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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.
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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.
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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.
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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.
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Cadée, Gerhard C. "Book review: Red Tides. Edited by Tomotoshi Okaichi, 2004, XIII + 439 pp. (Hardbound). Kluwer Academic Publishers, Dordrecht. ISBN 1-4020-1512-7. Price: € 90.00, US$ 99.00, GB £ 62.00." Aquatic Ecology 39, n. 2 (giugno 2005): 259. http://dx.doi.org/10.1007/s10452-005-5202-3.
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Florence, Eric, Christa Dreezen, Patrick Desmet, Eric Smets, Katrien Fransen, Bernard Vandercam, Jolanda Pelgrom, Nathan Clumeck e Robert Colebunders. "Ritonavir/Saquinavir plus One Nucleoside Reverse Transcriptase Inhibitor (NRTI) versus Indinavir plus Two Nrtis in Protease Inhibitor-Naive HIV-1-Infected Adults (Iris Study)". Antiviral Therapy 6, n. 4 (1 maggio 2000): 255–62. http://dx.doi.org/10.1177/135965350200600405.
Abstract (sommario):
Objectives To compare the efficacy, tolerability and safety of a ritonavir 400 mg/saquinavir hard gel fomulation 400 mg twice daily versus an indinavir 800 mg once every 8 h containing first-line protease inhibitor (PI) treatment regimen. Methods Open, randomized, multicentre clinical trial. PI-naive patients received either ritonavir/saquinavir and one nucleoside reverse transcriptase inhibitor (NRTI) or indinavir and two NRTIs. Intention-to-treat (ITT) and on-treatment (OT) analyses were performed. Results The baseline characteristics of the study participants were similar in both arms, 67 patients (37%) were naive to antiretroviral treatment. The proportion of patients who achieved a plasma viral load below the level of detection of 400 copies/ml at week 48 was 43% (39/90) in the ritonavir/saquinavir arm and 63% (57/90) in the indinavir arm ( P=0.005, ITT analysis). Using an OT analysis, these percentages were 84% and 88%, respectively ( P=0.6). There were more drop-outs in the ritonavir/saquinavir arm than in the indinavir arm (35.6% (32/90) versus 15.6% (14/90), P=0.002), mainly due to gastro-intestinal side-effects. Abnormal liver tests and increased lipids levels were more frequently reported in the ritonavir/saquinavir arm than in the indinavir arm. Conclusion In PI-naive patients, indinavir in combination with two NRTIs was more effective and better tolerated than ritonavir/saquinavir plus one NRTI. Both treatments were very effective for patients who were able to tolerate them.
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Gerber, David E., Jodi B. Segal, M. Yair Levy, Joyce Kane, Richard J. Jones e Michael B. Streiff. "The incidence of and risk factors for venous thromboembolism (VTE) and bleeding among 1514 patients undergoing hematopoietic stem cell transplantation: implications for VTE prevention". Blood 112, n. 3 (1 agosto 2008): 504–10. http://dx.doi.org/10.1182/blood-2007-10-117051.
Abstract (sommario):
AbstractVenous thromboembolism (VTE) is increasingly diagnosed among individuals with hematologic malignancies. However, the risk of VTE among patients undergoing hematopoietic stem cell transplantation (HSCT) is unclear. We examined the incidence and risk factors for VTE and bleeding among 1514 patients undergoing in-patient HSCT. No protocolized VTE prophylaxis was used. By HSCT day 180, 75 symptomatic VTE occurred in 70 patients (4.6%; 95% confidence interval [CI], 3.6%-5.8%). Fifty-five (3.6%) were catheter-associated, 11 (0.7%) were non–catheter-associated deep venous thromboses, and 9 (0.6%) were pulmonary emboli. Thirty-four percent of VTE occurred at a platelet count less than 50 ×109/L; 13% occurred at a platelet count less than 20 ×109/L. In multivariate analysis, VTE was associated with prior VTE (odds ratio [OR], 2.9; 95% CI, 1.3-6.6) and with graft-versus-host disease (GVHD; OR, 2.4; 95% CI, 1.4-4.0). Clinically significant bleeding occurred in 230 patients (15.2%; 95% CI, 13.4%-17.1%); 55 patients (3.6%; 95% CI, 2.7%-4.7%) had fatal bleeding. Bleeding was associated with anticoagulation (OR, 3.1; 95% CI, 1.8-5.5), GVHD (OR, 2.4; 95% CI, 1.8-3.3), and veno-occlusive disease (OR, 2.2; 95% CI, 1.4-3.6). In HSCT patients, VTE is primarily catheter-related and 3-fold less common than clinically significant bleeding. These findings warrant consideration when selecting VTE prophylaxis in HSCT patients.
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Simon, Dominique, Corinne Alberti, Marianne Alison, Loïc Le Henaff, Didier Chevenne, Priscilla Boizeau, Aurélie Canal et al. "Effects of Recombinant Human Growth Hormone for 1 Year on Body Composition and Muscle Strength in Children on Long-Term Steroid Therapy: Randomized Controlled, Delayed-Start Study". Journal of Clinical Endocrinology & Metabolism 98, n. 7 (1 luglio 2013): 2746–54. http://dx.doi.org/10.1210/jc.2012-4201.
Abstract (sommario):
Context: Recombinant human GH (rhGH) improves growth and body composition in glucocorticoid-treated children. Its effects on muscle strength are poorly evaluated. Objectives: Our objective was to evaluate rhGH effects on muscle strength in children receiving long-term glucocorticoid therapy; effects on height SD score (SDS) and body composition were assessed also. Design and Setting: A randomized, controlled, delayed-start study of rhGH for 12 months was started after randomization (baseline) or 6 months later (M6). Patients: Patients included 30 children with various diagnoses. Intervention: rhGH was administered at 0.065 mg/kg/d for 6 months and then in the dosage maintaining serum IGF-I levels below +2 SDS for chronological age. Main Outcome Measures: The primary criterion was the between-group difference in composite index of muscle strength (CIMS) change at M6. Secondary criteria included between-group differences in CIMS SDSheight, lean mass (LM), thigh muscle area (MA), and height SDS changes at M6; these parameters were also assessed in the overall population after 1 year of rhGH therapy. Results: At M6, rhGH therapy did not significantly affect changes in CIMS or CIMS SDSheight (+17.6% vs +7.5% and +0.14 ± 0.38 vs +0.11 ± 0.62, respectively); the rhGH-treated group had significantly larger changes in height SDS (+0.2 [0.3] vs −0.2 [0.3]; P = 0.003), LM (+7.3% [+3.7%; +21.6%] vs 0% [−4.7%; +3.2%]; P = 0.002), and MA (+8.8% [+5%; +15.6%] vs. −0.6% [−6.3%; +7.7%]; P = 0.01) compared with the untreated group. After 1 year of rhGH, height SDS, LM, and MA increased significantly, CIMS increased by 24.7% (+5.8%; +34.2%), and CIMS SDSheight remained within the normal range. Conclusions: rhGH increased height, LM, and MA. However, muscle strength did not improve significantly.
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Ananworanich, Jintanat, Meena Gorowara, Anchalee Avihingsanon, Stephen J. Kerr, Nadine van Heesch, Chuleeporn Khongpetch, Anuntaya Uanithirat, Andrew Hill, Kiat Ruxrungtham e David M. Burger. "Pharmacokinetics of and Short-Term Virologic Response to Low-Dose 400-Milligram Once-Daily Raltegravir Maintenance Therapy". Antimicrobial Agents and Chemotherapy 56, n. 4 (17 gennaio 2012): 1892–98. http://dx.doi.org/10.1128/aac.05694-11.
Abstract (sommario):
ABSTRACTBecause studies showed similar viral suppression with lower raltegravir doses and because Asians usually have high antiretroviral concentrations, we explored low-dose raltegravir therapy in Thais. Nineteen adults on raltegravir at 400 mg twice daily (BID) with HIV RNA loads of <50 copies/ml were randomized to receive 400 mg once daily (QD) or 800 mg QD for 2 weeks, followed by the other dosing for 2 weeks. Intensive pharmacokinetic analyses were performed, and HIV RNA was monitored. Two patients were excluded from the 400-mg QD analysis due to inevaluable pharmacokinetic data. The mean patient weight was 58 kg. Mean pharmacokinetic values were as follows: for raltegravir given at 400 mg BID, the area under the concentration-time curve from 0 to 12 h (AUC0-12) was 15.6 mg/liter-h and the minimum plasma drug concentration (Ctrough) was 0.22 mg/liter; for raltegravir given at 800 mg QD, the AUC0-24was 33.6 mg/liter-h and theCtroughwas 0.06 mg/liter; and for raltegravir given at 400 mg QD, the AUC0-24was 18.6 mg/liter-h and theCtroughwas 0.08 mg/liter. The HIV RNA load was <50 copies/ml at each dose level. Compared to the adjusted AUC0-24for Westerners on raltegravir at 400 mg BID, Thais on the same dose had double the AUC0-24and those on raltegravir at 400 mg QD had a similar AUC0-24. More patients had aCtroughof <0.021 mg/liter on raltegravir at 400 mg QD (9/17 patients) than on raltegravir at 800 mg QD (1/19 patients) or 400 mg BID (0/19 patients). Seventeen patients used raltegravir at 400 mg QD for a median of 35 weeks; two had confirmed HIV RNA loads between 50 and 200 copies/ml, and both had lowCtroughvalues. Low-dose raltegravir could be a cost-saving option for maintenance therapy in Asians or persons with low body weight. However, raltegravir at 400 mg QD was associated with a lowCtroughand with a risk for HIV viremia. Raltegravir at 200 or 300 mg BID should be studied, but new raltegravir formulations will be needed.
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Li, Yuzhi, Shiquan Cui, Samuel Baidoo e Lee Johnston. "Evaluation of Sow Caliper for body condition measurement of gestating sows". Journal of Swine Health and Production 29, n. 5 (1 settembre 2021): 245–52. http://dx.doi.org/10.54846/jshap/1232.
Abstract (sommario):
Objectives: To evaluate correlation between Sow Caliper measurement and backfat depth (BFD), and to determine the ideal caliper measurement that predicts optimal BFD prefarrowing to support performance of lactating sows. Materials and methods: Multiparous sows (n = 928, Parity 1-9) were group housed in pens from day 35 to 109 of gestation. Caliper measurements, BFD, visual body condition scores (BCS), and body weight were recorded upon sows’ entry and exit of gestation pens. Subsequent farrowing performance was recorded. Caliper measurements were classified into five categories: category 1 = 4.0 to 8.0 units, category 2 = 8.5 to 10.0 units, category 3 = 10.5 to 12.0 units, category 4 = 12.5 to 14.0 units, and category 5 = 14.5 to 18.0 units. Results: Caliper measurement was correlated positively with BFD (r = 0.71-0.75; P < .001) and BCS (r = 0.67-0.75; P < .001) on days 35 and 109 of gestation. Based on sow performance over one reproduction cycle and BFD recommendations, caliper category 4 on day 109 of gestation was deemed ideal for prefarrowing sows. The estimated lower and upper limits of BFD for prefarrowing sows in caliper category 4 were 15.6 and 18.0 mm, respectively. Caliper measurements explained about 55% of variation in BFD of gestating sows prefarrowing. Implications: The Sow Caliper can be used to evaluate body condition of gestating sows. To maintain body condition and reproductive performance, caliper measurements of 12.5 to 14.0 units are recommended for prefarrowing sows across parities, excluding gilts.
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Salem, Hytham S., Laura J. Huston, Alexander Zajichek, Eric C. McCarty, Armando F. Vidal, Jonathan T. Bravman, Kurt P. Spindler et al. "Anterior Cruciate Ligament Reconstruction With Concomitant Meniscal Repair: Is Graft Choice Predictive of Meniscal Repair Success?" Orthopaedic Journal of Sports Medicine 9, n. 9 (1 settembre 2021): 232596712110335. http://dx.doi.org/10.1177/23259671211033584.
Abstract (sommario):
Background: When meniscal repair is performed during anterior cruciate ligament (ACL) reconstruction (ACLR), the effect of ACL graft type on meniscal repair outcomes is unclear. Hypothesis: The authors hypothesized that meniscal repairs would fail at the lowest rate when concomitant ACLR was performed with bone--patellar tendon--bone (BTB) autograft. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent meniscal repair at primary ACLR were identified from a longitudinal, prospective cohort. Meniscal repair failures, defined as any subsequent surgical procedure addressing the meniscus, were identified. A logistic regression model was built to assess the association of graft type, patient-specific factors, baseline Marx activity rating score, and meniscal repair location (medial or lateral) with repair failure at 6-year follow-up. Results: A total of 646 patients were included. Grafts used included BTB autograft (55.7%), soft tissue autograft (33.9%), and various allografts (10.4%). We identified 101 patients (15.6%) with a documented meniscal repair failure. Failure occurred in 74 of 420 (17.6%) isolated medial meniscal repairs, 15 of 187 (8%) isolated lateral meniscal repairs, and 12 of 39 (30.7%) of combined medial and lateral meniscal repairs. Meniscal repair failure occurred in 13.9% of patients with BTB autografts, 17.4% of patients with soft tissue autografts, and 19.4% of patients with allografts. The odds of failure within 6 years of index surgery were increased more than 2-fold with allograft versus BTB autograft (odds ratio = 2.34 [95% confidence interval, 1.12-4.92]; P = .02). There was a trend toward increased meniscal repair failures with soft tissue versus BTB autografts (odds ratio = 1.41 [95% confidence interval, 0.87-2.30]; P = .17). The odds of failure were 68% higher with medial versus lateral repairs ( P < .001). There was a significant relationship between baseline Marx activity level and the risk of subsequent meniscal repair failure; patients with either very low (0-1 points) or very high (15-16 points) baseline activity levels were at the highest risk ( P = .004). Conclusion: Meniscal repair location (medial vs lateral) and baseline activity level were the main drivers of meniscal repair outcomes. Graft type was ranked third, demonstrating that meniscal repairs performed with allograft were 2.3 times more likely to fail compared with BTB autograft. There was no significant difference in failure rates between BTB versus soft tissue autografts. Registration: NCT00463099 (ClinicalTrials.gov identifier).
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Ertem, Ahmet Goktug, Yasin Ozen, Baran Yuksekkaya, Mehmet Akif Erdol, Mehmet Erdoğan, Koray Demirtas, Mustafa Karanfil, Ahmet Akdi, Cagri Yayla e Adnan Burak Akcay. "Association of the Novel Inflammatory Marker Systemic Immune-Inflammation index and Contrast-Induced Nephropathy in Patients Undergoing Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis". Angiology 73, n. 5 (20 gennaio 2022): 422–30. http://dx.doi.org/10.1177/00033197211045031.
