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1.
Herz ; 2024 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-39402240

RESUMO

BACKGROUND: The objective of this study was to assess the accuracy of VO2 measurements in predicting long-term major adverse cardiac events (MACEs) in patients with high cardiovascular risk. METHODS: Based on a 10-year atherosclerotic cardiovascular disease risk score, 333 patients with high cardiovascular risk were included in this retrospective analysis. The study endpoint was MACEs, comprising all-cause mortality, cardiovascular mortality, non-fatal myocardial infarction or stroke, and coronary revascularization. The study cohort was divided into two groups according to the frequency of MACE occurrence. Measurements of VO2 were assessed for the prediction of MACEs. RESULTS: The best predictive accuracy for 1­year MACEs was determined to be a VO2 max value of ≥ 20.3 mL/kg/min, with 60% specificity and 60% sensitivity (area under the curve [AUC]: 0.61; 95% confidence interval [CI]: 0.51-0.71; p < 0.001), and for 5­year MACEs it was ≥ 19.9 mL/kg/min, with 69% specificity and 64% sensitivity (AUC: 0.69; 95% CI: 0.62-0.76; p < 0.001). Multivariable Cox regression analysis, after adjusting for univariable factors, showed that VO2 max was independently associated with both short- and long-term MACEs in patients at high cardiovascular risk (hazard ratio [HR]: 0.900, 95% CI: 0.858-0.943, p < 0.001). CONCLUSION: According to the results of this pilot study, VO2 max can predict both short- and long-term MACEs in patients at high cardiovascular risk.

3.
J Chemother ; : 1-12, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39257075

RESUMO

Non-clear cell renal cell carcinoma (non-ccRCC) is a highly heterogeneous disease group, accounting for approximately 25% of all RCC cases. Due to its rarity and especially heterogeneity, phase III trial data is limited and treatment options generally follow those of clear cell RCC. In the literature, there exists a number of studies with sunitinib, cabozantinib, and everolimus, but data on the efficacy of pazopanib are limited. Our aim in this study was to compare the efficacy of pazopanib and sunitinib, in a multicenter retrospective cohort of non-ccRCC patients. Our study included patients diagnosed with non-ccRCC who received pazopanib or sunitinib treatment as first-line therapy from 22 tertiary hospitals. We compared the progression-free survival (PFS), overall survival (OS), and response rates of pazopanib and sunitinib treatments. Additionally, we investigated prognostic factors in non-ccRCC. PFS and response rates of sunitinib and pazopanib were found to be similar, while a numerical difference was observed in OS. Being 65 years and older, being in the intermediate or poor risk group according to the International Metastatic Renal Cell Carcinoma Database Consortium, having liver metastases, presence of a sarcomatoid component, and having de novo metastatic disease were found to be significantly associated with shorter PFS. Pazopanib treatment appears to have similar efficacy in the treatment of non-ccRCC compared to sunitinib. Though randomized controlled trials are lacking and will probably be never be available, we suggest that pazopanib could be a preferred agent like sunitinib and cabozantinib.


Pazopanib and sunitinib treatments show similar progression free survival, overall survival and objective response rate.IMDC risk group, liver metastasis, sarcomatoid component and de novo metastatic disease were determined as prognostic factors.

4.
Cureus ; 16(6): e62508, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39022492

RESUMO

OBJECTIVE: Despite their effectiveness, cardiac rehabilitation (CR) programs have low participation and adherence rates. CR participation and adherence are directly related to the social, economic, cultural, and geographical characteristics of the society. Therefore, our study aimed to investigate the reasons behind low participation in CR within Turkish society, as well as the barriers that restrict participation despite educational efforts. METHOD: The research was conducted with participants who were over 18 years of age, had any history of heart disease, and had been hospitalized in the last year. The patients' medical history, chronic diseases, demographics, habits, employment and income status, educational status, and approaches to CR were surveyed. Additionally, patients who still did not consider participating in CR after receiving information were asked about the reasons for their decisions. RESULTS: Although 95.6% of patients were eligible for CR, 91.9% of them were previously unaware of this treatment option. After being informed, 29.4% of patients agreed to participate in CR. The most common reasons for not participating after receiving information were as follows: three days a week is too much (21.9%); this place is far away, but if it were closer, I would come (18.1%); I can't come on weekdays (15.6%); and I would come if someone brought me (14.4%). CONCLUSION: We observed that the participation rate in CR increased from 0% to 29.4% after receiving information. Furthermore, it was determined that the CR schedule and transportation were significant factors influencing participation.

