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1.
Sensors (Basel) ; 24(3)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38339664

RESUMO

The advent of Industry 4.0 necessitates substantial interaction between humans and machines, presenting new challenges when it comes to evaluating the stress levels of workers who operate in increasingly intricate work environments. Undoubtedly, work-related stress exerts a significant influence on individuals' overall stress levels, leading to enduring health issues and adverse impacts on their quality of life. Although psychological questionnaires have traditionally been employed to assess stress, they lack the capability to monitor stress levels in real-time or on an ongoing basis, thus making it arduous to identify the causes and demanding aspects of work. To surmount this limitation, an effective solution lies in the analysis of physiological signals that can be continuously measured through wearable or ambient sensors. Previous studies in this field have mainly focused on stress assessment through intrusive wearable systems susceptible to noise and artifacts that degrade performance. One of our recently published papers presented a wearable and ambient hardware-software platform that is minimally intrusive, able to detect human stress without hindering normal work activities, and slightly susceptible to artifacts due to movements. A limitation of this system is its not very high performance in terms of the accuracy of detecting multiple stress levels; therefore, in this work, the focus was on improving the software performance of the platform, using a deep learning approach. To this purpose, three neural networks were implemented, and the best performance was achieved by the 1D-convolutional neural network with an accuracy of 95.38% for the identification of two levels of stress, which is a significant improvement over those obtained previously.


Assuntos
Aprendizado Profundo , Humanos , Qualidade de Vida , Redes Neurais de Computação , Software
2.
Pharmaceuticals (Basel) ; 16(10)2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37895893

RESUMO

Immunotherapy targeting program cell death protein 1 (PD-1) in addition to chemotherapy has improved the survival of triple-negative breast cancer (TNBC) patients. However, the development of resistance and toxicity remain significant problems. Using the translationally relevant 4T1 mouse model of TNBC, we report here that dietary administration of the phytochemical quercetin enhanced the antitumor action of Cyclophosphamide, a cytotoxic drug with significant immunogenic effects that is part of the combination chemotherapy used in TNBC. We observed that quercetin favorably modified the host fecal microbiome by enriching species such as Akkermansia muciniphilia, which has been shown to improve response to anti-PD-1 therapy. We also show that quercetin and, to a greater extent, Cyclophosphamide increased the systemic frequency of T cells and NK cells. In addition, Cyclophosphamide alone and in combination with quercetin reduced the frequency of Treg, which is consistent with an antitumor immune response. On the other hand, Cyclophosphamide did not significantly alter the host microbiome, suggesting complementarity between microbiome- and immune-mediated mechanisms in potentiating the antitumor action of Cyclophosphamide by quercetin. Overall, these results support the potential for microbiota-centered dietary intervention to overcome resistance to chemoimmunotherapy in TNBC.

3.
Sensors (Basel) ; 23(13)2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37447889

RESUMO

Smart living, an increasingly prominent concept, entails incorporating sophisticated technologies in homes and urban environments to elevate the quality of life for citizens. A critical success factor for smart living services and applications, from energy management to healthcare and transportation, is the efficacy of human action recognition (HAR). HAR, rooted in computer vision, seeks to identify human actions and activities using visual data and various sensor modalities. This paper extensively reviews the literature on HAR in smart living services and applications, amalgamating key contributions and challenges while providing insights into future research directions. The review delves into the essential aspects of smart living, the state of the art in HAR, and the potential societal implications of this technology. Moreover, the paper meticulously examines the primary application sectors in smart living that stand to gain from HAR, such as smart homes, smart healthcare, and smart cities. By underscoring the significance of the four dimensions of context awareness, data availability, personalization, and privacy in HAR, this paper offers a comprehensive resource for researchers and practitioners striving to advance smart living services and applications. The methodology for this literature review involved conducting targeted Scopus queries to ensure a comprehensive coverage of relevant publications in the field. Efforts have been made to thoroughly evaluate the existing literature, identify research gaps, and propose future research directions. The comparative advantages of this review lie in its comprehensive coverage of the dimensions essential for smart living services and applications, addressing the limitations of previous reviews and offering valuable insights for researchers and practitioners in the field.