Abstract (sommario):
This study investigated whether the systemic immune-inflammation index (SII) is an independent predictor of contrast-induced nephropathy (CIN) in patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. TAVR patients (n = 130) were included in the study. The patients were divided into 2 groups: those who developed CIN [CIN (+)] and those who did not [CIN (−)]. The SII was calculated as the ratio of the product of the total neutrophil count and the total platelet count to the lymphocyte count. CIN developed in 20 (15.3%) patients after TAVR. White blood cell count (7.66 ± 1.75 vs 6.78 ± 1.71 103/mm3 P = .038), neutrophil count (5.1 (3.9–6.7) vs 4.2 (3.5-5.1) 103/mm3 P = .024), neutrophillymphocyte ratio (4.20 (2.39–7.00) vs 2.75 (2.06-3.88), P = .010) and SII index (1069 (616–1514) vs 598 (426-955), P = .003) were at higher levels in patients with CIN. In addition, the SII index was an independent predictor for the development of CIN. The SII index, which can be easily calculated from a complete blood count, is an independent predictor of CIN in patients undergoing TAVR for severe aortic stenosis.
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Munir, M., SNH Shah, U. Almas, FA Khan, A. Zaidi, SM Bukhari e G. Murtaza. "An assessment of the wound healing potential of a herbal gel containing an Azadirachta indica leaf extract". Veterinární Medicína 66, No. 3 (2 marzo 2021): 99–109. http://dx.doi.org/10.17221/46/2020-vetmed.
Abstract (sommario):
The objective of this study was to produce a Carbopol 940 based gel formula containing an Azadirachta indica leaf extract and evaluate its wound healing potential. The ethanolic extract was derived from the dried leaves of Azadirachta indica and was subjected to a phytochemical evaluation. Three gel formulations of Carbopol 940 containing an Azadirachta indica extract in three different concentrations, i.e., 1, 2, and 3% w/w were prepared. These gels were evaluated for their physical appearance, stability, antimicrobial activity, extrudability, skin irritability, pH, spreadability, and viscosity. The prepared formulas were stable, greenish and homogeneous. None of them showed irritation to the skin. The spreadability (g.cm/sec), viscosity (cps), and pH of all three formulations was 34.68, 53 270–65 400, and 6–7, respectively. Gel-III exhibited the highest antimicrobial potential against E. coli and P. aeruginosa with a zone of inhibition of 16.2 ± 0.6 mm and 15.6 ± 0.6 mm, respectively. It was revealed from the wound healing studies that the epithelialisation time for the Albino rabbits treated with Gel-III was 23 days. The Albino rabbits treated with Gel-I, Gel-II, a standard gel, and those with the untreated one (control), epithelialised in 27, 25, 26, and 34 days, respectively. A formulation containing 3% w/w extract showed better antimicrobial activity, physicochemical characteristics, and pharmacological parameters than the other formulations. It can be concluded that the wound healing process was faster with the gel formulation containing 3% w/w of the Azadirachta indica extract, proposing that this formulation is a promising candidate for wound healing.
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Silvain, Johanne, Lee S. Nguyen, Vincent Spagnoli, Mathieu Kerneis, Paul Guedeney, Nicolas Vignolles, Kristel Cosker et al. "Contrast-induced acute kidney injury and mortality in ST elevation myocardial infarction treated with primary percutaneous coronary intervention". Heart 104, n. 9 (1 novembre 2017): 767–72. http://dx.doi.org/10.1136/heartjnl-2017-311975.
Abstract (sommario):
ObjectivesContrast-induced acute kidney injury (CI-AKI) is a common and potentially severe complication in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). There is no consensus on the best definition of CI-AKI to identify patients at risk of haemodialysis or death. The objective of this study was to assess the association of CI-AKI, using four definitions, on inhospital mortality, mortality or haemodialysis requirement over 1-year follow-up, in patients with STEMI treated with pPCI.MethodsIn this prospective, observational study, all patients with STEMI referred for pPCI were included. We identified independent variables associated with CI-AKI and mortality.ResultsWe included 1114 consecutive patients with STEMI treated by pPCI. CI-AKI occurred in 18.3%, 12.2%, 15.6% and 10.5% of patients according to the CIN, Acute Kidney Injury Network (AKIN), Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) Modification of Diet in Renal Disease (MDRD) and RIFLE Chronic Kidney Disease - Epidemiology Collaboration (CKD-EPI) definitions, respectively. The RIFLE (CKD-EPI) definition was the most discriminant definition to identify patients at higher risk of inhospital mortality (27.1% vs 4.0%; adjusted OR 2.7 (95% CI 1.4 to 5.1), p=0.003), 1-year mortality (27.4% vs 6.6%; adjusted OR 2.8 (95% CI 1.5 to 5.3), p=0.002) and haemodialysis requirement at 1-year follow-up (15.6% vs 2.7%; adjusted OR 6.7 (95% CI 3.3 to 13.6), p=0.001). Haemodynamic instability, cardiac arrest, preexisting renal failure, elderly age and a high contrast media volume were independently associated with 1-year mortality. Of interest, contrast-media volume was not correlated to increase of creatininaemia (r=0.06) or decrease in estimated glomerular filtration rate (r=0.05) after percutaneous coronary intervention in our population.ConclusionsCI-AKI is a frequent and serious complication of STEMI treated by pPCI. The RIFLE definition is the most accurate definition to identify patients with CI-AKI at high risk of mortality or haemodialysis.
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Rosti, Gianantonio, Fausto Castagnetti, Gabriele Gugliotta, Massimo Breccia, Luciano Levato, Adele Capucci, Mario Tiribelli et al. "Excellent Outcomes at 3 Years with Nilotinib 800 Mg Daily In Early Chronic Phase, Ph+ Chronic Myeloid Leukemia (CML): Results of a Phase 2 GIMEMA CML WP Clinical Trial". Blood 116, n. 21 (19 novembre 2010): 359. http://dx.doi.org/10.1182/blood.v116.21.359.359.
Abstract (sommario):
Abstract Abstract 359 Background: Nilotinib is a potent and selective inhibitor of BCR-ABL. In the phase 3 ENESTnd trial, nilotinib demonstrated superior efficacy to imatinib with higher and faster molecular responses. With a median follow-up of 18.5 months (ASCO/EHA 2010), the rates of progression to accelerated or blast phase (AP/BC) were 0.7% and 0.4% with nilotinib 300 mg and 400 mg BID, respectively, and significantly lower in comparison to imatinib (4.2% P = .006 and .003, respectively). Based on the results of the ENESTnd trial, nilotinib has been approved (FDA) for the frontline treatment of Ph+ CML. With imatinib 400 mg (IRIS trial), the rate of any event and the rate of progression to AP/BC were higher during the first 3 years on treatment (15.6% and 6.1%, respectively). Consequently, a confirmation of the durability of nilotinib responses at 3 years is extremely important. Aims: To evaluate responses (either cytogenetic and molecular) and to investigate outcomes of patients treated for 3-years with nilotinib 400 mg BID as frontline therapy. Outcomes evaluated include Overall Survival (OS), Progression-Free Survival (PFS), Failure-Free Survival (FFS) and Event-Free Survival (EFS). Method: A multicentre phase 2 trial (nilotinib 400 mg BID) was conducted by the GIMEMA CML Working Party (ClinicalTrials.gov.NCT00481052). The median follow-up is currently 30 months (3 years by November 2010). Definitions: Major Molecular Response (MMR): BCR-ABL/ABL ratio < 0,1% IS; Complete Molecular Response (CMR): undetectable transcript levels and nested PCR negative; failures: no CHR at 3 months, no CgR at 6 months, no PCgR at 1 year, no CCgR at 18 months, loss CHR or CCgR, progression and death (according to the revised European LeukemiaNet recommendations); events: failures and treatment discontinuation for any reason. All the analysis has been made according to the intention-to-treat principle. Result: 73 patients have been enrolled; median age 51 years (range 18–83); 45% low, 41% intermediate and 14% high Sokal risk. The cumulative CCgR rate (primary endpoint) at 12 months was 100%. CCgR at each milestone: 78% at 3 months, 96% at 6, 12 and 18 months, 92% at 24 months. The cumulative rate of MMR was 96%, while the rates of MMR at 3, 6, 12, 18 and 24 months were 52%, 66%, 85%, 81% and 82%, respectively. The cumulative rate of CMR was 41%, while the rates of CMR at 12 and 24 months were 7% and 12%, respectively. None of the patients who achieved a MMR progressed to AP/BC. Only one patient progressed at 6 months to AP/BC: a 63 years old female with a high Sokal risk disease in CCgR at 3 months, who developed a T315I mutation. During the first 12 months, the mean daily dose was 600–800 mg, 400–599 mg, and less than 400 mg in 74%, 18% and 8% of patients, respectively. The nilotinib last daily dose was as follows: 800 mg in 48 (71%) patients, 400 mg in 19 (28%) patients and 200 mg in 1 (1%) patient. Adverse events (AEs) were mostly grade 1 or 2 and manageable with appropriate dose adaptations. Two patients (3%) showed a prolongation of the QTcF above 450 msec (none above 50 msec). Four events lead to permanent discontinuation of nilotinib: 3 patients discontinued after 9, 15 and 27 months on treatment for recurrent episodes of amylase and/or lipase increase (no pancreatitis) and 1 patient after 25 months due to atrial fibrillation, unrelated to study drug. Three of them are currently on imatinib second-line and 1 on dasatinib third-line. Overall, 5 events have been recorded so far (1 progression to AB/BC and 4 permanent discontinuation of nilotinib due to AEs). At 30 months the OS, PFS and FFS are 99% and the EFS is 92%. Conclusion: The rate of failures was very low during the first 3 years. Responses remain stable. The very high rates of responses achieved during the first 12 months on treatment are being translated into optimal outcome for most of the patients. Acknowledgments: European LeukemiaNet, COFIN, Bologna University, BolognAIL Disclosures: Rosti: Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Bristol Myers Squibb: Honoraria, Speakers Bureau; Roche: Speakers Bureau. Castagnetti:Novartis: Honoraria; Bristol Myers Squibb: Honoraria. Gugliotta:Novartis: Honoraria. Saglio:Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Martinelli:Novartis: Consultancy, Honoraria; Bristol Myers Squibb: Consultancy, Honoraria; pfizer: Consultancy. Baccarani:Novartis: Consultancy, Research Funding, Speakers Bureau; Bristol Myers Squibb: Consultancy, Research Funding; Wyeth: Consultancy, Research Funding.
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Köhm, M., A. C. Foldenauer, T. Rossmanith, H. Kellner, U. Kiltz, A. Kleyer, G. R. Burmester et al. "POS0229 COMBINING MTX DOES NOT RESULT IN AN ADDITIONAL EFFICACY OF UST TREATMENT IN POLYARTHRITIC PSA: SUBGROUP ANALYSIS FROM A RANDOMIZED PLACEBO-CONTROLLED INVESTIGATOR INITIATED CLINICAL TRIAL". Annals of the Rheumatic Diseases 82, Suppl 1 (30 maggio 2023): 344–45. http://dx.doi.org/10.1136/annrheumdis-2023-eular.4112.
Abstract (sommario):
BackgroundBDMARD treatment in PsA patients usually requires treatment failure/intolerance to csDMARDs. The value of MTX in combination with bDMARDs is still unclear; an increase of efficacy is expected in polyarthritis. We designed an investigator-initiated, randomized, placebo-controlled trial (IIT) in active PsA to examine if outcomes of UST in combination with MTX (either newly initiated or ongoing) are different from UST only (+PBO), especially with focus on peripheral arthritic dominant PsA.ObjectivesTo compare ACR20/50/70 and MDA response rates at week 24 in treatment groups stratified by number of affected joints (oligo- vs polyarthritis).Methods186 patients with active PsA (defined as TJC≥4, SJC≥4 [68/66 joint count] and DAS28≥3.2) were screened for eligibility, 173 patients were randomized to UST+MTX (new or ongoing) or UST+PBO. 166 patients were included into the analysis. The cohort was stratified by number of affected joints: oligoarthritis (< 5 joints) and polyarthritis (≥ 5 joints.); for polyarthritis with additional subgroups (5-7, 8-10 and with >10 joints affected). Response rates (ACR20, 50, 70 response, MDA and 50% reduction in SJC/TJC) were calculated.ResultsBL data were well-balanced between treatment groups/subgroups (table 1) with exception to TJC/SJC. Independent from the number of affected joints, at week 24 no differences between the response behaviour were seen between UST (UST+PBO) or UST+MTX. By trend, UST+PBO showed better response in oligoarthritis and polyarthritis with >10 joints affected, whereas polyarthritis with affected joints >5 and <10 joints showed similar results for UST+PBO and UST+MTX (figure 1).ConclusionIL12/23 inhibition with UST is an effective treatment for active PsA independent of MTX use. Data from this subgroup analysis of the IIT indicate that additional MTX has no positive impact on UST efficacy, especially in focus on the arthritic PsA phenotype independent from the number of affected joints.Table 1.Baseline Characteristics: Subgroup analysis with stratification by number of affected joints at BaselineParametersUST + PBO, Oligoarthritis (< 5 joints)UST + MTX, Oligoarthritis (< 5 joints)UST + PBO, Polyarthritis (5-7 joints)UST + MTX, Polyarthritis (5-7 joints)UST + PBO, Polyarthritis (8-10 joints)UST + MTX, Polyarthritis (8-10 joints)UST + PBO, Polyarthritis (>10 joints)UST + MTX, Polyarthritis (>10 joints)N=10 (6%)N=10 (6 %)N=29 (17,5%)N=31 (18,7%)N=22 (13,3%)N=24 (14,5%)N=18 (10,8%)N=22 (13,3%)Sex [Female]2 (20.0%)5 (50.0%)14 (48.3%)10 (32.3%)8 (36.4%)14 (58.3%)8 (44.4%)8 (36.4%)Age [years]50.4 (SD 14.7)45.6 (SD 16.5)46.9 (SD 16.2)49.1 (SD 13.4)44.3 (SD 11.6)51.3 (SD 11.4)49.6 (SD 14.4)48.6 (SD 13.2)Age at PsA diagnosis [years]48.5 (SD 15.3)39.6 (SD 15.5)41.9 (SD 16.4)43.2 (SD 12.8)41.5 (SD 12.2)49.3 (SD 11.5)45.1 (SD 14.5)44.0 (SD 13.3)DAPSA [LOCF]25.1 (SD 6.3)23.7 (SD 5.5)28.7 (SD 5.5)29.7 (SD 9.0)33.9 (SD 6.7)36.0 (SD 12.2)51.7 (SD 15.6)53.5 (SD 17.6)TJC68 [LOCF]6.0 (6.0 to 14.0)7.5 (5.0 to 13.0)10.0 (7.0 to 12.0)9.0 (6.0 to 14.0)12.0 (9.0 to 16.0)11.0 (9.0 to 19.0)18.5 (15.0 to 24.0)17.0 (14.0 to 30.0)SJC66 [LOCF]4.0 (3.0 to 4.0)4.0 (4.0 to 4.0)6.0 (5.0 to 6.0)6.0 (5.0 to 7.0)8.0 (8.0 to 10.0)8.0 (8.0 to 9.5)14.0 (12.0 to 17.0)16.0 (14.0 to 22.0)BSA [%]1.0 (0.3 to 3.4)1.2 (0.5 to 3.0)1.8 (0.9 to 8.3)2.8 (1.0 to 12.0)2.0 (1.0 to 4.0)3.7 (1.0 to 6.5)1.0 (0.6 to 2.0)4.5 (0.9 to 18.0)PASI2.7 (0.3 to 7.7)1.2 (0.6 to 2.3)2.4 (0.6 to 5.0)2.8 (0.4 to 6.4)3.0 (0.6 to 6.5)3.7 (1.7 to 7.1)1.7 (0.3 to 6.0)4.5 (1.2 to 8.4)HAQ-DI [LOCF]0.7 (0.4 to 1.3)0.7 (0.3 to 1.3)0.9 (0.4 to 1.5)0.9 (0.5 to 1.5)0.6 (0.4 to 1.0)0.8 (0.3 to 1.3)1.3 (0.9 to 1.5)0.8 (0.3 to 1.6)DLQI [LOCF]5.5 (1.0 to 7.0)4.5 (1.0 to 9.0)4.0 (1.0 to 9.0)7.0 (3.0 to 14.0)6.5 (2.0 to 12.0)7.0 (2.5 to 13.0)6.5 (1.0 to 12.0)11.5 (3.0 to 17.0)Figure 1.Response to the different treatment regimes, stratified by number of affected joints at Baseline (mITT population)REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsMichaela Köhm Speakers bureau: Janssen, UCB, Novartis, Pfizer, Consultant of: Janssen, UCB, Novartis, Pfizer, Grant/research support from: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Ann Christina Foldenauer Grant/research support from: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Tanja Rossmanith Grant/research support from: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Herbert Kellner: None declared, Uta Kiltz: None declared, Arnd Kleyer: None declared, Gerd Rüdiger Burmester: None declared, Jan Brandt-Juergens: None declared, David M Kofler: None declared, Harald Burkhardt Speakers bureau: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Consultant of: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Grant/research support from: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Frank Behrens Speakers bureau: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Consultant of: Janssen, UCB, Novartis, Pfizer, GSK, BMS, Grant/research support from: Janssen, UCB, Novartis, Pfizer, GSK, BMS.
