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Arnaut, Oleg, Ion Grabovschi, Serghei Sandru, Gheorghe Rojnoveanu, and Ruslan Baltaga. "Indirect lung injury predictive model in experimental trauma." Moldovan Medical Journal 64, no. 2 (May 2021): 21–25. http://dx.doi.org/10.52418/moldovan-med-j.64-2.21.04.
Повний текст джерелаАнотація:
Background: Trauma remains a medical-social problem, still having high lethality rate. Indirect lung injury (ILI) occurs in trauma due to systemic neutrophils activation and proteases release into primarily intact tissues. There are no data in the literature regarding ILI predictive models in trauma. Material and methods: In the experimental study (19 traumatized male rabbits), the proteases, antiproteases and the pulmonary morphological changes, assessed according to the SAMCRS score (Semiquantitative Reflected Qualitative Changes Assessment Scale) were followed. There were used two statistical instruments – correlational analysis and multivariate linear regression. Results: Initially, a correlational analysis between the values of the SAMCRS score and the proteases/ anti proteases was performed. The null hypothesis was rejected (F = 7.017, p = .002). The correlation coefficient of the predicted results and the real values of SAMCRSlungs was .854, the determination coefficient being .626. The final model included the following parameters: constant (B = 9.427; 95% CI 7.341, 11.513; p <.001); α2-macroglobulin0 (B = -4.053; 95% Cl -6.350, -1.757; p = .002); AEAMP0 (B = .002; 95% CI .000, .004; p = .075); AEAMP24 (B = -. 006; 95% CI -.010, -.002; p = .003); AECG2 (B = .081; 95% CI .040, .122; p = .001); AEE0 (B = -. 026; 95% CI -.040, -.011; p = .002). Conclusions: In this research, a predictive model for indirect lung injury in experimental trauma was developed, the predictors being some elements of the proteases/antiproteases system. This, in turn, allows the hypotheses emission regarding the pathophysiology, prophylaxis and treatment of ILI.
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Rumalla, Kavelin, Chester K. Yarbrough, Andrew J. Pugely, and Ian G. Dorward. "Spinal Fusion for Pediatric Spondylolisthesis: National Trends, Complications, and Short-Term Outcomes." Neurosurgery 82, no. 5 (July 7, 2017): 701–9. http://dx.doi.org/10.1093/neuros/nyx295.
Повний текст джерелаАнотація:
AbstractBACKGROUNDCurrent surgical management guidelines for pediatric spondylolisthesis (PS) are reliant on data from single-center cohorts.OBJECTIVETo analyze national trends and predictors of short-term outcomes in spinal fusion surgery for PS by performing a retrospective cross-sectional analysis of the Kids’ Inpatient Database (KID).METHODSThe KID (sampled every 3 yr) was queried from 2003 to 2012 to identify all cases (age 5-17) of spinal fusion for PS (n = 2646). We analyzed trends in patient characteristics, surgical management, and short-term outcomes. Both univariate and multivariable analyses were utilized.RESULTSThe 2646 spinal fusions for PS included posterior-only fusions (86.8%, PSF), anterior lumbar interbody fusions (4.8%, ALIF), and combined anterior and posterior fusions (8.4%, APLF) procedures. The utilization of APLF decreased over time (9.9%-6.4%, P = .023), whereas the number of total spinal fusions and the proportion of PSF and ALIF procedures have not changed significantly. Uptrends in Medicaid insured individuals (1.2%-18.9%), recombinant human bone morphogenetic protein-2 insertion (8.8%-16.6%), decompression (34.7%-42.8%), and mean inflation-adjusted hospital costs ($21 855-$32 085) were identified (all P < .001). In multivariable analysis, Medicaid status (odds ratio [OR] = 1.93, P = .004), teaching hospitals (OR = 1.94, P = .01), decompression (OR = 1.78, P = .004), and the APLF procedure (OR = 2.47, P = .001) increased the likelihood of complication occurrence (all P < .001).CONCLUSIONThe addition of decompression during fusion and the APLF procedure were associated with more in-hospital complications, though this may have been indicative of greater surgical complexity. The utilization of the APLF procedure has decreased significantly, while costs associated with the treatment of PS have increased over time.
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Marcucci, Guido, K. Mrózek, A. S. Ruppert, K. Maharry, J. E. Kolitz, R. J. Mayer, M. J. Pettenati, et al. "t(8;21) Acute Myeloid Leukemia (AML) Differs from inv(16) AML in Pretreatment Characteristics, Outcome and Prognostic Factors Predicting Outcome: A Cancer and Leukemia Group B (CALGB) Study." Blood 104, no. 11 (November 16, 2004): 2017. http://dx.doi.org/10.1182/blood.v104.11.2017.2017.
Повний текст джерелаАнотація:
Abstract Since t(8;21) and inv(16) disrupt core binding factor in AML and confer a favorable prognosis, these cytogenetic groups are often treated similarly, but hitherto have not been compared in a large study. We compared 144 adult AML patients (pts) with t(8;21) with 168 with inv(16) enrolled on the cytogenetic study CALGB 8461. t(8;21) pts were less frequently white (P=.01), had lower hemoglobin levels (P=.03), WBC (P<.001) and % blood (P<.001) and BM blasts (P=.005), and had more frequently secondary chromosome aberrations (P<.001) than inv(16) pts, who more often had extramedullary disease (P<.001). Pts were induced with cytarabine/daunorubicin (AD) or cytarabine/daunorubicin/etoposide ±PSC833(ADE±P). Complete remission (CR) was achieved by 89% of t(8;21) and 87% of inv(16) pts. Upon multivariable analysis (MVA), non-white race (P=.006), lower platelets (P=.01) and higher BM blasts (P=.004) predicted negatively for CR in t(8;21), and lower platelets (P=.009) and hepatomegaly (P=.04) in inv(16) pts. Non-whites with t(8;21) had 5.7 times the odds of not achieving CR as whites. For the entire group (median follow-up 6.4 yrs), the estimated 5-yr overall survival (OS) and cumulative incidence of relapse (CIR) were 51% and 53%, respectively. Pts with t(8;21) showed a trend for shorter OS (46% vs 54%; P=.17) but no difference in CIR compared with inv(16) pts. Upon MVA, t(8;21) pts had worse OS than inv(16) pts (HR 1.5; P=.04), once adjusting for age, platelets, and WBC. Following first relapse, the 5-yr survival of t(8;21) pts (n=58) was shorter than that of inv(16) pts (n=74) (14% vs 36%; P=.01); in an age-adjusted model, the risk of death was 1.8 times higher for t(8;21) pts (P=.005). In a subanalysis of pts <60 yrs, consolidation therapy with multi-course high-dose cytarabine (HDAC x3 or 4) significantly decreased CIR compared to single-course HDAC (x1) in t(8;21) (5-yr CIR, 35% vs 64%; P=.005) and inv(16) (5-yr CIR, 44% vs 70%; P =.03) pts. Upon MVA, consolidation with multi-course HDAC reduced CIR for both t(8;21) and inv(16), but other prognostic factors differed (see Table). For t(8;21), induction with ADE±P and higher platelets increased risk of relapse. However, relatively few pts received ADE±P so its prognostic impact requires confirmation. For inv(16), +22 and other secondary cytogenetic aberrations, and male sex were favorable prognostic factors. Multivariable analysis (MVA) for CIR in pts <60 yrs achieving CR on CALGB 8221, 8525, 9022, 9222, 9621 Variable t(8;21) HR (95% CI); P inv(16) HR (95% CI); P HR=Hazard Ratio, CI=confidence intervals —, not included in final model Consolidation:Single vs multi-course HDAC 4.5 (2.1-9.4); <.001 3.4 (1.7-6.6); <.001 Induction:ADE±P vs AD 2.6 (1.1-5.9); .02 1.4 (0.6-3.2); .41 log(platelets) 1.8 (1.2-2.9); .007 — Secondary cytogenetics — 0.2 (<0.1-0.5); .002 Male vs Female — 0.5 (0.3-0.9); .03 In summary, once pretreatment factors and therapy are considered, the outcome of t(8;21) AML appears inferior to that of inv(16). Although these data should be confirmed prospectively, our analysis suggests that future studies should report the outcomes of pts with t(8;21) and inv(16) separately, and seek to identify and target therapeutically leukemogenic mechanisms accountable for these clinical differences.
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Lim, Sung-Nam, Je-Hwan Lee, Jung-Hee Lee, Dae-Young Kim, Se-Hyung Kim, Young-Shin Lee, Young-A. Kang, et al. "Pre-Transplant Comorbidity as An Outcome Predictor in Hematopoietic Cell Transplantation for Severe Aplastic Anemia." Blood 112, no. 11 (November 16, 2008): 4295. http://dx.doi.org/10.1182/blood.v112.11.4295.4295.
Повний текст джерелаАнотація:
Abstract A new hematopoietic cell transplantation specific comorbidity index (HCT-CI), which was modeled to effectively capture comorbidity and predict post-transplant outcomes, has been evaluated in a cohort of patients with a variety of hematologic disorders. In this study, we applied the HCT-CI to 77 patients with severe aplastic anemia who underwent HCT at the Asan Medical Center, Seoul, Korea between February 1995 and September 2007. Pre-transplant HCT-CI score was calculated in each patient using the clinico-pathologic data, which were retrieved from Asan Medical Center Bone Marrow Transplantation Registry Database. HCT-CI score was 0 in 54 patients (70%), 1 in 16 (21%), 2 in four (5%), and 4 in one (1%). The most prevalent comorbidity captured by the HCT-CI was infection (n=11) followed by arrhythmia (n=6). During a median follow-up period of 54.4 months (range, 4.0 to 159.0 months), 19 patients died and 16 experienced primary or secondary graft failure. The 5-year probabilities of overall survival (OS) and event-free survival (EFS) were 73.4% and 63.3%, respectively. OS and EFS were significantly different according to HCT-CI score; OS 86.6% and EFS 74.3% in patients with score 0 versus 43.5% and 38.5% in those with score 1 or more (P<0.001 for OS and P=0.001 for EFS). Other significant prognostic factors for OS were age (<30 years vs. ≥30, 90.8% vs. 58.3%, P=.002), pre-transplant transfusion amount (<50 units vs. ≥50, 93.0% vs. 61.0%; P=.005) and time from diagnosis to HCT (<120 days vs. ≥120, 85.2% vs. 61.4%; P=.013), and prognostic factors for EFS were age (<30 years vs. ≥30, 81.0% vs. 48.4%, P=.003) and time from diagnosis to HCT (<120 days vs. ≥120, 77.4% vs. 48.3%; P=.007). Multivariate analysis after adjustment for other variables demonstrated that HCT-CI score (HR 10.022, P<.001 for OS; HR 4.644, P<.001 for EFS), age (HR 8.447, P=.002 for OS; HR 4.060, P=.003 for EFS), time from diagnosis to HCT (HR 5.783, P=.002 for OS; HR 3.956, P=.002 for EFS) were independently significant prognostic factors for both OS and EFS. In conclusion, our data indicate that the presence of pre-transplant comorbidity assessed by HCT-CI may predict worse outcomes after HCT in severe aplastic anemia.
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Kim, S., J. Nam, S. Park, D. Bae, C. Park, C. Cho, J. Lee, and Y. Yun. "Study of anxiety and depression in cervical cancer survivors." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e20644-e20644. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e20644.
Повний текст джерелаАнотація:
e20644 Background: Cervical cancer is the second leading cause of cancer related deaths among women in Korea. However, few studies have been conducted to elucidate the psychological distress of this population. This study aimed to examine the prevalence of anxiety and depression among cervical cancer survivors, and to identify factors associated with such caseness. Methods: A total of 832 cervical cancer survivors recruited from six large hospitals in Korea completed a mailed survey, which included the Hospital Anxiety and Depression Scale (HADS), European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, and QLQ-CX24. Anxiety and depression were defined by a score of ≥ 8 on the HADS subscales. With a framework that included socio-demographic, clinical, and symptom characteristics, multivariate logistic regression models were used to identify factors associated with anxiety and depression. Results: Among cervical cancer survivors, 34.3% reported HADS-defined anxiety and 39.7% reported HADS-defined depression. Anxiety was associated with having a lower income (OR=1.95, p=.021), smoking (OR=2.42, p=.002), poor body image (OR=3.26, p<.001), peripheral neuropathy (OR=2.21, p=.002), menopausal symptoms (OR=2.02, p=.004), and sexual inactivity (OR=2.35, p=.001). Depression was associated with younger age (OR=1.75, p=.006), having a lower income (OR=2.14 p<.001), drinking (OR=1.56, p=.050), poor body image (OR=4.59, p<.001), peripheral neuropathy (OR=2.34, p<.001), and sexual inactivity (OR=2.68, p=.002). Both anxiety and depression were influenced by socio-demographic factors, health behaviors, and cervical cancer-specific symptom characteristics rather than cancer- or treatment-related factors. Conclusions: Anxiety and depression were highly prevalent among cervical cancer survivors in Korea. This examination of risk factors for anxiety and depression will be helpful for the development of clinical management strategies in cervical cancer survivors. No significant financial relationships to disclose.
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Bener, Abdulbari, Yaşar Özdenkaya, Cem Cahit Barışık, and Mustafa Öztürk. "The Impact of Metabolic Syndrome on Increased Risk of Thyroid Nodules and Size." Health Services Research and Managerial Epidemiology 5 (January 1, 2018): 233339281877551. http://dx.doi.org/10.1177/2333392818775517.
Повний текст джерелаАнотація:
Aim: The present research aimed to determine the relation between metabolic syndrome (MetS) and thyroid volume and nodule prevalence among Turkish population patients. Methods: This retrospective cohort study was carried on 850 patients between the ages of 20 and 65 who visited the diabetic, endocrinology, and general surgery outpatient clinics in the Mega Medipol and Medipol Hospital between January 2014 and December 2017. This study included sociodemographic information, body mass index (BMI), diabetes mellitus (DM), systolic (SBP) and diastolic (DBP) blood pressures, and clinical biochemistry results such as serum triglyceride, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL) cholesterol, hemoglobin A1c (HbA1c), fasting blood glucose levels, thyroid-stimulating hormone (TSH), T3, T4, and other MetS parameters. Thyroid fine needle aspiration biopsy was suggested to patients whose thyroid nodules were greater than 1.00 cm. The definition and diagnostic of MetS used as proposed by the National Cholesterol Education Program—Third Adult Treatment Panel. Results: There were statistically significant differences between patients with thyroid nodules and those without regarding age, gender, BMI, physical activity, cigarette smoking, shisha smoking, family history of diabetes, hypertension, and thyroid. Meanwhile, statistically significant differences were found between with and without MetS for calcium ( P = .028), magnesium ( P < .001), potassium ( P < .001), fasting blood glucose ( P = .047), HbA1c ( P < .001), HDL ( P < .001), LDL ( P < .001), albumin ( P = .008), bilirubin ( P = .002), triglyceride ( P = .011), SBP ( P = .001) and DBP ( P = .011), TSH ( P = .005), T3 ( P < .001), and T4 ( P < .001). Furthermore, there were statistically significant differences between participants with and without thyroid nodules for calcium ( P < .001), magnesium ( P < .001), potassium ( P < .001), fasting blood glucose ( P = .010), HbA1c ( P = .019), HDL ( P < .001), LDL ( P = .012), albumin ( P = .002), bilirubin ( P < .001), triglyceride ( P < .001), SBP ( P < .001) and DBP ( P = .004), TSH ( P = .015), T3 ( P < .001), and T4 ( P < .001). Multivariate stepwise logistic regression analysis used for independent predictors for the presence of thyroid nodules which TSH ( P < .001), family history of thyroid and DM ( P < .001), age in years ( P = .025), DBP and SBP ( P < .001), BMI ( P = .014), HDL-C ( P = .034), and waist circumference (in cm; P = .044) were considered at higher risk as a predictors of thyroid with patients with MetS. Conclusion: The results of the current study confirm a strong positive association between MetS and thyroid nodules risk among patients with MetS. This study suggest that the patients with MetS can be considered as a marker to have moderately increased risk of future thyroid nodules and cancer. Meanwhile, MetS, obesity, and hyperglycemia could be a qualifiable and modifiable risk factor for thyroid nodules. The regularly glycemic control may be the most important treatment for the reduction of incidence or the prevention of thyroid.
