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1.
Plant Biol (Stuttg) ; 26(3): 415-420, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38315483

RESUMO

Plants display various forms of phenotypic plasticity in anticipation of changing conditions, many of which are influenced by information obtained from neighbouring plants. Here, we tested the hypothesis that cleistogamic Lamium amplexicaule plants can adaptively modify production of chasmogamous (CH) and cleistogamous (CL) flowers based on the perception of conspecific neighbours. The production and proportion of CH and CL flowers was examined in individual L. amplexicaule grown at varying densities or treated with root leachates from plants grown at different densities. When growing at high density or treated with root leachates from high-density pots, L. amplexicaule increased production of more expensive, potentially outcrossing CH flowers. In contrast, single plants or plants treated with root leachates from empty pots or single-source plants predominantly developed cheaper, self-pollinated CL flowers. The results demonstrate a novel root-based neighbour-perception modality that enables plants to adaptively adjust production of CH and CL flowers in response to the presence of potential reproductive partners. Further research is needed to explore the broader ecological implications of this novel interplant cueing on reproductive bet-hedging and plasticity in natural settings, as well as to identify the involved cues and their mode of operation.


Assuntos
Plantas , Reprodução , Flores/fisiologia , Adaptação Fisiológica , Percepção
2.
Thromb Res ; 228: 54-60, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37276718

RESUMO

BACKGROUND: Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs. METHODS: The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe. RESULTS: SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life. CONCLUSIONS: We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers.


Assuntos
Fibrinolíticos , Neoplasias , Humanos , Fibrinolíticos/uso terapêutico , Qualidade de Vida , Neoplasias/tratamento farmacológico , Cuidados Paliativos , Morte , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Med Oral Patol Oral Cir Bucal ; 27(3): e285-e293, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35368009

RESUMO

BACKGROUND: Pediatric head and neck cancer (PHNC) is rare and its nonspecific clinical manifestations may often lead to delayed diagnosis. We aimed to describe the signs, symptoms, and clinicopathological characteristics of PHNC. MATERIAL AND METHODS: Medical records were retrospectively reviewed for all PHNC cases diagnosed from 1986 to 2016 affecting patients aged 19-years and younger from a tertiary referral center in Brazil. Demographic variables, anatomical site of primary tumors, histopathological diagnoses, signs and symptoms, and patterns of misdiagnosis were collected and interpreted by statistical and descriptive analysis. RESULTS: A total of 253 PHNC cases were included. The mean age was 9.3 years and male patients were more frequently affected (60.9%). Burkitt lymphoma (23.7%), nasopharyngeal carcinoma (15.8%), and rhabdomyosarcoma (15.4%) were the most common cancer types. The nasopharynx (28.9%), cervical/lymph node region (25.3%), and craniofacial bones (8.3%) were the predominant anatomical sites. Tumor/swelling (68.4%), was the clinical finding often presented. The univariable analysis showed association between tumor histology and clinical variables such as sex (p=0.022), age (p<0.0001), anatomical location (p<0.0001) tumor/swelling (p=0.034), pain (p=0.031), systemic/general manifestations (p=0.004), nasal/breathing alterations (p=0.012), orbital/ocular alterations (p<0.0001). Misdiagnosis such as tonsillitis, otitis, and abscess were frequent. CONCLUSIONS: Although the clinical findings of PHNC are often unspecific, this study provided signs and symptoms with significant correlations between tumor histology. The suspicion of malignancy should be considered when the main signs and symptoms reported here appear and persist, in order to conduct a timely diagnosis.


