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1.
Psychiatry Res ; 337: 115952, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38723408

RESUMO

Our aim is to review and perform a meta-analysis on the role of impulsivity in fatal suicide behaviour. We included papers who used psychological autopsy methodology, assessed adult death by suicide, and included assessment of impulsivity. We excluded papers about assisted suicide, terrorist suicide, or other cause of death other than suicide or postmortem diagnosis made only from medical records or database. 97 articles were identified. 33 were included in the systematic review and nine in the meta-analysis. We found that people who die by suicide with high impulsivity are associated with younger age, substance abuse, and low intention to die, whereas those with low impulsivity were associated with older age, depression, schizophrenia, high intention to die and low social support. In the meta-analysis, suicide cases had higher impulsivity scores than living controls (Hedges' g = 0.59, 95 % CI [0.28, 0.89], p=.002). However, studies showed heterogeneity (Q = 90.86, p<.001, I2=89.0 %). Impulsivity-aggressiveness interaction was assessed through meta-regression (ß=0.447, p=.045). Individuals with high impulsivity would be exposed to a higher risk of fatal suicide behaviour, aggressiveness would play a mediating role. People who die by suicide with high and low impulsivity display distinct characteristics, which may reflect different endophenotypes leading to suicide by different pathways.

2.
J Clin Med ; 13(9)2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38731156

RESUMO

Background: The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome represents a severe form of drug hypersensitivity reaction characterized by significant morbidity, mortality, and long-term sequelae, coupled with limited therapeutic avenues. Accurate identification of the causative drug(s) is paramount for acute management, exploration of safe therapeutic alternatives, and prevention of future occurrences. However, the absence of a standardized diagnostic test and a specific causality algorithm tailored to DRESS poses a significant challenge in its clinical management. Methods: We conducted a retrospective case-control study involving 37 DRESS patients to validate a novel causality algorithm, the ALDRESS, designed explicitly for this syndrome, comparing it against the current standard algorithm, SEFV. Results: The ALDRESS algorithm showcased superior performance, exhibiting an 85.7% sensitivity and 93% specificity with comparable negative predictive values (80.6% vs. 97%). Notably, the ALDRESS algorithm yielded a substantially higher positive predictive value (75%) compared to SEFV (51.40%), achieving an overall accuracy rate of 92%. Conclusions: Our findings underscore the efficacy of the ALDRESS algorithm in accurately attributing causality to drugs implicated in DRESS syndrome. However, further validation studies involving larger, diverse cohorts are warranted to consolidate its clinical utility and broaden its applicability. This study lays the groundwork for a refined causality assessment tool, promising advancements in the diagnosis and management of DRESS syndrome.

3.
Rev Esp Enferm Dig ; 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38767037

RESUMO

We report the case of a patient who comes to the emergency department with abdominal pain, oral intolerance and bloody stools, being diagnosed with intestinal obstruction secondary to a jejunal tumor with contained perforation. A laparotomy was performed with resection of the jejunal tumor and taking biopsies from lesions with similar characteristics in the rest of the small bowel compatible with monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL). The monomorphic epitheliotropic intestinal T-cell lymphoma is a rare intestinal tumor with a poor prognosis that is characterized by the proliferation of intraepithelial lymphocytes. The abdominal symptoms are nonspecific and the known major complications are intestinal perforation and obstruction. There is no standard therapeutic approach, being a combination of surgical resection, chemotherapy and autologous stem cell transplant.

4.
Int J Mol Sci ; 25(9)2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38732185

RESUMO

Herpes simplex virus (HSV) infections are highly widespread among humans, producing symptoms ranging from ulcerative lesions to severe diseases such as blindness and life-threatening encephalitis. At present, there are no vaccines available, and some existing antiviral treatments can be ineffective or lead to adverse effects. As a result, there is a need for new anti-HSV drugs. In this report, the in vitro anti-HSV effect of 9,9'-norharmane dimer (nHo-dimer), which belongs to the ß-carboline (ßC) alkaloid family, was evaluated. The dimer exhibited no virucidal properties and did not impede either the attachment or penetration steps of viral particles. The antiviral effect was only exerted under the constant presence of the dimer in the incubation media, and the mechanism of action was found to involve later events of virus infection. Analysis of fluorescence lifetime imaging data showed that the nHo-dimer internalized well into the cells when present in the extracellular incubation medium, with a preferential accumulation into perinuclear organelles including mitochondria. After washing the host cells with fresh medium free of nHo-dimer, the signal decreased, suggesting the partial release of the compound from the cells. This agrees with the observation that the antiviral effect is solely manifested when the alkaloid is consistently present in the incubation media.