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Hyams, Jeffrey S., Alan M. Leichtner, Lorna O. Zamett e J. Ken Walters. "Effect of Metoclopramide on Prolonged Intraesophageal pH Testing in Infants with Gastroesophageal Reflux". Journal of Pediatric Gastroenterology and Nutrition 5, n. 5 (settembre 1986): 716–20. http://dx.doi.org/10.1002/j.1536-4801.1986.tb09167.x.
Abstract (sommario):
SummaryThe effect of metoclopramide (MCP) on prolonged intraesophageal pH testing was evaluated in 42 infants with gastroesophageal reflux (GER). Following a baseline period of intraesophageal pH monitoring, MCP was administered by injection at 0.1 mg/kg/dose (10 patients), 0.2 mg/kg/dose (11 patients), or 0.3 mg/kg/dose (21 patients). The percentage of time of intraesophageal pH less than 4, reflux frequency, and acid clearance time were calculated for each subject before and after MCP for both 5% dextrose and formula feedings. These parameters were further separated into 2‐hour or shorter and more than 2‐hour postprandial periods. No significant differences with either type of feeding were noted at either 0.1 or 0.2 mg/kg/dose. Significant decreases in the percentage of time the intraesophageal pH was less than 4 (30.0 ± 2.9 versus 15.6 ± 3.1, p = 0.001), the reflux frequency (episodes/hour; 6.5 ± 0.9 versus 4.0 ± 0.6, p = 0.004), and the acid clearance time (minutes/episode; 3.8 ± 0.7 versus 2.2 ± 0.3, p = 0.047) were noted in the 2‐hour or shorter period following 5% dextrose feedings but not following the formula feedings in the subjects receiving 0.3 mg/kg/dose. Three of the 42 study patients developed increased irritability, and one developed dystonia following MCP. These data suggest that if a clinical trial of MCP in infants with GER is performed, a larger dose of the medication than previously appreciated might be required.
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Mayhew, Maureen, Karen J. Grant, Lorena Mota, Setareh Rouhani, Michael C. Klein e Arminée Kazanjian. "Facilitating refugees’ access to family doctors". International Journal of Migration, Health and Social Care 11, n. 1 (16 marzo 2015): 1–17. http://dx.doi.org/10.1108/ijmhsc-12-2013-0046.
Abstract (sommario):
Purpose – The purpose of this paper is to describe the patient level characteristics of government-assisted refugees (GARs) who had acquired family doctors after leaving specialized refugee clinics (RC). Design/methodology/approach – A cross-sectional telephone survey of GARs households, three to six years after arrival to British Columbia, that used logistic regression to identify GAR characteristics associated with having a family doctor compared to having no family doctor or remaining at a RC. Findings – Contact rate was 52 percent. Of 177 interviewed GARs who spoke 24 languages, only 61 percent had secured a family doctor. Only 57 percent were educated; 46 percent spoke English and 40 percent worked consistently. Central Asian or African origin was associated with having a family doctor (OR 10.6 (95 percent CI 3.1-36.8) for RC; OR 10.3 (95 percent CI 2.2-47.8) for no family doctor). Other significant characteristics in the comparison with GARs at a RC included English proficiency (OR 15.6 (95 percent CI 4.3-56.9)), and female sex (OR 4.0 (95 percent CI 1.4-1.1)). When compared to those with no family doctor, additional significant characteristics included Health Authority A compared to B (OR 8.9, 95 percent CI 1.4-55.6) and having recently visited a doctor (OR 7.7 (95 percent CI 1.9-30.7)). Research limitations/implications – The results of this study are limited to a specific environment and the low contact rate may have resulted in bias. Originality/value – This study described characteristics of GARs who had successfully transitioned to a family doctor and those who had not. This population is rarely captured in studies because they are difficult to contact, ethnically diverse and not proficient in English.
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Yee, A., L. Siriwardhana, G. Nixon, F. Wong e R. Horne. "P168 Pre and postnatal factors associated with periodic breathing in preterm infants". SLEEP Advances 2, Supplement_1 (1 ottobre 2021): A76. http://dx.doi.org/10.1093/sleepadvances/zpab014.206.
Abstract (sommario):
Abstract Introduction Immature cardio-respiratory control in preterm infants often manifests as periodic breathing (PB). A number of pre- and postnatal demographic and clinical factors, such as exposure to maternal smoking, respiratory support and medications may affect respiratory control. We aimed to identify specific factors affecting the frequency of PB in preterm infants before hospital discharge. Methods 32 healthy preterm infants (14M, 18F) born between 28–32 weeks of gestational age were studied for 2–3 hours with daytime polysomnography at 31–36 weeks (when they had been off respiratory support for ≥ 3 days). % sleep time spent in PB was calculated. Variables are reported as median (IQR) and were compared with Mann-Whitney U and Chi square tests, between infants who spent greater or less than the median time in PB. Results 29 infants (91%) exhibited at least one episode of PB. Median sleep time in PB was 9.6% (IQR 0.6, 15.6%). Infants with time in PB above the median spent fewer days on respiratory support (4.0 days (1.0, 7.5) vs 9.0 (6.5, 21.5) days, p=0.035), and were younger (post-menstrual age 33.8 (IQR 32.1, 34.5) vs 35.1 (IQR 32.4, 35.6) weeks, p= 0.039). Conclusions Of the large number of maternal and infant demographic and clinical variables examined, we found few associations with the time preterm infants spent in PB. Greater % time spent in PB was associated with earlier discontinuation of respiratory support, however larger studies are required to confirm these findings and to investigate if there are any long-term consequences.
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Bau, Anne-Madeleine, Sarah Krull, Andrea Ernert e Birgit Babitsch. "Eating behaviour and its association with social living conditions and weight status among adolescent girls: results of the cross-sectional Berlin School Children's Cohort study". Public Health Nutrition 14, n. 10 (5 aprile 2011): 1759–67. http://dx.doi.org/10.1017/s1368980011000541.
Abstract (sommario):
AbstractObjectiveTo capture a more holistic picture of eating behaviour by investigating the impact of the social living conditions and weight status of parents and daughters on food consumption frequency, the context of meals and daily portion sizes.DesignCross-sectional Berlin School Children's Cohort study.SettingA total of sixty-nine schools in Berlin (3 400 000 inhabitants, eastern Germany) participated in the present study.SubjectsA total of 1519 girls aged 11–14 years were selected. Bi- and multivariate analyses were performed to examine the impact of age, migration background, socio-economic status (SES), parental education, family situation and the weight status of parents and daughters on three different eating behaviour scores according to nutritional recommendations.ResultsFor the three dependent eating behaviour variables, different patterns of influencing factors emerged. Multivariate regression (model 1) revealed that low and middle SES, two-parent migration background and older age were significant risk factors. Meal context was also significantly influenced by living with a single parent. Similar results were obtained for the daily portion size scores and maternal overweight status was the most influential. Model 2 succeeded in showing that, within the composite variable of family SES, mothers’ level of education was the dominant component.ConclusionsSES as a whole, and especially the component of mothers’ level of education and two-parent migration background, was the strongest risk factor for an unfavourable eating pattern among adolescent girls. The results clearly indicated preventive potential. Using three different measures of eating behaviour simultaneously provided an in-depth understanding of general patterns and potential risk factors.
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Moriyama, Hiroaki, Masafumi Gotoh, Koji Tanaka, Yashuhiro Mitsui, Hidehiro Nakamura, Hiroki Ozono, Takahiro Okawa e Naoto Shiba. "Midterm Functional and Structural Outcomes of Large/Massive Cuff Tears Treated by Arthroscopic Partial Repair". Orthopaedic Journal of Sports Medicine 9, n. 3 (1 marzo 2021): 232596712098879. http://dx.doi.org/10.1177/2325967120988795.
Abstract (sommario):
Background: Previous studies have shown good clinical outcomes in patients with irreparable large or massive rotator cuff tears treated using arthroscopic partial repair (APR); however, few studies have evaluated both functional and structural outcomes in these patients. Purpose: To evaluate both functional and structural outcomes in patients with large or massive rotator cuff tears treated using APR. Study Design: Case series; Level of evidence, 4. Methods: Between March 2009 and November 2016, a total of 30 patients underwent APR because of the irreparability of their large or massive rotator cuff tears during surgery. Of these patients, 24 completed the minimum 24-month follow-up (mean, 61.8 ± 27.1 months; range, 24-112 months) and were included in this study. Functional outcome measures included the Japanese Orthopaedic Association (JOA) and University of California Los Angeles (UCLA) scores and the visual analog scale for pain. Structural outcome measures comprised preoperative fatty degeneration, mediolateral tear size, residual tendon attachment area, and glenohumeral (GH) arthritic changes evaluated on magnetic resonance imaging scans or plain radiographs before and after surgery. Functional and structural outcomes were evaluated preoperatively, at 3 months postoperatively, and at the final follow-up. Results: The JOA scores for all patients significantly improved from 67.9 ± 11.3 preoperatively to 85.4 ± 15.6 postoperatively ( P < .0001). Similarly, the UCLA scores significantly improved from 15.8 ± 4.20 preoperatively to 29 ± 6.69 at final follow-up postoperatively ( P < .0001). The mediolateral tear size were significantly decreased at 3 months postoperatively ( P < .001) and at the final follow-up ( P < .001). Compared with preoperative scores, the novel score evaluating the residual tendon attachment area improved from 3.08 ± 0.46 to 3.54 ± 0.41 ( P < .001) after surgery overall, although it significantly deteriorated from 3 months postoperatively to the final follow-up. GH osteoarthritis progressed in 6 patients (25%). Patients who developed osteoarthritis had lower JOA and UCLA scores than did those who did not (JOA, P = .010; UCLA, P = .037). Conclusion: In irreparable large or massive rotator cuff tears treated using APR, functional outcome improved after surgery. Although the residual tendon attachment area improved, functional outcome after APR corresponded to the GH alterations at the midterm follow-up. Longer-term follow-up is needed to further elucidate the effect of APR on clinical outcomes in these patients.
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Yamasaki, Alisa, Ciersten A. Burks e Neil Bhattacharyya. "Cognitive and Quality of Life-Related Burdens of Illness in Pediatric Allergic Airway Disease". Otolaryngology–Head and Neck Surgery 162, n. 4 (3 marzo 2020): 566–71. http://dx.doi.org/10.1177/0194599820908202.
Abstract (sommario):
Objective To analyze the prevalence of pediatric allergic airway disease (PAA) and recognize its impact on cognitive function, childhood activities, use of early intervention, and missed school days. Study Design Cross-sectional analysis of National Health Interview Survey (NHIS), 2014 to 2017. Setting US households. Subjects and Methods An NHIS survey of US children and responding caregivers was analyzed to determine the prevalence of PAA, including allergic rhinitis and allergic asthma. Associations were determined between the presence of PAA and activities limited by difficulty remembering, limitation in the amount of childhood play, use of special education/early intervention, and number of missed school days in the past 12 months. Multivariate analysis was used to adjust for age, sex, race, ethnicity, and income level. Results An estimated 11.1 million (10.6-11.6 million, 95% confidence interval) children (mean age, 9.9 years; 56.9% male) reported a diagnosis of PAA (15.1% [14.6-15.6%]). Children with PAA missed 4.0 (3.7-4.4) school days per year vs 2.2 (2.1-2.4) days for those without PAA ( P < .001, adjusted). PAA was associated with limited daily activities due to difficulty with memory (odds ratio, 1.8 [1.2-2.9]), limitations in childhood play (3.2 [2.2-4.7]), and need for special education/early intervention services (1.6 [1.4-1.8]) after adjusting for age, sex, race, ethnicity, and income level. Conclusion PAA is a common condition and is associated with declines in cognitive function and school attendance as well as increased use of special education/early intervention. Given the significant prevalence and burden of illness of PAA, further attention is needed to ensure timely diagnosis and treatment.