Assuntos
Neoplasias de Cabeça e Pescoço , Rabdomiossarcoma , Brasil/epidemiologia , Criança , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Masculino , Pescoço , Estudos Retrospectivos , Rabdomiossarcoma/diagnóstico , Rabdomiossarcoma/epidemiologia
4.
HNO ; 70(1): 33-43, 2022 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-33944963

RESUMO

Dizziness is a common leading symptom. Especially patients with chronic vertigo syndromes experience a significant impairment in quality of life up to a limitation of their ability to work in the case of employed persons. The consequences are financial and capacitive burdens on the health system due to frequently multiple examinations and sick leave up to occupational invalidity of the affected patient. In 150 patients with chronic vertigo syndromes and an unclear outpatient diagnosis, at least one diagnosis that justified the complaint was made in over 90% of cases on the basis of a structured interdisciplinary inpatient diagnostic concept. Chronic vertigo syndromes are often multifactorial. Psychosomatic (accompanying) diagnoses were found in more than half of the patients. Targeted therapy can only be recommended after establishing a specific diagnosis. This justifies an interdisciplinary inpatient diagnostic concept for persistently unclear cases.


Assuntos
Pacientes Internados , Qualidade de Vida , Tontura/diagnóstico , Tontura/etiologia , Humanos , Síndrome , Vertigem/diagnóstico
5.
Phys Rev Lett ; 126(18): 187801, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34018790

RESUMO

By neutron spin echo spectroscopy, we have studied the center of mass motion of short tracer chains on the molecular length scale within a highly entangled polymer matrix. The center of mass mean square displacements of the tracers independent of their molecular weight is subdiffusive at short times until it has reached the size of the tube d; then, a crossover to Fickian diffusion takes place. This observation cannot be understood within the tube model of reptation, but is rationalized as a result of important interchain couplings that lead to cooperative chain motion within the entanglement volume ∼d^{3}. Thus, the cooperative tracer chain motions are limited by the tube size d. If the center of mass displacement exceeds this size, uncorrelated Fickian diffusion takes over. Compared to the prediction of the Rouse model we observe a significantly reduced contribution of the tracer's internal modes to the spectra corroborating the finding of cooperative rather than Rouse dynamics within d^{3}.

6.
Phys Rev Lett ; 125(23): 238004, 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33337173

RESUMO

This work clarifies the self-similar dynamics of large polymer rings using pulsed-field gradient nuclear magnetic resonance and neutron spin echo spectroscopy. We find center of mass diffusion taking place in three dynamic regimes starting (i) with a strongly subdiffusive domain ⟨r^{2}(t)⟩_{com}∼t^{α} (0.4≤α≤0.65); (ii) a second subdiffusive region ⟨r^{2}(t)⟩_{com}∼t^{0.75} that (iii) finally crosses over to Fickian diffusion. While the t^{0.75} range previously has been found in simulations and was predicted by theory, we attribute the first to the effect of cooperative dynamics resulting from the correlation hole potential. The internal dynamics at scales below the elementary loop size is well described by ring Rouse motion. At larger scales the dynamics is self-similar and follows very well the predictions of the scaling models with preference for the self-consistent fractal loopy globule model.

7.
Phys Rev Lett ; 122(8): 088001, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30932610

RESUMO

A key ingredient within theories focusing on the rheology of entangled polymers is the way how the topological constraints of an entangled chain are lifted by unconstrained segments, i.e., how the constraining tube is dilated. This important question has been addressed by directly measuring the tube diameter d at the scale of the tube by neutron spin echo spectroscopy. The tube diameter d and plateau modulus G_{N}^{0} of highly entangled polyethylene oxide (PEO) chains of volume fraction c that are diluted by low molecular PEO show a concentration dependence d∝c^{a/2} and G_{N}^{0}∝c^{1+a} with an exponent a close to 4/3. This result allows the clear discrimination between different theoretical models that predict 4/3 or other values between 1 and 2 and provides an important ingredient to tube model theories.