Assuntos
Antivirais , Antivirais/farmacologia , Antivirais/química , Chlorocebus aethiops , Humanos , Células Vero , Animais , Simplexvirus/efeitos dos fármacos , Simplexvirus/fisiologia , Herpes Simples/tratamento farmacológico , Herpes Simples/virologia , Carbolinas/farmacologia , Carbolinas/química , Herpesvirus Humano 1/efeitos dos fármacos , Herpesvirus Humano 1/fisiologia , Harmina/farmacologia , Harmina/química , Harmina/análogos & derivados
5.
Span J Psychol ; 27: e15, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38769838

RESUMO

The present study aims to analyze the existence of different profiles in family caregivers of people with dementia according to psychosocial and resource variables. In addition, it aims to study whether there is a greater representation of each kinship group in each of the profiles and if there are differences in emotional distress among such profiles considering the kinship with the care-recipient. Participants were 288 family dementia caregivers, divided into four kinship groups (wives, husbands, sons and daughters). Psychosocial (familism, dysfunctional thoughts and experiential avoidance), resource (leisure activities and social support) and outcomes (depressive, anxious and guilt symptomatology) variables were collected. A hierarchical cluster analysis using Ward's method, an exploratory factor analysis of two fixed factors and contingency tables were performed. Five clusters were obtained: Low psychosocial vulnerability-High resources, Low psychosocial vulnerability-Low resources, Mixed, High psychosocial vulnerability-High resources, and High psychosocial vulnerability-Low resources. Results suggested that clusters associated with lower distress were the Low psychosocial vulnerability-High resources and the High psychosocial vulnerability-High resources. Clusters associated with higher distress were the Low psychosocial vulnerability-Low resources and Mixed. High levels of dysfunctional thoughts, familism and experiential avoidance do not always have a maladaptive function. This could depend on sociocultural and resource variables such as the kinship with the caregiver or perceived social support. The identification of profiles of family caregivers potentially needing protection and vulnerable to psychological distress could help to increase the effectiveness of interventions aimed at this population.


Assuntos
Cuidadores , Demência , Família , Apoio Social , Humanos , Cuidadores/psicologia , Masculino , Feminino , Demência/enfermagem , Idoso , Pessoa de Meia-Idade , Família/psicologia , Adulto , Angústia Psicológica , Idoso de 80 Anos ou mais , Estresse Psicológico/psicologia , Depressão/psicologia
6.
Clin Exp Rheumatol ; 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38757296

RESUMO

OBJECTIVES: Red blood cell distribution width (RDW) is a measure of variability in mean corpuscular volume. Alterations in RDW can be observed in a variety of human disorders, including inflammatory, cardiovascular, and hepatic or renal diseases. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect virtually any organ in the body. In this work, our objective was to analyse how a complete characterisation of disease characteristics in a large series of patients with SLE is related to RDW values. METHODS: 284 patients with SLE and 181 age- and sex-matched healthy controls were recruited. Complete blood count including RDW was assessed. Multivariable analysis was performed to analyse the relationship between RDW and SLE disease characteristics, including composite scores of disease activity and damage. RESULTS: After multivariable adjustment, RDW was higher in patients with SLE compared to controls (beta coefficient 0.8 [95% confidence interval: 0.3-1] %, p=0.003). Several disease characteristics, such as the presence of extractable nuclear antibodies and antiphospholipid syndrome, and the use of prednisone and azathioprine, were significantly associated with higher levels of RDW after adjustment for confounders. Of note, cumulative disease damage and disease activity scores were associated with higher RDW values after controlling for covariates. CONCLUSIONS: RDW may serve as a surrogate biomarker of accrual disease damage and activity in patients with SLE.