5.
J Coll Physicians Surg Pak ; 34(7): 795-799, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38978243

RESUMO

OBJECTIVE: To determine the relationship between the B2 prognostic index (B2PI) scoring method and prognosis in metastatic breast cancer, and to create a formula based on parameters that can be easily accessed in daily practice. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkiye, between May 2010 and June 2021. METHODOLOGY: The clinicopathological characteristics of the patients were compared between the groups. All female breast cancer patients over the age of 18 years with de novo metastatic and non-metastatic breast cancers who developed metastasis during follow-up, were included in the study. Those with a second solid cancer or haematological malignancy and with a life expectancy of less than 3 months were excluded from the study. Chi-square and Fisher's exact tests were used to compare categorical data between the groups. Overall survival evaluations were made using the Kaplan-Meier analysis method and Log-Rank test. Risk factors for mortality were evaluated in Cox regression analysis. In all statistical tests, p <0.05 was considered statistically significant. RESULTS: There were 176 patients in this study, out of which 111 (63.1%) were de novo metastatic. When the effect of B2PI risk groups on overall survival in intrinsic subtypes was analysed, significant differences were found in the overall survival of B2PI risk groups in all subtypes except HER2+ ER- (HER2 overexpression subtype). According to the B2PI scoring system, the median overall survival was higher for both low-risk and moderate-risk patients compared to those in the high-risk category. CONCLUSION: For metastatic breast cancer patients, the B2PI can be used to determine prognosis and develop treatment strategies, as it is a clinical decision-making tool based on parameters that are easily accessible in daily practice. KEY WORDS: Metastatic breast cancer, B2 prognostic index, Prognosis, Survival.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/patologia , Neoplasias da Mama/mortalidade , Pessoa de Meia-Idade , Prognóstico , Adulto , Idoso , Metástase Neoplásica , Fatores de Risco , Estimativa de Kaplan-Meier , Turquia/epidemiologia
6.
Sci Rep ; 14(1): 14651, 2024 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918433

RESUMO

Biomarkers such as hormone receptors (HR) and human epidermal growth factor receptor2 (HER2) may change after neoadjuvant chemotherapy (NAC) in breast cancer patients. The aim of this study was to investigate the rates of receptor change after NAC and to evaluate the prognostic impact of change. Patients with breast cancer who received NAC were included in the study. Changes in pathological findings (ER, PR, HER-2, Ki-67, grade) before and after NAC were examined. In addition, the effect of receptor exchange on prognosis was evaluated. Kaplan Meier analysis was used for survival analyses. Study was approved by Ethics Board of Tepecik Training and Research Hospital (Decision number 2021/10-02). We confirm that all methods were performed in accordance with relevant named guidelines and regulations. The study included 203 female patients. When pathological findings before and after NAC were compared, significant regression was found in grade and Ki-67 values (p = 0.003, p < 0.001). ER change rate was 11.8%, PR change rate was 24.6% and HER-2 change rate was 12.5%. No significant correlation was found between ER, PR and HER-2 changes and prognosis. The pathological T stage after NAC being 1 or 2, no lymph nodes detected, and the tumor grade being 1 or 2 were independent variables related to survival (p: 0.002, p: 0.014, p < 0.001). In patients with breast cancer, it would be appropriate to re-evaluate the HER-2 and HR status of the surgical specimen following NAC, especially in initially negative patients. The correlation of receptor discordance with prognosis is not clear and more extensive studies are needed.


