Literatura científica selecionada sobre o tema "155.4/18"

Pregnancy-associated cancer—that is diagnosed in pregnancy or within 365 days after delivery—is increasingly common as cancer therapy evolves and survivorship increases. This study assessed the incidence and temporal trends of pregnancy-associated cancer in Alberta and Ontario—together accounting for 50% of Canada’s entire population. Linked data from the two provincial cancer registries and health administrative data were used to ascertain new diagnoses of cancer, livebirths, stillbirths and induced abortions among women aged 18–50 years, from 2003 to 2015. The annual crude incidence rate (IR) was calculated as the number of women with a pregnancy-associated cancer per 100,000 deliveries. A nonparametric test for trend assessed for any temporal trends. In Alberta, the crude IR of pregnancy-associated cancer was 156.2 per 100,000 deliveries (95% CI 145.8–166.7), and in Ontario, the IR was 149.4 per 100,000 deliveries (95% CI 143.3–155.4). While no statistically significant temporal trend in the IR of pregnancy-associated cancer was seen in Alberta, there was a rise in Ontario (p = 0.01). Pregnancy-associated cancer is common enough to warrant more detailed research on maternal, pregnancy and child outcomes, especially as cancer therapies continue to evolve.

Accumulating data suggest that various neurologic manifestations are reported in critically-ill COVID-19 patients. Although low testosterone levels were associated with poor outcomes, the relationship between testosterone levels and indices of brain injury are still poorly understood. Therefore, we aimed to explore whether testosterone levels are associated with glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), biomarkers of brain injury, in patients with a severe form of COVID-19. The present study was conducted on 65 male patients aged 18–65 with severe COVID-19. Blood samples were collected at three time points: upon admission to ICU, 7 days after, and 14 days after. In patients with neurological sequels (n = 20), UCH-L1 serum concentrations at admission were markedly higher than in patients without them (240.0 (155.4–366.4) vs. 146.4 (92.5–243.9) pg/mL, p = 0.022). GFAP concentrations on admission did not differ between the groups (32.2 (24.2–40.1) vs. 29.8 (21.8–39.4) pg/mL, p = 0.372). Unlike GFAP, UCH-L1 serum concentrations exhibited a negative correlation with serum testosterone in all three time points (r = −0.452, p < 0.001; r = −0.430, p < 0.001 and r = −0.476, p = 0.001, respectively). The present study suggests that the traumatic brain injury biomarker UCH-L1 may be associated with neurological impairments seen in severe COVID-19. Moreover, a negative correlation between UCH-L1 and serum testosterone concentrations implies that testosterone may have a role in the development of neurological sequels in critically-ill COVID-19 patients.

Objective. The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) demonstrate good diagnostic accuracy in distinguishing lung cancer patients from healthy individuals, primarily in HIV-negative populations. We determined the sensitivity (Se), specificity (Sp), and area under the curve (AUC) of the NLR and PLR in discriminating between people living with HIV (PLWH) with and without lung cancer. Methods. This is a comparative analysis of secondary data. Cases were PLWH with lung cancer from a retrospective cohort treated at the Uganda Cancer Institute. Controls were unmatched PLWH without lung cancer who were randomly selected from three HIV clinics in Uganda. Se, Sp, and AUC analysis and determination of optimal cutoffs were performed using receiver operating characteristic (ROC) curves. Results. Of 115 PLWH (18 cases and 97 controls), 83 (72.2%) were female, 110 (95.7) were on ART, and the median (IQR) age was 46 (38–51) years. The median (IQR) NLR was higher among cases than controls (3.53 (3.14–7.71) vs. 0.92 (0.67–1.09), p <0.001). Similarly, the PLR was higher among cases than controls (237.5 (177.8–361.6) vs. 123.6 (100.6–155.4), p=0.001). At a cutoff of 2.44, the respective Se, Sp, and AUC of the NLR were 87.5% (95% CI: 61.7%–98.4%), 100% (95% CI: 96.2%–100%), and 0.94 (95% CI: 0.85–1.00, p <0.001). Similarly, the respective Se, Sp, and AUC for the PLR were 75% (95% CI: 47.6%–92.7%), 87.2% (95% CI: 78.8%–93.2%), and 0.81 (95% CI: 0.70–0.93, p <0.001) at a cutoff of 196.3. Conclusion. The NLR and PLR discriminated PLWH with and without lung cancer and could be useful in PLWH with respiratory symptoms in whom lung cancer can easily be misdiagnosed as other lung pathology.