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Heisel Kurth, Margaret A., Beverly Christie, Vicky Hanneman, Joni Osip, Kristen Appert, Christopher L. Moertel, Jan Watterson, and Maha Hag-Alshiekh. "Immune Tolerance Utilizing Intermediate Purity Factor VIII Concentrate in Hemophilia A Patients with High Factor VIII Titers." Blood 104, no. 11 (November 16, 2004): 3099. http://dx.doi.org/10.1182/blood.v104.11.3099.3099.
Повний текст джерелаАнотація:
Abstract Immune tolerance therapy (ITT) is a treatment that is used to eliminate factor VIII inhibitors associated with hemophilia A. However, standard ITT is not successful in approximately 20% of patients. In those who do not attain tolerance, the length of treatment with resultant cost of factor concentrate and family stress are major concerns. Utilization of intermediate purity products (IPP) has been suggested as a means to increase the success rate of ITT, shorten the duration of ITT, and decrease the quantity of factor concentrate used. We retrospectively analyzed outcomes for 8 patients who received IPP as part of an ITT regimen from 1993–2004. Four patients were switched from recombinant/monoclonal factor VIII to IPP during ITT because of poor response to initial therapy (Table 1). Four others were started on IPP at the initiation of ITT because they had already failed ITT or past history indicated a likelihood of failing standard ITT (Table 2). Tolerance was defined as having a Bethesda titer of <1 BU/ml, > 66% recovery of factor VIII, and/or a half-life of 6 hours or greater. In the first group, all four patients attained tolerance. In these patients the switch to IPP resulted in a faster drop in inhibitor titer than had been previously achieved. In the second group, one patient attained tolerance rapidly; one achieved partial tolerance and uses prophylactic IPP. A third patient is currently undergoing ITT and is responding well. The fourth patient has failed to achieve tolerance. These four patients had adverse risk factors that made them poor candidates for conventional ITT. Of the 6 patients who have achieved partial or complete tolerance, 4 have been switched back to recombinant factor VIII and have maintained tolerance. However, two patients have been maintained on IPP because attempts to switch to recombinant factor VIII resulted in a rise in their inhibitor titers. If tolerance can be achieved with IPP it can result in major cost savings for these patients. At our institution the cost of IPP is about 50–66% of the cost of recombinant factor VIII. These data are presented as further evidence that choice of factor may influence ITT success and that a subset of patients may benefit from an IPP regimen for ITT. Table 1: Recombinant/Monoclonal Use; Patients Switched to IPP ID Age at Inhibitor Dx (yrs) Peak Inhibitor (BU) Age at Start of ITT (yrs) Inhibitor at ITT Start (BU) Age at Switch to IPP (yrs) Reason for Switch Time to Tolerization 001 6.8 34 9.8 2 10.0 Poor response to ITT 12 months 002 8.2 100 11.8 1 12.1 Poor response to ITT by brother (001) 6 months 005 5.2 124 6.3 9 6.5–7.0 /8.2-present Poor response to initial therapy / inability to sustain tolerization 36 months 007 3.9 270 3.9 13 4.1 Poor response to ITT and bleeding complications 16 months Table 2: Patients Started on IPP Initially ID Age at Inhibitor Dx (yrs) Peak Inhibitor (BU) Age at Start of ITT (yrs) Inhibitor at ITT Start (BU) Time to Partial Tolerization Time to Tolerization 003 4.0 4833 21.4 6 Did not achieve NA 004 1.2 1000 12.4 10–20 29 months NA 006 1.3 600 12.4 0–1 6 months 8 months 008 0.8 277 5.8 1.1 6 months NA
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Supriyono, Supriyono, and Titiek Yulianti. "Tingkat Ketahanan 70 aksesi Plasma Nutfah Kenaf terhadap Fusarium oxysporum Schletch; Assessment of Kenaf Germplasm Against Fusarium oxysporum Schletch." Buletin Tanaman Tembakau, Serat & Minyak Industri 8, no. 2 (January 9, 2017): 65. http://dx.doi.org/10.21082/btsm.v8n2.2016.65-73.
Повний текст джерелаАнотація:
<p>Salah satu penyakit penting yang sangat merugikan tanaman kenaf adalah penyakit layu Fusarium yang disebabkan oleh <em>Fusarium oxysporum</em> Schlecht. Tujuan penelitian ini adalah untuk mengevaluasi tingkat ketahanan aksesi kenaf terhadap jamur <em>Fusarium oxysporum</em>. Penelitian dilakukan di laboratorium dan rumah kasa Balai Penelitian Tanaman Pemanis dan Serat, Malang menggunakan rancangan acak lengkap) yang diulang tiga kali. Dalam evaluasi ini digunakan 70 aksesi dan 1 aksesi tahan (BG-52-135) yang digunakan sebagai kontrol. Inokulasi dilakukan pada 7 hari setelah tanam (HST) menggunakan suspensi spora dengan kerapatan10<sup>5</sup>/ml sebanyak 100 ml setiap bak. Pengamatan intensitas serangan dilakukan mulai 10–40 hari setelah inokulasi (HSI) dengan interval pengamatan lima hari. Pengamatan persentase diskolorisasi batang dilakukan sekali pada 50 HSI. Hasil pengujian memperoleh 1 aksesi (FJ/017) sangat tahan dengan intensitas serangan terrendah (0,83%) dan 14 aksesi tahan dengan intensitas serangan <span style="text-decoration: underline;"><</span>10%, 28 aksesi dengan ketahanan moderat, dan 27 aksesi yang rentan terhadap infeksi <em>F. oxysporum</em>. Aksesisi FJ/017 (aksesi yang sangat tahan) dan 14 aksesi yang tahan: 1064(SUC/012), 1061(SRB/082), 1035(FJ/005), 839(PARC/2709), 955(FJ/003), 842(PARC/2712), 1095(SUC/003), 838(PARC/2708), 957(FJ/ 007), 1065(SUC/023), 1042(CHN/056), 145(BL/118), 1036(FJ/006), dan 778(PARC/2466) dapat digunakan sebagai sumber ketahanan pada perakitan varietas baru.</p><p> </p><p>One of the important disease that very detrimental to kenaf is Fusarium wilt caused by <em>Fusarium oxysporum</em> Schlecht. The purpose of this study was to evaluate the response of 70 kenaf germplasm<span style="text-decoration: line-through;">s</span> accessions against <em>F</em><em>.</em><em> oxysporum</em>. The study was conducted at the Phytopatology Laboratory and screen house of Indonesian Sweetener and Fiber Crops Research Institute, Malang using completely randomized design with three replicates. Seventy accessions and one resistant accession as control (1267 (BG-52-135) were used in this study. Inoculation of <em>Fusarium</em> was done 7 days after sowing (das) by sprinkling 100 ml of spore suspension into the soil. Observation of disease intensity started at 10–40 days after inoculation (dai) and repeated every five days. Percentage of stalk discolorization was estimated at 50 dai. The results showed that accession 1040 (FJ/017) had the lowest disease intensity (0.83%), hence was categorized as a highly resitant accession. Fourteen accessions were categorized as resistant with disease intensity below or equal to 10%; 28 accessions were moderate resistant; and 27 accessions were susceptible. FJ/017 (the highset resistant accession) and 14 resis-tant accessions (1064(SUC/012), 1061(SRB/082), 1035(FJ/005), 839(PARC/2709), 955(FJ/003), 842(PARC/ 2712), 1095(SUC/003), 838PARC/2708), 957(FJ/007), 1065(SUC/023), 1042(CHN/056), 145(BL/118), 1036 (FJ/006), dan 778(PARC/2466)) could be used as resistant genetic sources in developing new varieties.</p>
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O’Doherty, J. V., and U. Keady. "The effect of expander processing and extrusion on the nutritive value of peas for pigs." Animal Science 72, no. 1 (February 2001): 43–53. http://dx.doi.org/10.1017/s1357729800055545.
Повний текст джерелаАнотація:
AbstractTwo experiments were conducted to investigate the effect of expander processing of food for growing and finishing pigs. Experiment 1 examined the effects of expander processing on the nutritive value of a cereal-based diet and a pea-based diet for pigs while experiment 2 determined the effects of extrusion and expansion of the peas component of the diet on the nutritive value. In experiment 1, growth performance, carcass characteristics (no. = 12) and nutrient digestibility (no. = 4) were determined in pigs offered individually food containing a cereal diet (T1), a complete cereal diet that had been expander processed (T2), a 400 g/kg peas diet (T3) or a complete 400 g/kg peas diet that had been expander processed (T4). The expanded diets were processed at 105°C for 5 s at 35 bar pressure. In experiment 2, productive performance and nutrient digestibility were determined in pigs (no. = 12) offered individually diets including a control cereal diet (no peas) (TT1), a 400 g/kg raw peas diet (TT2), a 400 g/kg expander processed peas diet (TT3) or a 400 g/kg extruded peas diet (TT4). The pea portions of the diets were extruded at 130°C for 30 s and expanded at 130°C for 10 s at 42 bar pressure. In experiment 1, the inclusion of peas in the diet reduced (P < 0·001) the digestibility of the organic matter (OM) (0·871 v. 0·893, s.e. 0·003), protein (0·867 v. 0·907, s.e. 0·004) and energy (0·857 v. 0·880, s.e. 0·003). Expansion had no effect on the nutrient digestibility of the diets, however, it did increase (P < 0·05) the digestible energy content of the cereal diet. The inclusion of peas in the diet reduced (P < 0·05) daily gain (0·929 v. 0·999, s.e. 0·024 kg/day) and increased (P < 0·001) food conversion ratio (FCR) (2·31 v. 2·16, s.e. 0·029) from 34 kg to slaughter. Expansion had no effect on daily gain or FCR. In experiment 2, OM digestibilities of 0·891, 0·872, 0·882 and 0·885 (s.e. 0·0042) (P < 0·01), protein digestibilities of 0·905, 0·879, 0·874 and 0·877 (s.e. 0·0069) (P < 0·001) and gross energy digestibilities of 0·875, 0·861, 0·870 and 0·875 (s.e. 0·005) (P < 0·05) were recorded for TT1 to TT4 respectively. Gains (kg/day) of 0·981, 0·927, 0·940, and 1·016 (s.e. 0·036) (P < 0·05) and FCR of 2·17, 2·32, 2·28 and 2·18 (s.e. 0·037) (P < 0·05) were recorded for TT1 to TT4 respectively. In conclusion, expansion had no effect on the nutritive value of food for pigs.
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Homoud, Bareen, Alanoud Alhakami, Malak Almalki, Miselareem Shaheen, Alaa Althubaiti, Ali AlKhathaami, and Ismail A. Khatri. "The association of diabetes with ischemic stroke and transient ischemic attacks in a tertiary center in Saudi Arabia." Annals of Saudi Medicine 40, no. 6 (November 2020): 449–55. http://dx.doi.org/10.5144/0256-4947.2020.449.
Повний текст джерелаАнотація:
ABSTRACT BACKGROUND: Diabetes mellitus increases stroke risk 1.5 to 3 fold, particularly ischemic stroke. There is limited literature on the impact of diabetes on stroke patients in Saudi Arabia. OBJECTIVES: Determine the association of diabetes on the presentation, subtypes, in-hospital complications and outcomes of ischemic stroke and transient ischemic attacks (TIA). DESIGN: IRB approved, retrospective chart review. SETTING: Tertiary care center. PATIENTS AND METHODS: All adult patients with ischemic stroke or TIA aged 18 years or older admitted from January 2016 to December 2017 were included. MAIN OUTCOME MEASURES: Stroke severity at presentation, stroke-related complications, discharge disposition and discharge modified Rankin Scale (mRS) in relation to diabetes. SAMPLE SIZE: 802 patients. RESULTS: Among 802 cases, 584 (72.8%) had diabetes; the majority (63.1%) were males. The mean age was younger in the non-diabetic stroke group (54.6 [15.5] years vs. 63.3 [9.9], P <.001). Hypertension (83.6% vs 49.1%, P <.001), dyslipidemia (38.9% vs. 28.9%, P =.009), prior stroke (27.7% vs. 19.3% P =.014), and ischemic heart disease (20.4% vs. 7.8%, P <.001) were more common in diabetic patients whereas smoking was more common (19.3% vs. 11.1%, P =.003) in the non-diabetic patients. The commonest subtype of stroke was large artery disease followed by small vessel disease. Both were more common in diabetic vs. non-diabetic patients (55.8% vs. 44%, P =.003), and (16.6% vs. 11%, P =.05) respectively. Diabetic stroke patients were more likely to have lacunar stroke (16.4% versus 9.2%, P =.009). TIAs occurred more commonly in the non-diabetic group (26.1% vs. 13.7%, P <.001). Non-diabetic patients had a better outcome (mRS score of 0–2) at discharge (62.4% vs. 45.9%, P =.002). CONCLUSIONS: Almost three-fourth stroke patients were diabetic in our cohort. Diabetic stroke patients were older, had multiple vascular comorbid conditions, presented late to the hospital, and were likely to have more disability at the time of discharge. Large vessel atherosclerosis as well as lacunar infarctions were more common in diabetic stroke patients. LIMITATIONS: Missing data about time of presentation in few patients, missing modified Rankin Scale score at discharge. CONFLICT OF INTEREST: None.
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King, Katherine, Kirsten Graham, Briana Reid, Molly Church, and Juan Rosario. "The Hidden Cost of Age Oppression: Adultism, Ageism, and Interest in Serving Older Adults." Innovation in Aging 4, Supplement_1 (December 1, 2020): 594. http://dx.doi.org/10.1093/geroni/igaa057.1996.
Повний текст джерелаАнотація:
Abstract Adultism is an underappreciated influence on young adults’ career choices and a hidden contributing factor to the geropsychology workforce shortage. This study reports on the development of an Adultist Concerns scale and its correlations with several factors relevant to careers in aging. Clinical psychology doctoral students (n = 109) completed the new scale along with measures of ageism, training interests, and experience working with older adults. The Adultist Concerns scale had strong internal consistency (α = .952) and factor loadings .853 and .929. Females scored significantly higher than males (p = .003). There were significant positive correlations between Adultist Concerns and both overall ageist behaviors (p = .002) and negative ageist behaviors specifically (p = .002). Adultist concerns were significantly negatively correlated with age (p = .000), interest in working with older adults (p = .003), and experience with this population (p = .043).
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Nugraha, Harry G., Syawaluddin Hilman, Leni Santiana, Dian K. Dewi, Wilson M. Raffaelo, Arief Wibowo, Raymond Pranata, and Eppy B. Aristiady. "Drug-Coated Balloon Versus Drug-Eluting Stent in Patients With Femoropopliteal Artery Disease: A Systematic Review and Meta-Analysis." Vascular and Endovascular Surgery 56, no. 4 (February 28, 2022): 385–92. http://dx.doi.org/10.1177/15385744211051491.
Повний текст джерелаАнотація:
Objective In this systematic review and meta-analysis, we aimed to compare drug-coated balloon (DCB) to drug-eluting stent (DES) in patients with femoropopliteal lesions in terms of restenosis, target lesion revascularization (TLR), and mortality. Methods A comprehensive literature search was performed through PubMed, Scopus, and Embase databases. The intervention group was patients receiving percutaneous balloon angioplasty using the DCB. The control group was patients receiving percutaneous intervention using the DES. The primary outcome was restenosis, and the secondary outcomes were TLR and mortality. Results There were 4 studies comprising 812 patients (906 lesions) included in this systematic review and meta-analysis. The rate of restenosis was .19 [.13, .26] in DCB and .24 [.20, .28] in DES. There was a trend toward lower rate of restenosis (OR .73 [.52, 1.03], P = .074; I2: 46.3%) for DCB use compared to DES use. The rate of TLR was .11 [.08, .14] in DCB and .17 [.14, .21] in DES. TLR was lower (OR .61 [.41, .92], P = .017; I2: 1.2%) in the DCB group compared to the DES group. There were no significant differences in mortality (OR 1.38 [.78, 2.44], P = .268; I2: 0%) among the two groups. Meta-regression analysis showed that the rate of restenosis in DCB in this pooled analysis was affected by sex (reference: male, coefficient −.004, P = .009), smoking (coefficient: .003, P = .010), and total occlusion (coefficient: .008, P = .004). Conclusion DCB use in patients with femoropopliteal lesion was associated with similar rate of restenosis, lower TLR, and similar mortality rate compared to DES use.
