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1
Islam, Nurul. "The Big Five model of personality in Bangladesh: Examining the Ten-Item Personality Inventory". Psihologija 52, n. 4 (2019): 395–412. http://dx.doi.org/10.2298/psi181221013i.
Abstract (sommario):
Researchers, over the world, often create very brief measures of Big Five personality dimensions, so that they can assess people?s personality in a reasonably short period of time. The most prominent and well-established measure among all brief personality measures is the ?Ten Item Personality Inventory? (TIPI). The present study aimed to translate, adapt, and validate the TIPI for use in the Bangladeshi culture. After completing the standardized translation procedure, the Bangla version of the Ten Item Personality Inventory (TIPI?B) was examined in a study including 662 Bangladeshi adults. Though an exploratory factor analysis with one half of the sample (n = 330) had explained 77.53% of the total variance, it did not show the scale?s five dimensions as independent with two items for each. Acceptable goodness of fit indices (?2/df = 3.177, GFI =.960, CFI = .935, TLI = .937, SRMR = .061, and RMSEA = .76) were found for the scale through a confirmatory factor analysis performed on the second half of the sample (n = 332). Acceptable internal consistencies, significant test-retest reliabilities, and convergent and discriminant validities were established in the scale through different statistical analyses. Thus, the TIPI?B with its five dimensions can be used as a valid and reliable measure to assess the personality of Bangladeshi people.
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de Boer, Bas, Marit Peters e Lucas J. Lourens. "The transient impact of the African monsoon on Plio-Pleistocene Mediterranean sediments". Climate of the Past 17, n. 1 (29 gennaio 2021): 331–44. http://dx.doi.org/10.5194/cp-17-331-2021.
Abstract (sommario):
Abstract. Over the Plio-Pleistocene interval a strong linkage exists between northern African climate changes and the supply of dust over the surrounding oceans and continental runoff towards the Mediterranean Sea. Both these signatures in the sedimentary record are determined by orbital cycles influencing glacial variability on the one hand and northern African monsoon intensity on the other hand. In this paper, we use the intermediate-complexity model CLIMBER-2 to simulate African climate during the Plio-Pleistocene between 3.2 and 2.3 million years ago (Ma) and compare our simulations with existing and new climate reconstructions. The CLIMBER-2 model is externally forced with atmospheric CO2 concentrations, ice sheet topography, and orbital variations, all of which strongly influence climate during the Pliocene and Pleistocene. Our simulations indicate that the records of northern Africa climate oscillate in phase with climatic precession. For the Earth's obliquity cycle, the time lag between the 41 000-year component in insolation forcing and the climatic response increased after inception of Northern Hemisphere (NH) glaciation around 2.8 Ma. To test the outcome of our simulations, we have put emphasis on the comparison between the simulated runoff of grid boxes encompassing the Sahara desert and the Sahel region and the sedimentary records of marine sediment cores from ODP Site 659 (Atlantic Ocean) and ODP Site 967 (Mediterranean). In this study we will show for the first time an extended Ti∕Al record of Site 967 down to 3.2 Ma. This record strongly correlates with runoff in the Sahara and Sahel regions, whereas correlation with the dust record of Site 659 is moderate and slightly improves after NH ice sheet inception. We investigated the transient variability of the individual and combined contributions of the Sahel and Sahara regions and found significant transient behaviour overlapping the inception of NH ice sheets (2.8 Ma) and the Plio-Pleistocene transition (2.6 Ma). Prior to 2.8 Ma, a larger contribution from the Sahara region is required to explain the variability of Mediterranean dust input. After this transition, we found that a more equal contribution of the two regions is required, representing an increased influence of Sahel runoff and wet periods.
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Kern, Silke, Henrik Zetterberg, Jürgen Kern, Anna Zettergren, Margda Waern, Kina Höglund, Ulf Andreasson et al. "Prevalence of preclinical Alzheimer disease". Neurology 90, n. 19 (13 aprile 2018): e1682-e1691. http://dx.doi.org/10.1212/wnl.0000000000005476.
Abstract (sommario):
ObjectiveTo determine the prevalence of preclinical Alzheimer disease (AD) according to current classification systems by examining CSF from a representative general population sample of 70-year-olds from Gothenburg, Sweden.MethodThe sample was derived from the population-based H70 Gothenburg Birth Cohort Studies in Gothenburg, Sweden. The participants (n = 322, age 70 years) underwent comprehensive neuropsychiatric, cognitive, and somatic examinations. CSF levels of β-amyloid (Aβ)42, Aβ40, total tau, and phosphorylated tau were measured. Preclinical AD was classified according to criteria of the A/T/N system, Dubois 2016, National Institute on Aging–Alzheimer's Association (NIA-AA) criteria, and International Working Group-2 (IWG-2) criteria. Individuals with Clinical Dementia Rating score >0 were excluded, leaving 259 cognitively unimpaired individuals.ResultsThe prevalence of amyloid pathology was 22.8%, of total tau pathology was 33.2%, and of phosphorylated tau pathology was 6.9%. With the A/T/N system, the prevalence of A+/T−/N− was 13.1%, A+/T−/N+ was 7.3%, A+/T+/N+ was 2.3%, A−/T−/N+ was 18.9%, and A−/T+/N+ was 4.6%. When the Dubois criteria were applied, the prevalence of asymptomatic at risk for AD was 36.7% and of preclinical AD was 9.7%. With the NIA-AA criteria, the prevalence of stage 1 was 13.1% and stage 2 was 9.7%. With the IWG-2 criteria, the prevalence of asymptomatic at risk for AD was 9.7%. TheAPOEε4 allele was associated with several of the categories. Men more often had total tau pathology, A+/T−/N+, preclinical AD according to Dubois 2016, asymptomatic at risk for AD according to the IWG-2 criteria, and NIA-AA stage 2.ConclusionThe prevalence of pathologic AD markers was very common (46%) in a representative population sample of 70-year-olds. The clinical implications of these findings need to be scrutinized further in longitudinal studies.
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Park, Junghyun, e Marc Rodger. "Retrospective Cohort of Unprovoked Venous Thromboembolism Patients: What Proportion Have Potent Thrombophilias Necessitating Indefinite Anticoagulants?" Blood 126, n. 23 (3 dicembre 2015): 2318. http://dx.doi.org/10.1182/blood.v126.23.2318.2318.
Abstract (sommario):
Introduction Thrombophilia testing in unprovoked venous thromboembolism patients (VTE) is controversial. Common thrombophilias such as Factor V Leiden or prothrombin gene variant appear to not importantly increase the risk of VTE recurrence, and thus are not considered in anticoagulation management decisions. However, patients with potent thrombophilias such as antiphospholipid antibodies (APLA), antithrombin deficiency, protein C and S deficiency, and homozygous genetic thrombophilias or combined defects are at higher risk of recurrence and it is recommended that they receive long-term anticoagulation. If the proportion of patients with "potent" thrombophilia is high then thrombophilia testing should be conducted. We sought to determine the proportion of unprovoked VTE patients with "potent" thrombophilia. Methods All patients with managed in our oral anticoagulation management system in the period from 1998 to 2015 were potentially eligible for the study. Inclusion criteria were: 1) symptomatic, objectively confirmed VTE unprovoked proximal deep vein thrombosis or pulmonary embolism. Exclusion criteria were: 1) cancer or myeloproliferative disease at the time of VTE diagnosis; 2) no cast, surgery, trauma or immobilization (>3 days in bed 90% of waking hours) in the 90 days prior to diagnosis. We selected unprovoked VTE patients diagnosed between 2002 and 2010, as thrombophilia testing was relatively universal and available in our electronic system in that time frame (N=1344). We then selected a convenience sample of N=1165. The primary outcome measure was the proportion of patients with "potent" thrombophilia (potent= homozygous Factor V Leiden, homozygous Prothrombin gene variant, APLA, protein C, protein S or anti-thrombin deficiency or combined deficiencies). Results In 1165 patients with unprovoked VTE, complete screening was done in 470 patients (40.34%) and 976 (83.78%) had at least one thrombophilia test. Complete thrombophilia testing was defined as a screen including testing for factor V Leiden, prothrombin gene defect, APLA, anti-thrombin deficiency, protein C, and protein S. Potent thrombophilias were demonstrated in 103/1165 patients (8.84%; 95% CI, 7.34 to 10.61) (Table 2) in the total study population, and 103/976 (10.55%; 95% CI, 9.62-14.47) in patients with at least one thrombophilia test. Conclusion The proportion of unprovoked VTE patients with "potent" thrombophilia is high. Given a high proportion of "potent' thrombophilia patients who likely benefit from indefinite anticoagulation, complete thrombophilia testing appears warranted in patients with unprovoked VTE in whom anticoagulants maybe discontinued. Thrombophilia testing is warranted for a selected group of patients to detect high-risk thrombophilias that could impact anticoagulation management. Table 1. Thrombophilia screening Complete screening 470 (40.3%) No screening 189 (16.2%) At least one thrombophilia test 976 (83.8%) Table 2. Thrombophilia All patients (n=1165) Tested for individual thrombophilia % 95% CI % 95% CI FVL Heterozygous 162/1165 (13.9%) 12.0-16.0% 162/883 (18.4%) 15.9-21.0% FVL Homozygous 4/1165 (0.3%) 0.1-0.9% 4/883 (0.5%) 0.2-1.2% Prothrombin Heterozygous 63/1165 (5.4%) 4.3-6.9% 63/831 (7.6%) 6.0-9.6% Prothrombin Homozygous 1/1165 (0.0%) 0.0-0.5% 1/831 (0.1%) 0.0-0.7% Antithrombin deficiency 10/1165 (0.9%) 0.5-1.6% 10/815 (1.2%) 0.7-2.2% Protein C deficiency 18/1165 (1.6%) 1.0-2.4% 18/639 (2.8%) 1.8-4.4% Protein S deficiency 13/1165 (1.1%) 0.7-1.9% 13/635 (2.1%) 1.2-3.5% Lupus anticoagulant 24/1165 (2.1%) 1.4-3.1% 24/849 (2.8%) 1.9-4.2% Anticardiolipin IgM 16/1165 (1.4%) 0.9-2.2% 16/886 (1.8%) 1.1-2.9% Anticardiolipin IgG 20/1165 (1.7%) 1.1-2.6% 20/885 (2.2%) 1.5-3.5% β-2 microglobulin IgM 10/1165 (0.9%) 0.5-1.6% 10/333 (3.0%) 1.6-5.4% β-2 microglobulin IgG 8/1165 (0.7%) 0.4-1.4% 8/333 (2.4%) 1.2-4.7% Homocysteine 50/1165 (5.7%) 4.3-7.4% 50/668 (7.5%) 5.7-9.7% Factor VIII elevated 11/1165 (0.9%) 0.5-1.7% 11/646 (1.7%) 1.0-3.0% At least one or more of the above 331/1165 (28.4%) 25.9-31.1% 331/976 (33.9%) 31.0-36.9% Potent thrombophilia 103/1165 (8.8%) 7.34-10.6% 103/976 (10.6%) 9.6-14.5% Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.
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Li, Guojing, Wangli Zheng, Jinfang Yang, Tongsheng Qi, Yongcai He, Wangkai Chen, Hejia Ma et al. "Seroprevalence and Epidemiology of Toxoplasma gondii in Animals in the Qinghai-Tibetan Plateau Area, China". Pathogens 10, n. 4 (6 aprile 2021): 432. http://dx.doi.org/10.3390/pathogens10040432.
Abstract (sommario):
Toxoplasma gondii belongs to the Apicomplexan protozoa—an obligate intracellular parasite—causing toxoplasmosis that has a worldwide distribution and is very harmful to both human health and the livestock industry. However, the information on toxoplasmosis in the Qinghai-Tibetan Plateau Area (QTPA) and the seroprevalence of T. gondii in the food-borne animals in that area has been limited. Therefore, this study focused to T. gondii and toxoplasmosis to perform an indirect ELISA test based on recombinant TgSAG2 protein to establish a comprehensive record of the seroprevalence of T. gondii infections in a wide range of animals, including Tibetan sheep (Ovis aries), yaks (Bos grunniens), cows, chicken, pigs, and horses, in the QTPA. Overall, the seropositive rates of the specific-T. gondii IgG and IgM antibodies in all investigated animals were 44.1% (1179/2673) and 18.0% (469/2612), respectively. The 14.9% (389/2612) sera were determined to be both IgG and IgM positive samples, 30.2% (789/2673) were single-IgG seropositive, and a total of 80 in 2612 animals (3.0%) were single-IgM seropositive. Moreover, for the animal species, the pig was the most prevalent animal (90.2%, 304/337) for IgG positivity, followed by Tibetan sheep (50.7%, 460/907), chickens (45.8%, 229/500), yaks (21.1%, 140/663), cows (18.5%, 38/205) and horses (13.1%, 8/61), respectively. For the IgM antibody positivity, the pig was also the most prevalent animal (41.8%, 141/337), followed by Tibetan sheep (21.2%, 191/907), cows (15.1%, 31/205), chickens (12.4%, 62/500) and yaks (6.6%, 44/663), respectively. The significant differences in the prevalent distribution of T. gondii were found in the different altitudes. In conclusion, this study found the high seroprevalence for T. gondii infections among these animal species in the QTPA, and provides new data to facilitate further research for development of control measures against T. gondii infections in the surveyed locations.
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Díaz-Mesa, E. M., M. P. García-Portilla, S. Al-Halabí, P. A. Sáiz e J. Bobes. "Sexual dysfunction in patients with schizophrenia vs bipolar disorder". European Psychiatry 26, S2 (marzo 2011): 1542. http://dx.doi.org/10.1016/s0924-9338(11)73246-1.
Abstract (sommario):
IntroductionHealthy sexual functioning is an important part of the human experience, but there is a lack of studies regarding sexuality and sexual behavior in schizophrenia and bipolar disorder (García-Portilla, 2010).AimTo determine the differences on the sexual dysfunction profile between patients with schizophrenia and bipolar disorder.MethodNaturalistic, cross-sectional, multicentre, validation study. A total of 89 patients with schizophrenia (SQF) and 82 with bipolar disorder (BPD) were evaluated using the Changes in Sexual Functioning Questionnaire Short-Form (CSFQ-14).ResultsSample description (SQF vs BPD): Mean age (SD) were 39.2 (11.0) vs 46.7 (10.9) (p < 0.001), men were 58.8% vs 41.2% (χ2 = 4.0, df. = 1, p < 0.05), 61.8% vs 38.2% were single (χ2 = 12.8, df. = 1, p < 0.001). Mean (SD) scores on CSFQ-14 scales were (SQF vs BPD): Pleasure 2.2 (1.0) vs 2.6 (1.0) (t = -2.2, p < 0.05), Sexual desire/frequency 5.3 (2.0) vs 5.9 (2.0) (t = -2.0, p < 0.05), Sexual desire/interest 5.7 (2.6) vs 6.9 (3.0) (t = -2.5, p < 0.05), Arousal/excitement 8.6 (3.1) vs 8.9 (3.4), Orgasm/completion 7.9 (3.2) vs 8.8 (3.2), Desire 11.1 (3.9) vs 12.9 (4.4) (t = -2.7, p < 0.05), Arousal 8.6 (3.1) vs 8.9 (3.4), Orgasm 7.9 (3.2) vs 8.8 (3.2) and Total 39.5 (9.7) vs 42.2 (11.0).ConclusionsPatients with schizophrenia have more difficulty to get pleasure and more problems in the phase of desire (frequency and interest) than the patients with bipolar disorder.
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Klein Goldewijk, Kees, Arthur Beusen, Jonathan Doelman e Elke Stehfest. "Anthropogenic land use estimates for the Holocene – HYDE 3.2". Earth System Science Data 9, n. 2 (1 dicembre 2017): 927–53. http://dx.doi.org/10.5194/essd-9-927-2017.