Assuntos
Privacidade , Qualidade de Vida , Humanos , Reconhecimento Automatizado de Padrão , Atividades Humanas , Atenção à Saúde
4.
Sensors (Basel) ; 23(11)2023 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-37299868

RESUMO

Air quality monitoring is a very important aspect of providing safe indoor conditions, and carbon dioxide (CO2) is one of the pollutants that most affects people's health. An automatic system able to accurately forecast CO2 concentration can prevent a sudden rise in CO2 levels through appropriate control of heating, ventilation and air-conditioning (HVAC) systems, avoiding energy waste and ensuring people's comfort. There are several works in the literature dedicated to air quality assessment and control of HVAC systems; the performance maximisation of such systems is typically achieved using a significant amount of data collected over a long period of time (even months) to train the algorithm. This can be costly and may not respond to a real scenario where the habits of the house occupants or the environment conditions may change over time. To address this problem, an adaptive hardware-software platform was developed, following the IoT paradigm, with a high level of accuracy in forecasting CO2 trends by analysing only a limited window of recent data. The system was tested considering a real case study in a residential room used for smart working and physical exercise; the parameters analysed were the occupants' physical activity, temperature, humidity and CO2 in the room. Three deep-learning algorithms were evaluated, and the best result was obtained with the Long Short-Term Memory network, which features a Root Mean Square Error of about 10 ppm with a training period of 10 days.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluentes Ambientais , Humanos , Poluição do Ar em Ambientes Fechados/análise , Dióxido de Carbono/análise , Poluentes Atmosféricos/análise , Ar/análise , Poluentes Ambientais/análise , Ventilação , Ar Condicionado , Monitoramento Ambiental/métodos
5.
Cancers (Basel) ; 15(11)2023 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-37296833

RESUMO

Lifestyle modifications have been shown to be effective in reducing breast cancer [...].

6.
Sensors (Basel) ; 23(7)2023 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-37050566

RESUMO

Heart rate monitoring is especially important for aging individuals because it is associated with longevity and cardiovascular risk. Typically, this vital parameter can be measured using wearable sensors, which are widely available commercially. However, wearable sensors have some disadvantages in terms of acceptability, especially when used by elderly people. Thus, contactless solutions have increasingly attracted the scientific community in recent years. Camera-based photoplethysmography (also known as remote photoplethysmography) is an emerging method of contactless heart rate monitoring that uses a camera and a processing unit on the hardware side, and appropriate image processing methodologies on the software side. This paper describes the design and implementation of a novel pipeline for heart rate estimation using a commercial and low-cost camera as the input device. The pipeline's performance was tested and compared on a desktop PC, a laptop, and three different ARM-based embedded platforms (Raspberry Pi 4, Odroid N2+, and Jetson Nano). The results showed that the designed and implemented pipeline achieved an average accuracy of about 96.7% for heart rate estimation, with very low variance (between 1.5% and 2.5%) across processing platforms, user distances from the camera, and frame resolutions. Furthermore, benchmark analysis showed that the Odroid N2+ platform was the most convenient in terms of CPU load, RAM usage, and average execution time of the algorithmic pipeline.