Abstract Introduction: Therapy related myelodysplastic syndrome (t-MDS) and acute myeloid leukemia (t-AML) are significant long-term complications of MM treatment. We have treated pts on standard therapy protocols including TT2, TT3, TT4 and TT5. These protocols include an induction, tandem melphalan-based ASCT and consolidation, followed by three years of maintenance. As a part of the protocols, multiple bone marrow examinations including metaphase cytogenetics are performed at regular intervals, giving us the unique opportunity to examine the development of t-MDS/t-AML and understand the efficacy of subsequent treatment. Here we investigate the outcome of t-AML and t-MDS treated with autologous stem cell transplantation (ASCT) in MM patients. Materials and Methods, Results: During the period between 1998 to 2015, a total of 1558 pts were treated for MM with standard therapy protocols. We identified 68 pts out of 1558 who developed t-AML + t-MDS. Thirty-one had a confirmed diagnosis of t-AML, and thirty-seven had a diagnosis of t-MDS. The median age at diagnosis was 60 years (range 45-76). The median time from diagnosis MM of t-AML and t-MDS was 66 months (range, 9.6-155.4) and 63 months (range, 8-130), respectively. Baseline cytogenetics were as follows: complex cytogenetics in 34 pts out of 68, del(7) in 24 pts, del(5) in 17 pts, and del(17p) in 5 pts. Eighteen out of thirty-one t-AML pts were treated with ASCT. The remaining 13 pts did not receive ASCT. The treatment related mortality (TRM) at day100 (D100) in the ASCT group was 33% (6/18 pts). Neutrophil and platelet engraftment was achieved in all 18 pts by D21. Complete remission was achieved in 50% (9 out of 18) of pts. When we compared pts who received ASCT to those who were treated with chemotherapy only, the median overall survival (OS) was 11.28 months after ASCT vs 1.32 months without ASCT (p < 0.05). Nineteen out of thirty seven t-MDS pts were treated with ASCT. When we compared pts who received ASCT to chemotherapy only for t-MDS, there was no difference in survival between the groups. A mortality rate of 47% (9/19) was recorded at D200 after transplantation due to severe infections and lack of engraftment. Conclusion: t-AML and t-MDS treatment is a significant therapeutic challenge for the elderly, who often have poor risk cytogenetic markers, significant comorbidities and a compromised performance status. In our case series of post MM therapy t-AML, ASCT prolonged survival. In contrast, there was no change in survival of t-MDS pts, most likely due to high rate of infectious complications seen in this group. To our knowledge, this is the first analysis suggesting a survival benefit from ASCT in treating t-AML. Although the numbers in our study are small, we recommend that ASCT can be safely considered for t-AML patients who are physically fit, have autologous stem cells in storage and are overseen by a good supportive care team. These results need to be validated in large prospective studies. Disclosures Atrash: University of Arkansas for Medical Sciences: Employment. Barlogie:Millennium: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; European School of Haematology- International Conference on Multiple Myeloma: Other: Travel Stipend; ComtecMed- World Congress on Controversies in Hematology: Other: Travel Stipend; International Workshop on Waldenström's Macroglobulinemia: Other: Travel Stipend; Dana Farber Cancer Institute: Other: Travel Stipend; Multiple Myeloma Research Foundation: Other: Travel Stipend; Myeloma Health, LLC: Patents & Royalties: Co-inventor of patents and patent applications related to use of GEP in cancer medicine licensed to Myeloma Health, LLC. Zangari:Onyx: Research Funding; Novartis: Research Funding; Millennium: Research Funding; University of Arkansas for Medical Sciences: Employment. van Rhee:University of Arkansa for Medical Sciences: Employment. Waheed:University of Arkansas for Medical Sciences: Employment. Bailey:University of Arkansas for Medical Sciences: Employment. Petty:University of Arkansas for Medical Sciences: Employment. Heuck:Celgene: Consultancy; Janssen: Other: Advisory Board; Millenium: Other: Advisory Board; Foundation Medicine: Honoraria; University of Arkansas for Medical Sciences: Employment. Morgan:Bristol Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; MMRF: Honoraria; Weismann Institute: Honoraria; CancerNet: Honoraria; University of Arkansas for Medical Sciences: Employment; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees. Jethava:University of Arkansas for Medical Sciences: Employment.