8.
Sci Data ; 11(1): 465, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38719810

RESUMO

Myriad policy, ethical and legal considerations underpin the sharing of biological resources, implying the need for standardised and yet flexible ways to digitally represent diverse 'use conditions'. We report a core lexicon of terms that are atomic, non-directional 'concepts of use', called Common Conditions of use Elements. This work engaged biobanks and registries relevant to the European Joint Programme for Rare Diseases and aimed to produce a lexicon that would have generalised utility. Seventy-six concepts were initially identified from diverse real-world settings, and via iterative rounds of deliberation and user-testing these were optimised and condensed down to 20 items. To validate utility, support software and training information was provided to biobanks and registries who were asked to create Sharing Policy Profiles. This succeeded and involved adding standardised directionality and scope annotations to the employed terms. The addition of free-text parameters was also explored. The approach is now being adopted by several real-world projects, enabling this standard to evolve progressively into a universal basis for representing and managing conditions of use.


Assuntos
Bancos de Espécimes Biológicos , Humanos , Disseminação de Informação , Sistema de Registros
9.
Med Oncol ; 41(6): 139, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38709365

RESUMO

To evaluate the association of standardized phase angle (SPA) with nutritional status, functional parameters, and postoperative outcomes in surgical cancer patients. This prospective study includes 59 cancer patients from Pelotas (Brazil) admitted for elective cancer surgery. We obtained the phase angle through Bioelectrical Impedance Analysis (BIA) and standardized it according to the population's reference values. We estimated the muscle mass using BIA for later calculation of the Skeletal Muscle Index (SMI) and performed handgrip strength (HGS) and gait speed (GS) tests. We used the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status. Postoperative complications and duration of hospital stay were evaluated as the outcomes. The prevalence of malnutrition in the sample was 28.8%, according to ASG-PPP. SPA was statistically lower in patients with malnutrition, with lower HGS and reduced GS. For postoperative outcomes, patients with severe complications and those with prolonged hospitalization also had lower SPA values. The greater the number of functional alterations in patients, the lower the SPA value, mainly when associated with reduced muscle mass assessed by BIA, suggesting that muscle mass reduction plays an important role in the association between functional alterations and phase angle in patients with cancer. According to the parameters used in this study, low SPA value was associated with impaired nutritional and functional status and negative outcomes in the analyzed sample.


Assuntos
Músculo Esquelético , Neoplasias , Estado Nutricional , Complicações Pós-Operatórias , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Neoplasias/cirurgia , Neoplasias/patologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Idoso , Desnutrição , Força da Mão/fisiologia , Impedância Elétrica , Adulto , Brasil/epidemiologia , Tempo de Internação , Avaliação Nutricional
10.
J Affect Disord ; 358: 19-27, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38703903

RESUMO

BACKGROUND: Previous studies have indicated the association between poor oral health and depression in adults. This study evaluated oral and social functions contribution to the association between tooth loss and depressive symptoms in Chilean individuals. METHODS: We used data from the Chilean National Health Survey. The number of remaining teeth (≤19 versus ≥20 teeth) and anterior tooth losses were the exposure variables. Outcome was depression, measured through a self-report question and with the Composite International Diagnostic Interview - Short Form (CIDI SF). Mediating variables were determined by five questions, including problems regarding "speaking", "pain and suffering", "eating", "daily activities", and "social relationships". We performed logistic regression models adjusted by multiple confounders variables. Finally, we calculated indirect, direct effect, total effect, and the proportion mediated (PM). RESULTS: We included 5383 participants. The self-reported depression and suspected depression prevalence were 22,1 % and 14,0 % respectively. The total effect of fewer remaining teeth (≤19) on self-reported depression was 1.21 (95 % CI 1.02-1.44), and 1.09 (95 % CI 0.90-1.33) for suspected depression. All five variables of oral and social functions significantly mediated the association between tooth loss and depression. Feeling uncomfortable when speaking or eating discomfort were the most significant mediators. LIMITATIONS: The mediation analysis should be interpreted with caution due to the cross-sectional design. CONCLUSIONS: Deterioration of oral and social functions was a significant mediator in the association between tooth loss and depression, in particular feeling uncomfortable when speaking or eating. This mechanism should be considered in interventions to improve mental health.