Assuntos
Benchmarking , Determinação da Frequência Cardíaca , Humanos , Idoso , Frequência Cardíaca/fisiologia , Monitorização Fisiológica/métodos , Fotopletismografia/métodos , Processamento de Sinais Assistido por Computador
7.
Sensors (Basel) ; 23(2)2023 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-36679839

RESUMO

Embedded hardware systems, such as wearable devices, are widely used for health status monitoring of ageing people to improve their well-being. In this context, it becomes increasingly important to develop portable, easy-to-use, compact, and energy-efficient hardware-software platforms, to enhance the level of usability and promote their deployment. With this purpose an automatic tri-axial accelerometer-based system for postural recognition has been developed, useful in detecting potential inappropriate behavioral habits for the elderly. Systems in the literature and on the market for this type of analysis mostly use personal computers with high computing resources, which are not easily portable and have high power consumption. To overcome these limitations, a real-time posture recognition Machine Learning algorithm was developed and optimized that could perform highly on platforms with low computational capacity and power consumption. The software was integrated and tested on two low-cost embedded platform (Raspberry Pi 4 and Odroid N2+). The experimentation stage was performed on various Machine Learning pre-trained classifiers using data of seven elderly users. The preliminary results showed an activity classification accuracy of about 98% for the four analyzed postures (Standing, Sitting, Bending, and Lying down), with similar accuracy and a computational load as the state-of-the-art classifiers running on personal computers.


Assuntos
Benchmarking , Dispositivos Eletrônicos Vestíveis , Humanos , Idoso , Postura , Software , Algoritmos , Acelerometria
8.
Sensors (Basel) ; 24(1)2023 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-38202944

RESUMO

Gait analysis plays a crucial role in detecting and monitoring various neurological and musculoskeletal disorders early. This paper presents a comprehensive study of the automatic detection of abnormal gait using 3D vision, with a focus on non-invasive and practical data acquisition methods suitable for everyday environments. We explore various configurations, including multi-camera setups placed at different distances and angles, as well as performing daily activities in different directions. An integral component of our study involves combining gait analysis with the monitoring of activities of daily living (ADLs), given the paramount relevance of this integration in the context of Ambient Assisted Living. To achieve this, we investigate cutting-edge Deep Neural Network approaches, such as the Temporal Convolutional Network, Gated Recurrent Unit, and Long Short-Term Memory Autoencoder. Additionally, we scrutinize different data representation formats, including Euclidean-based representations, angular adjacency matrices, and rotation matrices. Our system's performance evaluation leverages both publicly available datasets and data we collected ourselves while accounting for individual variations and environmental factors. The results underscore the effectiveness of our proposed configurations in accurately classifying abnormal gait, thus shedding light on the optimal setup for non-invasive and efficient data collection.


Assuntos
Inteligência Ambiental , Doenças Musculoesqueléticas , Humanos , Atividades Cotidianas , Marcha , Análise da Marcha
9.
JAMA Netw Open ; 5(12): e2248332, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36574247

RESUMO

Importance: Despite access to routine laboratory evaluation, primary hyperparathyroidism (PHP) remains underdiagnosed and undertreated. Objective: To determine the consequences associated with missed diagnoses and prolonged time to diagnosis and treatment of PHP. Design, Setting, and Participants: This is a retrospective cohort study of patients older than 40 years with 2 instances of hypercalcemia during 2010 to 2020 and 3 years of follow-up. Patients were recruited from 63 health care organizations in the TriNetX Research Network. Data analysis was performed from January 2010 to September 2020. Exposures: Elevated serum calcium. Main Outcomes and Measures: Existing symptoms and diagnoses associated with PHP (osteoporosis, fractures, urolithiasis, major depressive disorder, anxiety, hypertension, gastroesophageal reflux disease, malaise or fatigue, joint pain or myalgias, constipation, insomnia, polyuria, weakness, abdominal pain, headache, nausea, amnesia, and gallstones) compared in patients deemed high-risk and without a diagnosis and matched controls, and those who experienced times from documented hypercalcemia to diagnosis and diagnosis to treatment within or beyond 1 year. Results: There were 135 034 patients analyzed (96 554 women [72%]; 28 892 Black patients [21%] and 88 010 White patients [65%]; 3608 Hispanic patients [3%] and 98 279 non-Hispanic patients [73%]; mean [SD] age, 63 [10] years). Two groups without a documented diagnosis of PHP were identified as high risk: 20 176 patients (14.9%) with parathyroid hormone greater than or equal to 50 pg/mL and 24 905 patients (18.4%) with no parathyroid hormone level obtained or recorded explanation for hypercalcemia. High-risk patients experienced significantly increased rates of all associated symptoms and diagnoses compared with matched controls. Just 9.7% of those with hypercalcemia (13 136 patients) had a diagnosis of PHP. Compared with individuals who received a diagnosis within 1 year of hypercalcemia, those whose workup exceeded 1 year had significantly increased rates of major depressive disorder, anxiety, hypertension, gastroesophageal reflux disease, malaise or fatigue, joint pain or myalgias, polyuria, weakness, abdominal pain, and headache at 3 years. The rate of osteoporosis increased from 17.1% (628 patients) to 25.4% (935 patients) over the study period in the group with delayed diagnosis. Among those with a diagnosis, 5280 patients (40.2%) underwent parathyroidectomy. Surgery beyond 1 year of diagnosis was associated with significantly increased rates of osteoporosis and hypertension at 3 years after diagnosis compared with those treated within 1 year. Conclusions and Relevance: Many patients were at high risk for PHP without a documented diagnosis. Complications in these patients, as well as those who received a diagnosis after prolonged workup or time to treatment, resulted in patient harm. System-level interventions are necessary to ensure proper diagnosis and prompt treatment of PHP.