Abstract (sommario):
Abstract. This paper presents an update and extension of HYDE, the History Database of the Global Environment (HYDE version 3.2). HYDE is an internally consistent combination of historical population estimates and allocation algorithms with time-dependent weighting maps for land use. Categories include cropland, with new distinctions for irrigated and rain-fed crops (other than rice) and irrigated and rain-fed rice. Grazing lands are also provided, divided into more intensively used pasture and less intensively used rangeland, and further specified with respect to conversion of natural vegetation to facilitate global change modellers. Population is represented by maps of total, urban, rural population, population density and built-up area. The period covered is 10 000 before Common Era (BCE) to 2015 Common Era (CE). All data can be downloaded from https://doi.org/10.17026/dans-25g-gez3. We estimate that global population increased from 4.4 million people (we also estimate a lower range < 0.01 and an upper range of 8.9 million) in 10 000 BCE to 7.257 billion in 2015 CE, resulting in a global population density increase from 0.03 persons (or capita, in short cap) km−2 (range 0–0.07) to almost 56 cap km−2 respectively. The urban built-up area evolved from almost zero to roughly 58 Mha in 2015 CE, still only less than 0.5 % of the total land surface of the globe. Cropland occupied approximately less than 1 % of the global land area (13 037 Mha, excluding Antarctica) for a long time period until 1 CE, quite similar to the grazing land area. In the following centuries the share of global cropland slowly grew to 2.2 % in 1700 CE (ca. 293 Mha, uncertainty range 220–367 Mha), 4.4 % in 1850 CE (578 Mha, range 522–637 Mha) and 12.2 % in 2015 CE (ca. 1591 Mha, range 1572–1604 Mha). Cropland can be further divided into rain-fed and irrigated land, and these categories can be further separated into rice and non-rice. Rain-fed croplands were much more common, with 2.2 % in 1700 CE (289 Mha, range 217–361 Mha), 4.2 % (549 Mha, range 496–606 Mha) in 1850 CE and 10.1 % (1316 Mha, range 1298–1325 Mha) in 2015 CE, while irrigated croplands used less than 0.05 % (4.3 Mha, range 3.1–5.5 Mha), 0.2 % (28 Mha, range 25–31 Mha) and 2.1 % (277 Mha, range 273–278 Mha) in 1700, 1850 and 2015 CE, respectively. We estimate the irrigated rice area (paddy) to be 0.1 % (13 Mha, range 9–16 Mha) in 1700 CE, 0.2 % (28 Mha, range 26–31 Mha) in 1850 CE and 0.9 % (118 Mha, range 117–120 Mha) in 2015 CE. The estimates for land used for grazing are much more uncertain. We estimate that the share of grazing land grew from 5.1 % in 1700 CE (667 Mha, range 507–820 Mha) to 9.6 % in 1850 CE (1192 Mha, range 1068–1304 Mha) and 24.9 % in 2015 CE (3241 Mha, range 3211–3270 Mha). To aid the modelling community we have divided land used for grazing into more intensively used pasture, less intensively used converted rangeland and less or unmanaged natural unconverted rangeland. Pasture occupied 1.1 % in 1700 CE (145 Mha, range 79–175 Mha), 1.9 % in 1850 CE (253 Mha, range 218–287 Mha) and 6.0 % (787 Mha, range 779–795 Mha) in 2015 CE, while rangelands usually occupied more space due to their occurrence in more arid regions and thus lower yields to sustain livestock. We estimate converted rangeland at 0.6 % in 1700 CE (82 Mha range 66–93 Mha), 1 % in 1850 CE (129 Mha range 118–136 Mha) and 2.4 % in 2015 CE (310 Mha range 306–312 Mha), while the unconverted natural rangelands occupied approximately 3.4 % in 1700 CE (437 Mha, range 334–533 Mha), 6.2 % in 1850 CE (810 Mha, range 733–881 Mha) and 16.5 % in 2015 CE (2145 Mha, range 2126–2164 Mha).
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Pea, Federico, Marcello Tavio, Federica Pavan, Angela Londero, Vittorio Bresadola, Gian Luigi Adani, Mario Furlanut e Pierluigi Viale. "Drop in trough blood concentrations of tacrolimus after switching from nelfinavir to fosamprenavir in four HIV-infected liver transplant patients". Antiviral Therapy 13, n. 5 (luglio 2008): 739–42. http://dx.doi.org/10.1177/135965350801300516.
Abstract (sommario):
Solid organ transplantation in HIV-infected individuals requires concomitant use of immunosuppressants and antiretrovirals that may cause significant drug interactions. Here we report on a peculiar pharmacokinetic interaction between tacrolimus and protease inhibitors (PIs) which occurred in four HIV-infected liver transplant patients who had to shift PI therapy from nelfnavir to fosamprenavir as a consequence of regulatory restrictions. After the switch, tacrolimus trough blood concentrations significantly dropped in all patients (mean ±sd 6.9 ±2.6 versus 3.2 ±2.0 ng/ml before and after the switch, respectively; P=0.01), so that a marked dosage increase was needed (0.29 ±0.14 versus 0.88 ±0.48 mg/day, 1–3 days before and 3 weeks after the switch, respectively; P=0.046) to attain the desired target (8.7 ±2.3 ng/ ml). Consistently, marked changes of the concentration/dose ratio of tacrolimus were observed in all cases (27.2 ±9.7 ng/ml per mg/kg/day versus 9.7 ±4.0 ng/ml per mg/kg/day before and after the switch, respectively; P<0.001). Our findings suggest that fosamprenavir may be less potent than nelfinavir in inhibiting tacrolimus clearance and support the need for higher tacrolimus dosage to avoid insufficient immunosuppression in HIV-infected liver transplant patients when switching from nelfinavir to fosamprenavir or even when directly starting antiretroviral therapy with fosamprenavir.
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Baltazar Meza, Carmen Yudex, Belén del Rosario Pérez Camborda, Dany Yanina Solís Mandujano e Alex Rubén Huaman De La Cruz. "Violence forms among university students from Junin Region, Perú". Revista de Salud Pública 22, n. 4 (1 luglio 2020): 1–7. http://dx.doi.org/10.15446/rsap.v22n4.87379.
Abstract (sommario):
Objective To examine the association among six forms of violence and their levels among Peruvian university students from a public University in Peru´s Junin region.Materials and Methods A cross-sectional study of students of both sexes from the Faculty of Education. Sampling comprised 961 voluntary students (629 females and 332 males) studying in the education faculty from the National University of Center of Perú. Data were collected in the period July-December 2019 using the Domestic Violence Measurements Scale (VIFJ4), which assessed six forms of violence (physical, psychological, sexual, social, patrimonial, and gender). These variables were assessed through three levels of violence (mild, moderate, and severe).Results All student felt violence in their six forms. A higher percentage of violence was found in females than males. According severe level the forms of violence were ordered as follow: physical > psychological > patrimonial > social > gender. For moderate level: social > sexual > physical > gender > patrimonial > psychological, and mild level: psychological > patrimonial > gender > social > physical > sexual.Conclusion It was confirmed that there are different forms of violence and their levels in both males and females. This knowledge will serve as a basis for the development and implementation of educational programs that help university students to establish adequate behavior and mental health.
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Creasy, John M., Eran Sadot, Bas Groot Koerkamp, Joanne F. Chou, Mithat Gonen, Nancy E. Kemeny, Andrea Cercek et al. "Right versus left: Impact of primary location on survival and cure in patients undergoing hepatic resection for metastatic colon cancer." Journal of Clinical Oncology 35, n. 4_suppl (1 febbraio 2017): 664. http://dx.doi.org/10.1200/jco.2017.35.4_suppl.664.
Abstract (sommario):
664 Background: Recent prospective studies in metastatic colorectal cancer (mCRC) have demonstrated an association between left-sided primaries and improved overall (OS) and progression-free survival (PFS). Primary location (right vs left colon) has not been well studied in patients undergoing potentially curative hepatic resection. Methods: A single-institution database was queried for all initial hepatic resections for mCRC 1992-2004. Postoperative deaths and patients with no followup after 90 days were excluded. Primary location determined by chart review (Right = cecum to transverse; Left = splenic flexure to sigmoid). Rectal cancer (distal 16cm), multiple primaries, and unknown location were excluded. Kaplan Meier and Cox regression methods were used. Cure was defined as actual 10-year survival with no recurrence or resected recurrence with at least 3 years of disease-free followup. Results: 907 patients were included with a median followup of 11 years. 578 patients (64%) had left-sided and 329 (36%) had right-sided primary. Median OS for patients with a left-sided primary was 5.2 years (95% CI: 4.6-6.0) versus 3.6 years (95% CI: 3.2-4.2) for right-sided (p = 0.004). The hazard ratio (HR) for right-sided tumors was 1.22 (95% CI: 1.02-1.45, p = 0.028) after adjusting for age, CEA > 200, DFI < 12 months, hepatic tumor > 5cm, > 1 tumor, lymph node status, margin, and extrahepatic disease. Recurrence-free survival (RFS) was marginally different stratified by primary location (p = 0.065). Estimated cure rates were 22% for left and 20% for right-sided tumors. Conclusions: Among patients selected for hepatic resection of metastatic colon cancer, left-sided primary tumors were associated with an improved OS but not RFS. This difference in OS was independent of common prognostic variables. Estimated cure rates were not statistically different. Patients with left-sided primary tumors display a prolonged clinical course after recurrence suggestive of more indolent biology. [Table: see text]
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Guevara Valtier, Milton Carlos, María de los Ángeles Paz Morales, Silvia Guadalupe Soltero Rivera, Cynthia Berenice Rueda-Sánchez, Roger Quintana Lagunas e Navarro Rodríguez Navarro Rodríguez. "Parental Upbringing, Nutritional Status, and Physical Activity in Preschoolers". Salud, Ciencia y Tecnología 4 (9 aprile 2024): 933. http://dx.doi.org/10.56294/saludcyt2024933.
Abstract (sommario):
Introduction: In Mexico the prevalence of childhood obesity has experienced an alarming increase; it was reported that 9.7% of children under 5 years of age were suffering from overweight or obesity. This situation was exacerbated in the northern region of the country with a prevalence of 13.2%. Within this context, Parenting Style has been identified as a determinant factor in children's eating behavior, directly influencing their Body Mass Index. Aim: To understand the relationship between Parenting Styles (General and by type of Parenting Style), Body Mass Index, and Physical Activity of preschoolers. Methodology: A cross-sectional, descriptive, and correlational study involved 664 individuals, comprising 332 mother/child dyads, aged between 3 and 5 years. Variables were measured using the Parenting Styles and Dimensions Questionnaire (PSDQ) and the Physical Activity Questionnaire for Parents of Preschool Children, with descriptive and correlational statistics being conducted. Results: A positive and significant correlation was found between the Democratic Parenteral Parenting Style with the minutes that preschoolers dedicated to performing mild physical activities (rs = .136, p<0.05) and moderate physical activities (rs = .172, p<0.01). ). Permissive and authoritarian parenting styles did not show significant relationships with minutes of physical activity. Discussion: Despite the lack of correlation between the general Parenting Style and BMI, this finding underscores the complexity of factors shaping children's physical activity, suggesting the need for multifaceted strategies that include parental education, improvements in infrastructure, and public policies to promote a healthy lifestyle among children.
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Jensen, Lars Henrik, Anne Haahr Mellergaard, Dan Hoegdall e Ole Larsen. "Effectiveness study of gemcitabine, oxaliplatin, and capecitabine as first-line treatment for nonresectable biliary tract cancer." Journal of Clinical Oncology 32, n. 3_suppl (20 gennaio 2014): 334. http://dx.doi.org/10.1200/jco.2014.32.3_suppl.334.
Abstract (sommario):
334 Background: Since 2010, the doublet gemcitabine and cisplatin has been standard first-line systemic treatment for non-resectable biliary tract cancer. In a phase I-II trial of the well-tolerated triplet of gemcitabine, oxaliplatin, and capecitabine, the median progression free survival (PFS) and overall survival (OS) were 6.9 and 12.5 months, respectively. Overall response rate was 34%. Since 2005 the regimen has been used in Denmark. We wanted to investigate the effectiveness of the triplet regimen given in daily clinic. Methods: We included 192 patients from two institutions. Patients had to have non-resectable biliary tract cancer and to be suitable for combination chemotherapy on doctor’s discretion. Gemcitabine 1000 mg/m2 and oxaliplatin 60 mg/m2 were given every two weeks followed by capecitabine 1000 mg/m2 b.i.d. for one week. At one institution the oxaliplatin dose was 50 mg/m2 and capecitabine dose 650 mg/m2 b.i.d. continuously. One cycle included two treatments and was typically administered for up to six cycles/months, but was allowed for longer time until progression. Results: At institution A, 117 patients were included and 73 (62%) were women. Median age was 66 years (range 25-80). Median treatment duration was six cycles/months (range 1-12). Thirty-five, 69, 12, and one patient(s) were in performance status 0, 1, 2, and 3, respectively. Ninety patients were evaluable for response and 6 (7%) had complete response, 18 (20%) partial response, 53 (59%) stable disease, and 13 (14%) progression as best response. Median PFS was 9.7 months (95% CI 8.5-11.7) and median OS 11.7 months (9.8-14.0). The results were comparable to institution B, where the response rate in 56 patients with measurable disease was 30%. In 75 patients evaluable for survival analysis, PFS was 8.1 months and OS 12.0 months for performance status 0-1 (n=55). Patients in performance status 2 (n=25) had a PFS and OS of only 1.7 and 2.8 months, respectively. Conclusions: A triplet of gemcitabine, oxaliplatin, and capecitabine given in daily clinic was well tolerated and has effectiveness comparable to results from a phase II trial and the pivotal phase III trial of gemcitabine and cisplatin.
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Sulejmanpasic-Arslanagic, Gorana. "Evaluation of disease frequency in the first line relatives of patients suffering from schizophrenia related to gender and diagnostic categories". Medical review 66, n. 1-2 (2013): 19–23. http://dx.doi.org/10.2298/mpns1302019s.
Abstract (sommario):
Introduction. Schizophrenia represents the most severe mental disorder. The aim of this study was to determine the frequency of disease in the first line relatives of patients suffering from schizophrenia related to gender differences and various subtypes. Material and Methods. The study included 453 subjects (121 patients suffering from schizophrenia - 52.1% males and 47.9% females and 332 first line relatives of the patients - 47.2% males and 52.7% females during a five year period, mostly in the region of Sarajevo. Results. According to the analysis of disease frequency related to the kinship, the disease developed more frequently in mothers (8.3%) and sisters (7.8%) than in fathers (6.9) and brothers (7.1%) of the patients suffering from paranoid schizophrenia. In the group of disorganized schizophrenia, only mothers were found (4.2%), whereas the statistical difference in the group of affected brothers and sisters was significant, the percentage being 9.7% and 15.3%, respectively. There was a statistically significant difference in gender (p<0.05) between the group of parents and siblings regarding the frequency of schizophrenia. Discussion. The proof of participation of genetic factors in etiology supports the assumption on genetic nature of familial aggregation of schizophrenia. Our results completely match those of studies which analyzed the frequency of disease regarding inheritance (gender distribution and various subtypes). Conclusion. Investigation points to the common epidemiological criteria regarding the frequency of schizophrenic psychosis. Genetic predisposition could be also a demonstrator of the disease course and outcome, which should enable better understanding of the etiology of this disease.
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Leong, Xin Yu Adeline, Xian Wen Charlene Kwa, Shu Hui Elizabeth Ng e Liang Khai Darren Koh. "Singapore General Hospital Experience on Ethnicity and the Incidence of Postoperative Nausea and Vomiting after Elective Orthopaedic Surgeries". Journal of Anesthesiology 2015 (15 dicembre 2015): 1–7. http://dx.doi.org/10.1155/2015/952302.
Abstract (sommario):
Introduction. We explored how ethnicity affects the risk of postoperative nausea and vomiting (PONV) and established the correlation of suggested risk factors of PONV in the multiethnic population of Singapore. Methods. 785 patients who underwent orthopaedic surgery were recruited. These comprised 619 Chinese (78.9%), 76 Malay (9.7%), 68 Indian (8.7%), and 22 other (2.8%) cases. The presence of possible risk factors of PONV and nausea and/or vomiting within 24 h after surgery was studied. Univariate and multivariate logistic regression analyses were performed. Results. The incidence of PONV was 33.2% (261 patients). There was no statistically significant difference of PONV incidence between Chinese, Malay, and Indian cases (34.6% versus 34.2% versus 29.4%, p=0.695). Indian females younger than 50 years were found to have a higher incidence of vomiting (p=0.02). The significant risk factors for this population include females, use of nitrous oxide, and a history of PONV. Conclusion. In the groups studied, ethnicity is not a significant risk factor for PONV except for young Indian females who have a higher risk of postoperative vomiting. We suggest the selective usage of antiemetic for young Indian females as prophylaxis and avoiding nitrous oxide use in high-risk patients.
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Taparra, Kekoa, Vera Qu e Erqi Pollom. "Disparities in Survival and Comorbidity Burden Between Asian and Native Hawaiian and Other Pacific Islander Patients With Cancer". JAMA Network Open 5, n. 8 (12 agosto 2022): e2226327. http://dx.doi.org/10.1001/jamanetworkopen.2022.26327.
