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Articoli di riviste sul tema "006.420 1516":
1
Mai, Phuong L., Mark E. Sherman, Marion Piedmonte, Olga B. Ioffe, Brigitte M. Ronnett, Linda Van Le, David Gardner Mutch et al. "Pathologic findings at risk-reducing salpingo-oophorectomy among women at increased ovarian cancer risk: Results from GOG-199." Journal of Clinical Oncology 30, n. 15_suppl (20 maggio 2012): 1519. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.1519.
Abstract (sommario):
1519 Background: Although risk-reducing salpingo-oophorectomy (RRSO) is a standard management option for women with BRCA1/2 mutations, the lack of large, prospective cohort studies makes estimating the prevalence of cancer at RRSO problematic. Methods: GOG-199 is a large, non-randomized multi-center trial which enrolled women at high-risk (due to BRCA mutations or strong family history) of ovarian cancer, comparing surgery at enrollment with serial transvaginal ultrasound and CA-125 screening. RRSO specimens were processed according to a standardized tissue processing protocol including 2-3mm sectioning of both ovaries and tubes. Results: 2,605 participants were accrued to GOG-199. Of the 1 030 enrolled in the baseline RRSO cohort, 28 were ineligible and 36 declined surgery after enrollment, resulting in 966 baseline RRSO. Pathology review demonstrated 4 tubal intraepithelial carcinoma and 20 serous pelvic cancers, of which 12 were identified only microscopically. Among the 20 serous cancers, the predominant or exclusive site of involvement was ovary in 10, fallopian tube in 5, and peritoneum in 5 cases. In addition, 6 endometrial cancers (among the 515 undergoing concomitant hysterectomy) and 3 adenocarcinomas suggestive of metastasis were identified. The serous pelvic cancer prevalence was: entire cohort=2.1% (20/966), all BRCA mutation carriers=3.2 (18/558), BRCA1 mutation carriers=3.7% (12/325), BRCA2 mutation carriers=2.6% (6/231), and mutation-negative=0.5% (2/402). Compared to those without cancer, women with serous pelvic cancer were older at surgery (p< .001), and more often menopausal (vs pre-menopausal, p= .002), nulliparous (vs parous, p=.04) and never users of tamoxifen (vs ever users, p= .04). Serous pelvic cancers were more frequent in BRCA mutation carriers (vs no mutation, p= .004), and among carriers, more common in those with BRCA1 mutations (vs BRCA2 mutation, p= .02). Conclusions: The prevalence of serous pelvic cancers in this cohort was 3.2% among carriers vs 0.5% among the mutation-negative but with a strong family history. Our data will be useful when counseling women at increased ovarian cancer risk who are contemplating risk-reducing surgery.
2
Pessôa Filho, Dalton Müller, Astor Reis Simionato, Leandro Oliveira da Cruz Siqueira, Mário André Espada e Daniel Pestana. "INFLUÊNCIA DA COMPOSIÇÃO CORPORAL REGIONAL E TOTAL SOBRE O DESEMPENHO DE NADO E ÍNDICES AERÓBIOS". Revista Brasileira de Medicina do Esporte 22, n. 3 (giugno 2016): 195–99. http://dx.doi.org/10.1590/1517-869220162203151766.