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Fu, Rong, Yiran Zhao, Zonghong Shao, Honglei Wang, Tian Zhang, Lijuan Li, and Hui Liu. "Expression and Clinical Significance of Notch1 On the Membrane of Bone Marrow CD38+CD138+Plasma Cells in the Patients with Multiple Myeloma." Blood 120, no. 21 (November 16, 2012): 4981. http://dx.doi.org/10.1182/blood.v120.21.4981.4981.
Повний текст джерелаАнотація:
Abstract Abstract 4981 Objective: To investigate the expression of bone marrow CD38+CD138+, CD38+CD138-plasma cells and the expression of Notch1 on the membrane of them in the patients with multiple myeloma(MM), and explore the importance of Notch signaling pathway in the formation and progression of MM further. Methods: Thirty-three MM patients and 15 healthy controls were enrolled in this study. The expression of bone marrow CD38+CD138+, CD38+CD138-plasma cells and the expression of Notch1 on the membrane of them were analyzed by flow cytometry. The expression of Notch1 mRNA of bone marrow mononuclear cells were analyzed by RT-PCR. Results: The ratio of CD38+CD138+ plasma cells from 24 newly diagnosed MM patients was (51. 50%±12. 48%) which was significantly higher than CD38+CD138- plasma cells of MM patients (42. 88%±11. 41%)(P=0. 016)and controls 20. 13%±5. 8(P=0. 000). The expression of CD38+CD138+ plasma cells from 24 newly diagnosed MM patients was correlated to the level of malignant plasma cells in there bone marrow(r=0. 546, p=0. 006), serum level of lactate dehydrogenase(LDH)(r=0. 567, p=0. 004), and β2-MG(r=0. 431, p=0. 035). The ratio of Notch1 on the membrane of CD38+CD138+ plasma cells of MM patients was (60. 21%±25. 06%) which was significantly higher than those of CD38+CD138- plasma cells of MM patients 39. 84%±18. 94%(P=0. 000)and controls (38. 34%±19. 39%)(P=0. 004). There was no statistical difference between the two latter groups(P>0. 05). The expression of Notch1 on CD38+CD138+ plasma cells from 24 newly diagnosed MM patients was correlated to the level of malignant plasma cells in there brone marrow(r=0. 914, p=0. 000), serum level of lactate dehydrogenase(LDH) (r=0. 604, p=0. 002), and β2-MG(r=0. 455, p=0. 026). The ratio of Notch1 on the membrane of CD38+CD138+ plasma cells of MM patients who had renal dysfunction was correlated to their abnormal serum creatinine levels. The expression of Notch1 on CD38+CD138+ plasma cells from 17 MM patients who received VD chemotherapy was correlated to the ratio of plasma cell reduction after the first VD chemotherapy(r=0. 842, p=0. 000). The expression of Notch1 mRNA of bone marrow mononuclear from 10 MM patients was (0. 8252±0. 4079) which was significantly higher than those of controls (0. 3759±0. 0813)(p=0. 032). Conclusion: Notch1 over expressed on CD38+CD138+ plasma cells with relation to the effects of early VD therapy and long term outcome of MM. Disclosures: No relevant conflicts of interest to declare.
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Prieto, Jesús M., Jordi Blanch, Jorge Atala, Enric Carreras, Montserrat Rovira, Esteve Cirera, and Cristóbal Gastó. "Psychiatric Morbidity and Impact on Hospital Length of Stay Among Hematologic Cancer Patients Receiving Stem-Cell Transplantation." Journal of Clinical Oncology 20, no. 7 (April 1, 2002): 1907–17. http://dx.doi.org/10.1200/jco.2002.07.101.
Повний текст джерелаАнотація:
PURPOSE: To determine the prevalence of psychiatric disorders during hospitalization for hematopoietic stem-cell transplantation (SCT) and to estimate their impact on hospital length of stay (LOS). PATIENTS AND METHODS: In a prospective inpatient study conducted from July 1994 to August 1997, 220 patients aged 16 to 65 years received SCT for hematologic cancer at a single institution. Patients received a psychiatric assessment at hospital admission and weekly during hospitalization until discharge or death, yielding a total of 1,062 psychiatric interviews performed. Psychiatric disorders were determined on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Univariate and multivariate linear regression analyses were used to identify variables associated with LOS. RESULTS: Overall psychiatric disorder prevalence was 44.1%; an adjustment disorder was diagnosed in 22.7% of patients, a mood disorder in 14.1%, an anxiety disorder in 8.2%, and delirium in 7.3%. After adjusting for admission and in-hospital risk factors, diagnosis of any mood, anxiety, or adjustment disorder (P = .022), chronic myelogenous leukemia (P = .003), Karnofsky performance score less than 90 at hospital admission (P = .025), and higher regimen-related toxicity (P < .001) were associated with a longer LOS. Acute lymphoblastic leukemia (P = .009), non-Hodgkin’s lymphoma (P = .04), use of peripheral-blood stem cells (P < .001), second year of study (P < .001), and third year of study (P < .001) were associated with a shorter LOS. CONCLUSION: Our data indicate high psychiatric morbidity and an association with longer LOS, underscoring the need for early recognition and effective treatment.
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Zhu, Yong, Walter H. Hsu, and James H. Hollis. "Increasing the number of masticatory cycles is associated with reduced appetite and altered postprandial plasma concentrations of gut hormones, insulin and glucose." British Journal of Nutrition 110, no. 2 (November 27, 2012): 384–90. http://dx.doi.org/10.1017/s0007114512005053.
Повний текст джерелаАнотація:
To determine the influence of masticatory efficiency on postprandial satiety and glycaemic response, twenty-one healthy males were recruited for this randomised cross-over trial. The participants consumed a fixed amount of pizza provided in equal-sized portions by chewing each portion either fifteen or forty times before swallowing. Subjective appetite was measured by appetite questionnaires at regular intervals for 3 h after the meal and plasma samples were collected for the measurement of selected satiety-related hormones, glucose, insulin and glucose-dependent insulinotropic peptide (GIP) concentrations. An ad libitum meal was provided shortly after the last blood sample was drawn and the amount eaten recorded. Compared with fifteen chews, chewing forty times per portion resulted in lower hunger (P= 0·009), preoccupation with food (P= 0·005) and desire to eat (P= 0·002). Meanwhile, plasma concentrations of glucose (P= 0·024), insulin (P< 0·001) and GIP (P< 0·001) were higher following the forty-chews meal. Chewing forty times before swallowing also resulted in a higher plasma cholecystokinin concentration (P= 0·045) and a trend towards a lower ghrelin concentration (P= 0·051). However, food intake at the subsequent test meal did not differ (P= 0·851). The results suggest that a higher number of masticatory cycles before swallowing may provide beneficial effects on satiety and facilitate glucose absorption.
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Brown, Hannah J., Hannah N. Kuhar, Max A. Plitt, Inna Husain, Pete S. Batra, and Bobby A. Tajudeen. "The Impact of Laryngopharyngeal Reflux on Patient-reported Measures of Chronic Rhinosinusitis." Annals of Otology, Rhinology & Laryngology 129, no. 9 (May 11, 2020): 886–93. http://dx.doi.org/10.1177/0003489420921424.
Повний текст джерелаАнотація:
Objective: This study explored the impact of laryngopharyngeal reflux (LPR) on quality-of-life outcomes captured by Sino-Nasal Outcome Test (SNOT-22) and Reflux Symptom Index (RSI) in patients with chronic rhinosinusitis (CRS) and patients with symptoms of LPR. Methods: In a retrospective chart review, SNOT-22 and RSI scores were analyzed in patients seen at a tertiary care center with CRS, LPR, or both CRS and LPR. SNOT-22 items were grouped into sleep, nasal, otologic, and emotional symptom subdomains. Results: A total of 138 patients (36 with CRS alone, 60 with LPR alone, and 42 with both CRS and LPR) were included. Compared to patients with CRS alone, those with CRS and LPR (CRS+LPR) had higher SNOT-22 total (50.54 ± 19.53 vs 35.31 ± 20.20, P < .001), sleep (19.61 ± 9.31 vs 14.42 ± 10.34, P < .022), nasal (17.38 ± 7.49 vs 11.11 ± 8.52, P < .001), otologic subdomains (9.17 ± 5.07 vs 5.53 ± 5.14, P < .002), and RSI (22.06 ± 9.42 vs 10.75 ± 8.43, P < .003). Patients with LPR alone had higher RSI compared to those with CRS (18.48 ± 9.77 vs 10.75 ± 8.43, P < .037). RSI and SNOT-22 scores were positively correlated irrespective of patient group (R = 0.289, P = .003). Conclusion: Compared to patients with CRS or LPR alone, those with CRS+LPR demonstrated higher RSI and total and subdomain SNOT-22 scores. Patients with LPR alone had elevated SNOT-22 despite absent endoscopic evidence of sinusitis.
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Alfaro Quezada, Jose, Zahid Mustafa, Xiaofei Zhang, Bishoy Zakhary, Matthew Firek, Raul Coimbra, and Megan Brenner. "A Nationwide Study of Intimate Partner Violence." American Surgeon 86, no. 10 (October 2020): 1230–37. http://dx.doi.org/10.1177/0003134820964191.
Повний текст джерелаАнотація:
Background Intimate partner violence (IPV) refers to physical or sexual violence, stalking, and psychological aggression by an intimate partner. The present study aims to examine the incidence, injury patterns, and outcomes using a representative nationwide data set. Study Design The Nationwide Emergency Department Sample database was queried from 2010 to 2014 to identify IPV in adult patients by injury code E967.3. Demographics, diagnoses, and injury mechanisms were captured. Primary outcome was mortality, and logistic regression analyses were used to compare the baselines and outcomes. Results 132 806 IPV emergency visits were identified, with 5.1% of patients requiring hospitalization. Most patients were female (92.6%). The most common injury mechanisms were unintentional injury (36%) and striking (22.0%). Contusions of face/scalp/neck (13.2%) and unspecified head injury (6.9%) were the most common diagnoses. Males were significantly older [median and interquartile range of 39 (30, 50)] than females [33 (26, 43)], and were more frequently hospitalized (6.7% vs. 5.0%, P = .002) with more injuries with injury severity score ≥ 15 (.7% vs. .4%, P = .004) than females. Overall, IPV-related mortality was .06%, .26% in males and .05% in females ( P = .003). Older age (odds ratio (OR) = 1.053) and male gender (OR = 3.102) were significantly associated with mortality. The annual incidence rate decreased from 9.7 in 2010 to 8.2/100 000 US population in 2014 ( R2 = .659). Conclusions Young women are more likely to be victims of IPV, whereas men are more likely to be older and hospitalized with more severe injuries and worse outcomes.
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Stilgenbauer, Stephan, Thorsten Zenz, Dirk Winkler, Andreas Bühler, Raymonde Busch, Günther Fingerle-Rowson, Kirsten Fischer, et al. "Genomic Aberrations, VH Mutation Status and Outcome after Fludarabine and Cyclophosphamide (FC) or FC Plus Rituximab (FCR) in the CLL8 Trial." Blood 112, no. 11 (November 16, 2008): 781. http://dx.doi.org/10.1182/blood.v112.11.781.781.
Повний текст джерелаАнотація:
Abstract The international multicenter randomized CLL8 trial evaluated 1st line treatment with FC or FCR in 817 CLL patients. Analyses of genomic aberrations by FISH and VH mutation status by DNA sequencing were scheduled for a subset of countries in a central reference laboratory. Samples were available for 648 (79%) patients and this cohort was representative of the full trial population regarding other baseline prognostic factors and demographics. The incidences of the most common genomic aberrations were 13q- 56.7%, 13q- single 36.4%, 11q- 24.6%, +12 12.0%, and 17p- 8.2%. No aberration was found for these regions in 22.4%. VH was unmutated in 63.4% and V3-21 was rearranged in 4.9%. Distributions of genetic parameters were not significantly different between treatment arms. Outcome was analyzed for subgroups defined by genetic parameters in univariate analyses. Genomic aberrations according to the hierarchical model were correlated with differences in CR, CR+PR, PFS and OS in both treatment arms combined and individually (all p<.001). Particularly poor outcome was observed for 17p- in both arms (FC and FCR): CR (4.5% and 19.0%), CR+PR (45.5% and 71.4%), PFS (at 24 months: 0.0% and 29.6%), and OS (at 24 months: 41.0% and 53.3%). Unmutated VH status was correlated with shorter PFS in both arms combined and individually (all p<.001), shorter OS in the FC arm (p=.006), and a trend towards shorter OS in the FCR arm (p=.092). Treatment results of FCR and FC were compared in subgroups defined by genetic parameters to identify prognostic and predictive markers. While FCR in general improved outcome, this effect was different in specific genetic subgroups (Table). Table: Treatment effect of FCR (odds ratio (OR) and hazard ratio (HR) with respective significance level for improvement of outcome in genetic subgroups) VH mut VH unmut 17p- 11q- +12 normal 13q-single CR OR 3.196 3.360 4941 10.000 9.000 154 2.386 p-value <.001 <.001 <.185 <.001 <.001 .274 .003 CR+PP OR 3.537 2.730 3.000 1.370 1.774 1.038 14,884 p-value .083 .008 .124 .723 1.000 1.000 .001 PFS HR .476 .599 .495 .405 .544 .962 .372 p-value .008 .001 .032 .001 251 .890 .001 OS HR .877 .625 .715 .328 .370 1.678 387 p-value .800 .073 .420 .047 .373 .339 .104 Multivariate analysis was performed by Cox regression with backward selection including age, sex, stage, treatment arms, VH status and genomic aberrations as parameters. Regarding PFS, independent prognostic factors were 17p- (HR 6.76, p<.001), unmutated VH (HR 1.97, p<.001), FCR (HR 0.51, p<.001) and +12 (HR 0.58, p=.020). Regarding OS, only 17p- (HR 7.47, p<.001) and unmutated VH (HR 2.09, p=.018) were identified as significant independent factors, while a trend was observed for FCR (HR 0.66, p=.085). In conclusion, genetic parameters remain powerful prognostic markers after 1st line FC and FCR treatment in CLL. The overall improvements by FCR result from specific treatment effects in distinct genetic subgroups and 11q- appears to benefit particularly. However, 17p- and unmutated VH status remain predictors for shorter PFS and OS independently of the overall improvement by FCR.
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Haddas, Ram, Yigal Samocha, and James Yang. "Effects of Volitional Spine Stabilization on Trunk Control During Asymmetric Lifting Task in Patients With Recurrent Low Back Pain." Global Spine Journal 10, no. 8 (October 28, 2019): 1006–14. http://dx.doi.org/10.1177/2192568219885898.
