nodular Sclerosis subtype. In NHL, the percentage higher in men, and occurred mostly during 51 – 60 years old age group. The most common histopathological type of Non Hodgkin Lymphoma is B cell type.
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Meliante, Laura Antonia, Giulia Piccotti, Lucia Tanga, Sara Giammaria, Gianluca Manni y Giulia Coco. "Glaucoma, Pseudoexfoliation and Hearing Loss: A Systematic Literature Review". Journal of Clinical Medicine 13, n.º 5 (28 de febrero de 2024): 1379. http://dx.doi.org/10.3390/jcm13051379.
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Purpose: To investigate the relationship between glaucoma, pseudoexfoliation and hearing loss (HL). Methods: A systematic literature search following PRISMA guidelines was conducted using the PubMed, Embase, Scopus and Cochrane databases from 1995 up to 28 August 2023. Results: Thirty studies out of the 520 records screened met the inclusion criteria and were included. Most articles (n = 20) analysed the association between pseudoexfoliation syndrome (XFS) and HL, showing XFS patients to have higher prevalence of sensorineural hearing loss (SNHL) at both speech frequencies (0.25, 0.5, 1 and 2 kHz), and higher frequencies (4 and 8 kHz) compared to controls in most cases. No significant differences in prevalence or level of HL between XFS and pseudoexfoliative glaucoma (XFG) were detected in most studies. Eight articles analysed the relationship between primary open-angle glaucoma (POAG) and HL. Overall, a positive association between the two conditions was highlighted across all studies except for two cases. Similarly, articles focusing on NTG and HL (n = 4) showed a positive association in most cases. The role of autoimmunity and, in particular, the presence of antiphosphatidylserine antibodies (APSA) in patients with NTG and HL suggested an underlying autoimmune or vascular mechanism contributing to their pathogenesis. Only one study analysed the relationship between angle-closure glaucoma (ACG) and HL, showing higher incidence of ACG in patients with SNHL compared to normal hearing controls. Conclusions: Most studies detected an association between XFS and HL as well as POAG/NTG/ACG and HL, suggesting the presence of a similar pathophysiology of neurodegeneration. However, given the strength of the association of XFS with HL, it remains unclear whether the presence of XFG is further associated with SNHL. Further research specifically targeted to assess the correlation between glaucoma, XFS and HL is warranted to provide a more comprehensive understanding of this association.