Assuntos
Biomarcadores Tumorais , Neoplasias da Mama , Terapia Neoadjuvante , Receptor ErbB-2 , Receptores de Progesterona , Humanos , Feminino , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Neoplasias da Mama/metabolismo , Neoplasias da Mama/mortalidade , Terapia Neoadjuvante/métodos , Pessoa de Meia-Idade , Prognóstico , Biomarcadores Tumorais/metabolismo , Adulto , Receptor ErbB-2/metabolismo , Idoso , Receptores de Progesterona/metabolismo , Imuno-Histoquímica , Receptores de Estrogênio/metabolismo , Antígeno Ki-67/metabolismo , Estimativa de Kaplan-Meier , Quimioterapia Adjuvante
7.
Ann Ital Chir ; 95(3): 411-415, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38918954

RESUMO

AIM: The aim of our study was to investigate the clinical results of omental flap application during pancreaticojejunostomy (PJ) anastomosis in pancreatoduodenectomy (PD) surgeries. METHODS: The data of patients who underwent pancreaticoduodenectomy in our hospital were evaluated retrospectively. The patients were divided into two groups; patients with an omental flap (Group 1) and those without an omental flap (Group 2). The demographic and other characteristics of the groups and the incidence of postoperative pancreatic fistula (POPF) development were compared. RESULTS: One hundred patients were included (39 females, 61 males) Group 1 consisted of 20 patients with omental flaps and Group 2 consisted of 80 patients without omental flaps. While no clinically significant (Grade B and C) leaks were observed in Group 1, both biochemical and clinically significant leak rates were lower in Group 1 compared to 4 patients (5%) in Group 2. There was no statistically significant difference compared with Group 2 (p > 0.05). CONCLUSIONS: Although not statistically significant in this study, postoperative complication rates and the incidence of POPF tended to decrease in patients who underwent omental flaps.


Assuntos
Omento , Fístula Pancreática , Pancreaticoduodenectomia , Pancreaticojejunostomia , Complicações Pós-Operatórias , Retalhos Cirúrgicos , Humanos , Feminino , Masculino , Fístula Pancreática/prevenção & controle , Fístula Pancreática/etiologia , Fístula Pancreática/epidemiologia , Pancreaticoduodenectomia/métodos , Pancreaticoduodenectomia/efeitos adversos , Pancreaticojejunostomia/métodos , Pancreaticojejunostomia/efeitos adversos , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Adulto
8.
J Sports Med Phys Fitness ; 64(10): 1026-1030, 2024 10.
Artigo em Inglês | MEDLINE | ID: mdl-38869502

RESUMO

BACKGROUND: The available evidence on the impact of altitude training on sports performance is inconclusive. Heart rate variability (HRV) and heart rate recovery (HRR) are among the most frequently used parameters in athletic performance analysis and monitoring. Our study aims to investigate the effect of high altitude training on HRR and HRV, which are reliable predictors of athletic performance. METHODS: Elite national swimmers were included in the study. Time domain and frequency domain analyzes were performed with the Polar Verity Sense device and Kubios HRV software. HRR were measured at one-minute intervals for the first 15 minutes after peak heart rate, and then recorded at the 20th, 25th and 30th minutes. RESULTS: A significant difference is observed from the beginning to the 11th minute. The P value at 1, 3, 5, 7 and 11 minutes is 0.001, 0.023, 0.032, 0.019 and 0.020, respectively. Similarly, a significant change was observed in delta HRR. Among the HRV parameters, RMSSD, SDNN, Poincaré SD1 and PNS are statistically significant. P values are 0.004, 0.018, 0.024 and 0.013 respectively. CONCLUSIONS: High altitude training program has a positive effect on HRV and CRV in elite swimmers. This condition is associated with increased cardiac parasympathetic activity. Time domain analyses have proven to be more beneficial for HRV. HRR and HRV are effective, reliable and inexpensive methods of performance monitoring of elite athletes.