Повний текст джерелаАнотація:
Study Design: Prospective, concurrent-cohort study. Objectives: To determine the effects of volitional preemptive abdominal contraction (VPAC) on trunk control during an asymmetric lift in patients with recurrent low back pain (rLBP) and compare with matched controls. Methods: Thirty-two rLBP patients and 37 healthy controls performed asymmetric lifting with and without VPAC. Trunk, pelvis, and hip biomechanical along with neuromuscular activity parameters were obtained using 3-dimensional motion capture and electromyography system. Hypotheses were tested using analysis of variance. Results: The VPAC resulted in significantly reduced muscle activity across all trunk extensor muscles in both groups (M ± SD, 6.4% ± 8.2% of maximum contraction; P ≤ .005), and reduced trunk side flexion (1.4° ± 5.1° smaller; P ≤ .005) and hip abduction (8.1° ± 21.1° smaller; P ≤ .003). rLBP patients exhibited reduced muscle activity in external oblique (12.3% ± 5.5% of maximum contraction; P ≤ .012), as well as decreased hip flexion (4.7°, P ≤ .008) and hip abduction (5.2°, P ≤ .001) at the final position of lifting in comparison with healthy controls. Conclusions: The results of this study defend the recommendation that the use of a VPAC increase spine stability during an asymmetrical loading task. Our results provide an indication that a VPAC strategy that is achieved during an asymmetric lifting decreases exposure for lumbar spine injury and instability. Spine care providers and ergonomists can use this information when designing neuromuscular control training programs, both for healthy individuals aimed at prevention of injury, as well as those with a history of rLBP, aimed at full functional recovery and protection from future injury.
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Voog, Eric, Jacques Bienvenu, Krzysztof Warzocha, Isabelle Moullet, Charles Dumontet, Catherine Thieblemont, Guillaume Monneret, Marie-Claude Gutowski, Bertrand Coiffier, and Gilles Salles. "Factors That Predict Chemotherapy-Induced Myelosuppression in Lymphoma Patients: Role of the Tumor Necrosis Factor Ligand-Receptor System." Journal of Clinical Oncology 18, no. 2 (January 1, 2000): 325. http://dx.doi.org/10.1200/jco.2000.18.2.325.
Повний текст джерелаАнотація:
PURPOSE: To analyze factors that predict the occurrence of chemotherapy-induced myelosuppression and, in particular, the role of the tumor necrosis factor (TNF) ligand-receptor system in lymphoma patients at the beginning of their treatment. PATIENTS AND METHODS: We investigated the predictive factors for myelosuppression after the first course of chemotherapy in a cohort of 101 consecutive, previously untreated lymphoma patients receiving regimens that include doxorubicin and cyclophosphamide. Plasma samples were tested at baseline by enzyme-linked immunosorbent assay for TNF and its soluble receptors. Univariate and multivariate analyses were performed with a forward regression procedure that included all of the parameters that were found to be significant in the univariate analysis. The dose of chemotherapy and the prophylactic treatment with granulocyte colony-stimulating factor were deliberately included in this model. RESULTS: Sixty-seven patients experienced World Health Organization (WHO) grade 4 neutropenia, and 37 patients experienced febrile neutropenia, which was responsible for WHO grade 2 through 4 infections in 23 patients. In multiparametric regression analysis, the occurrence of grade 4 neutropenia was associated with high doses of cyclophosphamide (odds ratio [OR], 19.8; P = .008) and high levels of soluble p75-R-TNF (OR, 8.52; P = .001). The duration of grade 4 neutropenia for more than 5 days was associated with the lack of hematopoietic growth factor administration (OR, 6.76; P = .004) and high levels of soluble p75-R-TNF (OR, 5.84; P = .0023). The occurrence of febrile neutropenia was associated with high doses of cyclophosphamide (OR, 4.7; P = .007), altered performance status (OR, 18.8; P < .0001) and high levels of soluble p75-R-TNF (OR, 3.49; P = .029). CONCLUSION: This study indicates that in addition to the dose of chemotherapy and the administration of hematopoietic growth factors, poor performance status and high p75-R-TNF levels can predict the occurrence of chemotherapy-induced myelosuppression in lymphoma patients. This model may help in selecting patients for prophylactic growth factor administration.
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Lyman, Gary H., Brandon McMahon, Nicole M. Kuderer, Jeffrey Crawford, Debra Wolff, Eva Culakova, Marek S. Poniewierski, and David C. Dale. "A Risk Model for Chemotherapy-Induced Anemia (CIA) in Cancer Patients." Blood 106, no. 11 (November 16, 2005): 754. http://dx.doi.org/10.1182/blood.v106.11.754.754.
Повний текст джерелаАнотація:
Abstract Background: Anemia represents the most common hematological toxicity in cancer patients receiving systemic chemotherapy and is associated with considerable morbidity and cost (Lyman‚ Value in Health 2005). Current ASH/ASCO guidelines call for intervention at a hemoglobin (Hgb) <10 gm/dl. Treatment options include transfusion or administration of an erythropoietic-stimulating protein (ESP). A recent meta-analysis demonstrated the clinical value of early versus late intervention with an ESP (Lyman‚ Cancer‚ 2005 in press). An accurate and valid risk model for CIA is needed to select patients for ESP treatment early in the course of chemotherapy when it can be most effective. Methods: More than 3‚000 patients with cancer of the breast‚ lung‚ colon and ovary or malignant lymphoma initiating a new chemotherapy regimen have been prospectively registered at 115 randomly selected U.S. practice sites. Data on at least one cycle of chemotherapy were available on 2‚842 patients. A logistic regression model for Hgb <10 gm/dl based on pretreatment characteristics was developed and predictive test performance characteristics examined. Results: Over a median of three cycles of chemotherapy, Hgb <10 gm/dl was reported one or more times in 817 (28.7%) patients. Significant independent predictive factors for Hgb <10 gm/dl include: history of peptic ulcer (OR=1.90; P=.015), myocardial infarction (OR=1.94; P=.009), or congestive heart failure (OR=2.13; P=.017), increasing age (OR=1.02; P=.002), female gender (OR=2.40; P<.001), ECOG performance status (OR=1.24; P=.002), Charlson Comorbidity Index (OR=1.06, P=.002), body surface area (OR=3.75, P<.001), low baseline hemoglobin (OR=1.95, P<.001), pretreatment hematocrit (OR=.85, P<.001), and glomerular filtration rate (OR=0.99, P=.027), and regimens containing anthracyclines (OR=3.21, P<.001), cisplatinum (OR=3.86, P<.001) or carboplatinum (OR=2.71, P<.001). Model fit was excellent (P<.001), R2=0.455 and c-statistic = 0.775 [95% CL: .76–.79, P<.0001]. Individual predicted risk of Hgb <10 gm/dl based on the model ranged from 0 to 98% with mean and median probabilities of 0.28 and 0.22, respectively. Based on a risk cutpoint of 20%, 1,541 patients (55%) were classified as high risk and 1,282 as low risk. The average risks of Hgb <10 gm/dl during chemotherapy in high and low risk subjects were 43% and 12%, respectively. Model test performance characteristics [±95% CL] included: sensitivity: 81% [78–84]; specificity: 56% [54–58]; likelihood ratio positive: 1.85 [1.74–1.96]; likelihood ratio negative: 0.34 [0.29–0.39]; positive predictive value: 43% [40–45]; negative predictive value: 88% [86–90] and diagnostic odds ratio: 5.47 [4.50–6.66]. Conclusions: This risk model identified cancer patients initiating chemotherapy who are at risk for clinically significant anemia using common clinical parameters. Validation of the model in a separate population of patients is in progress.
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Сахин, В. Т., М. А. Григорьев, Е. В. Крюков, С. П. Казаков, and О. А. Рукавицын. "Features of Cytokine Secretion and Their Influence on the Indicators of Iron Metabolism and Development of Anemia in patients with Rheumatic Pathology." Гематология. Трансфузиология. Восточная Европа, no. 1 (May 25, 2020): 140–48. http://dx.doi.org/10.34883/pi.2020.6.1.014.
Повний текст джерелаАнотація:
Цель. Изучить особенности секреции интерлейкина-6 (ИЛ-6), интерлейкина-10 (ИЛ-10), интерлейкина-1β (ИЛ-1β), интерферона-гамма (ИФН-γ), фактора некроза опухоли-альфа (ФНО-α) у пациентов с ревматическими заболеваниями и сопутствующей анемией хронических заболеваний (АХЗ), исследовать их влияние на обмен железа и эритропоэз.Материалы и методы. Обследованы 63 пациента ревматологического профиля, 26 мужчин (45 (36–54,9) лет), 37 женщин (49 (38–60) лет). Пациенты разделены на две группы: 1-я группа – 41 пациент с анемией, 2-я группа (контрольная) – 22 пациента без анемии. Выполнен сравнительный анализ показателей гемограммы, обмена железа (железо, ферритин, трансферрин, общая железосвязывающая способность (ОЖСС), коэффициент насыщения трансферрина железом (КНТ), гепцидин, растворимый рецептор трансферрина (sTfR), С-реактивный белок (СРБ)) и цитокинов. Выполнен корреляционный анализ между цитокинами и показателями гемограммы, обмена железа, гепцидином, sTfR, СРБ.Результаты. У пациентов с анемией в сравнении со 2-й группой выше концентрации фер ритина (292,7 (146,1–335,1) и 78,5 (36–90,7) мкг/л), СРБ (59,4 (10,9–100,2) и 4,6 (1,2–5,8) мг/л),гепцидина (504,9 (23,5–916,5) и 232 (0,0–858) нг/мл), sTfR (8,6 (3,9–7,1) и 2,2 (1,5–3,1) нмоль/л).Для железа, ОЖСС, КНТ, трансферрина не выявлено межгрупповых различий (p>0,05). Концентрация ИЛ-6 у пациентов с анемией больше в сравнении со 2-й группой (35,8 (2,1–41,1) и 2,7 (1,5–3)). Для ИЛ-10, ИЛ-1β, ИФН-γ, ФНО-α не выявлено межгрупповых различий (p>0,05). Выявлена корреляция между числом эритроцитов и ИЛ-6 (r=–0,3), ИЛ-10 (r=–0,4), ИНФ-γ (r=–0,4), ФНО-α (r=–0,3). Доказана взаимосвязь между концентрацией гемоглобина и ИЛ-6 (r=–0,6), ИЛ-10 (r=–0,4), ИНФ-γ (r=–0,3), ФНО-α (r=–0,3), ИЛ-1β (r=–0,4), между концентрацией железа и ИЛ-6 (r=–0,6), ИЛ-10 (r=–0,4). Установлена корреляция между ОЖСС и ИЛ-6 (r=–0,3), ИЛ-10 (r=–0,3), ИНФ-γ (r=–0,3), ФНО-α (r=–0,6) и ИЛ-1β (r=–0,4). Для ферритина установлена корреляция с ИЛ-6 и ИЛ-10 (r=0,5), ИНФ-γ (r=0,3), ИЛ-1β (r=0,4), ФНО-α (r=0,7). Доказана взаимосвязь между трансферрином и ИЛ-6, ИЛ-10, ИНФ-γ (r=–0,3), ИЛ-1β (r=–0,4), ФНО-α (r=–0,6).Заключение. Показано влияние цитокинов на развитие анемии у ревматических пациентов посредством их влияния на эритропоэз и обмен железа. Предложен рабочий вариант классификации АХЗ на основании ведущего патогенетического фактора (АХЗ с преимущественным дефицитом железа, АХЗ с нарушениями регуляторных механизмов эритропоэза, АХЗ с недостаточной продукцией эритропоэтина). Purpose. To study the features of secretion of interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin- 1β (IL-1β), interferon gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α) in patients with rheumatic diseases and concomitant anemia of chronic diseases (ACD), to study their effect on iron metabolism and erythropoiesis.Materials and methods. We examined 63 rheumatologic patients; 26 men (45 (36–54.9) years old), 37 women (49 (38–60) years old). Patients were divided into two groups: group 1 – 41 patients with anemia, group 2 (control) – 22 patients without anemia. A comparative analysis of hemogram and iron metabolism (iron, ferritin, transferrin, total iron binding capacity – TIBC, transferrin saturation index – TSI), hepcidin, soluble transferrin receptor (sTfR), C-reactive protein (CRP), and cytokines was performed. A correlation analysis between cytokines and hemogram, iron metabolism, hepcidin, sTfR, CRP was performed.Results. In comparison with the 2nd group, patients with anemia have higher concentrations of ferritin (292.7 (146.1–335.1) and 78.5 (36–90.7) mcg/l), CRP (59.4 (10.9–100.2) and 4.6 (1.2–5.8) mg/L),hepcidin (504.9 (23.5–916.5) and 232 (0.0–858) ng/ml), sTfR (8.6 (3.9–7.1) and 2.2 (1.5–3.1) nmol/L).For iron, TIBC, TSI, transferrin, no intergroup differences were found (p>0.05). The concentration of IL-6 in patients with anemia is higher in comparison with the 2nd group (35.8 (2.1–41.1) and 2.7 (1.5–3)). No intergroup differences were found for IL-10, IL-1β, IFN-γ, TNF-α (p>0.05). A correlation was found between the number of red blood cells and IL-6 (r=–0.3), IL-10 (r=–0.4), INF-γ (r=–0.4), TNF-α (r=–0,3). The relationship between the concentration of hemoglobin and IL-6 (r=–0.6), IL-10 (r=–0.4), INF-γ (r=–0.3), TNF-α (r=–0,3), IL-1β (r=–0.4), between the concentration of iron and IL-6 (r=–0.6), IL-10 (r=–0.4) was proven. A correlation was revealed between TIBC and IL-6 (r=–0.3), IL-10 (r=–0.3), INF-γ (r=–0.3), TNF-α (r=–0,6) and IL-1β (r=–0.4). For ferritin, a correlation was revealed with IL-6 and IL-10 (r=0.5), INF-γ (r=0.3), IL-1β (r=0.4), TNF-α (r=0,7). The relationship between transferrin and IL-6, IL-10, INF-γ (r=–0.3), IL-1β (r=–0.4), TNF-α (r=–0.6) was proven.Conclusion. The effect of cytokines on the development of anemia in rheumatic patients through their effect on erythropoiesis and iron metabolism was showed. A working version of the classification of ACD on the base of the leading pathogenetic factor was proposed (ACD with predominant iron deficiency, ACD with impaired regulatory mechanisms of erythropoiesis, ACD with insufficient production of erythropoietin).
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B, Mcdonald, Golden C, Willeumier K, and Amen D. "A-098 Regional Cerebral Blood Flow in Adults with Autism." Archives of Clinical Neuropsychology 35, no. 6 (August 28, 2020): 891. http://dx.doi.org/10.1093/arclin/acaa068.098.
Повний текст джерелаАнотація:
Abstract Objective To identify regional cerebral blood flow (rCBF) differences between individuals with Autism Spectrum Disorder and healthy controls. Method Healthy controls [n = 81, Mage = 41.9, 53.0% female] and persons diagnosed by psychiatric examination with Autism Spectrum Disorder (ASD) [n = 62, Mage = 29.8, 75.8% male] were selected from a deidentified adult clinical outpatient database. Those with comorbid diagnoses were included. Significant differences (alpha = .001) were found for gender [χ(2) = 13.4] and age [t(141) = −4.8] between groups. Multiple ANCOVA controlled for gender and age on outcomes of rCBF across 17 brain regions from Single-Photon Emission Computed Tomography (SPECT) were analyzed. Results Significant rCBF differences were noted in the cerebellum [left:F(1,143) = 9.43, p = .003; right: F(1,143) = 14.2, p < .001] and basal ganglia [left:F(1,143) = 8.2,p = .005; right:F(1,143) = 10.3, p = .002]. Group means comparisons indicated higher perfusion in the cerebellum and lower perfusion in the basal ganglia in the group with ASD. No significant differences were found bilaterally in limbic system, motor sensory strip, vermis, or occipital, parietal, frontal, or temporal lobes. Conclusion Results indicated that individuals diagnosed with ASD have diminished rCBF in the basal ganglia and increased rCBF in the cerebellum. Previous research supports these conclusions, as the basal ganglia is linked with repetitive and/or restricted motor behaviors, and the cerebellum aids in understanding gross motor and coordination in ASD, as well as social interactions, and language and communication. By understanding the underlying mechanisms of ASD, interventions focused on sensory-motor abilities, such as sensory enrichment (Woo and Leon, 2013), can show a decrease in motor behaviors and improve cognition. Future studies should control for potential comorbidities, the severity of ASD, and medication usage.