8.
Animal ; 12(12): 2627-2638, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29757124

RESUMO

This study investigates how the ecosystem services (ES) linked to livestock grazing are perceived across countries. A total of 82 case studies collected from 42 countries via survey (53.7% cases from Europe and 46.3% from outside of Europe) have been analysed through a multivariate approach. In all, 18 non-provisioning ES were considered. Overall, the reported impacts of livestock grazing on the different ES were much more positive than negative. Notably, a large proportion of respondents reported either positive or very positive impacts for some cultural ES, namely cultural, historic and natural heritage (84%), knowledge systems and educational values (77%), landscape values (74%), and for some supporting and regulating ES, namely habitat provision (66%), nutrient cycling (65%), and bush encroachment/fire control (66%). Based on multiple regression analysis, geographic origin, stakeholder type and species category, as well as protection status of the grazing area, had significant effects on the perception of the impacts. Respondents reported those impacts as more positive in Europe, in protected areas and where several species were present in the grazing area. A significantly larger proportion of respondents reported recognition of ES provided by the grazing livestock population in European countries (40.9%) compared with non-European countries (23.7%). Based on the survey responses it appears that in non-European countries absence of formal recognition, especially by policy makers, is a major challenge for the continued provision of ES in grazing systems. In Europe, where such recognition is already often included in legislation, the long-term sustainability of related policies and incentives to provide such services is viewed as a major issue by the respondents.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Gado , Animais , Europa (Continente) , Plantas
9.
Geburtshilfe Frauenheilkd ; 76(11): 1189-1193, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27904170

RESUMO

Borderline ovarian tumours are semimalignant tumours occurring unilaterally or bilaterally with a peak incidence among women of reproductive age. Since the affected women often wish to preserve fertility, particular precautions must be taken when counselling the patient and obtaining consent prior to planning an individual treatment. Options for preserving fertility include an organ-sparing surgical procedure and cryopreservation of oocytes and/or ovarian tissue. In this article, we report on a 25-year-old patient with a bilateral seromucinous borderline tumour who desired all fertility-preserving options. In order to perform the procedure without delay, we opted to perform luteal phase stimulation prior to oocyte retrieval. We conclude by discussing the current literature on the state of fertility preservation in the treatment of borderline ovarian tumours.

10.
J Anim Sci ; 94(12): 5055-5063, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28046135

RESUMO

This study investigates the relationships between various environmental and geographic, demographic, and socioeconomic factors with the diversity of livestock breeds reported within countries across the world. Statistical analyses were performed considering the numbers of breeds reported by 158 countries for 4 livestock mammalian species (cattle, sheep, goats, and pigs). Organization for Economic Cooperation and Development (OECD) countries reported more breeds than non-OECD countries in general. Strong and positive correlations were found between agricultural area, human population size, species population size, and number of breeds per country. When considering regression models, the species population size was found as the most important explanatory factor for the number of breeds reported by countries in the 4 species. Diversity of production systems in the country had a significant association with the number of breeds reported for sheep, goats, and pigs. The number of ruminant breeds was positively associated with the size of agricultural area and the diversity of land cover in the country. While demographic and cultural importance of a given species is a major factor associated with the number of livestock breeds within countries, this diversity is also connected to the variability in environmental and production conditions.


Assuntos
Bovinos/genética , Cabras/genética , Ovinos/genética , Suínos/genética , Agricultura , Animais , Cruzamento , Demografia , Meio Ambiente , Variação Genética , Geografia , Humanos , Gado , Densidade Demográfica , Análise de Componente Principal , Análise de Regressão , Fatores Socioeconômicos
11.
Arch Gynecol Obstet ; 293(3): 667-73, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26449238

RESUMO

PURPOSE: Anti-Müllerian hormone has a regulative function in the activation of folliculogenesis and an influence on atresia rate. It is considered a marker for the ovarian reserve. We know that a relationship exists between AMH levels and oocyte retrieval numbers, antral follicle count, pregnancy rates and birth rates. The role of AMH as an efficient prognostic factor in determining the probability of pregnancy has been largely discussed in the literature. The aim of this study is to determine the role age and AMH levels play in success rates of IVF/ICSI therapies. To date, the sample group we examined was one of the biggest ever included in a single study of the subject. METHODS: All patients who underwent an IVF/ICSI treatment with FSH stimulation in the Wiesbaden Kinderwunschzentrum between 2003 and 2010, were no older than 44 years old, and had an evaluation of serum AMH levels before treatment were included in this study. In total, 1287 patients were analysed retrospectively. Statistical analysis was performed with SPSS. RESULTS: Females' mean age was 34.89, ranging from 21 to 44 years. The patients underwent between 1 and 11 IVF cycles. Younger women had significantly higher AMH levels (p = 0.001). Patients with higher AMH levels had significantly lower break-off rates (p < 0.0005) and a significantly higher number of oocytes retrieved (p < 0.0005). Higher levels of AMH corresponded to higher pregnancy rates (p = 0.017). AMH levels do not influence pregnancy rates in younger patients (<36 years). CONCLUSIONS: AMH is a useful parameter that should be measured before performing an IVF/ICSI treatment. In younger patients, AMH levels do not predict pregnancy outcomes. In patients older than 36 years, AMH can be used as a prognostic factor. Even when a woman's AMH levels are too low to be detected, she still an acceptable chance of becoming pregnant.