Abstract (sommario):
RESUMO Introdução: Poucos estudos analisaram a contribuição da composição regional de nadadores para o perfil aeróbio, anaeróbio e o desempenho de nado. Objetivo: Verificar a influência da composição corporal regional e total sobre índices da aptidão aeróbia e anaeróbia em nado atado e livre, bem como sobre o desempenho de curta e média duração. Métodos: Onze nadadores (18,0 ± 4,0 anos) foram submetidos a: (1) teste incremental em nado atado, com coleta de gases respiração-a-respiração (K4b2 associado ao novo-AquaTrainerâ); e (2) tempo limite nos desempenhos de 200, 400 e 800 metros de nado livre. A regressão linear entre distância e tempo (d-tLim) empregou o método dos quadrados mínimos. O coeficiente de Pearson (r) averiguou as correlações da composição corporal regional e total com índices da aptidão aeróbica e anaeróbica em nado atado e livre. Resultados: Os valores da massa isenta de gordura (MIG) foram: 61,7 ± 7,4 kg; 7,5 ± 1,1 kg; 28,3 ± 3,7 kg; 22,1 ± 2,5 kg, respectivamente para corpo todo, membros superiores (MS), tronco (T) e membros inferiores (MI). O consumo máximo de oxigênio (VO2max) foi 52,1 ± 5,3 ml×kg-1×min-1, sendo a carga correspondente (iVO2max) de 93,9 ± 12,2 N. O tempo em 200 (132,2 ± 9,7 s), 400 (296,8 ± 17,2 s) e 800 metros (619,5 ± 26,9 s) forneceu velocidade crítica (VC = 1,23 ± 0,06 m×s-1) e capacidade anaeróbica de nado (CNA = 35,8 ± 15,1 m). Observaram-se correlações de iVO2max, CAN e v200m com MIG para MS (r = 0,64; 0,67 e 0,76), porém a MIG para T, MI e corporal demonstraram correlações apenas com v200m (r = 0,75; 0,69 e 0,75) e CAN (r = 0,71; 0,69 e 0,75). Conclusão: Houve, portanto, influência da MIG regional e corporal sobre o desempenho de curta distância e reservas anaeróbias, sendo a MIG-MS também influente sobre a iVO2max, e assim relacionada ao aprimoramento do desempenho de nado.
3
Nunes, R. D. M., I. M. S. Sales, S. I. O. Silva, J. M. C. Sousa e A. P. Peron. "Antiproliferative and genotoxic effects of nature identical and artificial synthetic food additives of aroma and flavor". Brazilian Journal of Biology 77, n. 1 (marzo 2017): 150–54. http://dx.doi.org/10.1590/1519-6984.12115.
Abstract (sommario):
Abstract This study aimed to analyze the antiproliferative and genotoxic potential of synthetic food flavorings, nature identical passion fruit and artificial vanilla. This assessment used root meristem cells of Allium cepa L., in exposure times of 24 and 48 hours and using doses of 0.2; 0.4 and 0.6 mL. Roots were fixed in Carnoy’s solution, hydrolyzed in hydrochloric acid, stained with acetic orcein and analyzed with optical microscope at 400× magnification, 5,000 cells for each treatment. For data analysis, it was used Chi-square test at 5%. Doses of 0.2 mL at ET 48 h; 0.4 and 0.6 mL at ET 24 and 48 h of passion fruit flavor, and the three doses of the vanilla flavor at ET 24 and 48 h significantly reduced the cell division rate in the meristems of roots, proving to be cytotoxic. Doses of 0.2; 0.4 and 0.6 mL of the passion fruit additive, and the three doses of vanilla tested, in the two exposure times, induced mitotic spindle changes and micronuclei formation in the cells of the test organism used, proving to be genotoxic. Therefore, under the studied conditions, flavoring solutions of vanilla and passion fruit, marketed nationally and internationally, significantly altered the functioning of the cell cycle in root meristem cells of A. cepa.
4
Jumaa, Klaudia, Badria Al Johani, Muriel Brackstone e Anat Kornecki. "A Single-Institute Experience With Radioactive Seed Localization of Breast Lesions—A Retrospective Study". Canadian Association of Radiologists Journal 71, n. 1 (22 gennaio 2020): 58–62. http://dx.doi.org/10.1177/0846537119885682.
Abstract (sommario):
Objectives: To assess the benefits associated with radioactive seed localization (RSL) in comparison to conventional wire localization (WL) for nonpalpable breast lesions. Methods: Radioactive seed localization was initiated at our institution in July 2013. Retrospective review of all WL performed between June 2012 and July 2013 (2013) and all RSL performed during June 2015 and July 2016 (2016). Patients who received neoadjuvant therapy or did not undergo their planned surgeries and WL performed in 2016 were excluded. The following data were collected: final pathology, resection margins for malignant lesions, time to surgery, seed migration, and number of localized lumpectomies performed by each surgeon. Results: A total of 292 WL procedures (288 women) in 2013 and 194 RSL procedures (186 women) in 2016 were eligible for the study. All WLs were inserted the day of surgery. Mean time from RSL insertion to surgery was 4.0 ± 2.8 days (range: 1-17 days). There was no difference in specimen size for malignant lesions (6.8 ± 2.8 cm for WL and 6.9 ± 2.9 cm for RSL; P = .5). Specimen radiographs were obtained in 233 (80%) of 292 WL compared to 194 (100%) of 194 RSL ( P < .001). For malignant lesions, positive margins were present in 34 (17.2%) of 198 with WL compared to 15 (10.3%) of 146 with RSL ( P < .001). Close margins (≤1 mm) were present in 31 (15.6%) of 198 with WL compared to 1 (0.6%) of 146 with RSL ( P < .001). The seed fell out of the specimen during surgery in 6 (3.1%) of 194. No seed loss was recorded. The surgeons (n = 4) who transitioned to RSL increased the number of surgeries per month from a mean of 4.4 ± 2.6 in 2013 to 6.9 ± 3.5 in 2016, equivalent to a 41% increase ( P = .003). Conclusions: The use of RSL, as compared to conventional WL, resulted in a reduction in the number of pathologically involved surgical margins and was associated with an increased number of surgeries. Furthermore, RSL can be performed up to 14 days prior to surgery, which may improve scheduling flexibility in the radiology department.