Abstract (sommario):
ImportanceImproper aggregation of Native Hawaiian and other Pacific Islander individuals with Asian individuals can mask Native Hawaiian and other Pacific Islander patient outcomes. A comprehensive assessment of cancer disparities comparing Asian with Native Hawaiian and other Pacific Islander populations is lacking.ObjectiveTo compare comorbidity burden and survival among East Asian, Native Hawaiian and other Pacific Islander, South Asian, and Southeast Asian individuals with non-Hispanic White individuals with cancer.Design, Setting, and ParticipantsThis retrospective cohort study used a national hospital-based oncology database enriched with Native Hawaiian and other Pacific Islander and Asian populations. Asian, Native Hawaiian and other Pacific Islander, and White individuals diagnosed with the most common cancers who received treatment from January 1, 2004, to December 31, 2017, were included. Patients younger than 18 years, without pathologic confirmation of cancer, or with metastatic disease were excluded. Data were analyzed from January to May 2022.Main Outcomes and MeasuresThe primary end points were comorbidity burden by Charlson-Deyo Comorbidity Index and overall survival (OS).ResultsIn total, 5 955 550 patients were assessed, including 60 047 East Asian, 11 512 Native Hawaiian and other Pacific Islander, 25 966 South Asian, 42 815 Southeast Asian, and 5 815 210 White patients. The median (IQR) age was 65 (56-74) years, median (IQR) follow-up was 58 (30-96) months, and 3 384 960 (57%) were women. Patients were predominantly from metropolitan areas (4 834 457 patients [84%]) and the Southern United States (1 987 506 patients [34%]), with above median education (3 576 460 patients [65%]), and without comorbidities (4 603 386 patients [77%]). Cancers included breast (1 895 351 patients [32%]), prostate (948 583 patients [16%]), kidney or bladder (689 187 patients [12%]), lung (665 622 patients [11%]), colorectal (659 165 patients [11%]), melanoma (459 904 patients [8%]), endometrial (307 401 patients [5%]), lymphoma (245 003 patients [4%]), and oral cavity (85 334 patients [1%]) malignant neoplasms. Native Hawaiian and other Pacific Islander patients had the highest comorbidity burden (adjusted odds ratio [aOR], 1.70; 95% CI, 1.47-1.94) compared with Asian and White groups. Asian patients had superior OS compared with White patients for most cancers; only Southeast Asian patients with lymphoma had inferior survival (adjusted hazard ratio [aHR], 1.26; 95% CI, 1.16-1.37). In contrast, Native Hawaiian and other Pacific Islander patients demonstrated inferior OS compared with Asian and White patients for oral cavity cancer (aHR, 1.56; 95% CI, 1.14-2.13), lymphoma (aHR, 1.35; 95% CI, 1.11-1.63), endometrial cancer (aHR, 1.30; 95% CI, 1.12-1.50), prostate cancer (aHR, 1.29; 95% CI, 1.14-1.46), and breast cancer (aHR, 1.09; 95% CI, 1.00-1.18). No cancers among Native Hawaiian and other Pacific Islander patients had superior OS compared with White patients.Conclusions and RelevanceIn this cohort study, compared with White patients with the most common cancers, Asian patients had superior survival outcomes while Native Hawaiian and other Pacific Islander patients had inferior survival outcomes. Native Hawaiian and other Pacific Islander patients had significantly greater comorbidity burden compared with Asian and White patients, but this alone did not explain the poor survival outcomes. These results support the disaggregation of these groups in cancer studies.
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Karlander, Markus, Johan Ljungqvist e Johan Zelano. "Post-traumatic epilepsy in adults: a nationwide register-based study". Journal of Neurology, Neurosurgery & Psychiatry 92, n. 6 (9 marzo 2021): 617–21. http://dx.doi.org/10.1136/jnnp-2020-325382.
Abstract (sommario):
ObjectiveTraumatic brain injury (TBI) is a leading cause of epilepsy. Our aim was to characterise the risk of epilepsy in adults after hospitalisation for TBI.MethodsRegister-based cohort study. All individuals aged 18–100 with a first hospitalisation for TBI in the comprehensive national patient register in Sweden between 2000 and 2010 (n=111 947) and three controls per exposed (n=325 881), matched on age and sex were included. Exposed individuals were categorised according to TBI severity. Kaplan-Meier curves were used to estimate the risk of epilepsy and Cox regression to estimate the hazard in univariate or multivariate regression.ResultsThe 10-year risk of epilepsy was 12.9% (95% CI 11.7% to 14.1%) for focal cerebral injuries, 8.1% (95% CI 7.5% to 8.7%) for diffuse cerebral injuries, 7.3% (95% CI 6.9% to 7.7%) for extracerebral injuries, 2.8% (95% CI 2.4% to 3.2%) for skull fractures and 2.6% (95% CI 2.4% to 2.8%) for mild TBI. The risk of epilepsy after any TBI was 4.0% (95% CI 3.8% to 4.2%). The corresponding 10-year risk for controls was 0.9% (95% CI 0.9% to 0.9%). The HR increased with a more severe injury, from 3.0 (95% CI 2.8 to 3.2) for mild injury to 16.0 (95% CI 14.5 to 17.5) for focal cerebral injury. Multivariable analyses identified central nervous system (CNS) comorbidities as risk factors, but TBI remained significant also after adjustment for these. Other identified risk factors were male sex, age, mechanical ventilation and seizure during index hospitalisation.ConclusionThe risk of post-traumatic epilepsy is considerable, also with adjustments for CNS comorbidities.
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Ficial, Benjamim, Iuri Corsini, Maria Clemente, Alessia Cappelleri, Giulia Remaschi, Laura Quer, Giulia Urbani et al. "Feasibility, Reproducibility and Reference Ranges of Left Atrial Strain in Preterm and Term Neonates in the First 48 h of Life". Diagnostics 12, n. 2 (29 gennaio 2022): 350. http://dx.doi.org/10.3390/diagnostics12020350.
Abstract (sommario):
Left atrial strain (LAS) is the most promising technique for assessment of diastolic dysfunction but few data are available in neonates. Our aim was to assess feasibility and reproducibility, and to provide reference ranges of LAS in healthy neonates in the first 48 h of life. We performed one echocardiography in 30 neonates to assess feasibility and develop a standard protocol for image acquisition and analysis. LAS reservoir (LASr), conduit (LAScd) and contraction (LASct) were measured. We performed echocardiography at 24 and 48 h of life in an unrelated cohort of 90 neonates. Median (range) gestational age and weight of the first cohort were 34.4 (26.4–40.2) weeks and 2075 (660–3680) g. LAS feasibility was 96.7%. Mean (SD) gestational age and weight of the second cohort were 34.2 (3.8) weeks and 2162 (833) g. Mean (SD) LASr significantly increased from 24 to 48 h: 32.9 (3.2) to 36.8 (4.6). Mean (SD) LAScd and LASct were stable: −20.6 (8.0) and −20.8 (9.9), −11.6 (4.9) and −13.5 (6.4). Intra and interobserver intraclass correlation coefficient for LASr, LAScd and LASct were 0.992, 0.993, 0.986 and 0.936, 0.938 and 0.871, respectively. We showed high feasibility and reproducibility of LAS in neonates and provided reference ranges.
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Fischer, M., U. K. Franzeck, I. Herrig, U. Costanzo, S. Wen, M. Schiesser, U. Hoffmann e A. Bollinger. "Flow velocity of single lymphatic capillaries in human skin". American Journal of Physiology-Heart and Circulatory Physiology 270, n. 1 (1 gennaio 1996): H358—H363. http://dx.doi.org/10.1152/ajpheart.1996.270.1.h358.
Abstract (sommario):
The purpose of this study was to investigate the previously unknown flow velocity in single lymphatic capillaries of humans in the supine position. Fifteen healthy subjects (10 women and 5 men; mean age 35.8 +/- 13.1 yr) were studied. Ten microliters of fluorescein isothiocyanate-dextran (150,000 mol wt) were injected into the subepidermal layer of the foot dorsum. The filling of the microlymphatics from the resulting depot was visualized by fluorescence video microscopy and stored on videotape. Flow velocity in the microlymphatics was determined on the video screen by direct measurement of the advancement of dyed lymph during a given time. The following median velocities were obtained: 0.51 mm/s (0.27 and 0.61 mm/s for lower and upper quartiles, respectively) for velocity during initial network filling and 9.7 microns/s (6.9 and 14.2 microns/s for lower and upper quartiles, respectively) for resting velocity at the end of the filling period. Mean lymphatic capillary diameter was 54.8 +/- 8.2 microns, and mean network extension was 8.3 +/- 3.2 mm. The high filling velocities are probably due to increased interstitial pressure and volume caused by dye microinjection, whereas the values measured during the end of network filling seem to approach resting flow velocities.
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Zammit, Gary, Thomas Roth, Dinesh Kumar, Carlos Perdomo, Norman Atkins e Margaret Moline. "336 Effect of Lemborexant Versus Placebo and Zolpidem on REM Sleep by Quarter Night Intervals in Older Adults with Insomnia Disorder". Sleep 44, Supplement_2 (1 maggio 2021): A134. http://dx.doi.org/10.1093/sleep/zsab072.335.
Abstract (sommario):
Abstract Introduction Effects of the dual orexin receptor antagonist lemborexant (LEM) on sleep architecture in adults ≥55y with insomnia disorder were assessed in Study E2006-G000-304 (Study 304; SUNRISE-1; NCT02783729). These post hoc analyses of Study 304 examined the acute effect of LEM on REM pressure (REM latency [REM-L] and REM by quarter of the night [QoN]). Methods This study was a 1mo, randomized, double-blind, placebo- and active-controlled (zolpidem tartrate extended-release 6.25mg [ZOL]) study of LEM (5mg, LEM5; 10mg, LEM10). Subjects received placebo (n=208), ZOL (n=263), LEM5 (n=266), or LEM10 (n=269). Two nights of PSGs were recorded at baseline, first 2 (N1/2), and last 2 (N29/30) treatment nights. Results Baseline REM-L (minutes) was similar across treatments (98.4–101.4). Significant decreases from baseline in REM-L were observed for LEM5 (−42.6 [53.9]) and LEM10 (−49.6[52.9]) vs placebo (−6.9[54.5]) and ZOL (0.2[54.2]) on N1/2 (all P<0.0001). No difference was observed for ZOL vs placebo. Baseline REM (minutes) for each QoN was similar across treatments. In Q1, mean(SD) REM (minutes) on N1/2 was 16.5(9.7), 19.7(10.5), 10.3(8.2), and 8.5(7.6) for LEM5, LEM10, placebo, and ZOL, respectively. The difference was significant for LEM5 and LEM10 vs placebo and ZOL (all P<0.0001), and ZOL vs placebo (P<0.05). In Q2, mean(SD) REM on N1/2 was 19.2(9.4), 21.6(10.0), 17.9(8.9), and 17.2(9.3) for LEM5, LEM10, placebo, and ZOL, respectively. The difference was significant for LEM10 vs placebo (P<0.0001) and for LEM5 and LEM10 vs ZOL (P<0.01, P<0.0001, respectively). No difference was observed for ZOL vs placebo. In Q3, mean(SD) REM on N1/2 was 23.3(10.3), 25.9(9.7), 20.8(9.4), and 22.8(9.9) for LEM5, LEM10, placebo, and ZOL, respectively. The difference was significant for LEM5, LEM10, and ZOL vs placebo (P<0.01, P<0.0001, P<0.05, respectively) and LEM10 vs ZOL (P<0.001). In Q4, mean (SD) REM on N1/2 was 23.8(9.4), 26.1(11.0), 21.6(10.9), and 22.5(10.1) for LEM5, LEM10, placebo, and ZOL, respectively. The differences were significant for LEM5 and LEM10 vs placebo (P<0.05, P<0.0001, respectively), and for LEM10 vs ZOL (P<0.0001). Generally, similar findings were noted at N29/30; these data will be reported. Conclusion LEM, but not ZOL, acutely increases REM pressure as evidenced by REM latency and REM duration per quarter. Support (if any) Eisai Inc.
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Ouabdesselam, Souhila, e Salim Benkhedda. "FEMALE GENDER: AN INDEPENDENT PREDICTOR OF HIGH NORMAL BLOOD PRESSURE IN LONG -TERM ADULT SURVIVORS OF CHILDHOOD, ADOLESCENT AND YOUNG ADULT CANCER". Journal of Hypertension 42, Suppl 1 (maggio 2024): e236. http://dx.doi.org/10.1097/01.hjh.0001021900.29903.29.
Abstract (sommario):
Objective: Determine the blood pressure profile in longterm adult survivors of childhood, adolescent and young adult cancer. Determine predictive factors for abnormal blood pressure figures in these patients. Design and method: 104 patients aged over 18, who had received chemotherapy with or without mediastinal radiotherapy for the treatment of neoplasia diagnosed and treated before the age of 21. High blood pressure was defined by a SBP > = 140 mmHg and/or DBP > = 90 mmHg or by the use of antihypertensive drugs. High normal blood pressure corresponded to a SBP between 130 mmHg and 139 mmHg and/or a DBP between 85 and 89 mmHg. Results: Male predominance (56.7%) with a sex ratio of 1.3. Mean current age 25.12 +/-5.40 years, age at diagnosis 13.4 ±5.13 years, duration since end of treatment of cancer 10.67 +/-5.80 years, BMI 22.77 ±4.66 kg/m2, male waist circumference (WC) 82.7 ±12.6 cm, female (WC) 78.6 ± 10.4 cm, SBP 114.5 ±11.7 mmHg, DBP 74.2 ±7.4 mmHg. Chemotherapy alone 80.8%, chemotherapy + mediastinal radiotherapy 19.2%, anthracyclines 100%, platinum salts 32%, corticoids 9%. Low HDL-cholesterol 44.7%, high normal blood pressure 24.3%, abdominal obesity 15.8%, hypertriglyceridemia 9.7%, obesity 8.7%, prediabetes 6.9%, fasting plasma glucose > = 110 mg/dl 6.9%, metabolic syndrome (MS) 3.8%. Multivariate study: Gender (OR = 3.32 95% CI 1.11 - 9.92 p=0.03) - MS (OR = 0.07 95% CI 0.06 - 0.81 p=0.03). Conclusions: Nearly a quarter of the patients in our study (24%) had a high normal blood pressure, which was associated with female gender and the presence of metabolic syndrome. These results confirm the need for early screening of cardiovascular risk factors, particularly hypertension, in long-term adult survivors of childhood, adolescent and young adult cancer.
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Kaleta, Francois, Heather Brody e Praveen Namireddy. "639 Immune-related thyroid dysfunction in patients with existing thyroid dysfunction". Journal for ImmunoTherapy of Cancer 8, Suppl 3 (novembre 2020): A675. http://dx.doi.org/10.1136/jitc-2020-sitc2020.0639.
