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BACKGROUND: For many years, the physicians are searching for easily measurable marker of immune response to the stress and inflammation. More than, 20 years ago Zahorec (2001) proposed neutrophil-to-lymphocyte ratio (NLR) as an easy available and valid biomarker of inflammation, stress, and activation of immune system. METHODS: In this narrative review we focused on the utility of neutrophil-to-lymphocyte ratio (Zahorec's index) in clinical practice of general medicine (inflammation and infection), intensive medicine (sepsis), oncology (prediction of prognosis in cancer of solid organs), surgery and perioperative medicine (diagnosis of complications, and prediction of clinical outcome). RESULTS AND CONCLUSION: We provide many evidences of clinical research which confirm that Neutrophil-to-lymphocyte ratio is a very sensitive marker of inflammation, stress reliable and valid parameter in everyday clinical practice. NLR (Zahorec index) is an effective tool for diagnosis of infection and severity of disease of variable etiologies. NLR reflect the grade of inflammation in cancer disease, which has a significant impact on the prognosis of cancer patients. Zahorec index should be used routinely in emergency medicine, surgery and perioperative medicine as a marker of the severity of affliction, infection, and complications in general. NLR may help physicians in decision making process for early diagnosis and therapy. NLR should be investigated frequently in acute states (sepsis, shock, peritonitis, stroke, trauma) on a daily basis, in subacute states few times per week (during hospital stay), and few times per year in chronic disease (cancer, diabetes mellitus, ischemic heart disease, psychiatry disorders). NLR has a deep biological sense connecting together function of three suprasystems: immune, endocrinne and autonomous nervous system (Tab. 2, Fig. 3, Ref. 86).
Assuntos
Neoplasias , Sepse , Humanos , Neutrófilos , Linfócitos , Prognóstico , Inflamação , Biomarcadores , Imunidade , Estudos RetrospectivosRESUMO
OBJECTIVES: We decided to compare the incidence and spectrum of pelvic fractures in 2020 affected by the anti-pandemic measures due to COVID-19 with previous years 2018 and 2019. METHODS: This retrospective study included 391 patients treated at the author's clinic for pelvic fractures. From the medical records we recorded gender, age, mechanism of injury, trauma energy, fracture type based on the AO classification and severity of injury. RESULTS: As expected, we observed no difference in the number of fractures caused by simple falls. However, we failed to prove a reduction in the number of high-energy injuries. In contrary, we observed an increase in the number of high-energy injuries in the period between lockdowns (p=0.0375). A surprising result was a dramatic increase in suicide attempts as a cause of pelvic fractures, with 6 (2.2 %) in 2018 and 2019 compared to 13 (10 %) in 2020 alone (p=0.0017). CONCLUSION: We observed the increased number of suicidal attempts only on a limited number of specific patients with pelvic fractures; therefore, we cannot formulate any general conclusions regarding the incidence of suicide during the COVID-19 pandemic. Nevertheless, we consider this to be a warning signal highlighting the worsened population mental health due to COVID-19 pandemic (Tab. 2, Fig. 1, Ref. 34).
Assuntos
COVID-19 , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pandemias , Estudos Retrospectivos , Tentativa de SuicídioRESUMO
The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship- emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.
RESUMO
The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiology.
Assuntos
Pesquisa Biomédica , Políticas Editoriais , Disseminação de Informação , Editoração , Humanos , Publicações Periódicas como AssuntoRESUMO
The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiology. Resumo O Comitê Internacional de Editores de Revistas Médicas (ICMJE) fornece recomendações para aprimorar o padrão editorial e a qualidade científica das revistas biomédicas. Tais recomendações variam desde requisitos técnicos de uniformização até assuntos editoriais mais complexos e elusivos, como os aspectos éticos do processo científico. Recentemente, foram propostos registro de ensaios clínicos, divulgação de conflitos de interesse e novos critérios de autoria, enfatizando a importância da responsabilidade e da responsabilização. No último ano, lançou-se uma nova iniciativa editorial para fomentar o compartilhamento dos dados de ensaios clínicos. Esta revisão discute essa nova iniciativa visando a aumentar a conscientização de leitores, investigadores, autores e editores filiados à Rede de Editores da Sociedade Europeia de Cardiologia.