Assuntos
Transtorno Depressivo Maior , Hipercalcemia , Hiperparatireoidismo Primário , Osteoporose , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Cálcio , Transtorno Depressivo Maior/complicações , Hipercalcemia/diagnóstico , Hipercalcemia/epidemiologia , Hipercalcemia/etiologia , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/diagnóstico , Hiperparatireoidismo Primário/epidemiologia , Osteoporose/complicações , Hormônio Paratireóideo , Poliúria/complicações , Estudos Retrospectivos , Idoso , Masculino
10.
Sensors (Basel) ; 22(13)2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35808387

RESUMO

COVID-19 has affected daily life in unprecedented ways, with dramatic changes in mental health, sleep time and level of physical activity. These changes have been especially relevant in the elderly population, with important health-related consequences. In this work, two different sensor technologies were used to quantify the energy expenditure of ageing adults. To this end, a technological platform based on Raspberry Pi 4, as an elaboration unit, was designed and implemented. It integrates an ambient sensor node, a wearable sensor node and a coordinator node that uses the information provided by the two sensor technologies in a combined manner. Ambient and wearable sensors are used for the real-time recognition of four human postures (standing, sitting, bending and lying down), walking activity and for energy expenditure quantification. An important first aim of this work was to realize a platform with a high level of user acceptability. In fact, through the use of two unobtrusive sensors and a low-cost processing unit, the solution is easily accessible and usable in the domestic environment; moreover, it is versatile since it can be used by end-users who accept being monitored by a specific sensor. Another added value of the platform is the ability to abstract from sensing technologies, as the use of human posture and walking activity for energy expenditure quantification enables the integration of a wide set of devices, provided that they can reproduce the same set of features. The obtained results showed the ability of the proposed platform to automatically quantify energy expenditure, both with each sensing technology and with the combined version. Specifically, for posture and walking activity classification, an average accuracy of 93.8% and 93.3% was obtained, respectively, with the wearable and ambient sensor, whereas an improvement of approximately 4% was reached using data fusion. Consequently, the estimated energy expenditure quantification always had a relative error of less than 3.2% for each end-user involved in the experimentation stage, classifying the high level information (postures and walking activities) with the combined version of the platform, justifying the proposed overall architecture from a hardware and software point of view.