Abstract (sommario):
BackgroundThyroid dysfunction is a well known side effect of immune checkpoint blockade (ICB) and is one of the most common causes of immune-related adverse events (IRAE). The incidence varies with each individual therapy but generally estimated to be in the range between 6–18% per one study. Hypothyroidism and thyroiditis are the most common manifestations. Initial hyperthyroidism followed by hypothyroidism is another manifestation. Hypothyroidism is more common with an incidence of 10% whereas hyperthyroidism has an incidence of 5%. Less is known about the incidence of worsening thyroid dysfunction in patients with pre-existing thyroid dysfunction treated with ICB.MethodsA retrospective analysis was collected on 370 patients who received immunotherapy from April 2015 to April 2019. Of those, 212 had abnormal thyroid function tests. We analyzed a subgroup of these patients who had baseline thyroid dysfunction for worsening thyroid dysfunction after they were given ICB. Fifty-three patients were included in the analysis and had an abnormal baseline TSH at the start of immunotherapy. Type of immunotherapy, worst TSH, duration between initiation of immunotherapy to worst TSH, treatment type, and grade of abnormality as per Immune Checkpoint Inhibitor Related Adverse Events Common Terminology Criteria for Adverse Events (IRAE-CTCAE) were also recorded. Analysis was done for patients to compare likelihood of worsening TSH resulting in change in treatment for thyroid disorder.ResultsOf the identified patients (N=53) with abnormal TSH screening values outside of the institution’s normal reference range 0.35 - 4.95 uIU/ml, 45.7% (N=16) were hypothyroid and 54.3% (N=19) were hyperthyroid at baseline. Of those who were hypothyroid, 50% (N=8) had worsening TSH and 50% (N=8) had unchanged TSH during treatment. Of those who were hyperthyroid, 31.6% (N=6) had unchanged TSH, 52.6% (N=10) had worsened TSH, and 15.8% (N=3) had normalization of TSH compared to baseline. Overall 26.4% had worsening and of those 11.3% required treatment change.ConclusionsThyroid dysfunction is one of the most common IRAE’s associated with immune checkpoint inhibitors. Little is known about the impact of immunotherapy on patients with existing thyroid dysfunction. Patients who have underlying thyroid dysfunction are at an increased risk for worsening thyroid dysfunction with the use of ICB but though not unduly above the risk general population. Of those with change, only a modest percentage required an alteration of their endocrine therapy. Of interest, our data suggests a potential increased risk in patients with baseline hyperthyroidism compared to hypothyroidism which may be clinically relevant.Ethics ApprovalThe study was approved by ECU Brody School of Medicine Institution’s Ethics Board, approval number 19-000710.ReferencesBarroso-Sousa R, Barry WT, Garrido-Castro AC, et al. Incidence of Endocrine Dysfunction Following the Use of Different Immune Checkpoint Inhibitor Regimens: A Systematic Review and Meta-analysis. JAMA oncology. 2018;4:173–182.Fessas P, Possamai LA, Clark J, et al. Immunotoxicity from checkpoint inhibitor therapy: clinical features and underlying mechanisms. Immunology. 2019; 2020;159:167–177.Brody HM, Macherla S, Bulumulle A, Namireddy P, Cherry CR. The real-world incidence of immunotherapy-related thyroid dysfunction: A retrospective analysis of a single center’s experience over five years. Journal of clinical oncology. 2020;38:98–98.Iyer PC, Cabanillas ME, Waguespack SG, et al. Immune-Related Thyroiditis with Immune Checkpoint Inhibitors. Thyroid (New York, N.Y.). 2018;28:1243–1251.Presotto EM, Rastrelli G, Desideri I, et al. Endocrine toxicity in cancer patients treated with nivolumab or pembrolizumab: results of a large multicentre study. Journal of endocrinological investigation. 2019; 2020;43:337–345.Chalan P, Di Dalmazi G, Pani F, De Remigis A, Corsello A, Caturegli P. Thyroid dysfunctions secondary to cancer immunotherapy. Journal of endocrinological investigation. 2017; 2018;41:625–638.Mangla A, Paydary K, Yadav U, Liu J, Lad TE. Predictors and outcomes of thyroid dysfunction with immunotherapy: A single institution observational experience. Journal of clinical oncology. 2019;37:e14134-e14134.Basak EA, van der Meer, Jan W M, Hurkmans DP, et al. Overt Thyroid Dysfunction and Anti-Thyroid Antibodies Predict Response to Anti-PD-1 Immunotherapy in Cancer Patients. Thyroid (New York, N.Y.). 2020;30:966–973.Kassi E, Angelousi A, Asonitis N, et al. Endocrine-related adverse events associated with immune-checkpoint inhibitors in patients with melanoma. Cancer medicine (Malden, MA). 2019;8:6585–6594.
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KILI, Yi, e Eda Turanl. "Venoarterial extra corporeal membrane oxygenation in pediatric patients and factors associated with mortality". Annals of Medical Research 29, n. 12 (2022): 1. http://dx.doi.org/10.5455/annalsmedres.2022.07.211.
Abstract (sommario):
Objective Extracorporeal membrane oxygenation (ECMO) is a life-saving strategy in pediatric patients when faced with cardiac or respiratory failure after cardiac surgery. In this article, we investigated the relationship between mortality and data, such as leukocyte, hematocrit (HCT), blood urea nitrogen (BUN), creatinine (CRE), albumin, lactate, c-reactive protein (CRP), systemic immune-inflammation index (SII), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), lactate- albumin ratio (LAR) which can be easily calculated from daily routine complete blood count and biochemistry tests of ECMO patients. Materials and Methods We obtained hospital records of 12 pediatric and newborn patients who needed ECMO therapy. The patients were divided into two as non-survivors (Group NS) and survivors (Group S). Factors that may affect mortality were investigated. Results Four patients (33%) were successfully weaned from ECMO and discharged. The remaining 8 patients died. 50% of the patients were male (n=6). While the median age was 28 (4-275) days in Group NS, the median age was 300 (300-960) days in Group S. Although not statistically significant (p=0.395), patients with younger age had a higher mortality rate. While the mean weight was 5.9±3.2 kg in Group NS, it was 6.9±3.2 kg in Group S. Postoperative PLR, SII in Group NS were higher compared to Group S. There was no statistically significant difference between the two groups. Bleeding rate was higher in Group NS than in Group S. There was an increase in postoperative NLR in Group NS compared to preoperative NLR. Conclusion Although postoperative PLR and SII were found to be higher in Group NS, postoperative NLR was increased compared to preoperative NLR, and bleeding complications were more common in group NS, none of these parameters reached a statistically significant level.
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Davalos, Antonio, Jose Castillo e Angel Chamorro. "Neuroprotection for acute ischemic stroke: Who is most to blame for current failure ?" Stroke 32, suppl_1 (gennaio 2001): 372. http://dx.doi.org/10.1161/str.32.suppl_1.372.
Abstract (sommario):
P179 Neuroprotection has so far proved disappointing in acute ischemic stroke. However, neither clinical nor biological cues of ongoing neurotoxicity were provided in previous phase III trials. Thus it remains unsettled whether faulty drug selection, inadequate patients′ traits, or both, explain treatment failure. In 258 patients with first ever acute hemispheric ischemic stroke we found that admission plasma concentrations of glutamate >200 μmol/L (OR, 26.1; 95%CI, 6.9 to 98.6), interleukin-6 >21.5 pg/mL (OR, 14.9; 95%CI, 4.4 to 50.8), and GABA <190 nmol/L (OR,5.5; 95%CI, 3.2 to 9.7), and NO-metabolites >5.0 μmol/mL in CSF (OR, 5.3; 95%CI, 1.5 to 18.5), were sensitive and specific independent predictors of patients at high-risk of early neurologic deterioration regardless of infarction topography, size, and mechanism. Sensitivity and specificity values are given in the table. Early neurologic deterioration is a harbinger of impending poor outcome that in many instances we could forecast using the aforementioned tests. As early neurologic deterioration most commonly reflects those molecular events that neuroprotectants are aimed to prevent, we advocate to include it as a primary end-point in forthcoming neuroprotectant trials. We also contend to launch large and expensive trials once smaller studies restricted to patients at high-risk of early worsening have disclosed laboratory indications of neuroprotection.
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Kousa, Petteri, Teppo L. N. Järvinen, Mika Vihavainen, Pekka Kannus e Markku Järvinen. "The Fixation Strength of Six Hamstring Tendon Graft Fixation Devices in Anterior Cruciate Ligament Reconstruction: Part II: Tibial Site". American Journal of Sports Medicine 31, n. 2 (marzo 2003): 182–88. http://dx.doi.org/10.1177/03635465030310020501.
Abstract (sommario):
Background: Tibial fixation is more problematic than femoral fixation in anterior cruciate ligament reconstruction. Hypothesis: There is no difference in initial fixation strength among hamstring tendon graft tibial fixation devices. Study Design: Randomized experimental study. Methods: Each of six devices used to fix 120 quadrupled human semitendinosus-gracilis tendon grafts into porcine tibiae was tested 10 times with a single-cycle load-to-failure test and 10 times with a 1500-cycle loading test. Specimens surviving cyclic loading were subjected to a single-cycle load-to-failure test. Results: Intrafix (1332 N) was the strongest in the single-cycle load-to-failure test, followed by WasherLoc (975 N), tandem spiked washer (769 N), SmartScrew ACL (665 N), BioScrew (612 N), and SoftSilk (471 N). After cyclic-loading tests, Intrafix showed the lowest residual displacement (1.5 mm) and was also strongest (1309 N) in the single-cycle load-to-failure test after the cyclic-loading test, followed by WasherLoc (3.2 mm; 917 N). Conclusion: The Intrafix provided clearly superior strength in the fixation of hamstring tendon grafts to the tibial drill hole. Clinical Relevance: Some caution may be warranted when using the implants that showed increased residual displacement, especially if aggressive rehabilitation is to be used. Preconditioning of the hamstring tendon graft-implant complex before tibial fixation is needed.
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Nicodemus, M. C., e J. E. Booker. "Two-dimensional kinematics of the jog and lope of the stock breed western pleasure horse". Equine and Comparative Exercise Physiology 4, n. 2 (maggio 2007): 59–70. http://dx.doi.org/10.1017/s1478061507811467.
Abstract (sommario):
AbstractKinematic studies of western pleasure horses are limited and were performed before current changes in the stock breed association judging standards on the western pleasure gaits. The objective was to measure the kinematics of the jog and lope of the stock breed western pleasure horse. Reflective markers attached along palpation points of the joint centres of the left forelimb and hind limb of four stock breed western pleasure horses were tracked for five strides for each gait for each horse. Both the jog and lope were determined to be four-beat stepping gaits. During the jogging stance, the elbow (159.7 ± 6.6°), carpal (179.9 ± 1.1°), fore (227.6 ± 2.7°) and hind fetlocks (227.4 ± 6.9°), stifle (159.5 ± 6.5°) and tarsal (166.5 ± 6.5°) joints demonstrated peak extension. The same joints demonstrated during swing peak flexion with the hind fetlock joint having double peaks of flexion (195.7 ± 3.2°, 182.3 ± 2.1°). During loping stance, the elbow (153.4 ± 4.2°), carpal (179.7+0.4°), and fore (228.3 ± 9.7°, 229.8 ± 10.0°) and hind fetlock (232.1 ± 2.6°) joints of the leading limbs demonstrated peak extension with tarsal peak extension (157.0 ± 9.6°) occurring at lift-off. Peak flexion occurred during swing for the elbow (105.1 ± 3.1°), carpus (119.8 ± 6.1°), hip (83.5 ± 5.4°), stifle (129.8 ± 9.6°) and tarsus (127.5 ± 6.1°). Kinematic measurements will assist in objectively defining the stock breed western pleasure gaits.
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Ilic-Popova, Srebra. "Climatic specifications of Ohrid area of vineyards". Journal of Agricultural Sciences, Belgrade 48, n. 2 (2003): 143–48. http://dx.doi.org/10.2298/jas0302143i.
Abstract (sommario):
The purpose of the research is the examination of the climatic characteristics, indexes and coefficients in the Ohrid area of vineyards. In the region under study the average annual air temperature was 11.5?C, and the vegetative air temperature had a value of 16.7?C. The annual temperature sum was 4198?C, and ranged from 4033?C to 4524?C. The vegetative sum had a value of 3570?C, and it ranged from 3326?C to 3754?C. The annual rain sum was 665 mm, and ranged from 483 mm to 927 mm. The vegetative rain sum had a value of 342 mm, and ranged from 200 mm to 541mm. On the basis of the values of effective temperature sum, it can be concluded that the Ohrid area of vineyards belongs to the climatic zone B. The values of the hydro-thermic coefficient indicated that in the area of vineyards, where the research was conducted, there was an irregular schedule of humidity. The helio-thermic coefficient had a value of 4.4. The bio-climatic index had a value of 7.7 and ranged from 4.8 to 15.2. The results of this research indicate that the Ohrid area of vineyards is favorable for production of table and wine grape for varieties that ripen from I to II epoch.
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Hickey, M. S., R. V. Considine, R. G. Israel, T. L. Mahar, M. R. McCammon, G. L. Tyndall, J. A. Houmard e J. F. Caro. "Leptin is related to body fat content in male distance runners". American Journal of Physiology-Endocrinology and Metabolism 271, n. 5 (1 novembre 1996): E938—E940. http://dx.doi.org/10.1152/ajpendo.1996.271.5.e938.
Abstract (sommario):
Leptin, the product of the ob gene, has been reported to be related to body fat in humans (Considine et al. N. Engl. J. Med. 334: 292, 1996). However, little is known about the physiology of this putative satiety signal in humans. The purpose of the present study was to determine whether leptin is related to body fat content in relatively lean endurance-trained adults. In addition, the effect of acute exercise on circulating leptin concentration was studied. Thirteen male runners, whose mean age, height, weight, %fat, and maximal oxygen consumption (VO2max) were 32.2 +/- 2.5 yr, 176.2 +/- 1.6 cm, 71.9 +/- 6.9 kg, 9.7 +/- 0.9%, and 62.9 +/- 2.2 ml.kg-1.min-1, respectively, were studied. Blood samples were obtained after an overnight fast and again immediately after the completion of a 20-mile run at 70% VO2max under controlled environmental conditions. Serum leptin was closely related to fat mass (r = 0.92) in the runners. Acute exercise had no detectable effect on serum leptin levels (PRE = 2.19 +/- 0.32 ng/ml, POST = 2.14 +/- 0.36 ng/ml). These data indicate that, even at a biological extreme of body fat, circulating leptin concentration is closely related to fat content. Furthermore, the data suggest that, in trained individuals with low leptin concentrations, acute exhaustive exercise has no immediate effect on circulating leptin concentration.
28
Armstrong, Andrew J., Celestia S. Higano, A. Oliver Sartor, Nicholas J. Vogelzang, William R. Berry, David F. Penson, Vahan Kassabian et al. "Changing characteristics of patients treated with sipuleucel-T (sip-T) over time: Real-world experience from the PROCEED registry." Journal of Clinical Oncology 34, n. 2_suppl (10 gennaio 2016): 320. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.320.
Abstract (sommario):
320 Background: Sip-T is an autologous cellular immunotherapy approved by the FDA for the treatment of asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer. PROCEED (NCT01306890) is a phase 4 registry evaluating men receiving sip-T therapy in the US. Patient characteristics and treatment trends were assessed from 2011 to 2013, when several agents with an overall survival benefit became commercially available. Methods: For patients enrolled from 2011 to 2013, baseline patient and disease characteristics at the first sip-T infusion, trends in prior therapy, and pre–sip-T baseline prostate-specific antigen (PSA) levels were examined year over year. Results: From 2011 to 2013, 1902 patients were enrolled and received ≥ 1 sip-T infusion: 2011, n = 145; 2012, n = 967; 2013, n = 790. During this time period, enrollment of African American men nearly doubled from 6.9% to 13.4%, and central venous catheter use to facilitate sip-T infusion decreased (from 53.8% to 44.1%). Median baseline lactate dehydrogenase (LDH) levels and the number of lymph node metastases also decreased as well as median baseline PSA values (17.8 ng/mL to 11.9 ng/mL [P = 0.002]). Prior use of first-generation anti-androgens (from 73.1% to 60.5%), ketoconazole (17.2% vs. 6.3%), and estrogen (4.8% vs. 1.6%) decreased along with prior docetaxel use (19.3% vs. 7.5%). In contrast, prior investigational use of abiraterone acetate (from 3.4% to 8.9%) and enzalutamide (1.4% vs. 3.2%) increased over time. Conclusions: Over the duration of PROCEED, the decrease in baseline PSA, lower LDH, fewer nodal metastases, and decline in prior docetaxel use suggest that sip-T is being used earlier in the course of metastatic castration-resistant disease. Moreover, second-line hormonal therapy use with agents that do not improve overall survival appears to be substituted by therapies that do. This decrease in second-line hormonal therapies during PROCEED could suggest a real-world preference for earlier sip-T use. Clinical trial information: NCT01306890.
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Giang, Lê Minh, Đào Thị Diệu Thúy e Nguyễn Thu Trang. "Mức độ hỗ trợ của gia đình cho bệnh nhân điều trị HIV muộn tại Thành phố Hồ Chí Minh năm 2017". Tạp chí Nghiên cứu Y học 144, n. 8 (26 agosto 2021): 244–52. http://dx.doi.org/10.52852/tcncyh.v144i8.436.