Assuntos
Altitude , Desempenho Atlético , Frequência Cardíaca , Natação , Humanos , Frequência Cardíaca/fisiologia , Natação/fisiologia , Masculino , Desempenho Atlético/fisiologia , Feminino , Adolescente , Adulto Jovem , Condicionamento Físico Humano/métodos , Condicionamento Físico Humano/fisiologia
9.
Clin Psychol Psychother ; 31(3): e2986, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38679965

RESUMO

BACKGROUND: Although it is often stated that children with special needs are at risk of being abused and neglected, research conducted on the abuse of children with specific learning disorders (SLDs) is limited. METHODS: This case-control study aims to compare exposure to neglect and abuse among children diagnosed with SLDs (case group) and children with typical development (control group). The study included children aged 6 to 12 years who were referred to the Child and Adolescent Psychiatry Outpatient Clinic and Pediatric Clinic of a hospital in Türkiye. The data collection process included 196 participants and lasted for 7 months in 2020. RESULTS: Based on the analysis of the data collected with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Turkish Version (K-SADS-PL-T) and the Abuse Assessment Questionnaire, we determined that children with SLDs were physically and emotionally abused more than the children of the control group. In addition, they witnessed violence between their parents more than the control group. Physical abuse, emotional abuse and witnessing family violence were identified as significant predictors for SLD. CONCLUSIONS: The presence of SLDs is a significant risk factor for children to be exposed to abuse even in the absence of ADHD as a comorbidity.


Assuntos
Maus-Tratos Infantis , Transtorno de Aprendizagem Específico , Humanos , Criança , Masculino , Feminino , Estudos de Casos e Controles , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Turquia/epidemiologia , Transtorno de Aprendizagem Específico/psicologia , Transtorno de Aprendizagem Específico/complicações , Fatores de Risco , Inquéritos e Questionários
10.
Disaster Med Public Health Prep ; 18: e60, 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38602096

RESUMO

OBJECTIVE: Pharmacists are vital in disaster response efforts, dispensing essential medications, managing pharmacy services, consulting, and educating survivors regarding their medications. Their contributions, however, are often underrepresented in scientific literature. This study aimed to explore the experiences of pharmacists who provided pharmacy services to meet the pharmaceutical needs of the survivors after 2 major earthquakes in Türkiye in 2023. METHODS: This study adopted a phenomenological approach. Data were collected using semi-structured interviews. Purposive sampling was used to invite pharmacists who provided pharmacy services to survivors. Interview transcripts were analyzed following an inductive, reflexive thematic analysis. RESULTS: In total, 15 pharmacists were interviewed. Four main overarching themes "response to the earthquake," "preparedness for the earthquake," "experiences during service delivery," and "mental and physical experiences" were developed. CONCLUSIONS: From participants' experiences, it is essential to expand the clinical responsibilities of pharmacists and train them in providing wound care, administering immunization, and prescribing. Pharmacists should be integrated as essential members of disaster health teams. International health organizations, nongovernmental organizations, and governments are encouraged to work collaboratively and develop disaster management plans including pharmacists in early responders. This might help mitigate the deficiencies and overcome challenges in health-care systems to provide effective patient-centered care by health professionals and respond effectively to disasters.


Assuntos
Planejamento em Desastres , Desastres , Terremotos , Humanos , Farmacêuticos , Turquia , Papel Profissional
11.
Pacing Clin Electrophysiol ; 47(4): 558-560, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-37377427

RESUMO

If a permanent pacemaker lead is misplaced in the left ventricle (LV), the lead may interfere with normal functioning of the heart leading various complications, including heart rhythm problems and blood clots. In our case, the LV lead that passed through the patent foramen ovale and was misplaced into the LV was detected in a 78-year-old patient who presented with embolic stroke. Thrombus regression was achieved with anticoagulation, and then the lead extraction was planned. The lead extraction is a priority in acute cases; but it is not the primary approach in long-term leads that were misplaced into the LV. A patient-based individual approach should be preferred in such cases.