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Rakshit, Suvendu. "Broad line region and black hole mass of PKS 1510-089 from spectroscopic reverberation mapping". Astronomy & Astrophysics 642 (ottobre 2020): A59. http://dx.doi.org/10.1051/0004-6361/202038324.
Abstract (sommario):
Reverberation results of the flat spectrum radio quasar PKS 1510-089 from 8.5 years of spectroscopic monitoring carried out at Steward Observatory over nine observing seasons between December 2008 and June 2017 are presented. Optical spectra show strong Hβ, Hγ, and Fe II emission lines overlying on a blue continuum. All the continuum and emission line light curves show significant variability with fractional root-mean-square variations of 37.30 ± 0.06% (f5100), 11.88 ± 0.29% (Hβ), and 9.61 ± 0.71% (Hγ); however, along with thermal radiation from the accretion disk, non-thermal emission from the jet also contributes to f5100. Several methods of time series analysis (ICCF, DCF, von Neumann, Bartels, JAVELIN, χ2) are used to measure the lag between the continuum and line light curves. The observed frame broad line region size is found to be 61.1−3.2+4.0 (64.7−10.6+27.1) light-days for Hβ (Hγ). Using the σline of 1262 ± 247 km s−1 measured from the root-mean-square spectrum, the black hole mass of PKS 1510-089 is estimated to be 5.71−0.58+0.62 × 107 M⊙.
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Addison, Poppy, Toni Iurcotta, Leo I. Amodu, Geoffrey Crandall, Meredith Akerman, Daniel Galvin, Annemarie Glazer et al. "Outcomes following operative vs. non-operative management of blunt traumatic pancreatic injuries: a retrospective multi-institutional study". Burns & Trauma 4 (1 dicembre 2016): 1–7. http://dx.doi.org/10.1186/s41038-016-0065-5.
Abstract (sommario):
Abstract Background Traumatic pancreatic injuries are rare, and guidelines specifying management are controversial and difficult to apply in the acute clinical setting. Due to sparse data on these injuries, we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic injuries. We hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated non-surgically. Methods We performed a retrospective review of data from four trauma centers in New York from 1990–2014, comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed non-operatively. We compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher’s exact tests. Univariate analysis was performed to determine the possible confounding factors associated with mortality in both treatment groups. Results Twenty nine patients were managed operatively and 32 non-operatively. There was a significant difference between the operative and non-operative groups in median age (37.0 vs. 16.2 years, P = 0.016), grade of pancreatic injury (grade I; 30.8 vs. 85.2%, P value for all comparisons <0.0001), median injury severity score (ISS) (16.0 vs. 4.0, P = 0.002), blood transfusion (55.2 vs. 15.6%, P = 0.0012), other abdominal injuries (79.3 vs. 38.7%, P = 0.0014), pelvic fractures (17.2 vs. 0.00%, P = 0.020), intensive care unit (ICU) admission (86.2 vs. 50.0%, P = 0.003), median length of stay (LOS) (16.0 vs. 4.0 days, P <0.0001), and mortality (27.6 vs. 3.1%, P = 0.010). Conclusions Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated non-operatively. The greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.
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Lee, Jang-kyu. "EFFECTS OF EXERCISE TYPE AND INTENSITY ON VISFATIN AND THE METABOLIC SYNDROME IN OBESITY". Revista Brasileira de Medicina do Esporte 27, n. 2 (giugno 2021): 170–73. http://dx.doi.org/10.1590/1517-8692202127022020_0088.