11.
PLoS One ; 19(5): e0301746, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38713680

RESUMO

INTRODUCTION: The aim of this study was to use cluster analysis based on the trajectory of five cognitive-emotional processes (worry, rumination, metacognition, cognitive reappraisal and expressive suppression) over time to explore differences in clinical and performance variables in primary care patients with emotional symptoms. METHODS: We compared the effect of adding transdiagnostic cognitive-behavioural therapy (TD-CBT) to treatment as usual (TAU) according to cluster membership and sought to determine the variables that predicted cluster membership. 732 participants completed scales about cognitive-emotional processes, anxiety and depressive symptoms, functioning, and quality of life (QoL) at baseline, posttreatment, and at 12 months. Longitudinal cluster analysis and logistic regression analyses were carried out. RESULTS: A two-cluster solution was chosen as the best fit, named as "less" or "more" improvement in cognitive-emotional processes. Individuals who achieved more improvement in cognitive-emotional processes showed lower emotional symptoms and better QoL and functioning at all three time points. TAU+TD-CBT, income level, QoL and anxiety symptoms were significant predictors of cluster membership. CONCLUSIONS: These results underscore the value of adding TD-CBT to reduce maladaptive cognitive-emotional regulation strategies. These findings highlight the importance of the processes of change in therapy and demonstrate the relevance of the patient's cognitive-emotional profile in improving treatment outcomes.


Assuntos
Cognição , Terapia Cognitivo-Comportamental , Emoções , Qualidade de Vida , Humanos , Masculino , Feminino , Terapia Cognitivo-Comportamental/métodos , Análise por Conglomerados , Adulto , Estudos Longitudinais , Pessoa de Meia-Idade , Cognição/fisiologia , Ansiedade/terapia , Ansiedade/psicologia , Depressão/terapia , Depressão/psicologia , Resultado do Tratamento
12.
J Ophthalmol ; 2024: 7345270, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38716087

RESUMO

Purpose: To determine the relationship between dyslipidemia and dry eye disease (DED), as well as its influence on tear film and meibomian glands. Methods: This cross-sectional study included 40 patients with a mean age of 35.2 ± 13.9 years without any history of dyslipidemia. DED and serum lipid profile were evaluated after 8 hours of fasting. Patients were classified according to serum lipid levels with the following cut-off values: total cholesterol (TC) (200 mg/dl), high-density lipoprotein (HDL) (40 mg/dl), low-density lipoprotein (LDL) (130 mg/dl), and triglycerides (TG) (150 mg/dl). The relationship between serum lipid levels and DED was analyzed with the following variables: dry eye questionnaire-5 (DEQ-5), first (F-NIBUT) and average (A-NIBUT) noninvasive breakup time, tear meniscus height (TMH), lipid layer grade (LLG), conjunctival bulbar redness (CBR), and upper (U-LAMG) and lower (L-LAMG) loss area of meibomian glands. Results: Regarding tear film, patients with elevated TC and LDL levels reported significantly higher DEQ-5 scores and TMH (P < 0.05), while those with lower HDL levels showed significantly higher LLG (p < 0.05). Regarding MGD, patients with elevated TC, LDL, and TG, as well as lower HDL levels showed significantly higher L-LAMG (p < 0.05). HDL was correlated with LLG (p < 0.05), while TC was correlated with TMH (p < 0.05) and L-LAMG (p < 0.05), respectively. Conclusions: Disorders in TC, HDL, LDL, and TG levels were associated with DED, having an impact on the tear film and meibomian glands, specifically in DEQ-5 scores, LLG, and L-LAMG.