Assuntos
COVID-19 , Dispositivos Eletrônicos Vestíveis , Adulto , Idoso , Envelhecimento , Metabolismo Energético , Humanos , Postura
11.
Sensors (Basel) ; 22(7)2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35408335

RESUMO

Sarcopenia is a geriatric condition characterized by a loss of strength and muscle mass, with a high impact on health status, functional independence and quality of life in older adults. [d=TT, ]To reduce the effects of the disease, just the diagnostic is not enough, it is necessary more than recognition.To reduce the effects of the disease, it is important to recognize the level and progression of sarcopenia early. Surface electromyography is becoming increasingly relevant for the prevention and diagnosis of sarcopenia, also due to a wide diffusion of smart and minimally invasive wearable devices suitable for electromyographic monitoring. The purpose of this work is manifold. The first aim is the design and implementation of a hardware/software platform. It is based on the elaboration of surface electromyographic signals extracted from the Gastrocnemius Lateralis and Tibialis Anterior muscles, useful to analyze the strength of the muscles with the purpose of distinguishing three different "confidence" levels of sarcopenia. The second aim is to compare the efficiency of state of the art supervised classifiers in the evaluation of sarcopenia. The experimentation stage was performed on an "augmented" dataset starting from data acquired from 32 patients. The latter were distributed in an unbalanced manner on 3 "confidence" levels of sarcopenia. The obtained results in terms of classification accuracy demonstrated the ability of the proposed platform to distinguish different sarcopenia "confidence" levels, with highest accuracy value given by Support Vector Machine classifier, outperforming the other classifiers by an average of 7.7%.


Assuntos
Sarcopenia , Idoso , Algoritmos , Eletromiografia/métodos , Humanos , Qualidade de Vida , Sarcopenia/diagnóstico , Máquina de Vetores de Suporte
12.
Sensors (Basel) ; 21(9)2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33922146

RESUMO

Drivers' road rage is among the main causes of road accidents. Each year, it contributes to more deaths and injuries globally. In this context, it is important to implement systems that can supervise drivers by monitoring their level of concentration during the entire driving process. In this paper, a module for Advanced Driver Assistance System is used to minimise the accidents caused by road rage, alerting the driver when a predetermined level of rage is reached, thus increasing the transportation safety. To create a system that is independent of both the orientation of the driver's face and the lighting conditions of the cabin, the proposed algorithmic pipeline integrates face detection and facial expression classification algorithms capable of handling such non-ideal situations. Moreover, road rage of the driver is estimated through a decision-making strategy based on the temporal consistency of facial expressions classified as "anger" and "disgust". Several experiments were executed to assess the performance on both a real context and three standard benchmark datasets, two of which containing non-frontal-view facial expression and one which includes facial expression recorded from participants during driving. Results obtained show that the proposed module is competent for road rage estimation through facial expression recognition on the condition of multi-pose and changing in lighting conditions, with the recognition rates that achieve state-of-art results on the selected datasets.


Assuntos
Condução de Veículo , Fúria no Trânsito , Acidentes de Trânsito/prevenção & controle , Humanos , Iluminação , Segurança , Visão Ocular
13.
Sci Rep ; 11(1): 410, 2021 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431978

RESUMO

Docosahexaenoic acid (DHA) is known to inhibit breast cancer in the rat. Here we investigated whether DHA itself or select metabolites can account for its antitumor action. We focused on metabolites derived from the lipoxygenase (LOX) pathway since we previously showed that they were superior anti-proliferating agents compared to DHA; 4-OXO-DHA was the most potent. A lipidomics approach detected several LOX-metabolites in plasma and the mammary gland in rats fed DHA; we also identified for the first time, 4-OXO-DHA in rat plasma. In a reporter assay, 4-OXO-DHA and 4-HDHA were more effective activators of PPARÉ£ than DHA. In breast cancer cell lines, 4-OXO-DHA induced PPARÉ£ and 15-hydroxyprostaglandin dehydrogenase (15-PGDH) but inhibited the activity of NF-κB and suppressed PI3K and mTOR signaling. Because of the structural characteristics of 4-OXO-DHA (Michael acceptor), not shared by any of the other hydroxylated-DHA, we used MS and showed that it can covalently modify the cysteine residue of NF-κB. We have also shown that the chemopreventive effect of DHA is associated with significant reduction of PGE2 levels, in both rat mammary tumors induced by MNU and non-involved mammary tissues. Collectively, our results indicate that 4-OXO-DHA is the metabolite of choice in future chemoprevention studies.