Abstract (sommario):
ABSTRACT Objective: Visfatin may regulate a variety of physiological functions and it has great potential to significantly enhance our knowledge of the treatment of metabolic syndrome. Metabolic syndrome (MS) refers to metabolic abnormalities, such as abdominal obesity, dyslipidemia, high low-density cholesterol, high blood pressure and diabetes, and physical activity is an important factor for the management of MS. Therefore, the purpose of this study is to investigate the effects of visfatin on MS and MS risk factors through differences in aerobic exercise intensity and exercise type based on the premise of the same amount of exercise (energy expenditure of 400 kcal per day). Method: Thirty two obese, middle-aged women were randomly assigned to exercise intensity groups VO2max 50% (MAE, n=8) and VO2max 80% (VAE, n=8) and to type of exercise groups VO2max 50% + TRX (MARE, n=8) and VO2max 80% + TRX (VARE, n=8). The exercise program was performed 5 times a week. The data was analyzed using two-way repeated measures ANOVA and post-hoc tests within groups with LSD. Results: Body weight (p<.01 and p<.001) and % body fat (p<.05 and p<.01) significantly decreased in all groups and visfatin only increased significantly after exercise in the VARE group (p<.05). TG, glucose, and waist circumstance (p<.05, p<.01, and p<.001) significantly decreased in all groups and HDL-C (p<.05) only increased significantly after exercise only in the MARE group. Conclusion: These results suggest that, in spite of differences in exercise intensity and exercise type, exercise is effective in improving obesity and MS risk factors, but further research is needed on the exact mechanisms of visfatin. Level of evidence I; Therapeutic Studies Investigating the Results of Treatment .
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Ganz, P. A., S. R. Land, D. L. Wickerham, M. Lee, M. Ritter, V. Vogel, J. P. Costantino e N. Wolmark. "The Study of Tamoxifen and Raloxifene (STAR): Change in patient-reported outcomes (PROs) after the end of treatment". Journal of Clinical Oncology 25, n. 18_suppl (20 giugno 2007): 1506. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.1506.
Abstract (sommario):
1506 Background: STAR is a double-blind, placebo controlled, randomized phase III prevention trial to evaluate the efficacy of 5 years of raloxifene (R) compared to tamoxifen (T) in reducing the incidence of breast cancer in high-risk postmenopausal women. STAR was unblinded on 3/30/2006. Primary clinical outcomes, quality of life (QOL) and symptoms (SXs) were reported (JAMA, 6/2006). We now describe changes in QOL and SXs post-treatment. Methods: Endpoints for QOL were the MOS SF-36 physical (PCS) and mental (MCS) component scales and the CES-D. SXs were measured using a modified checklist from the NSABP BCPT. Questionnaires were administered before treatment, every 6 months until 60 months, and then at 66 or 72 months. Participants enrolled in QOL study at selected sites from 1/4/2000–5/31/2001. SX data were collected on all participants in the main trial. The change in PCS, MCS and SX scales after the end of treatment was analyzed with linear regression. Results: From 7/1/1999–11/4/2004, 19,747 participants enrolled in STAR and were eligible for the SX assessment; 4,338 completed both on- and post-treatment assessments. The QOL study enrolled 1983 participants; 400 completed both on- and post-treatment assessments. CES-D scores improved significantly from on- to off-treatment (p=.007), but less so for those stopping treatment early (p=.03). The MCS and CES-D returned to pre-treatment levels; the PCS remained below (p=0.02). These endpoints did not differ by treatment group. Forgetfulness (p=.01), musculoskeletal (p=.01), vasomotor (p<.0001), dyspareunia (p<.0001), bladder (p=.0002), weight gain (p<.0001), gynecological (p<.0001), and leg cramp (p<.0001) scales decreased in severity after treatment. Those who stopped treatment early had a greater decrease in vasomotor SXs (p=.01) but a lesser decrease in gynecological SXs (p=.02). Patients on T had a greater decrease in the vasomotor (p=.02) and bladder (p=.009) scales and a lesser decrease in weight gain (p=.04). Compared to pre-treatment levels, post-treatment vasomotor SXs decreased (p=0.009) and leg cramps increased (p<.0001). Conclusions: QOL and SXs changed significantly after treatment, largely returning to pre-treatment levels. No significant financial relationships to disclose.