Assuntos
Forame Oval Patente , AVC Isquêmico , Marca-Passo Artificial , Acidente Vascular Cerebral , Humanos , Idoso , AVC Isquêmico/complicações , Marca-Passo Artificial/efeitos adversos , Forame Oval Patente/complicações , Acidente Vascular Cerebral/complicações
12.
Clin Pediatr (Phila) ; 63(4): 522-530, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37313800

RESUMO

Considering the possible adverse effects of thyroid autoantibodies on the brain, the present study aimed to investigate whether there was a difference in mental health difficulties and mindfulness awareness levels between subclinical Hashimoto's thyroiditis patients with and without levothyroxine (LT4) use. A case-control study was conducted. The Strengths and Difficulties Questionnaire (SDQ) and the Mindful Attention Awareness Scale (MAAS) were used to screen mental health difficulties and mindfulness awareness. Scale scores were compared by performing correlation analysis between the groups with respect to LT4 use and thyroid autoantibodies. Levothyroxine alone does not affect scale results. Higher thyroid peroxidase antibody (TPOAb) titers were positively correlated with the behavioral problems subscale of the SDQ, while awareness level in patients was inversely correlated with higher thyroglobulin antibody (TgAb) levels.


Assuntos
Doença de Hashimoto , Atenção Plena , Humanos , Adolescente , Tiroxina/uso terapêutico , Estudos de Casos e Controles , Saúde Mental , Doença de Hashimoto/tratamento farmacológico , Autoanticorpos
13.
BMC Complement Med Ther ; 23(1): 439, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-38053060

RESUMO

BACKGROUND: Social Media Influencers (SMIs) are a fashionable way of marketing products by creating electronic word-of-mouth (e-WOM) on social media. The marketing of complementary and alternative medicines (CAMs) by SMIs is becoming increasingly popular and gaining credibility within consumers on social media platforms. Nonetheless, advising about healthcare products on social media should be examined as it is different from endorsing other kinds of commercial products. The aim of this study is to develop a model that provides the underlying mechanisms of the stimuli of SMIs on social media towards consumers' purchase intention of CAMs. METHODS: This study used best fit framework synthesis methods to develop the model. A priori theory selection was conducted by identifying a BeHEMoTh strategy (Behavior of Interest, Health context, Exclusions and Models or Theories) to systematically approach identifying relevant models and theories relative to the research aim. Further evidence derived from primary research studies that describe the behavior identified is coded against selected a priori theory to develop the model. RESULTS: This study presents a novel model for understanding the purchase behavior of CAMs using SMIs as a marketing strategy. The model included two well-known theories (theory of planned behaviour theory and source credibility theory) as well as extensive existing research from a multidisciplinary perspective. The model is exclusively designed to help identify elements affecting perceived source credibility and factors that have an influence over consumers' preferences to purchase CAMs by taking into consideration SMIs' endorsements. CONCLUSIONS: This study provides unique insights introducing new research areas to health literature and offers, new roles for healthcare professionals in this digital era by gaining new skills and competencies required to provide more credible and accurate information about CAMs. The study also highlights the new marketing era of online health-related product endorsements and recommends that policymakers and researchers carefully evaluate the impact of SMI's on the use of CAMs, as well as to regulate the content of these promotional materials.


Assuntos
Intenção , Mídias Sociais , Humanos , Pessoal de Saúde , Teoria do Comportamento Planejado
14.
J Genet Couns ; 2023 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-38126130

RESUMO

This study aimed to examine the opinions of parents with children diagnosed with attention deficit/hyperactivity disorder about genetic tests. A total of 540 parents living in Turkey participated in the study face-to-face and online. A questionnaire form prepared by the researchers was used as the data collection instrument. Face-to-face data were collected in different institutions in the cities of Izmir, Bursa and Antalya, while online data were collected through Google Forms. The results revealed that parents' views on genetic testing differed according to the sex and age of the child, as well as the parents' level of education and income, and whether the parents had genetic testing during pregnancy (p < 0.05). In the analysis, it was determined that parents' knowledge and awareness levels about genetic tests were generally low, while parents who reported that they would consider having genetic tests had concerns about the storage of their DNA materials, family conflicts that could be caused by genetic tests, and the compatibility of genetic tests with their religious beliefs.