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Kuenze, Christopher M., Nathaniel Foot, Susan A. Saliba e Joseph M. Hart. "Drop-Landing Performance and Knee-Extension Strength After Anterior Cruciate Ligament Reconstruction". Journal of Athletic Training 50, n. 6 (1 giugno 2015): 596–602. http://dx.doi.org/10.4085/1062-6050-50.2.11.
Abstract (sommario):
Context Individuals with a history of anterior cruciate ligament reconstruction (ACLR) are at greater risk of reinjury and developing early-onset osteoarthritis due to persistent abnormal joint loading. Real-time clinical assessment tools may help identify patients experiencing abnormal movement patterns after ACLR. Objective To compare performance on the Landing Error Scoring System (LESS) between participants with ACLR and uninjured control participants and to determine the relationship between LESS score and knee-extension strength in these participants. Design Controlled laboratory study. Setting Research laboratory. Patients or Other Participants Forty-six recreationally active participants, consisting of 22 with ACLR (12 men, 10 women; age = 22.5 ± 5.0 years, height = 172.8 ± 7.2 cm, mass = 74.2 ± 15.6 kg, body mass index = 24.6 ± 4.0) and 24 healthy control participants (12 men, 12 women; age = 21.7 ± 3.6 years, height = 168.0 ± 8.8 cm, mass = 69.2 ± 13.6 kg, body mass index = 24.3 ± 3.2) were enrolled. Main Outcome Measure(s) Bilateral normalized knee-extension maximal voluntary isometric contraction (MVIC) torque (Nm/kg) and LESS scores were measured during a single testing session. We compared LESS scores between groups using a Mann-Whitney U test and the relationships between LESS scores and normalized knee-extension MVIC torque using Spearman ρ bivariate correlations. Results The ACLR participants had a greater number of LESS errors (6.0 ± 3.6) than healthy control participants (2.8 ± 2.2; t44 = −3.73, P = .002). In ACLR participants, lower normalized knee-extension MVIC torque in the injured limb (ρ = −0.455, P = .03) was associated with a greater number of landing errors. Conclusions Participants with ACLR displayed more errors while landing. The occurrence of landing errors was negatively correlated with knee-extension strength, suggesting that weaker participants had more landing errors. Persistent quadriceps weakness commonly associated with ACLR may be related to a reduced quality of lower extremity movement during dynamic tasks.
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Thornton, Charlene Eliza, e Hannah Grace Dahlen. "Born before arrival in NSW, Australia (2000–2011): a linked population data study of incidence, location, associated factors and maternal and neonatal outcomes". BMJ Open 8, n. 3 (marzo 2018): e019328. http://dx.doi.org/10.1136/bmjopen-2017-019328.
Abstract (sommario):
ObjectivesTo determine incidence, associated factors, outcomes and geographical occurrence of born before arrival (BBA) in New South Wales, Australia.DesignA linked population data study involving population-based surveillance systems was undertaken for the years 2000–2011.SettingNew South Wales, Australia.ParticipantsAll women who underwent BBA compared with women who birthed in hospital/birth centre settings.ResultsDuring the time period, there were 1 097 653 births and a BBA rate of 4.6 per 1000 births. The BBA rate changed from 4.2 to 4.8 per 1000 births over time (p=0.06). Neonates BBA were more likely to be premature (12.5% compared with 7.3%), of lower birth weight (209.8 g mean difference) and/or be admitted to a special care nursery or neonatal intensive care unit (20.6% compared with 15.6%). The perinatal mortality rate was significantly higher in the BBA cohort (34.6 compared with 9.3 per 1000 births). Women in the BBA cohort were more likely to be in the lowest socioeconomic decile, multiparous, have higher rates of smoking (30.5% compared with 13.8%) and more likely to suffer a postpartum haemorrhage requiring transfusion than the non-BBA cohort (1.5% compared with 0.7%). The most commonly occurring complications for neonates were suspected infection (6.9%), hypothermia (6.9%), respiratory distress (5.4%), congenital abnormality (4.0%) and neonatal withdrawal symptoms (2.4%). BBA more commonly occurred in geographical areas where the distance to a maternity unit is >2 hours drive and in coastal regions where there is also a high rate of homebirth.ConclusionBBA occurs more frequently in multiparous women of lower socioeconomic status. There potentially is an effect of geography on the occurrence of BBA, as geographical area of high homebirth and BBA coexists, indicating that freebirth followed by an unplanned transfer to hospital may be occurring.
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Pathare, Anil, Salam AlKindi, Ali AlMadhani, Shoaib AlZadjali, Hamood AlHaddabi, Qamariya AlAbri, S. Muralitharan, J. David Dennison e R. Krishnamoorthy. "Predictive Value of Red Cell Indices and High Performance Liquid Chromatography in the Diagnosis of Haemoglobinopathies: Interim Results of the National Neonatal Cord Blood Screening Programme." Blood 108, n. 11 (16 novembre 2006): 3352. http://dx.doi.org/10.1182/blood.v108.11.3352.3352.
Abstract (sommario):
Abstract Objective: The aim of the study was to ascertain the feasibility of cord blood screening to determine the prevalence of haemoglobinopathies by a cost-effective method. Background: High rate of consanguinity and intercousin marraiges are prevalent in the Sultanate of Oman, leading to an increase in haemoglobinopathies, which is of growing importance as knowledge of a population structure can be a unique aid in planning genetic services. Methods: 1864 consecutive cord blood samples were screened by HPLC using Biorad Variant II program between April 2005 & March 2006. Complete blood counts [CBC] were also obtained on Cell Dyn 4000 automated blood cell counter. All samples were then processed to isolate and store mononuclear leukocytes for subsequent molecular diagnostics. Results: We observed a 46.83% incidence of α-thalassaemia, based on significant amounts of Hb Barts on HPLC and low mean cell volume [MCV] & mean cell haemoglobin [MCH] on the CBC. Table : Neonatal Cord Blood Screening - HPLC and CBC data with Red Cell Indices Normal ATT HbS HbD HbE HbC ?BTT Values in parenthesis represent SD Mean HbF % 77.4[7.3] 76.4[8.7] 89.4[9.4] 78.1[1.2] 81.1[4.9] 80.2[7.8] 92.1[2.0] Mean HbA % 22.5[7.3] 23.6[8.2] 14.1[6.0] 13.7[9.9] 12.7[3.1] 13.1[4.5] 8.1[2.1] Mean Haemoglobin g/dl 15.4[1.8] 14.4[1.4] 14.7[1.6] 14.9[0.7] 15.6[1.1] 15.2[0.8] 13.9[2.5] Mean RBC Count × 1012/L 4.5[0.6] 5.0[0.6] 4.9[0.6] 4.5[0.4] 4.8[0.4] 4.6[0.2] 4.0[0.6] Mean MCV fl 105.2[5.4] 89.9[4.1] 95.1[9.1] 100.8[7.0] 98.1[4.7] 99.1[5.6] 104.4[9.5] Mean MCH pg 34.4[2.1] 28.5[1.8] 30.7[3.4] 33.3[2.7] 32.6[3.3] 32.9[1.2] 34.8[1.0] Mean MCHC g/dL 32.7[1.1] 31.7[1.3] 32.2[1.0] 33.1[0.9] 33.6[2.1] 33.2[1.5] 33.3[1.0] Mean RDW % 16.1[1.1] 17.4[2.1] 17.1[2.4] 16.1[1.5] 17.7[2.4] 16.5[1.9] 16.1[2.5] Furthermore, the overall incidence of other haemoglobinopathies was 9.39%, with 6.01% incidence of sickle haemoglobin. On HPLC, D-window, E-window and C-window were present in 1.02%, 0.32% and 0.11% of the samples respectively. Figure: Distribution of abnormal Haemoglobins in Newborns Figure:. Distribution of abnormal Haemoglobins in Newborns Since HPLC cannot diagnose β-thalassemia major at birth, in samples with HbA below 10%, the beta globin gene was directly sequenced including the promoter, all exons and introns in the abnormal samples. [n=36] Additionally, direct sequencing of abnormal samples with HbS,[n=112] HbD,[n=19], HbE[n=6] and HbC[n=2] were also performed to validate the HPLC results. Conclusions: It is emphasized that neonatal cord blood screening is an important the first step in the national strategy towards total management of haemoglobinopathies including early diagnosis, comprehensive clinical care and counseling of the affected families. Between group differences were significant for RBC count, MCV, MCH, MCHC and the red cell distribution width (RDW), which along with Hb Barts, and HPLC results can successfully predict the correct underlying diagnosis.
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Gonzalez Velez, Miguel, Carolyn Mead-Harvey, Heidi E. Kosiorek, Yael Kusne e Leslie Padrnos. "Racial Differences in Nutritional Anemias: Analysis of Folate, Vitamin B12, and Iron Deficiencies". Blood 134, Supplement_1 (13 novembre 2019): 3387. http://dx.doi.org/10.1182/blood-2019-123791.
Abstract (sommario):
Background: Serum folate (SF), vitamin B12 (B12), and iron deficiencies (def) are common causes of nutritional anemias. These deficiencies are usually multifactorial, with nutritional and non-nutritional factors playing a role. SF, B12, and iron levels are usually ordered in the setting of anemia, and malnutrition with or without neurologic symptoms. Since folic acid fortification, the prevalence of SF def in the United States (US) is <1% in the general population. B12 def and iron def range between 6-12%, and 1-11% respectively depending on the population studied. The prevalence of nutritional anemias secondary to SF, B12, and/or iron def by racial groups in the US is poorly studied, and most data available focuses on non-Hispanic whites (NHW). We aimed to determine the prevalence of anemia secondary to nutritional deficiencies by racial groups in the US. Methods: We performed a retrospective analysis of patients with SF, B12 and iron levels at Mayo Clinic Arizona between 01/2010 and 10/2018. Race was classified according to the NIH criteria. Normal laboratory values were determined according to our lab reference and the US National Health and Nutrition Examination Survey (NHANES) III. SF levels (mcg/Lt) were defined as deficient <4, normal ≥4.0, and excess ≥20. B12 levels (ng/L) as deficient <150, borderline 150-400, normal >400-900, and excess ≥900. Iron def was determined by ferritin levels (mcg/L) as low <24, normal 24-336, elevated ≥336 for men, low <11, normal 11-307, elevated ≥307 for women. Demographics and clinical variables were compared between groups by chi-square test for frequency data or Kruskal Wallis rank-sum test for continuous variables. Multivariable logistic regression was used for a sample-level analysis adjusting for age and gender and using NHW as a reference group. Results: A total of 79,926 SF, 107,731 B12, and 39,827 ferritin samples from 67,683 patients were analyzed. Demographics and sample analysis are presented in Table 1. In the sample-level analysis, 23,008 (25%) had anemia with higher prevalence in the American Indian/Alaskan Native (AI/AN) 49% and African Americans (AA) 43% (p<0.001). The prevalence of SF def was 446/79,926 (0.6%), B12 def 1,548/107,731 (1.4%), and iron def 5,212/39,827 (13.1%). 23 had concomitant SF and B12 deficiency, 25 SF and iron def, and 144 B12 and iron def. The SF def prevalence by racial groups was: AI/AN 11 (1.9%), AA 19 (1.1%), NHW 378 (0.6%), Hispanic 28 (0.5%), Asian 4 (0.2%). The B12 def prevalence by racial groups was: Asian 89 (3.4%), NHW 1,274 (1.4%), Hispanic 87 (1.3%), AA 30 (1.3%), AI/AN 10 (1.3%). Iron def prevalence by racial groups: AI/AN 71 (20.5%), Asian 198 (17.6%), AA 180 (16.9%), Hispanic 432 (15.6%), NHW 4,161 (12.4%). In the multivariate sample-level analysis, the presence of anemia was higher in the AI/AN (OR: 4.51, 95%CI: 3.70-5.49, p<0.0001), AA (OR 3.34, 95%CI: 2.99-3.74, p<0.0001), Asian (OR 1.52, 95%CI: 1.35-1.73, p<0.0001) and Hispanic racial group (OR 1.41, 95%CI: 1.30-1.52, p<0.0001). SF def was more common in the AI/AN (OR: 2.94, 95%CI: 1.60-5.39, p<0.001) and AA (OR 1.71, 95%CI: 1.08-1.53, p=0.02). B12 def was more common in the Asian racial group (OR: 2.535, 95%CI: 20.03-3.16, p<0.0001). Iron def was more common in the AI/AN (OR: 1.62, 95%CI: 1.21-2.17, p<0.001), Asian (OR 1.31, 95%CI: 1.0-1.57, p=0.003), and AA racial group (OR 1.26, 95%CI: 1.05-1.52, p=0.001). Conclusions: In our cohort, we show that despite the low prevalence of nutritional anemias in the US, racial disparities exist. Major differences were observed in the prevalence of anemia, SF def and iron def especially among AI/AN and AA. These differences may be linked to medical causes, nutritional practices and other social determinants of health. More research regarding the causes of these disparities and its clinical implications on a population level are needed. Targeted strategies to improve folate, B12 and iron intake in at higher risk populations could decrease adverse outcomes and decrease healthcare disparities caused by nutritional anemias. T able 1. Sample-level comparison by race Disclosures No relevant conflicts of interest to declare.
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Sanjana Devi e Revathi Duraisamy. "Correlation between Age, Gender and Habits among Children - A Retrospective Study". International Journal of Research in Pharmaceutical Sciences 11, SPL3 (12 settembre 2020): 418–22. http://dx.doi.org/10.26452/ijrps.v11ispl3.2956.