Assuntos
Ensaios Clínicos como Assunto/organização & administração , Conjuntos de Dados como Assunto/normas , Políticas Editoriais , Disseminação de Informação , Publicações Periódicas como Assunto/normas , Ensaios Clínicos como Assunto/normas , Humanos , Cooperação Internacional , Sociedades MédicasRESUMO
Abstract: The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability -, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.
Resumen: El Comite internacional de editores de revistas medicas (CIERM) propone recomendaciones para mejorar los standares editoriales y la calidad científica de las revistas biomédicas. Estas recomendaciones abarcan desde requerimeintos ténicos uniformados a temas editoriales mas complejos y evasivos, como los aspectos bioéticos relacionados con el proceso científico. Recientemente se han propuesto algunas iniciativas editoriales, como el registro de los ensayos clinicos, la declaración de los conflictos de interés y los nuevos criterios para autoría (que destacan la responsabilidad de los autores sobre el estudio). El año pasado se presentó una nueva iniciativa editorial para resaltar la importancia de compartir los datos generados en los estudios clinicos. En este artículo se discute esta nueva iniciativa editorial, con la idea de difundir su conocimiento entre los lectores, investigadores, autores y editores de la red de editores de revistas cardiovasculares nacionales de la Sociedad Europea de Cardiología.
Assuntos
Publicações Periódicas como Assunto , Editoração , Cardiologia , Disseminação de Informação , Políticas Editoriais , Cooperação InternacionalRESUMO
The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability - have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.
Assuntos
Ensaios Clínicos como Assunto , Políticas Editoriais , Disseminação de Informação , Jornalismo Médico/normas , Autoria , Bioética , Cardiologia , Revelação , Sociedades MédicasRESUMO
The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.
Assuntos
Políticas Editoriais , Disseminação de Informação , Guias como AssuntoRESUMO
The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability -, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.
Assuntos
Cardiologia , Políticas Editoriais , Disseminação de Informação , Publicações Periódicas como Assunto , Editoração , Cooperação InternacionalRESUMO
Abstract The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship - emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors´ Network of the European Society of Cardiology.
Resumo O Comitê Internacional de Editores de Revistas Médicas (ICMJE) fornece recomendações para aprimorar o padrão editorial e a qualidade científica das revistas biomédicas. Tais recomendações variam desde requisitos técnicos de uniformização até assuntos editoriais mais complexos e elusivos, como os aspectos éticos do processo científico. Recentemente, foram propostos registro de ensaios clínicos, divulgação de conflitos de interesse e novos critérios de autoria, enfatizando a importância da responsabilidade e da responsabilização. No último ano, lançou-se uma nova iniciativa editorial para fomentar o compartilhamento dos dados de ensaios clínicos. Esta revisão discute essa nova iniciativa visando a aumentar a conscientização de leitores, investigadores, autores e editores filiados à Rede de Editores da Sociedade Europeia de Cardiologia.
Assuntos
Humanos , Publicações Periódicas como Assunto/normas , Ensaios Clínicos como Assunto/organização & administração , Disseminação de Informação , Políticas Editoriais , Conjuntos de Dados como Assunto/normas , Sociedades Médicas , Ensaios Clínicos como Assunto/normas , Cooperação InternacionalRESUMO
The International Committee of Medical Journal Editors (ICMJE) provides recommendations to improve the editorial standards and scientific quality of biomedical journals. These recommendations range from uniform technical requirements to more complex and elusive editorial issues including ethical aspects of the scientific process. Recently, registration of clinical trials, conflicts of interest disclosure, and new criteria for authorship -emphasizing the importance of responsibility and accountability-, have been proposed. Last year, a new editorial initiative to foster sharing of clinical trial data was launched. This review discusses this novel initiative with the aim of increasing awareness among readers, investigators, authors and editors belonging to the Editors' Network of the European Society of Cardiology.
