Assuntos
Escleroderma Sistêmico , Dermatopatias , Biomarcadores , Proteínas de Choque Térmico HSP27 , Proteínas de Choque Térmico , Humanos , Chaperonas Moleculares , Escleroderma Sistêmico/diagnóstico , Escleroderma Sistêmico/patologia , Esclerose/patologia , Pele/patologia , Dermatopatias/patologiaAssuntos
Colo Sigmoide/patologia , Doenças Inflamatórias Intestinais/diagnóstico , Subunidade gama Comum de Receptores de Interleucina/genética , Mutação/genética , Úlcera/diagnóstico , Abscesso , Diarreia , Genes Ligados ao Cromossomo X , Humanos , Lactente , Doenças Inflamatórias Intestinais/genética , Masculino , Úlcera/genéticaRESUMO
Transverse single-spin asymmetries of very forward neutral pions generated in polarized p+p collisions allow us to understand the production mechanism in terms of perturbative and nonperturbative strong interactions. During 2017, the RHICf Collaboration installed an electromagnetic calorimeter in the zero-degree region of the STAR detector at the Relativistic Heavy Ion Collider (RHIC) and measured neutral pions produced at pseudorapidity larger than 6 in polarized p+p collisions at sqrt[s]=510 GeV. The large nonzero asymmetries increasing both in longitudinal momentum fraction x_{F} and transverse momentum p_{T} have been observed at low transverse momentum p_{T}<1 GeV/c for the first time, at this collision energy. The asymmetries show an approximate x_{F} scaling in the p_{T} region where nonperturbative processes are expected to dominate. A non-negligible contribution from soft processes may be necessary to explain the nonzero neutral pion asymmetries.
RESUMO
The probiotic Lactobacillus gasseri SBT2055 (LG2055) has a protective effect against metabolic syndrome in rats and humans. Metabolic syndrome increases the risk of type 2 diabetes mellitus. In this study, Goto-Kakizaki rats were used as a diabetic model and fed diets containing LG2055-fermented or nonfermented skim milk for 4 wk. Indices of diabetes such as blood glucose levels, serum glucagon levels, plasma levels of insulin, C-peptide, and glucagon-like peptide-1, tissue glycogen contents, and pancreatic mRNA levels were measured. The plasma C-peptide levels and pancreatic mRNA levels of insulin genes (Ins1 and Ins2) and Pdx1 (a transcriptional factor of insulin genes) were increased in LG2055 diet-fed rats. The increase in insulin secretion corresponded to an improvement in serum and pancreatic inflammatory status, associated with decreases in serum levels of serum amyloid P and pancreatic levels of granulocyte colony-stimulating factor. Insulin resistance in Goto-Kakizaki rats was ameliorated by increased glycogen storage in the liver and quadriceps femoris muscles and decreased serum free fatty acid levels. This improvement may be related to the increased cecal production of short-chain fatty acids. In conclusion, dietary LG2055 improved insulin secretion in diabetic rats by improving the inflammatory status in the pancreas and serum.
Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Secreção de Insulina/fisiologia , Lactobacillus gasseri , Probióticos/administração & dosagem , Animais , Glicemia/análise , Ceco/metabolismo , Dieta , Ácidos Graxos Voláteis/metabolismo , Peptídeo 1 Semelhante ao Glucagon/sangue , Glicogênio/análise , Glicogênio/metabolismo , Humanos , Insulina/sangue , Resistência à Insulina , Fígado/química , Masculino , Músculo Esquelético/química , RatosRESUMO
Dopamine in prefrontal cortices is implicated in cognitive and emotional functions, and the dysfunction of prefrontal dopamine has been associated with cognitive and emotional deficits in mental illnesses. These findings have led to clinical trials of dopamine-targeting drugs and brain imaging of dopamine receptors in patients with mental illnesses. Rodent studies have suggested that dopaminergic pathway projecting to the medial prefrontal cortex (mPFC) suppresses stress susceptibility. Although various types of mPFC neurons express several dopamine receptor subtypes, previous studies neither isolated a role of dopamine receptor subtype nor identified the site of its action in mPFC. Using social defeat stress (SDS) in mice, here we identified a role of dopamine D1 receptor subtype in mPFC excitatory neurons in suppressing stress susceptibility. Repeated social defeat stress (R-SDS) reduces the expression of D1 receptor subtype in mPFC of mice susceptible to R-SDS. Knockdown of D1 receptor subtype in whole neuronal populations or excitatory neurons in mPFC facilitates the induction of social avoidance by SDS. Single social defeat stress (S-SDS) induces D1 receptor-mediated extracellular signal-regulated kinase phosphorylation and c-Fos expression in mPFC neurons. Whereas R-SDS reduces dendritic lengths of mPFC layer II/III pyramidal neurons, S-SDS increases arborization and spines of apical dendrites of these neurons in a D1 receptor-dependent manner. Collectively, our findings show that D1 receptor subtype and related signaling in mPFC excitatory neurons mediate acute stress-induced dendritic growth of these neurons and contribute to suppression of stress susceptibility. Therefore, we propose that D1 receptor-mediated dendritic growth in mPFC excitatory neurons suppresses stress susceptibility.