Abstract (sommario):
Thiết kế nghiên cứu mô tả cắt ngang với mục tiêu mô tả mức độ hỗ trợ của gia đình đối với người nhiễm HIV điều trị muộn và một số yếu tố liên quan. Đối tượng nghiên cứu bao gồm 242 bệnh nhân điều trị HIV muộn tại thành phố Hồ Chí Minh (TPHCM) năm 2017. Tiêu chuẩn lựa chọn: từ 18 tuổi trở lên, sống ở TPHCM ít nhất 6 tháng, chưa từng điều trị ARV và số lượng CD4 khi đăng ký điều trị dưới 100 tế bào/mm3. Kết quả cho thấy hỗ trợ đối tượng nhận được từ gia đình hầu hết tập trung vào hỗ trợ liên quan HIV và chăm sóc sức khỏe, rất ít hỗ trợ khác. Có gia đình hạt nhân (bố/mẹ hoặc vợ/chồng) là điều kiện thuận lợi (aOR=10,2; 95% CI: 4,4 – 23,9) để nhận được hỗ trợ so với mối quan hệ khác (anh/chị/em ruột, anh/em họ, họ hàng). Đã tiết lộ với gia đình về tình trạng nhiễm HIV (aOR=6,9; 95% CI: 2,7 – 17,3) và nhóm tuổi ≥40 so với nhóm <30 tuổi (aOR=3,2; 95% CI: 1,1 – 9,7) cũng là các yếu tố thuận lợi để nhận được hỗ trợ nhiều. Các can thiệp nên tập trung vào nhóm bệnh nhân nhiễm HIV trẻ tuổi, không có/không nhận được hỗ trợ từ gia đình hạt nhân và chưa tiết lộ tình trạng nhiễm HIV.
30
Sohn, Woon-Mok, Byoung-Kuk Na, Shin-Hyeong Cho, Jung-Won Ju, Cheon-Hyeon Kim, Min-Ah Hwang, Kyeong-Woo No e Jong-Ho Park. "Prevalence and Infection Intensity of Zoonotic Trematode Metacercariae in Fish from Soyang-cheon (Stream), in Wanju-gun, Jeollabuk-do, Korea". Korean Journal of Parasitology 59, n. 3 (21 giugno 2021): 265–71. http://dx.doi.org/10.3347/kjp.2021.59.3.265.
Abstract (sommario):
We surveyed on the infection status of zoonotic trematode metacercariae (ZTM) in freshwater fishes from Soyang-cheon (a branch stream of Mangyeong-gang) in Wanju-gun, Jeollabuk-do, the Republic of Korea. A total of 927 fishes were individually examined with the artificial digestion method during 2013-2015 (462 fish in 15 spp.) and 2018-2019 (465 fish in 25 spp.). Clonorchis sinensis metacercariae were detected in 207 (31.4%) out of 659 fishes in 14 positive fish species (PFS), and their mean intensity was 114 per fish infected (PFI). Metagonimus spp. metacercariae were found in 302 (37.4%) out of 808 fishes in 21 PFS, and their mean intensity was 12 PFI. Centrocestus armatus metacercariae were detected in 222 (59.0%) out of 376 fishes in 12 PFS, and their mean intensity was 383 PFI. Echinostoma spp. metacercariae were found in 139 (22.1%) out of 628 fishes in 10 PFS, and their mean intensity was 7 PFI. Clinostomum complanatum metacercariae were detected in 14 (6.5%) out of 214 fishes in 4 PFS, and their mean intensity was 2.4 PFI. Metorchis orientalis metacercariae were detected in 36 (13.5%) out of 267 fishes in 5 PFS, and their mean intensity was 4.3 PFI. Conclusively, the prevalence and infection intensity of ZTM is generally not so high in fishes from Soyang-cheon. However, those of C. sinensis metacercariae are more or less higher in 2 fish species, Pungtungia herzi and Sarcocheilichthys variegatus wakiyae.
31
Guo, Fukun, David Hildeman, David A. Williams e Yi Zheng. "Rac1 and Rac2 GTPases Play Redundant but Critical Role in T-Cell Development and Survival." Blood 106, n. 11 (16 novembre 2005): 3304. http://dx.doi.org/10.1182/blood.v106.11.3304.3304.
Abstract (sommario):
Abstract The Rac subfamily GTPases of the Rho family have been implicated in the control of actin dynamics, cell proliferation, apoptosis, adhesion and migration of many blood cell types including hematopoietic stem/progenitors, neutrophils and macrophages, but their role in T cell development remains poorly understood. T cells from the Rac2 deficient mice appear to mostly undergo normal development, whereas previous constitutively active mutant Rac2 or Rac1 overexpression studies suggest Rac GTPases are required for CD4+ and CD8+ T cell maturation. Using conditional gene targeting, we have achieved specific deletion of Rac1 or Rac1 together with Rac2 in the T cell lineage by cross-breeding the Lck-Cre transgenic mice with the Rac1flox/flox mice that contain a pair of loxP sites sandwiching the exon 1 sequences of Rac1 or the Rac1flox/flox;Rac2−/− mice. We show that similar to Rac2 deficiency, inactivation of Rac1 alone had little effect on various developmental stages of T cells in the animal. However, deletion of both Rac1 and Rac2 significantly affected both the immature CD4−CD8− (2.3 fold increase) and CD4+CD8+ (13% decrease) populations in the mouse thymus and the mature CD4+ and CD8+ populations in the thymus and spleen (Table). These developmental defects are associated with proliferation defects of thymocytes and splenocytes in response to ConA or PMA/ionomycin stimulation and deficient survival of various T cell populations at different developmental stages (Table). Together, these data show that Rac1 and Rac2 play overlapping and obligatory roles in T-cell development and serve as important cell survival regulators at various stages. Table. Frequency and apoptosis rate of different T-cell subsets in thymocytes and splenocytes T cell subsets WT (n=10) Rac1−/− (n=6) Rac1−/−Rac2−/−(n=6) Total thymocyte number (×106) 101.3±30.0 98.0±25.0 44.7±25.5 CD4−CD8− thymocyte frequency (%) 5.5±1.9 4.5±0.7 12.7±4.3 apoptosis rate (%) 20.1±2.2 15.0±1.3 CD4+CD8+ thymocyte frequency (%) 76.2±3.2 77.3±4.1 66.2±5.4 apoptosis rate (%) 18.8±4.3 27.9±2.8 CD4+ thymocyte frequency (%) 14.5±3.4 14.4±2.4 7.9±2.3 apoptosis rate (%) 13.3±2.3 21.5±4.5 CD8+ thymocyte frequency (%) 3.9±1.2 3.8±1.0 13.2±2.2 apoptosis rate (%) 12.5±2.2 8.8±1.1 Total splenocyte number (×106) 60.4±21.8 62.0±13.0 51.1±28.9 CD4+TCRβ+ splenocyte frequency (%) 9.7±2.2 8.0±2.3 3.2±1.1 apoptosis rate (%) 15.1±3.1 27.5±6.9 CD8+TCRβ+ splenocyte frequency (%) 3.2±0.8 2.4±0.9 0.6±0.4 apoptosis rate (%) 13.1±3.0 24.5±6.4
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Kumar, Rajah Vijay, e Hendrik R. Franke. "Sustained transanorectal cryogenic treatment of hemorrhoids with the cryocure device: a prospective study". International Journal of Advances in Medicine 6, n. 4 (24 luglio 2019): 1036. http://dx.doi.org/10.18203/2349-3933.ijam20192600.
Abstract (sommario):
Background: Globally about 330 million people suffer from hemorrhoids at some time during their lives. About 1.2 million new cases are reported annually, it is not discussed freely and a simple, safe and cost effective solution is yet to be proposed. The authors studied a new technique called Transanorectal Vasoconstriction as a possible treatment of grade 1, 2 and 3 hemorrhoids.Methods: The study randomly recruited 1591 patients suffering from grade 1 to 3 hemorrhoids in Europe and India and subjected them to Transanorectal Cryogenic Vasoconstriction technique using a device called Cryocure that provides sustained release cooling of hemorrhoids leading to vasoconstriction and shrinkage. The technique was applied between 7 and 15 days and patients were assessed after 3 months.Results: The treatment outcome of 1591 patients (M:F 962:629) recruited randomly, showed that 86.12% were practically symptom free after 7 to 14 days of the treatment, and during the assessment after three months. 6.36% of the treated patients reported that one or more symptoms of itching and pain persisted but were not bleeding after the treatment period of 7 to 14 days. A few patients, 3.11% had reported that they had no benefit whatsoever from the treatment. All patients were followed for a period of 9 months. However, it was found that 4.45% of patients had various types of recurrences including bleeding.Conclusions: The present study concludes that Transanorectal Cryogenic Vasoconstriction technique using Cryocure can be a simple, safe and cost effective choice of treatment in uncomplicated grade 1, 2 and 3 hemorrhoids.
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Yeter, Deniz, Deena Woodall, Matthew Dietrich e Barbara Polivka. "Rural and Urban Ecologies of Early Childhood Toxic Lead Exposure -- the State of Kansas, 2005 to 2012". Kansas Journal of Medicine 15, n. 2 (22 agosto 2022): 285–92. http://dx.doi.org/10.17161/kjm.vol15.17960.
Abstract (sommario):
Introduction. No safe detectable level of lead (Pb) exists in the blood of children. Until recently, Centers for Disease Control and Prevention (CDC) guidelines designate a blood lead level (BLL) ≥5 µg/dL as an elevated BLL (EBLL). For the State of Kansas, early childhood blood lead burdens lack reporting in the literature. Methods. Secondary analysis of passively-reported EBLL rates ≥5 µg/dL among children ages 0–5 years at the zip code-level in Kansas during 2005 to 2012. Data weights using corresponding population estimates were applied to produce statewide outcomes. Results. Statewide estimates of annual testing coverage in Kansas among children ages 0–5 years were low (9.7%). Approximately 17,000 children ages 0–5 years developed an EBLL ≥5 µg/dL each year in Kansas with a 6.9% statewide EBLL rate compared to the national rate of 3.2% for the corresponding years. Significant variations in EBLL rates were found between suburban zip codes compared to urban, urban cluster, or rural at 3.1%, 7.2%, 8.8%, and 10.0% respectively. Among the worst outcomes in EBLL rates was observed for zip codes in Southeast Kansas (13.5%) and rural areas with <500 persons (15.1%). Conclusions. Young children in Kansas have twice the risk of developing an EBLL ≥5 µg/dL compared to the national rate, while higher rates are consistently seen outside of the suburbs and particularly in rural areas. At-risk children and troubled areas of toxic lead exposure in the State of Kansas require increased recognition with improved targeting and interventions.
34
Pospíšil, R. "Costs related to bovine spongiform encephalopathy control in the Czech Republic in 2001–2008". Agricultural Economics (Zemědělská ekonomika) 55, No. 3 (6 aprile 2009): 149–55. http://dx.doi.org/10.17221/586-agricecon.
Abstract (sommario):
This paper pays attention to and analyses two of the economic impacts of the BSE occurrence in the Czech Republic, namely the financial compensations to the farmers whose herds had been affected and the costs of animal killing and carcass disposal in the rendering plant. Between February 2001 and the end of June 2008, a total of 1 263 749 cows were examined and 28 cases of the BSE were detected. Consequently, 4 022 cows in cohorts were killed and their carcasses were safely disposed of. The farmers whose herds had been affected were provided compensations for the losses suffered. The total of the compensations in this period reached CZK 198,413 thousand. Of these, 83.3% (CZK 164.9 million) were compensations for the value of the killed animals, 9.7% (CZK 19.2 million) for the related costs, i.e., killing, safe disposal of carcasses and the examination for the BSE, and 6.9% (CZK 13.5 million) for the losses due to non-materialised production. The average costs per 1 BSE-positive animal were CZK 7.08 million and the average costs per 1 cohort animal were CZK 49 331. In the rendering plant responsible for killing the infected and cohort animals and safely disposing of their carcasses, the total of 2 221 tons of raw material was processed between March 2003 and February 2008, and this cost CZK 9 315 thousand. The fact that there were only two cases of the BSE in 2007 and none in 2008 suggests a trend towards the disease eradication, which is in agreement with the situation in the other EU countries.
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Bruno, Piergiorgio, Federico Cammertoni, Raphael Rosenhek, Andrea Mazza, Natalia Pavone, Mauro Iafrancesco, Marialisa Nesta et al. "Improved Patient Recovery With Minimally Invasive Aortic Valve Surgery: A Propensity-Matched Study". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 14, n. 5 (21 agosto 2019): 419–27. http://dx.doi.org/10.1177/1556984519868715.
Abstract (sommario):
Objective Despite conflicting evidence available, minimally invasive aortic valve replacement (MIAVR) is increasingly used as an alternative to full sternotomy. We sought to compare early outcomes of aortic valve replacement through a full sternotomy (conventional aortic valve replacement [CAVR]) and upper ministernotomy (MIAVR). Methods We analyzed 297 patients having undergone primary, elective, isolated MIAVR or CAVR between January 2014 and June 2018. Following propensity score matching, 120 patients remained in each group. Results MIAVR required longer bypass (93 ± 26 vs 81 ± 24 minutes, P < 0.01) and operative times (214 ± 39 vs 182 ± 37 minutes, P < 0.01). However, aortic cross-clamp times were comparable (57 ± 17 vs 54 ± 14 minutes for MIAVR and CAVR, respectively, P = 0.14). MIAVR had less 24-hour blood loss (253 ± 204 vs 323 ± 296 mL, P = 0.03), less red blood cells transfusions [1.4 packs (1.1 o 1.9) vs 2.1 packs (1.8 to 2.7), P = 0.01], and shorter assisted ventilation time (7.1 ± 3.3 vs 9.7 ± 3.8 hours, P < 0.01) when compared to CAVR. These results led to significantly shorter intensive care unit and hospital stays for MIAVR patients (2.5 ± 1.3 vs 3.4 ± 1.1 days, P < 0.01 and 6.9 ± 4.1 vs 8.2 ± 4.8 days, P = 0.03, respectively). Thirty-day mortality and clinical outcomes did not differ significantly among groups. Conclusions MIAVR through upper ministernotomy was shown to be as safe and reliable as CAVR. Patient recovery time was improved by shortening mechanical ventilation and reducing blood loss and transfusions. These results may be significant for high-risk patients undergoing aortic valve surgery.
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Yurdakök, Kadriye, Elif Özmert, S. Songül Yalçin e Yahya Laleli. "Vitamin A Supplementation in Acute Diarrhea". Journal of Pediatric Gastroenterology and Nutrition 31, n. 3 (settembre 2000): 234–37. http://dx.doi.org/10.1002/j.1536-4801.2000.tb07108.x.
Abstract (sommario):
ABSTRACTBackgroundVitamin A supplementation reduces the severity of subsequent diarrheal episodes. This study was conducted to examine the effect of single oral high‐dose vitamin A supplementation on the duration of acute diarrhea in 6‐to 12‐month‐old infants who are not malnourished.MethodIn this double‐blind, randomized, placebo‐controlled study, infants who were admitted to Hacettepe University Ihsan Dogramaci Children's Hospital Diarrheal Diseases Training and Treatment Unit with acute diarrhea were randomly assigned either to a group receiving a single oral dose of 100,000 IU vitamin A or placebo. There were 60 infants in each group. All infants were followed up until the diarrheal episode ended. Serum vitamin A levels were determined both at admission and 2 weeks later.ResultsNo effect of vitamin A supplementation could be demonstrated on either the total duration of diarrhea (7.4 ± 3.2 days in the treatment group vs. 7.8 ± 3.1 days in the placebo group) or on its duration after intervention (3.8 ± 2.3 days in the treatment group vs. 3.9 ± 1.9 days in the placebo group;P > 0.05 for both comparisons). Serum vitamin A levels were not significantly different at admission (23.5 ± 9.7 μg/dL in the treatment group vs. 24.1 ± 9.7 μg/dL in the placebo group;P > 0.05) nor at the end of a follow‐up period of 2 weeks (treatment: 33.3 ± 13.7 μg/dL, placebo: 35.2 ± 11.2 μg/dL;P > 0.05). However, the increase in serum vitamin A levels at the end of the 2‐week follow‐up interval for infants in both the treatment and placebo groups were found to be significant compared with levels at admission (P < 0.01). The mean weight gain in both groups were similar by the end of the first month (6.9 ± 5.0% in the treatment group vs. 6.3 ± 4.2% in the placebo group;P > 0.05).ConclusionNo effect of oral vitamin A supplementation on serum vitamin A levels, duration of diarrhea, or weight gain during an acute diarrheal episode could be demonstrated in our study group of infants between 6 and 12 months of age who had no malnutrition.
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Kirova, Milena, Lex Heerma van Voss, Chiara Bonfiglioli, Noemi Stoichkova, Niya Neykova, Marija Bosančić, Zorana Simić et al. "Book Reviews". Aspasia 17, n. 1 (1 giugno 2023): 192–223. http://dx.doi.org/10.3167/asp.2023.170111.