Assuntos
Antineoplásicos/metabolismo , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Ácidos Docosa-Hexaenoicos/metabolismo , Lipoxigenase/metabolismo , Animais , Anticarcinógenos/metabolismo , Anticarcinógenos/uso terapêutico , Antineoplásicos/isolamento & purificação , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Catálise , Dinoprostona/metabolismo , Feminino , Metabolismo dos Lipídeos/fisiologia , Lipídeos/análise , Redes e Vias Metabólicas/fisiologia , PPAR gama/metabolismo , Ratos , Ratos Sprague-Dawley
14.
Front Public Health ; 9: 780098, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34993171

RESUMO

Introduction: Parkinson's disease (PD) is one of the most frequent causes of disability among older people, characterized by motor disorders, rigidity, and balance problems. Recently, dance has started to be considered an effective exercise for people with PD. In particular, Irish dancing, along with tango and different forms of modern dance, may be a valid strategy to motivate people with PD to perform physical activity. The present protocol aims to implement and evaluate a rehabilitation program based on a new system called "SI-ROBOTICS," composed of multiple technological components, such as a social robotic platform embedded with an artificial vision setting, a dance-based game, environmental and wearable sensors, and an advanced AI reasoner module. Methods and Analysis: For this study, 20 patients with PD will be recruited. Sixteen therapy sessions of 50 min will be conducted (two training sessions per week, for 8 weeks), involving two patients at a time. Evaluation will be primarily focused on the acceptability of the SI-ROBOTICS system. Moreover, the analysis of the impact on the patients' functional status, gait, balance, fear of falling, cardio-respiratory performance, motor symptoms related to PD, and quality of life, will be considered as secondary outcomes. The trial will start in November 2021 and is expected to end by April 2022. Discussions: The study aims to propose and evaluate a new approach in PD rehabilitation, focused on the use of Irish dancing, together with a new technological system focused on helping the patient perform the dance steps and on collecting kinematic and performance parameters used both by the physiotherapist (for the evaluation and planning of the subsequent sessions) and by the system (to outline the levels of difficulty of the exercise). Ethics and Dissemination: The study was approved by the Ethics Committee of the IRCCS INRCA. It was recorded in ClinicalTrials.gov on the number NCT05005208. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.


Assuntos
Doença de Parkinson , Acidentes por Quedas , Idoso , Terapia por Exercício/métodos , Medo , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/terapia , Qualidade de Vida
15.
Cancers (Basel) ; 14(1)2021 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-35008321

RESUMO

In vivo evidence of heterogeneous effects of n-3 fatty acids (N3FA) on cell signaling pathways associated with the reduced growth of breast cancer has been reported and is consistent with the expectation that N3FA will not exert uniform effects on all molecular subtypes of the disease. Similarly, available evidence indicates that many metabolites of N3FA are synthesized by mammalian cells and that they exert metabolite-specific biological activities. To begin to unravel the complex relationships among molecular subtypes and effects exerted by specific N3FA metabolites on those pathways, proof-of-concept experiments were conducted using cell lines representative of common molecular subtypes of human breast cancer. N3FA differed in anticancer activity with docosahexaenoic acid (DHA) having greater anticancer activity than eicosapentaenoic acid. 4-oxo-docosahexaenoic (4-oxo-DHA), a penultimate metabolite of 5-lipoxygenase mediated DHA metabolism, induced dose-dependent inhibition of cell number accumulation with apoptosis as a primary effector mechanism. Interrogation of protein expression data using the Ingenuity Pathway Analysis (IPA) bioinformatics platform indicated that 4-oxo-DHA differentially impacted six canonical pathways and the cellular functions they regulate across common molecular subtypes of breast cancer. This included the endocannabinoid pathway for cancer inhibition that has not been previously reported. These findings provide a rationale for juxtaposing molecular subtype targeted treatment strategies with the adjuvant use of specific N3FA metabolites as an example of precision onco-nutrition (PON) for the management and control of breast cancer.