Assuntos
Dendritos/metabolismo , Córtex Pré-Frontal/metabolismo , Receptores de Dopamina D1/metabolismo , Resiliência Psicológica , Estresse Psicológico/metabolismo , Animais , Aprendizagem da Esquiva/fisiologia , Crescimento Celular , Dendritos/patologia , Modelos Animais de Doenças , Suscetibilidade a Doenças/metabolismo , Dominação-Subordinação , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Técnicas de Silenciamento de Genes , Masculino , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos ICR , Córtex Pré-Frontal/patologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , Células Piramidais/metabolismo , Células Piramidais/patologia , Receptores de Dopamina D1/genética , Estresse Psicológico/patologiaRESUMO
Our aim was to assess the incidence and anatomical site of branches of the inferior dental canal that supply mandibular third molars using dental cone-beam computed tomography (CT). We evaluated the incidence and diameter of branches of the inferior dental canal using 272 cone-beam CT mandibular scans from 172 patients referred for imaging before the extraction of impacted mandibular third molars. We found three typical branching patterns from the inferior dental canal in the third molar region: the retromolar canal (in the retromolar triangle), the dental canal (that courses directly beneath the socket of the third molar), and the accessory canal (that courses through the socket and leads from the inferior dental canal to a bony ridge). The incidences of retromolar, dental, and accessory canals were 75 (28%), 223 (82%), and 21 (8%), respectively, with mean diameters of 0.9 (0.4), 0.7 (0.5), and 1.1 (0.4) mm, respectively. Operative injury to the neurovascular contents within the branches of the inferior dental canal can lead to excessive bleeding and postoperative paraesthesia, so identification of its branches on preoperative cone-beam CT images may prove useful during extraction of impacted mandibular third molars or when harvesting bone blocks from the region of mandibular third molars. We also describe two cases of branches detected on panoramic and cone-beam CT images that prompted this research.
Assuntos
Tomografia Computadorizada de Feixe Cônico , Dente Serotino/anatomia & histologia , Dente Impactado/diagnóstico por imagem , Humanos , Incidência , Mandíbula , Dente Molar , Radiografia PanorâmicaRESUMO
BACKGROUND AND PURPOSE: Preoperative identification of plaque vulnerability may allow improved risk stratification for patients considered for carotid endarterectomy. The present study aimed to determine which plaque imaging technique, cardiac-gated black-blood fast spin-echo, magnetization-prepared rapid acquisition of gradient echo, source image of 3D time-of-flight MR angiography, or noncardiac-gated spin-echo, most accurately predicts development of microembolic signals during exposure of carotid arteries in carotid endarterectomy. MATERIALS AND METHODS: Eighty patients with ICA stenosis (≥70%) underwent the 4 sequences of preoperative MR plaque imaging of the affected carotid bifurcation and then carotid endarterectomy under transcranial Doppler monitoring of microembolic signals in the ipsilateral middle cerebral artery. The contrast ratio of the carotid plaque was calculated by dividing plaque signal intensity by sternocleidomastoid muscle signal intensity. RESULTS: Microembolic signals during exposure of carotid arteries were detected in 23 patients (29%), 3 of whom developed new neurologic deficits postoperatively. Those deficits remained at 24 hours after surgery in only 1 patient. The area under the receiver operating characteristic curve to discriminate between the presence and absence of microembolic signals during exposure of the carotid arteries was significantly greater with nongated spin-echo than with black-blood fast spin-echo (difference between areas, 0.258; P < .0001), MPRAGE (difference between areas, 0.106; P = .0023), or source image of 3D time-of-flight MR angiography (difference between areas, 0.128; P = .0010). Negative binomial regression showed that in the 23 patients with microembolic signals, the contrast ratio was associated with the number of microembolic signals only in nongated spin-echo (risk ratio, 1.36; 95% confidence interval, 1.01-1.97; P < .001). CONCLUSIONS: Nongated spin-echo may predict the development of microembolic signals during exposure of the carotid arteries in carotid endarterectomy more accurately than other MR plaque imaging techniques.