Abstract (sommario):
Nikolay Aretov, Zhelani i plasheshti: Chuzhdite zheni i muzhe v bulgarskata literature na gulgia devetnadeseti vek (Desired and frightening: Foreign women and men in Bulgarian literature of the long nineteenth century), Sofia: Queen Mab, 2023, 280pp., BGN 20 (paperback), ISBN: 978-954-533-208-1. Eloisa Betti, Leda Papastefanaki, Marica Tolomelli, and Susan Zimmermann, eds., Women, Work and Activism: Chapters of an Inclusive History of Labor in the Long Twentieth Century, Work and Labor: Transdisciplinary Studies for the 21st Century, vol. III, Budapest: CEU Press, 2022, xiv +354 pp., $95.00/€80.00/£68.00 (hardback), ISBN: 978-963-386-441-8. Francisca de Haan, ed., The Palgrave Handbook of Communist Women Activists around the World, London: Palgrave, 2023, 701 pp., €213.99 (hardback), ISBN: 978-3-031-13126-4. Milena Kirova, Bulgarskata literature prez XXI vek (2000–2020) (Bulgarian literature in the twenty-first century (2000–2020)), Part I, Sofia: Colibri, 2023, 287 pp., BGN 24 (paperback), ISBN: 978-619-02-1200-3. Ina Merdjanova, ed., Women and Religiosity in Orthodox Christianity, New York: Fordham University Press, 2021, 336 pp., $35 (paperback), ISBN: 9780823298617. Katja Mihurko Poniž, Biljana Dojčinović, and Maša Grdešić, Defiant Trajectories: Mapping Out Slavic Women Writers Routes, Ljubljana: Forum of Slavic Cultures, 2021, 96 pp., free online publication, https://www.fsk.si/wp-content/uploads/2021/03/WWR_DefiantTrajectories.pdf (accessed 3 July 2023), ISBN: 978-961-94672-7-5. Jasmina V. Milanović, Žensko društvo 1875–1942 (The women's society, 1875–1945), Belgrade: Institute for Contemporary History, The Official Gazette, 2020, 638 pp., RSD 2.970, ISBN: 978-86-519-2579-8. Valentina Mitkova, Pol, periodichen pechat i modernizatsia v Bulgaria (ot kraya na XIX do 40-te godini na XX vek) (Gender, periodicals, and modernization in Bulgaria (from the end of the 19th century to the 1940s)), Sofia: St. Kliment Ohridski University Press, 2022, 261 pp., BGN 20, ISBN: 978-954-07-5588-5. Agnieszka Mrozik, Architektki PRL-u: Komunistki, literatura i emancypacja kobiet w powojennej Polsce (The architects of the PRL: Communist women, literature, and women's emancipation in postwar Poland), Warsaw: Wydawnictwo IBL PAN, Lupa Obscura, 2022, 532 pp., PLN 59 (paperback), ISBN: 978-83-66898-84-4. Miglena S. Todorova, Unequal under Socialism: Race, Women, and Transnationalism in Bulgaria, Toronto: University of Toronto Press, 2021, 218 pp., $31.95 (paperback), ISBN: 978-1-4875-2841-6. Zhivka Valiavicharska, Restless History: Political Imaginaries and their Discontents in Post-Stalinist Bulgaria, Montreal: McGill-Queen's University Press, 2021, 275 pp., $36.46 (paperback), ISBN: 978-0-2280-0583-4. Susan Zimmermann, Frauenpolitik und Männergewerkschaft: Internationale Geschlechterpolitik, IGB-Gewerkschafterinnen und die Arbeiter- und Frauenbewegungen der Zwischenkriegszeit (Policies for women and men's trade unions: International gender politics, female IFTU unionists, and the labor and women's movements of the interwar period), Vienna: Löcker, 2021, 717 pp., €39.80 (paperback), ISBN: 978-3-99098-026-2.
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Maffeis, Claudio, Roberto Franceschi, Paolo Moghetti, Marta Camilot, Silvana Lauriola e Luciano Tatò. "Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment with LHRH analog". European Journal of Endocrinology 156, n. 1 (gennaio 2007): 99–103. http://dx.doi.org/10.1530/eje.1.02320.
Abstract (sommario):
Decreased levels of ghrelin have been measured in growing children during puberty. No data are available for girls with central precocious puberty (CPP). Aims: To explore ghrelin changes before, during, and after GnRH analog treatment in girls with CPP. Subjects and methods: A sample of 20 Caucasian girls (8.08 ± 0.65 years of age) with CPP was recruited. Height and weight, bone age, LH, FSH, 17β estradiol (E2), and ghrelin were measured before starting treatment with GnRH analog, 18 months after therapy began and again 6 months after therapy discontinuation. Results: LH and E2 serum levels decreased significantly during treatment (2.45 ± 2.03 vs 0.67 ± 0.49 UI/l, P < 0.01 and 28.17 ± 9.7 vs 15 pmol/l, P < 0.01 respectively), returning to baseline levels after the discontinuation of therapy (4.75 ± 1.66 UI/l and 29.23 ± 6.99 pmol/l respectively). LH peaked following LHRH stimulation significantly (P < 0.01) decreased during treatment (24.45 ± 14.17 vs 1.3 ± 0.18 UI/l) and then increased after therapy discontinuation (12.58 ± 6.09, P < 0.01). Ghrelin decreased significantly (P < 0.05) during treatment (1849 ± 322 vs 1207 ± 637 pg/ml), and increased, though not significantly (P = 0.09) after therapy withdrawal (1567 ± 629 pg/ml). Conclusions: Contrary to what is expected in physiologic puberty, where ghrelin is progressively reduced, the prepubertal hormone milieau induced by GnRHa treatment in patients suffering from central precocious puberty (CPP) did not promote an increase in ghrelin circulating levels. Therefore, in CPP, ghrelin secretion seems to be independent from pubertal development per se. Concomitant estrogen suppression during treatment may play a potential role in the regulation of ghrelin secretion in these girls.
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Arakelyan, R. S., e G. L. Shendo. "Sanitary and parasitological state of water bodites in the Аstrakhan region". Bulletin of the Russian Military Medical Academy 22, n. 4 (15 dicembre 2020): 168–71. http://dx.doi.org/10.17816/brmma62824.
Abstract (sommario):
The article analyzes the sanitary and parasitological state of water bodies in the Astrakhan region in 20152019. A total of 16683 laboratory studies of water samples were conducted during the analyzed period. The number of samples taken from various environmental objects was 15253 (91,4%), of which 2595 (17%) were water samples taken from various water bodies. Of the last 82 (3,2%), samples did not meet sanitary standards. Centralized water supply was tested for parasitic contamination in 666 (25,7%) samples, swimming pool water in 947 (36,5%) samples, open water (river water) in 696 (26,8%) and wastewater in 286 (11%) samples. Of the 635 (24,5%) water samples collected in 2015, 14 (2,2%) did not meet hygiene standards. Of the 671 (25,9%) samples taken in 2016, 32 (4,8%) samples showed positive findings. Percentage of water samples collected and examined in 2017 it accounted for 463 (17,8%) of all water samples studied during the analyzed period, of which 14 (3%) did not meet sanitary standards. The share of water samples selected and tested for parasitic indicators in 2018 was 518 (22,4%), of which 18 (3,5%) samples did not meet the hygiene standards. In 2019, compared to previous years, the number of water samples taken for parasitic indicators decreased several times and amounted to 308 (11,9%), of which positive findings were noted in 4 (1,3%) samples. The absence of positive findings in water samples taken from Central water supply facilities indicates high-quality filtration and prevention of these facilities. The presence of cysts of pathogenic intestinal protozoa, as well as eggs and larvae of helminths in water samples taken from swimming pools and open reservoirs indicates fecal contamination of these objects. The presence of positive findings in wastewater samples indicates that sewage treatment plants do not provide reliable deworming and disinfection of wastewater.
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Ciezki, J. P., C. A. Reddy, P. A. Kupelian, E. A. Klein, C. Robinson, N. Chehade, K. Angermeier, A. Altman e J. Ulchaker. "A comparison of overall and cause-specific survival among patients with low- and intermediate-risk prostate cancer treated with brachytherapy, external beam radiotherapy, or radical prostatectomy". Journal of Clinical Oncology 25, n. 18_suppl (20 giugno 2007): 5126. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.5126.
Abstract (sommario):
5126 Background: The factors thought to influence overall survival (OS) and cause-specific survival (CSS) in patients treated for low and intermediate-risk prostate cancer (CaP) with brachytherapy (PI), external beam radiotherapy (RT), or radical prostatectomy (RP) were evaluated. Methods: From 1996 to 2003, 2285 patients with low or intermediate-risk CaP were treated at the Cleveland Clinic with either PI (n=662), RT (n=570), or RP (n=1053). Factors thought to influence OS and CSS were recorded. These factors included: Charlson score, age, socioeconomic status, race, body mass index (BMI), presence of coronary artery disease (CAD), presence of hypertension (HTN), presence of dyslipidemia (DL), initial prostate-specific antigen (iPSA), biopsy Gleason score (bGS), clinical stage, use of androgen deprivation (AD), AD duration, smoking history including pack-years, alcohol use, and cancer treatment modality (TX). Univariate and multivariate analyses were done using Cox proportional hazards regression. Results: The median follow-up is 59 months (range: 24–119 months). The 5- year OS rate is 96.0%, and the 8-year rate is 89.9%. Multivariate analysis revealed that Charlson score, age, smoking history, and TX were significantly associated with OS. Treatment with RT was independently associated with worse OS relative to PI and RP. CSS was grouped into 4 major categories: CAD, CaP, other cancer, and other. The only significant difference between these CSS categories and the treatment modalities was CaP. The percent of deaths due to CaP in the TX groups were: PI - 3.2%, RP - 9.7%, and RT - 24.5%. Conclusions: Charlson score, age, smoking history, and TX independently affect OS in patients treated for low and intermediate-risk CaP. The cause of the lower OS rate with RT may be related to an increased risk of death due to CaP. [Table: see text] No significant financial relationships to disclose.
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Kapoor, Nimmi S., Lisa D. Curcio, Carlee A. Blakemore, Amy K. Bremner, Rachel E. McFarland, John G. West e Kimberly C. Banks. "Benefits and safety of multigene panel testing in patients at risk for hereditary breast cancer." Journal of Clinical Oncology 33, n. 28_suppl (1 ottobre 2015): 16. http://dx.doi.org/10.1200/jco.2015.33.28_suppl.16.
Abstract (sommario):
16 Background: Recently introduced multi-gene panel testing including BRCA1 and BRCA2 genes (BRCA1/2) for hereditary cancer risk has raised concerns with the ability to detect all deleterious BRCA1/2 mutations compared to older methods of sequentially testing BRCA1/2 separately. The purpose of this study is to evaluate rates of pathogenic BRCA1/2mutations and variants of uncertain significance (VUS) between previous restricted algorithms of genetic testing and newer approaches of multi-gene testing. Methods: Data was collected retrospectively from 966 patients who underwent genetic testing at one of three sites from a single institution. Test results were compared between patients who underwent BRCA1/2testing only (limited group, n = 629) to those who underwent multi-gene testing with 5-43 cancer-related genes (panel group, n = 337). Results: Deleterious BRCA1/2 mutations were identified in 37 patients, with equivalent rates between limited and panel groups (4.0% vs 3.6%, respectively, p = 0.86). Thirty-nine patients had a BRCA1/2 VUS, with similar rates between limited and panel groups (4.5% vs 3.3%, respectively, p = 0.49). On multivariate analysis, there was no difference in detection of either BRCA1/2 mutations or VUS between both groups. Of patients undergoing panel testing, an additional 3.9% (n = 13) had non-BRCA pathogenic mutations and 13.4% (n = 45) had non-BRCA VUSs. Mutations in PALB2, CHEK2, and ATM were the most common non-BRCA mutations identified. Conclusions: Multi-gene panel testing detects pathogenic BRCA1/2 mutations at equivalent rates as limited testing and increases the diagnostic yield. Panel testing increases the VUS rate, mainly due to non-BRCA genes. Patients at risk for hereditary breast cancer can safely benefit from upfront, more efficient, multi-gene panel testing.
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Socha, Piotr, Berthold Koletzko, Joanna Pawlowska, Krystyna Proszynska e Jerzy Socha. "Treatment of Cholestatic Children with Water‐soluble Vitamin E (α‐Tocopheryl Polyethylene Glycol Succinate): Effects on Serum Vitamin E, Lipid Peroxides, and Polyunsaturated Fatty Acids". Journal of Pediatric Gastroenterology and Nutrition 24, n. 2 (febbraio 1997): 189–93. http://dx.doi.org/10.1002/j.1536-4801.1997.tb01733.x.
Abstract (sommario):
Background:Treatment of vitamin E‐deficient cholestatic children with water‐soluble α‐tocopherol polyethylene glycol succinate (TPGS) was previously shown to normalize vitamin E status and to improve neurological outcome.Methods:Because vitamin E plays an important role as a free‐radical scavenger, we studied the effects of long‐term TPGS supplementation on lipid peroxidation and polyunsaturated fatty acid status in 15 children ages 9 months‐3.4 years (median, 1.3 years) with chronic cholestasis with low serum vitamin E concentrations [1.95 (0.8‐3.7) mg/L; median (1st‐3rd quartile)]. The previous supplementation of α‐tocopherol was replaced by a 20% solution of TPGS in one daily dose of 20 IU/kg. Serum α‐tocopherol, plasma lipid peroxides expressed as thiobarbiturate reactive substance concentration (TBARS) and plasma phospholipid fatty acid profile were estimated at baseline and again after 1 month in all 15 patients, and after 1 year of TPGS therapy in 11 patients.Results:α‐Tocopherol was significantly increased after 1 month [6.9 (4.4‐8.4) mg/L; p = 0.008] and rose further after 1 year [9.7 (7.2‐14.9) mg/L]; similar results were obtained for the ratio vitamin E/total lipids. TBARS concentrations were significantly higher in cholestatic children at baseline [2.9 (1.5‐3.32) nmol/ml] than in a control group [1.2 (1.1‐1.3) nmol/ml; p = 0.0006], but were not changed significantly during TPGS therapy [after 1 year 2.34 (1.9‐3.0) nmol/ml]. Compared with controls, the contributions of polyunsaturated fatty acids to total phospholipid fatty acids were markedly decreased in cholestatic patients at baseline [27.7 (22.4‐31.5)% versus 36.9 (34.5‐39.0)%; p = 0.001] and did not show major changes after 1 year of TPGS supplementation.Conclusions:We conclude that oral TPGS supplementation of cholestatic children can quickly normalize serum vitamin E levels but does not improve the increased lipid peroxidation and poor polyunsaturated fatty acid status.
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Buch, M. H., T. Takeuchi, V. Rajendran, J. E. Gottenberg, A. Pechonkina, Y. Tan, Q. Gong, K. Van Beneden e R. Caporali. "AB0394 CLINICAL OUTCOMES UP TO WEEK 48 OF ONGOING FILGOTINIB (FIL) RHEUMATOID ARTHRITIS (RA) LONG-TERM EXTENSION (LTE) TRIAL OF BIOLOGIC DISEASE-MODIFYING ANTIRHEUMATIC DRUG (bDMARD) INADEQUATE RESPONDERS (IR) INITIALLY ON FIL OR PLACEBO IN A PHASE 3 PARENT STUDY (PS)". Annals of the Rheumatic Diseases 81, Suppl 1 (23 maggio 2022): 1325–26. http://dx.doi.org/10.1136/annrheumdis-2022-eular.1624.