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Kumar, Sarvesh, Rinku Bhaskar, Subhash Chandra, Ankit Kumar, Ramesh Chand, Parmanand Kumar Maurya e Vishwajeet. "Screening of Mungbean [Vigna radiata (L.) Wilczek] Genotypes against Cercospora Leaf Spot Caused by (Cercospora canescens) for Disease Resistance". International Journal of Environment and Climate Change 13, n. 12 (18 dicembre 2023): 250–55. http://dx.doi.org/10.9734/ijecc/2023/v13i123681.
Abstract (sommario):
In India, where vegetarianism is the norm, mungbean [Vigna radiata (L.) Wilczek] is a significant source of proteins, minerals, and vitamins. One of the most significant fungal diseases, Cercospora leaf spot caused by Cercospora canescens, appears every year with varying intensity and significantly reduces yield. The objective of the current studies was to test 100 genotypes for resistance to Cercospora canescens in vivo at the Student's Instructional Farm (S.I.F.) A.N.D.U.A. &T., Kumarganj, Ayodhya. According to the rating system, which is based on the severity of the disease, different genotypes were assigned to different grades. Out of total test entries 13 genotypes LGG 607, PM 14- 3, AKM 12-28, VGG 16- 036, Pusa 171, Pusa 172, RMG 1092, RMG 1097, JLM 302-46, IPM 312-19, IPM 312-20, MGG 387 were found free from infection, 18 genotypes SKNM 1502, COGG 13-39 , PM 1511, Type 44, , DDG3, VGG 05-006, TRAM 1, Asha ,BPMR 145, IPM 02-14, TMB -36, CO -6, BMU, MH 805, MH 2-15, MH 421, MVSKAN, Pusa 0672, were found highly resistant 14 genotypes were noticed susceptible and only 3 genotypes were recorded highly susceptible.
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Rodriguez, Erika F., Ricardo G. Pastorello, Paul Morris, Mauro Saieg, Sayanan Chowsilpa e Zahra Maleki. "Suspicious for Malignancy Diagnoses on Pleural Effusion Cytology". American Journal of Clinical Pathology 154, n. 3 (11 giugno 2020): 394–402. http://dx.doi.org/10.1093/ajcp/aqaa058.
Abstract (sommario):
Abstract Objectives A definitive diagnosis of malignancy may not be possible in pleural effusions. We report our experience with the diagnosis of suspicious for malignancy (SFM) in pleural effusion. Methods A search for pleural effusions diagnosed as SFM (2008-2018) was performed. Patient records and pathology reports were reviewed. Specimens were subdivided into groups depending on volume (<75, 75-400, >400 mL). Diagnoses of malignant pleural effusion (MPE) served as controls. Results We identified 90 patients, with a mean age of 60.6 years. Diagnoses included suspicious for involvement by carcinoma/adenocarcinoma in 64.4%, leukemia/lymphoma in 15.6%, melanoma in 2.2%, sarcoma in 3.3%, germ cell tumor in 1.1%, and not otherwise specified in 13.3%. Immunostains were performed in 47.8% and considered inconclusive in 24%. Average sample volume was 419 mL. There was a statistically significant difference between the SFM vs MPE groups for volumes greater than 75 mL (P = .001, χ 2 test), with SFM having increased proportion of volumes greater than 400 mL, compared with the MPE group. There was no statistically significant difference in mean overall survival when the groups were compared (P = .49). Conclusions Samples with low cellularity, scant cell blocks, and inconclusive immunostains may contribute to a suspicious category diagnosis in pleural effusions.
Libri sul tema "006.420 1516":
1
Sequeira, Anthony, e Terry Vinson. Mastering the CCIE Evolving Technologies Section: Covering Exams 400-101, 400-051, 400-151, 352-001, 400-251, 400-201, And 400-351. Independently Published, 2017.
Atti di convegni sul tema "006.420 1516":
1
Silva Júnior, Mário Luciano de Mélo, Gabriella Camelo Oliveira, Lucas Pereira Ferreira, Roberto Carlos de Sousa Alves Junior, Yuri de Almeida Oliveira, Caline de Almeida Barbosa, Rasec Kayan Oliveira Santos, Weslley Medeiros Gois, Rômulo Martins Ferreira Santos e Giuliana Maria Morais Gonzalez. "Knowledge of Brazilian genral people on risk factors for stroke". In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.613.