13.
Cardiovasc Diagn Ther ; 14(2): 294-303, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38716318

RESUMO

Background: Sarcomeric hypertrophic cardiomyopathy (HCM) must be differentiated from phenotypically similar conditions because clinical management and prognosis may greatly differ. Patients with unexplained left ventricular hypertrophy require an early, confirmed genetic diagnosis through diagnostic or predictive genetic testing. We tested the feasibility and practicality of the application of a 17-gene next-generation sequencing (NGS) panel to detect the most common genetic causes of HCM and HCM phenocopies, including treatable phenocopies, and report detection rates. Identification of transthyretin cardiac amyloidosis (ATTR-CA) and Fabry disease (FD) is essential because of the availability of disease-specific therapy. Early initiation of these treatments may lead to better clinical outcomes. Methods: In this international, multicenter, cross-sectional pilot study, peripheral dried blood spot samples from patients of cardiology clinics with an unexplained increased left ventricular wall thickness (LVWT) of ≥13 mm in one or more left ventricular myocardial segments (measured by imaging methods) were analyzed at a central laboratory. NGS included the detection of known splice regions and flanking regions of 17 genes using the Illumina NextSeq 500 and NovaSeq 6000 sequencing systems. Results: Samples for NGS screening were collected between May 2019 and October 2020 at cardiology clinics in Colombia, Brazil, Mexico, Turkey, Israel, and Saudi Arabia. Out of 535 samples, 128 (23.9%) samples tested positive for pathogenic/likely pathogenic genetic variants associated with HCM or HCM phenocopies with double pathogenic/likely pathogenic variants detected in four samples. Among the 132 (24.7%) detected variants, 115 (21.5%) variants were associated with HCM and 17 (3.2%) variants with HCM phenocopies. Variants in MYH7 (n=60, 11.2%) and MYBPC3 (n=41, 7.7%) were the most common HCM variants. The HCM phenocopy variants included variants in the TTR (n=7, 1.3%) and GLA (n=2, 0.4%) genes. The mean (standard deviation) ages of patients with HCM or HCM phenocopy variants, including TTR and GLA variants, were 42.8 (17.9), 54.6 (17.0), and 69.0 (1.4) years, respectively. Conclusions: The overall diagnostic yield of 24.7% indicates that the screening strategy effectively identified the most common forms of HCM and HCM phenocopies among geographically dispersed patients. The results underscore the importance of including ATTR-CA (TTR variants) and FD (GLA variants), which are treatable disorders, in the differential diagnosis of patients with increased LVWT of unknown etiology.

14.
Front Oncol ; 14: 1334845, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38706600

RESUMO

Introduction: Patients with adverse pathological features (APF) at radical prostatectomy (RP) for prostate cancer (PC) are candidates for adjuvant treatment. Clinicians lack reliable markers to predict these APF preoperatively. Protein tyrosine phosphatase 1B (PTP-1B) is involved in migration and invasion of PC, and its expression could predict presence of APF. Our aim was to compare PTP-1B expression in patients with and without APF, and to explore PTP-1B expression as an independent prognostic factor. Methods: Tissue microarrays (TMAs) were constructed using RP archival specimens for immunohistochemical staining of PTP-1B; expression was reported with a standardized score (0-9). We compared median PTP-1B score between cases with and without APF. We constructed two logistic regression models, one to identify the independence of PTP-1B score from biologically associated variables (metformin use and type 2 diabetes mellitus [T2DM]) and the second to seek independence of known risk factors (Gleason score and prostate specific antigen [PSA]). Results: A total of 73 specimens were suitable for TMA construction. Forty-four (60%) patients had APF. The median PTP-1B score was higher in those with APF: 8 (5-9) vs 5 (3-8) (p=0.026). In the logistic regression model including T2DM and metformin use, the PTP-1B score maintained statistical significance (OR 1.21, 95% CI 1.01-1.45, p=0.037). In the model including PSA and Gleason score; the PTP-1B score showed no independence (OR 1.68, 95% CI 0.97-1.41, p=0.11). The area under the curve to predict APF for the PTP-1B score was 0.65 (95% CI 0.52-0.78, p=0.03), for PSA+Gleason 0.71 (95% CI 0.59-0.82, p=0.03), and for PSA+Gleason+PTP-1B score 0.73 (95% CI 0.61-0.84, p=0.001). Discussion: Patients with APF after RP have a higher expression of PTP-1B than those without APF, even after adjusting for T2DM and metformin exposure. PTP-1B has a good accuracy for predicting APF but does not add to known prognostic factors.