RESUMO
Microparticles (MPs) are phenotypically and functionally heterogeneous population of microvesicles. Although MP formation represents a physiological phenomenon. A multitude of pathologies, including inflammatory and autoimmune diseases, atherosclerosis, and malignancies, are associated with a considerable increase in circulating MPs. Elevated levels of platelet, endothelial cell, and monocytederived MPs have been documented in a number of clinical conditions in which vascular dysfunction and inflammation are important pathophysiological mechanisms (e.g., coronary artery disease or thrombotic microangiopathies). Knowledge of the functional properties of MPs will contribute to a better understanding of the pathological mechanisms of communication between cells and of the causes of various diseases.
Assuntos
Doenças Cardiovasculares/patologia , Micropartículas Derivadas de Células/patologia , Células Endoteliais/patologia , Endotélio Vascular/patologia , Inflamação/patologia , Aterosclerose/metabolismo , Aterosclerose/patologia , Doenças Cardiovasculares/metabolismo , Micropartículas Derivadas de Células/metabolismo , Células Endoteliais/metabolismo , Endotélio Vascular/metabolismo , Humanos , Inflamação/metabolismoRESUMO
Disclosure of potential conflicts of interest is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for conflicts of interest disclosure. This paper provides a comprehensive editorial perspective on classical conflict of interest-related issues. New insights into current conflicts of interest policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardized questionnaire, are discussed.
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Cardiologia , Conflito de Interesses , Revelação/normas , Publicações Periódicas como Assunto/normas , Sociedades MédicasRESUMO
Las revistas biomédicas utilizan la declaración de posibles conflictos de intereses para garantizar la credibilidad y la transparencia del proceso científico. Sin embargo, las revistas no abordan la declaración de conflictos de intereses de manera sistemática ni uniforme. Recientes esfuerzos editoriales conjuntos han abierto el camino a la aplicación de herramientas uniformes para la declaración de conflictos de intereses. En este artículo se presenta una visión integral sobre cuestiones clásicas relacionadas con los conflictos de intereses desde un punto de vista editorial. Además, a partir de los datos de un estudio transversal basado en el empleo de un cuestionario estandarizado, se comentan nuevas apreciaciones sobre las políticas y los actuales procedimientos editoriales relativos a los conflictos de intereses en las diversas revistas cardiovasculares nacionales de la Sociedad Europea de Cardiología.
Disclosure of potential conflicts of interest is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for conflicts of interest disclosure. This paper provides a comprehensive editorial perspective on classical conflict of interest-related issues. New insights into current conflicts of interest policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardized questionnaire, are discussed.
Assuntos
Autoria/normas , Conflito de Interesses , Revelação , Políticas Editoriais , Publicações Periódicas como Assunto , Cardiologia , Coleta de Dados , Revelação/normas , Indústria Farmacêutica/economia , Indústria Farmacêutica , Europa (Continente) , Publicações Periódicas como Assunto/normas , Apoio à Pesquisa como Assunto , Sociedades MédicasRESUMO
OBJECTIVE: During last few decades a considerable number of data has emerged supporting the hypothesis that central nervous system might monitor and modulate tumor growth. This assumption is based on two facts: 1. immune system plays a crucial role in the development and progression of cancer; 2. immune and nervous systems communicate tightly and bidirectionally. The aim of present study was to elucidate whether tumor growth may induce detectable changes in brain structures that are involved in the response to immune challenges. METHODS: Using Fos immunohistochemistry, we investigated whether the advanced stage of cancer, induced by a single intraperitoneal injection of BP6-TU2 fibrosarcoma cells to male Wistar rats, could activate Fos expression in the nucleus of the solitary tract (NTS), amygdala and parabrachial nuclei (PBN) and also activate some of neuronal phenotypes including tyrosine hydroxylase (TH) neurons in the brainstem noradrenergic cell groups and hypothalamic oxytocinergic neurons. RESULTS: Twenty eight days after the initiation of tumor process we found increased Fos expression in NTS/A2, A1 noradrenergic cells, PBN as well as in the hypothalamic paraventricular, supraoptic and accessory oxytocinergic neurons. These structures are involved in the transmission of signals related to immune challenges within the brain and consequent elaboration of neuro-endocrine responses. CONCLUSIONS: The data obtained are supporting the view that the information on peripheral tumor development might be transmitted to the brain. However, further studies are necessary to be performed to reveal whether our findings can be attributed to specific effect of cancer or whether observed changes in the activity of brainstem and hypothalamic neurons reflex processes that only accompany the cancer progression.