Abstract (sommario):
Background: Stroke is one of the main causes of death in the Brazil and worldwide. The level of lay people’s knowledge on risk factors for stroke have yet to be fully described. Objectives: To assess the level of information on risk factors for stroke among lay people Design and setting: Cross-sectional study applying a survey to people in public spaces in cities of Brazil’s Northeast, in 2020. Methods: Individuals who were passing by in such places were invited in a quasi- random strategy, to be interviewed. We exposed the volunteers to a typical case of a stroke presentation and asked what risk factors for it. We did not provide alternatives for the question. Ethical principles were followed. Results: We enrolled 1,477 individuals (52.5% female, 36.2±14.8yo). Stroke was identified for 1,226/1,477 (83.0%) individuals. From these, 423/1,226 (34.5%) did not mention any risk factors for stroke; and 393/1,226 (32.1%) reported two or more factors. The often-indicated risk factors were hypertension (418, 34.1%), stress (201, 16.4%), inappropriate diet (125, 10.2%), diabetes (124, 10.1%) and sedentary lifestyle (109, 8.9%). There was not differences on mention or not risk factors in relation to sex (p=.290) and age (p=.085), but those who known had more years of formal education (p <.001) and more frequently had health insurance (p=.010). Conclusion: The knowledge of general population on risk factors for stroke is poor. It is necessary to provide public campaigns in order to improve knowledge on this theme and to encourage screening in individuals at risk.
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Кияев, А. В., М. А. Словак, А. А. Удачина e Л. И. Савельев. "ЕСТЕСТВЕННОЕ ТЕЧЕНИЕ ВРОЖДЕННОГО СУБКЛИНИЧЕСКОГО ГИПОТИРЕОЗА НЕ ВЛИЯЕТ НА РОСТ И ФИЗИЧЕСКОЕ РАЗВИТИЕ ДЕТЕЙ В ПРОЦЕССЕ 4-ЛЕТНЕГО НАБЛЮДЕНИЯ". In X (XXIX) НАЦИОНАЛЬНЫЙ КОНГРЕСС ЭНДОКРИНОЛОГОВ с международным участием «Персонализированная медицина и практическое здравоохранение». ФГБУ «НМИЦ эндокринологии» Минздрава России, 2023. http://dx.doi.org/10.14341/cong23-26.05.23-189.
Abstract (sommario):
ЦЕЛЬ: оценить влияние различных терапевтических подходов на физическое развитие у детей с врожденным субклиническим гипотиреозом.
МАТЕРИАЛЫ И МЕТОДЫ: проведено одноцентровое, проспективное, двухвыборочное, сравнительное
исследование (период наблюдения: от 1 до 15 лет); основные критерии включения: 1) уровень сТ4 неонатального ре-теста выше нижнего предела референсных значений; 2) уровень ТТГ неонатального ре-теста
выше 10 мМЕ/л; 3) наличие тиреоидной ткани в типичном месте по данным УЗИ шеи; 4) период наблюдения
не менее 1 года с момента установления диагноза; пациенты разделены на две группы: 1 гр. «динамическое
наблюдение» (n=15): пациенты, которые находились без заместительной терапии левотироксином натрия
с момента установления диагноза, и получали лечебную дозу калия йодида весь период наблюдения; 2 гр.
«заместительная гормональная терапия» (n=9): пациенты, которые получали терапию левотироксином
натрия с момента установления диагноза не менее 1 года; протокол динамического наблюдения в обеих
группах включал осмотр с частотой не реже 1 раза в 2 месяца в течение первого года жизни, и далее – индивидуально (1 раз в 3-6 месяцев), с оценкой физического развития (коэффициенты стандартного отклонения (SDS) роста и индекса массы тела (ИМТ) в зависимости от пола и возраста на момент осмотра), а также
оценкой конечного генетически прогнозируемого роста (Δ SDS роста) и нервно-психического развития.
Статистическая обработка данных выполнена с использованием пакетов прикладных программ Analyse-it
v5.51.1 (Analyse-it Software, Ltd., United Kingdom) и Microsoft Excel.