16.
Arch Pediatr ; 30(7): 445-449, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37704523

RESUMO

BACKGROUND: This study aimed to evaluate the anxiety, depression, obsessive-compulsive disorder symptoms, and quality of life of children whose parents were healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic period. METHODS: The participants completed a sociodemographic questionnaire, the depression inventory for children (CDI), the screening for anxiety disorders in children (SCARED), the Maudsley obsessive compulsive question list (MOCQL), and the pediatric quality of life inventory (PedsQL) using online applications. A total of 153 children and adolescents whose parents were healthcare workers and 356 children and adolescents whose parents were not healthcare workers were included in the study. RESULTS: One tenth of all children participating in our study had a high level of depression, and nearly half of them had a high level of anxiety. There was no significant difference in CDI (p = 0.306), SCARED (p = 0.841), and PedsQL (p = 0.863) scale scores between the two groups. The MOCQL scale scores were higher in the group whose parents were not health professionals for cleanliness (p<0.001), slowness (p = 0.001), and total score (p<0.001). CONCLUSION: It was found that all participants were affected by anxiety, depression, and quality of life decline; moreover, obsessive-compulsive symptoms were more common in children whose parents were healthcare workers. In this context, our findings could help determine possible mental health problems of children and adolescents whose parents are or are not healthcare workers.


Assuntos
COVID-19 , Transtorno Obsessivo-Compulsivo , Adolescente , Humanos , Criança , Pandemias , Qualidade de Vida , Depressão/diagnóstico , Depressão/epidemiologia , COVID-19/epidemiologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Ansiedade/epidemiologia , Pessoal de Saúde , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia
17.
J Coll Physicians Surg Pak ; 33(8): 872-878, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37553925

RESUMO

OBJECTIVE: To determine the predictive value of Ki67 on pathological complete response (pCR) of breast and axilla regions in breast cancer (BC) patients receiving neoadjuvant therapy (NAT). STUDY DESIGN: Descriptive study. Place and Duration of the Study: Departments of Medical Oncology, Sirnak State Hospital, Aydin State Hospital, Manisa Celal Bayar University, and Dokuz Eylul University, from November 2010 to July 2022. METHODOLOGY: PCR and various histopathological parameters were evaluated for BC patients receiving NAT. The Youden Index method was used to find the cut-off value for the Ki67 variable according to the receiver operating characteristic (ROC) curve. This value was obtained as 77.5. Breast and axillary responses were individually evaluated to assess response to NAT. Univariate and multivariate logistic regression analysis were used to predict both breast and axillary pCR. RESULTS: A total number of 280 females receiving NAT for BC were included in the study. Multivariate analysis for breast pCR to NAT showed that Ki67 index (>77.5 vs <77.5, p=0.047) was statistically significant marker. While Ki67 index was significant for breast pCR in both univariate and multivariate analyses, the same was not observed on axillary response (p=0.387). CONCLUSION: High Ki67 level was significantly associated with breast pCR in BC patients receiving NAT, but a similar effect was not observed on axillary pCR. These findings suggest that breast and axilla tissues have a biological differences in treatment responses. KEY WORDS: Axillary response, Breast cancer, Ki67 Labeling Index, Neoadjuvant therapy, pathological complete response.


Assuntos
Neoplasias da Mama , Antígeno Ki-67 , Terapia Neoadjuvante , Humanos , Feminino , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Mama/patologia , Axila/patologia , Valor Preditivo dos Testes
18.
Acta Cardiol ; 78(9): 1000-1005, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37318090

RESUMO

BACKGROUND: This investigation aims to assess the influence of a mobile application and smart devices on cardiopulmonary exercise testing (CPET) over a one-year period in individuals who have high risk for cardiovascular disease. METHODS: This is a post-hoc subgroup analysis of Lifestyle Intervention Using Mobile Technology in Patients with High Cardiovascular Risk: A Pragmatic Randomised Clinical Trial (LIGHT). In the intervention plus standard care standard standard care arms, 138 and 103 patients were recruited, respectively. The 1-year VO2 measurements were adjusted to the baseline VO2 measurements as the study's endpoint. VO2 measurements were taken for each subject during the randomisation and final CPET examinations. RESULTS: The intervention plus standard care improved VO2 measurements by 1.1 (adjusted treatment effect 1.1, 95% confidence interval (CI): 0.8, 1.4, p < 0.001) compared to standard care following 1-year follow-up. CONCLUSION: At a 1-year follow-up, the smart device and mobile application technologies increased VO2 measurements in individuals with high cardiovascular risk compared to conventional treatment alone.