This study aims to determine the effect of the whole language approach to the ability to read and write in English in early stages of children aged 5-6 years in one of the kindergartens in the Yogyakarta Special Region. The population in this study were 43 children who were in the age range of 5-6 years in the kindergarten. Twenty-nine participants were included in the experimental class subjects as well as the control class with posttest only control group design. Observation is a way to record data in research on early reading and writing ability. The results of Multivariate Anal- ysis of Covariance (Manova) to the data shows that 1) there is a difference in ability between the application of the whole language approach and the conventional approach to the ability to read the beginning of English; 2) there is a difference in ability between applying a whole language approach and a conventional approach to writing English beginning skills; 3) there is a difference in ability between the whole language approach and the conventional approach to the ability to read and write the beginning in English Keywords: Whole language approach, Early reading, Early writing, Early childhood Reference Abdurrahman, M. (2003). Pendidikan bagi Anak Berkesulitan Belajar. Jakarta: Rineka Cipta. Aisyah, S., Yarmi, G., & Bintoro, T. (2018). Pendekatan Whole Language dalam Pengembangan Kemampuan Membaca Permulaan Siswa Sekolah Dasar. Prosiding Seminar Nasional Pendidikan, 160–163. Alhaddad, A. S. (2014). 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Clinical trials have shown that maintenance therapy for ovarian can­cer after response to platinum chemotherapy prolongs progression-free survival. We sought to examine the real-world use of various maintenance therapies for recurrent ovarian cancer. Methods. We conducted a retrospective cohort study of US patients ≥18 years old with recurrent ovarian cancer utilizing diagnoses from claims data. Patients were identified using a two-step algorithm and if they had ≥2 diagnoses ≥30 days apart between July 1, 2010, and December 31, 2019, a subsequent systemic chemotherapy, and a second-line maintenance thera­py with a poly (ADP-ribose) polymerase (PARP) inhibitor or bevacizumab. Prev­alence of use for all second-line maintenance therapies was calculated. Treat­ment duration, adherence to treatment, dose decreases, and the time without dose interruption or treatment discontinuation were analyzed between thera­py groups. Results. A total of 1,092 patients met the inclusion criteria. Among these, 446 (40.8%) subsequently received second-line maintenance treatment: 38 (8.5%) received rucaparib, 110 (24.7%) niraparib, 114 (25.6%) olaparib, and 184 (41.3%) bevacizumab. Average durations of maintenance treatment in days were as follows: olaparib, 187.6 (SD, 178.7); bevacizumab, 185.2 (SD, 149.2); ruca­parib, 147.2 (SD, 155.4); and niraparib, 124.2 (SD, 122.9). Treatment adherence was similar across all therapies (86%-88%). Dose decreases were numerically more common in the niraparib group (28.1%) than in the rucaparib (21.1%) or olapar­ib (20.2%) groups but were not statistically significant (both P > .10). Compared with rucaparib, niraparib was associated with a shorter time to dose interrup­tion or discontinuation (hazard ratio: 3.7; 95% confidence interval: 1.1%-12.6%; P = .03). Conclusions. In this cohort, less than half of patients with recurrent ovarian cancer received second-line maintenance therapy with a PARP inhibitor or bevacizumab. Adherence was similar in all PARP inhibitor regimens regardless of dosing schedule, with dose reductions and discontinuations varying between treatments. Niraparib was associated with the shortest time to dose interruption or discontinuation among the agents evaluated.

This thesis's aim was to examine the effect of vocal intonation on mental state understanding. This thesis has found that vocal intonation provides important cues for communicating the intentions of others' to infants. The results indicate that infants rely on intonation when making attributions about other people's goal-directed behaviour. These results were first found using an imitation paradigm and extended and confirmed with a looking time paradigm. The first two experimental chapters of this thesis have shown that the tone of voice is a salient cue to mental states. Infants did not only distinguish between intentional and accidental words such as "Whoops" and "There" but they also made the distinction between intentional and accidental mental states from the intonation alone. A looking time measure has also shown promising results for the same distinction between intentional and accidental mental states. The looking time study has confirmed and extended the findings that we saw through imitation. Infants seemed able to distinguish between an intentional and an accidental intonation and looked longer during scenes where the accidental intonation was paired with the end-result. These findings are the first to report results on the intonation of accidental and intentional mental states. The results of this thesis contribute to the literature concerning intention understanding and they extend our knowledge about intonation and the significant role it plays in infancy.