Assuntos
Encéfalo/patologia , Imuno-Histoquímica , Neoplasias Experimentais/patologia , Ocitocina/análise , Proteínas Proto-Oncogênicas c-fos/análise , Tirosina 3-Mono-Oxigenase/análise , Tonsila do Cerebelo/química , Tonsila do Cerebelo/citologia , Animais , Encéfalo/imunologia , Química Encefálica , Tronco Encefálico/química , Tronco Encefálico/citologia , Linhagem Celular Tumoral , Fibrossarcoma , Hipotálamo/química , Hipotálamo/citologia , Masculino , Transplante de Neoplasias , Neoplasias Experimentais/química , Neoplasias Experimentais/imunologia , Neurônios/química , Norepinefrina/fisiologia , Ratos , Ratos WistarRESUMO
There is no doubt that the nervous system is involved in the etiopathogenesis of various pathological states and diseases. Interactions between the nervous, endocrine, and immune systems might represent the anatomical and functional basis for understanding the pathways and mechanisms that enable the brain to modulate the progression of disease. The aim of this article is to encourage us to shift our current opinion of the etiopathogenesis of disease to one of highly complex interactions between peripheral tissues and the brain and in this way introduce new diagnostic and therapeutic approaches.
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Encéfalo/fisiopatologia , Progressão da Doença , Doença/etiologia , Sistema Endócrino/fisiologia , Sistema Imunitário/fisiologia , Neurobiologia , HumanosRESUMO
The interactions between the nervous, endocrine and immune systems are studied intensively. The communication between immune and cancer cells, and multilevel and bi-directional interactions between the nervous and immune systems constitute the basis for a hypothesis assuming that the brain might monitor and modulate the processes associated with the genesis and progression of cancer. The aim of this article is to describe the data supporting this hypothesis.
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Encéfalo/fisiologia , Transformação Celular Neoplásica , Sistema Endócrino/fisiologia , Sistema Imunitário/imunologia , Animais , Transformação Celular Neoplásica/imunologia , Transformação Celular Neoplásica/patologia , Humanos , Neurônios/metabolismo , Fatores de RiscoRESUMO
The aim of the present study was to investigate the activity of tyrosine hydroxylase (TH) immunopositive neurons, measured by Fos protein expression, in the hindbrain noradrenergic (NA) cell groups in animals exposed to visceral tumor growth for 28 days induced by intraperitoneal implantation of fibrosarcoma cells. We were also interested in determining whether brain stem NA neurons of tumor-bearing and intact animals exhibit similarities in their response to a strong heterotypic stimulus-immobilization (IMO) stress. We found increased Fos expression in NA cells of the nucleus tractus solitarii (A2 cell group) and of the A1 cell group of tumor-bearing rats. However, Fos expression in other brain stem NA cell groups, including A5, locus ceruleus, and A7, were similar to control rats. The effect of 60 min of IMO was evident in both groups, but there were no differences between Fos expression in brain stem NA cell groups in control and tumor-bearing rats. This indicates that the sensitivity of NA cells in tumor-bearing animals was not altered by the IMO-induced stress challenge. However, whether the increased Fos expression in NA cells in tumor-bearing animals is a consequence of a specific visceral response activated by cancer development or just a nonspecific event accompanying the cancer progression requires further study.