15.
Heliyon ; 10(9): e30043, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38756605

RESUMO

The gender perspective is important for a better diagnosis and treatment of diseases, especially in the field of oncology. This study aimed to analyse the gender approach in scientific articles in the field of oncology by studying the gender composition of the authorship of papers and the gender inclusion in the research carried out. A bibliographic search of articles and reviews signed by at least one Spanish institution published between 2010 and 2019 was carried out using the Science Citation Index Expanded database in the Oncology category. A total of 7523 studies were classified according to the gender composition determined by the author's name and a randomised sample was used to evaluate the inclusion of gender perspectives using a checklist. This study revealed a lack of gender parity in the authorship of oncology publications involving Spanish participation. Papers without author gender parity were eight times higher than papers with parity and showed a greater presence of male than female authorship (58 % versus 31 %). Regarding the introduction of the gender perspective, a negative response of 68 % referring to compliance with the entire checklist was obtained, and only a fifth of the articles presented gender balance in the study sample. Moreover, there is a positive correlation between gender parity in authorship and gender perspective integration in published research. In conclusion, there is a great need to advance the inclusion of gender perspectives in cancer research to overcome gender bias and promote better prevention, detection, and intervention for cancer.

16.
Ann Surg Oncol ; 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38762644

RESUMO

BACKGROUND: Neoadjuvant systemic therapy (NAST) for patients with stage III melanoma achieves high major pathologic response rates and high recurrence-free survival rates. This study aimed to determine how NAST with targeted therapies (TTs) and immune checkpoint inhibitors (ICIs) influences surgical outcomes after lymph node dissection in terms of complications, morbidity, and textbook outcomes. METHODS: Patients who underwent a lymph node dissection after either NAST in a clinical trial or upfront surgery for stage III melanoma between 2014 and 2022 were identified from an institutional research database. RESULTS: The study included 89 NAST-treated patients and 79 upfront surgery-treated patients. The rate of postoperative complications did not differ between the NAST- and upfront surgery-treated patients (55% vs. 51%; p = 0.643), and steroid treatment for drug toxicity did not influence the complication rate (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.4-3; p = 0.826). No significant differences in postoperative morbidity were observed in terms of seroma (23% vs. 11%; p = 0.570) or lymphedema (36% vs. 51%; p = 0.550). The rate of achieving a textbook outcome was comparable for the two groups (61% vs. 57%; p = 0.641). CONCLUSIONS: The surgical outcomes after lymph node dissections were comparable between the patients who received NAST and those who had upfront surgery, indicating that surgery can be safely performed after NAST with TT or ICI for stage III melanoma.

17.
Ann Oncol ; 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38754780

RESUMO

BACKGROUND: Neoadjuvant dabrafenib plus trametinib has a high pathological response rate and impressive short-term survival in patients with resectable stage III melanoma. We report five-year outcomes from the phase II NeoCombi trial. METHODS: NeoCombi (NCT01972347) was a single-arm, open-label, single-centre, phase II trial. Eligible patients were adults (aged ≥18) with histologically-confirmed, resectable, RECIST-measurable AJCC 7th ed. clinical stage IIIB-C BRAF V600E/K-mutant melanoma and Eastern Co-operative Oncology Group performance status ≤1. Patients received 52 weeks of treatment with 150 mg dabrafenib (orally twice per day) plus 2 mg trametinib (orally once per day), with complete resection of the pre-therapy tumour bed at Week 12. RESULTS: Between August 20, 2014, and April 19, 2017, 35 patients were enrolled. At data cut-off (August 17, 2021), the median follow-up was 60 months (95% CI 56-72). Overall, 21 of 35 (60%) patients recurred, including twelve (57%) with first recurrence in locoregional sites (followed by later distant recurrence in six) and nine (43%) with first recurrence in distant sites, including three in the brain. Most recurrences occurred within two years, with no recurrences beyond three years. At five years, recurrence-free survival was 40% (95% CI 27-60), distant metastasis-free survival was 57% [95% CI 42-76%], and overall survival was 80% (95% CI 67-94). Five-year survival outcomes were stratified by pathological response: recurrence-free survival was 53% with pCR versus 28% with non-pCR (p=0.087), distant metastasis-free survival was 59% versus 55% (p=0.647), and overall survival was 88% versus 71% (p=0.205), respectively. CONCLUSIONS: Neoadjuvant dabrafenib plus trametinib has high pathological response rates in clinical stage III melanoma, but low rates of recurrence-free survival, similar to those achieved with adjuvant targeted therapy alone. Patients with a pCR to dabrafenib plus trametinib still had a high risk of recurrence, unlike that seen with immunotherapy where recurrences are rare.