Abstract (sommario):
Oral health influences the overall health of an individual. Hence, when oral health is affected the general well-being of the individual is unbalanced. Habits are repetitive actions done automatically. They represent an altered pattern of muscle contraction, done unconsciously and on a regular basis. Some habits are helpful, whereas other habits are deleterious over the long run. Habits can be either functional or non-functional. Functional habits include repeating normal functions unnecessarily like swallowing, chewing and nasal breathing. Whereas non-functional habits are unnecessary extra functions like thumb-sucking, nail-biting and lip sucking. The aim of this study was to evaluate the correlation between age, gender and habits. A retrospective study was conducted in the Saveetha Dental College, Chennai, India. Ethical clearance was obtained from the SRB committee, Saveetha Dental College, Chennai, India. The clinical portion of this retrospective study was conducted over nine months, i.e., between June 2019 to March 2020. Data were collected from a total of 86000 patients who visited the Saveetha dental college between Jun 2019 to March 2020. Out of this, the data of 400 patients who visited the institute were retrieved with the inclusion criteria of the study. The data obtained were tabulated in SPSS for Windows, version 20. Frequencies were analysed. Chi square test was done to evaluate the association between age, gender and habits. In the present study, there was 35.3% were males, and 64.7% were females. 15.6% were four years of age, 9% were five years of age, 11.3% were six years of age, 10.7% were seven years of age, 17.6% were eight years of age, 12.7% were nine years of age, 0.6% were ten years of age, 10.7% were 11 years of age. 16.8% have tongue thrusting, 36.1% have thumb sucking, 25.7% have nail-biting, 21.4% have mouth breathing. Within the limitations of this study, there was no significant association between habits and age [P=0.086] and gender [P=0.102].
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Thariat, Juliette, Dawn Aranguren, Yazici Gozde, Gabriela Studer, Marco Krengli, Pirus Ghadjar, Candan Demiroz et al. "Chemotherapy with irradiation in salivary gland carcinomas (SGC): A Rare Cancer Network study (RCN)." Journal of Clinical Oncology 31, n. 15_suppl (20 maggio 2013): e17019-e17019. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e17019.
Abstract (sommario):
e17019 Background: To report the role of combined chemotherapy in SGT. Methods: 251 patients with SGC treated in 2001-2011 were included in a collaborative IRB-approved retrospective RCN study. Chemotherapy is empirically administered based on extrapolation from conventional head and neck squamous cell carcinoma (Ca) (SCC) and data on systemic treatment in localized SGC are lacking. Results: Median age was 60 yo with 2/5 females/males. Tumor sites were the parotid 74.9%, submandibular 16%, sublingual 2.8% or minor gland 4%. Histologic findings were adenoid cystic (ACC) 17.3%, mucoepidermoid (MEC) 19.8%, adenoCa 15.6%, salivary duct (SDC) 10.3%, acinic cell (Aci) 6.2%, ex-pleomorphic 7.8%, undifferentiated 4.9%, myoepithelial 3.3%, epithelial myoepithelial 1.6%, basal cell 1.2%, lymphoepithelial 1.2%, others 4.0%. Surgery was performed in 95.1% (complete resection 38.1%). T stages 1, 2, 3 and 4 were 17.2%, 41.2%, 18.1% and 23.5% respectively. N stages were N0 61%, N1 13%, N2 24%, N3 2%. Perineural, vascular or lymphatic emboli were present in 47%, 24%, 27% respectively. Irradiation was performed postoperatively 96% or exclusively 4% (unilateral 84%, performed w/ photons only 78%, IMRT 41%). Chemotherapy was administered in 18%, dependent on grade, N stage, and emboli (p ≤ .05). None of 17 ex-pleomorphic, 25% of undifferentiated, 36% of SDC, and 66.7% of lymphoepithelial Ca received chemotherapy (p NS). With a median follow-up of 42 months for living patients, crude local, regional, metastatic relapse rates were 112% (in field 85%), 10%, 25%, respectively. Crude death rate was 28% including 77% from SGC. 5-year survival (5y OS) was 63%. The only prognostic factor was nodal involvement (p .002). However, 5y OS differed by histology: ACC 79%, MEC 84%, Aci 67%, SCC 43%, adenoCa NOS 40%, SDC 37%. Chemotherapy did not improve survival whatever histology. Conclusions: Further prospective studies are warranted to define the role of chemotherapy by histology in the setting of localized SGT. Also molecular profile-driven systemic treatments should be investigated.
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Limumpornpetch, Padiporn, Ann W. Morgan, Ana Tiganescu, Victoria N. Nyaga, Mar Pujades Rodriguez, Paul D. Baxter e Paul Michael Stewart. "Real World Mortality and Specific Causes of Death in Chronic Oral Glucocorticoid Use: A Systematic Review, Meta-Analysis and Meta-Regression". Journal of the Endocrine Society 5, Supplement_1 (1 maggio 2021): A93. http://dx.doi.org/10.1210/jendso/bvab048.186.
Abstract (sommario):
Abstract Background: Glucocorticoids (GCs) are widely used as therapeutic agents with prevalence 0.9–3.7%, but they are associated with significant side effects. Understanding of mortality ratios and causes of death from GC use is poorly appreciated and likely to help shape future stratification of clinical practice. Aims: To perform a meta-analysis of all-cause and specific cause -mortality amongst chronic GC users. Methods: The protocol was registered in PROSPERO (CRD42017067530). Searches were undertaken of PubMed, EMBASE, CINHAL, web of science and Cochrane Central from 1966 to April 2019. The primary outcomes were proportion of death and SMR in chronic GC use patients. The meta-analysis was performed with STATA version 16.1. The I2, subgroup analysis and meta-regression were used to assess heterogeneity among included studies. Results: A total of 109,511 articles, were screened. One hundred eighteen articles with 128 patient cohorts containing 51,374 patients reporting mortality fulfilled the eligibility criteria and were included in the meta-analysis. SMR from seven autoimmune/inflammatory disease studies was 1.84 (95%CI 1.27,2.41) with I2 70.2 6%. The proportion of overall death was 0.12 (95% CI 0.1, .014) with I2 89.3%. The proportion of death was 0.18 (95% CI 0.13,0.24) with I2 92.0% in vasculitis diseases (40 studies), 0.10 (95% CI 0.08, 0.13) with I2 86.2% in connective tissue diseases (67 studies), 0.07 (95% CI 0.03, 0.13) with I2 88.7% in inflammatory diseases (15 studies), 0.28 (95% CI 0.21–0.37) with I2 0.0% in haematologic diseases (2 studies), and 0.06 (95% CI 0.05, 0.09) with I2 0.0% in respiratory diseases (3 studies). GC prescription reports were different across studies and led to different prediction of mortality with high heterogeneity. Proportion of death amongst a GC cumulative dose of 0.3 to 3.9 gram, 4.0 to 7.3 gram and 7.4 to 36.7 gram were 0.11 (95% CI 0.06, 0.20), 0.04 (95% CI 0.02, 0.08) and 0.16 (95% CI 0.08, 0.28), respectively. The proportion of deaths predicted by average mean dose of ≥ 5mg/d, >5–7.5 mg/d, >7.5–10 mg/d and >10–30 mg/d were 0.02 (95% CI 0.01, 0.10), 0.15 (95% CI 0.15, 0.16), 0.08 (95% CI 0.03, 0.19) and 0.14 (95% CI 0.11, 0.19), respectively. The proportion of death predicted by a maintenance dose of ≥5mg/d, >5–7.5 mg/d, >7.5–10 mg/d and >10–30 mg/d were 0.08 (95% CI 0.05, 0.13), 0.12(95% CI 0.05, 0.23), 0.11(95% CI 0.06, 0.210) and 0.12(95% CI 0.05, 0.24) respectively. The causes of death (77 studies) were cardiac (25.3%), infection (13.2%), malignancy (15.6%), respiratory failure (10.6%), active underlying disease (4.4%), cerebrovascular disease (1.1%) and thromboembolism (0.9%). Conclusion: This is the first meta-analysis of oral GC use and mortality from real-world clinical practice publications. Multiple factors contribute to mortality, including GC dose, duration of exposure, route, preparation, together with patient and disease-specific factors.
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Cheung, Yin Ting, Noah D. Sabin, Wilburn E. Reddick, Deepa Bhojwani, Wei Liu, Tara M. Brinkman, John O. Glass et al. "Association Between Acute Leukoencephalopathy and Long-Term Neurobehavioral and Brain Imaging Outcomes in Survivors of Childhood Acute Lymphoblastic Leukemia Treated with Chemotherapy Only". Blood 126, n. 23 (3 dicembre 2015): 3255. http://dx.doi.org/10.1182/blood.v126.23.3255.3255.
Abstract (sommario):
Abstract Introduction: Leukoencephalopathy is observed in a subset of children undergoing chemotherapy for acute lymphoblastic leukemia (ALL), though the impact of these white matter abnormalities on long-term behavior and brain integrity are unknown. This study examines associations between acute (on-therapy) leukoencephalopathy and neurobehavioral ratings and white matter integrity in long-term survivors of ALL treated with chemotherapy only. Methods: 408 patients with newly diagnosed ALL were treated on St. Jude Total XV protocol which omitted cranial irradiation in all patients. Of the 369 patients who had prospective MRI scan of brain during active therapy, 294 were eligible for long-term follow-up and 189 (64%) participated in neurobehavioral assessment and brain imaging when ≥5 years post-diagnosis. Brain MRI's during therapy and at follow-up were systematically coded by a Board Certified Neuroradiologist (blinded to the neurobehavioral outcomes) using the Common Terminology Criteria for Adverse Events (CTCAE) 4.03. At follow-up, survivors' parents completed the Behavior Rating Inventory of Executive Function (BRIEF) to assess survivors' neurobehavioral problems. Diffusion tensor imaging (DTI) was conducted to assess white matter integrity. Fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) were extracted from DTI voxels within the frontostriatal tract, given its association with executive function. Generalized linear models were used to examine associations among leukoencephalopathy, long-term neurobehavioral and DTI outcomes, adjusting for current age. Results: Acute leukoencephalopathy was identified in 49 survivors (28.3%), 78% of whom continued to demonstrate leukoencephalopathy at follow-up. Compared to population norms, survivors had more severe problems with working memory (mean[SD] Z-score of 0.60 [1.27]), organization (0.31[1.05]), initiation (0.25[1.10]) and planning (0.33[1.19]), all p's<0.001. Survivors who developed acute leukoencephalopathy displayed more neurobehavioral problems at follow-up than those who did not, adjusting for age at diagnosis and parents' education (Table 1). Acute leukoencephalopathy was associated with reduced white matter integrity at follow-up: lower FA (p=0.03), higher AD (p=0.03) and higher RD (p=0.002). Lower FA at follow-up was associated with more neurobehavioral problems on initiation (Est -19.3, p=0.03), planning (Est -41.3, p=0.007), working memory (Est -40.6, p=0.002) and organization (Est -23.8, p=0.02). Leukoencephalopathy at follow-up was also associated with concurrent abnormalities in white matter integrity and more neurobehavioral problems on planning and organization. Conclusions: Even without cranial radiation, approximately a quarter of ALL patients developed leukoencephalopathy during active therapy, and are at risk for long-term neurobehavioral problems and reduced white matter integrity in frontal brain regions. Survivors who develop early leukoencephalopathy may benefit from preventative cognitive and/or behavioral interventions. Table 1. Survivor characteristics: Acute LeukoencephalopathyN (%) / mean [SD] No Acute LeukoencephalopathyN (%) / mean [SD] P Male (%) 27 (55) 62 (50) 0.55 Whites (%) 35 (71) 89 (72) 0.75 High risk (%) 23 (47) 48 (39) 0.32 Current age (years) 15.5 [4.8] 14.0 [4.6] 0.06 Age at diagnosis (years) 7.6 [5.0] 6.4 [4.0] 0.38 Time since diagnosis (years) 7.9 [2.0] 7.7 [1.7] 0.76 Total IV high-dose methotrexate (g/m2) 15.0 [4.4] 15.6 [7.4] 0.69 Total no. of intrathecal injections^ 15.1 [4.0] 14.1 [4.0] 0.07 Total oral dexamethasone (mg/m2) 1066.3 [343.0] 1108.1 [286.9] 0.43 BRIEF domains: Neurobehavioral problems Mean [SD]* Initiation 0.46 [1.1] 0.17 [1.1] 0.04 Organization of materials 0.65 [1.0] 0.18 [1.0] 0.004 Planning 0.57 [1.1] 0.24 [1.2] 0.04 Working memory 0.74 [1.4] 0.54 [1.2] 0.16 Emotional control 0.03 [1.0] 0.08 [1.1] 0.68 Inhibition 0.06 [1.1] 0.08 [1.2] 0.74 Shift 0.16 [1.3] -0.02 [1.1] 0.22 Monitor 0.08 [1.1] 0.02 [1.1] 0.33 *Age- and gender- adjusted scores with population mean=0 and SD=1. A higher score is indicative of more severe neurobehavioral problems. ^Inthrathecal combination of methotrexate, hydrocortisone and cytarabine Disclosures No relevant conflicts of interest to declare.
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Reynaud, T., A. Bertaut, W. Farah, D. Thibouw, G. Crehange, G. Truc e N. Vulquin. "P14.78 Hypofractionated stereotactic radiotherapy as a salvage therapy for recurrent high-grade gliomas: Single-center experience". Neuro-Oncology 21, Supplement_3 (agosto 2019): iii86. http://dx.doi.org/10.1093/neuonc/noz126.313.
Abstract (sommario):
Abstract BACKGROUND The standard of care for patients with recurrent glioblastoma or grade III glioma has not yet been clearly defined and many approaches are available for salvage strategies. These include surgery, re-irradiation or systemic agents. For the treatment of High-Grade (HGG) recurrence by radiation therapy, Hypofractionated Stereotactic Radiotherapy (HFSRT) is an interesting approach because it is minimally invasive, ambulatory, short-lasting and well tolerated. The aim of this study was to evaluate the efficacy of and safety to HFSRT as alvage treatment for patients suffering from HGG relapse in our cancer center and to compare these results with the literature. MATERIAL AND METHODS Between March 2012 and March 2017, 32 consecutive patients (12 women, 20 men) treated in a single-center were retrospectively included included in this study.Grade III gliomas were diagnosed in 14 patients and grade IV in 18 patients. Thirty-four lesions were treated with HFSRT on LINAC. HFSRT delivered a dose of 30 Gy in six fractions of 5Gy (27 Gy in three fractions for one patient) with two or three fractions per week. The treatment plans were normalized to 100% at the isocenter, and prescribed to the 80 % isodose line. Clinical outcomes and prognostic factors were analyzed. RESULTS HFSRT characteristics: The median tumor volume was of 6.1 (0.1–42.2) cm3 and the median PTV was 15 (0.6–67.5) cm3. The median maximum dose, median minimum dose and median mean dose were 38.7 (32.7–42.0) Gy, 29.1 (14.0–32.4) Gy and 35.1 (31.5–37.5) Gy, respectively. Median follow-up was 20.9 months. Median overall survival (OS) following HFSRT was 15.6 months (Median OS for patients patients with GBM and grade III glioma were 8.2 and 19.5 months, respectively; p=0.0496). Progression-free survival (PFS) was 3.7 months (Median PFS for patients with GBM and grade III glioma were 3.6 and 4.5months, respectively; p=0.2424). In multivariate analysis, tumor grade III (p=0.0027), an ECOG status <2 at the time of reirradiation (p=0.0023) and a mean dose >35 Gy (p=0.0055) significantly improved OS. A maximum reirradiation dose above 38 Gy (p=0.0179) was significantly associated with longer PFS. Treatment was well tolerated, no acute toxicity > grade 2 was observed. During the follow-up, ten patients (31.25%) had suspected radionecrosis. In six patients, this suspicion corresponded to tumor progression. For the other patients, radionecrosis was suggested on multi-modal MRI. CONCLUSION HFSRT appears to be a feasible and effective salvage treatment option for recurrent high-grade gliomas, with OS of 15.6 months. Prognostic factors associated with longer OS were a good general state of health and grade III glioma. Dosimetric data suggested that the dose gradient had an impact on tumor control and indicate that a study with dose-escalation is warranted. These results need to be confirmed in a prospective study with a greater number of patients.