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Seward, Kirsty, Luke Wolfenden, Meghan Finch, John Wiggers, Rebecca Wyse, Jannah Jones, and Sze Lin Yoong. "Improving the implementation of nutrition guidelines in childcare centres improves child dietary intake: findings of a randomised trial of an implementation intervention." Public Health Nutrition 21, no. 03 (November 27, 2017): 607–17. http://dx.doi.org/10.1017/s1368980017003366.
Повний текст джерелаАнотація:
AbstractObjectiveEvidence suggests that improvements to the childcare nutrition environment can have a positive impact on child dietary intake. The primary aim of the present study was to assess, relative to usual care, the effectiveness of a multi-strategy implementation intervention in improving childcare compliance with nutrition guidelines. As a secondary aim, the impact on child dietary intake was assessed.DesignParallel-group, randomised controlled trial design. The 6-month intervention was designed to overcome barriers to implementation of the nutrition guidelines that had been identified by applying the theoretical domains framework.SettingHunter New England region, New South Wales, Australia.SubjectsForty-five centre-based childcare services.ResultsThere were no differences between groups in the proportion of services providing food servings (per child) compliant with nutrition guideline recommendations for all five (5/5) food groups at follow-up (i.e. full compliance). Relative to control services, intervention services were more likely to be compliant with guidelines (OR; 95 % CI) in provision of fruit (10·84; 1·19, 551·20;P=0·0024), meat and meat alternatives (8·83; 1·55, –;P=0·023), dairy (8·41; 1·60, 63·62;P=0·006) and discretionary foods (17·83; 2·15, 853·73;P=0·002). Children in intervention services consumed greater servings (adjusted difference; 95 % CI) of fruit (0·41; 0·09, 0·73;P=0·014) and vegetables (0·70; 0·33, 1·08;P<0·001).ConclusionsFindings indicate that service-level changes to menus in line with dietary guidelines can result in improvements to children’s dietary intake. The study provides evidence to advance implementation research in the setting as a means of enhancing child public health nutrition.
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Cinar, Eda, Shikha Saxena, and Fatma Uygur. "Combination Therapy Versus Exercise and Orthotic Support in the Management of Pain in Plantar Fasciitis: A Randomized Controlled Trial." Foot & Ankle International 39, no. 4 (January 12, 2018): 406–14. http://dx.doi.org/10.1177/1071100717747590.
Повний текст джерелаАнотація:
Background: This study aimed at estimating the effectiveness of two commonly used modalities—extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT)—each combined with usual care (exercises and orthotic supports) in comparison to only usual care to relieve pain in patients with plantar fasciitis (PF). Methods: Participants with PF were randomly allocated into 3 groups: ESWT (n = 25), LLLT (n = 24), and control (n = 17). All participants received a home exercise program with orthotic support. The ESWT group received 2000 shock waves with 0.02 mJ/mm2 for 3 sessions, once a week; LLLT group received gallium-aluminum-arsenide laser with 850 nm wavelength for 10 sessions, 3 times a week. Pain was measured by Foot Function Index-pain subscale (FFI-p) and Numerical Rating Scale for pain (NRS-p). The scores were recorded at baseline, third week, and third month after the treatment. Analysis was performed using repeated measures ANOVA. Results: There was a significant improvement in pain over the 3 months in all groups on both FFI-p ( P < .001) and NRS-p ( P < .001). In NRS-p, LLLT group had significantly lower pain than ESWT ( P = .002) at the third week and control ( P = .043) and ESWT ( P = .003) at third month. In FFI-p total score, ESWT group had higher pain than LLLT ( P = .003) and control ( P = .035) groups at third week and LLLT ( P = .010) group at third month. Conclusion: When LLLT and ESWT were combined with usual care, LLLT was found to be more effective than ESWT in reducing pain in PF at short-term follow-up. Level of Evidence: Level II, comparative study.
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Chua, Terence C., Brendan J. Moran, Paul H. Sugarbaker, Edward A. Levine, Olivier Glehen, François N. Gilly, Dario Baratti, et al. "Early- and Long-Term Outcome Data of Patients With Pseudomyxoma Peritonei From Appendiceal Origin Treated by a Strategy of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy." Journal of Clinical Oncology 30, no. 20 (July 10, 2012): 2449–56. http://dx.doi.org/10.1200/jco.2011.39.7166.
Повний текст джерелаАнотація:
Purpose Pseudomyxoma peritonei (PMP) originating from an appendiceal mucinous neoplasm remains a biologically heterogeneous disease. The purpose of our study was to evaluate outcome and long-term survival after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) consolidated through an international registry study. Patients and Methods A retrospective multi-institutional registry was established through collaborative efforts of participating units affiliated with the Peritoneal Surface Oncology Group International. Results Two thousand two hundred ninety-eight patients from 16 specialized units underwent CRS for PMP. Treatment-related mortality was 2% and major operative complications occurred in 24% of patients. The median survival rate was 196 months (16.3 years) and the median progression-free survival rate was 98 months (8.2 years), with 10- and 15-year survival rates of 63% and 59%, respectively. Multivariate analysis identified prior chemotherapy treatment (P < .001), peritoneal mucinous carcinomatosis (PMCA) histopathologic subtype (P < .001), major postoperative complications (P = .008), high peritoneal cancer index (P = .013), debulking surgery (completeness of cytoreduction [CCR], 2 or 3; P < .001), and not using HIPEC (P = .030) as independent predictors for a poorer progression-free survival. Older age (P = .006), major postoperative complications (P < .001), debulking surgery (CCR 2 or 3; P < .001), prior chemotherapy treatment (P = .001), and PMCA histopathologic subtype (P < .001) were independent predictors of a poorer overall survival. Conclusion The combined modality strategy for PMP may be performed safely with acceptable morbidity and mortality in a specialized unit setting with 63% of patients surviving beyond 10 years. Minimizing nondefinitive operative and systemic chemotherapy treatments before definitive cytoreduction may facilitate the feasibility and improve the outcome of this therapy to achieve long-term survival. Optimal cytoreduction achieves the best outcomes.
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Kornblith, Alice B., Helen Q. Huang, Joan L. Walker, Nick M. Spirtos, Jacob Rotmensch, and David Cella. "Quality of Life of Patients With Endometrial Cancer Undergoing Laparoscopic International Federation of Gynecology and Obstetrics Staging Compared With Laparotomy: A Gynecologic Oncology Group Study." Journal of Clinical Oncology 27, no. 32 (November 10, 2009): 5337–42. http://dx.doi.org/10.1200/jco.2009.22.3529.
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Purpose The study's objective was to compare the quality of life (QoL) of patients with endometrial cancer undergoing surgical staging via laparoscopy versus laparotomy. Patients and Methods The first 802 eligible patients (laparoscopy, n = 535; laparotomy, n = 267) participated in the QoL study in a Gynecologic Oncology Group (GOG) randomized trial of laparoscopy versus laparotomy (GOG 2222). Patients completed QoL assessments at baseline; at 1, 3, and 6 weeks; and at 6 months postsurgery. Results In an intent-to-treat analysis, laparoscopy patients reported significantly higher Functional Assessment of Cancer Therapy–General (FACT-G) scores (P = .001), better physical functioning (P = .006), better body image (BI; P < .001), less pain (P < .001) and its interference with QoL (P < .001), and an earlier resumption of normal activities (P = .003) and return to work (P = .04) over the 6-week postsurgery period, as compared with laparotomy patients. However, the differences in BI and return to work between groups were modest, and the adjusted FACT-G scores did not meet the minimally important difference (MID) between the two surgical arms over 6 weeks. By 6 months, except for better BI in laparoscopy patients (P < .001), the difference in QoL between the two surgical techniques was not statistically significant. Conclusion Although the FACT-G did not show a MID between the two surgical groups, and only modest differences in return to work and BI were found between the two groups, statistically significantly better QoL across many parameters in the laparoscopy arm at 6 weeks provides modest support for the QoL advantage of using laparoscopy to stage patients with early endometrial cancer.
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Ntalla, Ioanna, Margarita Giannakopoulou, Panagiota Vlachou, Kalliope Giannitsopoulou, Vasiliki Gkesou, Chrysoula Makridi, Maria Marougka, et al. "Body composition and eating behaviours in relation to dieting involvement in a sample of urban Greek adolescents from the TEENAGE (TEENs of Attica: Genes & Environment) study." Public Health Nutrition 17, no. 3 (February 11, 2013): 561–68. http://dx.doi.org/10.1017/s1368980013000074.
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AbstractObjectiveTo document the prevalence of dieting and to compare body composition markers, dietary intakes and eating behaviours across dieting categories.DesignProspective, cross-sectional study.SettingTwenty-four randomly selected secondary public schools located in Attica, Greece.SubjectsAnthropometric, medical and dietary information was obtained from 857 (54·9 % females) adolescents (mean age 13·4 (sd 0·9) years). Meal patterns, eating behaviours and eating style score, reflecting conditions around eating, were assessed. Adolescents were asked about their dieting involvement and were categorised as ‘never dieters’, ‘current dieters’ or ‘past dieters’.ResultsOverall, 20·1 % of the adolescents were currently dieting and 15·2 % reported past dieting. Mean BMI and body fat percentage of never dieters were significantly lower than those of both groups of dieters (P < 0·001). Breakfast skipping (χ2 = 10·92, P = 0·004) and eating large quantities of food (χ2 = 7·18, P = 0·028) differed significantly across dieting groups in females. Significant differences in dinner skipping were observed in both males (χ2 = 10·55, P = 0·005) and females (χ2 = 20·91, P < 0·001). Female past dieters had significantly higher eating style scores than never dieters (P = 0·010) and current dieters (P = 0·042), indicating less well-structured feeding practices and food intake for reasons other than hunger.ConclusionsThe present study showed a high prevalence of dieting among adolescents. Current dieters and past dieters had higher BMI and body fat percentage than never dieters. Eating behaviours differed significantly depending on dieting involvement, especially in females; while an apparently healthier, ordered eating style adopted by dieters during the dieting period seemed not to be maintained in the long term.
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Kuendgen, Andrea, Michael Lauseker, Alan F. List, Pierre Fenaux, Aristoteles Giagounidis, Nancy Brandenburg, Jay Backstrom, Axel Glasmacher, Joerg Hasford, and Ulrich Germing. "Lenalidomide Treatment Is Not Related to AML Progression Risk but Is Associated with a Survival Benefit in RBC Transfusion-Dependent Patients with IPSS Low- or Int-1-Risk MDS with del5q: Results From a Comparative Study." Blood 118, no. 21 (November 18, 2011): 119. http://dx.doi.org/10.1182/blood.v118.21.119.119.
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Abstract Abstract 119 Background: Lenalidomide (LEN) treatment resulted in RBC transfusion independence for ≥ 8 wks in 51–67% of patients (pts) and cytogenetic response in 25–73% of pts with lower-risk MDS and del5q in 2 large multicenter trials (MDS-003 and -004) (List A et al. NEJM 2006;355:1456–65; Fenaux P et al. Blood 2011; doi:10.1182/blood-2011-01-330126). However, these studies were either single-arm or allowed early crossover to LEN, thus data on the influence of LEN on AML progression and overall survival (OS) is lacking. Aims: To assess the risk of AML progression and death in LEN-treated MDS-003 and -004 pts vs untreated MDS pts with del5q from a large multicenter registry, and to determine relevant risk factors. Methods: Data from 459 MDS pts with del5q entered into local or regional MDS registries were retrospectively collected from 9 centers (Europe, USA, Australia) using a uniform minimal data set. Eligible pt controls had IPSS Low-/Int-1-risk MDS and were RBC transfusion-dependent (≥ 1 unit/8 wks), reflecting the relevant inclusion criteria for both trials, and received best supportive care only including ESAs. Incidence of AML progression was assessed using a cumulative incidence estimator in the presence of competing risk (ie, death), and considering left truncation (LT) for the LEN cohort. OS was assessed using a cumulative probability estimator considering LT. Cox proportional hazards (PH) models with LT were used to assess the impact of LEN treatment and baseline factors (ie, age, sex, cytogenetics, bone marrow [BM] blast %, transfusion burden, no. of cytopenias, hemoglobin [Hgb] level [g/dL], and platelet and neutrophil counts) on risk of AML progression and death. LT is a statistical method to correct for different starting points of follow-up (ie, date of first LEN dose in clinical trial pts vs date of diagnosis in registry pts). Results: We analyzed 295 LEN-treated and 125 untreated pts. Baseline characteristics of treated (at first LEN dose) vs untreated (at diagnosis) pts were similar: mean age 65.0 vs 66.2 yrs; female sex 71% vs 68%; IPSS Low-/Int-1-risk 43%/57% vs 43%/57%. Median observation time was 4.3 vs 4.6 yrs. Baseline RBC transfusion burden was higher in the LEN cohort (median [range] units/8 wks: 6 [1–25] vs 2 [1–10]). Two- and 5-yr cumulative AML incidences were 7% and 23% for LEN vs 12% and 20% for the untreated cohort. Two- and 5-yr cumulative OS probabilities were 90% and 54% for LEN vs 74% and 41% for the untreated cohort. Median time to AML progression has not been reached for either cohort. Median OS was 5.2 yrs (95% CI 4.5–5.9) for LEN-treated vs 3.8 yrs (95% CI 2.9–4.8) for untreated pts. In the final Cox PH models, LEN treatment (hazard ratio [HR].939; p =.860) and 1 cytogenetic abnormality (abn) in addition to del5q (HR 1.111; p =.755) did not increase the risk of AML progression. Significant factors associated with an increased risk of AML progression were complex cytogenetics (del5q plus > 1 abn; HR 3.627; p =.002), BM blasts 5–10% (HR 2.215; p =.016), and higher transfusion burden (HR 1.097 [10% increase in risk per unit at baseline]; p =.029); higher Hgb levels were associated with a reduced risk (HR.857; p =.054). Regarding survival, LEN treatment was associated with a reduced risk of death (HR.597; p =.012). Other factors associated with decreased mortality were higher Hgb levels (HR.883; p =.028), higher platelet counts (HR.999; p =.035), and female sex (HR.598; p =.002). Higher transfusion burden (HR 1.056; p =.037) and age (HR 1.049; p <.001) increased the risk of death. In separate Cox PH models considering IPSS risk (Int-1 vs Low) and transfusion dependency for AML progression and OS, as well as age and sex for OS only, IPSS Int-1-risk was associated with an increased risk of AML progression (HR 1.689; p =.041) but not with an increased risk of death (HR 1.056; p =.723). Findings for LEN treatment when considering IPSS risk were similar to the final Cox PH models that considered individual covariates (AML progression: HR.892, p =.741; OS: HR.545; p =.003). Results were similar when Cox PH models were reanalyzed without LT. Conclusions: In this retrospective analysis of RBC transfusion-dependent pts with lower-risk MDS and del5q, LEN treatment was not associated with a higher risk of AML progression but led to a survival benefit vs untreated pts, despite a higher transfusion burden in the LEN cohort. Other significant risk factors for AML progression and death are consistent with previous findings in MDS pts. Disclosures: Kuendgen: Celgene Corporation: Honoraria. List:Celgene Corporation: Consultancy, Honoraria, Research Funding. Fenaux:Merck: Honoraria; Johnson & Johnson: Honoraria; Amgen: Honoraria, Research Funding; Roche: Honoraria, Research Funding; Celgene Corporation: Honoraria, Research Funding; Cephalon: Honoraria; Novartis: Honoraria. Giagounidis:Celgene Corporation: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Brandenburg:Celgene Corporation: Employment, Equity Ownership. Backstrom:Celgene Corporation: Employment, Equity Ownership. Glasmacher:Celgene Corporation: Employment, Equity Ownership. Hasford:Celgene Corporation: Research Funding. Germing:Celgene Corporation: Honoraria, Research Funding.