19.
Breast ; 70: 56-62, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37343321

RESUMO

BACKGROUND: CDK4/6 inhibitors combined with endocrine therapy have significantly improved treatment outcomes for metastatic hormone receptor-positive (HR+) breast cancer patients. However, the impact of low HER2 expression on treatment response and progression-free survival (PFS) remains unclear. METHODS: This multicenter retrospective study included 204 HR+ breast cancer patients treated with a combination of CDK4/6 inhibitor and endocrine therapy. HER2-zero disease was detected in 138 (68%) and HER2-low disease in 66 (32%) patients. Treatment-related characteristics and clinical outcomes were analyzed, with a median follow-up of 22 months. RESULTS: The objective response rate (ORR) was 72.7% in the HER2 low group and 66.6% in the HER2 zero group (p = 0.54). Median PFS was not significantly different between the HER2-low and HER2 zero groups (19 months vs.18 months, p = 0.89), although there was a trend toward longer PFS in the HER2-low group for first-line treatment (24 months progression-free survival rate 63% vs 49%). In recurrent disease, the median PFS was 25 months in the HER2-low group and 12 months in the HER2-zero group (p = 0.08), while in de novo metastatic disease, the median PFS was 18 months in the HER2-low group and 27 months in the HER2-zero group (p = 0.16). The order of CDK4/6 inhibitor use and the presence of visceral metastasis were identified as independent variables affecting PFS. CONCLUSION: Low HER2 expression did not significantly impact treatment response or PFS in HR+ breast cancer patients treated with a CDK4/6 inhibitor and endocrine therapy. Because of the conflicting results in the literature, further prospective studies are needed to evaluate the clinical significance of HER2 expression in HR+ breast cancer.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/patologia , Estudos Retrospectivos , Receptor ErbB-2/metabolismo , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Resultado do Tratamento , Quinase 4 Dependente de Ciclina
20.
Arch Pediatr ; 30(5): 277-282, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37061358

RESUMO

PURPOSE: Childhood obesity is one of the most severe public health problems, and psychiatric conditions have been associated with obesity. In this study, we aimed to investigate psychological resilience and possible related factors in adolescents with obesity. METHOD: The study included 90 adolescents with obesity and 100 healthy adolescents of similar age. Data were collected using a sociodemographic information form, the Child and Youth Resilience Measure-28 (CYRM-28), and the Multidimensional Scale of Perceived Social Support. Scale scores were compared by Pearson's correlation coefficient test with SPSS-23. Multiple linear regression was performed to describe the relationships between variables. RESULTS: The adolescents participating in the study were similar in terms of age and gender. Psychological resilience and social support in the obesity group were lower than in the control group (p < 0.05). A negative relationship was found between body mass index (BMI) and resilience levels of adolescents with obesity, and a positive relationship was found between social support and resilience levels (p = 0.027 and p < 0.001, respectively). The perceived family and significant other social support subscale scores of adolescents in the obesity group were significantly lower than in the control group (p = 0.037 and p = 0.023, respectively). The most related variable with the CYRM-28 was the level of perceived social support: standardized ß = 0.409; t(151) = 5.626; p < 0.001. CONCLUSION: A higher BMI has a negative effect on psychological resilience, and family support tends to be lower in these cases. New studies are needed to clarify whether this result is one of the causes of obesity or one of its consequences.


Assuntos
Transtornos Mentais , Obesidade Infantil , Resiliência Psicológica , Humanos , Adolescente , Criança , Obesidade Infantil/epidemiologia , Apoio Social , Índice de Massa Corporal
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