Assuntos
Hormônio Antimülleriano/sangue , Biomarcadores/sangue , Fertilização in vitro , Recuperação de Oócitos , Indução da Ovulação/métodos , Injeções de Esperma Intracitoplásmicas/métodos , Adulto , Feminino , Humanos , Oócitos , Folículo Ovariano , Reserva Ovariana , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Estudos Retrospectivos
12.
Anim Genet ; 47(2): 141-53, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26662214

RESUMO

Preservation of specific and inheritable phenotypes of current or potential future importance is one of the main purposes of conservation of animal genetic resources. In this review, we investigate the issues behind the characterisation, utilisation and conservation of rare phenotypes, considering their multiple paths of relevance, variable levels of complexity and mode of inheritance. Accurately assessing the rarity of a given phenotype, especially a complex one, is not a simple task, because it requires the phenotypic and genetic characterisation of a large number of animals and populations and remains dependent of the scale of the study. Once characterised, specific phenotypes may contribute to various purposes (adaptedness, production, biological model, aesthetics, etc.) with adequate introgression programmes, which justifies the consideration of (real or potential) existence of such characteristics in in situ or ex situ conservation strategies. Recent biotechnological developments (genomic and genetic engineering) will undoubtedly bring important changes to the way phenotypes are characterised, introgressed and managed.


Assuntos
Animais Domésticos/genética , Variação Genética , Fenótipo , Agricultura , Animais , Biotecnologia , Cruzamento , Conservação dos Recursos Naturais , Engenharia Genética , Padrões de Herança
13.
Animal ; 10(2): 262-73, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26503101

RESUMO

Crossbreeding, considering either terminal or rotational crossing, synthetic breed creation or breed replacement, is often promoted as an efficient strategy to increase farmers' income through the improvement of productivity of local livestock in developing countries. Sustainability of crossbreeding is however frequently challenged by constraints such as poor adaptation to the local environment or lack of logistic support. In this review, we investigate factors that may influence the long-term success or the failure of crossbreeding programs, based on the scientific literature and country reports submitted for The Second Report on the State of the World's Animal Genetic Resources for Food and Agriculture. Crossbreeding activities vary widely across species and countries. Its sustainability is dependent on different prerequisites such as continual access to adequate breeding stock (especially after the end of externally funded crossbreeding projects), the opportunity of improved livestock to express their genetic potential (e.g. through providing proper inputs) and integration within a reliable market chain. As formal crossbreeding programs are often associated with adoption of other technologies, they can be a catalyst for innovation and development for smallholders. Given the increasing global demand for animal products, as well as the potential environmental consequences of climate change, there is a need for practical research to improve the implementation of long-term crossbreeding programs in developing countries.


Assuntos
Criação de Animais Domésticos/economia , Animais Domésticos , Países em Desenvolvimento , Hibridização Genética , Criação de Animais Domésticos/métodos , Animais , Cruzamento/economia , Cruzamento/métodos , Bovinos , Galinhas , Países em Desenvolvimento/economia , Cabras , Ovinos , Suínos
14.
Reprod Domest Anim ; 50(6): 958-64, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26446780