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Letter, Michael, Andrew Beauperthuy, Rosalia L. Parrino, Kevin Posner, Michael G. Baraga, Thomas M. Best, Lee D. Kaplan, et al. "Association Between Neuromuscular Variables and Graft Harvest in Soft Tissue Quadriceps Tendon Versus Bone–Patellar Tendon–Bone Anterior Cruciate Ligament Autografts." Orthopaedic Journal of Sports Medicine 9, no. 10 (October 1, 2021): 232596712110415. http://dx.doi.org/10.1177/23259671211041591.
Повний текст джерелаАнотація:
Background: Quadriceps tendon (QT) autografts are increasingly popular for anterior cruciate ligament reconstruction (ACLR). However, no study has compared QT autografts with bone–patellar tendon–bone (BTB) autografts regarding the electromechanical delay (EMD), the peak torque (PT), and the rate of force development (RFD) in the superficial quadriceps muscles (rectus femoris [RF], vastus medialis [VM], and vastus lateralis [VL]). Hypotheses: We hypothesized (1) there would be a significantly lower PT, lower RFD, and longer quadriceps EMD of the operative limb for the QT versus the BTB autograft; (2) the PT, the RFD, and the quadriceps EMD of the operative limb would be significantly depressed compared with those of the nonoperative limb, regardless of the surgical technique; and (3) there would be greater increases in the RF EMD than in the VM or the VL EMD. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 34 patients (age, 18-40 years), who had undergone ACLR (QT, n = 17; BTB, n = 17) at least 1 year before testing and performed 3 perceived maximal effort isometric tests, which were time synchronized with surface electromyography (EMG) on their operative and nonoperative limbs, were included in this study. EMD, PT, and RFD data were analyzed using a 2 (limb) × 2 (graft) × 3 (repetition) mixed repeated-measures analysis of variance. Results: The EMD, the PT, and the RFD were not significantly affected by graft choice. For the VL, a significant repetition × graft × limb interaction was detected for the VL EMD ( P = .027; ηp = 0.075), with repetition 3 having longer EMD than repetition 2 (mean difference [MD], 16 milliseconds; P = .039). For the RF EMD, there was a significant repetition × limb interaction ( P = .027; ηp = 0.074), with repetition 3 being significantly longer on the operative versus the nonoperative limb (MD, 24 milliseconds; P = .004). Further, the operative limb EMD was significantly longer for repetition 3 versus repetition 2 (MD, 17 milliseconds; P = .042). For the PT, there was a significant effect for repetition ( P = .003; ηp = 0.114), with repetition 1 being significantly higher than both repetitions 2 (MD, 8.52 N·m; P = .001) and 3 (MD, 7.79 N·m; P = .031). For the RFD, significant limb ( P = .034; ηp = 0.092) and repetition ( P = .010; ηp = 0.093) effects were seen, with the nonoperative limb being significantly faster than the operative limb (MD, 23.7 N·m/s; P = .034) and repetition 1 being significantly slower than repetitions 2 (MD, -20.46 N·m/s; P = .039) or 3 (MD, −29.85 N·m/s; P = .002). Conclusion: The EMD, the PT, and the RFD were not significantly affected by graft type when comparing QT and BTB autografts for ACLR; however, all neuromuscular variables were affected regardless of the QT or the BTB harvest.
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Dai, Qi, Yu-Tang Gao, Xiao-Ou Shu, Gong Yang, Ginger Milne, Qiuyin Cai, Wanqing Wen, et al. "Oxidative Stress, Obesity, and Breast Cancer Risk: Results From the Shanghai Women's Health Study." Journal of Clinical Oncology 27, no. 15 (May 20, 2009): 2482–88. http://dx.doi.org/10.1200/jco.2008.19.7970.
Повний текст джерелаАнотація:
Purpose Increased reactive oxygen species may exhaust the antioxidant capability of human defense systems, leading to oxidative stress and cancer development. Urinary F2-isoprostanes, secondary end products of lipid peroxidation, are more accurate markers of oxidative stress than other available biomarkers. No prospective study has investigated whether levels of 15-F2t-isoprostane (15-F2t-IsoP) and its metabolite 2,3-dinor-5,6-dihydro-15-F2t-IsoP (15-F2t-IsoPM) are related to breast cancer risk. Patients and Methods We conducted a nested case-control study within the Shanghai Women's Health Study, a population-based cohort study of 74,942 Chinese women between 40 and 70 years of age. Prediagnostic urinary 15-F2t-IsoP and 15-F2t-IsoPM were measured by gas chromatography mass spectrometry for 436 breast cancer cases and 852 individually matched controls. Results Urinary excretion of isoprostanes was not significantly different between cases and controls. However, among overweight women, levels of isoprostanes were positively associated with breast cancer risk, which became stronger with increasing body mass index (BMI). Among women with a BMI ≥ 29, the odds ratio (OR) increased to 10.27 (95% CI, 2.41 to 43.80) for the highest compared with the lowest tertile of 15-F2t-IsoPM (P for trend = .003; P for interaction = .0004). In contrast, 15-F2t-IsoP and 15-F2t-IsoPM were inversely associated with breast cancer risk among nonoverweight women. Among women with a BMI ≤ 23, breast cancer risk was reduced with increasing 15-F2t-IsoP levels in a dose-response manner (P for trend = .006), with an OR of 0.46 (95% CI, 0.26 to 0.80) for the highest tertile versus the lowest (P for interaction = .006). Conclusion Our results suggest that the role of oxidative stress in breast cancer development may depend on adiposity.
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Sharma, Mamta, Kaylin Braekevelt, Pramodini Kale-Pradhan, Susan Szpunar, and Riad Khatib. "Are Blacks at Higher Risk for Vancomycin-Related Acute Kidney Injury?" Journal of Pharmacy Practice 33, no. 5 (January 22, 2019): 592–97. http://dx.doi.org/10.1177/0897190018800093.
Повний текст джерелаАнотація:
Background: Black individuals have a higher lifetime risk of acute kidney injury (AKI) and chronic kidney disease than whites. Vancomycin has a potential for nephrotoxicity. The objective of this study was to determine whether the incidence of AKI among patients being treated with vancomycin differs by race. Methods: Retrospective study of adult (3 ≥18 years) inpatients who were on vancomycin for 348 hours between January 2012 and December 2014. Data on demographics, comorbid conditions, clinical characteristics, vancomycin dose, duration, and nephrotoxic drugs were collected. Patients with a creatinine clearance <30 mL/min or undergoing dialysis were excluded. Results: We identified 1130 patients during the study period; 48.1% (544) were black. The overall incidence of AKI was 8.2% (10.1% blacks, 6.5% whites; P = .03). Independent predictors of AKI included black race ( P = .011); higher Charlson score ( P = .006); higher body mass index (BMI; P = .002); higher vancomycin trough level ( P < .0001); and sepsis/systemic inflammatory response syndrome (<.0001), pneumonia ( P = .001) or gastrointestinal/genitourinary ( P = .025) as the source of infection. Conclusion: The incidence of vancomycin-related AKI was higher in blacks, independent of other risk factors. Based on our study, vancomycin trough levels and renal function need to be closely monitored in blacks.
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Wild, Catherine Y., Avril Grealish, and Diana Hopper. "Lower Limb and Trunk Biomechanics After Fatigue in Competitive Female Irish Dancers." Journal of Athletic Training 52, no. 7 (July 1, 2017): 643–48. http://dx.doi.org/10.4085/1062-6050-52.3.12.
Повний текст джерелаАнотація:
Context: Because of the increasing popularity of participation in Irish dance, the incidence of lower limb injuries is high among this competitive population. Objective: To investigate the effects of fatigue on the peak lower limb and trunk angles as well as the peak lower limb joint forces and moments of competitive female Irish dancers during the performance of a dance-specific single-limb landing. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: Fourteen healthy, female, competitive Irish dancers (age = 19.4 ± 3.7 years, height = 165.3 ± 5.9 cm, mass = 57.9 ± 8.2 kg). Intervention(s): Participants performed an Irish dance–specific leap before and after a dance-specific fatigue protocol. During each landing movement, 3-dimensional lower limb kinematics (250 Hz) and ground reaction forces (1000 Hz) were collected. Paired t tests were performed to determine the differences (P ≤ .05) in lower limb and trunk biomechanics prefatigue and postfatigue. Main Outcome Measure(s): Peak lower limb and trunk angles as well as peak lower limb joint reaction forces and external moments. Results: Compared with the prefatigue trials, dancers landed with reduced ankle plantar flexion (P = .003) and hip external rotation (P = .007) and increased hip-adduction alignment (P = .034) postfatigue. Dancers displayed greater anterior shear (P = .003) and compressive (P = .024) forces at the ankle and greater external knee-flexion moments (P = .024) during the postfatigue compared with the prefatigue landing trials. Conclusions: When fatigued, dancers displayed a decline in landing performance in terms of aesthetics as well as increased ankle- and knee-joint loading, potentially exposing them to a greater risk of injuries.
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García-García, María de Lourdes, Aida Jiménez-Corona, María Eugenia Jiménez-Corona, Leticia Ferreyra-Reyes, Kenneth Martínez, Blanca Rivera-Chavira, María Elena Martínez-Tapia, et al. "Factors Associated With Tuberculin Reactivity in Two General Hospitals in Mexico." Infection Control & Hospital Epidemiology 22, no. 02 (February 2001): 88–93. http://dx.doi.org/10.1086/501869.
Повний текст джерелаАнотація:
Abstract Objective: To identify risk factors associated with tuberculin reactivity in healthcare workers (HCWs). Design: Cross-sectional survey of tuberculin reactivity (2 TU of purified protein derivative (PPD) RT23, using the Mantoux two-step test). Setting: Two general hospitals located in a region with a high prevalence of tuberculosis and high bacille Calmette-Guérin (BCG) coverage. Participants: Volunteer sample of HCWs. Results: 605 HCWs were recruited: 71.2% female; mean age, 36.4 (standard deviation [SD], 8.2) years; 48.9% nurses, 10.4% physicians, 26.8% administrative personnel; mean time of employment, 10.9 (SD, 6.7) years. PPD reactivity (≥10 mm) was found in 390 (64.5%). Multivariate analysis revealed an association of tuberculin reactivity with occupational exposure in the hospital: participation in autopsies (odds ratio [OR], 9.3; 95% confidence interval [CI95], 2.1-40.5; P=.003.), more than 1 year of employment (OR, 2.4; CI95, 1.1-5.0; P=.02), work in the emergency or radiology departments (OR, 2.0; CI95,1.03-3.81; P=.04), being physicians or nurses (OR, 1.5; CI95, 1.04-2.11; P=.03), age (OR, 1.04; CI95, 1.02-1.07 per year of age; P<.001), and BCG scar (OR, 2.1; CI95, 1.2-3.4; P=.005). Conclusions: Although the studied population has a high baseline prevalence of tuberculosis infection and high coverage of BCG vaccination, nosocomial risk factors associated with PPD reactivity were identified as professional risks; strict early preventive measures must be implemented accordingly.
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Lee, Young, Afsha Aurshina, Aaron J. Lee, Israel M. Ackerman, Michael Chait, Daniel Novak, Anil Hingorani, Enrico Ascher, and Natalie Marks. "Routine colonoscopy, diabetic eye care, mammogram and pap smear screening in vascular surgery patients." Vascular 26, no. 4 (November 19, 2017): 372–77. http://dx.doi.org/10.1177/1708538117742830.
Повний текст джерелаАнотація:
Objective An increasing emphasis on preventive medicine has been supported by the recent reforms in United States health care system. Majority of the patients seen in vascular surgery clinics are elderly with more extensive medical comorbidities compared to the general population. Thus, these patients would be expected at higher risk for common malignant pathologies such as colon, breast and cervical cancer, and nonmalignant diseases such as diabetic retinopathy. This study looked at the screening compliance of vascular patients compared to data provided by Centers for Disease Control on the national and state levels. Methods The office records of 851 consecutive patients seen in Brooklyn and Staten Island vascular clinics were examined. We queried patients regarding their last colonoscopy, diabetic eye exams, recent mammograms, and Pap smears. Our patient screening compliance was compared between the two clinics as well as to the national and New York state data provided by Centers for Disease Control. Compliance with regard to patient’s age was also examined. Results Patients referred to the Staten Island office have a better colonoscopy compliance compared to the Brooklyn office ( P = .0001) and the national Centers for Disease Control average ( P = .026). Compliance for mammography and cervical cancer screening was higher in Staten Island office compared to the Brooklyn office ( P = .0001, P < .0001), respectively. Compliance was lower for Pap smear ( P = .0273) in Brooklyn when compared to the national average. Compliance for colonoscopy increased with age for both clinics ( P = .001, P < .001), while Pap smear decreased ( P < .001, P = .004). Conclusion Patients in vascular clinics in an urban setting had better adherence to screening protocol than the national and state average, with the exception of female patients for colonoscopy in our Brooklyn vascular office. There exists variability in both patient populations based on sub-specific locality and demographics including socioeconomic status. Overall, however patients in Staten Island had better compliance and adherence to the screening protocol than Brooklyn vascular clinic.
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Mendoza-Núñez, Víctor Manuel, Elsa Correa-Muñoz, Elsa A. Garfias-Cruz, Martha A. Sánchez-Rodriguez, Rosa Elba Galván-Duarte, and Raquel Retana-Ugalde. "Hyperleptinemia as a Risk Factor for High Blood Pressure in the Elderly." Archives of Pathology & Laboratory Medicine 130, no. 2 (February 1, 2006): 170–75. http://dx.doi.org/10.5858/2006-130-170-haarff.
Повний текст джерелаАнотація:
Abstract Context.—Studies have demonstrated that high serum leptin levels are associated with aging. However, we do not know whether hyperleptinemia is a relevant risk factor for high blood pressure (HBP) in the elderly. Objective.—To determine the relationship between hyperleptinemia and HBP in the elderly. Design.—A comparative cross-sectional study was carried out in a convenience sample of 70 healthy elderly persons comprising 46 women (mean age, 67 ± 5.8 years) and 24 men (mean age, 73 ± 7.5 years), and a group of 91 elderly persons with HBP, comprising 62 women (mean age, 67 ± 8.2 years) and 29 men (mean age, 70 ± 0.3 years). We measured serum leptin levels through the radioimmunoassay method. Results.—The elderly subjects with HBP had significantly higher leptin levels than the healthy elderly subjects (P = .02). Furthermore, in female elderly subjects we observed a statistically significant correlation between systolic blood pressure and leptin (r = 0.37, P = .003), as well as systolic blood pressure and age (r = 0.29, P = .02), but not with diastolic blood pressure. In male elderly subjects, there was no correlation between leptin and systolic blood pressure or leptin and diastolic blood pressure. However, hyperleptinemia as risk factor for HBP was nearly 5 times higher in men than in women (men, odds ratio = 18.0, 95% confidence interval 3.2–100.9, P < .001 vs women, odds ratio = 3.33, 95% confidence interval 1.4–7.4, P = .003). Conclusions.—Our data suggest that hyperleptinemia was a significant risk factor for HBP elderly individuals, mainly in men.
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Han, Michael M., Jessica Hsueh, Andrew X. Chen, Tyler E. Greenlee, Thais F. Conti, Susannah L. Rose, Rishi P. Singh, and Aleksandra V. Rachitskaya. "Ophthalmology Provider Ratings and Patient, Disease, and Appointment Factors." Journal of Patient Experience 8 (January 1, 2021): 237437352110337. http://dx.doi.org/10.1177/23743735211033750.