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Lappe, Claudia, Holger Reinecke, Jannik Feld e Jeanette Köppe. "Sex Differences in Ischemic Cerebral Infarction: A Nationwide German Real-Life Analysis from 2014 to 2019". Clinical and Translational Neuroscience 6, n. 3 (12 settembre 2022): 23. http://dx.doi.org/10.3390/ctn6030023.
Abstract (sommario):
Female sex has been shown to be associated with an unfavorable outcome after ischemic stroke. In this nationwide analysis, we evaluate a large dataset of patients suffering from acute ischemic stroke to elucidate the factors associated with an increased risk of mortality after stroke in women. We analyzed a nationwide dataset from the German Federal Bureau of Statistics including 1,577,884 (761,537 female sex, 48.3%) in-hospital cases admitted between 1 January 2014 and 31 December 2019 with a primary diagnosis of acute ischemic cerebral infarction. Patients were analyzed regarding morbidity, treatments and in-hospital mortality. A multiple logistic regression analysis was performed, adjusted by patients’ risk profile including age, to evaluate the association of sex and in-hospital mortality. According to the median, women were older than men (79 years vs. 73 years). The multiple logistic regression analysis however revealed female sex remained an independent factor for an increased in-hospital mortality (odds ratio [OR] 1.12; 95% confidence interval [CI] 1.11–1.14; p < 0.001). Women had a higher prevalence of relevant risk factors, namely arterial hypertension (77.0% vs. 74.7%), arterial fibrillation (33.3% vs. 25.6%), chronic heart failure (12.3% vs. 9.7%), chronic kidney disease (15.6% vs. 12.9%) and dementia (6.6% vs. 4.1%), but were less affected with respect to other relevant co-morbidities such as cerebrovascular disease (11.7% vs. 15.1%), coronary heart disease (11.7% vs. 18.8%), diabetes mellitus (26.4% vs. 29.6%), dyslipidemia (38.1% vs. 42.0%), ischemic heart disease (12.3% vs. 19.3%) and previous coronary artery bypass grafting (1.1% vs. 3.2%). Overall, therapeutic interventions were performed less frequently in women such as carotid endarterectomy (1.1% vs. 2.3%), carotid stent (0.7% vs. 1.4%), as well as hematoma drainage (0.1% vs. 0.2%), and renal replacement therapy (0.4% vs. 0.6%). Conclusions: Our nationwide analysis revealed a higher mortality rate after stroke in women. Nevertheless, women had fewer in-hospital complications and were also less likely to experience the severe effects of some important co-morbidities. The dataset, however, showed that women received surgical or interventional carotid treatments after stroke less often. It is important for research on sex disparities in stroke to keep these treatment frequency differences in mind.
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Chaverri, Carlos, e José F. Cicció. "Essential oils of Baccharis trinervis (Asteraceae) from Costa Rica". Revista de Biología Tropical 65, n. 4 (19 settembre 2017): 1307. http://dx.doi.org/10.15517/rbt.v65i4.27845.
Abstract (sommario):
Baccharis is an Asteraceae genus of flowering plants, which has about 340 to 400 species, ranging from the Southern United States to the Southern extreme of Argentina and Chile through Central America and the Caribbean regions. The species Baccharis trinervis is a native shrub from Mexico, Central America and throughout South America. In Costa Rica, this species is commonly known as alcotán and the fresh leaves are used as a poultice on wounds and ulcers. The objective of the present research was to characterize the chemical composition of seven hydrodistilled essential oils of diverse morphological parts of B. trinervis. For this, samples were obtained from three locations in Costa Rica and standard laboratory analyses were followed. The essential oils were analyzed by capillary gas chromatography-flame ionization detector (GC-FID) and gas chromatography-mass spectrometry (GC-MS) using the retention indices on a 5 % phenyl/dimethylpolysiloxane fused silica column in addition to mass spectral fragmentation patterns, which allowed the identification of 268 compounds. The essential oils consisted mainly of terpenoids (92.3 to 97.8 %). The major constituents from the leaf oils were caryophyllene oxide (0.1-22.5 %), viridiflorol (8.8-21.0 %), germacrene D (0.5-19.1 %), germacrene B (0.2-16.0 %), β-caryophyllene (3.5-9.1 %), spathulenol (0.1-8.3 %), δ-3-carene (2.0-6.8 %), and α-pinene (2.5-5.9 %). The flower oil consisted mainly of globulol (0-24 %), β-caryophyllene (9.5-17.1 %), cis-muurola-4(14), 5-diene (traces-13.7 %), germacrene D (4.3-9.9 %), bicyclogermacrene (5.9-8.3 %), ar-curcumene (0-8.0 %), spathulenol (4.3-4.8 %), caryophyllene oxide (3.1-4.7 %), and viridiflorol (0.3-4.7 %). The major components of the branch oil were germacrene B (1.4-18.7 %), germacrene D (14.7-15.6 %), β-caryophyllene (10.1-12.4 %), viridiflorol (0-11.5 %), globulol (0.6-11.3 %), δ-3-carene (4.1-8.1 %), β-phellandrene (1.5-6.5 %), and bicyclogermacrene (3.6-4.9 %). The essential oil composition differed markedly from that of previously studied oils of plants growing in Brazil, which contain two characteristic stereoisomeric methyl dec-2-en-4,6-diynoate compounds not detected in this study. This is the first report about the chemical composition of the essential oils obtained from this species growing wild in Costa Rica.
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Cronce, Marcia, Robert M. Rauber, Kevin R. Knupp, Brian F. Jewett, Justin T. Walters e Dustin Phillips. "Vertical Motions in Precipitation Bands in Three Winter Cyclones". Journal of Applied Meteorology and Climatology 46, n. 10 (1 ottobre 2007): 1523–43. http://dx.doi.org/10.1175/jam2533.1.
Abstract (sommario):
Abstract The University of Alabama in Huntsville Mobile Integrated Profiling System 915-MHz profiler was deployed in January and February of 2004 to measure vertical air velocities in finescale precipitation bands in winter cyclones. The profiler was placed to sample the “wraparound” quadrant of three winter cyclones in the central and southern United States, and it obtained high-resolution measurements of the vertical structure of a series of bands in each storm. The data revealed bands that were up to 6 km deep, 10–50 km wide, and spaced about 5–20 km apart. Measurements of vertical air motion w within these bands were retrieved from the Doppler spectra using the lower-bound method, adapted to account for the effects of spectral broadening caused by the horizontal wind, wind shear, and turbulence. Derived vertical air motions ranged from −4.3 to 6.7 m s−1, with an uncertainty of about ±0.6 m s−1. Approximately 29% of the 1515 total derived values were negative, 35% exceeded 1 m s−1, and 9% exceeded 2.0 m s−1. These values are consistent with studies in the Pacific Northwest, except that more extreme values were observed in one band than have been previously reported. There was a high correlation between values of signal-to-noise ratio (SNR) and w within each band (0.60 ≤ r ≤ 0.85), in the composite of bands from each cyclone (0.59 ≤ r ≤ 0.79), and in the overall analysis (r = 0.68). The strongest updrafts were typically between 2.0 and 4.0 m s−1 and were located near the center of each band in regions of high SNR. Regions of downdrafts within the bands had maximum values between −1.0 and −4.3 m s−1 and were typically located along the edges of the bands in regions of low SNR. These results are consistent with snow growth and sublimation processes. The magnitudes of the vertical velocities in the core of the bands were comparable to theoretical predictions for moist symmetric instability (MSI) under inviscid conditions but would appear to be somewhat larger than expected for MSI when turbulent mixing is considered, suggesting that other instabilities, such as potential instability, may have contributed to the band development in these storms.
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Bishop, T. M., H. F. Crean, J. S. Funderburk, K. J. Speed e W. R. Pigeon. "1087 Early Session Effects of CBT-I on Insomnia and Depression". Sleep 43, Supplement_1 (aprile 2020): A413—A414. http://dx.doi.org/10.1093/sleep/zsaa056.1082.
Abstract (sommario):
Abstract Introduction Cognitive behavioral therapy for insomnia (CBT-I) has been shown to reduce depressive symptomatology among patients with co-occurring insomnia and depression. Brief forms of CBT-I have been tested in various settings including primary care. As delivery formats of CBT-I broaden, it is important to enhance our understanding of what doses and what components of CBT-I, provide the optimal balance of treatment efficacy and brevity. In the present study, we examine session-by-session effects of CBT-I on insomnia and depression. Methods Fifty-four Veterans with insomnia and co-occurring depression or posttraumatic stress disorder were randomized to either four sessions of CBT-I or treatment as usual in a published parent study. We report here on the effects among those who received CBT-I (n =22). At each session participants provided a completed sleep diary and completed the Insomnia Severity Index (ISI) and Patient Health Questionnaire-9 for depression (PHQ-9). Results At baseline, participants endorsed a moderate level of both insomnia (ISI score = 18.5 [SD=4.2]) and depression (PHQ-9 score = 15.6 [SD=5.2]). A mean decrease of 4.0 points in ISI total score was observed between sessions 1 and 2 [t(21)=-3.88, p<.001] and a 3.3 points between sessions 2 and 3 [t(19)=-2.63, p<.05]. Mean PHQ-9 scores decreased by 2.9 points between sessions 1 and 2 [t(21)=-2.84, p<.01] and a 2.8 points between sessions 2 and 3 [t(19)=-2.77, p<.05]. In contrast, changes in ISI and PHQ-9 scores between baseline and session 1, and sessions 3 and 4 did not reach significance. Conclusion The majority of improvements in both insomnia and depression were observed following sessions 1 and 2 of CBT-I. Findings suggest that even a limited exposure to CBT-I may have a clinically significant impact on functioning across multiple domains. Whether such early improvements represent an optimal balance compared with the more modest additional improvements achieved by adding more sessions is discussed. Support This work was supported by the VISN 2 Center of Excellence for Suicide Prevention at the Canandaigua VAMC.
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Donovan, Luke, Scott Hetzel, Craig R. Laufenberg e Timothy A. McGuine. "Prevalence and Impact of Chronic Ankle Instability in Adolescent Athletes". Orthopaedic Journal of Sports Medicine 8, n. 2 (1 febbraio 2020): 232596711990096. http://dx.doi.org/10.1177/2325967119900962.
Abstract (sommario):
Background: The prevalence and impact of chronic ankle instability (CAI) in adolescent athletes are unknown. To better develop and justify prevention strategies of lateral ankle sprains and CAI, it is important to understand the origin and associated long-term impact of CAI within populations other than adults. Purpose/Hypothesis: The purpose of this study was to determine the prevalence and impact of CAI on ankle function, health-related quality of life (HRQoL), and physical activity in adolescent athletes. The hypothesis was that the presence of CAI will be commonly reported among adolescent athletes and that participants with CAI will have lower self-reported ankle function, HRQoL, and physical activity when compared with participants without CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A cohort of 1002 healthy (able to fully participate) adolescent athletes (50.4% female; mean age, 15.6 ± 1.6 years) across 8 club sport facilities and high schools completed paper-and-pencil surveys to establish the presence of CAI (Identification of Functional Ankle Instability [IdFAI]) and estimate perceived ankle function (Foot and Ankle Ability Measure [FAAM]–Activities of Daily Living and FAAM-Sport), HRQoL (Pediatric Quality of Life Inventory 4.0 [PedsQL]), and physical activity (Hospital for Special Surgery Pediatric Functional Activity Brief Scale [HSS Pedi-FABS]). Results: The overall prevalence of CAI was 20.0%. Participants with unilateral CAI reported significantly lower ( P < .001) ankle function (FAAM-Sport: 87.0 ± 14.8) and HRQoL (total PedsQL: 89.8 ± 9.8) than participants who did not have CAI (FAAM-Sport: 97.7 ± 6.0; total PedsQL: 93.5 ± 9.1). Physical activity was not different between participants with and without CAI. Conclusion: The prevalence of CAI was high among adolescent athletes. The presence of CAI negatively affected ankle function and HRQoL in adolescent athletes. Given the high prevalence and negative impact of CAI in an adolescent population, strategies to prevent ankle injuries and maintain physical activity are needed to alleviate future long-term consequences associated with developing CAI. These strategies should be implemented as soon as sport participation begins, as it appears that the origin of CAI may occur before adulthood.
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Yi, Cecilia Y. Arana, Jorge Cortes, Stefan Faderl, Guillermo Garcia-Manero, Marina Konopleva, Zeev Estrov, Susan O'Brien et al. "Final Report of Combination of Sorafenib, Idarubicin, and Cytarabine for Initial Therapy in Younger Patients with Acute Myeloid Leukemia". Blood 120, n. 21 (16 novembre 2012): 1516. http://dx.doi.org/10.1182/blood.v120.21.1516.1516.