Assuntos
Estenose das Carótidas/diagnóstico por imagem , Endarterectomia das Carótidas/efeitos adversos , Imageamento por Ressonância Magnética/métodos , Placa Aterosclerótica/diagnóstico por imagem , Idoso , Área Sob a Curva , Artérias Carótidas/cirurgia , Estenose das Carótidas/cirurgia , Embolia/diagnóstico por imagem , Embolia/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placa Aterosclerótica/cirurgia , Curva ROCRESUMO
To emphasize the coffee flavor, many milk coffee beverages contain coffee extracts; these are the so-called "rich milk coffee" beverages. When the content of the coffee extracts increases, milk coffee beverages become unstable. The milk ring formation, or oiling off, is accelerated in these kinds of drinks. We prepared a "rich milk coffee" beverage and studied the stability of the emulsion. We also investigated the influence of the food emulsifiers on the stability of the emulsion. We tried to test the emulsifier system in order to improve the emulsion stability. When the milk coffee beverage with a low light value for the roasted coffee beans sterilized by UHT was stored at a low temperature, the milk component strongly separated. We found that the sucrose monoester with a high HLB and diglycerol monoester accelerated the milk separation, and the decaglycerol monoester controlled the milk separation. We discussed the milk separation mechanism and showed that maintaining the hydration of the hydrophilic group in the rich milk coffee beverage was related to the combination of emulsifiers that control the milk separation.
RESUMO
Sixty-two infants with MLL gene-rearrangement-positive acute lymphoblastic leukemia (MLL-r ALL) were treated with the MLL03 protocol of the Japanese Pediatric Leukemia/Lymphoma Study Group: short-course intensive chemotherapy followed by early allogeneic hematopoietic stem cell transplantation (HSCT) within 4 months of the initial induction. The 4-year event-free survival and overall survival rates were 43.2% (95% confidence interval (CI)=30.7-55.1%) and 67.2% (53.8-77.4%), respectively. A univariate analysis showed younger age (<90 days at diagnosis), central nervous system disease and poor response to initial prednisolone therapy significantly associated with poor prognosis (P<0.05). In a multivariate analysis, younger age at diagnosis tended to be associated with poor outcome (hazard ratio=1.969; 95% CI=0.903-4.291; P=0.088). Although the strategy of early use of HSCT effectively prevented early relapse and was feasible for infants with MLL-r ALL, the fact that substantial number of patients still relapsed even though transplanted in their first remission indicates the limited efficacy of allogeneic HSCT for infants with MLL-r ALL. Considering the risk of severe late effects, indications for HSCT should be restricted to specific subgroups with poor risk factors. An alternative approach incorporating molecular-targeted drugs should be established.
Assuntos
Rearranjo Gênico , Transplante de Células-Tronco Hematopoéticas , Proteína de Leucina Linfoide-Mieloide/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Antineoplásicos/uso terapêutico , Pré-Escolar , Intervalo Livre de Doença , Feminino , Histona-Lisina N-Metiltransferase , Humanos , Lactente , Masculino , Análise Multivariada , Recidiva Local de Neoplasia/terapia , Neoplasia Residual , Prednisolona/uso terapêutico , Prognóstico , Modelos de Riscos Proporcionais , Recidiva , Fatores de Risco , Transplante Homólogo , Resultado do TratamentoRESUMO
Throughout human history, economic bubbles have formed and burst. As a bubble grows, microeconomic behavior ceases to be constrained by realistic predictions. This contradicts the basic assumption of economics that agents have rational expectations. To examine the neural basis of behavior during bubbles, we performed functional magnetic resonance imaging while participants traded shares in a virtual stock exchange with two non-bubble stocks and one bubble stock. The price was largely deflected from the fair price in one of the non-bubble stocks, but not in the other. Their fair prices were specified. The price of the bubble stock showed a large increase and battering, as based on a real stock-market bust. The imaging results revealed modulation of the brain circuits that regulate trade behavior under different market conditions. The premotor cortex was activated only under a market condition in which the price was largely deflected from the fair price specified. During the bubble, brain regions associated with the cognitive processing that supports order decisions were identified. The asset preference that might bias the decision was associated with the ventrolateral prefrontal cortex and the dorsolateral prefrontal cortex (DLPFC). The activity of the inferior parietal lobule (IPL) was correlated with the score of future time perspective, which would bias the estimation of future price. These regions were deemed to form a distinctive network during the bubble. A functional connectivity analysis showed that the connectivity between the DLPFC and the IPL was predominant compared with other connectivities only during the bubble. These findings indicate that uncertain and unstable market conditions changed brain modes in traders. These brain mechanisms might lead to a loss of control caused by wishful thinking, and to microeconomic bubbles that expand, on the macroscopic scale, toward bust.