Abstract (sommario):
BackgroundThe preferential Janus kinase-1 inhibitor FIL is approved for treatment of moderate to severe active RA in Europe and Japan.ObjectivesEfficacy and safety of FIL were assessed in patients (pts) with IR to bDMARDs in a LTE trial (NCT03025308) enrolled from a Phase 3 PS (NCT02873936).1MethodsbDMARD-IR pts received FIL 200 mg (FIL200), FIL 100 mg (FIL100), or placebo (PBO), all with stable conventional synthetic (cs)DMARDs up to 24 weeks (W). At W14 of the PS, pts with IR to FIL or PBO (<20% improvement in swollen [66] and tender [68] joint counts) switched to standard of care (SOC; investigator’s choice of treatment). Pts completing the PS on FIL, PBO, or SOC could enter the LTE. PS FIL pts were maintained, blinded, on their FIL dose; PS PBO and PS SOC pts were rerandomized, blinded, to FIL200 or FIL100. Efficacy data to LTE W48 and safety data to data cutoff (June 1, 2020) are reported.ResultsThe PS included 147, 153, and 148 pts on FIL200, FIL100, and PBO. Pts continuing on LTE FIL200 and FIL100 at data cutoff: 80/121 (66%) and 76/110 (69%) from PS FIL200 and FIL100; 35/47 (75%) and 32/46 (70%) from PS PBO, and 13/23 (57%) and 13/22 (59%) from PS SOC. LTE baseline (BL) characteristics were similar in FIL200 and FIL100 pts. During LTE, PS FIL ACR20/50/70 response rates decreased modestly by W48 (Figure 1). Among PS PBO pts, response rates were lower at LTE BL, reaching similar levels to PS FIL pts by W48; rates increased to W48 in PS SOC pts on either FIL dose but not to levels of other groups. Percentages of pts attaining DAS28(CRP) ≤3.2, DAS28(CRP) <2.6, CDAI ≤10, and CDAI ≤2.8 were maintained up to W48 for FIL/FIL pts. PBO/FIL and SOC/FIL pts showed similar patterns to ACR responses (Figure 1). Exposure-adjusted incidence rates (EAIRs)/100 pt-years of exposure for treatment-emergent adverse events (TEAE), serious AEs, and serious infection were higher in SOC/FIL pts vs FIL/FIL or PBO/FIL pts, but samples were small and confidence intervals overlapped. There were 5 deaths (Table 1).Table 1.EAIRs of TEAEs in LTE, as of June 1, 2020EAIR (95% CI)FIL200+csD → FIL200+csD n=121PYE 228.4PBO+csD → FIL200+csD n=47PYE 98.1SOC+csD → FIL200+csD n=23PYE 42.1FIL100+csD → FIL100+csD n=110PYE 223.3PBO+csD → FIL100+csD n=46PYE 91.1SOC+csD → FIL100+csD n=22PYE 38.2TEAE46.9 (38.8, 56.6)38.7 (28.2, 53.2)52.2 (34.4, 79.3)40.3 (32.8, 49.5)40.6 (29.4, 56.1)49.8 (31.8, 78.0)TEAE Grade ≥310.5 (7.0, 15.7)10.2 (5.5, 18.9)19.0 (9.5, 38.0)10.3 (6.8, 15.5)13.2 (7.5, 23.2)18.3 (8.7, 38.5)TE serious AE12.3 (8.5, 17.8)12.2 (6.9, 21.5)21.4 (11.1, 41.1)8.1 (5.1, 12.8)13.2 (7.5, 23.2)21.0 (10.5, 41.9)Death1.3 (0.4, 4.1)1.0 (0, 5.7)0 (0, 8.8)0.4 (0.1, 3.2)0 (0, 4.0)0 (0, 9.7)TE infections34.2 (27.4, 42.6)22.4 (14.8, 34.1)35.6 (21.5, 59.1)22.4 (17.0, 29.5)26.3 (17.7, 39.3)39.3 (23.7, 65.2)TE serious infections3.5 (1.8, 7.0)2.0 (0.5, 8.2)7.1 (2.3, 22.1)0.9 (0.2, 3.6)2.2 (0.5, 8.8)7.9 (2.5, 24.4)Opportunistic infections0 (0, 1.6)0 (0, 3.8)0 (0, 8.8)0 (0, 1.7)0 (0, 4.0)0 (0, 9.7)TE herpes zoster2.2 (0.7, 5.1)1.0 (0.1, 7.2)0 (0, 8.8)0 (0, 1.7)2.2 (0.5, 8.8)2.6 (0.1, 14.6)TE MACE (adjudicated)1.3 (0.4, 4.1)1.0 (0.1, 7.2)0 (0, 8.8)0.9 (0.2, 3.6)1.1 (0.2, 7.8)0 (0, 9.7)TE DVT/PE (adjudicated)0.9 (0.2, 3.5)0 (0, 3.8)2.4 (0.1, 13.2)0.4 (0.1, 3.2)0 (0, 4.0)0 (0, 9.7)Malignancies (excluding NMSC)1.3 (0.4, 4.1)3.1 (1.0, 9.5)4.7 (0.6, 17.2)1.8 (0.7, 4.8)3.3 (1.1, 10.2)0 (0, 9.7)NMSC0 (0, 1.6)0 (0, 3.8)4.7 (0.6, 17.2)0 (0, 1.7)0 (0, 4.0)0 (0, 9.7)DVT, deep vein thrombosis; MACE, major adverse cardiovascular event; NMSC, nonmelanoma skin cancer; PE, pulmonary embolism; TE, treatment-emergentConclusionEfficacy was mostly maintained in PS FIL pts up to W48. Response among PS PBO and SOC pts increased from BL to W48, but response in PS SOC pts continued to be lower than in other groups; these pts may represent a refractory population. FIL safety was largely consistent between PS and LTE.References[1]Genovese MC et al. JAMA 2019;322:315–25.AcknowledgementsThis study was funded by Gilead Sciences, Inc., Foster City, CA. Medical writing support was provided by Claudine Bitel, PhD, of AlphaScientia, LLC, San Francisco, CA; and funded by Gilead Sciences, Inc., Foster City, CA.Disclosure of InterestsMaya H Buch Speakers bureau: AbbVie, Consultant of: AbbVie, Galapagos, Gilead, and Pfizer, Grant/research support from: Gilead and Pfizer, Tsutomu Takeuchi Speakers bureau: AbbVie, AYUMI, Bristol Myers Squibb, Chugai, Daiichi Sankyo, Dainippon Sumitomo, Eisai, Eli Lilly Japan, Gilead Sciences, Mitsubishi-Tanabe, Novartis, Pfizer Japan, and Sanofi, Consultant of: Astellas, Chugai, and Eli Lilly Japan, Grant/research support from: AbbVie, Asahi Kasei, Astellas, Chugai, Daiichi Sankyo, Eisai, Mitsubishi-Tanabe, Shionogi, Takeda, and UCB Japan, Vijay Rajendran Shareholder of: Galapagos, Employee of: Galapagos, Jacques-Eric Gottenberg Speakers bureau: AbbVie, Eli Lilly and Co., Galapagos, Gilead Sciences, Inc., Roche, Sanofi Genzyme, and UCB, Consultant of: Bristol Myers Squibb, Sanofi Genzyme, and UCB, Grant/research support from: Bristol Myers Squibb and Pfizer, Alena Pechonkina Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., YingMeei Tan Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Qi Gong Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Katrien Van Beneden Shareholder of: Galapagos, Employee of: Galapagos, Roberto Caporali Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, and UCB, Consultant of: AbbVie, Amgen, BMS, Celltrion, Galapagos, Janssen, Lilly, Fresenius-Kabi, MSD, Novartis, Pfizer, Roche, Sandoz, and UCB
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Castrejon, I., J. Molina Collada, C. Perez-Garcia, P. Vela-Casasempere, C. Diaz-Torne, C. Bohórquez, J. M. Blanco e F. Sánchez-Alonso. "POS1439 CANCER IN PATIENTS WITH RHEUMATIC DISEASES EXPOSED TO DIFFERENT BIOLOGIC AND TARGETED SYNTHETIC DMARDS IN REAL-WORLD CLINICAL PRACTICE: DATA FROM A MULTICENTER REGISTER". Annals of the Rheumatic Diseases 81, Suppl 1 (23 maggio 2022): 1063. http://dx.doi.org/10.1136/annrheumdis-2022-eular.3834.
Abstract (sommario):
BackgroundExtensive evidence has confirmed no increased risk of cancer associated to either conventional synthetic DMARDs or anti-TNF in patients with rheumatic diseases. The risk of cancer in biologic (bDMARDs) different to anti-TNF and targeted synthetic (tsDMARDs) is considerably less investigated. As new therapies are emerging, more data in real-world registries are needed to confirm safety in other treatment groups.ObjectivesTo compare the risk of cancer of tsDMARDs and other bDMARDs versus anti-TNF in patients with rheumatic diseases.MethodsData of patients enrolled in BIOBADASER 3.0 up to October 2021 with the start of any bDMARD or tsDMARD were analyzed. For each group, demographic and clinical variables were estimated. Changes to therapy and occurrence of serious adverse events collected annually. Incident cancer was defined as any cancer during the exposure classified according to Meddra dictionary leading to therapy discontinuation. Incidence rate ratios of cancer per 1000 patients-year (PYs) and 95% confidence interval were estimated. Incidence rate ratio was calculated for each group versus anti-TNF.ResultsWe identified 271 cancers in BIOBADASER 3.0, corresponding to a cancer incident rate of 7.4 (6.5-8.3) per 1000 PY of exposure. Patients exposed to anti-TNF and anti-IL17 were younger, with lower disease duration and comorbidity versus other groups. Proportionally more malignancies were identified in the anti-CTLA-4 group (3.4%) versus the anti-TNF group (2.9%). The rates of incident cancer ranged between 2.6 events/1000 PY in the anti-IL17 group and 15.3 events/1000 PY in the anti-CTLA-4 group. The rate of cancer did not differ significantly in patients exposed to JAKi [0.8 (95% CI 0.4-1.5)], anti CD20 [1.1 (95% CI 0.6-1.8)], or anti-IL6 [1.3 (95% CI 0.9-1.9)] versus anti-TNF; it was significantly lower in patients exposed to anti-Il17 [0.4 (95% CI 0.2-0.9)], and significantly higher in patients exposed to anti-CTLA-4 [2.2 (95% CI 1.4-3.2)]. The most frequent malignancy was non-melanoma skin cancer, followed by solid cancer (mainly breast cancer with 24 events and lung cancer with 14 events) and melanoma (13 events).Table 1.New Cancer Diagnosis Among Patients with anti-TNF versus other therapiesAnti-TNF (N=6356)JAKi (N=1079)Anti-CD20 (N=667)Anti-IL6 (N=1178)Anti-CTLA-4 (N=783)Anti-IL17 (N=1051)Female, n (%)3738 (58.8)868 (80.4)523 (78.4)947 (80.4)598 (76.4)492 (46.81)Mean age, (SD)54.8 (14.7)58.5 (12.4)60.9 (13.6)59.8 (15.1)64.0 (12.8)52.2 (11.6)Mean start age, (SD)49.1 (14.0)56.6 (12.3)57.9 (13.5)55.7 (15.2)59.7 (13.0)49.8 (22.2)Disease duration, median (IQR)6.2[2.2-13.0]10.4[4.7 -17.2]11.0[5.1-18.5]8.3[3.2-15.1]10.3[5.2-17.0]3.1[0.3-10.7]Charlton Index1.9 (1.3)2.4 (1.6)2.4 (1.7)2.4 (1.7)2.8 (1.9)1.8 (1.3)First line biologic, n (%)99 (53.2)2 (22.2)1 (7.1)6 (20.0)5 (18.5)2 (66.7)New cancer diagnosis, n (%)186 (2.9%)9 (0.8%)14 (2.1%)30 (2.5%)27 (3.4%)5 (0.5%)Median years of follow-up months4.2 [2.3-7.3]2.4 [1.4-3.2]1.0 [1.0-1.0]2.6 [1.3-6.6]4.4 [1.5-5.7]1.8 [1-5-2.2]Time of exposure, yrs26233.51652.71871.53196.71762.11921Cancer Incidence Rate (per 1000 PY) ancer Incide7.1 (6.1-8.2)5.4 (2.8-10.5)7.5 (4.4-12.6)9.4 (6.6-13.4)15.3 (10.5-22.3)2.6 (1.1-6.3) .6 (1.1-6.3).5.2 (4.4-6.1)6.3 (1.6-8.1)5.9 (3.3-10.6)7.5 (5-11.2)10.8 (6.9-16.9)1.6 (0.5-4.8) .6 (0.5-40.3 (0.2-0.6)0 (0-0)1.1 (0.3-4.3)0.3 (0-2.2)0.6 (0.1-4)0 (0-0) (0-0)1-4)3)9)) Rate (per1.6 (1.2-2.2)1.8 (0.6-5.6)0.5 (0.1-3.8)1.6 (0.7-3.8)4 (1.9-8.3)1 (0.3-4.2)Rate ratio (vs anti-TNF)NA0.8 (0.4-1.5)1.1 (0.6-1.8)1.3 (0.9-1.9)2.2 (1.4-3.2)0.4 (0.2-0.9)ConclusionIn this register-based study, rates of incident cancer did not differ between patients treated with anti-TNF and other bDMARDs or tsDMARDs, with the possible exception of a potential increased risk in patients treated with anti-CTLA-4.AcknowledgementsThank you to all patients, rheumatologists, and to the research personnel from the Spanish Foundation of Rheumatology who made this study possible.Disclosure of InterestsIsabel Castrejon: None declared, Juan Molina Collada: None declared, Carolina Perez-Garcia: None declared, Paloma Vela-Casasempere Speakers bureau: ROCHE, UCB, GSK, LILLY, Consultant of: PFIZER, BMS, LILLY, UCB, GSK, Abbvie, Fresenius Kabi, Grant/research support from: ROCHE, ABBVIE, PFIZER, BMS, LILLY, SANDOZ, AMGEN, Cesar Diaz-Torne: None declared, Cristina Bohórquez: None declared, J M Blanco: None declared, Fernando Sánchez-Alonso: None declared
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Saraf, Santosh L., Robert Molokie, Johara Hassan, Michel Gowhari, James Lash e Victor R. Gordeuk. "Clinical and Laboratory Predictors for Renal Damage in Sickle Cell Disease". Blood 120, n. 21 (16 novembre 2012): 3252. http://dx.doi.org/10.1182/blood.v120.21.3252.3252.
Abstract (sommario):
Abstract Abstract 3252 Renal failure is an independent marker for developing other forms of chronic organ damage and for early mortality in sickle cell disease (SCD). We conducted a retrospective, cross-sectional chart review of 292 adults with SCD (type SS or S-beta thal) treated at the University of Illinois Medical Center to assess the prevalence and factors related to kidney damage. Data was recorded from a clinic visit at least four weeks from a vaso-occlusive pain episode or red blood cell transfusion. The glomerular filtration rate (GFR) was calculated using the modification of diet in renal disease formula. Hemoglobinuria was defined by dipstick urinalysis showing trace, small, or moderate blood and <2 RBC/high power field. Urine albumin to creatinine ratios of 30 to 300 mg/g and >300 mg/g were categorized as microalbuminuria and macroalbuminuria, respectively. The median age was 33 years and 46% of patients were on hydroxyurea. We observed microalbuminuria in 41%, macroalbuminuria in 20%, hemoglobinuria in 41% and GFR <90 mL/min in 20% of adults with SCD. Univariate associations with GFR <90 mL/min are summarized in Table 1. By logistic regression, macroalbuminuria (OR 7.5, 95% CI: 2.5–22.2; p<0.0001) and age (OR 1.11, 95% CI: 1.06–1.16; p <0.0001) were independent predictors of GFR <90 mL/min (r2 = 0.23). Given the strong correlation of macroalbuminuria with GFR <90 mL/min, we explored factors related to degree of albuminuria. Univariate associations with degree of albuminuria are shown in Table 2. Logistic regression showed that independent predictors for macroalbuminuria were the presence of hemoglobinuria (OR 93.7, 95% CI: 15.2–576.5; p<0.0001) and age (OR 1.07, 95% CI: 1.01–1.14; p=0.03) (r2=0.28, p<0.0001). We further explored predictors of hemoglobinuria given its independent association with macroalbuminuria. By logistic regression, the strongest predictor of hemoglobinuria was the natural log LDH (OR 32.4; 95% CI: 8.4–124.9; p<0.0001) (r2=0.22), but other markers of hemolysis including higher absolute reticulocyte count, greater indirect bilirubin concentration and lower hemoglobin concentration were also associated with hemoglobinuria in univariate analyses. In summary, increasing age and macroalbuminuria were independent factors associated with GFR < 90mL/min in this cohort of adults with SCD, and intravascular hemolysis as reflected in hemoglobin-positive urine dipstick with negative microscopy was associated with macroalbuminuria. Further research is needed to determine if measures to decrease intravascular hemolysis and to prevent the development of macroalbuminuria can preserve renal function in patients with SCD. Investigation is also needed to identify genomic and genetic markers that put patients at risk for kidney disease and might serve as targets for preventive and therapeutic interventions. Table 1: Correlation of GFR to clinical and laboratory variables. Variable N >90 N <90 p-value Age (years) 234 30 (25–39) 58 45 (37–54) <0.0001 Female gender 234 141 (60%) 58 38 (65%) 0.63 MAP 231 86 (90–93) 58 91 (86–98) <0.0001 HU therapy 110 48 (44%) 30 16 (53%) 0.35 Hemoglobin (g/dL) 234 8.9 (7.9–10) 58 8.1 (7.4–8.9) <0.0001 LDH (u/L) 146 309 (235–425) 41 375 (251–481) 0.11 Absolute Reticulocyte Count (×103/μL) 111 332 (234–444) 29 302 (197–368) 0.001 Hgb F (%) 218 5.5 (2.9–9.8) 52 5.5 (2.5–9.8) 0.98 Albuminuria: Microalbuminuria Macroalbuminuria 112 46 (41%) 30 11 (36.7%) 0.001 15 (13%) 13 (43.4%) Table 2: Correlation of Albuminuria to clinical and laboratory variables. Variable N Normal N Micro-albuminuria N Macro-albuminuria p-value Age (years) 57 32 (26–42) 58 38 (28–48) 28 35 (27–45) 0.20 Female gender 57 43 (75%) 58 34 (59%) 28 18 (64%) 0.16 MAP (mmHg) 56 86 (80–97) 58 88 (84–92) 28 91 (84–98) 0.24 HU therapy 56 24 (42.9%) 57 24 (42.1%) 28 17 (60.7%) 0.22 Hemoglobin (g/dL) 57 8.9 (8.1–10.3) 58 8.1 (7.5–9.4) 28 8.5 (6.9–9.4) 0.008 LDH (u/L) 54 270 (212–358) 49 363 (251–434) 27 377 (355–488) <0.0001 Indirect bilirubin (mg/dL) 56 1.7 (1.2–2.5) 57 2.4 (1.4–3.3) 28 2.0 (1.3–4.3) 0.03 Absolute reticulocyte count (×103/μL) 57 256 (213–399) 56 332 (243–448) 28 369 (276–466) 0.06 Hgb F (%) 52 6.6 (2.7–9.7) 56 5.1 (2.8–11.7) 26 7.8 (3.7–13) 0.54 Hemoglobinuria 53 3 (5.7%) 54 29 (53.7%) 26 22 (84.6%) <0.0001 Disclosures: No relevant conflicts of interest to declare.