16.
BMJ Case Rep ; 13(4)2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32350052

RESUMO

A 40-year-old man, with a history of metastatic parathyroid carcinoma, status post primary tumour resection and lung metastasectomy, was hospitalised for persistent severe hypercalcaemia and elevated parathyroid hormone levels despite conventional management and escalating doses of cinacalcet. A single dose (120 mg) of denosumab was given and his calcium level plummeted from 14.8 mg/dL to 5.5 mg/dL. After second lung metastasectomy, he developed prolonged hypocalcaemia that required calcium and vitamin D supplements for more than 3 years. In patients with severe hypercalcaemia refractory to conventional therapies, denosumab has been used off-label with some success. A known side effect of denosumab is hypocalcaemia, which is often short-lived. The risk of prolonged hypocalcaemia should be fully evaluated before using denosumab preoperatively, especially in patients with renal insufficiency, prolonged hyperparathyroidism or anticipated tumour debulking surgery.


Assuntos
Denosumab/administração & dosagem , Denosumab/efeitos adversos , Hipercalcemia/tratamento farmacológico , Hipocalcemia/induzido quimicamente , Adulto , Cálcio/uso terapêutico , Humanos , Hipocalcemia/tratamento farmacológico , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Masculino , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Cuidados Pré-Operatórios , Vitamina D/uso terapêutico
17.
Nutr Cancer ; 72(2): 183-186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31407927

RESUMO

Literature data revealed that the benefits of consuming omega-3 fatty acid (n-3FA) supplements such as fish oil with the goal of reducing the incidence of chronic diseases such as cardiovascular disease and cancer remain controversial. The purpose of this commentary is to discuss factors that may account for the inconsistency of results across different studies. Critical review of the published data, including our own preclinical and clinical studies, strongly suggests that customized clinical prevention trials are needed to resolve the above-mentioned controversy. Specifically, in order to develop a personalized cancer prevention strategy, more attention should be given to multiple factors including the dose of the n-3FA, the specific placebo used as a comparator, duration of administration, type of intervention (primary vs secondary prevention trial), specific compound (DHA vs EPA vs their metabolites), the ratio of n-3FA:n-6FA and the target population tested (high vs average risk).


Assuntos
Ensaios Clínicos como Assunto/normas , Suplementos Nutricionais , Ácidos Graxos Ômega-3/uso terapêutico , Necessidades e Demandas de Serviços de Saúde/normas , Neoplasias/prevenção & controle , Prevenção Secundária/métodos , Humanos , Neoplasias/dietoterapia , Resultado do Tratamento
18.
J Proteome Res ; 18(9): 3461-3469, 2019 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-31369706

RESUMO

We reported that breast density (BD) was inversely correlated with the plasma level of DHA in postmenopausal obese, but not in nonobese, women given Lovaza (n-3FA). To identify protein biomarkers for the possible differential effect of n-3FA on BD between obese and nonobese women, an iTRAQ method was performed to analyze plasma from obese and lean women at each time point (baseline, 12 and 24-months, n = 10 per group); 173 proteins with >95% confidence (Unuses Score >1.3 and local false discovery rate estimation <5%) were identified. Comparative analysis between various groups identified several differentially expressed proteins (hemopexin precursor, vitamin D binding protein isoform 1 precursor [VDBP], fibronectin isoform 10 precursor [FN], and α-2 macroglobulin precursor [A2M]). Western blot analysis was performed to verify the differential expression of proteins in the iTRAQ study, and those found to be altered in a tumor protective fashion by an n-3FA rich diet in our previous preclinical study; gelsolin, VDBP, and FN were altered by n-3FA in a manner consistent with reduction in inflammation in obese women. To test the impact of our findings on breast cancer risk reduction by n-3FA, a posthoc analysis revealed that n-3FA administration reduced BD selectively in obese postmenopausal women.