Abstract (sommario):
Abstract Abstract 1516 Background: Sorafenib is a potent inhibitor of FLT3 kinase with demonstrable clinical activity in patients with acute myeloid leukemia (AML) and FLT3-ITD mutation, but not those with FLT3-D835 mutation. Objectives: To determine the long term outcome of patients with AML treated with the combination of Sorafenib, cytarabine and idarubicin, and in particular those with FLT3-ITD mutation. Method: Between October 2007 to March 2010, 62 patients with newly diagnosed, previously untreated AML, were treated with Sorafenib 400 mg orally twice daily (BID) for 7 days, cytarabine 1.5 g/m2 by continuous intravenous (IV) infusion daily for 4 days (3 days if > 60 years of age), and idarubicin at 12 mg/m2 IV daily for 3 days on an IRB-approved clinical trial. After achieving remission, patients received up to 5 cycles of consolidation with sorafenib 400 mg BID continuously and abbreviated doses of cytarabine and idarubicin given at approximately one month intervals. Results: 62 patients were treated on the phase II portion of the study. Median age was 53 years (range, 18 – 66) and 12 (19%) patients were > 60 years. 23 (37%) had FLT3 mutations including 17 with FLT3-ITD, 4 with FLT3-D835, and 2 with both mutations. Cytogenetics was diploid in 36 (58%), chromosome 5 and 7 deletion in 4 (6%) and 1 (2%) respectively, complex in 8 (13%), miscellaneous in 13 (21%). Median white blood cell count (WBC) at diagnosis was 7.25 × 109/L (range, 0.6 – 225), and 28 (45%) patients had WBC > 10 × 109/L; among these, 12 (43 %) had FLT3-ITD. After induction, 49 (79 %) patients achieved CR and 5 (8%) CR with incomplete platelet recovery (CRp). 1 (2%) patient died before response assessment could be performed and 7 (11%) were non responders. Patients with FLT3-ITD were more likely to achieve a CR/CRp than patients without FLT3-ITD [18/19 (95%) patients vs. 36/43 (83%) patients, respectively (p=0.23)]. To date, 32 (59%) of the responders have relapsed including 10 of 18 (56%) patients with FLT3-ITD and 22 of 36 (61%) patients without FLT3-ITD (P=0.86). 35 patients received salvage therapy; 14 died after receiving salvage therapy, 11 achieved a second CR and 10 were refractory. After a median follow up of 40.6 months (range, 5.7 to 50 months), the median DFS and OS were 13 months and 29 months, respectively. Hematopoietic stem cell transplantation (HSCT) was performed in 34 (55 %) patients, including 23 in CR, and 11 with active disease. Stem cell source was from related donors in 15 (44%), unrelated donors in 9 (26%), cord blood in 7 (21%), and haploidentical donors in 3 (9%) patients. Overall, 35 (56%) patients have died; 16 (26%) had infectious complications, 12 (19%) multi-organ failure, 9 (15%) graft versus host disease, and 10 (16%) other causes with some patients having overlapping causes. Three-year disease free survival (DFS)(in patients achieving CR, n=54) and overall survival (OS) (n=62) were 34% and 47%, respectively (Figures 1 and 2). Conclusion: Combination of sorafenib, idarubicin and cytarabine is an effective regimen with durable responses in patients with newly diagnosed AML, particularly those with FLT3-ITD. Disclosures: Ravandi: Bayer: Research Funding; Onyx: Research Funding.
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Fonseca, Ana, Ana Laranjinha e Miguel Meira e. Cruz. "0472 INSOMNIAS IN OSA PATIENTS WITH DIFERENT DEGREES OF SEVERITY: A STEP TOWARDS PHENOTYPING COMISA". SLEEP 46, Supplement_1 (1 maggio 2023): A209—A210. http://dx.doi.org/10.1093/sleep/zsad077.0472.
Abstract (sommario):
Abstract Introduction With this pilot study, authors aimed to find how OSA and insomnias (sleep onset and maintenance insomnia) interact. Methods Data from PSG-level 1 consecutive Obstructive Sleep Apnea (OSA) patients were retrospectively collected. Insomnia and OSA severity were assessed. Arousals (A), arousal index (AI), wakefulness after sleep onset (WASO), total sleep time (TST) and sleep eficiency (SE) were used to better characterize insomnias. Epworth Sleepiness Sclae (ESS) was used to assess excessive daytime sleepiness (EDS). Results From 87 OSA patients, 43 (51.8 %): 53.5 % being females (F), where insomniacs (COMISA). Patients with COMISA where distributed as follows: Mild OSA (5 F: 22%; BMI=26.9±4.0 Kg/m2; Age=50.3±15.8 years old - yo; AHI=15.9±13.3 ev/h; ODI3%=4.0±3.9 ev/h; SaO2mean=96.4±0.98 %; SaO2min=89.5±4.2 %) with a TST of 414.5±70.9 min, SE=79.6±13.6 %, WASO=83.7±57.0 min and 182.7±84.8 arousals (AI=26.6±11.1 ev/h); Moderate OSA (8 F: 35%; BMI=28.7±4.7 Kg/m2; Age=53.5±13.4 yo; AHI=24.4±3.1 ev/h; ODI3%=8.8±5.7 ev/h; SAO2mean=95.3±1.2 %; SaO2min=87.7±3.9 %) with a TTS=385.8±69.2 min, SE=80.7±12.6 %, WASO=81.4±62.3 min and 178.8±69.5 arousals (AI=27.5±8.9 ev/h); Severe OSA (10 F: 43 %; BMI=30±5.2 Kg/m2; Age=58.6±7.8 yo; AHI=48.1± 19.9 ev/h; ODI3%=25.4±25.1 ev/h; SaO2mean=94.5±2.4%; SaO2min=82.6±10%) had a TTS=386.5±64.5 min, SE=77.4±11.4%, WASO=93.3±49.8 min and 274.2±95.3 arousals (AI=42.6±12.9 ev/h). The others 40:48.2 % presented with Isolated OSA: Mild OSA (7 F: 39 %; BMI=27.8±3.9 Kg/m2; Age=48.3±12.1 years old - yo; AHI=8.9±3.2 ev/h; ODI3%=2.5±2.7 ev/h; SaO2mean=96.4±0.8%; SaO2min=90.8±2.6%) had a TST of 423.9±36.7 min, SE=86.4±7.3%, WASO=58.1±27.2 min and 151.6±42.1 arousals (AI=21.6±6.5 ev/h); Moderate OSA (7 F: 39%; BMI=27.1±5.4 Kg/m2; Age=53±13.1 yo; AHI=21.2±3.8 ev/h; ODI3%=6.9±3.8 ev/h; SAO2mean=95.9±0.6%; SaO2min=86.7±4.1%) had a TTS=406.3±86.5 min, SE=79.4±15.2%, WASO=77.2.3±68 min and 196.3.8±60.4 arousals (AI= 29.1±6.6 ev/h); Severe OSA (4 F: 22%; BMI=28.3±4.2 Kg/m2; Age=62±12.5 yo; AHI=51.8± 18.7 ev/h; ODI3%=28.5±21.2 ev/h; SaO2mean=93.9±3.5%; SaO2min=81.4±10.2%) had a TTS=385.9±105.7 min, SE=76.2±20.1%, WASO=92.9±80.1 min and 272.7±115.6 arousals (AI=42.5±14.9 ev/h). ESS was 10.1±7.9, 9±5.4 and 8±5.7 for the Mild, Moderate and Severe OSA in COMISA group, and 14.6±7.3, 10.9±5.2 and 5.9±5.2, for the mild, moderate and severe forms of the isolated OSA group. Conclusion Insomnia complaints in OSA patients and PSG correlates seems to indicate clinically relevant COMISA phenotypes that would help to better characterize and manage this condition at different degrees of OSA severity. Support (if any)
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Wong, Kerry, Ari R. Joffe, Jason Yap, Bryan Acton, Irina Dinu, Elham Khodayari Moez e Charlene MT Robertson. "KINDERGARTEN-AGE QUALITY OF LIFE OUTCOMES AFTER LIVER TRANSPLANTATION AT <6 YEARS". Paediatrics & Child Health 23, suppl_1 (18 maggio 2018): e13-e14. http://dx.doi.org/10.1093/pch/pxy054.035.
Abstract (sommario):
Abstract BACKGROUND Given the improved mortality after paediatric liver transplantation, health related quality of life (HRQL) is an important outcome measure and provides valuable information for families. OBJECTIVES To determine the HRQL of kindergarten-age children who have undergone liver transplantation at age <6 years old. DESIGN/METHODS Between 1999–2014, all paediatric liver transplant recipients at our center were enrolled in this ethics board approved, longitudinal inception-cohort study. Following informed consent, HRQL was measured using the parent completed Pediatric Quality of Life Inventory, version 4.0 (PedsQL). The association between pre-transplant, transplant, and post-transplant variables and HRQL was examined using multiple regression analyses. Scores were compared to normative scores for HRQL in 8700 children [total PedsQL 82.2 (15.5), psychosocial summary 81.2 (15.3), and physical summary 84.0 (19.7)] and to scores for 130 children with surgical congenital heart disease from early infancy [81.1 (13.9), 77.5 (16.4), and 86.4 (15.3) respectively]. RESULTS 78 liver transplants for children <6 years of age were performed; 69 patients (88.5%) survived, and all (100%) were assessed at 55.4 (7.2) months of age: 38 with biliary atresia, 11 with acute liver failure, 11 with cholestasis, and 9 with metabolic disease. The mean total PedsQL was 75.6 (SD=15.6), psychosocial summary 72 (15.9) [a composite of emotional functioning 73.8 (16.4), social functioning 74.6 (19.2), and school functioning 70.6 (19.1)], and physical summary 78.2 (20.9). These composite scores were all statistically significantly different from population norms (p<0.001, <0.001, 0.026 respectively) and surgical congenital heart disease patients (p=0.015, 0.029, 0.005). The proportion having a score >1 (expected 15.9%) and >2 (expected 2.27%) SD below population norms were: total PedsQL 20.6% and 11.8%, psychosocial summary 32.3% and 11.3%, and physical summary 19.1% and 7.4%. Having a wait-list status 1 on the Canadian System of Classification was associated with higher total PedsQL (Effect size 9, 95%CI 2, 16; p=0.018) and physical summary (Effect size 15, 95%CI 16, 79; p=.004). None of the perioperative variables were predictive for psychosocial summary. Variables not associated with PedsQL included metabolic disease, PELD score, growth failure, any post-operative severe complication, age at transplant, weight at transplant, socioeconomic status, and year of transplant. CONCLUSION HRQL after liver transplantation is lower than population norms and congenital heart disease patients. More research is needed to determine why HRQL is low in order to improve the lives of these children.
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Mesto, Ernesto, Salvatore Laurita, Maria Lacalamita, Rosa Sinisi, Giovanna Rizzo, Emanuela Schingaro e Giovanni Mongelli. "Crystal Chemistry and Thermal Behavior of Fe-Carpholite from the Pollino Massif, Southern Italy". American Mineralogist 106, n. 1 (1 gennaio 2021): 123–34. http://dx.doi.org/10.2138/am-2020-7385.
Abstract (sommario):
Abstract The crystal chemistry and thermal behavior of Fe-carpholite from the Pollino Massif have been investigated by a multi-method approach. A combination of optical microscopy, scanning electron microscopy, mRaman spectroscopy, thermal analysis, room-temperature single-crystal X-ray diffraction, and high-temperature X-ray powder diffraction was employed. Field and micromorphological observations showed that the studied carpholite occurs in veins embedded in fine-grained matapelites and coexist with quartz, calcite, chlorite, and phengite. In particular, the tiny carpholite crystals are closely associated with quartz, suggesting simultaneous formation. Structure refinements from single-crystal X-ray diffraction confirm that carpholite crystallizes in the Ccce space group. Anisotropic refinements converged at 2.3 ≤ R (%) ≤ 2.6 and yielded unit-cell parameters a ~13.77 Å, b ~20.16 Å, c ~5.11 Å, and V ~1419 Å3. An XFe [i.e., the molar fraction Fe2+/(Mg+Fe2++Mn)] of ~0.6 was derived from the refined occupancy at the M1 site and is correlated to structural expansion mainly along the b and a axes and to geometrical distortions of the M1, M2, and M3 octahedra. mRaman spectrum of unoriented Fe-carpholite crystals exhibits several bands in the 200–1200 cm–1 region, a strong peak at 3630 cm–1 and a weak peak at 3593 cm–1, the latter two of which account for the presence of two independent OH groups, as also revealed by the X-ray structure refinement. The TG curve indicates a total mass loss of 15.6% in the temperature range 30–1000 °C, and the DTA curve shows a broad endothermic band at ~400 °C, extending up to ~650 °C, and weak exothermic peaks at ~700 and 750 °C. The latter may be ascribed to the breakdown of the Fe-carpholite structure and crystallization of new phases. The in situ high-temperature X-ray powder diffraction from 30 to 1105 °C revealed no significant changes in XRD patterns from 30 to 355 °C but reflection splittings from 380 °C due to a Fe-oxidation/deprotonation process. The carpholite and deprotonated carpholite phases coexist in the temperature range 380–580 °C, whereas only the deprotonated phase is observed up to 630 °C. Above this temperature, the carpholite structure collapses and the characteristic peaks of spinel and quartz phases are observed. At 1105 °C, spinel, mullite, garnet, cristobalite, and tridymite can be clearly identified. Our results provide insight into the thermal stability of Fe-carpholites and may help understand the thermal evolution of HP/LT metasediments.
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Akpoviroro, Ogheneyoma, Nathan Kyle Sauers, Oghenetejiro Princess Akpoviroro, Sameer Ahmed, Myriam Castagne, Elga Rodrigues, Sara Humayun, Queeneth Uwandu, Brian Bolden e Wasique Mirza. "Risk of treatment refusal in male patients with advanced-stage cancers." Journal of Clinical Oncology 41, n. 16_suppl (1 giugno 2023): e18690-e18690. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e18690.