РЕЗУЛЬТАТЫ: группы были сопоставимы по полу, исходным показателям ТТГ и сТ4 при проведении
неонатального ре-тестирования, а также по периоду наблюдения (p>0.05). В 1 гр. на фоне динамического
наблюдения, продолжавшегося в среднем около 3,5 лет [3,0; 6,8] (1,1 – 15,6), ни у одного ребенка не развился явный гипотиреоз, потребовавший бы назначения ЗГТ. Период наблюдения во 2 гр. составил около
4,0 лет [3,8; 7,7] (1,2–10,3). В конечной точке наблюдения мы не получили статистически значимых различий
в группах детей по фактическому показателю роста детей: SDS роста (1 гр. -0,01 [-0,50; 0,26] против 2 гр.
+0,22 [-0,06; 0,96], p=0,318), а также по показателю конечного генетически прогнозируемого роста: Δ SDS
роста (1 гр. +0,09 [-1,23;0,41] против 2 гр. +0,28 [-0,26;0,51], p=0,558). Дети из 2 гр., находившиеся на ЗГТ, имели более высокие значения SDS ИМТ (1 гр. -0,59 [-0,84; 0,23] против 2 гр. +0,71 [0,45;1,71], p=0,018), однако
они не превышали двух коэффициентов стандартного отклонения.
ВЫВОДЫ: получены первые доказательства отсутствия влияния «повышенного» уровня ТТГ на рост
и физическое развитие детей с врожденным субклиническим гипотиреозом в процессе динамического
наблюдения в течение как минимум первых 4-х лет жизни, что, в свою очередь, дает клиницисту дополнительные аргументы при обсуждении выбора терапевтической тактики при врожденном субклиническом
гипотиреозе у детей.
Rapporti di organizzazioni sul tema "006.420 1516":
1
J, Ramos, Novillo F, Nava D, Ávila C, Rojas AM, Veloso V, Rada G e Verdugo-Paiva F. In patients with acute COVID-19, should remdesivir be used compared to placebo? Epistemonikos Interactive Evidence Synthesis, settembre 2023. http://dx.doi.org/10.30846/ies.83ffa48119.
Abstract (sommario):
Objective The aim of this living systematic review is to provide a summary of the effects of remdesivir in the of people with acute covid-19. Methods Eligible studies were randomised trials evaluating the effect of remdesivir versus placebo or no treatment. We conducted searches in COVID-19 L·OVE (Living OVerview of Evidence) platform, a system that performs regular searches in databases, trial registries, preprint servers and websites relevant to COVID-19. All the searches covered the period until 06/23/2023. No date or language restrictions were applied. Two reviewers independently evaluated potentially eligible studies according to predefined selection criteria, and extracted data on study characteristics, methods, outcomes, and risk of bias, using a predesigned, standardised form. We performed meta-analyses using random-effect models and assessed overall certainty in evidence using the GRADE approach. Results Our search strategy yielded 897 references. 10 randomized controlled trials reported in 15 references met our inclusion criteria and were included in the review. The relative risk of mortality was 0.91 (95% CI 0.83 - 1.00). This means remdesivir reduced the risk of mortality in 9%, compared with placebo or no treatment. In the studies identified in this review 760 people not receiving remdesivir out of 5372 presented the outcome Mortality (141 per 1000) versus 732 out of 5790 in the group that did receive it, with a risk difference of -12.22 per 1000 (from -24 to 0). In other words, -12.22 per 1000 (from -24 to 0) people did not develop the outcome because of the intervention. We assessed the certainty of the evidence for this outcome as low. The estimated absolute effect, -12.22 per 1000 (from -24 to 0), falls in the range of an effect of small magnitude. The relative risk of mechanical ventilation requirement was 0.62 (95% CI 0.40 - 0.94). This means placebo or no treatment reduced the risk of mechanical ventilation requirement by 38%, compared with . In the studies identified in this review 710 people not receiving placebo or no treatment out of 4539 presented the outcome Mechanical ventilation requirement (156 per 1000) versus 616 out of 4920 in the group that did receive it, with a risk difference of -60.11 per 1000 (from -93 to -10). In other words, -60.11 per 1000 (from -93 to -10) people did not develop the outcome because of the intervention. We assessed the certainty of the evidence for this outcome as low. The estimated absolute effect, -60.11 per 1000 (from -93 to -10), falls in the range of an effect of moderate magnitude. The relative risk of serious adverse events was 0.75 (95% CI 0.60 - 0.92). This means reduced the risk of serious adverse events by 25%, compared with . In the studies identified in this review 266 people not receiving out of 1266 presented the outcome Serious adverse events (210 per 1000) versus 266 out of 1665 in the group that did receive it, with a risk difference of -53.38 per 1000 (from -84 to -16). In other words, -53.38 per 1000 (from -84 to -16) people did not develop the outcome because of the intervention. We assessed the certainty of the evidence for this outcome as moderate. The estimated absolute effect, -53.38 per 1000 (from -84 to -16), falls in the range of an effect of moderate magnitude. Conclusions Remdesivir may result in a slight reduction in mortality. Remdesivir may result in a reduction in mechanical ventilation requirement. Remdesivir probably results in a reduction in serious adverse events.