Assuntos
Tomada de Decisões/fisiologia , Córtex Pré-Frontal/fisiologia , Adulto , Encéfalo/fisiologia , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Adulto JovemAssuntos
Preservação de Sangue/instrumentação , Criopreservação/métodos , Dimetil Sulfóxido/química , Plastificantes/análise , Armazenamento de Sangue/métodos , Preservação de Sangue/métodos , Eritrócitos/citologia , Feminino , Sangue Fetal/citologia , Humanos , Masculino , Ácidos Ftálicos/efeitos adversos , Ácidos Ftálicos/análise , Plastificantes/efeitos adversos , Cloreto de Polivinila/química , GravidezRESUMO
OBJECTIVES: Patients with peripheral facial palsy frequently complain of fluid leakage and food retention during meals. We investigated oral function during eating in adults with peripheral facial palsy. DESIGN: A prospective two-phase controlled observational study. SETTING: Data were collected at the ENT clinic in Nihon University Itabashi Hospital (patients) and Nihon University Dental Hospital (controls) between September 2009 and August 2011 and analysed at the Department of Oral Diagnostic Sciences in Nihon University School of Dentistry. PARTICIPANTS: Fourteen patients with acute idiopathic facial palsy and 14 controls completed Study 1. Sixteen patients with acute idiopathic facial palsy and 16 controls completed Study 2. MAIN OUTCOME MEASURES: In Study 1, oral vestibular cleansing capability was assessed by measuring the amount of rice remaining in the oral vestibule after mastication. In Study 2, masticatory efficiency was evaluated by measuring glucose eluted from gummy jelly during chewing. These oral functions were observed at the first visit and final visit (after patients with facial palsy had recovered). RESULTS: Oral vestibular cleansing capability at the first visit was significantly decreased by facial palsy (P < 0.001 versus healthy volunteers and P < 0.001 versus contralateral side) but recovered as facial muscular function improved (P = 0.034). There was a significant correlation between improvement in paralysis and decreased food retention (r = -0.528, P = 0.010). At the first visit, masticatory efficiency on the affected side was significantly lower than that of controls (P = 0.002) but had mostly recovered after resolution of facial palsy (P = 0.033). CONCLUSIONS: Oral functions were decreased by peripheral facial palsy. Oral vestibular cleansing capability was more significantly associated than masticatory efficiency with facial muscle function. Our data suggest that peripheral facial palsy impairs eating and worsens oral hygiene, which may result in oral disease.