RESUMO

The goal of this study was to compare a traditional slow-freeze method (TF) with an open unidirectional slow freeze cooling system (UF) for whole ovary cryopreservation. Therefore, whole pig ovaries were randomly assigned to (A) fresh control, (B) traditional slow freeze (TF) or (C) unidirectional slow freeze (UF). Ovaries were perfused with 10% DMSO in Krebs-Ringer. For TF, whole ovaries were placed in specimen jars containing 10% DMSO and placed into a specialized container for freezing filled with propan-2-ol. For UF, whole ovaries were placed within a specially designed container containing 10% DMSO and transferred to a specialized freezing machine (CTE 920). Histological evaluation demonstrated intact morphology of follicles in all groups; however, an overall decrease of follicle numbers in TF (46%) and UF (50%) compared to fresh control. Live/dead assay indicated significantly lower populations of live cells in both TF (60%) and UF (58%) compared to fresh tissue (74%). TUNEL assay confirmed a difference in percentage of apoptotic follicles between fresh and TF, but there was no significant difference between fresh and UF. To improve the structural and functional integrity of whole ovaries, further investigation, especially into directional freezing, is needed. Whole ovary cryopreservation could provide opportunities for women facing fertility loss due to chemo- or radiotherapy treatment.


Assuntos
Criopreservação/métodos , Preservação da Fertilidade/métodos , Preservação da Fertilidade/veterinária , Folículo Ovariano/fisiologia , Suínos , Animais , Feminino
15.
Geburtshilfe Frauenheilkd ; 75(12): 1243-1249, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26726265

RESUMO

Protecting the fertility of patients with oncologic disease is becoming more and more important, as fulfilling the wish to have children is increasingly occurring at a later stage in life and long-term survival rates after cancer are continuing to improve. A number of fertility-preserving options exist. In addition to techniques which have been around for some time such as medical ovarian suppression, ovarian transposition, and organ-preserving surgery, there are other, more recent, innovative methods which have developed over the last few years such as cryopreservation of oocytes or ovarian tissue transplantation after completing cancer therapy. As every procedure has its specific advantages and disadvantages, informed patient consent is essential. The physician's aim must be to select the optimal procedure for each patient. The extent of patients' information about the options to preserve fertility in women with oncologic disease remains limited. One of the main reasons for this is that clinicians are not sure how to inform patients about existing procedures and methods. The aim of this review article is to provide help in clinical practice.

16.
Eur J Clin Nutr ; 68(3): 324-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24398637

RESUMO

BACKGROUND/OBJECTIVES: The validity of dietary assessment in large-scale cohort studies has been questioned. Combining data sources for the estimation of usual intake in a blended approach may enhance the validity of dietary measurement. Our objective was to develop a web-based 24-h food list for Germany to identify foods consumed during the previous 24 h and to evaluate the performance of the new questionnaire in a feasibility study. SUBJECTS/METHODS: Available data from the German National Nutrition Survey II were used to develop a finite list of food items. A total of 508 individuals were invited to fill in the 24-h food list via the Internet up to three times during a 3-6-month time period. In addition, participants were asked to evaluate the questionnaire using a brief online evaluation form. RESULTS: In total, 246 food items were identified for the 24-h food list, reflecting >75% variation in intake of 27 nutrients and four major food groups. Among the individuals invited, 64% participated in the feasibility study. Of these, 100%, 85% and 68% of participants completed the 24-h food list one, two or three times, respectively. The average time needed to complete the questionnaire was 9 min, and its acceptability by participants was rated as high. CONCLUSIONS: The 24-h food list represents a promising new dietary assessment tool that can be used as part of a blended approach combining multiple data sources for valid estimation of usual dietary intake in large-scale cohort studies.


Assuntos
Registros de Dieta , Avaliação Nutricional , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos de Viabilidade , Feminino , Alemanha , Humanos , Internet , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
17.
J Chem Phys ; 140(3): 034902, 2014 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-25669409

RESUMO

The mesoscopic dynamical properties of oil-in-water microemulsions (MEs) bridged with telechelic polymers of different number of arms and with different lengths of hydrophobic stickers were studied with neutron spin-echo (NSE) probing the dynamics in the size range of individual ME droplets. These results then were compared to those of dynamicic light scattering (DLS) which allow to investigate the dynamics on a much larger length scale. Studies were performed as a function of the polymer concentration, number of polymer arms, and length of the hydrophobic end-group. In general it is observed that the polymer bridging has a rather small influence on the local dynamics, despite the fact that the polymer addition leads to an increase of viscosity by several orders of magnitude. In contrast to results from rheology and DLS, where the dynamics on much larger length and time scales are observed, NSE shows that the linear polymer is more efficient in arresting the motion of individual ME droplets. This finding can be explained by a simple simulation, merely by the fact that the interconnection of droplets becomes more efficient with a decreasing number of arms. This means that the dynamics observed on the short and on the longer length scale depend in an opposite way on the number of arms and hydrophobic stickers.