2
J, Ramos, Novillo F, Nava D, Ávila C, Rojas AM, Veloso V, Rada G e Verdugo-Paiva F. In patients with acute COVID-19, should remdesivir be used compared to placebo? Epistemonikos Interactive Evidence Synthesis, settembre 2023. http://dx.doi.org/10.30846/ies.83ffa48119.v1.
Abstract (sommario):
Objective The aim of this living systematic review is to provide a summary of the effects of remdesivir in the of people with acute covid-19. Methods Eligible studies were randomised trials evaluating the effect of remdesivir versus placebo or no treatment. We conducted searches in COVID-19 L·OVE (Living OVerview of Evidence) platform, a system that performs regular searches in databases, trial registries, preprint servers and websites relevant to COVID-19. All the searches covered the period until 06/23/2023. No date or language restrictions were applied. Two reviewers independently evaluated potentially eligible studies according to predefined selection criteria, and extracted data on study characteristics, methods, outcomes, and risk of bias, using a predesigned, standardised form. We performed meta-analyses using random-effect models and assessed overall certainty in evidence using the GRADE approach. Results Our search strategy yielded 897 references. 10 randomized controlled trials reported in 15 references met our inclusion criteria and were included in the review. The relative risk of mortality was 0.91 (95% CI 0.83 - 1.00). This means remdesivir reduced the risk of mortality in 9%, compared with placebo or no treatment. In the studies identified in this review 760 people not receiving remdesivir out of 5372 presented the outcome Mortality (141 per 1000) versus 732 out of 5790 in the group that did receive it, with a risk difference of -12.22 per 1000 (from -24 to 0). In other words, -12.22 per 1000 (from -24 to 0) people did not develop the outcome because of the intervention. We assessed the certainty of the evidence for this outcome as low. The estimated absolute effect, -12.22 per 1000 (from -24 to 0), falls in the range of an effect of small magnitude. The relative risk of mechanical ventilation requirement was 0.62 (95% CI 0.40 - 0.94). This means placebo or no treatment reduced the risk of mechanical ventilation requirement by 38%, compared with . In the studies identified in this review 710 people not receiving placebo or no treatment out of 4539 presented the outcome Mechanical ventilation requirement (156 per 1000) versus 616 out of 4920 in the group that did receive it, with a risk difference of -60.11 per 1000 (from -93 to -10). In other words, -60.11 per 1000 (from -93 to -10) people did not develop the outcome because of the intervention. We assessed the certainty of the evidence for this outcome as low. The estimated absolute effect, -60.11 per 1000 (from -93 to -10), falls in the range of an effect of moderate magnitude. The relative risk of serious adverse events was 0.75 (95% CI 0.60 - 0.92). This means reduced the risk of serious adverse events by 25%, compared with . In the studies identified in this review 266 people not receiving out of 1266 presented the outcome Serious adverse events (210 per 1000) versus 266 out of 1665 in the group that did receive it, with a risk difference of -53.38 per 1000 (from -84 to -16). In other words, -53.38 per 1000 (from -84 to -16) people did not develop the outcome because of the intervention. We assessed the certainty of the evidence for this outcome as moderate. The estimated absolute effect, -53.38 per 1000 (from -84 to -16), falls in the range of an effect of moderate magnitude. Conclusions Remdesivir may result in a slight reduction in mortality. Remdesivir may result in a reduction in mechanical ventilation requirement. Remdesivir probably results in a reduction in serious adverse events.