Assuntos
Neoplasias da Mama/sangue , Ácidos Docosa-Hexaenoicos/sangue , Ácido Eicosapentaenoico/sangue , Obesidade/sangue , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Densidade da Mama/efeitos dos fármacos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Ácidos Docosa-Hexaenoicos/administração & dosagem , Combinação de Medicamentos , Ácido Eicosapentaenoico/administração & dosagem , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-3/sangue , Feminino , Fibronectinas/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Hemopexina/genética , Humanos , Pessoa de Meia-Idade , Obesidade/tratamento farmacológico , Obesidade/patologia , Pós-Menopausa/sangue , Proteômica/métodos , Proteína de Ligação a Vitamina D/genética , Adulto Jovem , alfa-Macroglobulinas/genética
19.
Int J Mol Sci ; 19(1)2017 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-29271901

RESUMO

There is strong evidence that obesity poses a significant risk factor for postmenopausal breast cancer. There are multiple mechanisms by which obesity can predispose to breast cancer, prominent among which is the creation of a pro-inflammatory milieu systemically in the visceral and subcutaneous tissue, as well as locally in the breast. Although dietary intervention studies have shown in general a favorable effect on biomarkers of breast cancer risk, it is still unclear whether losing excess weight will lower the risk. In this manuscript, we will review the evidence that omega-3 fatty acids, and among them docosahexaenoic acid (DHA) in particular, may reduce the risk of obesity related breast cancer primarily because of their pleotropic effects which target many of the systemic and local oncogenic pathways activated by excess weight. We will also review the evidence indicating that intentional weight loss (IWL) induced by dietary energy restriction (DER) will augment the tumor protective effect of DHA because of its complementary mechanisms of action and its ability to reverse the obesity-induced alterations in fatty acid metabolism predisposing to carcinogenesis. We believe that the combination of DER and DHA is a promising safe and effective intervention for reducing obesity-related breast cancer risk which needs to be validated in appropriately designed prospective, randomized clinical trials.


Assuntos
Anticarcinógenos/uso terapêutico , Neoplasias da Mama/etiologia , Neoplasias da Mama/prevenção & controle , Restrição Calórica , Ácidos Docosa-Hexaenoicos/uso terapêutico , Obesidade/complicações , Animais , Mama/efeitos dos fármacos , Mama/metabolismo , Neoplasias da Mama/dietoterapia , Neoplasias da Mama/metabolismo , Restrição Calórica/métodos , Ácidos Graxos Ômega-3/uso terapêutico , Feminino , Humanos , Obesidade/metabolismo , Risco
20.
Chemosphere ; 186: 124-131, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28772179

RESUMO

The assessment of organic and inorganic contaminants in agricultural soils is a difficult challenge due to the large-scale dimensions of the areas under investigation and the great number of samples needed for analysis. On-site screening techniques, such as Field Portable X-ray Fluorescence (FPXRF) spectrometry, can be used for inorganic compounds, such as heavy metals. This method is not destructive and allows a rapid qualitative characterization, identifying hot spots from where to collect soil samples for analysis by traditional laboratory techniques. Recently, fast methods such as immuno-assays for the determination of organic compounds, such as dioxins, furans and PCBs, have been employed, but several limitations compromise their performance. The aim of the present study was to find a method able to screen contaminants in agricultural soil, using FPXRF spectrometry for metals and a statistical procedure, such as the Artificial Neural Networks technique, to estimate unknown concentrations of organic compounds based on statistical relationships between the organic and inorganic pollutants.


Assuntos
Monitoramento Ambiental/métodos , Redes Neurais de Computação , Poluentes do Solo/análise , Agricultura , Dioxinas/análise , Metais Pesados/análise , Bifenilos Policlorados/análise , Solo/química
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