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Crowther, Caroline A., Pat Ashwood, Philippa F. Middleton, Andrew McPhee, Thach Tran, Jane E. Harding, Jane Alsweiler et al. "Prenatal Intravenous Magnesium at 30-34 Weeks’ Gestation and Neurodevelopmental Outcomes in Offspring". JAMA 330, n. 7 (15 agosto 2023): 603. http://dx.doi.org/10.1001/jama.2023.12357.
Abstract (sommario):
ImportanceIntravenous magnesium sulfate administered to pregnant individuals before birth at less than 30 weeks’ gestation reduces the risk of death and cerebral palsy in their children. The effects at later gestational ages are unclear.ObjectiveTo determine whether administration of magnesium sulfate at 30 to 34 weeks’ gestation reduces death or cerebral palsy at 2 years.Design, Setting, and ParticipantsThis randomized clinical trial enrolled pregnant individuals expected to deliver at 30 to 34 weeks’ gestation and was conducted at 24 Australian and New Zealand hospitals between January 2012 and April 2018.InterventionIntravenous magnesium sulfate (4 g) was compared with placebo.Main Outcomes and MeasuresThe primary outcome was death (stillbirth, death of a live-born infant before hospital discharge, or death after hospital discharge before 2 years’ corrected age) or cerebral palsy (loss of motor function and abnormalities of muscle tone and power assessed by a pediatrician) at 2 years’ corrected age. There were 36 secondary outcomes that assessed the health of the pregnant individual, infant, and child.ResultsOf the 1433 pregnant individuals enrolled (mean age, 30.6 [SD, 6.6] years; 46 [3.2%] self-identified as Aboriginal or Torres Strait Islander, 237 [16.5%] as Asian, 82 [5.7%] as Māori, 61 [4.3%] as Pacific, and 966 [67.4%] as White) and their 1679 infants, 1365 (81%) offspring (691 in the magnesium group and 674 in the placebo group) were included in the primary outcome analysis. Death or cerebral palsy at 2 years’ corrected age was not significantly different between the magnesium and placebo groups (3.3% [23 of 691 children] vs 2.7% [18 of 674 children], respectively; risk difference, 0.61% [95% CI, −1.27% to 2.50%]; adjusted relative risk [RR], 1.19 [95% CI, 0.65 to 2.18]). Components of the primary outcome did not differ between groups. Neonates in the magnesium group were less likely to have respiratory distress syndrome vs the placebo group (34% [294 of 858] vs 41% [334 of 821], respectively; adjusted RR, 0.85 [95% CI, 0.76 to 0.95]) and chronic lung disease (5.6% [48 of 858] vs 8.2% [67 of 821]; adjusted RR, 0.69 [95% CI, 0.48 to 0.99]) during the birth hospitalization. No serious adverse events occurred; however, adverse events were more likely in pregnant individuals who received magnesium vs placebo (77% [531 of 690] vs 20% [136 of 667], respectively; adjusted RR, 3.76 [95% CI, 3.22 to 4.39]). Fewer pregnant individuals in the magnesium group had a cesarean delivery vs the placebo group (56% [406 of 729] vs 61% [427 of 704], respectively; adjusted RR, 0.91 [95% CI, 0.84 to 0.99]), although more in the magnesium group had a major postpartum hemorrhage (3.4% [25 of 729] vs 1.7% [12 of 704] in the placebo group; adjusted RR, 1.98 [95% CI, 1.01 to 3.91]).Conclusions and RelevanceAdministration of intravenous magnesium sulfate prior to preterm birth at 30 to 34 weeks’ gestation did not improve child survival free of cerebral palsy at 2 years, although the study had limited power to detect small between-group differences.Trial Registrationanzctr.org.au Identifier: ACTRN12611000491965
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Jani, Chinmay T., Samuel A. Kareff, Harpreet Singh, Ana Salazar Zetina e Gilberto Lopes. "Abstract 803: Disparities unveiled: A comprehensive analysis of evolving trends in lung cancer risk factors in the ten most populous countries". Cancer Research 84, n. 6_Supplement (22 marzo 2024): 803. http://dx.doi.org/10.1158/1538-7445.am2024-803.
Abstract (sommario):
Abstract Introduction: Evolving Lung cancer (LC) trends necessitate a continual reassessment of associated risk factors. Methods: We utilized the Global Burden of Disease database to extract Age-Standardized Mortality Rates (ASMR) and risk factor-associated ASMR for Tracheal, Bronchial, and Lung cancer (TBLC) from 1990-2019. The aim was to analyze overall trends along with two pivotal LC risk factors associated trends—tobacco use and air pollution—across ten most populous nations as of 2023 population census. Joinpoint analysis was employed to analyze trends. Results: Globally, TBLC mortality has decreased by 8%, with reductions observed in both tobacco and air pollution-associated mortality. Despite a decrease in male mortality (-17%) and increase in female mortality (+15%), males have exhibited higher mortality for past three decades with M:F ratio of 2.5 in 2019. Similarly, male mortality was higher across all countries. Globally, although tobacco and air pollution-associated mortality has decreased for males and increased for females, both risk factors are linked to significantly higher mortality in males, with M:F ratios of 4.4 and 2.6 for tobacco and air pollution, respectively, in 2019. For tobacco-associated ASMR, China and Indonesia have shown an increase, while China, India, Pakistan, and Nigeria have shown an increase for Air pollution-associated ASMR. On evaluating proportional ASMR, tobacco and air pollution have overall shown a reduction, indicating an increase in other or non-risk factor-related mortality. Conclusion: The fluctuating trends in tobacco-associated and the concerning rise in air pollution-associated in specific countries underscore the complex interplay of societal and environmental factors in LC mortality. The decline in ASMR associated with established risk factors emphasizes the necessity for focused interventions to tackle the changing molecular characteristics of lung cancer and its associated risk factors. Comparison of risk factor-associated Lung Cancer ASMR (1990 vs 2019) Country(ASMR per 100,000 population) 1990 overall ASMR (N) 1990 Tobacco associated ASMR N (%) 1990 Air Pollution Associated N (%) 2019 overall ASMR(N) 2019 Tobacco associated ASMR N (%) 2019 Air Pollution Associated ASMR N (%) Global 27.3 19.8 (72) 5.6 (20) 25.2 16.7 (66) 4.8 (19) India 7.0 4.2 (60) 2.5 (35) 8.1 4.0 (50) 2.6 (33) China 31.2 20.2 (65) 10.3 (33) 38.7 26.3 (68) 10.7 (28) US 49.4 40 (81) 4.5 (9) 36.1 26.1 (72) 1.5 (4) Indonesia 18.0 10.6 (59) 5.4 (30) 24.4 14.7 (60) 4.6 (19) Pakistan 14.7 10.9 (74) 5.4 (36) 17.2 10.7 (63) 5.5 (32) Nigeria 6.8 2 (29) 2.6 (38) 8.3 1.9 (23) 2.7 (32) Brazil 18.0 13.9 (77) 3.2 (18) 15.8 9.7 (61) 1.5 (10) Bangladesh 9.7 6.9 (71) 3.6 (37) 7.8 4.7 (59) 2.6 (33) Russia 32.4 23.2 (72) 4.4 (13) 22.8 16.6 (73) 1.8 (8) Mexico 15.1 9.6 (63) 3.4 (22) 9.7 4.4 (45) 1.5 (16) Citation Format: Chinmay T. Jani, Samuel A. Kareff, Harpreet Singh, Ana Salazar Zetina, Gilberto Lopes. Disparities unveiled: A comprehensive analysis of evolving trends in lung cancer risk factors in the ten most populous countries [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 803.
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Sikder, Md Aminul Islam, Kazi Khairul Alam e Md Humayun Kabir Talukder. "Dietary habits and body weight status of Undergraduate Medical Students of Bangladesh and their Influence on Academic Performance". Bangladesh Journal of Medical Education 10, n. 2 (25 dicembre 2019): 6–11. http://dx.doi.org/10.3329/bjme.v10i2.44636.
Abstract (sommario):
This cross sectional descriptive study was conducted to explore the dietary habits and body weight status of undergraduate medical students of Bangladesh and their influence on academic performance. The study period was from July 2017 to June 2018. The sample size was 907. Medical colleges were selected purposively and convenience sampling technique was adopted for data collection. The study was carried out among the students of 3rd and 4th phase MBBS course of five public and three non-government medical colleges of Dhaka and outside Dhaka. Academic performance was determined by the results of professional examinations and class attendance. A self-administered structured questionnaire was used. Among the respondents medical students 330 (36.5%) were males and 575 (63.5%) were females. Descriptive statistics were used to identify the dietary practices of the students. Chi squared test and unpaired t test were done to examine the influence of diets and BMI on academic performance. The study revealed that 535 (59.9%) students took three main meals regularly. Breakfast was the commonest meal skipped among 230 (24%) students altogether. Among the respondents students, 652 (73.2%) took first class proteins daily, 398 (44.8%) vegetables daily and only 85 ((9.6%) students took fruits daily. 661 (74.4%) of the students belonged to healthy BMI group and 73 (8.2%) students were underweight, 12 (1.4%) students were obese and 3 (0.3%) were morbidly obese. Gender wise there was no significant difference of BMI. The study further revealed that students who took first class protein daily had better performance in the professional examinations. Skipping of breakfast and consumption of vegetable and fruits did not affect students' academic performance. The students with healthy BMI had higher percentage in class attendance than the overweight students. The study recommended that steps to be taken to implement healthy dietary practices among the medical students for positive influence on academic performance.
Bangladesh Journal of Medical Education Vol.10(2) 2019: 6-11
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Powles, Thomas, Syed A. Hussain, Andrew Protheroe, Alison Birtle, Prabir R. Chakraborti, Robert Huddart, Satinder Jagdev et al. "PLUTO: A randomised phase II study of pazopanib versus paclitaxel in relapsed urothelial tumours." Journal of Clinical Oncology 34, n. 2_suppl (10 gennaio 2016): 430. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.430.
Abstract (sommario):
430 Background: Two previous single arm trials have drawn conflicting conclusions regarding pazopanib in urothelial bladder cancers (UBC) after failure of platinum-based chemotherapy. PLUTO is a randomized phase II trial to compare the efficacy of pazopanib with paclitaxel in this setting. Methods: It was planned for 140 patients with progressive, advanced UBC (with at least a component of transitional cell carcinoma) who had previously received a single prior platinum containing chemotherapy regimen for advanced UBC to be randomised(1:1). Patients in arm A received weekly paclitaxel 80mg/m2 and those in arm B received pazopanib (800mg once daily) until progression. The primary endpoint was overall survival analysis of which would occur after 110 events. The efficacy was assessed by an independent data monitoring committee during the trial. Results: Between Aug 2012- Oct 2014, 131 patients were randomised. 74.0% of patients had visceral metastases. The study was terminated early by the IDMC due to futility of pazopanib. Final analysis after 110 deaths occurred in July 2015. The median number of cycles of paclitaxel received was 4 (12 weeks). The median time on pazopanib was 11 weeks. Median overall survival was 8.0 months for paclitaxel [80% confidence interval (CI) 6.9 to 9.7 months] and 4.7 months for pazopanib [80% CI 4.2 to 6.4 months]. The hazard ratio (HR) adjusted for baseline stratification factors was 1.25 [80% CI 0.96 to 1.63; 1-sided p = 0.86] in favour of paclitaxel. Median progression free survival was 3.2 months for paclitaxel [80% CI 2.9 to 5.0 months] and 3.1 months for pazopanib [80% CI 2.7 to 3.8 months]. The adjusted HR for PFS was 1.06 [80% CI 0.83 to 1.36; 1-sided p = 0.62] (in favour of paclitaxel). Discontinuations for toxicity occurred in 6.3% and 20.0% for paclitaxel and pazopanib respectively. VHL, HIF1alpha, VEGFR2 and PD-L1 expression were measured from archived tissue and correlated with outcome. Conclusions: Pazopanib does not have greater efficacy than paclitaxel in the second line treatment of UBC. There is a trend towards superior OS with paclitaxel. Clinical trial information: NCT00949455.
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Smith, Denis Michel, Antonio Sa Cunha, Magali Rouyer, Pernelle Noize, Jeremy Jove, Emmanuelle Bignon, Alise Le Monies, Emmanuel Mitry, Eric Francois e Annie Fourrier-Réglat. "Surgical resection of liver metastases and survival outcomes in real-life for metastatic colorectal cancer (mCRC) patients treated in front-line with cetuximab (CTX): The EREBUS cohort." Journal of Clinical Oncology 31, n. 15_suppl (20 maggio 2013): e14514-e14514. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e14514.
Abstract (sommario):
e14514 Background: CTX has demonstrated improved survival outcomes and resection rate in unresectable mCRC patients (pts) but little data is available from real-life use. Methods: EREBUS is a French multicentre (n=65) cohort that included pts with unresectable mCRC and wt KRAS initiating 1st-line CTX in 2009 and 2010, and followed 12 months. An expert committee validated baseline resectability and resection results. Resection rates and survival outcomes were described according to metastases site: liver-only, liver-not exclusively, other. Results: 389 pts were included: 37.8% liver-only metastases, 38.3% liver-not exclusively, 23.9% other. Baseline characteristics of the cohort: median age 64 yrs, 67.4% male, 77.9% ECOG=0-1, 55.5% primary tumor resection, 53% single metastatic site. Combined chemotherapy regimen were with irinotecan (56.6%) or oxaliplatin (38.2%). Median duration of CTX use was 4.8 months. 97 pts (24.9%, 95%CI: 20.6-29.2) had metastases resection; rates for liver-only: 36.7% (28.9-44.5), liver-not exclusively: 20.8% (14.3-27.3), other: 12.9% (6.9-21.5). Among them, 51.5% had radical resection with R0+/-radiofrequency (liver-only: 61.1% and liver-not exclusively: 32.3%), 11.3% R1+/-radiofrequency (liver-only: 16.7% and liver-not exclusively: 3.2%) and 9.4% missing metastases, 27.3%R2. 52.6% had post-operative complications (20.6% infection, 8.2% thromboembolic event, 8.2% other cardiovascular event, 3.1% death). Median PFS for the cohort was 9.7 months (8.6-10.5). In multivariate Cox analysis progression was independently associated with metastases site, liver-only: HR=1.93 (1.36-2.74), liver-not exclusively: HR=1.46 (1.06-2.02). The 1-yr OS probability was 71.3% (66.4-75.6) without any site difference. In Cox analysis, death was less likely in responders with or without metastases surgery: HR=0.26 (0.08-0.90) and HR=0.37 (0.21-0.63). Conclusions: This cohort shows that 1st-line CTX in wt KRAS mCRC allows a high proportion of metastases resection, particularly in liver-only. It also provides data on rarely studied mCRC pts (liver-not exclusively and other metastases).