Повний текст джерелаАнотація:
The purpose of the current study is to examine how nonmodifiable sociodemographic, disease, appointment, management, and survey factors correlate with provider rating. This was a retrospective cross-sectional study conducted on 29 857 patient Clinician and Group Consumer Assessment of Healthcare Providers and Systems surveys collected from January 2017 to January 2019 at a tertiary eye center. We included surveys of patients aged 18 years or older, who answered at least 4 of 6 subfield questions, and completed the survey within 90 days of the appointment. The main outcome was the odds of receiving top box score (TBS) of 10/10 on the survey question regarding overall provider rating. The results showed that the variables with higher odds of TBS included higher overall appointment attendance (odds ratio [OR]: 2.66 [95% CI: 1.23-5.75], P = .013); older patient age (OR 2.44 [95% CI: 2.08-2.87], P < .001]; higher percentage of survey questions completed (OR: 2.02 [95% CI: 1.79-2.27], P < .001); better best corrected visual acuity (OR: 1.85 [95% CI: 1.3-2.64], P = .001); optometry clinic visit (OR: 1.25 [95% CI: 1.15-1.36], P < .001); having procedures (OR: 1.19 [95% CI: 1.04-1.36], P = .013), surgery scheduled (OR: 1.18 [95% CI: 1.03-1.36], P = .020], or refraction done (OR: 1.16 [95% CI: 1.08-1.25], P < .001); being seen by male providers (OR: 1.11 [95% CI: 1.04-1.17], P = .001); and having additional eye testing performed (OR: 1.06 [95% CI: 1.00-1.13], P = .048). Variables associated with lower odds of TBS included longer time to complete survey (OR: 0.42 [95% CI: 0.3-0.58], P = .001); new patient encounter (OR: 0.62 [95% CI: 0.58-0.65], P < .001); and glaucoma (OR: 0.66 [95% CI: 0.59-0.75], P < .001), cornea (OR: 0.79 [95% CI: 0.71-0.87], P < .001), or comprehensive clinic visits (OR: 0.86 [95% CI: 0.79-0.94], P < .001). Thus, nonmodifiable factors may affect the provider rating, and these factors should be studied further and accounted for when interpreting the results of patient experience surveys.
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Ji, Keven, Thomas J. Risoli, Maragatha Kuchibhatla, Lyndon Chan, Ralph Abi Hachem, and David W. Jang. "Symptom Profile of Chronic Rhinosinusitis Versus Obstructive Sleep Apnea in a Tertiary Rhinology Clinic." Annals of Otology, Rhinology & Laryngology 128, no. 10 (May 22, 2019): 963–69. http://dx.doi.org/10.1177/0003489419851527.
Повний текст джерелаАнотація:
Objectives: Patients with undiagnosed obstructive sleep apnea (OSA) often present to an otolaryngologist with symptoms of chronic rhinosinusitis (CRS). This study analyzes symptom profiles of such patients to help identify those who may benefit from polysomnography. Methods: This is a 2-year retrospective analysis of adult patients at an academic practice with a rhinologic chief complaint. Results of the 22-Item Sinonasal Outcomes Test (SNOT-22) were compared between patients with untreated OSA without CRS (OSA group) and a control group of CRS patients (CRS group). Univariate analysis with Bonferroni correction and multiple logistic regression were used. Results: Forty-one patients were included in the OSA group (mean apnea-hypopnea index = 28.8, SD = 21.0) and 124 patients in the CRS group. CRS group demonstrated higher scores in nasal, extra-nasal, and ear/facial symptom domains ( P < .001), while OSA group displayed higher psychological ( P = .020) and sleep domain scores ( P = .048). Nasal discharge ( P < .001) and loss of smell/taste ( P = .004) scores were higher in CRS group, whereas facial pain ( P = .285) and nasal obstruction ( P = .822) were not significantly different. On logistic regression, thick nasal discharge, loss of smell/taste, and ear pain were predictive of CRS, while waking up tired was predictive of OSA. Finally, OSA group was more likely to choose a sleep-related issue as a most important symptom (MIS) ( P < .001). Conclusions: OSA and CRS have significant overlap in symptom profiles. The SNOT-22 can help identify those with undiagnosed OSA. OSA should be suspected in patients who report a sleep-related item as a MIS and display higher psychological and sleep domain scores.
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Kunwor, Ranju, Mahesh Nepal, Dominic Ho, and Krishna Bilas Ghimire. "Survival trends among patients with metastatic melanoma in the United States: A population based study." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 9555. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.9555.
Повний текст джерелаАнотація:
9555 Background: Ipilimumab was approved by FDA in March 2011 for the treatment of Metastatic Melanoma. We conducted this study to compare survival outcome in patients with Metastatic Melanoma in pre- (1973-2010) and post- (2011-2013) ipilimumab era in the United States using U.S. Surveillance, Epidemiology, and End Result (SEER) registry database. Methods: We selected patients with metastatic melanoma age ≥ 20 years from the SEER database. We used SEER 18 registry database to evaluate relative survival (RS) rate during 1973-2010 and 2011-2013. The RS rate at 1year and 2 year were analyzed for cohorts by age (20-49 years, 50-74 and ≥75 years), race [White, African American (AA), and others] and gender. The RS rates (%) accompany standard error (SE). We used SEER Stat software for statistical analysis. Results: There were a total of 129,362 (106,516 and 22,846 in pre and post ipilimumab era) metastatic melanoma patients, male (n = 71,220), female (n = 58,142), white (n = 121,843), AA (n = 854) other (n = 1,315) reported in the registry. RS in pre vs post-ipilimumab era for age group 20-49 was: 96.50 ± 0.1% vs 97.20 ±0.3%, P = 0.013; and 94.10 ± 0.1% to 95.60 ±0.40, P = 0.0009; for age group 50-74 was: 94.10 ± 0.1% vs 95.30 ± 0.2%, P = 0.0001; and 90.70 ± 0.1%vs 92.90 ± 0.3%, P = 0.0001; and for age group ≥75 was 90.80 ± 0.3% vs 91.40 ± 0.7%, P = 0.23; and 85.0 ± 0.4% vs 88.10 ± 1.0%, P = 0.011 at 1 and 2 years respectively. Overall RS in pre and post ipilimumab era for white population was: 93.83 ± 0.16% vs 94.567 ± 0.4%, P = 0.017; and 90.0 ± 0.2% vs 92.033 ± 0.6%, P = 0.0008 at 1 and 2 years respectively. Similarly RS for AA was: 78.07 ± 2.93% vs 73.33 ± 8.23%, P = 0.37; and 65.87 ± 3.47% vs 65.33 ± 9.73%, P = 0.94; and for other race was: 85.2 ± 2.13% vs 77.97 ± 5.6%, P = 0.04; and 74.43 ± 5.2% vs 69.67 ± 6.7%, P = 0.1 at 1 year and 2 years. Conclusions: Our study showed that younger (20-74 years) patients with metastatic melanoma have improvement in 1 and 2-year RS rates in post ipilimumab era. Subgroup analysis by race showed no improvement in RS in AA and other races patients during this period. There was also no significant survival benefit seen in older (≥ 75 years) patients of all races and gender in post ipilimumab era.
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Wang, Fei, Shihua Zhao, Xiaopei Shen, Guangwu Zhu, Rengyun Liu, David Viola, Rossella Elisei, et al. "BRAF V600E Confers Male Sex Disease-Specific Mortality Risk in Patients With Papillary Thyroid Cancer." Journal of Clinical Oncology 36, no. 27 (September 20, 2018): 2787–95. http://dx.doi.org/10.1200/jco.2018.78.5097.
Повний текст джерелаАнотація:
Purpose To test whether the prognostic risk of male sex in papillary thyroid cancer (PTC) is determined by BRAF V600E and can thus be stratified by BRAF status. Patients and Methods We retrospectively investigated the relationship between male sex and clinicopathologic outcomes in PTC, particularly mortality, with respect to BRAF status in 2,638 patients (male, n = 623; female, n = 2,015) from 11 centers in six countries, with median age of 46 years (interquartile range, 35-58 years) at diagnosis and median follow-up time of 58 months (interquartile range, 26-107 months). Results Distant metastasis rates in men and women were not different in wild-type BRAF PTC but were different in BRAF V600E PTC: 8.9% (24 of 270) and 3.7% (30 of 817; P = .001), respectively. In wild-type BRAF PTC, mortality rates were 1.4% (five of 349) versus 0.9% (11 of 1175) in men versus women ( P = .384), with a hazard ratio (HR) of 1.59 (95% CI, 0.55 to 4.57), which remained insignificant at 0.70 (95% CI, 0.23 to 2.09) after clinicopathologic multivariable adjustment. In BRAF V600E PTC, mortality rates were 6.6% (18 of 272) versus 2.9% (24 of 822) in men versus women ( P = .006), with an HR of 2.43 (95% CI, 1.30 to 4.53), which remained significant at 2.74 (95% CI, 1.38 to 5.43) after multivariable adjustment. In conventional-variant PTC, male sex similarly had no effect in wild-type BRAF patients; mortality rates in BRAF V600E patients were 7.2% (16 of 221) versus 2.9% (19 of 662) in men versus women ( P = .004), with an HR of 2.86 (95% CI, 1.45 to 5.67), which remained significant at 3.51 (95% CI, 1.62 to 7.63) after multivariable adjustment. Conclusion Male sex is a robust independent risk factor for PTC-specific mortality in BRAF V600E patients but not in wild-type BRAF patients. The prognostic risk of male sex in PTC can thus be stratified by BRAF status in clinical application.
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Hwang, Kun, Ji Soo Son, and Woo Kyung Ryu. "Smoking and Flap Survival." Plastic Surgery 26, no. 4 (January 9, 2018): 280–85. http://dx.doi.org/10.1177/2292550317749509.
Повний текст джерелаАнотація:
Purpose: The aim of this study was to compare the complications of flap surgery in non-smokers and smokers and to determine how the incidence of complications was affected by the abstinence period from smoking before and after flap surgery. Methods: In PubMed and Scopus, terms “smoking” and “flap survival” were used, which resulted in 113 papers and 65 papers, respectively. After excluding 6 duplicate titles, 172 titles were reviewed. Among them, 45 abstracts were excluded, 20 full papers were reviewed, and finally 15 papers were analyzed. Results: Post-operative complications such as flap necrosis ( P < .001), hematoma ( P < .001), and fat necrosis ( P = .003) occurred significantly more frequently in smokers than in non-smokers. The flap loss rate was significantly higher in smokers who were abstinent for 24 hours post-operatively than in non-smokers (n = 1464, odds ratio [OR] = 4.885, 95% confidence interval [CI] = 2.071-11.524, P < .001). The flap loss rate was significantly lower in smokers who were abstinent for 1 week post-operatively than in those who were abstinent for 24 hours post-operatively (n = 131, OR = 0.252, 95% CI = 0.074-0.851, P = .027). No significant difference in flap loss was found between non-smokers and smokers who were abstinent for 1 week preoperatively (n = 1519, OR = 1.229, 95% CI = 0.482-3.134, P = .666) or for 4 weeks preoperatively (n = 1576, OR = 1.902, 95% CI = 0.383-2.119, P = .812). Conclusion: Since smoking decreases the alveolar oxygen pressure and subcutaneous wound tissue oxygen, and nicotine causes vasoconstriction, smokers are more likely to experience flap loss, hematoma, or fat necrosis than non-smokers. Preoperative and post-operative abstinence period of at least 1 week is necessary for smokers who undergo flap operations.
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Iwaasa, Alan D., Paul G. Jefferson, and Edward J. Birkedal. "Beef cattle grazing behaviour differs among diploid and tetraploid crested wheatgrasses (Agropyron cristatumandA. desertorum)." Canadian Journal of Plant Science 94, no. 5 (July 2014): 851–55. http://dx.doi.org/10.4141/cjps2013-373.
Повний текст джерелаАнотація:
Iwaasa, A. D., Jefferson, P. G. and Birkedal, E. J. 2014. Beef cattle grazing behaviour differs among diploid and tetraploid crested wheatgrasses (Agropyron cristatum and A. desertorum). Can. J. Plant Sci. 94: 851–855. A study was conducted over 4 yr (1999, 2000, 2002 and 2003) at Swift Current to evaluate the forage preferences of steers grazing five different crested wheatgrass (CWG) cultivars: Kirk (2n=28), Fairway (2n=14) and Parkway (2n=14) [Agropyron cristatum (L.) Gaertn.], Hycrest (2n=28) (A. cristatum×A. desertorum) and Nordan (2n=28) [(A. desertorum (Fisch. Ex Link) Schult.)]. Animal grazing frequencies for each CWG cultivar patch were converted to percentages (Grazing%) for each grazing time period. Grazing% for Kirk and Hycrest CWGs were similar with Nordan having higher (P<0.05) Grazing% compared with the hybrid and diploid CWGs. Contrasts revealed no differences (P=0.48) in Grazing% between diploid versus hybrid cultivars, while higher (P<0.01) Grazing% were observed for tetraploid compared with diploid and hybrid CWG cultivars. For forage nutritive values, significant Cultivar (P<0.01) and Year (P<0.0001) main effects were observed. Overall mean values for percent crude protein (%CP) and percent acid detergent fibre (%ADF) for Nordan, Kirk, Hycrest, Fairway and Parkway were 10.6±0.3 and 29.2±0.4, 11.0±0.3 and 28.7±0.4, 10.4±0.3 and 29.7±0.4, 9.9±0.3 and 28.5±0.4, and 10.0±0.3 and 28.7±0.4, respectively (± SE). Correlation coefficients between Grazing% and all nutritive value constituents were low and not significant. This study observed grazing preference differences among different CWG cultivars that may lead to grazing management strategies to improve pasture utilization potential and animal production.
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Delevatti, Rodrigo Sudatti, Ana Carolina Kanitz, Cláudia Gomes Bracht, Salime Donida Chedid Lisboa, Elisa Corrêa Marson, Thaís Reichert, Vitória Bones, and Luiz Fernando Martins Kruel. "Effects of 2 Models of Aquatic Exercise Training on Cardiorespiratory Responses of Patients With Type 2 Diabetes: The Diabetes and Aquatic Training Study—A Randomized Controlled Trial." Journal of Physical Activity and Health 17, no. 11 (November 1, 2020): 1091–99. http://dx.doi.org/10.1123/jpah.2020-0236.
Повний текст джерелаАнотація:
Background: There are a lack of clinical trials with suitable methodological quality that compare aquatic exercise training types in type 2 diabetes (T2D) treatment. This study aimed to compare the effects of aerobic and combined aquatic training on cardiorespiratory outcomes in patients with T2D. Methods: Untrained patients with T2D were randomized to receive an aerobic aquatic training, a combined aquatic training, or a procedure control in 3 weekly sessions for 15 weeks. The sessions were 50 minutes long. The intensities were from 85% to 100% of heart rate of anaerobic threshold and at maximal velocity for aerobic and resistance parts, respectively. Resting heart rate, peak oxygen uptake (VO2peak), and oxygen uptake corresponding to second ventilatory threshold and its relation with VO2peak were evaluated. Results: Participants were 59.0 (8.2) years old and 51% women. Intervention groups increased in VO2peak (aerobic aquatic training group: 4.48 mL·kg−1·min−1, P = .004; combined aquatic training group: 5.27 mL·kg−1·min−1; P = .006) and oxygen uptake corresponding to second ventilatory threshold, whereas the control group presented an increase in oxygen uptake corresponding to second ventilatory threshold and minimal change in VO2peak. Conclusions: Aerobic and combined aquatic exercise interventions improve the cardiorespiratory fitness of patients with T2D.
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Goloeva, R., Z. Alekberova, T. Popkova, S. Glukhova, and D. Novikova. "POS0116 HEART RATE VARIABILITY IN PATIENTS WITH BEHCETS DISEASE." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 269.2–269. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3682.