18.
Data Brief ; 54: 110469, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38725550

RESUMO

This article presents the results of soil and water analysis plus the plans -or "maps"- from the Report [1] issued 1974 on salt-affected soils in a new irrigation district located in the semi-arid Bardenas area of Aragón, northern Spain (Fig. 1). The survey was carried out by the now defunct Institute for Agrarian Reform and Development (i.e., IRYDA by its Spanish acronym). Work began in January 1972, with a preliminary reconnaissance survey on 53,000 ha using aerial photographs at a scale of 1:32,000 from the USAF photogrammetric flight of 1956-57 which covered almost the whole of Spain. Photographs from this flight are available on the Spanish aerial photograph viewer (https://fototeca.cnig.es/fototeca/). At that time, levelling for irrigation had not yet begun. This reconnaissance allowed the selection of an area of 32,300 ha (Fig. 1) with relevant salinity symptoms, like irrigated fields with irregular or no crop growth. A more detailed photo interpretation of the area was carried out at 1:12,000 scale from a flight in August 1971. The new irrigation district is fed by high quality water from the Pyrenees, but soon faced salinity problems that were well known to the farmers and echoed by the media [2, 3, 4] in an environment of great social concern about increasing agricultural production [5]. The Report, written in Spanish, is dated July 1974, but the soil profiles were described and sampled between April 1972 and March 1974. The Report [1] consists of two volumes, the first is a Memoria containing data from the surveys, laboratory analyses, pedological descriptions and some photographs of the soils and other land features of agricultural importance, as well as data and calculations for designing the drainage of selected plots. The second volume consists of five folded plans: a) location of the surveyed area at the scale of 1:200,000, and four plans at the scale of 1:25,000, b) soil-geomorphologic units, c) soil units describing their characteristics, d) land use, and e) locations of the described soil profiles and other field observations. Taken together, these data, improved by our orthorectification, gives a picture of the salinity and other soil properties in this area. The reuse of the data for comparisons with the evolution of agriculture in subsequent years -especially soil salinity and sodicity- will help to evaluate the agricultural practices over the last fifty years, particularly after intensive land levelling and irrigation.

19.
Sci Data ; 11(1): 464, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38719839

RESUMO

Improving patient care and advancing scientific discovery requires responsible sharing of research data, healthcare records, biosamples, and biomedical resources that must also respect applicable use conditions. Defining a standard to structure and manage these use conditions is a complex and challenging task. This is exemplified by a near unlimited range of asset types, a high variability of applicable conditions, and differing applications at the individual or collective level. Furthermore, the specifics and granularity required are likely to vary depending on the ultimate contexts of use. All these factors confound alignment of institutional missions, funding objectives, regulatory and technical requirements to facilitate effective sharing. The presented work highlights the complexity and diversity of the problem, reviews the current state of the art, and emphasises the need for a flexible and adaptable approach. We propose Digital Use Conditions (DUC) as a framework that addresses these needs by leveraging existing standards, striking a balance between expressiveness versus ambiguity, and considering the breadth of applicable information with their context of use.


Assuntos
Disseminação de Informação , Humanos
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