Assuntos
Paralisia de Bell/fisiopatologia , Músculos Faciais/fisiopatologia , Mastigação/fisiologia , Músculos da Mastigação/fisiopatologia , Boca/fisiopatologia , Recuperação de Função Fisiológica/fisiologia , Adulto , Paralisia de Bell/complicações , Paralisia de Bell/terapia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal , Estudos ProspectivosRESUMO
BACKGROUND AND PURPOSE: Cognitive function can improve or decline after carotid endarterectomy. Proton MR spectroscopy can be used evaluate cerebral metabolites, such as N-acetylaspartate, choline, and creatine, in vivo. The purpose of the present study was to determine whether postoperative changes in cerebral metabolites measured by using 3T proton MR spectroscopy were associated with changes in cognitive function after CEA. MATERIALS AND METHODS: In 100 patients undergoing CEA for ipsilateral cervical internal carotid artery stenosis (≥70%), brain proton MR spectroscopy was performed before and after surgery. NAA/Cr and Cho/Cr ratios were measured in regions of interest placed in the centrum semiovale of both cerebral hemispheres. Neuropsychological testing was also performed preoperatively and 1 month postoperatively. Multivariate statistical analysis of factors related to postoperatively changed cognition was performed, and odds ratios with 95% confidence intervals were calculated. RESULTS: On the basis of the neuropsychological assessments, 10 (10%), 80 (80%), and 10 (10%) patients were defined as having postoperatively improved, unchanged, and impaired cognition, respectively. A positive and high ΔNAA/Cr ratio (postoperative value-preoperative value) in the cerebral hemisphere ipsilateral to the operative site was significantly associated with postoperatively improved cognition (95% CI, 13.3-21.3; P = .0016). Negative and high absolute values of the ΔNAA/Cr ratio (95% CI, 0.018-0.101; P = .0039) and ΔCho/Cr ratio (95% CI, 0.042-0.135; P = .0046) in the ipsilateral cerebral hemisphere were significantly associated with postoperatively impaired cognition. CONCLUSIONS: Postoperative changes in cerebral metabolites measured by using proton MR spectroscopy were associated with changes in cognitive function after CEA.
Assuntos
Encéfalo/metabolismo , Estenose das Carótidas/metabolismo , Estenose das Carótidas/cirurgia , Transtornos Cognitivos/metabolismo , Endarterectomia das Carótidas/estatística & dados numéricos , Espectroscopia de Ressonância Magnética/estatística & dados numéricos , Complicações Pós-Operatórias/metabolismo , Idoso , Estenose das Carótidas/epidemiologia , Transtornos Cognitivos/epidemiologia , Comorbidade , Feminino , Humanos , Japão/epidemiologia , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Prevalência , Prótons , Reprodutibilidade dos Testes , Medição de Risco , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
We report a case of palmoplantar lichen planus in a 7-year-old Japanese girl with congenital deafness, who presented with erythematous eruptions and hyperkeratosis, with peeling and fissures on her soles, palms and digits. On histological examination of a skin biopsy from the lesion on her wrist, lichen planus was identified. Using computed tomography of the inner ears, bilateral cochlear dysplasia was found. The patient's DNA was sequenced; no sequence variants were detected in the GJB2 gene encoding connexin-26, but she had a missense mutation in SLC26A4 (solute carrier family 26, member 4). Mutations in SLC26A4 are known causes of hearing loss, but this is a novel mutation, which has not been reported previously. In addition, there have been no reports of cutaneous symptoms in previously reported patients with mutations in SLC26A4. To our knowledge, therefore, this is the first report of palmoplantar lichen planus associated with sensorineural deafness accompanied by a mutation in the SLC26A4 gene.
Assuntos
Dermatoses do Pé/genética , Dermatoses da Mão/genética , Perda Auditiva Neurossensorial/genética , Ceratodermia Palmar e Plantar/genética , Líquen Plano/genética , Proteínas de Membrana Transportadoras/genética , Mutação de Sentido Incorreto , Criança , Conexina 26 , Conexinas , Surdez , Feminino , Perda Auditiva Neurossensorial/congênito , Humanos , Transportadores de SulfatoRESUMO
INTRODUCTION: Juvenile angiofibromas (JA) are highly vascular, benign tumours for which surgery is the treatment of choice. In most services, embolisation is performed prior to resection. Nevertheless, there are few data on the complications of preoperative embolisation for JA. AIM: To describe major and minor complications of preoperative embolisation in a 32-year experience of patients undergoing surgical resection of JA at a tertiary hospital. METHODS: Retrospective chart review study of 170 patients who underwent surgical resection of JA at a tertiary hospital between September 1976 and July 2008. RESULTS: All patients were male. Age ranged from 9 to 26 years. Ninety-one patients had no complications after embolisation. Overall, 105 complication events occurred of which four major and 101 minor. CONCLUSION: In our series, preoperative embolisation for JA produced no irreversible complications and no aesthetic or functional sequelae. The vast majority of complications were transient and amenable to clinical management.