Повний текст джерелаАнотація:
Background:Behcet’s disease (BD) is a systemic vasculitis affecting all types and sizes of blood vessels. Heart rate variability (HRV) reflects sympathetic -parasympathetic imbalance in the autonomic NS regulation. Low HRV values are known as independent risk factor of death and non-fatal cardiovascular events in both - survivors of a myocardial infarction and in asymptomatic population.Objectives:The aim of this study is to evaluate HRV in BD pts vs healthy controls.Methods:The study group included 74 BD pts (53males/21females) with disease duration of 9,0 (5,0;15,0)/9,0 (7;20) years, and the control group - 32/15 age-matched healthy m/f. The following HRV parameters from 24h ECG ambulatory recording were assessed: MeanNN and time-domain variables, adjusted by MeanNN (SDNNn%, SDNNin%, RMSSDn%). Additionally, all traditional cardiovascular risk factors such as systolic blood pressure (SPB), smoking status, BMI values, dyslipidemia profile, ultrasonographic values of carotid intima-media thickness (IMT), and levels high sensitive CRP (hsCRP) as a marker of inflammation were evaluated.Results:In BD patients HRV values (RMSSDn%) were significantly lower compared to healthy controls (table 1).Table 1.HRV parameters in BD patients and control groupParametersMalesFemalesBD (n=53)Control (n=32)BD (n=21)Control (n=15)Age, years30 (24; 36)30 (26; 35)32 (26; 37)28 (24; 31)MeanNN, ms810 (732; 849)782 (732; 835)776 (708; 830)764 (694; 832)SDNN n (%)16,9 (13,6; 19,4)17,2 (16,3; 21,1)13,1 (11,3; 5,3)12,2 (10,7; 14,6)SDNNi n (%)6,8 (5,1; 8,1)6,8 (5,0; 8,3)7,1 (6,1; 7,7)5,2 (4,9; 5,7)RMSSD n (%)2,1 (1,5; 2,3)**4,1 (2,7; 5,2)**1,7 (1,4; 3,7)*2,8 (2,2; 3,9)*Data are presented in median values and interquartile range, *p<0,05, **p<0,005 vs controls.There was a significant negative correlation in BD patients between HRV (SDNNin%) and age (r= -0,4; p=0,00), disease duration (r= -0,3; p=0,00), BMI (r= -0,2; p<0,01), cholesterol levels (r= -0,3; p=0,00), LDLP (r= -0,3; p=0,00) and increased IMT (r= -0,2; p=0,04), and also between HRV (RMSSD%) and age (r= -0,2; p=0,04), disease duration (r= -0,2; p=0,01), cholesterol levels (r= -0,3; p=0,00), HDLP (r= -0,2; p=0,04); a positive correlation was established between HRV (SNNN%) and smoking (r= -0,2; p=0,04). The control group showed positive correlation between HRV (SNNN%) and increased IMT (r= 0,4; p=0,01).Conclusion:HRV reduction reflects impaired sympathetic -parasympathetic regulation in BD pts, associated with pts’ age, disease duration and presence of traditional cardiovascular risk factors: BMI, increased cholesterol levels, LDLP, and such asymptomatic manifestation of atherosclerosis as increased IMT.Disclosure of Interests:None declared
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Lee, Shing Fung, Miguel Angel Luque-Fernandez, Yu Hui Chen, Paul J. Catalano, Chi Leung Chiang, Eric Yuk-Fai Wan, Ian Chi-Kei Wong, Ming Hui Chen, and Andrea K. Ng. "Doxorubicin and subsequent risk of cardiovascular diseases among survivors of diffuse large B-cell lymphoma in Hong Kong." Blood Advances 4, no. 20 (October 21, 2020): 5107–17. http://dx.doi.org/10.1182/bloodadvances.2020002737.
Повний текст джерелаАнотація:
Abstract Evidence regarding the dose-related impact of doxorubicin on subsequent cardiovascular diseases (CVDs) in Asian patients with diffuse large B-cell lymphoma (DLBCL) without preexisting CVDs is lacking. From a territory-wide electronic database in Hong Kong, we identified adults who were diagnosed with DLBCL and treated with chemotherapy between 2000 and 2018. We evaluated the patients for incident CVDs (including ischemic heart disease, heart failure, and cardiomyopathy). We evaluated the cause-specific cumulative incidence (csCI) of CVD with levels of doxorubicin exposure by using flexible parametric competing risk analysis and adjusting for demographics, comorbidities, therapeutic exposure, cardiovascular risk factors, and lifestyle factors. Controls were age- and sex-matched to DLBCL patients. We analyzed 2600 patients and 13 000 controls. The adjusted cause-specific hazard ratio (HR) for CVD in patients treated with >500 mg doxorubicin compared with non-doxorubicin regimens was 2.65 (95% confidence interval [CI], 1.23-5.74; P = .013). The 5-, 10-, and 15-year csCIs were 8.2%, 11.3%, and 12.8% in patients vs 3.1%, 4.4%, and 5.2% in controls, respectively. Hypertension (HR, 6.20; 95% CI, 0.79-48.44; P = .082) and use of aspirin/angiotensin-converting enzyme inhibitor/beta-blocker at baseline (HR, 2.13-4.63; P < .001 to .002) might confer a higher risk of subsequent CVDs. In this Hong Kong population-based study, doxorubicin exposure (absolute dose >500 mg), together with hypertension or baseline use of medication for cardiovascular risk factors, was found to be associated with an increase in csCIs of CVDs. Tailoring therapeutic strategies to underlying CVD risk factors and risk-adapted monitoring and follow-up of susceptible DLBCL patients are advisable.
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Sumiati, Neneng Tati, and Syanindia Annisa Dewi. "The Relationship of Severity Level of Autism and Parent’s Unconditional Love on Children with Autism Moderated by Religiosity and Social Support." Jurnal Psikologi 20, no. 2 (October 31, 2021): 187–204. http://dx.doi.org/10.14710/jp.20.2.187-204.
Повний текст джерелаАнотація:
Children with autism have difficulties in social interaction, lack of communication, and repetitive behavior. Thoseconditions make parents come to grips with several drawbacks in taking care of their autistic children. Thepurpose of this study was to determine the relationship between the severity level of autism and the unconditionallove of parents, moderated by religiosity and social support. This study was using a quantitative approach withstructural equation model (SEM) analysis. Participants in this study were 200 parents of children with AutismSpectrum Disorder (ASD) aged 2-17 years old and were selected by the non-probability sampling technique. Themeasurements applied in this study were unconditional love scale, taken from Porter Parent Acceptance scale,which consists of four items (α = .802; AVE = .628), social support scale, which consists of three items (α = .703;AVE= .628), Brief Multidimensional Measure of Religiousness/Spirituality, which consists of ten items (α =.952; AVE= .699), and Childhood Autism Rating Scale, which consists of four items (α = .756; AVE= .574). Theresult indicated that the unconditional love of parents was significantly affected by severity level of autism, b = -.162; t(196) = 2.849, p = .005; religiosity, b = .534; t(196) = 7.101, p = .000; and social support, b = .157; t(196)= 2.426, p = .016. Religiosity was proven to be essential in moderating the relationship of severity level of autismand unconditional love, b = .249; t(196) = 3.262, p = .001); while social support was not, b = -.020; t(196) = .293,p = .770. Religiosity could help maintain the unconditional love of parents for their autistic children, while socialsupport was not enough to buffer stress caused by them. Thus, parents of children with autism are urged toincrease their level of religiosity
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Haugnes, Hege S., Nina Aass, Sophie D. Fosså, Olav Dahl, Marianne Brydøy, Ulf Aasebø, Tom Wilsgaard, and Roy M. Bremnes. "Pulmonary Function in Long-Term Survivors of Testicular Cancer." Journal of Clinical Oncology 27, no. 17 (June 10, 2009): 2779–86. http://dx.doi.org/10.1200/jco.2008.18.5181.
Повний текст джерелаАнотація:
Purpose Long-term toxicity after cancer treatment has gained increasing clinical attention. We evaluated pulmonary function in long-term survivors of testicular cancer (TC). Patients and Methods The pulmonary function of 1,049 TC survivors treated during 1980 to 1994 at three university hospitals in Norway was assessed by spirometry and a questionnaire (1998 to 2002). The patients were categorized into five treatment groups, as follows: surgery only (n = 202); radiotherapy only (n = 449); chemotherapy (cisplatin ≤ 850 mg; n = 306); chemotherapy (cisplatin > 850 mg [higher-dose group]; n = 62); and chemotherapy and pulmonary surgery (cis/pulmsurg; n = 30). Spirometry variables included forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1). Actual values and percentages of predicted normal values (FVC%pred and FEV1%pred, respectively) are reported. Restrictive lung disease was defined as FEV1/FVC ≥ 70% and FVC%pred less than 80%. Results Median observation time was 11.2 years (range, 5 to 21 years). Compared with the surgery group, the higher-dose or cis/pulmsurg groups had considerably lower age-adjusted FVC (higher-dose: β = −.37; P = .001; cis/pulmsurg: β = −.58; P < .001), FEV1 (higher-dose: β = −.24; P = .014; cis/pulmsurg: β = −.55; P < .001), FVC%pred (higher-dose: β = −8.3; cis/pulmsurg: β = −10.5; bothP < .001), and FEV1%pred (higher-dose: β = −6.8; P = .003; cis/pulmsurg: β = −12.4; P < .001). Adjustment for total testosterone, body mass index, smoking, and physical activity did not change these associations. Eight percent of all patients had restrictive lung disease, and the highest prevalence was in the higher-dose group (17.7%) and the cis/pulmsurg (16.7%) group. Compared with patients who underwent surgery only, these groups had odds ratio for restrictive disease of 3.1 (95% CI, 1.3 to 7.3) and 2.5 (95% CI, 0.8 to 7.6), respectively. Conclusion Large doses of cisplatin-based chemotherapy and combined chemotherapy/pulmonary surgery are significantly associated with decreased pulmonary function several years after TC treatment.
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Datta, Rupak, Shawn Brown, Vinh Q. Nguyen, Chenghua Cao, John Billimek, Taliser Avery, Bruce Y. Lee, and Susan S. Huang. "Quantifying the Exposure to Antibiotic-Resistant Pathogens Among Patients Discharged From a Single Hospital Across All California Healthcare Facilities." Infection Control & Hospital Epidemiology 36, no. 11 (September 21, 2015): 1275–82. http://dx.doi.org/10.1017/ice.2015.181.
Повний текст джерелаАнотація:
OBJECTIVETo assess the time-dependent exposure of California healthcare facilities to patients harboring methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), extended-spectrum β-lactamase (ESBL)–producing Escherichia coli and Klebsiella pneumoniae, and Clostridium difficile infection (CDI) upon discharge from 1 hospital.METHODSRetrospective multiple-cohort study of adults discharged from 1 hospital in 2005–2009, counting hospitals, nursing homes, cities, and counties in which carriers were readmitted, and comparing the number and length of stay of readmissions and the number of distinct readmission facilities among carriers versus noncarriers.RESULTSWe evaluated 45,772 inpatients including those with MRSA (N=1,198), VRE (N=547), ESBL (N=121), and CDI (N=300). Within 1 year of discharge, MRSA, VRE, and ESBL carriers exposed 137, 117, and 45 hospitals and 103, 83, and 37 nursing homes, generating 58,804, 33,486, and 15,508 total exposure-days, respectively. Within 90 days of discharge, CDI patients exposed 36 hospitals and 35 nursing homes, generating 7,318 total exposure-days. Compared with noncarriers, carriers had more readmissions to hospitals (MRSA:1.8 vs 0.9/patient; VRE: 2.6 vs 0.9; ESBL: 2.3 vs 0.9; CDI: 0.8 vs 0.4; all P<.001) and nursing homes (MRSA: 0.4 vs 0.1/patient; VRE: 0.7 vs 0.1; ESBL: 0.7 vs 0.1; CDI: 0.3 vs 0.1; all P<.001) and longer hospital readmissions (MRSA: 8.9 vs 7.3 days; VRE: 8.9 vs 7.4; ESBL: 9.6 vs 7.5; CDI: 12.3 vs 8.2; all P<.01).CONCLUSIONSPatients harboring antibiotic-resistant pathogens rapidly expose numerous facilities during readmissions; regional containment strategies are needed.Infect. Control Hosp. Epidemiol. 2015;36(11):1275–1282
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Carhuapoma De la Cruz, Víctor, Nicasio Valencia Mamani, Teresa Huaman Gonzales, Rufino Paucar Chanca, Epifanio Hilario Lizana, and Jorge L. Huere Peña. "Resistencia antibiótica de Salmonella sp, Escherichia coli aisladas de alpacas (Vicugna pacus) con y sin diarrea." La Granja 31, no. 1 (February 29, 2020): 98–109. http://dx.doi.org/10.17163/lgr.n31.2020.08.
Повний текст джерелаАнотація:
A nivel mundial, el problema de resistencia a antibióticos es considerado de prioridad sanitaria pública y veterinaria, por ello el objetivo de esta investigación fue evaluar la presencia de resistencia antibiótica frente a Salmonella sp., y Escherichia coli provenientes de crías de alpacas con y sin diarrea. La investigación fue de tipo descriptivo transversal múltiple. Se recolectaron 300 muestras de heces por hisopado rectal de crías de alpacas entre 10 a 60 días nacidas con y sin cuadros diarreicos provenientes de Comunidades Campesinas de Huancavelica-Perú. La presencia de Escherichia coli y Salmonella sp. se identificó mediante pruebas bioquímicas, la susceptibilidad antibacteriana por método Kirby Bauer y se evaluaron 8 antibióticos usuales del mercado veterinaria. El 100 % de muestras con diarreas fueron positivas a Escherichia coli, 40,0 % Salmonella sp. 20% Escherichia coli-Salmonella sp. y muestras sin diarrea 57,0% positivas a Escherichia coli, 24,0% Salmonella sp. 19.0% E. coli-Salmonella sp. Las cepas de Escherichia coli y Salmonella sp. fueron resistentes a Ampicilina (10,4± 0,3), (9,3± 0,2); Novomicina (11,1± 0,2), (11,2± 0,1); Tetraciclina (8,2± 0,1), (9,2± 0,3); Penicilina (9,1± 0,4), (11,1± 0,3); Gentamicina (10,1± 0,4), (10,2± 0,3) provenientes de muestras con diarrea y en muestras sin diarrea resistentes a Gentamicina (10,3± 0,1), (8,2± 0,1); Tetraciclina (9,2± 0,4), (8,2± 0,4); Ampicilina (11,2± 0,1), (9,3± 0,2); Penicilina (10,2± 0,4), (10,1± 0,3). Las cepas de Salmonella sp., y Escherichia coli aisladas de crías de alpacas con y sin diarreas evidencian resistencia antibacteriana a múltiples antibióticos usados en la veterinaria.
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Frenette, Charles, David Sperlea, Yveta Leharova, and Daniel J. G. Thirion. "Impact of an Infection Control and Antimicrobial Stewardship Program on Solid Organ Transplantation and Hepatobiliary Surgical Site Infections." Infection Control & Hospital Epidemiology 37, no. 12 (October 3, 2016): 1468–74. http://dx.doi.org/10.1017/ice.2016.213.
Повний текст джерелаАнотація:
OBJECTIVEThe goal of this long-term quasi-experimental retrospective study was to assess the impact of a 5-year serial infection control and antimicrobial stewardship intervention on surgical site infections (SSIs).METHODSThis study was conducted in a tertiary-care public teaching institution over a 5-year period from January 2010 to December 2014. All patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas–kidney transplantation were included. Outcomes were compared between a preintervention group (2010–2011) and a postintervention group (2012–2014).RESULTSA total of 1,424 procedures averaged an overall SSI rate of 11.2%. After implementation of the interventions, a decrease of 52.8% in SSI rates from 17.4% to 8.2% was observed (P<.001; odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5–2.9). An overall significant decrease >50% (relative rate; P<.001) was observed in superficial incisional and organ-space infections between pre- and postintervention groups. In addition, a 54.9% decrease from 19.7% to 8.9% (P<.001; OR, 2.2; 95% CI, 1.4–3.5) and a 51.6% decrease from 15.5% to 7.5% (P=.001; OR, 2.2; 95% CI, 1.4–3.5) were observed for SSI rates in hepatobiliary surgery and solid organ transplantation, respectively. The antimicrobial stewardship intervention increased overall conformity to the internal surgical prophylaxis protocol by 15.2% (absolute rate) from 45.1% to 60.3% (P<.003; 95% CI, 5.4–24.9).CONCLUSIONSA long-term serial infection control and antimicrobial stewardship intervention decreased SSIs among patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas–kidney transplantation.Infect Control Hosp Epidemiol 2016;1468–1474