19.
Oncogene ; 32(14): 1831-42, 2013 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-22665057

RESUMO

We have previously identified a Rho protein, RhoD, which localizes to the plasma membrane and the early endocytic compartment. Here, we show that a GTPase-deficient mutant of RhoD, RhoDG26V, causes hyperplasia and perturbed differentiation of the epidermis, when targeted to the skin of transgenic mice. In vitro, gain-of-function and loss-of-function approaches revealed that RhoD is involved in the regulation of G1/S-phase progression and causes overduplication of centrosomes. Centriole overduplication assays in aphidicolin-arrested p53-deficient U2OS cells, in which the cell and the centrosome cycles are uncoupled, revealed that the effects of RhoD and its mutants on centrosome duplication and cell cycle are independent. Enhancement of G1/S-phase progression was mediated via Diaph1, a novel effector of RhoD, which we have identified using a two-hybrid screen. These results indicate that RhoD participates in the regulation of cell-cycle progression and centrosome duplication.


Assuntos
Centrossomo/fisiologia , Fase G1/fisiologia , Mutação/genética , Fase S/fisiologia , Pele/patologia , Proteínas rho de Ligação ao GTP/genética , Proteínas Adaptadoras de Transdução de Sinal/genética , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Animais , Apoptose , Western Blotting , Neoplasias Ósseas/genética , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Proliferação de Células , Células Cultivadas , Imunofluorescência , Forminas , Humanos , Hiperplasia/metabolismo , Hiperplasia/patologia , Camundongos , Camundongos Transgênicos , Osteossarcoma/genética , Osteossarcoma/metabolismo , Osteossarcoma/patologia , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Pele/metabolismo , Proteína Supressora de Tumor p53/deficiência , Proteína Supressora de Tumor p53/genética , Técnicas do Sistema de Duplo-Híbrido , Proteínas rho de Ligação ao GTP/metabolismo
20.
Eur J Cancer ; 49(3): 553-63, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22959469

RESUMO

UNLABELLED: Adjuvant clinical trials (CTs) usually compare a standard treatment regime versus an innovative new substance or regimen. Participation in CT however, is available for only few patients and exclusion criteria are usually very strict. Therefore we used an unselected patient cohort to investigate the following questions: MATERIAL AND METHODS: This German retrospective multi-centre cohort study included 9433 patients with primary breast cancer recruited from 1992 to 2008. RESULTS: One thousand two hundred and fifty-five (13.3%) patients participated in adjuvant clinical trials (PA) and 8178 (86.7%) did not (NPA). RFS was higher among participants (PA) than among non-participants (NPA) [p=0.006], but differences in overall survival (OAS) were not significant [p=0.15]. When stratified for guideline adherence, the outcome was not different for guideline conform NPA [RFS: p=0.88] [OAS: p=0.37] compared to PA. Survival parameters however, were significantly poorer in non-guideline conform PA [RFS: p<0.001] [OAS: p<0.001] and non-guideline conform NPA [RFS: p<0.001] [OAS: p<0.001] as compared to guideline adherent PA. DISCUSSION: There is a strong association between guideline adherence in adjuvant treatment in BC and survival. PA in clinical trials tended to higher survival rates, but only if guideline-adherent treatment was applied. Patients who do not have access to clinical trials may profit substantially from guideline-adherent adjuvant treatment.


Assuntos
Neoplasias da Mama/mortalidade , Neoplasias da Mama/terapia , Ensaios Clínicos como Assunto , Fidelidade a Diretrizes , Participação do Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Análise de Sobrevida
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