Abstract (sommario):
e18690 Background: A previous study conducted revealed that males with advanced cancer(CA) were 1.6 times more likely to refuse treatment(TX) than females. Based on this study, we sought to determine factors associated with TX refusal in males. Methods: Retrospective review. Inclusion criteria: male, 18-75 years, stage IV CA, between 01/01/2010-12/31/2015, refused any CA TX(refusal group(RG)). A randomly selected group of stage IV males who accepted TX in the same timeframe was used for comparison(acceptance group(AG)). Geisinger Health System’s data was used. Results: RG had 307 males; AG had 298. Mean age of RG was 62.9 (standard deviation(SD)7.9) and 59.2 (SD9.8) in AG; p < 0.001. Lung CA was the most prevalent CA in both groups: 29.9% in AG and 34.9% in RG. Median interval-to-mortality was 42 days in RG (IQR 101.5), and 387 days in AG (IQR 686.5) p < 0.001. Median Charlson Comorbidity Index(CCI) was greater in AG (9, IQR 6) than RG (median 5, IQR 5.5). BMI, PHQ score, median household income, mean number of years educated and tobacco use history were not associated with TX decisions. While 38.3% of AG had government-funded insurance(GFI), 67.1% of RG had GFI; p < 0.001, OR 3.3, 95% CI 2.3-4.6. The prevalence of alcohol use disorder in RG was 9.8% compared with 3.4% in AG; p = 0.001, OR 3.1, 95% CI 1.5-6.5. RG had a greater prevalence of pre-cancer use of: antidepressants (28.3%) vs AG (14.4%)(p < 0.001, OR 2.3, 95% CI 1.6-3.5), antipsychotics (20.8%) vs 11.1% in AG(p = 0.001, OR 2.1, 95% CI 1.3-3.3), benzodiazepines (24.1%) vs 16.8% in AG(p = 0.03, OR 1.6, 95% CI 1.1-2.4), non-benzodiazepine anxiolytics (26.7%) vs 19.8% in AG(p = 0.04, OR 1.5, 95% CI 1.0-2.2), mood stabilizers(15.6%) vs 7% in AG(p < 0.001; OR 2.4; 95% CI 1.4-4.2). After cancer diagnosis(dx), the use of psychiatric medications becomes more prevalent in the AG. RG had a lower prevalence of post-cancer use of: antipsychotics(42.0%) vs 61.4% in AG (p < 0.001, OR 0.5, 95% CI 0.3-0.6), benzodiazepines (51.5%) vs in 76.5% AG(p < 0.001, OR 0.3, 95% CI 0.2-0.5), non-benzodiazepine anxiolytics(37.8%) vs 78.2% in AG(p < 0.001, OR 0.2, 95% CI 0.1-0.2); mood stabilizers(16.6%) vs 28.2% in AG(p < 0.001, OR 0.5, 95% CI 0.3-0.8). A married status was more prevalent in AG(58.4%) than RG(47.2%)(p = 0.005, OR 0.6, 95% CI 0.5-0.9). Only 19.2% and 20.1% in RG and AG, respectively, were referred to palliative medicine. Conclusions: TX refusal in males with advanced CA is associated with older age, GFI and a lower comorbid burden. Survival in males who accepted TX was 9 times longer. Males with private insurance were 3 times more likely to accept TX. TX of psychiatric disorders was more prevalent in the refusal group prior to CA dx but becomes more prevalent in the acceptance group after CA dx; this may indicate an increased prevalence of psychiatric disease in males who refused TX before CA dx, and a potential lack of psychiatric disease TX after CA dx. Married males were 1.6 times more likely to accept TX than single males.
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Siegel, David S., Katja C. Weisel, Meletios A. Dimopoulos, Rachid Baz, Paul G. Richardson, Michel Delforge, Kevin Song et al. "Analysis of Pomalidomide Plus Low-Dose Dexamethasone in Patients with Relapsed/Refractory Multiple Myeloma with Vs without Moderate Renal Impairment". Blood 126, n. 23 (3 dicembre 2015): 3031. http://dx.doi.org/10.1182/blood.v126.23.3031.3031.
Abstract (sommario):
Abstract Introduction: Renal impairment (RI) occurs in ≈ 20% to 40% of patients (pts) with multiple myeloma (MM; Kastritis et al, Haematologica, 2007) and is a major comorbidity with this disease (Korbet et al, J Am Soc Nephrol, 2006). Pts with MM who relapse on or become refractory to treatment (Tx) experience shortened overall survival (OS; Kumar et al, Leukemia, 2012). Pomalidomide + low-dose dexamethasone (POM + LoDEX) is approved for the Tx of relapsed/refractory MM (RRMM) in pts who have had Tx failure with lenalidomide and/or bortezomib. POM + LoDEX demonstrated safety and efficacy in pts with RRMM (MM-010; Dimopoulos et al, EHA 2015) as well as extended progression-free survival (PFS) and OS vs high-dose dexamethasone (MM-003; San Miguel et al, Lancet Oncol, 2013) or POM alone (MM-002; Richardson et al, Blood, 2014). Each trial included pts with moderate RI, and this pooled analysis examines the safety and efficacy of POM + LoDEX in pts with moderate RI. Patients and Methods: Pts from MM-002, MM-003, and MM-010 who had received POM + LoDEX were grouped by RI status (with moderate RI [creatinine clearance (CrCl) ≥ 30 to < 60 mL/min] and without RI [CrCl ≥ 60 mL/min]) and assessed for safety and efficacy. Results: Overall, from the 3 trials, data from 356 pts with moderate RI and 716 pts without RI were analyzed. Pts with moderate RI were slightly older (70 vs 63 yrs) and more commonly had International Staging System stage III disease (45.8% vs 25.4% in the 271 and 544 pts with available data). Median time from diagnosis was similar, 5.2 yrs (with moderate RI) vs 5.3 years (without RI); pts in both subgroups had a median of 5 prior Tx. The proportions of pts with moderate RI vs without RI who were refractory to LEN (95.5% vs 93.0%), BORT (82.0% vs 80.7%), and both LEN and BORT (78.4% vs 76.1%) were similar. The median Tx duration was slightly shorter for pts with moderate RI vs without RI (16.6 vs 20.4 weeks), but the median average daily dose (4.0 mg/day) and median relative dose intensity (0.9) were the same between renal subgroups. There were similar frequencies of discontinuations (7.4% vs 5.8%), dose reductions (22.7% vs 21.1%), and interruptions (63.1% vs 63.5%) due to adverse events (AEs) between subgroups of pts with moderate RI vs without RI. The most common grade 3/4 AEs for pts with moderate RI vs without RI were neutropenia (45.5% vs 48.3%), anemia (34.9% vs 27.5%), infections (31.3% vs 32.3%), and thrombocytopenia (21.3% vs 22.6%). The frequency of deep vein thrombosis/pulmonary embolism or peripheral neuropathy was ≤ 2% in both subgroups. The overall response rate (ORR) was 32.0% vs 33.0%, the median PFS was 18.1 weeks (95% CI, 15.6-20.9 weeks) vs 21.1 weeks (95% CI, 19.0-24.3 weeks), and median time to progression (TTP) was 20.3 weeks (95% CI, 17.3-24.1 weeks) vs 24.0 weeks (95% CI, 20.1-25.6 weeks) in pts with vs without moderate RI, respectively. Consistent with the poor prognosis associated with RI, median OS was shorter for pts with moderate RI (45.6 weeks [95% CI, 37.9-50.1 weeks]) vs those without RI (62.7 weeks [95% CI, 54.9-70.3 weeks]). Conclusions: In a pooled analysis of 3 trials of pts with RRMM treated with POM + LoDEX, ORR, PFS, TTP, and tolerability results appeared to be independent of the presence or absence of moderate RI. This analysis supports the use of POM + LoDEX as a standard of care in RRMM for pts with or without moderate RI. Disclosures Siegel: Celgene Corporation: Speakers Bureau; Amgen: Speakers Bureau; Takeda: Speakers Bureau; Merck: Speakers Bureau; Novartis: Speakers Bureau. Weisel:Amgen: Consultancy, Honoraria, Other: Travel Support; Celgene: Consultancy, Honoraria, Other: Travel Support, Research Funding; Janssen Pharmaceuticals: Consultancy, Honoraria, Other: Travel Support, Research Funding; Novartis: Other: Travel Support; Onyx: Consultancy, Honoraria; Noxxon: Consultancy; BMS: Consultancy, Honoraria, Other: Travel Support. Dimopoulos:Genesis: Honoraria; Novartis: Honoraria; Celgene: Honoraria; Onyx: Honoraria; Janssen: Honoraria; Amgen: Honoraria; Janssen-Cilag: Honoraria. Baz:Karyopharm: Research Funding; Millennium: Research Funding; Celgene Corporation: Research Funding; Sanofi: Research Funding. Richardson:Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Millennium Takeda: Membership on an entity's Board of Directors or advisory committees; Johnson & Johnson: Membership on an entity's Board of Directors or advisory committees. Delforge:Celgene Corporation: Honoraria; Janssen: Honoraria; Amgen: Honoraria; Novartis: Honoraria. Song:Celgene Canada: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. San Miguel:Celgene: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees; Millennium: Membership on an entity's Board of Directors or advisory committees; Onyx: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; BMS: Membership on an entity's Board of Directors or advisory committees; MSD: Membership on an entity's Board of Directors or advisory committees. Moreau:Millennium: Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen-Cilag: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees. Yu:Celgene Corporation: Employment, Equity Ownership. Hong:Celgene Corporation: Employment, Equity Ownership. Sternas:Celgene Corporation: Employment, Equity Ownership. Zaki:Celgene Corporation: Employment, Equity Ownership. Palumbo:Novartis, Sanofi Aventis: Honoraria; Celgene, Millennium Pharmaceuticals, Amgen, Bristol-Myers Squibb, Genmab, Janssen-Cilag, Onyx Pharmaceuticals: Consultancy, Honoraria.
49
Kamilova, N. M., O. K. Gasymov e U. G. Alieva. "Comparative Assessment of Hormonal, Echographic and Spectral Parameters in Chronic Endometritis and Chronic Salpingo-Oophoritis". Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 7, n. 3 (2 luglio 2022): 143–46. http://dx.doi.org/10.26693/jmbs07.03.143.
Abstract (sommario):
The purpose of the study was to assess the effectiveness and clinical significance of the use of spectral analysis of molecular markers for an objective assessment of the clinical course of chronic endometritis and salpingo-oophoritis. Materials and methods. The paper presents survey data of 100 women aged 18-47 years with a diagnosis of chronic endometritis and chronic salpingo-oophoritis. Laboratory methods of blood tests were carried out according to the generally accepted methods when patients were admitted for examination. The assessment of the hormonal status was carried out using standard kits from the company "Immunotec" (Czech Republic) on a radioisotope analyzer "Gamma-800" (Narcotest). All subjects underwent ultrasound of the pelvic organs using the Voluson E8 apparatus, using transabdominal transducers of 11 Hz and 18 Hz and a transvaginal transducer with a frequency of 20 Hz and 31 Hz. To study molecular markers, we used the method of molecular Raman spectroscopy. We used a standard two-beam infrared spectrometer "SPECORD-75 IR" in the frequency range of 4000-400 cm-1. Statistical data processing was carried out using Microsoft Excel 2000 and SPSS 10.0.5 software. Results and discussion. The results of our research showed that the use of hormonal and echographic studies, although they are informative methods in the diagnosis of chronic endometritis and salpingo-oophoritis, are not specific enough. One of the important points of pathogenesis, both for acute and chronic inflammatory diseases of the genitals, is the development of endogenous intoxication. A manifestation of acute inflammation against the background of intoxication is a change in the biosynthesis of "acute phase proteins". Spectral analysis of molecular markers allows detecting chronic endometritis / salpingo-oophoritis with higher accuracy (98%), sensitivity (99%) and specificity (97%). Stretching and bending vibrations of -CO and its derivatives are most intensely manifested. At the same time, depending on the pathological process, a shift in the position of the maxima in the absorption spectra was noted. The magnitude of the shift between the wave numbers obtained in patients with endometritis and salpingo-oophoritis was 1000/1500 cm-1, which is important for the identification and differentiation of components in the mixture. Conclusion. For samples of the spectrum of blood plasma in patients with chronic endometritis, characteristic bands with maxima are located in the region of 1510 cm-1, 1520 cm-1, 1535 cm-1. The absorption spectrum corresponds to 0.13-0.18. In patients with chronic salpingo-oophoritis, 1720cm-1 is characteristic for the 1600/1750cm-1 band, but 3420cm-1 for the 3300/3680cm-1 band. In this case, the absorption of waves during this process has significant differences – 0.16-0.25 for the first band and 0.06-0.20 for the second, on average 0.11
50
Shlyk, I. V., A. A. Spiridonova e V. A. Panafidina. "The effectiveness of biapenem in the treatment of sepsis". Messenger of ANESTHESIOLOGY AND RESUSCITATION 21, n. 2 (17 aprile 2024): 46–51. http://dx.doi.org/10.24884/2078-5658-2024-21-2-46-51.
Abstract (sommario):
The objective was to evaluate the clinical effectiveness and safety of biapenem (Bianem–AF drug) in the treatment of severe forms of infection in ICU patients.Materials and methods. The prospective observational study. At the first stage, microbiological testing of strains (n = 51) isolated from patients in ICU of the Scientific and Clinical Center of Anesthesiology and Intensive Care of the Pavlov University was performed to determine sensitivity to meropenem and biapenem by serial dilution method with the determination of MIC (Minimal Inhibitory Concentration). The genes of serine and metallocarbapenemases were detected by PCR method. At the second stage, patients over 18 years old with the site of infection that required surgical treatment and with clinical and laboratory signs of sepsis were included (n = 19: 11 females, 8 males, mean age 63.4 years). These patients received therapy with biapenem 600 mg every 12 hours as extended infusions over 1 hours (after bolus injection for the first 24 hours). Daily assessment of the severity of the inflammatory reaction and organ dysfunction was conducted to all patients included in the study. Microbiological analysis of biological material obtained from the site of infection has been obtained. Clinical effectiveness was evaluated as recovery/improvement or lack of effect. Adverse effects were recorded.Results. Among 51 isolates of microorganisms: 27 (52.9%) Klebsiella pneumonia, 16 (31%) strains of other representatives of the order Enterobacteriales, 8 (15,6%) non-fermenting gram-negative microorganisms. 48% of Klebsiella pneumoniae isolates were resistant to meropenem and biapenem. All of them had serine (class A and D) and metallo-carbapenemase (class B) genes, as well as their combination. Of the 16 strains of other representatives of the order Enterobacteriales, only 2 (12.5%) were resistant to meropenem and biapenem. Resistance to carbapenems in the non-fermenting gram-negative microorganisms reached 87.5%. The proportion of ESBL producers among carbapenem-sensitive Enterobacteriales reached 93%. The response to biapenem therapy was received in 100% of patients. A day after the start of biapenem administration, a decrease in the level of procalcitonin was noted from 4.65 ng/ml (1.26; 18.8) to 2.2 (1.3; 16.2), after 72 hours – to 1.9 (0.8; 5.0) ng/ ml, by the 7th day – to 0.6 (0.3; 2.5) ng/ml. The median SOFA score decreased from 3.0 (1.5; 4.0) after 24 hours to 2.0 (0,5; 3,5). The average duration of antibacterial therapy was 6 days, the duration of stay in the ICU was two days, and the duration of hospitalization was 9.5 days. There were no adverse effects when using biapenem.Conclusion. Given the high prevalence of ESBL producers and Pseudomonas aeruginosa strains in hospitals, the more favorable safety profile of biapenem compared to other carbapenems, Biapenem appears to be a justified choice for initial empirical therapy MDR sepsis.