Assuntos
Angiofibroma/terapia , Embolização Terapêutica/efeitos adversos , Adolescente , Adulto , Angiofibroma/cirurgia , Criança , Terapia Combinada , Humanos , Masculino , Período Pré-Operatório , Adulto JovemRESUMO
Diet has a significant effect on immune and inflammatory responses. To date, no studies have described how consumption of a diet containing a relatively high amount of cheese affects immune responses and the inflammatory status of the body. We examined these responses in normal mice and mice with dextran sodium sulfate (DSS)-induced colitis associated with increased inflammatory responses, using a diet containing approximately 44% of a whole cheese powder and a diet containing casein, lard, and corn oil as the control. In normal mice, consumption of the cheese-containing diet induced regulatory T cells (T(reg)), which regulate immune and inflammatory responses, and suppressed the production of IL-17, IL-4, and IL-10 in Peyer's patch cells from the intestine. The T(reg) population and cytokine production were not altered in spleen cells. In mice with DSS-induced colitis, consumption of the cheese-containing diet alleviated the symptoms of colitis, as evidenced by prevention of body weight loss and colon length shortening, and inhibition of an increase in the disease activity index, which includes diarrhea and fecal bleeding. This relief of clinical symptoms was also associated with decreased production of proinflammatory cytokines (IL-17 and IL-6) and increased production of the antiinflammatory cytokine transforming growth factor-ß1 in Peyer's patch cells. The T(reg) population was reduced by consumption of the cheese-containing diet in Peyer's patch cells and spleen cells, which might reflect the alleviated symptoms of colitis. Consumption of the cheese-containing diet compared with the control diet enhanced antiinflammatory and immune regulatory responses in normal mice and in a DSS-colitis mouse model.
Assuntos
Queijo , Colite/prevenção & controle , Dieta , Imunidade Celular/efeitos dos fármacos , Animais , Colite/induzido quimicamente , Colite/dietoterapia , Citocinas/biossíntese , Sulfato de Dextrana/efeitos adversos , Citometria de Fluxo , Imunidade Celular/fisiologia , Inflamação/dietoterapia , Inflamação/prevenção & controle , Masculino , Camundongos , Camundongos Endogâmicos C57BLRESUMO
BACKGROUND: Various risk factors for depression in lung cancer patients have been suggested but have been examined separately in studies with relatively small sample sizes. The present study examined the biopsychosocial risk factors of depression in lung cancer patients, focusing on psychological factors in the largest patient sample reported to date. PATIENTS AND METHODS: A total of 1334 consecutively recruited lung cancer patients were selected, and data on cancer-related variables, personal characteristics, health behaviors, physical symptoms, and psychological factors were obtained. The participants were divided into groups with or without depression using the Hospital Anxiety and Depression Scale. RESULTS: Among the recruited patients, 165 (12.4%) manifested depression. The results of a binary logistic regression analysis were significant (overall R2, 36.5%), and a greater risk for depression was strongly associated with psychological factors, such as personality characteristics (neuroticism) and coping style (low fighting spirit, helplessness/hopelessness, and anxious preoccupation). Although the contributions of cancer-related variables, personal characteristics, health behaviors, and clinical state were relatively low, cancer stage, cancer type, sex, and age correlated significantly with depression. CONCLUSION: Depression was most strongly linked with personality traits and coping style, and using screening instruments to identify these factors may be useful for preventive interventions.
Assuntos
Depressão/psicologia , Neoplasias Pulmonares/psicologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Japão/epidemiologia , Modelos Logísticos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Classe SocialRESUMO
A second SCT is generally accepted as the only potentially curative approach for ALL patients that relapse after SCT, but the role of second SCT for pediatric ALL is not fully understood. We performed a retrospective analysis of 171 pediatric patients who received a second allo-SCT for relapsed ALL after allo-SCT. OS at 2 years was 29.4 ± 3.7%, the cumulative incidence of relapse was 44.1 ± 4.0% and non-relapse mortality was 18.8 ± 3.5%. Relapse occurred faster after the second SCT than after the first SCT (117 days vs 164 days, P=0.04). Younger age (9 years or less), late relapse (180 days or more after first SCT), CR at the second SCT, and myeloablative conditioning were found to be related to longer survival. Neither acute GVHD nor the type of donor influenced the outcome of second SCT. Multivariate analysis showed that younger age and late relapse were associated with better outcomes. Our analysis suggests that second SCT for relapsed pediatric ALL is an appropriate treatment option for patients that have achieved CR, which is associated with late relapse after the first SCT.